Reviews in cardiovascular medicine最新文献

{"title":"Impact of Obstructive Sleep Apnea and Triglyceride Glucose Index on Cardiovascular Events in Acute Coronary Syndrome Patients: A Post-Hoc Analysis of the OSA-ACS Study.","authors":"Yuekun Zhang, Ding Xu, Wen Zheng, Wen Hao, Lei Zhen, Yan Yan, Xiao Wang, Shaoping Nie","doi":"10.31083/RCM36205","DOIUrl":"10.31083/RCM36205","url":null,"abstract":"<p><strong>Background: </strong>Obstructive sleep apnea (OSA) is highly prevalent in patients with acute coronary syndrome (ACS). The triglyceride glucose (TyG) index is considered closely linked to cardiovascular risk. However, the relationship between OSA, TyG index, and cardiovascular outcomes in ACS patients remains unclear. Hence, this study aimed to examine the effects of OSA and the TyG index on cardiovascular outcomes in ACS patients.</p><p><strong>Methods: </strong>This post-hoc analysis included 1853 patients from the OSA-ACS project, a single-center prospective cohort study that enrolled ACS patients admitted between January 2015 and December 2019. OSA was defined as an apnea-hypopnea index of ≥15 events/hour. The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE). Multivariable Cox regression models were used to evaluate the impact of OSA on cardiovascular events across the TyG index categories.</p><p><strong>Results: </strong>OSA was present in 52.5% of the participants, with a mean TyG index of 9.02 ± 0.68. Over a median follow-up of 35.1 (19.0-43.5) months, OSA was significantly associated with a heightened risk of MACCE (adjusted hazard ratio (aHR): 1.556; 95% confidence interval (CI): 1.040-2.326; <i>p</i> = 0.031) in the high TyG group within the fully adjusted model, along with elevated risk of hospitalization for unstable angina (aHR: 1.785; 95% CI: 1.072-2.971; <i>p</i> = 0.026). No significant associations were observed between OSA and MACCE in the low and moderate TyG groups.</p><p><strong>Conclusions: </strong>This analysis demonstrates that OSA significantly increases the risk of adverse cardiovascular events in ACS patients with a high TyG index, underscoring the importance of routine OSA screening in these high-risk ACS patients to optimize cardiovascular risk stratification and personalize treatment strategies.</p><p><strong>The clinical trial registration: </strong>NCT03362385, https://clinicaltrials.gov/expert-search?term=NCT03362385.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 5","pages":"36205"},"PeriodicalIF":1.9,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Freedom of Atrial Fibrillation Predictions After Pulmonary Vein Isolation: A Review of Current Evidence.","authors":"Ibrahim Antoun, Ahmed Abdelrazik, Mahmoud Eldesouky, Ahmed I Kotb, Zakkariya Vali, Abdulmalik Koya, Edward Y M Lau, Ivelin Koev, Riyaz Somani, G André Ng","doi":"10.31083/RCM36588","DOIUrl":"10.31083/RCM36588","url":null,"abstract":"<p><p>Atrial fibrillation (AF), the most common sustained cardiac arrhythmia, poses significant challenges due to high morbidity, mortality, and healthcare costs. Pulmonary vein isolation (PVI) is a cornerstone treatment that disrupts arrhythmogenic pathways through electrically isolating pulmonary veins. However, recurrence rates remain substantial, driven by complex demographic, biochemical, imaging, and electrocardiographic factors reflecting underlying pathophysiologies. Advancements in PVI techniques, including pulsed-field ablation and electroanatomic mapping, have improved procedural success. Antiarrhythmic drugs (AADs) enhance outcomes by stabilising atrial activity and reducing early recurrence, although the long-term benefits of these drugs are debated. Nonetheless, integrating these predictors into patient selection, procedural strategies, and post-ablation management enables personalised interventions. This review uniquely integrates demographic, biochemical, imaging, electrocardiographic, and procedural predictors into a multidimensional framework for comprehensive risk stratification of PVI outcomes. We critically evaluate emerging procedural techniques, notably pulsed-field ablation (PFA), emphasising the clinical applicability of these procedures. Key biochemical markers (e.g., N-terminal pro-brain natriuretic peptide (NT-pro-BNP), C-reactive protein (CRP), interleukin-6 (IL-6)) and imaging findings (e.g., left atrial fibrosis, epicardial fat) reflecting atrial pathophysiology are discussed in detail. Furthermore, readily accessible electrocardiographic parameters such as prolonged P wave duration and dispersion are emphasised as practical tools for patient risk assessment. This multidimensional approach holds promise for reducing AF recurrence and improving long-term outcomes in PVI, advancing patient-centered care in AF management.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 5","pages":"36588"},"PeriodicalIF":1.9,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Left Atrium Remodeling With Major Adverse Cardiovascular Events in Asymptomatic Type 2 Diabetes Patients With Early Chronic Kidney Disease.","authors":"Mingxia Gong, Min Xu, Suoya Pan, Shu Jiang, Xiaohong Jiang","doi":"10.31083/RCM27247","DOIUrl":"10.31083/RCM27247","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to use four-dimensional automatic left atrial quantification (4D Auto LAQ) to quantitatively evaluate the morphological and functional changes in the left atrium (LA) in asymptomatic type 2 diabetes mellitus (T2DM) patients with early chronic kidney disease (CKD), and explore its correlation with major adverse cardiovascular event (MACE) occurrence.</p><p><strong>Methods: </strong>This study enrolled patients with asymptomatic T2DM complicated with early CKD. Then, 4D-Auto LAQ was used to evaluate LA volume index (minimum, maximum, pre-ejection) and LA longitudinal and circumferential strains during each of the three LA phases: reservoir, conduit, and contraction. The primary endpoint for follow-up was defined as the first occurrence of nonfatal acute myocardial infarction, stroke, congestive heart failure, or cardiac death. Univariate and multivariate Cox proportional hazard analyses were used to evaluate the correlation between LA parameters and the MACEs in T2DM patients with early CKD.</p><p><strong>Results: </strong>A total of 361 patients were analyzed (mean age, 59.51 ± 11.17 years). During a median follow-up period of 47 months (interquartile range, 17-59 months), MACEs occurred in 70 patients. After adjusting for various clinical and echocardiographic predictors, increased LA volume and impaired reservoir function (ResF) were each independently associated with the primary endpoint: Left atrium minimum volume index (LAVImin) had an adjusted hazard ratio (HR) of 1.21 (95% confidence interval (CI), 1.08-1.35; <i>p</i> = 0.010), whereas left atrium longitudinal strain during the reservoir phase (LASr) had an adjusted HR of 0.81 (95% CI, 0.74-0.89; <i>p</i> < 0.001). Univariate and multivariate Cox regression analyses indicated that the cumulative incidence of MACEs was significantly greater in patients with LAVImin >16.9 mL/m² than in those with LAVImin ≤16.9 mL/m² (HR, 2.25; 95% CI, 1.03-6.39; <i>p</i> = 0.005). Furthermore, patients with a LASr <18.5% faced a markedly elevated risk of MACEs-nearly fourfold greater than individuals with a LASr ≥18.5% (HR, 3.95; 95% CI, 1.76-8.86; <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>An enlarged left atrium (LAVImin) and impaired ResF (LASr) are strongly associated with long-term outcomes in T2DM patients complicated with early CKD. LASr showed the strongest associations with the occurrence of MACEs.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 5","pages":"27247"},"PeriodicalIF":1.9,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Studies of Different Ablation Techniques for Atrial Fibrillation.","authors":"Monika Keževičiūtė, Germanas Marinskis, Diana Sudavičienė, Jūratė Barysienė, Neringa Bileišienė, Greta Radauskaitė, Audrius Aidietis, Gediminas Račkauskas","doi":"10.31083/RCM33490","DOIUrl":"10.31083/RCM33490","url":null,"abstract":"<p><p>Atrial fibrillation (AF) is the most common supraventricular arrhythmia, affecting 2-3% of the adult population, with an increasing prevalence due to demographic shifts; however, detection methods have also improved. This rhythm disorder is associated with significant morbidity, manifesting through symptoms that worsen the quality of life, as well as with adverse outcomes and increased mortality. The substantial AF burden on the healthcare system necessitates the development of effective and durable treatment strategies. While pharmacological management represents the first-line approach for AF, the limitations associated with this approach, including side effects and insufficient efficacy, have promoted the evolution of catheter ablation techniques that isolate pulmonary veins (PVs) and, thus, disrupt arrhythmia-causing impulses from the atria. Currently, three energy sources have gained U.S. Food and Drug Administration (FDA) and European regulatory approval (The Conformité Européene (CE) mark certification) for catheter ablation: radiofrequency ablation (RFA), cryoballoon ablation (CBA), and, more recently, pulsed-field ablation (PFA). RFA has subsequently become an effective treatment, demonstrating superior outcomes in randomized controlled trials compared to antiarrhythmic drug therapy. CBA has also proven to be a safe and effective alternative, particularly for patients with symptomatic paroxysmal AF, showing comparable efficacy to RFA and similar rates of complications. Meanwhile, PFA is emerging as a promising technique, offering non-inferior efficacy to conventional thermal methods while potentially minimizing the thermal damage to adjacent tissues associated with RFA and CBA. Despite higher equipment costs, the advantages of PFA in reducing complications highlight its potential role in AF management. However, considering the novelty of PFA, no data currently exist comparing this strategy with thermal techniques. Therefore, further research is needed to improve the management of AF and patient outcomes to reduce healthcare burdens.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 5","pages":"33490"},"PeriodicalIF":1.9,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic Status and Atrioventricular Block Risk: The Role of Physical Activity.","authors":"Ho-Gi Chung, Pil-Sung Yang, Eunsun Jang, Daeun Joung, Daehoon Kim, Hee Tae Yu, Tae-Hoon Kim, Jae-Sun Uhm, Jung-Hoon Sung, Hui-Nam Pak, Moon-Hyoung Lee, Boyoung Joung","doi":"10.31083/RCM37291","DOIUrl":"10.31083/RCM37291","url":null,"abstract":"<p><strong>Background: </strong>The relationship between metabolic status as a possible risk factor and predictor of response to moderate-to-vigorous physical activity (MVPA) in atrioventricular block (AVB) remains unclear.</p><p><strong>Methods: </strong>A total of 82,365 UK Biobank participants without a history of AVB or pacemaker implantation, and who were involved in accelerometer work-up, were chosen for the study population. Metabolic status was classified into two categories, healthy and unhealthy, using modified criteria for metabolic syndrome from the International Diabetes Federation. We used the multivariable Cox proportional model to assess the associations between metabolic status and primary outcome (composite of second-degree AVB or third-degree AVB) or secondary outcomes (each component in the primary outcome and AVB-related pacemaker implantation). The relationship between MVPA min/week and the primary outcome in each metabolic status category was assessed using restricted cubic splines.</p><p><strong>Results: </strong>Of the 82,365 participants, the mean age was 62.3 years, and 44.1% were men. In total, 299 primary outcome events occurred during the 6.1-year follow-up. Compared to metabolically healthy participants, metabolically unhealthy participants had a 58% higher risk of the primary outcome (hazard ratio (HR): 1.58, 95% confidence interval (CI): 1.25-2.00; <i>p</i> < 0.001). This pattern was consistent for second-degree AVB (HR: 1.59, 95% CI: 1.12-2.27; <i>p</i> = 0.010), third-degree AVB (HR: 1.50, 95% CI: 1.12-2.03; <i>p</i> = 0.008), and AVB-related pacemaker implantation (HR: 2.25, 95% CI: 1.44-3.52; <i>p</i> < 0.001). Increased MVPA provided statistically significant protection against the primary outcome only in metabolically unhealthy participants, with a threshold of 830 min/week.</p><p><strong>Conclusions: </strong>Generally, in the middle-aged population, metabolically unhealthy participants had a statistically significantly higher risk of second- or third-degree AVB and AVB-related pacemaker implantation than metabolically healthy participants. However, MVPA reduced the risk of second- or third-degree AVB in the metabolically unhealthy participants, though the effect was attenuated with excessive MVPA. From this perspective, identifying and encouraging exercise in metabolically unhealthy individuals is essential. Due to its observational nature, future research should verify the preventive effects of increased MVPA on conduction block in populations with metabolic abnormalities through randomized controlled trials. Moreover, the biological mechanisms and safety of the protective effects of excessive MVPA require further verification.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 5","pages":"37291"},"PeriodicalIF":1.9,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Cardiometabolic Index and Blood Pressure: A Cross-Sectional Analysis of the NHANES 2015-2018 Data.","authors":"Lingyan He, Ling Sun, Haihua Pan, Changlin Zhai","doi":"10.31083/RCM37359","DOIUrl":"10.31083/RCM37359","url":null,"abstract":"<p><strong>Background: </strong>Hypertension is a major risk factor for cardiovascular diseases (CVDs) and is closely related to metabolic abnormalities. The cardiometabolic index (CMI) integrates lipid profiles and anthropometric indicators, reflecting overall cardiometabolic health. However, the CMI and blood pressure (BP) relationship is poorly understood. Therefore, this study aimed to investigate the correlation between CMI and clinical BP and evaluate the potential of using this correlation as a cardiovascular risk indicator.</p><p><strong>Methods: </strong>National Health and Nutrition Examination Survey (NHANES) data from 2015 to 2018 were used to calculate the CMI based on the triglycerides to high-density lipoprotein cholesterol ratio and the waist-to-height ratio. The relationship between CMI and systolic blood pressure (SBP)/diastolic blood pressure (DBP) was analyzed using multivariate regression, threshold effect analysis, and subgroup analysis.</p><p><strong>Results: </strong>In this study cohort of 4240 participants, CMI positively correlated with SBP and DBP. After adjusting for age, gender, and race, the partial correlation for SBP was 0.56 (95% CI: 0.19-0.93; <i>p</i> < 0.01), while for DBP, it was 1.15 (95% CI: 0.60-1.71; <i>p</i> < 0.001). The threshold effect analysis revealed a positive association with SBP when the CMI was below 6.83 (β = 1.44, 95% CI: 0.64-2.24; <i>p</i> < 0.001) and a negative association when the CMI was above 6.83 (β = -1.52, 95% CI: -2.77- -0.28; <i>p</i> = 0.0123). For the DBP, a positive correlation was found when the CMI was below 2.81 (β = 1.45, 95% CI: 0.10-2.79; <i>p</i> = 0.0345), and a negative correlation when the CMI was above 2.81 (β = -1.92, 95% CI: -3.08- -0.77; <i>p</i> = 0.0012). A strong interaction was observed between the CMI and gender for the SBP (<i>p</i> = 0.0054) and a trend for the interaction between CMI and age for the DBP (<i>p</i> = 0.1667).</p><p><strong>Conclusions: </strong>This study found a significant positive correlation between the CMI and BP, with threshold effects supporting a non-linear relationship. The strong interaction between the CMI and gender for SBP suggests that the influence of the CMI on BP may be gender-dependent. These results highlight the importance of utilizing CMI in personalized cardiovascular risk stratification and underscore the relevance of considering patient factors such as gender in managing hypertension.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 5","pages":"37359"},"PeriodicalIF":1.9,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Machine Learning to Predict MACEs Risk in Patients with Premature Myocardial Infarction.","authors":"Jing-Xian Wang, Miao-Miao Liang, Peng-Ju Lu, Zhuang Cui, Yan Liang, Yu-Hang Wang, An-Ran Jing, Jing Wang, Meng-Long Zhang, Yin Liu, Chang-Ping Li, Jing Gao","doi":"10.31083/RCM31298","DOIUrl":"10.31083/RCM31298","url":null,"abstract":"<p><strong>Background: </strong>The study aimed to develop an interpretable machine learning (ML) model to assess and stratify the risk of long-term major adverse cardiovascular events (MACEs) in patients with premature myocardial infarction (PMI) and to analyze the key variables affecting prognosis.</p><p><strong>Methods: </strong>This prospective study consecutively included patients (male ≤50 years, female ≤55 years) diagnosed with acute myocardial infarction (AMI) at Tianjin Chest Hospital between January 2017 and December 2022. The study endpoint was the occurrence of MACEs during the follow-up period, which was defined as cardiac death, nonfatal stroke, readmission for heart failure, nonfatal recurrent myocardial infarction, and unplanned coronary revascularization. Four machine learning models were built: COX proportional hazards model (COX) regression, random survival forest (RSF), extreme gradient boosting (XGBoost), and DeepSurv. Models were evaluated using concordance index (C-index), Brier score, and decision curve analysis to select the best model for prediction and risk stratification.</p><p><strong>Results: </strong>A total of 1202 patients with PMI were included, with a median follow-up of 26 months, and MACEs occurred in 200 (16.6%) patients. The RSF model demonstrated the best predictive performance (C-index, 0.815; Brier, 0.125) and could effectively discriminate between high- and low-risk patients. The Kaplan-Meier curve demonstrated that patients categorized as low risk showed a better prognosis (<i>p</i> < 0.0001).</p><p><strong>Conclusions: </strong>The prognostic model constructed based on RSF can accurately assess and stratify the risk of long-term MACEs in PMI patients. This can help clinicians make more targeted decisions and treatments, thus delaying and reducing the occurrence of poor prognoses.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 5","pages":"31298"},"PeriodicalIF":1.9,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanistic Insights into Bioprosthetic Heart Valve Calcification and Anti-Calcification Strategies.","authors":"Yuxiao Yang, Limin Lan, Yi Lin","doi":"10.31083/RCM36688","DOIUrl":"10.31083/RCM36688","url":null,"abstract":"<p><p>Prosthetic heart valves are crucial for treating valvular heart disease and serve as substitutes for native valves. Bioprosthetic heart valves (BHVs) are currently the most common type used in clinical practice. However, despite the long history of use, challenges remain in clinical applications, notably via valve calcification, which significantly affects longevity and quality. The mechanisms through which calcification occurs are complex and not yet completely understood. Therefore, this paper aims to provide a comprehensive review of developments in prosthetic valves, focusing on the calcification processes in bioprosthetic heart valves and the biological, chemical, and mechanical factors involved. In addition, we highlight various anti-calcification strategies currently applied to BHVs and assess whether anti-calcification approaches can prolong valve durability and improve patient prognosis. Finally, we describe the imaging methods presently used to monitor calcification clinically. Advances in nanotechnology and tissue engineering may provide better options for mitigating prosthetic heart valve calcification in the future.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 5","pages":"36688"},"PeriodicalIF":1.9,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Family Support on Self-Management Behavior in Postoperative Cardiac Surgery Patients: A Cross-Sectional Study.","authors":"Ting Shen, Qiuhong Chen, Ting Leng, Mengling Gu, Lin Luo, Furong Jiang, Xiahong Huang","doi":"10.31083/RCM31261","DOIUrl":"10.31083/RCM31261","url":null,"abstract":"<p><strong>Background: </strong>Cardiac rehabilitation (CR) serves as a critical component in ongoing care for cardiovascular disease patients, improving postoperative anxiety and depression in cardiac surgery patients while reducing readmission rates and mortality. However, patient completion rates for CR programs remain low due to insufficient awareness and lack of social support. This study aimed to investigate the impact of family support levels on self-management behaviors in postoperative cardiac surgery patients, providing a basis for family-based cardiac rehabilitation interventions.</p><p><strong>Methods: </strong>This cross-sectional survey involved 76 patients who had undergone major vascular surgeries one month prior and were subsequently discharged from the hospital's cardiology department. Participants completed questionnaires assessing demographic details, family support, psychological status, and self-management practices. Logistic regression analysis identified factors influencing perceived social support from family (PSS-Fa), while correlation analyses examined relationships between family support and self-management behaviors.</p><p><strong>Results: </strong>The mean PSS-Fa score was 10.82 ± 1.50, and the average self-management behavior score was 140.80 ± 20.46. Female gender, marital status, and educational attainment significantly influenced higher family support scores (<i>p</i> < 0.05). For the univariate analysis, key determinants of better self-management included age, educational level, marital status, household income, type of medical insurance, presence of comorbidities, cardiac function classification, and psychological states indicative of anxiety or depression (all <i>p</i> < 0.05). Multiple linear regression analysis showed that PSS-Fa, age, and education level significantly influenced self-management behaviors in postoperative cardiac patients. Family support and education level had a positive effect, while age had a negative impact. The model's overall fit statistics are <i>R²</i> = 0.821 and <i>F</i> = 33.722 (<i>p</i> < 0.05). Pearson's correlation analysis revealed a positive association between family support and overall self-management behaviors (<i>r</i> = 0.303, <i>p</i> < 0.05), particularly in nutrition management, exercise adherence, self-monitoring, and timely medical consultations.</p><p><strong>Conclusion: </strong>This suggests that the role of family support should be fully considered in developing CR programs in the future, and targeted interventions should be implemented to enhance this support, thereby potentially improving patient outcomes and adherence to CR programs.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 5","pages":"31261"},"PeriodicalIF":1.9,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of the International, Regional, and National Endocarditis-Related Disease Burdens (1990-2021), and Changes to Projections for the Next 15 Years: A Population-Based Study.","authors":"Qiyuan Bai, Hao Chen, Hongxu Liu, Xuhua Li, Yang Chen, Dan Guo, Bing Song, Cuntao Yu","doi":"10.31083/RCM27168","DOIUrl":"10.31083/RCM27168","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Endocarditis can lead to health loss and even death, making it one of the major contributors to the global disease burden, with its incidence continuously increasing. This study aimed to assess the trends and frontier analysis of the worldwide burden of endocarditis over the past 30 years and to improve the predictions of its future burden by 2035.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We analyzed the trends of global endocarditis incidence, prevalence, deaths, and disability-adjusted life years (DALYs) at international, regional, and national levels from 1990 to 2021 using a comprehensive, localized, and multidimensional approach. Clustering analysis assessed the changing patterns of disease burden related to endocarditis in the Global Burden of Disease (GBD) study regions. Correlation analysis was conducted to determine the potential relationships between the burden of endocarditis and the socio-demographic index (SDI) and the Human Development Index (HDI). Frontier analysis was performed to identify possible areas for improvement and the disparities in development status among countries. Additionally, we projected the changes in the burden of endocarditis by 2035.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;From a global perspective, between 1990 and 2021, the incidence, prevalence, mortality, and DALYs associated with endocarditis have shown a continuous upward trend. At the national level, significant differences were observed in the incidence, prevalence, mortality, and DALYs of endocarditis worldwide. The United States had the highest number of deaths; India had the highest number of DALYs; Thailand had the highest incidence; Sri Lanka had the highest prevalence. The age-standardized rates (ASRs) for endocarditis prevalence, incidence, mortality, and DALYs increased steadily with age, peaking in the 95-year-old and above age group. The incidence, prevalence, mortality, and DALYs for males were 1.27 times, 1.02 times, 1.06 times, and 1.37 times those of females, respectively. Clustering analysis results indicated a significant increase in the estimated annual percentage change (EAPC) of mortality and DALY rates for endocarditis in East Asia. A significant correlation exists between EAPC and the ASRs of disease burden. Frontier analysis showed that countries and regions with higher SDIs have greater potential for improving the disease burden. The Bayesian age-period-cohort (BAPC) results indicated that the incidence, prevalence, mortality, and DALYs case numbers are expected to increase, with the ASRs for incidence and prevalence also projected to show a continuous upward trend by 2035.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The global burden of endocarditis, a significant public health issue, has shown an overall upward trend from 1990 to 2021. The continuous increase in the prevalence and incidence of endocarditis, driven by population growth and aging, has become a major challenge for its control and management, which may guide","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 5","pages":"27168"},"PeriodicalIF":1.9,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}