Reviews in cardiovascular medicine最新文献

{"title":"Evaluation of the Atherogenic Index of Plasma in the Prognostic Value of Ischemic Heart Failure Post-Percutaneous Coronary Intervention.","authors":"Yinxiao Xu, Biyang Zhang, Meishi Ma, Yi Kan, Tienan Sun, Xin Huang, Yujie Zhou","doi":"10.31083/RCM33470","DOIUrl":"10.31083/RCM33470","url":null,"abstract":"<p><strong>Background: </strong>The atherogenic index of plasma (AIP) is calculated as the logarithm of the triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) ratio. While previous studies suggested that TG and HDL-C levels were linked to the prognosis in various cardiovascular conditions, including ischemic heart failure (IHF), there is limited research specifically examining AIP in the context of IHF. Therefore, our study sought to explore the association between AIP and the prognosis of IHF and to compare the predictive value of AIP, HDL-C, and TG levels for identifying patients with poor outcomes.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted at a single institution involving 2036 IHF patients with post-percutaneous coronary intervention (PCI) who were followed for 36 months. Patients were divided into four groups categorized according to AIP quartiles. The primary outcome of interest was major adverse cardiovascular events (MACEs), while secondary outcomes included all-cause mortality, non-fatal myocardial infarction (MI), and any revascularization. Kaplan-Meier survival curves were used to evaluate the occurrence of endpoints across the four groups. Multivariate Cox regression analysis reinforced that AIP independently predicted primary and secondary outcomes. Restricted cubic spline (RCS) method was employed to examine the non-linear association between AIP and endpoints. Receiver operating characteristic (ROC) curves, combined with the Delong test, were used to assess and compare the predictive accuracy of AIP, TG, and HDL-C.</p><p><strong>Result: </strong>The incidence of MACEs (Q4:Q1 = 50.6:23.0, <i>p</i> < 0.001), all-cause death (Q4:Q1 = 25.0:11.6, <i>p</i> < 0.001), and any revascularization (Q4:Q1 = 21.6:9.6, <i>p</i> < 0.001) were significantly higher in patients with elevated AIP. The Kaplan- Meier curve analysis further supported a positive association between AIP and MACEs (<i>p</i> <sub>log-rank</sub> < 0.001). Multivariate Cox analysis showed that AIP was independently associated with the increased risk of MACEs (Q4:Q1 (HR (95% CI)): 2.84 (2.25-3.59), <i>p</i> <sub>trend</sub> < 0.001), all-cause death (Q4:Q1 (HR (95% CI)): 2.76 (1.98-3.84), <i>p</i> <sub>trend</sub> < 0.001), non-fatal MI (Q4:Q1 (HR (95% CI)): 3.01 (1.32-6.90), <i>p</i> <sub>trend</sub> < 0.001), and any revascularization (Q4:Q1 (HR (95% CI)): 2.92 (2.04-4.19), <i>p</i> <sub>trend</sub> < 0.001). In RCS, higher AIP was non-linearly relevant to an increased risk of MACEs (<i>p</i> <sub>non-linear</sub> = 0.0112). In subgroup analysis, the predictive value of AIP for MACEs was more pronounced in the younger patient subgroup (<i>p</i> <sub>interaction</sub> = 0.003). The ROC curves showed the predictive value of AIP (area under curve [AUC] = 0.641), HDL-C (AUC = 0.600), and TG (AUC = 0.629), and AIP had the best predictive value among TG (AIP:TG: difference in AUC (95% CI), 0.012 (0.001-0.024), <i>p</i> for Delong t","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 6","pages":"33470"},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592067","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 Impaired Cerebral Autoregulation on Postoperative Delirium in Neonates and Infants After Corrective Cardiac Surgery: A Study on Modifiable Risk Factors for Delirium.","authors":"Yordan H Georgiev, Marcel Methner, Maximilian Iller, Juliane Engel, Jörg Michel, Johannes Nordmeyer, Felix Neunhoeffer","doi":"10.31083/RCM37292","DOIUrl":"10.31083/RCM37292","url":null,"abstract":"<p><strong>Background: </strong>The risk factors for developing postoperative pediatric delirium (PD) are multifactorial and include underlying conditions, cyanosis, surgery, intensive care stay, analgesia used for sedation, and withdrawal symptoms. Disturbed cerebral autoregulation in children with congenital heart disease (CHD) can lead to hyper- and hypoperfusion states of the central nervous system and is potentially associated with poor neurological outcomes. Our study aimed to investigate whether disturbed cerebral autoregulation postoperatively is associated with the onset of PD in children with CHD.</p><p><strong>Methods: </strong>We conducted a prospective observational study in neonates and infants undergoing corrective surgery for CHD via cardiopulmonary bypass (CPB). Cerebral regional oxygen saturation (rSO2) and mean arterial pressure (MAP) were measured within the first 24 hours after surgery in the pediatric intensive care unit (PICU). The cerebral oximetry index (COx) was calculated from these parameters using ICM+ software. A COx ≥0.4 was considered indicative of impaired autoregulation. Delirium symptoms were assessed using the Sophia Observation of Withdrawal-Pediatric Delirium (SOS-PD) score.</p><p><strong>Results: </strong>Cerebral autoregulation was evaluated postoperatively at the bedside of 49 neonates and infants (22 males, 44.9%, vs. 27 females, 55.1%) between January 2019 and April 2023. The median age of the patients was 134 days (interquartile range (IQR): 49.5-184 days), the median weight was 5.1 kg (IQR: 4.0-6.3 kg), and the monitoring duration was 23.0 hours (IQR: 20-24.5 hours). In total, 27/49 (55%) patients developed postoperative PD during their stay in the PICU. There was no statistically significant difference in the duration of globally impaired autoregulation between the delirious and non-delirious groups (14.5% vs. 13.9%, <i>p</i> = 0.416). No evidence was found supporting the effect of MAP outside the lower and upper limits of autoregulation for the onset of postoperative delirium (<i>p</i> = 0.145 and <i>p</i> = 0.904, respectively). Prolonged mechanical ventilation, longer PICU stay, and higher use of opioids and benzodiazepines were observed in the delirious group.</p><p><strong>Conclusion: </strong>Our findings suggest that impairment of cerebral autoregulation cannot solely explain the higher rate of PD in children undergoing congenital cardiac surgery. Rigorous hemodynamic management may potentially minimize the impact of cerebral hypo- or hyperperfusion states during the postoperative period, preventing their harmful effects. Additional studies with a larger sample size are needed to confirm the hypothesis and current findings.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 6","pages":"37292"},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592085","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":"Impact of Uncontrolled Diabetes on Myocardial Global Longitudinal Strain: A Case-Control Study.","authors":"Khaled Elenizi, Rasha Alharthi, Abdullah Alanazi, Nasser Alotaibi, Mubarak Alajmi, Abdulrahman Alsubaie, Sahar Gamil, Mohammed Alqahtani","doi":"10.31083/RCM38967","DOIUrl":"10.31083/RCM38967","url":null,"abstract":"<p><strong>Background: </strong>Subclinical systolic dysfunction due to diabetic microangiopathy and its impact on left ventricular (LV) function remains unclear. Myocardial deformation (strain) imaging can detect LV systolic dysfunction earlier than conventional ejection fraction evaluations. Thus, this study aimed to examine the relationship between uncontrolled diabetes and impaired LV global longitudinal strain (GLS) in patients with diabetes mellitus (DM) compared to non-diabetic individuals.</p><p><strong>Methods: </strong>A total of 76 asymptomatic patients with uncontrolled type 2 DM and 76 age- and gender-matched healthy controls underwent transthoracic echocardiography imaging. Patients with coronary artery disease, an LV ejection fraction <55%, atrial fibrillation, or inadequate echocardiographic quality were excluded. The presence of proliferative retinopathy, microalbuminuria, nephropathy, or peripheral neuropathy defines diabetic microvascular complications.</p><p><strong>Results: </strong>The absolute GLS% was significantly lower in the uncontrolled diabetic group (-18.4 ± 1.7) compared to controls (-22 ± 1.9, <i>p</i> < 0.001). Diabetic patients with complications had lower absolute GLS% values of -18.9 ± 1.7 for no complications, -17.5 ± 1.3 for one complication, and -16.8 ± 1.3 for two or more complications (<i>p</i>-value = 0.001). Regression analysis showed a positive association between complications and lower absolute GLS% (β = 0.41, <i>p</i> < 0.001). No significant difference was found in LV mass between hypertensive (155.1 ± 40.4) and non-hypertensive individuals (139.8 ± 44.3; <i>p</i>-value = 0.19).</p><p><strong>Conclusion: </strong>Uncontrolled diabetes and the presence of complications were associated with lower absolute GLS% values, suggesting impaired myocardial deformation. These findings highlight the importance of monitoring GLS% as a potential marker for cardiac involvement in diabetic patients.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 6","pages":"38967"},"PeriodicalIF":1.9,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592081","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":"Wearable Technology in Cardiology: Advancements, Applications, and Future Prospects.","authors":"Nihar Jena, Prabhat Singh, Deepak Chandramohan, Hari N Garapati, Jyotsna Gummadi, Maneeth Mylavarapu, Bushra Firdous Shaik, Athmananda Nanjundappa, Dinesh Reddy Apala, Christian Toquica, Boney Lapsiwala, Prathap Kumar Simhadri","doi":"10.31083/RCM39025","DOIUrl":"10.31083/RCM39025","url":null,"abstract":"<p><p>As the use of wearable devices continues to expand, their integration into various aspects of healthcare becomes increasingly prevalent. Indeed, significant advancements have been made in the field of cardiology through the application of wearable technology to monitor heart rate, rhythm, and other biological signals. This review examines the various applications of wearable technology in cardiology, with the goal of improving patient care. We evaluate the accuracy and functionality of existing wearable electrocardiograms, defibrillators, blood pressure monitors, fitness trackers, activity trackers, and sleep trackers, including their roles in cardiac rehabilitation. Furthermore, we highlight the significant advancements in wearable electrocardiograms, demonstrating their accuracy comparable to that of traditional monitoring devices, as shown by studies such as the Apple Heart Study and the Fitbit Heart Study. Recent research suggests that wearable electrocardiograms are comparable to conventional monitoring devices in terms of performance and can help reduce healthcare costs. However, as technological improvements continue to evolve, challenges related to accessibility, patient privacy, and the need for improved accuracy are also emerging. This review highlights recent advancements that aim to address these challenges. Nonetheless, further research is crucial to critically assess and identify shortcomings, as wearable devices possess significant potential to enhance cardiovascular and overall health.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 6","pages":"39025"},"PeriodicalIF":1.9,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592089","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 Impact of Age and Sex on Left Ventricular Function Based on Transthoracic Echocardiograms.","authors":"Lu Tang, Rui Wu, Chen Cheng, Zheng Li, Yang Hua, Jin-Yu Sun, Yan-Juan Zhang, Wei Sun, Xiang-Qing Kong","doi":"10.31083/RCM38779","DOIUrl":"10.31083/RCM38779","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to reveal the age- and gender-related differences in left ventricular function among patients with normal cardiac structure.</p><p><strong>Methods: </strong>A retrospective analysis was performed on 10,853 individuals with normal cardiac structures undergoing transthoracic echocardiography (2017-2020). We performed distribution analysis using kernel density estimation with Gaussian kernels and created smooth trajectories based on generalized additive models. Moreover, correlation analysis and multivariable regression were applied to evaluate the impact of age and gender on ventricular function.</p><p><strong>Results: </strong>A weak but statistically significant correlation was found between age and ejection fraction (B-coefficient = -0.077, <i>p</i> < 0.001). Females presented with a higher early diastolic mitral inflow velocity (E)/ early diastolic mitral annular tissue velocity (e') ratio than males across all age decades (<i>p</i> < 0.001). However, age demonstrated stronger associations with functional parameters in individuals below 51.4 years (both genders, <i>p</i> < 0.001). Multivariable regression analysis indicated that age and the male gender were independent predictors of reduced septal and lateral e' velocities (both <i>p</i> < 0.001), with males showing lower values (septal B-coefficient = -0.290; lateral B-coefficient = -0.463).</p><p><strong>Conclusion: </strong>This study provided the distribution of left ventricular systolic/diastolic function across age decades in males and females and highlighted the clinical importance of monitoring ventricular function even for patients with normal cardiac structure.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 6","pages":"38779"},"PeriodicalIF":1.9,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592086","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":"Blood Transfusions are Associated With Prolonged Mechanical Ventilation Following Cardiac Surgery in Neonates.","authors":"Yansong Zuo, Han Zhang, Lizhi Lv, Gang Li, Ju Zhao, Qiang Wang","doi":"10.31083/RCM36566","DOIUrl":"10.31083/RCM36566","url":null,"abstract":"<p><strong>Background: </strong>To investigate the factors that influence blood transfusions after neonatal cardiac surgery and their association with prolonged mechanical ventilation (PMV) to provide a basis for optimizing blood transfusion strategies.</p><p><strong>Methods: </strong>This study retrospectively analyzed the clinical data of 202 neonates who had undergone cardiac surgery with cardiopulmonary bypass (CPB) in Beijing Anzhen Hospital from 2019 to 2023. Demographic data, preoperative parameters (body weight, hemoglobin, Risk-Adjusted Classification of Congenital Heart Surgery 1 (RACHS-1) score), intraoperative data (CPB time, aortic cross-clamp time, deep hypothermic circulatory arrest (DHCA)), and transfusions of red blood cells (RBCs), fresh frozen plasma (FFP), and platelet concentrate (PC) within 48 hours after surgery were collected. PMV was defined as mechanical ventilation ≥96 hours after surgery. Multivariate logistic regression was used to analyze independent risk factors for PMV, and the dose-response relationship between transfusion volume and PMV was evaluated by restricted cubic splines (RCSs).</p><p><strong>Results: </strong>Within 48 hours postoperation, 50.00% of patients were transfused with RBCs, 37.62% were transfused with FFP, and 27.72% were transfused with PC. The PMV incidence was 36.63% in patients with lower body weight (odds ratio (OR) = 0.38, 95% confidence interval (CI): 0.20-0.74; <i>p</i> = 0.005), lower preoperative hemoglobin (OR = 0.99; 95% CI: 0.97-0.99; <i>p</i> = 0.041), and a RACHS-1 score of 4 (OR = 2.56; 95% CI: 1.04-6.27; <i>p</i> = 0.040), and RBCs (OR = 2.02; 95% CI: 1.02-4.00; <i>p</i> = 0.043), and FFP infusion (OR = 1.98; 95% CI: 1.02-3.85; <i>p</i> = 0.043) were independent risk factors. The RCS demonstrated a linear dose-response relationship between the volume of RBCs infused and PMV (<i>p</i> nonlinear = 0.668), whereas there was no association for FFP. The duration of intensive care unit (ICU) stay in patients with PMV (14 days vs. 8 days) and the hospitalization (18 days vs. 13 days) were significantly longer (both <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Blood transfusion after neonatal cardiac surgery is an important controllable risk factor for the development of PMV, and its risk increases linearly with the volume of RBC transfusion. Future multicenter prospective studies are needed to validate the causal association further.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 6","pages":"36566"},"PeriodicalIF":1.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592045","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":"A Prediction Model of Stable Warfarin Doses in Patients After Mechanical Heart Valve Replacement Based on a Machine Learning Algorithm.","authors":"Bowen Guo, Cong Chen, Junhang Jia, Jubing Zheng, Yue Song, Taoshuai Liu, Kui Zhang, Yang Li, Ran Dong","doi":"10.31083/RCM33425","DOIUrl":"10.31083/RCM33425","url":null,"abstract":"<p><strong>Background: </strong>The narrow therapeutic range of warfarin, alongside the response of numerous influencing factors and significant inter-individual variability, presents major challenges for personalized medication. This study aimed to combine clinical and genetic characteristics with machine learning (ML) algorithms to develop and validate a model for predicting stable warfarin doses in patients from Northern China after mechanical heart valve replacement surgery.</p><p><strong>Methods: </strong>This study included patients who underwent mechanical heart valve replacement surgery at the Beijing Anzhen Hospital between January 2021 and January 2024 and achieved a stable warfarin maintenance dose. Comprehensive clinical and genetic data were collected, and patients were divided into training and validation cohorts at an 8:2 ratio through random division. The variables were selected using analysis of covariance (ANCOVA). Algorithms for predicting the stable warfarin dose were constructed using a traditional linear model, general linear model (GLM), and 10 ML algorithms. The performance of these algorithms was evaluated and compared using R-squared (R²), mean absolute error (MAE), and ideal prediction percentage to identify the optimal algorithm for predicting the stable warfarin dose and verify its clinical significance.</p><p><strong>Results: </strong>A total of 413 patients were included in this study for model training and validation, and 13 important features were selected for model development. The support vector machine radial basis function (SVM Radial) algorithm showed the best performance of all models, with the highest R² value of 0.98 and the lowest MAE of 0.14 mg/day (95% confidence interval (CI): 0.11-0.17). This model successfully predicted the ideal warfarin dose in 93.83% of patients, with the highest ideal prediction percentage found in the medium-dose group (95.92%). In addition, the model demonstrated high predictive accuracy in both the low-dose and high-dose groups, with ideal prediction percentages of 85.71% and 92.00%, respectively.</p><p><strong>Conclusions: </strong>Compared to previous methods, SVM Radial demonstrates significantly higher accuracy for predicting the warfarin maintenance dose following heart valve replacement surgery, suggesting it has potential for widespread application. However, this study was based on a relatively small sample size and conducted at a single center. Future research should involve larger sample sizes and multicenter data to validate the predictive accuracy of the SVM Radial model further.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 6","pages":"33425"},"PeriodicalIF":1.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592071","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":"Electrophysiological Mechanisms and Therapeutic Potential of Calcium Channels in Atrial Fibrillation.","authors":"Zuyuan Huang, Cheng Luo, Zimin Wu, Baoshi Zheng","doi":"10.31083/RCM33507","DOIUrl":"10.31083/RCM33507","url":null,"abstract":"<p><p>Atrial fibrillation (AF) is a prevalent and complex arrhythmia for which the pathogenesis involves various electrophysiological factors, notably the regulation of calcium channels. This article aimed to investigate the specific roles and molecular mechanisms of the L-type and T-type calcium channels, ryanodine receptors (RyRs), inositol 1,4,5-triphosphate receptors (IP3Rs), calcium release-activated calcium (CRAC) channels, and transient receptor potential (TRP) channels in the pathogenesis and persistence of AF. In addition, this article reviews recent advances in calcium channel-targeted drugs from experimental and clinical studies, offering new insights into the relationship between calcium channel regulation and AF pathology. These findings suggest promising directions for further research into the mechanisms of AF and the development of targeted therapeutic strategies.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 6","pages":"33507"},"PeriodicalIF":1.9,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592066","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":"AI-based Assessment of Risk Factors for Coronary Heart Disease in Patients With Diabetes Mellitus and Construction of a Prediction Model for a Treatment Regimen.","authors":"Zhen Gao, Qiyuan Bai, Mingyu Wei, Hao Chen, Yan Yan, Jiahao Mao, Xiangzhi Kong, Yang Yu","doi":"10.31083/RCM36293","DOIUrl":"10.31083/RCM36293","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to construct a prediction model for a treatment plan for patients with coronary artery disease combined with diabetes mellitus using machine learning to efficiently formulate the treatment plan for special patients and improve the prognosis of patients, provide an explanation of the model based on SHapley Additive exPlanation (SHAP), explore the related risk factors, provide a reference for the clinic, and concurrently, to lay the foundation for the establishment of a multicenter prediction model for future treatment plans.</p><p><strong>Methods: </strong>To investigate the relationship between concomitant coronary heart disease (CHD) and diabetes mellitus (DM), this study retrospectively included patients who attended the Beijing Anzhen Hospital of Capital Medical University between 2022 and 2023. The processed data were then input into five different algorithms for model construction. The performance of each model was rigorously evaluated using five specific evaluation indicators. The SHAP algorithm also provided clear explanations and visualizations of the model's predictions.</p><p><strong>Results: </strong>The optimal set of characteristics determined by the least absolute shrinkage and selection operator (LASSO) regression were 15 features of general information, laboratory test results, and echocardiographic findings. The best model identified was the eXtreme Gradient Boost (XGBoost) model. The interpretation of the model based on the SHAP algorithm suggests that the feature in the XGBoost model that has the greatest impact on the prediction of the results is the glycated hemoglobin level.</p><p><strong>Conclusions: </strong>Using machine-learning algorithms, we built a prediction model of a treatment plan for patients with concomitant DM and CHD by integrating patients' information and screened the best feature set containing 15 features, which provides help and strategies to develop the best treatment plan for patients with concomitant DM and CHD.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 6","pages":"36293"},"PeriodicalIF":1.9,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592074","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":"Delayed Diagnosis of Aortic Dissection: A Scoping Review.","authors":"Yaru Xiao, Sufang Huang, Danli Zheng, Ying Li, Jian Ke, Xiaorong Lang, Danni Feng","doi":"10.31083/RCM33487","DOIUrl":"10.31083/RCM33487","url":null,"abstract":"<p><strong>Background: </strong>Patients with aortic dissection (AD) exhibit an elevated early mortality rate. A timely diagnosis is essential for successful management, but this is challenging. There are limited data delineating the factors contributing to a delayed diagnosis of AD. We conducted a scoping review to assess the time to diagnosis and explore the risk factors associated with a delayed diagnosis.</p><p><strong>Methods: </strong>This scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We conducted online searches in PubMed, Web of Science, Cochrane Library, Bing, Wanfang Data Chinese database, and the China National Knowledge Infrastructure (CNKI) Chinese database for studies that evaluated the diagnostic time and instances of delayed diagnoses of AD.</p><p><strong>Results: </strong>A total of 27 studies were retrieved from our online searches and included in this scoping review. The time from symptom onset to diagnosis ranged from 40.5 min to 84.4 h, and the time from hospital presentation to diagnosis ranged from 0.5 h to 25 h. Multiple factors resulted in a significantly delayed diagnosis. Demographic and medical history predictors of delayed diagnosis included the female sex, age, North American versus European geographic location, initial AD, history of congestive heart failure, history of hyperlipidemia, distressed communities index >60, walk-in visits to the emergency department, those who transferred from a non-tertiary care hospital, and preoperative coronary angiography. Furthermore, chest and back pain, especially abrupt or radiating pain, low systolic blood pressure, pulse deficit, and malperfusion syndrome required less time for diagnostic confirmation. In contrast, painlessness, syncope, fever, pleural effusion, dyspnea, troponin positivity, and acute coronary syndrome-like electrocardiogram were more prevalent in patients with a delayed diagnosis.</p><p><strong>Conclusions: </strong>A recognition of the features associated with both typical and atypical presentations of AD is useful for a rapid diagnosis. Educational efforts to improve clinician awareness of the various presentations of AD and, ultimately, improve AD recognition may be relevant, particularly in non-tertiary hospitals with low exposure to aortic emergencies.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 6","pages":"33487"},"PeriodicalIF":1.9,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592064","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}