Scandinavian Cardiovascular Journal最新文献

{"title":"Reply to the letter-to-the-editor \"Percutaneous coronary intervention in nonagenarians\".","authors":"Matti Riihiniemi, Jarkko Piuhola, Matti Niemelä, Juhani Junttila","doi":"10.1080/14017431.2026.2744009","DOIUrl":"https://doi.org/10.1080/14017431.2026.2744009","url":null,"abstract":"","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":"61 1","pages":"2744009"},"PeriodicalIF":1.4,"publicationDate":"2027-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149114630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond stroke: atrial fibrillation and the broader burden of thromboembolic events in the population-based EpiHealth study.","authors":"Pernilla Höiby, Moncef Zarrouk, Lars Lind, Rani Basna, Marie Claire Overton, Sölve Elmståhl","doi":"10.1080/14017431.2026.2748120","DOIUrl":"10.1080/14017431.2026.2748120","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the distribution and risk of thromboembolic events (TEs) among adults with and without atrial fibrillation (AF), and to assess oral anticoagulant (OAC) use over time.</p><p><strong>Design: </strong>This population-based longitudinal cohort study included EpiHealth participants recruited between April 2011 and December 2016 and followed through linkage to Swedish health data registers from baseline until the first TE, death, or December 31, 2016.</p><p><strong>Results: </strong>At baseline, 873 of 22,616 participants (3.9%) had AF and 297 developed incident AF during follow-up. 484 participants experienced at least one TE during 70,587 person-years. Participants with AF had higher TE incidence (68 events, 5.9%; <i>p</i> < 0.001), predominantly arterial (73.5%), with 94% of arterial events involving the cerebral circulation. Approximately one quarter of TEs among participants with AF occurred outside the cerebral circulation and comprised both venous and non-cerebral arterial events. Although participants with incident AF represented less than one quarter of participants with AF, they accounted for 40% of TEs in the AF group. OAC use increased from 39.0% to 50.4%, with a shift from predominantly warfarin to direct oral anticoagulants. In time-dependent Cox regression adjusted for age, sex, and prior arterial thromboembolism, untreated AF was associated with increased thromboembolic risk compared with no AF (HR 2.53), whereas OAC use was associated with lower risk.</p><p><strong>Conclusions: </strong>AF was associated with substantially increased thromboembolic risk, predominantly arterial in nature. One in five TEs among participants with AF coincided with newly diagnosed AF, suggesting potential opportunities for earlier AF detection and timely initiation of anticoagulant treatment.</p>","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":" ","pages":"2748120"},"PeriodicalIF":1.4,"publicationDate":"2027-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circulatory arrest versus aortic cross-clamping in proximal thoracic aortic aneurysm repair.","authors":"Erik Braatz, Malin Stenman, Julia Al-Mousli, Magnus Dalén, Christian Olsson","doi":"10.1080/14017431.2026.2745873","DOIUrl":"10.1080/14017431.2026.2745873","url":null,"abstract":"<p><strong>Introduction: </strong>Aortic cross‑clamping and mild hypothermic circulatory arrest (MHCA) are commonly used strategies in proximal thoracic aortic aneurysm surgery. This study compared these approaches in elective procedures for patients with a distal ascending aortic diameter of 40-50 mm. The primary outcome was a composite of 30‑day mortality, stroke, or acute kidney injury, with secondary outcomes including long‑term survival and postoperative complications.</p><p><strong>Material and methods: </strong>This single‑center observational cohort included patients treated between 2016 and 2024. Distal ascending aortic diameters were assessed on preoperative computed tomography, and clinical data were obtained from SWEDEHEART. Patients were assigned to aortic cross‑clamp (<i>n</i> = 261) or MHCA (<i>n</i> = 138). Propensity score matching was performed in a 1:1 ratio to balance baseline characteristics.</p><p><strong>Results: </strong>The composite primary outcome occurred in 15 patients (3.8%) and was more common with MHCA than with cross‑clamp (6.5% vs 2.3%, <i>p</i> = 0.035). Two patients (0.5%), both in the MHCA group, died within 30 days. After matching, the odds ratio for the composite endpoint was 2.4 (95% CI, 0.66-11.5), indicating no significant difference. Long‑term survival was similar between groups (log‑rank <i>p</i> = 0.33).</p><p><strong>Conclusions: </strong>Both strategies were associated with low perioperative risk and comparable long‑term survival. These results support flexible operative planning, allowing the distal anastomotic technique to be chosen based on individual anatomy and surgical preference.</p>","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":" ","pages":"2745873"},"PeriodicalIF":1.4,"publicationDate":"2027-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative infections after cardiac surgery with cardiopulmonary bypass - incidence, performance of diagnostic procedures, and predictive factors.","authors":"Clara Erixon, Emilia Johannesson, Alain Dardashti, Lisa Melhammar, Johan Nilsson, Louise Thelaus, Adam Linder, Igor Zindovic","doi":"10.1080/14017431.2026.2745880","DOIUrl":"10.1080/14017431.2026.2745880","url":null,"abstract":"<p><strong>Objectives: </strong>Cardiac surgery using cardiopulmonary bypass (CPB) induces a systemic inflammatory response that affects common inflammatory markers, including C-reactive protein (CRP), white blood cell count (WBC), and body temperature, complicating postoperative diagnosis of infections. The objective of this study was to assess the incidence of postoperative infections and evaluate the performance of clinically used biomarkers.</p><p><strong>Design: </strong>This was a bidirectional cohort study including patients undergoing cardiac surgery with CPB between 1st of February 2020 and 22nd of September 2021. Patients with postoperative infection were compared to patients without. Multivariable logistic regression was used to identify independent predictors of postoperative infections. Receiver operating characteristic (ROC) curves evaluated the diagnostic ability of current biomarkers to detect infection.</p><p><strong>Results: </strong>A total of 1,222 patients were included. The incidence of postoperative infections (during hospitalisation and/or late infection) was 17.3%. Patients with postoperative infection had more comorbidities, underwent more complex procedures, and had higher mortality (90-day mortality 3.8% vs 1.5%, <i>p</i> = 0.045; 1-year mortality 5.7% vs 2.7%, <i>p</i> = 0.032). CRP, WBC, and temperature performed poorly in detecting postoperative infection, although peak CRP (OR 1.069, <i>p</i> < 0.001) and peak temperature (OR 2.408, <i>p</i> = 0.005) were independent predictors of postoperative infection. Peak temperature occurred on postoperative day 5 in infected patients versus day 2 in those without infection.</p><p><strong>Conclusion: </strong>Postoperative infections following cardiac surgery with CPB remain common and are associated with increased postoperative complications and mortality. Common inflammatory biomarkers perform poorly in detecting infection. Improved diagnostic tools are needed to facilitate early detection and treatment.</p>","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":" ","pages":"2745880"},"PeriodicalIF":1.4,"publicationDate":"2027-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes following invasive coronary angiography for patients with acute coronary syndromes pretreated with P2Y₁₂ inhibitors and considered for urgent coronary artery bypass graft surgery.","authors":"Chai Jin Lim, Manwi Singh, Mark Anthony Sammut, Mohammed Ejaz Faizur Rahman, William A E Parker, Syed Asif Arafat Sadeque, Robert F Storey","doi":"10.1080/14017431.2026.2746519","DOIUrl":"10.1080/14017431.2026.2746519","url":null,"abstract":"<p><p>This retrospective single-centre observational study included 262 sequential patients with acute coronary syndromes (ACS) undergoing invasive coronary angiography (ICA) while receiving P2Y₁₂ inhibitors and considered for coronary artery bypass graft surgery (CABG); P2Y₁₂ inhibitors (ticagrelor 91%, thienopyridine 9%) were stopped prior to CABG. The primary outcome was recurrent myocardial infarction or death following ICA and prior to revascularisation or decision for conservative management. 2 patients (0.8%) had recurrent MI and died following ICA and prior to planned CABG, demonstrating a small risk of MI and death in patients who have delays to CABG following ICA for ACS.</p>","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":" ","pages":"2746519"},"PeriodicalIF":1.4,"publicationDate":"2027-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining sex differences in care-seeking patterns for acute myocardial infarction - a cross-sectional study.","authors":"Laura Gumaelius, Erika Börjes Andersson, Matthias Lidin, Caroline Löfvenmark, Carolin Nymark","doi":"10.1080/14017431.2025.2606505","DOIUrl":"10.1080/14017431.2025.2606505","url":null,"abstract":"<p><strong>Aim: </strong>To examine sex differences in care-seeking when afflicted by an acute myocardial infarction (AMI).</p><p><strong>Method: </strong>This was a cross-sectional study in the region of Stockholm, Sweden. All patients from the Swedish national registry SWEDEHEART who were hospitalized due to an acute myocardial infarction in Stockholm, between March and June 2020, were asked to participate. A self-administered questionnaire Patients' appraisal, emotions, and action tendencies preceding care-seeking in acute myocardial infarction' (PA-AMI) including demographical questions, was sent out <i>via</i> mail, which was answered by a total of 326 participants. Additional variables for each participant were obtained from SWEDEHEART.</p><p><strong>Results: </strong>There were no differences between women and men regarding patients' thoughts, feelings, and actions prior to care-seeking, as well as the time from symptom onset to care-seeking, both the patients' own assessed time, and the times reported to SWEDEHEART. However, the results shows that both women and men experience a high degree of uncertainty when afflicted by an AMI.</p><p><strong>Conclusions: </strong>Our results indicate that there are no significant sex differences in care-seeking patterns when afflicted by an AMI. Regardless of sex, AMI is associated with a high level of uncertainty among patients. To address this uncertainty and improve timely care, it is crucial to implement enhanced educational initiatives at both the individual and community levels. These efforts should focus on increasing awareness of the diverse symptom presentation of AMI and emphasize the critical importance of seeking immediate medical attention. Such interventions could help reduce delays in care and improve patient outcomes.</p>","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":" ","pages":"2606505"},"PeriodicalIF":1.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145805267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of right atrial function using two-dimensional speckle tracking echocardiography in patients with obstructive sleep apnea hypopnea syndrome.","authors":"Ya Liu, Yanyan Zhang, Miaomiao Pei, Ning Zhang, Xuejia Guo","doi":"10.1080/14017431.2026.2709195","DOIUrl":"10.1080/14017431.2026.2709195","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to unveil the right atrial function in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) using two-dimensional speckle tracking echocardiography (2D-STE).</p><p><strong>Methods: </strong>A total of 120 OSAHS patients were enrolled as the OSAHS group, with 100 healthy individuals served as the control group. Conventional echocardiography assessed right atrial structure, including superior-inferior diameter, transverse diameter, area, and volume. Myocardial longitudinal strain parameters (reservoir strain (RASr), conduit strain (RAScd), and contraction strain (RASct)) were measured using 2D-STE. Comparisons were made between groups, and patients were further stratified by apnea-hypopnea index (AHI) into mild (5-14 events/h), moderate (15-39 events/h), and severe (≥ 40 events/h) subgroups. Correlation with AHI was assessed by Pearson correlation analysis.</p><p><strong>Results: </strong>Compared to controls, the OSAHS group showed progressive decreases in RASr and RAScd, and increases in RASct and transverse diameter with increasing disease severity (<i>p</i> < 0.05). AHI was negatively correlated with RASr and RAScd, and positively correlated with RASct and transverse diameter (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>Patients with OSAHS exhibit significant structural and functional alterations of the right atrium. 2D-STE provides a reliable, non-invasive method for early assessment and clinical evaluation of right atrial dysfunction in OSAHS patients.</p>","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":" ","pages":"2709195"},"PeriodicalIF":1.4,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis of traumatic diaphragmatic injury remains a clinical challenge - Brief report.","authors":"Joonas Kuorikoski, Matti Huuskonen, Antti Riuttanen, Mikko Uimonen, Ari Mennander, Ville Mattila","doi":"10.1080/14017431.2026.2690771","DOIUrl":"10.1080/14017431.2026.2690771","url":null,"abstract":"<p><p>Traumatic diaphragmatic injury (TDI) is a rare injury accounting for 10% to 15% of penetrating injuries and 1% to 8% of blunt injuries to the thoracoabdominal region. The most common mechanism of blunt trauma is motor vehicle collision, while stabbings and gunshot wounds are the most frequent causes of penetrating TDIs. More than 62% of TDIs are initially undiagnosed. We identified 22 TDIs. Of these, diagnosis was delayed > 24 h in eight patients. The diagnosis was missed in seven patients, even though they were scanned with CT. Even today, primary CT after traumatic injury does not reliably reveal TDI.</p>","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":"60 1","pages":"2690771"},"PeriodicalIF":1.4,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148606730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Scandinavian perspective of the projected lifetime cost-effectiveness of rivaroxaban plus aspirin in the COMPASS trial.","authors":"Andre Lamy, Lars Ryden, Wesley Tong, Fei Yuan, John W Eikelboom","doi":"10.1080/14017431.2026.2728343","DOIUrl":"10.1080/14017431.2026.2728343","url":null,"abstract":"<p><p><i>Objectives</i>. Rivaroxaban 2.5 mg twice daily with aspirin 100 mg daily was superior to aspirin 100 mg daily in the COMPASS trial but the cost-effectiveness in Scandinavia is unknown. <i>Design</i>. Mean lifetime costs (USDs) and quality-adjusted life-years were determined from a Scandinavian perspective using a 2-state Markov model with US mortality data. Subgroup and sensitivity analyses were performed. <i>Results</i>. Over a lifetime adding rivaroxaban to aspirin had lower costs (-$3791USD/-23675DKK/-27410NOK/-29200SEK) and gained 1.17 QALYs versus ASA alone. <i>Conclusion.</i> Rivaroxaban 2.5 mg twice daily with aspirin is a dominant strategy compared to aspirin alone in COMPASS participants from a Scandinavian perspective.</p>","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":" ","pages":"2728343"},"PeriodicalIF":1.4,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of endothelial dysfunction in women with primary dysmenorrhea.","authors":"Betül Sarıbıyık Çakmak, Ahmet Can Çakmak, Yusuf Can, Harun Kilic","doi":"10.1080/14017431.2026.2613540","DOIUrl":"10.1080/14017431.2026.2613540","url":null,"abstract":"<p><strong>Objectives: </strong>Primary dysmenorrhea is a common condition characterized by cramp-like menstrual pain in young women. Recently, its effects on the cardiovascular system have garnered attention. Endothelial dysfunction is an early indicator of cardiovascular risk; however, its relationship with primary dysmenorrhea remains unclear. This study aims to evaluate endothelial function in individuals with primary dysmenorrhea using post-ischemic flow-mediated dilation (FMD) and volumetric flow (VolFlow) methods, and to compare the results with healthy controls.</p><p><strong>Design: </strong>This study included 31 women with a clinical diagnosis of primary dysmenorrhea and 31 healthy control women. Endothelial function was assessed using Flow-Mediated Dilation (FMD) and VolFlow methods. FMD measures the dilation of the brachial artery, while VolFlow evaluates arterial blood flow volume. Differences between the groups were analyzed using SPSS, and a p-value of < 0.05 was considered statistically significant. Normality was assessed using the Shapiro-Wilk test, and between-group comparisons were performed using appropriate parametric and non-parametric methods.</p><p><strong>Findings: </strong>The FMD values were significantly lower in the dysmenorrhea group (5.97 ± 5.29 vs. 10.95 ± 3.78, <i>p</i> < 0.001), and the proportion of individuals with endothelial dysfunction was higher (%51.6 vs. %6.45, <i>p</i> < 0.001). In the dysmenorrhea group, the baseline VolFlow value was 77.4 ± 24.1 ml/min, which increased to 81.4 ± 25.1 ml/min after cuff inflation (<i>p</i> < 0.001). In healthy controls, the VolFlow increased from 69.8 ± 15.3 ml/min to 92.0 ± 15.3 ml/min, but this change was not statistically significant (<i>p</i> = 0.08). The change in VolFlow (ΔVF) was significantly lower in the dysmenorrhea group (<i>p</i> < 0.001).</p><p><strong>Results: </strong>Our findings indicate a significant impairment of endothelial function in the primary dysmenorrhea group compared to the control group. Specifically, individuals with primary dysmenorrhea exhibited lower flow-mediated dilation (FMD) and Δ vascular function (ΔVF) values. To further investigate this relationship, large-scale studies are needed.</p>","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":" ","pages":"2613540"},"PeriodicalIF":1.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145912841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}