Scandinavian Cardiovascular Journal最新文献

{"title":"Body size in young adulthood is associated with thoracic aortic events later in life.","authors":"Linn Skoglund Larsson, Sara Själander, Lars Johansson, Stefan Söderberg, Mattias Brunström","doi":"10.1080/14017431.2026.2690778","DOIUrl":"10.1080/14017431.2026.2690778","url":null,"abstract":"<p><p><i>Objectives</i>. Larger body size is associated with larger thoracic aortic diameter, a risk factor for thoracic aortic disease (TAD). Studies of body size-indexed aortic diameters suggest wider aortas may be less harmful in large people, but the association between body size and TAD events is unknown. This study aims to assess if body size is associated with TAD events. <i>Methods</i>. Swedish 18-year-olds attending mandatory military conscription 1969-1997 were included. Body size was assessed as height, weight, body surface area (BSA) and body mass index (BMI) stratified into quartiles. A composite endpoint of dissection, rupture, surgery of the ascending aorta, or death from TAD was constructed, linking data from the Swedish Inpatient Register and the Cause of Death Register. Cox regression analyses, adjusted for diabetes mellitus and blood pressure at conscription, socioeconomic factors, and Marfan's syndrome, bicuspid aortic valve, and coronary artery by-pass surgery before endpoint or censoring, were performed. <i>Results</i>. During a median follow-up of 36 years (48,404,276 person-years), the composite endpoint occurred in 3,355 out of 1.4 million individuals, 99.7% male. The adjusted hazard ratio (95% confidence interval) for the highest versus lowest quartile of body size was 1.58 (1.43-1.73) for height, 1.90 (1.73-2.09) for weight, 1.87 (1.70-2.07) for BSA, and 1.55 (1.41-1.71) for BMI. Results were robust when surgery was excluded from the composite endpoint. <i>Conclusions</i>. Larger body size is associated with increased risk for TAD, regardless of the category of body size. Further studies including women, and also analyzing aortic diameter are warranted.</p>","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":" ","pages":"2690778"},"PeriodicalIF":1.4,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148259654","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":"Evaluating and predicting of the cardiac function class and re-hospitalization in CHD with HF using IVC diameter and collapsibility index.","authors":"Junwen Zhang, Yuan Yuan, Ke Wei, Chunrong Bao","doi":"10.1080/14017431.2026.2690769","DOIUrl":"10.1080/14017431.2026.2690769","url":null,"abstract":"<p><strong>Aims: </strong>Transthoracic echocardiography is widely used to assess the volume status of patients with coronary heart disease combined with heart failure (CHD-HF) because of its noninvasive and convenient nature. Inferior vena cava (IVC) measurement is a commonly used alternative method for evaluating central venous pressure. This study analyzed the specific clinical applications of IVC diameter (IVCD) and collapse index (IVCCI) in assessing the cardiac dysfunction severity and prognosis of CHD-HF patients.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 340 CHD patients treated at our hospital between January 2021 and March 2023. Patients were categorized into CHD (<i>n</i> = 123) and CHD-HF (<i>n</i> = 217) groups. Ultrasound measurements of IVCD and IVCCI were performed, and 2-year follow-up data were compiled to record cardiovascular re-hospitalization and all-cause death. Spearman or Pearson was utilized for correlation analysis. ROC analysis was used for performance analysis, and Kaplan-Meier and Cox regression were harnessed for survival analysis.</p><p><strong>Results: </strong>CHD-HF patients showed increased IVCD and decreased IVCCI. CHD-HF patients experiencing cardiovascular re-hospitalization or all-cause death exhibited elevated IVCD and reduced IVCCI. IVCD (AUC = 0.715, 95%CI = 0.638-0.792, cut-off = 14.15 mm; AUC = 0.795, 95%CI = 0.732-0.858, cut-off = 13.04 mm) and IVCCI (AUC = 0.790, 95%CI = 0.726-0.853, cut-off = 51.47%; AUC = 0.731, 95%CI = 0.661-0.801, cut-off = 50.00%) demonstrated high predictive values for cardiovascular re-hospitalization and all-cause death in CHD-HF patients. IVCD (<i>HR</i> = 1.124, 95%CI = 1.056-1.196; <i>HR</i> = 1.139, 95%CI = 1.078-1.203) and IVCCI (<i>HR</i> = 0.959, 95%CI = 0.921-0.999; <i>HR</i> = 0.956, 95%CI = 0.921-0.992) were both independently associated with cardiovascular re-hospitalization and all-cause death in CHD-HF patients.</p><p><strong>Conclusion: </strong>IVCD and IVCCI effectively predict cardiovascular re-hospitalization and all-cause death in CHD-HF patients.</p>","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":" ","pages":"2690769"},"PeriodicalIF":1.4,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148405834","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":"Outcome after cardiac surgery in Jehovah's Witnesses.","authors":"Elin Karlsson, Magnus Dalén, Peter Svenarud, Emelie Carlestål, Torbjörn Ivert","doi":"10.1080/14017431.2026.2690764","DOIUrl":"10.1080/14017431.2026.2690764","url":null,"abstract":"<p><strong>Objectives: </strong>Jehovah's Witnesses categorically refuse allogenic blood transfusions on religious grounds, a major challenge if intervention for heart disease is required. We retrospectively analyzed outcome after open-heart surgery in 26 Jehovah's Witnesses.</p><p><strong>Methods: </strong>Jehovah's Witnesses undergoing open heart surgery between 2010 and June 2025 were compared to matched patients operated at our clinic by year of surgery, age, gender and type of surgical procedure.</p><p><strong>Results: </strong>Seven of the Jehovah's Witnesses (27%) were not accepted for open-heart surgery at other clinics because of an assumed high risk, three of whom were admitted from abroad. Two patients were operated on for acute aortic dissection. Six of the Jehovah's Witnesses (23%) had previously undergone open-heart surgery, two of whom required reoperation for prosthetic valve endocarditis. There was one early death (4%) among the Jehovah's Witnesses from renal failure and septicaemia at haemoglobin 44 g/L. Cardiopulmonary bypass, aortic occlusion and total time of the operation, bleeding and hospital stay and postoperative complications did not differ significantly in Jehovah's Witnesses and matched patients. Eleven of the 26 matched patients (42%) received blood transfusion. Mean haemoglobin before the operation, lowest recorded level, and level at discharge from hospital and at follow-up one to three months after the operation did not differ significantly in the two groups. Haemoglobin level after the operation recovered within three months.</p><p><strong>Conclusions: </strong>Complex cardiac surgery can be performed with low risk in Jehovah's Witnesses. Blood conservation should be applied at all operations to avoid unnecessary blood transfusion.</p>","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":" ","pages":"2690764"},"PeriodicalIF":1.4,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148259573","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":"Development and validation of a nomogram for predicting long-term survival in patients with infective endocarditis: a single-center retrospective study.","authors":"TianXu Song, Bo Hai, WeiGuang Yang, SongZhe Wu, NaiShi Wu","doi":"10.1080/14017431.2026.2726653","DOIUrl":"https://doi.org/10.1080/14017431.2026.2726653","url":null,"abstract":"<p><strong>Objective: </strong>To develop and internally validate a nomogram for predicting long-term survival in patients with infective endocarditis (IE), focusing on microbiological characteristics and surgical treatment.</p><p><strong>Methods: </strong>We retrospectively analyzed 210 patients with IE. Clinical characteristics, laboratory data, echocardiographic findings, microbiological profiles, and treatment information were collected. LASSO regression was used for variable selection, followed by multivariable Cox regression to identify independent prognostic factors and construct the nomogram. Model performance was evaluated using time-dependent ROC curves, concordance index, calibration curves, and decision curve analysis. Internal validation was performed using bootstrap resampling.</p><p><strong>Results: </strong>Among 210 patients (67.1% male; median age, 55 years), 125 (59.5%) underwent surgery. Seven independent prognostic factors identified from 11 LASSO-selected candidates were incorporated into the nomogram. The model showed good discrimination, with AUCs of 0.872, 0.840, and 0.846 for 1-, 3-, and 5-year survival prediction, respectively. The concordance index was 0.826. Calibration and decision curve analyses demonstrated good predictive accuracy and clinical utility. Blood culture-negative IE and Gram-negative bacterial infection were associated with poorer survival, whereas surgical treatment predicted improved outcomes.</p><p><strong>Conclusion.: </strong>We developed and internally validated a nomogram integrating clinical, microbiological, and treatment-related variables to predict long-term survival in IE patients, which may support individualized risk assessment and prognostic stratification.</p>","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":"60 1","pages":"2726653"},"PeriodicalIF":1.4,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008526","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":"Critical reflections on the ESCAPER study: addressing inconsistencies and methodological challenges in exploring cardiovascular resilience.","authors":"Çağrı Zorlu, Mehmet Eyuboglu","doi":"10.1080/14017431.2026.2699501","DOIUrl":"10.1080/14017431.2026.2699501","url":null,"abstract":"","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":" ","pages":"2699501"},"PeriodicalIF":1.4,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148376831","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":"Transcatheter aortic valve implantation in patients with tricuspid, bicuspid and bioprosthetic valves: observations from COMPARE-TAVI 1.","authors":"Troels Thim, Henrik Nissen, Phillip Freeman, Jordi Sanchez Dahl, Evald Høj Christiansen, Michala Norsell, Ashkan Eftekhari, Bjarne Linde Nørgaard, Christian Alcaraz Frederiksen, Henrik Ølholm Vase, Julia Ellert, Kristian Altern Øvrehus, Mariann Tang, Christian Juhl Terkelsen","doi":"10.1080/14017431.2026.2704938","DOIUrl":"10.1080/14017431.2026.2704938","url":null,"abstract":"<p><p><i>Background.</i> Transcatheter aortic valve implantation (TAVI) is most extensively documented for the treatment of aortic stenosis in patients with tricuspid valves. To compare the 30-day and 1-year outcomes after TAVI in patients with tricuspid, bicuspid and bioprosthetic valves who participated in the COMPARE-TAVI 1 trial. <i>Methods.</i> In COMPARE-TAVI 1, all-comer patients treated with transfemoral TAVI were randomized to treatment with one of two balloon-expandable valves. In this study, these patients were divided into three groups based on valve anatomy. 30-day and 1-year outcomes among patients with bicuspid and bioprosthetic valves (surgical or transcatheter) were compared with outcomes among patients with tricuspid valves. <i>Results.</i> Patients with tricuspid valves (<i>N</i> = 892, median 82 years) were slightly older than patients with bicuspid (<i>N</i> = 98, median 78 years) and bioprosthetic (<i>N</i> = 40, median 80 years) valves. Procedural outcomes were similar. There were no differences in death or bleeding at 30 days, nor in death, myocardial infarction, percutaneous revascularization, or endocarditis at 1 year. Stroke was more frequent among patients with bicuspid valves at 30 days (<i>n</i> = 7), while new pacemaker was less frequent among patients with bioprosthetic valves at 30 days (<i>n</i> = 0). The need for reoperation was more frequent among patients with bicuspid valves (<i>n</i> = 3). <i>Conclusions.</i> In this observational study performed within the COMPARE-TAVI 1 cohort, patients with tricuspid, bicuspid or bioprosthetic valves had similar outcomes. No patients with bioprosthetic valves had a new pacemaker within 30 days after TAVI. <i>Clinical trial registration</i>. ClinicalTrials.gov: NCT04443023.</p>","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":" ","pages":"2704938"},"PeriodicalIF":1.4,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991204","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":"Long-term mortality and shock-rate in patients surviving out-of-hospital cardiac arrest with and without early implantation of an implantable cardioverter defibrillator.","authors":"Matilde Winther-Jensen, Berit Thornvig Philbert, Marie L Laursen, Jesper Kjaergaard, Tommi B Lindhardt, Jacob E Møller, Emilie Gregers, Louise Linde, Jens Brock Johansen, Freddy K Lippert, Lars Køber, Helle Søholm","doi":"10.1080/14017431.2026.2725365","DOIUrl":"10.1080/14017431.2026.2725365","url":null,"abstract":"<p><strong>Introduction: </strong>In patients who survive out-of-hospital cardiac arrest (OHCA), guidelines for implantation of an implantable cardioverter-defibrillator (ICD) are not unequivocal.</p><p><strong>Methods: </strong>Patients resuscitated from OHCA of cardiac cause, without a reversible cause and an expected survival >1 year, were identified (year 2007-2011). Patients with acute coronary syndrome (ACS) and primary arrhythmia were compared with respect to: (1) incidence of early ICD-implantation prior to hospital discharge, (2) first shock- and anti-tachycardia (ATP) therapy up to 5 years, and (3) 5-year mortality rate assessed by Cox-regression analyses.</p><p><strong>Results: </strong>ACS patients (<i>n</i> = 256) less often had an ICD implanted compared to primary arrhythmia patients (<i>n</i> = 258) (30% vs. 82%). Cumulative 5-year incidence of appropriate ICD-therapy did not differ (ATP; ACS: 28% vs. primary arrhythmia: 27%, shock; ACS: 22% vs. primary arrhythmia: 29%). Crude 5-year mortality was lower in ICD patients; ACS: No ICD: 22% vs. ICD: 13%; primary arrhythmia: No ICD; 66% vs. ICD: 16%. No difference in mortality between patients was noted (adjusted hazard ratio (HR_ACS): 0.91, 95% CI: 0.50-1.67). ICD implantation was independently associated with lower 5-year mortality risk in both patient groups after adjusting for cause of arrest, age > 65 years, left ventricular ejection fraction (LVEF) ≤35%, sex, and successful revascularization (in ACS only) (HR_ACS: 0.35, CI: 0.17-0.73, HR_PA: 0.15, CI: 0.08-0.27).</p><p><strong>Conclusions: </strong>Cumulative incidences of appropriate therapy did not differ according to cause of arrest. Implantation of an early ICD after OHCA was significantly and independently associated with a lower 5-year mortality risk in both ACS and primary arrhythmia patients.</p>","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":" ","pages":"2725365"},"PeriodicalIF":1.4,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040514","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":"Completeness and interrater reliability of the Norwegian National Electrophysiology and Ablation Registry (AblaNor).","authors":"Vegard Vavik, Kristina Skåre, Mary Autenried, Erik Lyseggen, Farzad Vahedi, Brage Høyem Amundsen, Christian van den Heuvel, Eva Torsvik, Peter Schuster","doi":"10.1080/14017431.2026.2690760","DOIUrl":"10.1080/14017431.2026.2690760","url":null,"abstract":"<p><p><i>Objectives</i>. Data quality is a prerequisite for the use of registries. National Registry for Ablation and Electrophysiology in Norway (AblaNor) is a nationwide medical quality register of Norwegian patients undergoing electrophysiology (EP) examination and ablation. The aim of this study is to assess the coverage of registrations and completeness and reliability variables in AblaNor. <i>Design.</i> National coverage was assessed by comparing EP patients registered in the Norwegian Patient Registry (NPR) and AblaNor in 2021. Completeness of AblaNor registrations was calculated by examining fraction of missing data in key variables. To study reliability, 13 dummy patients were invented and distributed to electrophysiologists in all five EP-centres in Norway. Interrater reliability between the five ratings was assessed for categorical variables by calculating observed percent agreement (PA), Gwet's agreement coefficient (AC1, AC2) and Krippendorff's alpha (K alpha) coefficient. The intraclass correlation coefficient (ICC) was calculated for continuous variables. <i>Results.</i> National coverage was high (93%) with excellent variable completeness (99%). Most variables showed almost perfect (AC₁ 0.8) or substantial (AC₁ 0.61-0.80) reliability. <i>Conclusions.</i> Data in AblaNor shows very good national coverage and completeness of data, with a high degree of reliability for most variables.</p>","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":" ","pages":"2690760"},"PeriodicalIF":1.4,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148272607","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 novel risk score based on exercise capacity to predict prognosis in adults with congenital heart disease.","authors":"Sandra Dalman-Skogby, Urban Wiklund, Anna Wikner, Daniel Rinnström, Christina Christersson, Peder Sörensson, Aleksandra Trzebiatowska-Krzynska, Zacharias Mandalenakis, Joanna Hlebowicz, Camilla Sandberg, Bengt Johansson","doi":"10.1080/14017431.2026.2690782","DOIUrl":"10.1080/14017431.2026.2690782","url":null,"abstract":"<p><strong>Background: </strong>Exercise capacity (EC) is a key prognostic indicator in adults with congenital heart disease (ACHD), closely associated with all-cause mortality. Thus, EC may serve a valuable tool for risk-stratification in ACHD. We propose a novel risk score incorporating EC, age, and lesion complexity to improve mortality risk prediction in ACHD.</p><p><strong>Methods: </strong>This observational study utilized data from the Swedish National Register of Congenital Heart Disease. Adults aged 18 to 60 years who had completed at least one bicycle ergometer exercise test were included. EC was classified according to percentage of predicted capacity (% ECpred): normal (>70%), moderately impaired (50-70%), severely impaired (<50%). Patients were followed for ten years or until death. Odds ratios for mortality were used to derive a 5-point risk-score to estimate 10-year mortality, with the following point allocation: % ECpred 50-70 = 1 point, <50% = 2 points; age 25-40 years = 1 point, 40-60 years = 2 points; moderate/severe lesion complexity = 1 point. Internal validation of risk score resulted in a median AUC of 0.72 for training data, and 0.70 for test data.</p><p><strong>Results: </strong>In total, 1,525 patients (mean age 31.1 ± 11.8 years; 44% women) were included, where 104 deaths occurred during follow-up. Risk scores ranged from 0 to 5, corresponding to 10-year mortality rates of 1%, 3%, 5%, 10%, 18%, and 34%, respectively.</p><p><strong>Conclusion: </strong>A simple risk score incorporating exercise capacity, age, and congenital heart lesion complexity can effectively stratify ACHD patients to 10-year risk of all-cause mortality following an exercise test.</p>","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":" ","pages":"2690782"},"PeriodicalIF":1.4,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148318793","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":"Response to critical reflections on the ESCAPER study.","authors":"Ola Ekström, Anders Gottsäter, Peter M Nilsson","doi":"10.1080/14017431.2026.2699502","DOIUrl":"10.1080/14017431.2026.2699502","url":null,"abstract":"","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":" ","pages":"2699502"},"PeriodicalIF":1.4,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148397662","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}