Vascular Health and Risk Management最新文献

{"title":"Associations of High-Sensitivity Cardiac Troponin T, D-Dimer, and N-Terminal Pro-B-Type Natriuretic Peptide with Subclinical Cardiovascular Dysfunction in the General Population: A Retrospective Cross-Sectional Study.","authors":"Grzegorz K Jakubiak, Natalia Pawlas, Monika Starzak, Agata Stanek, Grzegorz Cieślar","doi":"10.2147/VHRM.S583398","DOIUrl":"https://doi.org/10.2147/VHRM.S583398","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to analyze the relationship between resting high-sensitive serum cardiac troponin T concentration (hs-cTnT), D-dimer, and N-terminal pro-B-type natriuretic peptide (NT-proBNP), measured outside the clinical context of acute illness, and selected parameters related to subclinical cardiovascular (CV) dysfunction in the general population.</p><p><strong>Patients and methods: </strong>This retrospective study included patients hospitalized at the Department of Internal Medicine, Angiology and Physical Medicine, Medical University of Silesia, Katowice, Poland, from January 2023 to May 2024. CV system assessment comprised transthoracic echocardiography, Doppler ultrasound of the carotid and lower extremity arteries, pulse wave velocity (PWV) measurement, ankle-brachial index (ABI) measurement, and toe-brachial index (TBI) measurement.</p><p><strong>Results: </strong>Univariate analysis identified the strongest correlations (R > 0.5) between hs-cTnT and intima-media thickness (IMT) in the common carotid and femoral arteries, PWV, and pulse pressure. In multivariate analysis, hs-cTnT independently accounted for the variability in PWV (<i>β</i> = 0.239; 95% CI: 0.016-0.463; <i>p</i> = 0.036) and central diastolic blood pressure [<i>β</i> = -0.3; 95% CI: (-0.582)-(-0.017); <i>p</i> = 0.038], after adjusting for confounding factors. NT-proBNP independently explained the variability in left atrial volume index (LAVI) (<i>β</i> = 0.257; 95% CI: 0.052-0.462; <i>p</i> = 0.015). D-dimer independently accounted for the variability in log-transformed average E/E' value (<i>β</i> = 0.244; 95% CI: 0.039-0.45; <i>p</i> = 0.02) and log-transformed common femoral IMT value (<i>β</i> = 0.169; 95% CI: 0.0001-0.339; <i>p</i> = 0.05).</p><p><strong>Conclusion: </strong>hs-cTnT, D-dimer, and NT-proBNP, determined in the absence of acute illness, correlate with selected parameters of subclinical CV dysfunction independently of confounding factors such as age, gender, body mass index, diabetes, hypertension, and smoking.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"583398"},"PeriodicalIF":2.8,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13052235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence for Cardiovascular Risk Prediction: An Umbrella Review of Applications and Translational Challenges.","authors":"Razieh Parizad, Juniali Hatwal, Ajit Brar, Rupak Desai, Akash Batta, Bishav Mohan","doi":"10.2147/VHRM.S590502","DOIUrl":"https://doi.org/10.2147/VHRM.S590502","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular diseases (CVDs) remain the leading cause of mortality worldwide. Conventional risk prediction models often demonstrate suboptimal calibration and limited generalizability across populations. Artificial intelligence (AI) approaches, including machine learning (ML) and deep learning (DL), enable integration of multimodal clinical and imaging data for individualized cardiovascular risk estimation.</p><p><strong>Objective: </strong>To evaluate the applications, predictive performance, and translational limitations of AI models for cardiovascular risk prediction within an umbrella review framework.</p><p><strong>Methods: </strong>PubMed, Scopus, and Web of Science were systematically searched for studies published between January 2015 and October 2025 investigating AI-based prediction of cardiovascular outcomes. Eligible designs included randomized controlled trials (RCTs), cohort studies, systematic reviews, and meta-analyses. Predictive performance was the primary outcome, mainly assessed using the area under the receiver operating characteristic curve (AUC). Methodological quality was evaluated using established risk-of-bias tools. From 3500 identified records, 48 studies (8 RCTs, 28 cohort studies, and 12 systematic reviews or meta-analyses) were included in the final analysis.</p><p><strong>Results: </strong>AI models achieved AUC values greater than 0.90 in more than 70% of imaging-based studies. Evidence synthesis showed predominant reliance on internal validation, inconsistent calibration reporting, and limited evaluation of algorithmic fairness. Multimodal data integration improved detection of coronary artery disease (CAD) and heart failure (HF). Wearable monitoring was associated with 18-25% lower hospitalization rates compared with usual care.</p><p><strong>Conclusion: </strong>AI improves predictive accuracy in cardiovascular risk assessment. Despite strong discrimination performance (AUC), methodological heterogeneity, insufficient calibration assessment, algorithmic bias, limited external validation, and regulatory uncertainty remain major barriers to implementation. Clinical translation requires multicenter RCTs, explainable AI frameworks, and standardized reporting guidelines such as Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis Artificial Intelligence (TRIPOD-AI).</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"590502"},"PeriodicalIF":2.8,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13044801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Investigation and Management of the Abdominopelvic Vascular Compression Syndromes in Patients with Ehlers-Danlos Syndrome and Hypermobility Spectrum Disorder.","authors":"Paulina Bruessel, Mogeshni Govender, Gert Frahm-Jensen","doi":"10.2147/VHRM.S592420","DOIUrl":"https://doi.org/10.2147/VHRM.S592420","url":null,"abstract":"<p><strong>Objective: </strong>Abdominopelvic Vascular Compression Syndrome(s) (VCS) are rare disorders with diverse symptoms that appear to occur more frequently in patients with Ehlers-Danlos Syndrome (EDS) and Hypermobility Spectrum Disorder (HSD). The reported associations between EDS/HSD, Postural Orthostatic Tachycardia Syndrome (POTS), and Mast Cell Activation Syndrome (MCAS) further complicate the diagnosis and management of the VCS in this specific patient population. This review summarises the established literature on this complex topic, highlighting these relationships, with the aim to propose a framework for recognising and managing VCS among patients with EDS/HSD. Given the limited body of literature on this topic, we also aim to underscore the need for further research within this specific patient population.</p><p><strong>Methods: </strong>A PRISMA-guided systematic review was conducted using PubMed and Ovid/Medline databases. VCS included Median Arcuate Ligament Syndrome (MALS), Superior Mesenteric Artery Syndrome (SMAS), Nutcracker Syndrome (NCS), and May-Thurner Syndrome (MTS). Given the limited number of studies, small cohort studies and case reports/series were also reviewed.</p><p><strong>Results: </strong>Of 183 screened studies, 62 met the inclusion criteria. Only six studies directly addressed the VCS in EDS/HSD. Five discussed an EDS-POTS association, two described links between MCAS, POTS, and EDS, and five associated POTS with VCS. Only one study explored all four conditions.</p><p><strong>Conclusion: </strong>Evidence suggests an association between EDS/HSD, VCS, POTS, and MCAS but remains limited. Underdiagnosis and delayed treatment are common and underscore the need for multi-disciplinary care. Invasive imaging and interventions appear generally safe in EDS/HSD, excluding vascular EDS, yet robust safety and outcome data and tailored diagnostic or treatment algorithms are lacking and require further investigation.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"592420"},"PeriodicalIF":2.8,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13037643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful Life-Saving Repair of Innominate Vein Injury Secondary to Primary Sternotomy for CABG: A Case Report.","authors":"Abudar Al-Ganadi, Ismail Al-Shameri, Naseem Al-Wsabi, Salem Bashraheel, Ghada Qasem","doi":"10.2147/VHRM.S591425","DOIUrl":"10.2147/VHRM.S591425","url":null,"abstract":"<p><strong>Background: </strong>Iatrogenic injury to the innominate vein during primary sternotomy for open heart surgery is rare but potentially life-threatening. Prompt recognition and structured management are essential to prevent catastrophic hemorrhage and cerebral venous congestion.</p><p><strong>Case presentation: </strong>We report a patient undergoing primary coronary artery bypass grafting (CABG) who sustained a catastrophic rupture of the innominate vein at its confluence with the superior vena cava during sternal retraction. Immediate hemorrhage control was achieved with digital compression and intermittent venous clamping. Temporary decompression was facilitated using a saphenous vein patch to the left brachiocephalic vein. Definitive reconstruction was then performed using prosthetic Dacron grafts: the right brachiocephalic vein was reconstructed in an end-to-end fashion to the distal superior vena cava, while the left brachiocephalic vein was anastomosed to the main graft in a side-to-end configuration. Venous reconstruction was completed prior to the initiation of cardiopulmonary bypass (CPB). CPB was subsequently established to complete CABG, with a total bypass time of 74 minutes and an aortic cross-clamp time of 52 minutes. The postoperative course was favorable. Therapeutic anticoagulation with heparin bridging to warfarin (target INR 2.0-3.0) was instituted. At follow-up, the patient demonstrated no neurological deficits, no clinical evidence of venous congestion, and no signs of graft thrombosis.</p><p><strong>Conclusion: </strong>Although exceedingly rare during primary sternotomy, innominate vein avulsion represents a critical intraoperative event. This case illustrates that rapid hemorrhage control, structured venous reconstruction using prosthetic grafts, and appropriate postoperative anticoagulation can result in favorable outcomes. Awareness of mediastinal venous anatomy and careful sternal technique remain essential preventive measures.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"591425"},"PeriodicalIF":2.8,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13033301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distal Venous Arterialization Modulates Autophagy-Related Markers in Skeletal Muscle in a Rat Hindlimb Ischemia Model.","authors":"Teguh Marfen Djajakusumah, Bethy Suryawathy Hernowo, Pei Ho, Herry Herman, Kiki Lukman, Ronny Lesmana","doi":"10.2147/VHRM.S572547","DOIUrl":"10.2147/VHRM.S572547","url":null,"abstract":"<p><strong>Background: </strong>Distal venous arterialization (DVA) is a surgical option for limb salvage in peripheral arterial disease (PAD) without distal runoff. While increasingly applied, the skeletal muscle response after arterial-venous anastomosis remains unclear. This study evaluated skeletal muscle adaptation following DVA, focusing on autophagy regulation.</p><p><strong>Methods: </strong>This experimental preclinical study evaluated skeletal muscle adaptation following distal venous arterialization (DVA) in a rat hindlimb ischemia model. An experimental microsurgical study was conducted in 30 Wistar rats. Hindlimb ischemia (HLI) was induced by right femoral artery ligation. On day 7, rats were re-operated and divided into DVA, opened ligation (OL), or persistent ligation (HLI) groups, with contralateral limbs serving as sham. On day 14, skeletal muscles were harvested for capillary density (CD31) and Western blot analysis of HIF-1α, AMPK, LC3-II, and p62. Gait analysis (stride length and width) and limb thermography were also performed.</p><p><strong>Results: </strong>At day 7, HLI showed significant stride length reduction (<i>p</i>=0.029) and lower limb temperature (<i>p</i><0.001). By day 14, gait and thermography normalized in DVA and OL but remained impaired in HLI (<i>p</i>=0.041 and <i>p</i><0.001, respectively). Capillary density increased in HLI compared with sham (<i>p</i>=0.031), but not in DVA or OL. HIF-1α and AMPK were elevated in HLI (<i>p</i>=0.016 and <i>p</i>=0.011), while AMPK decreased in DVA (<i>p</i>=0.044). LC3-II expression was reduced in DVA compared with sham and HLI (<i>p</i>=0.002 and <i>p</i>=0.032). No significant differences were observed in p62.</p><p><strong>Conclusion: </strong>DVA enhances skeletal muscle recovery in ischemic limbs and is associated with normalization of hypoxia- and autophagy-related molecular markers.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"572547"},"PeriodicalIF":2.8,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13033198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ambient Cold and Mortality in Pan-Arterial Diseases: A Nationwide Ecological Analysis of CDC WONDER Data.","authors":"Heng Wang, Keyi Fan, Yaling Li, Ziyan Wang, Shule Wang, Guoping Zheng","doi":"10.2147/VHRM.S589152","DOIUrl":"10.2147/VHRM.S589152","url":null,"abstract":"<p><strong>Introduction: </strong>Pan-arterial diseases, including atherosclerosis (AS), aortic aneurysm and dissection (AAD), and peripheral arterial disease (PAD), impose a substantial global health burden. Although ambient temperature has been implicated in individual arterial conditions, its association with mortality across the pan-arterial spectrum remains incompletely understood.</p><p><strong>Objective: </strong>To evaluate the association between ambient temperature and mortality from pan-arterial diseases across the United States.</p><p><strong>Methods: </strong>We analysed mortality data for adults aged ≥25 years with AS, AAD, or PAD in the United States CDC WONDER database from 1999 to 2023. Age-adjusted mortality rates (AAMR) and average annual percent change (AAPC) were estimated. Monthly air-temperature metrics (1999-2023) were linked at the United States Census region level. Seasonal variation was assessed using analysis of variance. Associations between temperature and mortality were examined using Spearman correlation, Poisson regression with lag structures, and distributed lag non-linear models (DLNM), with results expressed as relative risks (RR) per 10°F increase in temperature.</p><p><strong>Results: </strong>Between 1999 and 2023, AAMRs declined for AS, AAD, and PAD, yet mortality burden remained substantial. Mortality from all three conditions was consistently higher in winter than in summer across Census regions. Monthly mean temperature was inversely correlated with crude mortality for pan-arterial diseases (P < 0.05). In the Northeast, cumulative RR per +10°F across lags 0-3 months was 0.919 for AS, 0.945 for AAD, and 0.953 for PAD, with similar patterns observed in other regions. DLNM analyses demonstrated a predominantly cold-related excess risk, with acute effects and regional heterogeneity at higher temperatures.</p><p><strong>Conclusion: </strong>Lower ambient temperatures are associated with increased mortality from pan-arterial diseases in the United States. These findings highlight shared vulnerability to cold exposure across arterial diseases and support winter-focused preventive and healthcare preparedness strategies.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"589152"},"PeriodicalIF":2.8,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13025725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147575652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolving Trends in Carotid Endarterectomy and Stenting in Australia: A 15-Year Analysis in the Post-CREST Era.","authors":"Lakmali Anthony, Madeline Gillies, David Goh","doi":"10.2147/VHRM.S580500","DOIUrl":"10.2147/VHRM.S580500","url":null,"abstract":"<p><strong>Background: </strong>Stroke remains a leading cause of mortality in Australia. Over the past three decades, carotid endarterectomy (CEA) has been the gold standard for stroke prevention in patients with symptomatic high-grade carotid stenosis. Carotid artery stenting (CAS) has emerged as a minimally invasive alternative, particularly for high-risk surgical candidates. This study aims to evaluate national trends in CEA and CAS in Australia over a 15-year period, reflecting evolving practices in the post-CREST era.</p><p><strong>Methods: </strong>A population-level retrospective trend analysis was conducted using Australian Institute of Health and Welfare Procedures Data Cubes to identify CEA and CAS procedures performed between 2009 and 2023. Population-adjusted incidence rates were calculated using data from the Australian Bureau of Statistics. Simple linear regression analysis was used to assess changes in procedure rates overtime.</p><p><strong>Results: </strong>A total of 41,845 carotid interventions were performed during the study period, with males accounting for 70.47% of procedures. CEA comprised the majority of interventions (78.86%), while CAS accounted for 21.14%. The population-adjusted incidence of CEA declined significantly by 0.346 procedures per 100,000 people annually (p < 0.001), consistent across all age groups and genders. Conversely, CAS incidence increased modestly by 0.061 procedures per 100,000 people annually (p = 0.044), with the most significant rise observed in patients aged 60-69 years.</p><p><strong>Conclusion: </strong>This study highlights significant changes in carotid revascularisation practices in Australia, with a marked decline in revascularisation procedures overall, primarily driven by a significant decline in CEA overtime. CAS showed a modest but significant increase over the study period. These findings align with global trends, reflecting the impact of improved medical management, shifting clinical guidelines, and the growing role of minimally invasive techniques. Future research should investigate the clinical outcomes and indications associated with these trends to optimise patient selection and refine management strategies for carotid artery disease.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"580500"},"PeriodicalIF":2.8,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13007701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147514268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Interpretable Machine Learning with SHAP to Assess Dynapenic Abdominal Obesity as a Stroke Risk Predictor: A Prospective Cohort Study.","authors":"Weichen Chen, Ying Cao, Jine Xiao, Dan Wang","doi":"10.2147/VHRM.S591884","DOIUrl":"10.2147/VHRM.S591884","url":null,"abstract":"<p><strong>Background: </strong>Stroke is a major cause of mortality and disability worldwide, with a particularly high burden in China. While dynapenic abdominal obesity (DAO) is associated with adverse cardiometabolic outcomes, its relationship with stroke risk remains unclear. We examined whether DAO predicts stroke using interpretable machine learning in a nationally representative cohort of middle-aged and older Chinese adults.</p><p><strong>Methods: </strong>We analysed prospective data from the China Health and Retirement Longitudinal Study, including 11,207 participants aged ≥ 45 years. Dynapenia was defined as a handgrip strength ≤ 28 kg (men)/≤ 18 kg (women); abdominal obesity was defined as a waist circumference ≥ 90 cm (men)/≥ 80 cm (women). Stroke events were identified via self-reported physician diagnoses. We employed logistic regression, subgroup analyses, multiple machine learning models, and Shapley additive explanations (SHAP) to assess the association and evaluate robustness.</p><p><strong>Results: </strong>Over the 4-year follow-up period, 210 (1.9%) participants experienced stroke. DAO was significantly associated with increased stroke risk (adjusted OR = 1.58, 95% CI: 1.21-2.06). Subgroup analysis demonstrated consistent associations across all subgroups (all interaction <i>p-</i>values > 0.05). XGBoost demonstrated the highest predictive performance (AUC = 0.92, accuracy = 0.84). SHAP analysis ranked DAO as the fourth most important predictor after age, BMI, and residence.</p><p><strong>Conclusion: </strong>DAO was independently associated with an increased risk of stroke, with an interpretable machine learning model further supporting its potential as a predictor. Maintaining muscle strength and managing abdominal obesity may reduce the risk of stroke in older adults. These findings suggest that DAO may serve as a potential risk marker for stroke. Future research, including external validation and implementation studies, is needed before any recommendations for screening or intervention can be made.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"591884"},"PeriodicalIF":2.8,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13006024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147504949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dual Left Atrial Masses Causing Inflow Obstruction: A Rare Presentation of Primary Cardiac Intimal Sarcoma.","authors":"Xian Zhang, Yuejian Zhuo, Dongdong Zhang","doi":"10.2147/VHRM.S596709","DOIUrl":"https://doi.org/10.2147/VHRM.S596709","url":null,"abstract":"<p><strong>Aim: </strong>Primary cardiac intimal sarcoma is a rare entity with a poor prognosis, often requiring distinction from other undifferentiated cardiac sarcomas.</p><p><strong>Case presentation: </strong>A 55-year-old female presented with symptoms of heart failure. Imaging identified dual left atrial masses compromising mitral inflow and pulmonary venous return. Surgical excision was performed, and morphological analysis revealed a high-grade spindle cell sarcoma. Crucially, the diagnostic dilemma was resolved through molecular testing; immunohistochemistry showed diffuse overexpression of MDM2 and CDK4, and fluorescence in situ hybridization (FISH) confirmed the amplification of the <i>MDM2</i> and <i>CDK4</i> loci.</p><p><strong>Conclusion: </strong>This case illustrates the diagnostic utility of MDM2 and CDK4 as specific biomarkers for cardiac intimal sarcoma. It reinforces the necessity of a multidisciplinary approach involving advanced molecular pathology to ensure accurate classification and appropriate management of rare cardiac malignancies.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"596709"},"PeriodicalIF":2.8,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13005582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147499927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction Model for Frailty in Middle-Aged and Older Adults with Cardiovascular Disease.","authors":"Xiaohe Yang, Hui Zhou, Can Huang, Min Yuan, Xuemei Du, Chenhao Zhang","doi":"10.2147/VHRM.S581066","DOIUrl":"https://doi.org/10.2147/VHRM.S581066","url":null,"abstract":"<p><strong>Background: </strong>Frailty is common among patients with cardiovascular disease (CVD) and is associated with adverse clinical outcomes. However, practical tools for predicting frailty risk in middle-aged and older patients with CVD remain limited. This study aimed to develop and validate a prediction model for frailty risk in patients with CVD.</p><p><strong>Methods: </strong>A cross-sectional study was conducted using data from the 2015 China Health and Retirement Longitudinal Study (CHARLS). A total of 1184 participants aged ≥45 years with CVD were included and randomly divided into training and validation cohorts at a 7:3 ratio. Least absolute shrinkage and selection operator (LASSO) regression was used for variable selection, followed by multivariable logistic regression to construct a nomogram model. Model performance was evaluated using receiver operating characteristic (ROC) curves, calibration plots, the Hosmer-Lemeshow test, and decision curve analysis (DCA).</p><p><strong>Results: </strong>Frailty was identified in 148 participants (12.5%). Sleep duration, activities of daily living (ADL), waist circumference, cognitive function, handgrip strength, age, and depression were independent predictors of frailty. The nomogram demonstrated good discrimination, with area under the curve (AUC) values of 0.851 (95% CI: 0.814-0.888) in the training cohort and 0.861 (95% CI: 0.804-0.917) in the validation cohort. Calibration showed good agreement between predicted and observed outcomes (Hosmer-Lemeshow test, P>0.05). DCA indicated favorable clinical utility.</p><p><strong>Conclusion: </strong>This nomogram provides a simple and effective tool for predicting frailty risk in patients with CVD and may facilitate early screening and risk stratification in clinical practice.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"581066"},"PeriodicalIF":2.8,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13005584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147499903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}