IJC Heart and Vasculature最新文献

{"title":"Predictive value of the cardiogenic shock working group-modified SCAI criteria in early-stage heart failure-related cardiogenic shock","authors":"Tijmen H. Ris ,&nbsp;Morsal Atazadah ,&nbsp;Roel Hoek ,&nbsp;Jeroen Hoogland ,&nbsp;Tim Balthazar ,&nbsp;Federico Pappalardo ,&nbsp;Paul Knaapen ,&nbsp;Mariëlle C. van de Veerdonk ,&nbsp;Alexander Nap","doi":"10.1016/j.ijcha.2025.101776","DOIUrl":"10.1016/j.ijcha.2025.101776","url":null,"abstract":"<div><h3>Background</h3><div>The Cardiogenic Shock Working Group-modified Society for Cardiovascular Angiography and Interventions (CSWG-SCAI) has been validated in patients with cardiogenic shock (CS) related to heart failure (HF). Its prognostic value in patients with early-stage HF-CS has been scarcely investigated.</div></div><div><h3>Methods</h3><div>In 208 patients with HF-CS, the relationship between the CSWG-SCAI stage at diagnosis, at 24 and 48 h, the maximum CSWG-SCAI stage, and in-hospital mortality were assessed. In addition, the added value of urine output (UO) to the CSWG-SCAI was evaluated.</div></div><div><h3>Results</h3><div>At HF-CS diagnosis, stages A and B were most prevalent (33 % and 36 %), while stage C dominated at 24 h (51 %), 48 h (44 %) and maximum CSWG-SCAI (37 %). In total, 87 (42 %) patients died during hospitalization. At HF-CS diagnosis, lower stages (A/B) showed similar prognostic value compared to more severe stages (C/D/E) (p = 0.994). The CSWG-SCAI was associated with in-hospital mortality at 24 h (p = 0.005), 48 h (p = 0.005) and at maximum CSWG SCAI (p &lt; 0.001). Stage deterioration after 24 h was associated with mortality (deteriorated vs. improved: p &lt; 0.001). SCAI-UO showed modest additive predictive value at 48 h (AUC 0.67 vs. AUC 0.70; p = 0.015) and maximum SCAI compared to CSWG-SCAI (AUC 0.66 vs. AUC 0.69; p = 0.032).</div></div><div><h3>Conclusions</h3><div>At the time of HF-CS diagnosis, the CSWG-SCAI classification failed to predict in-hospital mortality, suggesting that it may not adequately capture the severity of early-stage HF-CS. The CSWG-SCAI classification was associated with in-hospital mortality at 24 and 48 h and at maximum CSWG-SCAI. Incorporating UO into the CSWG-SCAI criteria minimally improved risk stratification.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"60 ","pages":"Article 101776"},"PeriodicalIF":2.5,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144895917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid beta-blocker up-titration enhances cardiac adrenergic innervation improvement in dilated cardiomyopathy","authors":"Ewa Dziewięcka ,&nbsp;Katarzyna Holcman ,&nbsp;Magdalena Kostkiewicz ,&nbsp;Wojciech Szot ,&nbsp;Sylwia Wiśniowska-Śmiałek ,&nbsp;Mateusz Winiarczyk ,&nbsp;Natalia Przytuła ,&nbsp;Agnieszka Stępień-Wroniecka ,&nbsp;Katarzyna Graczyk ,&nbsp;Małgorzata Mazur ,&nbsp;Agata Leśniak-Sobelga ,&nbsp;Jarosław Gąsiorek ,&nbsp;Agnieszka Czapska ,&nbsp;Jan Jamroś ,&nbsp;Karolina Garlicka ,&nbsp;Paweł Rubiś","doi":"10.1016/j.ijcha.2025.101784","DOIUrl":"10.1016/j.ijcha.2025.101784","url":null,"abstract":"","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"60 ","pages":"Article 101784"},"PeriodicalIF":2.5,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144895918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary vasodilator capacity in obesity and morbid obesity – divergent flow responses with left ventricular hypertrophy","authors":"Elgin Ozkan ,&nbsp;Liya Dai ,&nbsp;Farrokh Dehdashti ,&nbsp;Kan Liu ,&nbsp;Thomas H. Schindler","doi":"10.1016/j.ijcha.2025.101785","DOIUrl":"10.1016/j.ijcha.2025.101785","url":null,"abstract":"<div><h3>Background</h3><div>To investigate the relationship between coronary vasodilator capacity, left ventricular hypertrophy, and regional myocardial function in two different disease entities of obese (OB) and morbidly obese (MOB) individuals.</div></div><div><h3>Methods</h3><div>¹³N-ammonia PET/CT determined myocardial blood flow (MBF) at rest and during pharmacologically induced hyperemia, and corresponding myocardial flow reserve (MFR) with ¹³N-ammonia PET/CT. Left ventricular mass (LVM), early diastolic flow (E), relaxation (e’) velocities, and global longitudinal strain (GLS) were acquired with 2D, <em>trans</em>-mitral Doppler and tissue Doppler, and speckle tracking echocardiography, respectively. Patients were then grouped according to the body mass index (BMI) into normal weight (NW: BMI 20.0–24.9 kg/m², n = 27), overweight (OW: BMI 25.0–29.9 kg/ m², n = 31), obesity (OB: BMI 30.0–39.9 kg/m², n = 71), and morbid obesity (MOB: BMI ≥ 40 kg/m², n = 97).</div></div><div><h3>Results</h3><div>MFR progressively decreased from NW, OW, to OB (2.71 ± 0.84 vs. 2.50 ± 0.67 and 2.33 ± 0.63; p ≤ 0.04 by ANOVA), while it increased again in MOB comparable to NW (2.51 ± 0.51 vs. 2.71 ± 0.84, p = 0.70). In OB and MOB, MFR was inversely correlated with E velocity (cm/s), respectively (r = 0.32, SEE = 0.58, p = 0.02; and r = 0.29, SEE = 0.47, p = 0.02). Conversely, LVM, and GLS associated significantly and inversely with the MFR in OB (r = 0.27, SEE = 0.59, p = 0.05; and r = 0.31, SEE = 0.61, p = 0.04), but not in MOB, respectively (r = 0.13, SEE = 0.49, p = 0.27; and r = 0.05, SEE = 0.54, p = 0.73). Notably, GLS, E-velocity, and LVM remained independent predictors of MFR.</div></div><div><h3>Conclusion</h3><div>Divergent associations of coronary vasodilator capacity with left ventricular mass and early myocardial contractile dysfunction outline OB and MOB to affect left ventricular remodeling differently.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"60 ","pages":"Article 101785"},"PeriodicalIF":2.5,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144893010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Carbohydrate antigen-125 (CA125): a marker of right ventricular dysfunction and poor prognosis in heart failure with preserved ejection fraction","authors":"Sher May Ng ,&nbsp;Geert H.D. Voordes ,&nbsp;Michelle Lobeek ,&nbsp;Michiel Rienstra ,&nbsp;Adriaan A. Voors ,&nbsp;Elke S. Hoendermis ,&nbsp;Dirk J. van Veldhuisen ,&nbsp;Thomas M. Gorter","doi":"10.1016/j.ijcha.2025.101775","DOIUrl":"10.1016/j.ijcha.2025.101775","url":null,"abstract":"<div><h3>Background</h3><div>Right ventricular (RV) dysfunction (RVD) in heart failure (HF) with preserved ejection fraction (HFpEF) is recognised late and associated with poor outcomes. We aimed to identify biomarkers associated with RV dysfunction in HFpEF and evaluate their prognostic significance.</div></div><div><h3>Methods</h3><div>77 patients with HFpEF were enrolled from a prospective, multicentre study. At baseline, patients underwent echocardiography, cardiac magnetic resonance (CMR) imaging and laboratory testing. They were followed up for the composite outcome parameter of all-cause mortality and HF hospitalisation. RVD was defined as RV ejection fraction (RVEF) &lt; 45 % on CMR. Proteomics analysis was performed using Olink proteomics multiplex panels (CVDII, CVDIII, Inflammatory and Immuno-oncology) with further verification on immunoassay analysis.</div></div><div><h3>Results</h3><div>19 patients with HFpEF (25 %) had RVD. The Olink proteomic analysis identified carbohydrate antigen 125 (CA125) as the most differentially abundant in plasma of patients with HFpEF and RVD as compared to those without RVD, which corroborated with further immunoassay analysis − median CA125 in patients with RVD was 23 kU/L [21–47] vs. 16 [<span><span>[12]</span></span>, <span><span>[13]</span></span>, <span><span>[14]</span></span>, <span><span>[15]</span></span>, <span><span>[16]</span></span>, <span><span>[17]</span></span>, <span><span>[18]</span></span>, <span><span>[19]</span></span>, <span><span>[20]</span></span>] in patients without RVD (p &lt; 0.001). Log-normalised CA125 (LnCA125) was associated with worse RVEF (r = −0.29, p = 0.03) and predicted worse clinical outcomes [HR 2.28 (1.28–4.07) for the composite outcome of all-cause mortality and HF hospitalisation] adjusted for age, gender, body mass index, LVEF, RVD, atrial fibrillation, renal function and NTproBNP.</div></div><div><h3>Conclusion</h3><div>Targeted proteomic analysis reveals CA125 as a biomarker for RVD in a HFpEF population. Higher serum CA125 concentration, but not NTproBNP, was associated with an increased risk of all-cause mortality and HF hospitalisation.</div><div>Word Count: 249.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"60 ","pages":"Article 101775"},"PeriodicalIF":2.5,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144879596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of traditional Chinese exercises on the rehabilitation of patients with chronic heart failure: A meta-analysis","authors":"Yue Wu ,&nbsp;Hong Wang","doi":"10.1016/j.ijcha.2025.101778","DOIUrl":"10.1016/j.ijcha.2025.101778","url":null,"abstract":"<div><div>The systematic <em>meta</em>-analysis was conducted to evaluate the clinical efficacy of Traditional Chinese Exercises (TCE) in the rehabilitation of patients with chronic heart failure (CHF). The findings provide evidence-based support for the implementation of non-pharmacological interventions in the management of CHF. A systematic search of PubMed, Web of Science, Cochrane Library, and Embase (up to November 2024) identified RCTs evaluating Traditional Chinese Exercise (TCE) for chronic heart failure rehabilitation. The Cochrane Risk of Bias Tool assessed study quality. RevMan 5.4 calculated mean differences (MD) with 95 % CIs; heterogeneity was evaluated using the I² statistic (P &lt; 0.05). Fifteen RCTs involving 1,132 patients (573 intervention, 559 control) were included. Meta-analysis revealed that TCE significantly improved CHF outcomes: reduced BNP levels (MD=–38.34, 95 %CI:[–54.88, –21.79], P &lt; 0.00001), increased 6-minute walking distance (MD = 49.75, 95 % CI:[33.86,65.65], P &lt; 0.00001), elevated LVEF (MD = 2.91, 95 % CI:[1.32,4.50], P = 0.0003), and lowered MLHFQ scores (MD = –9.58, 95 % CI:[ –12.75, –6.40], P &lt; 0.00001). NT-pro BNP levels also decreased significantly (MD = –547.14, 95 % CI:[ –698.38, –395.90], P = 0.0001). This <em>meta</em>-analysis demonstrates that traditional Chinese exercises (including Tai Chi, Baduanjin, and Liuzijue) as adjunctive rehabilitation for chronic heart failure patients yield significant clinical benefits compared to conventional treatment alone. The interventions showed marked improvements in cardiac function parameters (BNP, NT-proBNP, and LVEF levels), exercise capacity (6MWT assessment), and quality of life (MLHFQ scores). These findings provide robust evidence for integrating traditional Chinese exercises into comprehensive rehabilitation management for chronic heart failure patients.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"60 ","pages":"Article 101778"},"PeriodicalIF":2.5,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144863467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postprocedural myocardial injury and outcomes following transcatheter aortic valve implantation","authors":"Jeppe K. Petersen ,&nbsp;Lauge Østergaard ,&nbsp;Jarl Emanuel Strange ,&nbsp;Louise Marqvard Sørensen ,&nbsp;Ole de Backer ,&nbsp;Lars Køber ,&nbsp;Emil Fosbøl","doi":"10.1016/j.ijcha.2025.101773","DOIUrl":"10.1016/j.ijcha.2025.101773","url":null,"abstract":"<div><h3>Background</h3><div> <!-->Transcatheter aortic valve implantation (TAVI) has transformed aortic stenosis treatment, yet some patients still experience complications such as post-procedural myocardial injury (PPMI). However, the prognostic significance of PPMI remains unclear. Therefore, this study aimed to investigated the association between post-TAVI cardiac troponin T (cTnT) levels and all-cause mortality.</div></div><div><h3>Methods</h3><div>Using Danish nationwide registries (2014–2023), we identified TAVI patients with recorded cTnT measurements before discharge. PPMI was defined as cTnT ≥ 15 times the upper limit of normal (14 ng/L). One-year mortality was analyzed using multivariable Cox regression and results were further elaborated after stratification on sex, age groups, recent PCI (within 3 months), and eGFR groups.</div></div><div><h3>Results</h3><div>Among 5,187 patients, 866 (16.7 %) had PPMI. Compared to those without PPMI, these patients had longer hospital stays (median 6 vs. 4 days), higher rates of pacemaker implantation (14.2 % vs. 11.4 %), and lower baseline eGFR (54 vs. 63 ml/min). At one year, the cumulative incidence of all-cause mortality was 9.0 % in patients with PPMI versus 6.6 % in those without (p &lt; 0.01. In adjusted analysis, PPMI was associated with an increased risk of one-year mortality (HR 1.36; 95 % CI 1.04–1.77). No effect modification was found irrespective of sex, age groups, or eGFR. However, PPMI patients with recent PCI did not carry an increased rate of mortality (HR 0.88; 95 % CI 0.28–2.75).</div></div><div><h3>Conclusion</h3><div>PPMI following TAVI was linked to higher one-year mortality and myocardial infarction rates, highlighting the need for increased clinical awareness in this patient subgroup.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"60 ","pages":"Article 101773"},"PeriodicalIF":2.5,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144863585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of a deep-learning algorithm for rule-in and rule-out coronary artery disease based on electrocardiogram without evidence of myocardial ischemia","authors":"Runchen Sun ,&nbsp;Xiangqian Zhu ,&nbsp;Shen Lin ,&nbsp;Mengnan Shi ,&nbsp;Xuexin Yu ,&nbsp;Chang Liu ,&nbsp;Yaoguan Yue ,&nbsp;Juntong Zeng ,&nbsp;Yan Zhao ,&nbsp;Xiaoqi Wang ,&nbsp;Xiaocong Lian ,&nbsp;Xin Jin ,&nbsp;Zhe Zheng ,&nbsp;Xiangyang Ji","doi":"10.1016/j.ijcha.2025.101772","DOIUrl":"10.1016/j.ijcha.2025.101772","url":null,"abstract":"<div><h3>Background</h3><div>Current coronary artery disease (CAD) guidelines recommend to rule-out or rule-in patients for further examination by assessing a pretest probability (PTP) ≤ 5 % or ≥ 15 %. We developed and validated a deep-learning algorithm for rule-in or rule-out based on electrocardiogram (ECG) without myocardial ischemia evidence.</div></div><div><h3>Methods</h3><div>Between October 2019 and June 2022, data from two centers (Fuwai Hospital [Beijing] and Yunnan Fuwai Hospital) of CAD-suspected patients undergoing either coronary angiography or coronary computed tomography were used. Data from the Fuwai Hospital (Beijing) were used to train (randomly 90 %) and internally validate (randomly 10 %) a deep-learning algorithm to detect CAD (≥ 70 % stenosis) based on 12-lead ECGs. An algorithm-based decision-making protocol was established for rule-out or rule-in based on a predefined threshold allowing for a 95 % negative predictive value (NPV). Data from the Yunnan Fuwai Hospital were used to externally validate the performance of the decision-making protocol. The CAD prevalence was calculated in patients who were recommended to rule-in or rule-out.</div></div><div><h3>Results</h3><div>In internal validation set, area under the receiver operating characteristic curve (AUC) was 0.81 and the CAD prevalence of patients who were recommended rule-out and rule-in were 5 % (40/790) and 23 % (527/2253), respectively. In external validation set, the CAD prevalence of patients who were recommended rule-out and rule-in were 0 % (0/661) and 15 % (255/1699), respectively.</div></div><div><h3>Conclusions</h3><div>Our algorithm based on ECG without myocardial ischemia evidence performed good in CAD detection. An algorithm-based decision-making protocol could achieve the guideline-recommended performance in guiding rule-out or rule-in for further examination.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"60 ","pages":"Article 101772"},"PeriodicalIF":2.5,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144852626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of intravenous methotrexate carried by lipid nanoemulsion in patients with anterior ST-elevation myocardial infarction","authors":"Aline G. Ferrari ,&nbsp;Raul C. Maranhão ,&nbsp;Rocío Salsoso ,&nbsp;Vanessa M.G.T.F. Baldo ,&nbsp;Remo H.M. Furtado ,&nbsp;Talia F. Dalçóquio ,&nbsp;Carlos A.K. Nakashima ,&nbsp;Luciano M. Baracioli ,&nbsp;Felipe G. Lima ,&nbsp;Aleksandra T. Morikawa ,&nbsp;Gabriela Liberato ,&nbsp;Carlos E. Rochitte ,&nbsp;Cesar H. Nomura ,&nbsp;Roberto Kalil Filho ,&nbsp;Paul M. Ridker ,&nbsp;Robert P. Giugliano ,&nbsp;Marc S. Sabatine ,&nbsp;Thauany M. Tavoni ,&nbsp;Roberto R.C.V. Giraldez ,&nbsp;José C. Nicolau","doi":"10.1016/j.ijcha.2025.101771","DOIUrl":"10.1016/j.ijcha.2025.101771","url":null,"abstract":"<div><h3>Background</h3><div>Inflammation plays a central role in the pathophysiology of ST-elevation myocardial infarction (STEMI), being associated with larger infarct size (IS) and worse left ventricular remodeling (LVR). Methotrexate (MTX) is a potent anti-inflammatory drug with potential benefits in the treatment of STEMI. Experimental studies have suggested that a formulation of MTX incorporated into lipid nanoemulsion (LDE-MTX) could be beneficial and safe.</div></div><div><h3>Objectives</h3><div>To evaluate the efficacy and safety of LDE-MTX in patients with STEMI.</div></div><div><h3>Methods</h3><div>Randomized, double-blinded, placebo-controlled, proof-of-concept study. Patients were randomized 4 ± 2 days after first anterior STEMI to receive LDE-MTX (40 mg/m² intravenous infusion) or LDE-placebo weekly for 6 weeks. The primary efficacy endpoint was left ventricle end-diastolic volume (LVEDV) assessed by cardiac magnetic resonance at 90 ± 7 days post-randomization; the main secondary endpoints were changes in LVEDV, other LVR parameters and IS.</div></div><div><h3>Results</h3><div>Due to the COVID-19 pandemic the study was stopped prematurely, with 32 randomized patients (15 LDE-placebo, 17 LDE-MTX) completing the protocol. At 90 days, there was no difference in LVEDV between groups. Among other secondary endpoints, there appeared to be a greater reduction of IS (%LV) in favor of the LDE-MTX group (−3.9 ± 6.9 vs −9.4 ± 8.4, p = 0.030). LDE-MTX was well tolerated.</div></div><div><h3>Conclusions</h3><div>In patients with STEMI, LDE-MTX appears to be safe but did not influence LVEDV and other LVR parameters, although it possibly reduced infarct size at 90 days. These hypothesis-generating results support further investigation of a novel nanomedicine approach to STEMI in larger trials.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"60 ","pages":"Article 101771"},"PeriodicalIF":2.5,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144827256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in heart rate variability parameters following pulsed-field ablation in patients with atrial fibrillation: A systematic review and meta-analysis HRV changes after pulsed-field ablation in AF","authors":"Xinyi Wang ,&nbsp;Zhicheng Hu ,&nbsp;Yan Yao ,&nbsp;Pakezhati Maimaitijiang,&nbsp;Aiyue Chen,&nbsp;Lihui Zheng","doi":"10.1016/j.ijcha.2025.101766","DOIUrl":"10.1016/j.ijcha.2025.101766","url":null,"abstract":"<div><h3>Introduction</h3><div>Atrial fibrillation (AF) is a prevalent cardiac arrhythmia. Pulmonary vein isolation (PVI) is a cornerstone for catheter ablation for AF. Most recently, pulsed-field ablation (PFA) has emerged as a novel technique that minimizes tissue damage due to its tissue selectivity with promising clinical success. Despite its promise, the impact of PFA on cardiac autonomic function following PVI, particularly heart rate variability (HRV), and the differences between catheter ablation (CA) techniques, remain unclear.</div></div><div><h3>Methods</h3><div>Following PRISMA guidelines, we conducted a systematic review and <em>meta</em>-analysis to evaluate changes in HRV parameters in three months post-catheter ablation using PFA, cryoballoon (CRYO), and radiofrequency (RF) ablation techniques. We searched databases including PubMed, Embase, Scopus, and Web of Science for relevant studies, focusing on HRV metrics such as SDNN, LF and HF in AF patients undergoing CA.</div></div><div><h3>Results</h3><div>Our <em>meta</em>-analysis included 35 studies involving 6,267 AF patients. The results demonstrated a significant increase in heart rate and a decrease in HRV parameters such as SDNN and LF following CA in three months. Subgroup analyses revealed variations across ablation techniques, with PFA showing a milder impact on autonomic function compared to CRYO and RF. Notably, PFA was associated with a lower AF recurrence rate, suggesting superior therapeutic efficacy.</div></div><div><h3>Conclusion</h3><div>PFA demonstrates a lower effect on cardiac autonomic function than the other two ablation techniques in three months. Notably, PFA showed a trend toward superior treatment outcomes, which may inform future choices of ablation technique for PVI in AF management. Further research is warranted to explore long-term autonomic effects and optimize treatment protocols.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"60 ","pages":"Article 101766"},"PeriodicalIF":2.5,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144827692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of clinical outcomes between catheter ablation and permanent pacemaker implantation in Tachycardia-Bradycardia Syndrome patients: a meta-analysis","authors":"Sunu Budhi Raharjo ,&nbsp;Emir Yonas ,&nbsp;Sarah Naura Irbah ,&nbsp;Dicky Armein Hanafy ,&nbsp;Muhammad Rizky Felani ,&nbsp;Aldo Ferly ,&nbsp;Fa Po Chung","doi":"10.1016/j.ijcha.2025.101767","DOIUrl":"10.1016/j.ijcha.2025.101767","url":null,"abstract":"<div><h3>Introduction</h3><div>Tachycardia-Bradycardia Syndrome (TBS) is a clinical disorder resulting from complications associated with sick sinus syndrome (SSS). In patients with SSS, TBS is marked by alternating episodes of tachycardia and bradycardia. This <em>meta</em>-analysis aims to evaluate and compare the differences in clinical outcomes between ablation and pacemaker treatments for TBS.</div></div><div><h3>Methods</h3><div>We performed a systematic search on libraries, including PubMed, EuropePMC, SCOPUS, Cochrane Central, and medRxiv, for preprint studies. The search terms used were “Tachycardia Bradycardia Syndrome,” “Pacing,” and “Ablation” between the pacing and ablation groups in TBS patients. Review Manager Software Version 5.4 (Cochrane Collaboration) was used to perform the <em>meta</em>-analysis.</div></div><div><h3>Results</h3><div>We identified 1,138 potential articles from our search, and 521 duplicates were removed. After screening the titles and abstracts of the remaining 662 articles, we obtained 23 potentially relevant articles. Finally, we included the remaining eight studies in our qualitative synthesis and <em>meta</em>-analysis, which comprised 1,266 patients.</div><div>Catheter ablation was associated with a lower incidence of AF recurrence (OR of 0.09 [0.04, 0.22; p &lt; 0.001], with moderate heterogeneity (I² = 76 %, p &lt; 0.001), stroke (OR of 0.28 [0.14, 0.53; p &lt; 0.001] low heterogeneity I² = 0 %, p = 0.99 favouring the ablation group.) and lower mortality (OR of 0.37 [0.17, 0.80; p0.01] low heterogeneity I² = 0 %, p = 0.84 favouring the ablation group), compared to those who underwent pacemaker implantation in patients with TBS.</div></div><div><h3>Conclusion</h3><div>Catheter ablation resulted in a lower incidence of AF recurrence, stroke, and mortality compared to the pacemaker in TBS patients. There was no difference between groups regarding procedure-related complications and cardiovascular rehospitalization.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"60 ","pages":"Article 101767"},"PeriodicalIF":2.5,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144813975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}