IJC Heart and Vasculature最新文献

{"title":"Spontaneous echo contrast in the left atrial appendage is linked to a higher risk of thromboembolic events and mortality in patients with atrial fibrillation","authors":"Jan Traub ,&nbsp;David Hettesheimer ,&nbsp;Jule Pinter ,&nbsp;Floran Sahiti ,&nbsp;Georg Fette ,&nbsp;Carsten Henneges ,&nbsp;Caroline Morbach ,&nbsp;Sebastian Herrmann ,&nbsp;Frank Puppe ,&nbsp;Anna Frey ,&nbsp;Stefan Störk ,&nbsp;Martin Christa","doi":"10.1016/j.ijcha.2024.101590","DOIUrl":"10.1016/j.ijcha.2024.101590","url":null,"abstract":"<div><h3>Background</h3><div>Cardioversion, a rhythm control treatment for atrial fibrillation (AF), requires ruling out cardiac embolic sources, often originating from the left atrial appendage (LAA). Transesophageal echocardiography (TEE) is used for LAA evaluation, but it is invasive and not widely available. This study aimed to identify cardiovascular risk factors linked to LAA abnormalities and predictors of thromboembolic events and all-cause mortality.</div></div><div><h3>Methods</h3><div>A single-center retrospective analysis included AF patients admitted to the University Hospital Würzburg between 2009 and 2018 undergoing TEE.</div></div><div><h3>Results</h3><div>Among 2400 AF patients (median age 72; 36 % women), 469 (20 %) had LAA abnormalities: 282 (60 %) had spontaneous echo contrast (SEC), 72 (15 %) had thrombus formation (THR), and 115 (25 %) had both. Predictors of LAA abnormalities included age (OR 1.04; p = 0.002), congestive heart failure (OR 1.70; p = 0.009), diabetes (OR 1.74; p = 0.007), stroke history (OR 3.36; p = 0.001), vascular disease (OR 1.57; p = 0.026), elevated alkaline phosphatase (OR 1.15; p = 0.003), prior VKA intake (OR 1.53; p = 0.002), and DOAC intake (OR 0.57; p = 0.038). SEC with or without THR independently predicted thromboembolic events (HR 1.74, p = 0.031 and HR 1.53, p = 0.006) and all-cause mortality (HR 1.77, p = 0.011 and HR 1.57, p = 0.002), adjusted for cardiovascular risk factors, anticoagulation, and laboratory data.</div></div><div><h3>Conclusions</h3><div>In AF patients undergoing TEE, SEC, often overlooked in cardioversion decisions, independently predicted thromboembolic events and mortality.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"56 ","pages":"Article 101590"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11742588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013345","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":"Glycemic control after aortic valve replacement: A retrospective study","authors":"Yuval Avidan ,&nbsp;Amir Aker ,&nbsp;Ibrahim Naoum ,&nbsp;Nili Stein ,&nbsp;Sameer Kassem","doi":"10.1016/j.ijcha.2024.101596","DOIUrl":"10.1016/j.ijcha.2024.101596","url":null,"abstract":"<div><h3>Background</h3><div>Aortic stenosis (AS) is treated through transcatheter aortic valve implantation (TAVI) or surgical aortic valve replacement (SAVR), with diabetes being prevalent among these patients. Inflammation participates in the pathogenesis of AS, and emerging evidence suggests that TAVI may exert anti-inflammatory effects. Given the established link between diabetes and inflammation, we sought to evaluate the impact of aortic valve replacement (AVR) on glycemic control.</div></div><div><h3>Methods</h3><div>Data from 10,129 consecutive patients undergoing either TAVI or SAVR between January 2010 and January 2022 were analyzed. Of these, 3,783 with diabetes had available pre- and post-procedural glycated hemoglobin (HbA1c) measurements. Analysis of 1,284 individuals with HbA1c ≥ 7 % was conducted. Propensity-score matching produced two well-matched cohorts of 266 TAVI and SAVR patients, enabling comparison of periprocedural HbA1c.</div></div><div><h3>Results</h3><div>In the total cohort (n = 1,284), HbA1c decreased from 8.15 ± 1.12 to 7.88 ± 1.38 (p &lt; 0.001). After matching, the TAVI group showed a significant reduction from 8.31 ± 1.31 to 7.86 ± 1.56 (p &lt; 0.001), while a modest decrease from 8.33 ± 1.33 to 8.15 ± 1.61 (p = 0.046) was observed in SAVR group. The TAVI group showed a trend toward a greater percentage change in HbA1c (p = 0.051). Clinically meaningful improvement in HbA1c (≥ 0.3 %) was similar between TAVI (53.1 %) and SAVR (45.6 %) patients (OR = 1.34, 95 % CI 0.93–1.95).</div></div><div><h3>Conclusions</h3><div>Management of AS through either intervention improved post-procedural glycemia in patients with uncontrolled diabetes. The extent of glycemic improvement was more pronounced with TAVI. Further investigations through controlled and prospective studies could provide more conclusive insights into this matter.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"56 ","pages":"Article 101596"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11754825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029831","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":"Progress in the application of cardiac magnetic resonance to predict recurrence of atrial fibrillation after catheter ablation: A systematic review and meta-analysis","authors":"Cuncun Yu ,&nbsp;zhenjuan Liu ,&nbsp;shiyu Zhu","doi":"10.1016/j.ijcha.2025.101603","DOIUrl":"10.1016/j.ijcha.2025.101603","url":null,"abstract":"<div><h3>Background</h3><div>This systematic review and <em>meta</em>-analysis aimed to assess changes in left atrial structure and function at baseline and after catheter ablation and their association with atrial fibrillation recurrence using cardiac magnetic resonance imaging (MRI).</div></div><div><h3>Methods</h3><div>As of June 2024, a total of 3086 articles have been obtained through searching PubMed, Embase, and Cochrane databases. Standard mean differences and 95% confidence intervals were used to examine structural and functional changes of left atrium after catheter ablation and their relationship with recurrence of atrial fibrillation.</div></div><div><h3>Results</h3><div>A total of 13 prospective cohort studies were included in the analysis. Decreased left atrial emptying capacity is seen in the short term after catheter ablation, and structural changes in the left atrium are seen in the long term (EFActive: SMD, 1.23, 95 % CI, 1.10–2.36, p &lt; 0.05; EFTotal: SMD, 0.83, 95 % CI, 0.02–1.64, p &lt; 0.05; MinLAV: SMD, 0.30, 95 % CI, 0.01–0.59, p &lt; 0.05). Decrease in left atrial volume after catheter ablationis positively associated with the risk of recurrence of atrial fibrillation. (MaxLAV: SMD, 1.27, 95 % CI, 0.05, 2.49, p &lt; 0.05; MaxLAVi: SMD, 0.48, 95 % CI, 0.05,0.9, p &lt; 0.05;MinLAVi: SMD, 0.78, 95 % CI, 0.39,1.16, p &lt; 0.05). The larger the left atrial volume and the lower the emptying and strain function, the greater the likelihood of recurrence of atrial fibrillation following catheter ablation, (MaxLAV: SMD, 0.38, 95 % CI, 0.18,0.59, p &lt; 0.05;MinLAV: SMD, 0.83,95 % CI, 0.41,1.24, p &lt; 0.05; MaxLAVi: SMD, 0.35, 95 % CI, 0.21,0.50, p &lt; 0.05;MinLAVi: SMD, 0.62, 95 % CI, 0.47,0.78, p &lt; 0.05; EFPassive: SMD, −0.57, 95 % CI, −0.78, −0.37, p &lt; 0.05; EFActive: SMD, −0.62, 95 % CI, −1.08, −0.15, P &lt; 0.05; EFTotal: SMD, −0.70, 95 % CI, −0.97, −0.44, P &lt; 0.05; ℇCT: SMD, −0.61, 95 % CI, −0.90, −0.32, p &lt; 0.05; PLAS: SMD, −1.22, 95 % CI, −1.87, −0.57, p &lt; 0.05; ℇR: SMD, −0.50, 95 % CI, −0.79, −0.21, p &lt; 0.05; PLAS: SMD, −1.22, 95 % CI, −1.87, −0.57, p &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Short-term left atrial functional impairment can be observed after catheter ablation, while long-term reduction in left atrial volume can be seen. Changes in left atrial volume are likely to lead to the recurrence of atrial fibrillation, while alterations in left atrial function help maintain sinus rhythm. Larger left atrial volume and lower emptying and strain function at baseline assessment by cardiac magnetic resonance are more likely to lead to recurrence of atrial fibrillation after catheter ablation, which may be useful to identify those for whom catheter ablation has reduced success or for whom more aggressive ablation or medications may be useful.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"56 ","pages":"Article 101603"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11787533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081428","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":"Is nifekalant more effective than amiodarone in improving the clinical outcomes of catheter ablation in patients with persistent atrial fibrillation?","authors":"Tingqiong Ma ,&nbsp;Chunxia Zhao ,&nbsp;Luyun Wang ,&nbsp;Yang Bai ,&nbsp;Lei Lei ,&nbsp;Li Ni ,&nbsp;Mei Hu ,&nbsp;Guangzhi Chen ,&nbsp;Yan Wang","doi":"10.1016/j.ijcha.2025.101612","DOIUrl":"10.1016/j.ijcha.2025.101612","url":null,"abstract":"<div><h3>Background</h3><div>Traditionally, amiodarone or electrical cardioversion was used if radiofrequency catheter ablation (RFCA) could not terminate atrial fibrillation during the procedure in patients with persistent atrial fibrillation (PeAF).</div></div><div><h3>Objective</h3><div>To investigate whether the nifekalant instead of amiodarone during RFCA improve procedure outcomes in patients with PeAF.</div></div><div><h3>Methods</h3><div>This study enrolled patients with PeAF who failed to achieve cardioversion after initial ablation at our center between January 2020 and December 2022. These patients were classified into the nifekalant (N) group and the amiodarone (A) group. And patients were followed for 1 year to evaluate long-term success rates. Subgroup analyses and the logistic regression analyses were performed.</div></div><div><h3>Results</h3><div>The study comprised 300 participants and included N (n = 121) and A (n = 179) groups. Following propensity score matching (PSM), 101 participants were in each group. Within the N and A groups, 57(56.44 %) and 19(18.81 %) cases successfully terminated AF, 45 (44.56 %) and 15(14.85 %) cases achieved conversion to atrial tachycardia (P &lt; 0.001), respectively. The ventricular tachycardia was observed in only one case in the N group (P &gt; 0.05). The follow-up results demonstrated that one-year success rates were 63.37 % and 49.50 % for the N and A groups (P &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>For patients with PeAF that persists after initial catheter ablation, compared to amiodarone, administration of nifekalant could convert atrial fibrillation into atrial tachycardia, following by target ablation, has the potential to improve the procedure outcomes.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"56 ","pages":"Article 101612"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143474940","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":"Sudden cardiac death associated with fatty liver disease","authors":"Jonathan Vo ,&nbsp;Thien T.T.T. Truyen ,&nbsp;Audrey Uy-Evanado ,&nbsp;Arayik Sargsyan ,&nbsp;Harpriya Chugh ,&nbsp;Christopher Young ,&nbsp;Sean Hurst ,&nbsp;Christina Y. Miyake ,&nbsp;Kyndaron Reinier ,&nbsp;Sumeet S. Chugh","doi":"10.1016/j.ijcha.2025.101602","DOIUrl":"10.1016/j.ijcha.2025.101602","url":null,"abstract":"<div><h3>Background</h3><div>Fatty liver disease or steatotic liver disease (SLD) affects 25% of the global population and has been associated with heart disease. However, there is a lack of postmortem studies in the context of sudden cardiac death (SCD).</div></div><div><h3>Objectives</h3><div>To investigate the relationship between SLD and SCD.</div></div><div><h3>Methods</h3><div>A post-mortem case-case study was conducted in victims of SCD from an ongoing community-based study in Southern California (Ventura, CA, 2015–2023). Diagnosis of SLD was determined from post-mortem liver histopathology reports. For each patient, demographic variables, laboratory values, and presence of co-morbidities were ascertained from medical records and were compared between patients with and without SLD.</div></div><div><h3>Results</h3><div>Of 162 individuals with SCD, there were 101 SLD cases and 61 without SLD. Individuals with SLD were found to have higher BMI (31.6 ± 7.6 vs. 26.7 ± 5.7, p &lt; 0.001), higher prevalence of heavy drinking (28 % vs. 12 %, p = 0.008), heavier liver weights (2433.6 g ± 940.6 vs 1934.7 g ± 505.3, p &lt; 0.001), and were more often Hispanic (37 vs. 18 %, p = 0.01). Patients with SLD had lower prevalence of coronary artery disease (CAD) (49 % vs. 70 %). Multivariable logistic regression analysis showed that CAD was a negative predictor of SCD with SLD (OR = 0.35, 95 % CI 0.14 – 0.83).</div></div><div><h3>Conclusion</h3><div>Among adults with SCD, SLD was associated with higher prevalence of Hispanic ethnicity and lower prevalence of CAD. Given the major rise in SLD burden, these ethnicity-based differences as well as the specific nature of non-ischemic SCD etiologies warrant urgent further investigation.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"56 ","pages":"Article 101602"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11759637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048185","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":"Prognostic value of left atrial stiffness in patients undergoing transcatheter aortic valve implantation","authors":"Hiroki Usuku ,&nbsp;Eiichiro Yamamoto ,&nbsp;Ryudai Higashi ,&nbsp;Atsushi Nozuhara ,&nbsp;Yuichiro Shirahama ,&nbsp;Fumi Oike ,&nbsp;Noriaki Tabata ,&nbsp;Masanobu Ishii ,&nbsp;Shinsuke Hanatani ,&nbsp;Tadashi Hoshiyama ,&nbsp;Hisanori Kanazawa ,&nbsp;Yuichiro Arima ,&nbsp;Hiroaki Kawano ,&nbsp;Yasuhiro Izumiya ,&nbsp;Yasuhito Tanaka ,&nbsp;Kenichi Tsujita","doi":"10.1016/j.ijcha.2024.101559","DOIUrl":"10.1016/j.ijcha.2024.101559","url":null,"abstract":"<div><h3>Aim</h3><div>This study was performed to evaluate the association between left atrial (LA) stiffness and outcomes in patients undergoing transcatheter aortic valve implantation (TAVI).</div></div><div><h3>Methods and Results</h3><div>This study involved 279 patients with aortic stenosis (AS) who underwent TAVI at Kumamoto University Hospital between 2015 and 2023. During a median follow-up of 468 days (interquartile range: 258–825 days), 42 deaths occurred. Pre-TAVI echocardiography showed that the LA stiffness index (E/e′ ratio/LA strain during the reservoir phase [LASr]) was significantly higher in the all-cause death group than in the survival group (2.80 ± 2.56 vs. 1.70 ± 1.23, p &lt; 0.01). Multivariate Cox proportional hazard analysis identified LA stiffness as significantly and independently associated with all-cause death after adjusting for body mass index, <em>trans</em>-aortic valve velocity, atrial fibrillation, log-transformed high-sensitivity cardiac troponin T (hazard ratio [HR]: 1.31, 95 % confidence interval [CI]: 1.14–1.51, p &lt; 0.01), tricuspid regurgitation, left ventricular global longitudinal strain (HR: 1.24, 95 % CI: 1.06–1.44, p &lt; 0.05), and LASr (HR: 1.27, 95 % CI: 1.05–1.60, p &lt; 0.05). Receiver operating characteristic analysis showed that the optimal cutoff value of the LA stiffness index for predicting all-cause mortality was 1.69 (sensitivity: 60 %, specificity: 62 %, area under the curve: 0.64). Kaplan–Meier analysis demonstrated that patients with a high LA stiffness index (≥1.69) had a significantly higher probability of all-cause death (p &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Estimation of LA stiffness provides significant prognostic value in patients with AS undergoing TAVI, even after adjusting for multiple predictive factors.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"56 ","pages":"Article 101559"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984951","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":"Observational study of sudden cardiac arrest risk (OSCAR): Rationale and design of an electronic health records cohort","authors":"Kyndaron Reinier ,&nbsp;Harpriya S. Chugh ,&nbsp;Audrey Uy-Evanado ,&nbsp;Elizabeth Heckard ,&nbsp;Marco Mathias ,&nbsp;Nichole Bosson ,&nbsp;Vinicius F. Calsavara ,&nbsp;Piotr J. Slomka ,&nbsp;David A. Elashoff ,&nbsp;Alex A.T. Bui ,&nbsp;Sumeet S Chugh","doi":"10.1016/j.ijcha.2025.101614","DOIUrl":"10.1016/j.ijcha.2025.101614","url":null,"abstract":"<div><h3>Background</h3><div>Out-of-hospital sudden cardiac arrest (SCA) is a major cause of mortality and improved risk prediction is needed. The Observational Study of Sudden Cardiac Arrest Risk (OSCAR) is an electronic health records (EHR)-based cohort study of patients receiving routine medical care in the Cedars-Sinai Health System (CSHS) in Los Angeles County, CA designed to evaluate predictors of SCA. This paper describes the rationale, objectives, and study design for the OSCAR cohort.</div></div><div><h3>Methods and Results</h3><div>The OSCAR cohort includes 379,833 Los Angeles County residents with at least one patient encounter at CSHS in each of two consecutive calendar years from 2016 to 2020. We obtained baseline cohort characteristics from the EHR from 2012 until the start of follow-up, including demographics, vital signs, clinical diagnoses, cardiac tests and imaging, procedures, laboratory results, and medications. Follow-up will continue until Dec. 31, 2025, with an expected median follow-up time of ∼ 7 years. The primary outcome is out-of-hospital SCA of likely cardiac etiology attended by Los Angeles County Emergency Medical Services (LAC-EMS). The secondary outcome is total mortality identified using California Department of Public Health – Vital Records death certificates. We will use conventional approaches (diagnosis code algorithms) and artificial intelligence (natural language processing, deep learning) to define patient phenotypes and biostatistical and machine learning approaches for analysis.</div></div><div><h3>Conclusions</h3><div>The OSCAR cohort will provide a large, diverse dataset and adjudicated SCA outcomes to facilitate the derivation and testing of risk prediction models for incident SCA.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"56 ","pages":"Article 101614"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11787554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081385","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":"Just as “You can’t judge a book by its cover”...","authors":"James A. Reiffel","doi":"10.1016/j.ijcha.2025.101617","DOIUrl":"10.1016/j.ijcha.2025.101617","url":null,"abstract":"","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"56 ","pages":"Article 101617"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143474245","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":"Higher cardiorespiratory fitness levels attenuate but do not negate the heightened risk of sudden cardiac death due to obesity: A prospective cohort study","authors":"Jari A. Laukkanen ,&nbsp;Sudhir Kurl ,&nbsp;Kai Savonen ,&nbsp;Setor K. Kunutsor","doi":"10.1016/j.ijcha.2024.101588","DOIUrl":"10.1016/j.ijcha.2024.101588","url":null,"abstract":"<div><h3>Background</h3><div>Higher levels of CRF have been demonstrated to attenuate or negate the adverse cardiovascular impacts of other risk factors. We aimed to assess the interplay between body mass index (BMI), CRF and sudden cardiac death (SCD) risk.</div></div><div><h3>Methods</h3><div>Body mass index was calculated based on guideline recommendations and CRF assessed using a respiratory gas exchange analyzer during clinical exercise testing at baseline in 2308 men aged 42–61 years of age. Cox regression analysis was used to estimate hazard ratios (HRs) with 95 % confidence intervals (CIs) for SCD.</div></div><div><h3>Results</h3><div>During a median follow-up of 28.1 years, 264 SCDs occurred. Comparing obese vs normal weight category, the multivariable-adjusted HR (95 % CI) for SCD was 1.86 (1.28–2.71). Comparing low vs high CRF levels, the corresponding adjusted HR (95 % CI) for SCD was 1.99 (1.38–2.87). The HRs persisted on mutual adjustment for each exposure. Compared with non-obese and medium–high CRF, obese individuals with low CRF levels had the greatest risk of SCD (HR = 2.90, 95 % CI, 1.98–4.25), which was attenuated but persisted in obese individuals with medium–high CRF levels (HR = 2.02, 95 % CI, 1.08–3.78).</div></div><div><h3>Conclusions</h3><div>There is an interplay between BMI, CRF and SCD risk. Higher CRF levels may attenuate the risk associated with obesity.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"56 ","pages":"Article 101588"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11742585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013326","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":"Sex-specific differences in infective endocarditis: A systematic review and meta-analysis of clinical profiles and management outcomes","authors":"Heba T. Salim ,&nbsp;Yousef A. Hamad ,&nbsp;Huda Alwadiya ,&nbsp;Woroud Siriya ,&nbsp;Baraa Mansour ,&nbsp;Haya Alhadad ,&nbsp;Walid Marouf ,&nbsp;Mohammed Ayyad ,&nbsp;Ragavendar Saravanabavanandan ,&nbsp;Saif Almaghrabi ,&nbsp;Mohammed Al-Tawil ,&nbsp;Assad Haneya","doi":"10.1016/j.ijcha.2025.101607","DOIUrl":"10.1016/j.ijcha.2025.101607","url":null,"abstract":"<div><h3>Background</h3><div>Infective endocarditis (IE) presents significant morbidity and mortality, with potential sex differences in clinical profile and outcomes. This is the first meta-analysis that aims to compare the clinical profile and outcomes of IE between males and females.</div></div><div><h3>Methods</h3><div>We conducted a meta-analysis of nine studies evaluating the clinical profile and outcomes of IE in males versus females extracted from PubMed, EMBASE, SCOPUS, and Cochrane databases up to 1st of Jan 2024.</div></div><div><h3>Results</h3><div>Our meta-analysis revealed notable sex differences in the incidence and complications of IE. Males exhibited a higher incidence of aortic valve IE (RR 1.57, 95 % CI [1.31, 1.88]), surgical indications for IE (RR 1.38, [1.12, 1.70]), Streptococci infection (RR 1.36, [1.04, 1.77]), intracardiac abscess (RR 1.22, [1.05, 1.42]), and Enterococci IE (RR 1.44, [1.28, 1.61]). In contrast, females had a higher incidence of mitral valve IE (RR 0.79, [0.67, 0.94]) and a higher in-hospital mortality rate (RR 0.84, [0.74, 0.96]). No significant sex differences were found in the incidence of valve vegetations, tricuspid valve IE, embolization, and Staphylococcus IE. In-hospital stay was longer in male patients, however, with borderline significance (RR 3.15, [-0.16, 6.45], p = 0.06). In patients who underwent surgery for IE, mortality rates were significantly lower in male patients (RR: 0.67 [0.59, 0.76], p &lt; 0.01).</div></div><div><h3>Conclusions</h3><div>Compared to females, males exhibit higher rates of aortic valve IE, intracardiac abscess, streptococci IE, enterococci IE and IE-related surgery indication. In contrast, females have higher rates of mitral valve IE and in-hospital mortality.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"56 ","pages":"Article 101607"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081436","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}