IJC Heart and Vasculature最新文献

{"title":"The impact of thrombocytopenia on mortality in infective endocarditis − a meta-analysis","authors":"Nadji Hannachi ,&nbsp;Antoine Mariotti ,&nbsp;Nabila El Gueddari ,&nbsp;Laurence Camoin-Jau","doi":"10.1016/j.ijcha.2025.101760","DOIUrl":"10.1016/j.ijcha.2025.101760","url":null,"abstract":"<div><div>Thrombocytopenia, a condition characterized by low platelet counts, is recognized as a risk factor in various infectious diseases, but it is not commonly included in prognostic scoring systems for infective endocarditis (IE). This <em>meta</em>-analysis aimed to assess the relationship between thrombocytopenia and mortality in patients with IE.</div><div>The study included 25 observational studies (21 retrospective and 4 prospective), covering a total of 110,411 patients diagnosed with IE. The primary outcome was in-hospital mortality associated with thrombocytopenia. Secondary outcomes included the mean difference in platelet counts between survivors and deceased patients, as well as long-term mortality.</div><div>The results demonstrated that patients with thrombocytopenia had significantly higher in-hospital mortality (Odds Ratio [OR]: 1.99; 95 % Confidence Interval [CI]: 1.72–2.31; <em>P</em> &lt; 0.00001). Additionally, patients who died during hospitalization had significantly lower platelet counts compared to survivors (Mean Difference [MD]: −36,750/µL; 95 % CI: −52,570 to −20,920; <em>P</em> &lt; 0.00001). Long-term mortality was also elevated in thrombocytopenic patients (Hazard Ratio [HR]: 2.08; 95 % CI: 1.29–3.34; <em>P</em> = 0.002).</div><div>These findings suggest that thrombocytopenia is significantly associated with both in-hospital and long-term mortality in patients with IE. The notable reduction in platelet counts among deceased patients further emphasizes its prognostic significance. The study highlights the need to consider thrombocytopenia in future prognostic models for IE. However, caution is advised when interpreting these results, and additional research is necessary to confirm these associations.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"60 ","pages":"Article 101760"},"PeriodicalIF":2.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144771620","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":"Quantitative precision in cardiac sarcoidosis imaging: the emerging role of myocardial-to-background ratio in FDG-PET","authors":"Nitish Behary Paray ,&nbsp;Kristian Bailey ,&nbsp;Raheel Ahmed","doi":"10.1016/j.ijcha.2025.101763","DOIUrl":"10.1016/j.ijcha.2025.101763","url":null,"abstract":"","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"60 ","pages":"Article 101763"},"PeriodicalIF":2.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144771617","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":"Association between epicardial adipose tissue imaging characteristics and left atrial appendage thrombus in patients with atrial fibrillation","authors":"Chengyi Li ,&nbsp;Chengchen Zhao ,&nbsp;Bing Wu ,&nbsp;Fandong Zhu ,&nbsp;Chen Yang ,&nbsp;Buyun Xu","doi":"10.1016/j.ijcha.2025.101765","DOIUrl":"10.1016/j.ijcha.2025.101765","url":null,"abstract":"<div><h3>Aim</h3><div>To explore the epicardial adipose tissue (EAT) characteristics associated with left atrial appendage thrombus (LAAT) in patients with atrial fibrillation (AF).</div></div><div><h3>Methods</h3><div>This 1:1 individual-match (by age, sex, CHA₂DS₂-VASc score, and anticoagulant use) study respectively enrolled 95 pairs of patients, comparing those with and without LAAT. EAT parameters derived from cardiac computed tomography angiography (CTA)—including volume, mean CT attenuation (CTmean), and radiomic features—were extracted and analyzed for their association with LAAT.</div></div><div><h3>Results</h3><div>On contrast-enhanced CT, the mean CT attenuation of EAT was significantly higher in patients with LAAT than in those without at both 1 mm (median [IQR]: −75 [−88 to − 71] vs. − 71 [−86 to − 65.5],<!--> <!-->P &lt; 0.01) and 3 mm (median [IQR]: −81 [−83.5 to − 78] vs. − 74 [−77.5 to − 72],<!--> <!-->P &lt; 0.01) from the LAA boundary. However, no significant difference was observed at 5 mm (median [IQR]: −87 [−90 to − 85] vs. − 86 [−89 to − 83],<!--> <!-->P &gt; 0.05). Relative EAT volume was not significantly associated with LAAT. Eight radiomic features were selected using least absolute shrinkage and selection operator (LASSO) regression to generate a radiomics score. The radiomics score was significant associated with LAAT, independent of clinical characteristics and traditional CT parameters of EAT.</div></div><div><h3>Conclusion</h3><div>Imaging characteristics of EAT surrounding the LAA in patients with AF, particularly increased mean CT attenuation and radiomic features, were found to be associated with the presence of LAAT.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"60 ","pages":"Article 101765"},"PeriodicalIF":2.5,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144771618","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":"Assessing the value of routine preprocedural CT angiography in cryoballoon pulmonary vein isolation: a prospective, propensity score–matched study","authors":"Krisztian Istvan Kassa ,&nbsp;Csenge Jurenka ,&nbsp;Zoltan Som ,&nbsp;Csaba Foldesi ,&nbsp;Attila Kardos","doi":"10.1016/j.ijcha.2025.101769","DOIUrl":"10.1016/j.ijcha.2025.101769","url":null,"abstract":"<div><h3>Background</h3><div>We aimed to evaluate the impact of routine preprocedural left atrial and coronary computed tomography angiography (CTA) on procedural strategies and clinical outcomes in patients undergoing cryoballoon pulmonary vein isolation (PVI).</div></div><div><h3>Methods</h3><div>In this prospective, propensity score–matched study, we analyzed patients who underwent cryoballoon PVI at our institution between January 2019 and March 2023. Patients were assigned to either a CTA group, where preprocedural CTA was performed, or a control group, where PVI was guided by fluoroscopy alone. To minimize selection bias, 1:1 propensity score matching (PSM) was applied based on baseline characteristics, including age, sex, left atrial diameter, BMI, and AF type. Coronary artery disease (CAD) was assessed in the CTA group, and three-dimensional left atrial reconstruction images assisted the operator during the procedure.</div></div><div><h3>Results</h3><div>After PSM, 320 patients (160 per group) were included in the final analysis. Procedural time was comparable between the CTA and control groups (52 ± 13 min vs. 51 ± 15 min, p = 0.36), as was left atrial dwell time (39.9 ± 11 min vs. 40.5 ± 13 min, p = 0.63). Acute pulmonary vein isolation rates (96 % vs. 92 %, p = 0.23) and 12-month arrhythmia-free survival (CTA: 75 % vs. control: 75.6 %, p = 0.90) did not significantly differ. However, previously undiagnosed CAD was identified in 84 patients (52.5 %) in the CTA group, leading to 23 (27.4 %) referrals for invasive coronary angiography.</div></div><div><h3>Conclusions</h3><div>Routine preprocedural CTA did not significantly impact procedural efficiency or clinical outcomes in cryoballoon PVI. However, the high prevalence of previously undiagnosed CAD underscores the potential value of coronary assessment in this population.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"60 ","pages":"Article 101769"},"PeriodicalIF":2.5,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144771619","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":"PCI for Chronic Total Occlusions with Distal Diffuse Disease: Stent Alone vs. Stent plus Drug Balloon","authors":"Xinyi Yan ,&nbsp;Xinchen Gao ,&nbsp;Yingying Hu ,&nbsp;Jianlei Cao ,&nbsp;Wei Zhang ,&nbsp;Yi Lu ,&nbsp;Jia Zhou ,&nbsp;Qingqing Wu ,&nbsp;Xiaorong Hu","doi":"10.1016/j.ijcha.2025.101762","DOIUrl":"10.1016/j.ijcha.2025.101762","url":null,"abstract":"<div><h3>Background</h3><div>Chronic total occlusion (CTO) of coronary arteries is a significant challenge in percutaneous coronary intervention (PCI). Despite successful revascularization, patients often develop diffuse coronary lesions, increasing the risk of restenosis and necessitating complex stent strategies.</div></div><div><h3>Objective</h3><div>This study aimed to compare the clinical outcomes of drug-eluting stents (DES) combined with drug-coated balloon (DCB) angioplasty versus DES-only treatment in patients with revascularized CTO and diffuse coronary artery disease.</div></div><div><h3>Methods</h3><div>Patients with successfully revascularized CTO and diffuse lesions were divided into DES-only (n = 191) and DES plus DCB (n = 100) groups. The primary endpoint was major adverse cardiovascular events (MACE), including all-cause death, cardiac death, stroke, and revascularization. The secondary endpoint was the rate of cardiovascular-related hospitalization. Symptom improvement was evaluated using the Canadian Cardiovascular Society (CCS) classification.</div></div><div><h3>Results</h3><div>At 24-month follow-up, the DES plus DCB group had significantly lower MACE incidence (26.00 % vs. 41.36 %, P = 0.008) and cardiovascular-related hospitalization (20.00 % vs. 36.65 %, P = 0.005) compared to the DES-only group. CCS classification improved more significantly in the DES plus DCB group (P &lt; 0.001). Multivariate Cox regression identified DES plus DCB as an independent protective factor against MACE (HR, 0.57; 95 % CI, 0.33–0.99; P = 0.046).</div></div><div><h3>Conclusion</h3><div>In patients with revascularized CTO and diffuse coronary artery disease, the combined DES plus DCB strategy was associated with a lower incidence of MACE and reduced cardiovascular-related hospitalization compared to DES-only treatment. This approach may represent a superior therapeutic option for managing complex coronary lesions.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"60 ","pages":"Article 101762"},"PeriodicalIF":2.5,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144757630","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":"Artificial-intelligence-assisted CCTA quantifies sex differences in coronary atherosclerotic burden at low atheroma volumes","authors":"Zoee D’Costa ,&nbsp;Ronald P. Karlsberg ,&nbsp;Geoffrey W. Cho","doi":"10.1016/j.ijcha.2025.101758","DOIUrl":"10.1016/j.ijcha.2025.101758","url":null,"abstract":"<div><h3>Background</h3><div>Coronary artery disease (CAD) manifests differently between sexes, with data suggesting females develop more non-calcified plaques that traditional calcium-centric tools may not detect.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of 100 individuals with low total atheroma volume (TAV) &lt; 250 mm³ using artificial intelligence (AI)-enabled coronary computed tomography angiography (CCTA) to assess sex-based differences in coronary plaque composition. Plaque subtypes included calcified, non-calcified, and low-density non-calcified atheroma volumes.</div></div><div><h3>Results</h3><div>Females had significantly lower total (p = 0.018) and non-calcified plaque (p &lt; 0.001) burden compared to males. Calcified (p = 0.52) and low-density non-calcified (p = 0.16) plaque volumes did not differ significantly. Age was a consistent predictor of plaque volume across most subtypes.</div></div><div><h3>Conclusions</h3><div>Despite low overall plaque burden, males demonstrated a higher non-calcified plaque burden than females. This finding contrasts with previous literature and underscores the potential of AI-enabled CCTA to detect subclinical coronary disease, particularly in low-risk cohorts. These results support the use of comprehensive plaque profiling in both sexes to improve early risk stratification.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"60 ","pages":"Article 101758"},"PeriodicalIF":2.5,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144714136","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":"5-Hydroxymethylcytosine signatures in cell-free DNA as biomarkers for distinguishing acute coronary syndrome following COVID-19 infection and its association with neutrophil activation and PDE4D expression","authors":"Zhongheng Li ,&nbsp;Maimaitiyasen Duolikun ,&nbsp;Hangyu Chen ,&nbsp;Lei Zhang ,&nbsp;Yishuo Liu ,&nbsp;Ruining Li ,&nbsp;Dan Li ,&nbsp;Lijie Sun ,&nbsp;Long Chen","doi":"10.1016/j.ijcha.2025.101727","DOIUrl":"10.1016/j.ijcha.2025.101727","url":null,"abstract":"<div><h3>Background</h3><div>While 5hmC features in cell-free DNA (cfDNA) show promise as early biomarkers for COVID-19 severity, myocardial injury, and long-term outcomes, their specific role in acute coronary syndrome (ACS) triggered shortly after COVID-19 infection remains unclear.</div></div><div><h3>Methods</h3><div>We generated genome-wide 5hmC profiles from plasma cfDNA using the 5hmC-Seal technique across three cohorts: ACS patients without prior COVID-19 infection (ACS, n = 16), patients experiencing ACS within 2 months post-COVID-19 (ACS2N, n = 24), and patients experiencing ACS beyond 2 months post-COVID-19 (ACS2W, n = 28). Differential 5hmC analysis, functional enrichment (GO, KEGG), immune cell deconvolution, and protein–protein interaction (PPI) network analysis were performed.</div></div><div><h3>Results</h3><div>Significant differences in 5hmC profiles were identified between ACS2N and ACS patients, but not between ACS2W and ACS. Functional analysis implicated immune and inflammatory pathways. Immune infiltration analysis revealed abnormal neutrophil activation specifically in the ACS2N group. PPI network analysis pinpointed phosphodiesterase 4D (PDE4D) as a key hub gene; it was highly expressed in the ACS2N group, a finding corroborated using external datasets.</div></div><div><h3>Conclusions</h3><div>Our findings indicate that plasma cfDNA 5hmC markers can distinguish ACS occurring shortly after COVID-19 infection (ACS2N) from ACS without prior infection. We observed distinct immune dysregulation, notably abnormal neutrophil activation, in ACS2N patients. Critically, we identified PDE4D as a potential key mediator, suggesting that recent COVID-19 infection may contribute to ACS onset by abnormally upregulating PDE4D expression. This study highlights 5hmC signatures and PDE4D as potential biomarkers and therapeutic targets for post-COVID ACS.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"60 ","pages":"Article 101727"},"PeriodicalIF":2.5,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144721555","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":"Relationship between ankle brachial index and carotid-femoral pulse wave velocity in hypertension patients with diabetes mellitus","authors":"Jinbo Liu ,&nbsp;Xuechen Cui ,&nbsp;Shantong Jiang ,&nbsp;Jin Wang ,&nbsp;Huan Wen ,&nbsp;Kun Xiong ,&nbsp;Hongwei Zhao ,&nbsp;Na Zhao ,&nbsp;Hongyu Wang","doi":"10.1016/j.ijcha.2025.101761","DOIUrl":"10.1016/j.ijcha.2025.101761","url":null,"abstract":"<div><h3>Background</h3><div>Ankle-brachial index (ABI) is used to diagnose peripheral artery disease. Arterial stiffness could be measured by carotid-femoral pulse wave velocity (CF-PWV). The study was to investigate relationship between ABI and CF-PWV in patients with hypertension and diabetes mellitus.</div></div><div><h3>Methods</h3><div>1577 patients (M/F 812/765) from Department of Vascular Medicine were enrolled. ABI was recorded by VaseraVS-1000 vascular screening system (Fukuda Denshi, Tokyo, Japan). CF-PWV was recorded by Complior apparatus.</div></div><div><h3>Results</h3><div>CF-PWV was significantly higher in hypertension patients with diabetes mellitus than hypertension patients without diabetes mellitus (13.77 ± 3.91 vs 11.83 ± 3.26 m/s, p &lt; 0.05). Right ABI was significantly lower in hypertension patients with diabetes mellitus than hypertension patients without diabetes mellitus (1.062 ± 0.163 vs 1.102 ± 0.105, p &lt; 0.05). Right ABI was negatively correlated with age, systolic blood pressure, CF-PWV and creatinine in entire study group (r = −0.081, p = 0.001; r = −0.069,p &lt; 0.001; r = −0.178, p &lt; 0.001; r = −0.124, p &lt; 0.001, respectively). Multiple linear regressions found that CF-PWV, body mass index (BMI), gender, creatinine, total cholesterol, uric acid and diabetes mellitus were independent associating factors of RABI in all patients (β = −0.168, p &lt; 0.001; β = 0.180, p &lt; 0.001; β = −0.189, p &lt; 0.001; β = −0.102, p = 0.008; β = 0.088, p = 0.004; β = −0.100, p = 0.009;β = −0.062, p = 0.043; respectively). CF-PWV, BMI, gender and HDL-C were independent associating factors of left ABI in all patients (β = −0.170, p &lt; 0.001; β = 0.172, p &lt; 0.001; β = −0.104, p = 0.001; β = 0.074, p = 0.023; respectively).</div></div><div><h3>Conclusions</h3><div>ABI was significantly lower in hypertension patients with diabetes mellitus, with higher level of CF-PWV. CF-PWV was an independent associating factor of ABI, indicating the greater the elasticity of the large arteries, the higher the probability of lower limb artery occlusion.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"60 ","pages":"Article 101761"},"PeriodicalIF":2.5,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144722870","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":"Recurrences of the infective endocarditis: clinical features and outcomes. Results from the Polish infective endocarditis registry (POL-ENDO)","authors":"Jakub W. Orzech ,&nbsp;Karina Zatorska ,&nbsp;Maciej Grabowski ,&nbsp;Małgorzata Misztal-Ogonowska ,&nbsp;Dagmara B. Orzech ,&nbsp;Ilona Kowalik ,&nbsp;Katarzyna Kurnicka ,&nbsp;Magdalena Potapowicz-Krysztofiak ,&nbsp;Edyta Płońska-Gościniak ,&nbsp;Mariusz Gąsior ,&nbsp;Tomasz Hryniewiecki","doi":"10.1016/j.ijcha.2025.101743","DOIUrl":"10.1016/j.ijcha.2025.101743","url":null,"abstract":"<div><h3>Background</h3><div>Patients with prior infective endocarditis are associated with an increased risk of recurrence.</div></div><div><h3>Aims</h3><div>This study aimed to assess the clinical profile and treatment results of recurrent IE patients in Poland and compare them to European recurrent IE profile.</div></div><div><h3>Methods</h3><div>A prospective multicenter observational cohort study of recurrent IE and first-episode IE patients from 160 medical centers in Poland registered between August 2022 and August 2024 was conducted. Polish recurrent IE cases were compared with those recorded in the ESC-EORP EURO-ENDO registry.</div></div><div><h3>Results</h3><div>Of a total of 1758 IE patients, recurrent IE patients (n = 371) were younger than first-episode IE (n = 1387) patients [58.2 ± 16.6 vs. 62.6 ± 16.2, p &lt; 0.001] and predominated in Poland [21.1 % vs. 8.6 %, p &lt; 0.001]. Dental treatment predisposed to IE recurrence [12.8 % vs. 5.5 %, p &lt; 0.001]. Prosthetic valve IE predominated among recurrent IE patients [33.1 % vs. 19.7 %, p &lt; 0.001]. Fever &gt; 38° was observed less often among recurrent IE cases [34.8 % vs. 54.1 %, p &lt; 0.001]. Negative blood culture predominated among recurrent IE cases [43.3 % vs. 27.2 %, p &lt; 0.001]. Polish recurrent IE patients were rarely operated than European counterparts [55.2 % vs. 64.8 %, p = 0.032]. The embolic surgery indications were less prominent in Poland [0.08 % vs. 20.2 %, p &lt; 0.001].</div></div><div><h3>Conclusions</h3><div>The IE recurrence rate in Poland is greater. Dental treatment and valve prosthesis predispose to recurrence of IE. Fever &gt; 38° is less often observed among recurrent IE. Surgical treatment is underutilized among Polish recurrent IE patients. Embolic and uncontrolled infection indications for surgery was underrated in Poland. The IE recurrence is not associated with increased in-hospital mortality.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"60 ","pages":"Article 101743"},"PeriodicalIF":2.5,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144721554","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":"Novel insights into short-term troponin remeasurement and long-term cardiac function and structure following fulminant myocarditis","authors":"Mengmeng Ji ,&nbsp;Luying Jiang ,&nbsp;Zixuan Zhang,&nbsp;Shupeng Jiang,&nbsp;Houjuan Zuo","doi":"10.1016/j.ijcha.2025.101759","DOIUrl":"10.1016/j.ijcha.2025.101759","url":null,"abstract":"<div><h3>Background</h3><div>Elevated serum high-sensitivity cardiac troponin (hs-cTn) levels are commonly observed in patients with fulminant myocarditis (FM) after the acute phase. This study aims to evaluate the relationship between elevated hs-cTnI levels at 30-day post-discharge and long-term cardiac structure and function.</div></div><div><h3>Methods</h3><div>This study is a retrospective cohort study that selected FM patients hospitalized at Tongji Hospital in Wuhan from April 2016 to December 2022. All patients underwent serial monitoring of hs-cTnI levels. Patients were stratified into two groups based on hs-cTnI levels at 30 days post-discharge: the normal hs-cTnI (N-cTnI) group and the high hs-cTnI (H-cTnI) group. Left ventricular (LV) function and structure were assessed using 2-dimensional volume and speckle tracking strain echocardiography. Measurements were obtained at admission, discharge, and 6 months, 12 months, and annually thereafter post-discharge.</div></div><div><h3>Results</h3><div>Among 95 patients with analysable echocardiographic data (median age: 33 years; 42.11 % male), the N-cTnI group demonstrated significantly higher proportions of patients meeting cardiac function criteria during follow-up compared to the H-cTnI group: LV ejection fraction (LVEF) &gt; 50 % (95 % vs. 72 %; P = 0.003), global longitudinal strain (GLS) &gt; 16 % (68 % vs. 36 %; P = 0.002), and LV end-diastolic dimension &lt; 5 cm (86 % vs. 65 %; P = 0.020). Given that the primary composite endpoint occurred in only 5 patients, statistical analyses focused on secondary composite endpoints. The incidence of secondary composite endpoints was significantly higher in the H-cTnI group than in the N-cTnI group (61.91 % vs. 16.98 %; P &lt; 0.001). Multivariable Cox regression identified elevated hs-cTnI at 30 days post-discharge (HR: 5.365; 95 % CI: 1.876–15.344; P = 0.002) and LV-GLS at discharge (HR: 0.844; 95 % CI: 0.732–0.974; P = 0.021) as independent predictors of secondary composite endpoints.</div></div><div><h3>Conclusion</h3><div>Delayed normalization of hs-cTnI after 30 days post-discharge may predict long-term deterioration of cardiac function and structural remodeling in patients with FM.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"60 ","pages":"Article 101759"},"PeriodicalIF":2.5,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144721564","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}