Circulation Journal最新文献_第3页

Implementing the Certified Heart Failure Educator System in Japan　- Initial Experience. 在日本实施心衰认证教育者制度的初步经验。

IF 3.7 3区医学

Circulation Journal Pub Date : 2025-09-25 Epub Date: 2025-08-10 DOI: 10.1253/circj.CJ-25-0304

Koshiro Kanaoka, Yoshitaka Iwanaga, Yoko Sumita, Masahiro Nishi, Takeshi Nakamura, Yoshihiro Miyamoto, Yoshio Kobayashi, Satoaki Matoba

{"title":"Implementing the Certified Heart Failure Educator System in Japan　- Initial Experience.","authors":"Koshiro Kanaoka, Yoshitaka Iwanaga, Yoko Sumita, Masahiro Nishi, Takeshi Nakamura, Yoshihiro Miyamoto, Yoshio Kobayashi, Satoaki Matoba","doi":"10.1253/circj.CJ-25-0304","DOIUrl":"10.1253/circj.CJ-25-0304","url":null,"abstract":"Background: The Japanese Circulation Society (JCS) launched a Certified Heart Failure Educator (CHFE) program in 2021. However, reports regarding this program are lacking. Here we describe the initial experience following implementation of CHFE program and assess its association with hospital quality measures.Methods and results: We performed a retrospective study using data from CHFE certification data for 2021-2024 and data from the Japanese Registry of All Cardiac and Vascular Diseases-Diagnosis Procedure Combination in 2021. The cumulative number of CHFEs increased from 1,771 in 2021 to 6,603 in 2024. Various medical professionals joined the system, and almost all CHFEs were affiliated with hospitals. Of all 813 hospitals included, 416 (51.2%) had at least 1 CHFE in 2021, with a median number of 2 CHFEs per hospital. The group of hospitals with CHFEs had a higher proportion of JCS training hospitals and a higher number of annual heart failure (HF) hospitalizations and cardiology beds. Of 71,678 patients hospitalized for acute HF and discharged to home, 41,558 (58.0%) were hospitalized in facilities with CHFEs. After adjustment for baseline characteristics, hospital admission to a facility with a CHFE was associated with higher achievement of process measures and lower in-hospital mortality.Conclusions: The CHFE system was successfully implemented and contributed to HF management primarily in high-quality hospitals. Our findings may provide insights for future strategies regarding this system.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1709-1715"},"PeriodicalIF":3.7,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144823095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pediatric Case of Infective Endocarditis After Implantation of Atrial Septal Occlusion Device Following Self-Injurious Behavior. 儿童自残行为后植入房间隔阻断器并发感染性心内膜炎1例。

IF 3.7 3区医学

Circulation Journal Pub Date : 2025-09-25 Epub Date: 2025-08-30 DOI: 10.1253/circj.CJ-25-0252

Naoki Tsuboya, Kazuto Fujimoto, Keisuke Shibagaki, Yuji Tominaga, Shigemitsu Iwai, Kenichi Kurosaki

引用次数: 0

Association of Medication Profiles, Including Polypharmacy, Guideline-Directed Medical Therapy, and Potentially Inappropriate Medications, With All-Cause Mortality in Older Adults With Heart Failure, With or Without Frailty and Disability. 老年心力衰竭患者，伴或不伴虚弱和残疾的全因死亡率与综合用药、指导药物治疗和潜在不适当药物的相关性

IF 3.7 3区医学

Circulation Journal Pub Date : 2025-09-25 Epub Date: 2025-06-27 DOI: 10.1253/circj.CJ-25-0200

Yuka Sekiya, Shinya Fujiki, Hiroki Tsuchiya, Takeshi Kashimura, Yuji Okura, Kunio Kodera, Hiroshi Watanabe, Kazuyoshi Takahashi, Shogo Bannai, Taturo Hatano, Takahiro Tanaka, Nobutaka Kitamura, Tohru Minamino, Takayuki Inomata

{"title":"Association of Medication Profiles, Including Polypharmacy, Guideline-Directed Medical Therapy, and Potentially Inappropriate Medications, With All-Cause Mortality in Older Adults With Heart Failure, With or Without Frailty and Disability.","authors":"Yuka Sekiya, Shinya Fujiki, Hiroki Tsuchiya, Takeshi Kashimura, Yuji Okura, Kunio Kodera, Hiroshi Watanabe, Kazuyoshi Takahashi, Shogo Bannai, Taturo Hatano, Takahiro Tanaka, Nobutaka Kitamura, Tohru Minamino, Takayuki Inomata","doi":"10.1253/circj.CJ-25-0200","DOIUrl":"10.1253/circj.CJ-25-0200","url":null,"abstract":"Background: Polypharmacy, driven by guideline-directed medical therapy (GDMT) and medications for comorbidities, including potentially inappropriate medications (PIMs), is common in older adults with heart failure (HF). Although medication profiles affect survival, the effects of frailty and disability status remain underexplored.Methods and results: This retrospective study assessed polypharmacy (≥5 medications), the use of GDMT, and PIMs based on the Beers Criteria. Frailty and disability status were determined using Japan's Long-term Care Insurance (LTCI) certification. Patients were stratified according to LTCI, and the prognostic impact of medication profiles was analyzed. The total medication count was correlated with both GDMT and PIM use. Among 1,264 patients, those with LTCI were older, had more severe comorbidities, higher polypharmacy and PIM use, and lower use of GDMT medications. In multivariate Cox regression analysis, regardless of LTCI, GDMT medication use was associated with a favorable prognosis (LTCI: odds ratio [OR] 0.47, 95% confidence interval [CI] 0.258-0.866, P=0.015; no LTCI: OR 0.57, 95% CI 0.400-0.799, P=0.001). PIM use was associated with a poor prognosis only in the no-LTCI group (OR 1.51; 95% CI 1.040-2.203; P=0.030).Conclusions: Polypharmacy may have both beneficial and harmful effects, with prognostic implications potentially influenced by frailty and disability status. Although GDMT medications were consistently associated with favorable outcomes, the impact of PIMs appeared to differ depending on LTCI.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1662-1671"},"PeriodicalIF":3.7,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Sex Differences in Sudden Cardiac Death During Long-Term Follow-up in Patients With Chronic Heart Failure　- A Report From the CHART-2 Study. 慢性心力衰竭患者长期随访期间心源性猝死的性别差异——来自图表2研究的报告

IF 3.7 3区医学

Circulation Journal Pub Date : 2025-09-25 Epub Date: 2025-01-18 DOI: 10.1253/circj.CJ-24-0484

Hideka Hayashi, Kotaro Nochioka, Makoto Nakano, Takashi Shiroto, Yuhi Hasebe, Takashi Noda, Satoshi Miyata, Hiroaki Shimokawa, Satoshi Yasuda

{"title":"Sex Differences in Sudden Cardiac Death During Long-Term Follow-up in Patients With Chronic Heart Failure　- A Report From the CHART-2 Study.","authors":"Hideka Hayashi, Kotaro Nochioka, Makoto Nakano, Takashi Shiroto, Yuhi Hasebe, Takashi Noda, Satoshi Miyata, Hiroaki Shimokawa, Satoshi Yasuda","doi":"10.1253/circj.CJ-24-0484","DOIUrl":"10.1253/circj.CJ-24-0484","url":null,"abstract":"Background: Although sudden cardiac death (SCD) generally occurs more frequently in men than in women, there are limited data on sex differences in SCD in patients with chronic heart failure (HF) across a range of left ventricular ejection fraction (LVEF).Methods and results: We examined sex differences in SCD incidence, timing, and risk factors in 4,683 patients with chronic HF (3,186 men, 1,497 women) from a multicenter prospective observational cohort study (CHART-2). Over a median follow-up of 8.8 years after study enrollment, there were 215 SCDs (160 in men, 55 in women). The SCD incidence rates in men and women were 6.1 and 4.6 per 1,000 person-years, respectively (P=0.088). Among women, more than half the SCDs occurred in the first 5 years of follow-up. Beyond 5 years, the SCD incidence rate was significantly lower in women than in men (3.6 vs. 5.9 per 1,000 person-years, respectively; P=0.044). After adjusting for confounders, age, increased B-type natriuretic peptide, and LVEF <50% were common prognostic factors. After 5 years of follow-up, left ventricular (LV) enlargement was a risk factor for SCD in both sexes.Conclusions: These results indicate that there are sex differences in SCD, especially beyond 5 years of follow-up, with a lower prevalence in women. LV enlargement is a common long-term prognostic factor in both sexes, suggesting the importance of preventing LV remodeling in HF management.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1644-1651"},"PeriodicalIF":3.7,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Dialysis Modality and Risk of Infective Endocarditis in Patients With End-Stage Renal Disease. 终末期肾病患者的透析方式和感染性心内膜炎的风险

IF 3.7 3区医学

Circulation Journal Pub Date : 2025-09-25 Epub Date: 2025-07-12 DOI: 10.1253/circj.CJ-25-0382

Chun-Yu Chen, Feng-Cheng Chang, Chia-Pin Lin, Ming-Jer Hsieh, Chih-Hsiang Chang, Yu-Ting Cheng, Yi-Hsin Chan, Victor Chien-Chia Wu, An-Hsun Chou, Shao-Wei Chen

引用次数: 0

Deep Learning for Cardiac Overload Estimation　- Predicting B-Type Natriuretic Peptide (BNP) Levels From Heart Sounds and Electrocardiogram. 心脏负荷估计的深度学习-从心音和心电图预测b型利钠肽（BNP）水平。

IF 3.7 3区医学

Circulation Journal Pub Date : 2025-09-25 Epub Date: 2025-06-17 DOI: 10.1253/circj.CJ-25-0098

Shimpei Ogawa, Masanobu Ishii, Shumpei Saito, Hiroshi Seki, Koshiro Ikeda, Yuhei Yasui, Tomohiro Komatsu, Ginga Sato, Noriaki Tabata, Mitsuru Ohishi, Takuro Kubozono, Naritatsu Saito, Eri Toda Kato, Xiaoyang Song, Masahiro Yamada, Shunsuke Natori, Yuki Kunikane, Takafumi Yokomatsu, Masashi Kato, Yasuaki Sagara, Nami Uchiyama, Nobuhiko Atsuchi, Shota Kawahara, Shoji Natsugoe, Kenichi Tsujita

{"title":"Deep Learning for Cardiac Overload Estimation　- Predicting B-Type Natriuretic Peptide (BNP) Levels From Heart Sounds and Electrocardiogram.","authors":"Shimpei Ogawa, Masanobu Ishii, Shumpei Saito, Hiroshi Seki, Koshiro Ikeda, Yuhei Yasui, Tomohiro Komatsu, Ginga Sato, Noriaki Tabata, Mitsuru Ohishi, Takuro Kubozono, Naritatsu Saito, Eri Toda Kato, Xiaoyang Song, Masahiro Yamada, Shunsuke Natori, Yuki Kunikane, Takafumi Yokomatsu, Masashi Kato, Yasuaki Sagara, Nami Uchiyama, Nobuhiko Atsuchi, Shota Kawahara, Shoji Natsugoe, Kenichi Tsujita","doi":"10.1253/circj.CJ-25-0098","DOIUrl":"10.1253/circj.CJ-25-0098","url":null,"abstract":"Background: B-type natriuretic peptide (BNP) and N-terminal pro-BNP (NT-pro-BNP) are key biomarkers used for heart failure (HF) management. Although traditional auscultation lacks objective evaluation, the SSS01-series phonocardiogram enables rapid recording of heart sounds and ECG. We developed a deep-learning model to estimate plasma BNP levels from these non-invasive dynamic physiological signals, with the aim of validating the model's performance with an external validation dataset and assessing its feasibility for clinical application.Methods and results: This multicenter study evaluated the estimated BNP (eBNP) model for predicting plasma BNP levels ≥100 pg/mL using 8 s of heart sound and ECG data. Validation was performed on an external validation dataset of 140 patients, achieving an area under the receiver operating characteristic curve (AUROC) of 0.895, with sensitivity and specificity of 84.3% and 82.9%, respectively. Subgroup analysis of patients with body mass index of 18.5-25 (n=127) showed more substantial predictive capability, with an AUROC of 0.959, sensitivity of 92.5%, and specificity of 84.8%.Conclusions: The eBNP model demonstrated strong potential for non-invasive and rapid HF screening. Its simplicity and objectivity make it ideally suited for point-of-care testing, offering a promising approach for early HF diagnosis and detection monitoring of HF exacerbations. These findings, validated on datasets independent of training, highlight the model's robustness across diverse clinical populations.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1684-1692"},"PeriodicalIF":3.7,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Identification of Metabolomics Profile in Elderly Patients at the End Stage of Heart Failure. 老年终末期心力衰竭患者代谢组学特征的鉴定。

IF 3.7 3区医学

Circulation Journal Pub Date : 2025-09-25 Epub Date: 2025-09-04 DOI: 10.1253/circj.CJ-25-0278

Yukari Okuma, Koji Yoshie, Sho Suzuki, Masatoshi Minamisawa, Ken Nishikawa, Masafumi Kanai, Kazuhiro Kimura, Yasushi Ueki, Yasutaka Oguchi, Tamon Kato, Tatsuya Saigusa, Soichiro Ebisawa, Ayako Okada, Hirohiko Motoki, Koichiro Kuwahara

{"title":"Identification of Metabolomics Profile in Elderly Patients at the End Stage of Heart Failure.","authors":"Yukari Okuma, Koji Yoshie, Sho Suzuki, Masatoshi Minamisawa, Ken Nishikawa, Masafumi Kanai, Kazuhiro Kimura, Yasushi Ueki, Yasutaka Oguchi, Tamon Kato, Tatsuya Saigusa, Soichiro Ebisawa, Ayako Okada, Hirohiko Motoki, Koichiro Kuwahara","doi":"10.1253/circj.CJ-25-0278","DOIUrl":"10.1253/circj.CJ-25-0278","url":null,"abstract":"Background: With an increase in the aging population, heart failure (HF) has become a major healthcare problem. Therefore, early detection of key signals characteristic of each of the stages of HF has the potential to improve treatment and palliative care. Metabolomics profiling may be useful in identifying biomarkers of HF and improving HF treatment.Methods and results: This study was a retrospective subanalysis of the CURE-HF registry, a prospective observational study of patients with acute decompensated HF. Patients were divided into 3 groups: those who died within 3 months of discharge due to cardiovascular disease (CVD), those who died within 3-6 months of discharge due to CVD, and those who survived >2 years as a control group. Serum samples from 28 patients (median age 85 years [interquartile range 74-90 years]; 11 (39.3%) women) were subjected to capillary electrophoresis time-of-flight mass spectrometry. Partial least-squares (PLS) discriminant analysis showed a negative correlation between carnitine and short-term mortality (R=-0.508, P=0.006). Urea (R=-0.597, P<0.001) and symmetric dimethylarginine (R=-0.634, P<0.001) were negatively correlated with survival, while tryptophan was positively correlated with survival (R=0.548, P=0.003).Conclusions: Carnitine, symmetric dimethylarginine, urea, and tryptophan appear to be critical biomarkers for monitoring terminal stages in HF. Our results suggest that myocardial energy metabolism and renal dysfunction are associated with changes in the metabolome.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1608-1615"},"PeriodicalIF":3.7,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Contribution of Seasonal Variation and Inflammation to Increased In-Hospital Events and Early Mortality in Patients With Takotsubo Syndrome. 季节变化和炎症对Takotsubo综合征患者住院事件和早期死亡率增加的影响

IF 3.7 3区医学

Circulation Journal Pub Date : 2025-09-25 Epub Date: 2025-06-19 DOI: 10.1253/circj.CJ-24-0762

Maximilien Martz, Kensuke Matsushita, Antonin Trimaille, Shinnosuke Kikuchi, Taraneh Tatarcheh, Benjamin Marchandot, Amandine Granier, Loic Faucher, Valerie Schini-Kerth, Patrick Ohlmann, Laurence Jesel, Oliver Morel

{"title":"Contribution of Seasonal Variation and Inflammation to Increased In-Hospital Events and Early Mortality in Patients With Takotsubo Syndrome.","authors":"Maximilien Martz, Kensuke Matsushita, Antonin Trimaille, Shinnosuke Kikuchi, Taraneh Tatarcheh, Benjamin Marchandot, Amandine Granier, Loic Faucher, Valerie Schini-Kerth, Patrick Ohlmann, Laurence Jesel, Oliver Morel","doi":"10.1253/circj.CJ-24-0762","DOIUrl":"10.1253/circj.CJ-24-0762","url":null,"abstract":"Background: Initially regarded as a benign acute cardiomyopathy, recent insights have shown that takotsubo syndrome (TTS) carries a prognosis comparable to that of acute coronary syndrome, with a notable impact of inflammatory burden. Given the seasonal variation seen in air pollution, inflammation, and coronary events, we investigated whether chronobiology and inflammation contribute to adverse outcomes.Methods and results: Between 2008 and 2020, all consecutive TTS patients were retrospectively included in a multicenter registry. We analyzed the impact of seasonal variation and inflammation on in-hospital events, including acute cardiac failure, cardiogenic shock, and death, as well as 30-day mortality. In-hospital events were identified in 238 (42.6%) patients. Higher rates of in-hospital events and 30-day mortality were observed during winter and spring than in summer and autumn. Multivariate analysis identified the presence of dyspnea on admission (odds ratio [OR] 4.02; 95% confidence interval [CI] 2.61-6.17; P<0.001), a neurological trigger (OR 2.58; 95% CI 1.21-5.50; P=0.014), hyperleukocytosis (OR 1.04; 95% CI 1.02-1.17; P=0.002), and left ventricular ejection fraction at admission (OR 0.98; 95% CI 0.96-1.00; P=0.011) as independent predictors of adverse outcomes.Conclusions: In TTS, higher rates of in-hospital events and 30-day mortality were observed during winter and spring. Inflammatory burden and neurological disorders emerged as independent predictors of poor prognosis.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1627-1636"},"PeriodicalIF":3.7,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cardiopulmonary Risk in Chronic Obstructive Pulmonary Disease　- A Perspective for Reducing Mortality. 慢性阻塞性肺疾病的心肺风险-降低死亡率的观点。

IF 3.7 3区医学

Circulation Journal Pub Date : 2025-09-25 Epub Date: 2025-06-27 DOI: 10.1253/circj.CJ-24-1025

Michihiro Yoshimura, Shigeo Muro, Koichiro Kuwahara, Hisatoshi Sugiura, Koichi Fukunaga, Ryoko Sorimachi, Munehiro Seki, Toyoaki Murohara

{"title":"Cardiopulmonary Risk in Chronic Obstructive Pulmonary Disease　- A Perspective for Reducing Mortality.","authors":"Michihiro Yoshimura, Shigeo Muro, Koichiro Kuwahara, Hisatoshi Sugiura, Koichi Fukunaga, Ryoko Sorimachi, Munehiro Seki, Toyoaki Murohara","doi":"10.1253/circj.CJ-24-1025","DOIUrl":"10.1253/circj.CJ-24-1025","url":null,"abstract":"Chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD) show a relationship through the sharing of several risk factors, and the prevalence of each disease increases in an age-related manner. Therefore, clinicians are very likely to encounter patients with both diseases. Importantly, the risk of death in patients with CVD is even greater in those with coexisting COPD. Cardiopulmonary risk, defined as \"the risk of serious respiratory and/or cardiovascular events in patients with COPD,\" is a concept whereby COPD exacerbations (characterized by worsening of COPD symptoms over a short period of time) and/or CVD events may increase the risk of death due to these events in patients with COPD. Lowering cardiopulmonary risk requires appropriate treatment to prevent COPD exacerbations. Inhalation therapies can prevent COPD exacerbations and may reduce mortality rates. Research to investigate whether inhaled therapies can lower cardiopulmonary risk is ongoing. There is a need for early COPD diagnosis and timely, effective treatment that prevents COPD exacerbations while also considering cardiopulmonary risk. We propose an urgent call to action for cardiology and respirology societies to address cardiopulmonary risk and reduce COPD and CVD deaths.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1583-1590"},"PeriodicalIF":3.7,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Relationships Between Cumulative Resting Heart Rate and the Incidence of Cardiovascular Events and All-Cause Mortality　- Post Hoc Analysis of STEP Trial Data. 累积静息心率与心血管事件发生率和全因死亡率之间的关系——STEP试验数据的事后分析。

IF 3.7 3区医学

Circulation Journal Pub Date : 2025-09-25 Epub Date: 2025-04-08 DOI: 10.1253/circj.CJ-24-0690

Run Lin, Qianhui Ling, Wei Wang, Weiwen Li, Ying Lin, Jinhao Chen, Shuangshuang Tong, Jun Cai, Jilin Li, Youren Chen

{"title":"Relationships Between Cumulative Resting Heart Rate and the Incidence of Cardiovascular Events and All-Cause Mortality　- Post Hoc Analysis of STEP Trial Data.","authors":"Run Lin, Qianhui Ling, Wei Wang, Weiwen Li, Ying Lin, Jinhao Chen, Shuangshuang Tong, Jun Cai, Jilin Li, Youren Chen","doi":"10.1253/circj.CJ-24-0690","DOIUrl":"10.1253/circj.CJ-24-0690","url":null,"abstract":"Background: The long-term effects of cumulative resting heart rate (cumRHR) on the incidence of cardiovascular events and all-cause mortality in older (age ≥60 years) hypertensive populations remain unclear. Therefore, the aim of this study was to investigate the association between cumRHR and cardiovascular events and all-cause mortality.Methods and results: This post hoc analysis used data from the Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients (STEP) trial of 7,517 patients in whom resting heart rate (RHR) was measured at 0, 3, 6, 9, and 12 months. \"cumRHR\" refers to the weighted mean of the RHR for each time interval. Participants were divided into quartiles (Q1-Q4) based on cumRHR. After adjustment for potential confounders and using Q3 (72.19-75.88 [beats/min] × year) as the reference, patients in Q4 (75.94-109.44 [beats/min] × year) had higher risks of the primary outcome (a composite of stroke, acute coronary syndrome, acute decompensated heart failure, coronary revascularization, atrial fibrillation, and death from any cardiovascular cause) (hazard ratio [HR] 2.21; 95% confidence interval [CI] 1.42-3.43; P<0.001), major adverse cardiovascular events (HR 1.93; 95% CI 1.18-3.16; P=0.009), and stroke (HR 3.55; 95% CI 1.42-8.86; P=0.007) and those in Q1 (44.50-68.44 [beats/min] × year) had an increased risk of the primary outcome (HR 1.71; 95% CI 1.08-2.71; P=0.02). No such trends were observed for all-cause mortality. A U-shaped relationship was observed with the primary outcome, with higher risk for both very low or very high cumRHR levels compared with midrange values.Conclusions: Both low and high cumRHR levels were associated with higher risk of cardiovascular events in older patients with hypertension.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1652-1661"},"PeriodicalIF":3.7,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0