Circulation Journal最新文献

{"title":"Aortic Dissection or Aneurysm and In-Hospital Mortality in Patients With Turner Syndrome　- A Retrospective Cohort Study in Japan.","authors":"Kayo Ikeda Kurakawa, Akira Okada, Masanobu Kawai, Takafumi Inoue, Reiko Inoue, Yuichiro Matsuo, Kiyohide Fushimi, Hiroki Matsui, Hideo Yasunaga, Toshimasa Yamauchi, Masaomi Nangaku, Takashi Kadowaki, Satoko Yamaguchi","doi":"10.1253/circj.CJ-26-0128","DOIUrl":"10.1253/circj.CJ-26-0128","url":null,"abstract":"<p><strong>Background: </strong>Aortic dissection and aneurysm are major causes of early mortality in Turner syndrome. However, data on aortic dissection in Turner syndrome remain limited compared with those for Marfan syndrome. We evaluated the associations of Turner syndrome and Marfan syndrome with in-hospital mortality among female patients hospitalized for aortic dissection or aneurysm, using patients without either syndrome as the common reference group for both comparisons.</p><p><strong>Methods and results: </strong>This retrospective cohort study used data from the Diagnosis Procedure Combination, a national inpatient database in Japan. Adult female patients hospitalized for first-time aortic dissection or aneurysm between 2010 and 2022 were included, with in-hospital mortality as the primary outcome. Associations between Turner/Marfan syndrome and mortality were evaluated using multivariable logistic regression analysis. Of 10,927 eligible female patients aged 16-61 years, 29 (0.27%) had Turner syndrome and 686 (6.3%) had Marfan syndrome. In-hospital mortality was higher for Turner syndrome (odds ratio [OR] 5.35; 95% confidence interval [CI] 1.61-17.8) compared with the group without either syndrome. In contrast, Marfan syndrome was not significantly associated with mortality (OR 0.72; 95% CI 0.44-1.17). Unscheduled admission was similar in Turner syndrome, but less frequent in Marfan syndrome, compared with the group without either syndrome.</p><p><strong>Conclusions: </strong>In-hospital mortality was higher among patients with Turner syndrome admitted for aortic dissection or aneurysm, highlighting the need to raise awareness of aortic risk in this high-risk population.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1453-1462"},"PeriodicalIF":5.8,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148809521","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}

{"title":"E2F5 Promotes Vascular Endothelial Cell Proliferation and Angiogenesis in Diabetic Lower Limb Ischemia via an Autophagy-Related Mechanism.","authors":"Yuyan Zhan, Hongwei Shi, Xiaoying Miu, Xiaoping Peng, Jungang Nie, Dong Liu, Qiong Duan, Ting Kang","doi":"10.1253/circj.CJ-25-0736","DOIUrl":"10.1253/circj.CJ-25-0736","url":null,"abstract":"<p><strong>Background: </strong>Because vascular regeneration of diabetic lower limb ischemia (LLI) and prevention of disease progression is a major problem, we explored the molecular mechanism of E2F transcription factor 5 (E2F5) in regulating autophagy to promote angiogenesis in diabetic HLI.</p><p><strong>Methods and results: </strong>The streptozotocin-induced diabetic mice model, hindlimb ischemia (HLI) model and high glucose (HG)-induced human umbilical vein endothelial cells (HUVECs) were constructed for in vivo and in vitro assays. Autophagy inhibitor, 3-methyladenine, reversed the effects of E2F5 overexpression on microtubule-associated protein 1 light chain 3B (LC3B) expression, cell proliferation, migration and tube formation, supporting the involvement of autophagy in E2F5-mediated HUVEC restoration. In vivo injection of E2F5 overexpressed lentivirus also promoted angiogenesis in diabetic HLI mice, concomitant with autophagy activation. Phosphorylated yes-associated protein (pYAP) expression in HUVECs was upregulated after HG treatment and E2F5 overexpression reversed this change. pYAP colocalized with CD31, and pYAP expression was decreased after E2F5 overexpression. Treatment with Ki16425 increased pYAP expression and affected the influence of E2F5 on the proliferation, migration and tubule formation of HUVECs, and LC3B expression.</p><p><strong>Conclusions: </strong>E2F5 promoted angiogenesis by downregulating pYAP, which is associated with autophagy activation. These findings provide a novel therapeutic strategy for diabetic LLI.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1425-1434"},"PeriodicalIF":5.8,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693599","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}

{"title":"Brain Cortex Thinning in Cardiac Allograft Vasculopathy　- Associations With Myocardial Fibrosis and Cognitive Impairment.","authors":"Qian Qin, Dongyong Zhu, Ning Zheng, Jia Liu, Jun Wu, Jiaqi Chen, Hildo J Lamb, Ziqiao Lei, Jing Wang","doi":"10.1253/circj.CJ-26-0006","DOIUrl":"10.1253/circj.CJ-26-0006","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to investigate changes in cortical thickness in patients with cardiac allograft vasculopathy (CAV) using magnetic resonance imaging (MRI), and links to myocardial fibrosis and cognitive function.</p><p><strong>Methods and results: </strong>In all, 77 patients after heart transplantation (35 with CAV, 42 without CAV), as well as 45 healthy controls (HC), underwent brain MRI and cardiac MRI (CMR). Analysis of covariance (ANCOVA), partial correlation and mediation analyses were performed. The CAV group exhibited significant cortical thinning in several brain regions, including the bilateral superior frontal gyrus, left angular gyrus, and left supramarginal gyrus (false discovery rate [FDR] P<0.05). Cortical thickness in the left cingulate gyrus (r=-0.377, P=0.015) and right cuneus (r=-0.297, P=0.009) was negatively correlated with extracellular volume (FDR P<0.05). Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination scores were lower in the CAV than non-CAV and HC groups. Cortical thickness in the bilateral inferior frontal gyrus, left cingulate gyrus, right angular gyrus, and right postcentral sulcus was positively correlated with MoCA scores (FDR P<0.05). The cortical thickness of the left cingulate gyrus partially mediated the association between extracellular volume and MoCA scores (β=-0.135; 95% confidence interval -0.323, -0.025).</p><p><strong>Conclusions: </strong>Our findings reveal a cardiocerebral interaction, highlighting cortical thinning as a neuroimaging marker for CAV-related myocardial fibrosis and cognitive decline.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1473-1483"},"PeriodicalIF":5.8,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148297247","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}

{"title":"Association Between Changes in Serum N-Terminal Pro B-Type Natriuretic Peptide Levels and All-Cause and Cause-Specific Mortality　- The Hisayama Study.","authors":"Asahi Kato, Emi Oishi, Akihiro Maezono, Satoko Sakata, Yoshihiko Furuta, Mao Shibata, Jun Hata, Tetsuro Ago, Kohtaro Abe, Toshiharu Ninomiya","doi":"10.1253/circj.CJ-25-1168","DOIUrl":"10.1253/circj.CJ-25-1168","url":null,"abstract":"<p><strong>Background: </strong>Few epidemiological studies have investigated the association between changes in serum N-terminal pro B-type natriuretic peptide (NT-proBNP) and mortality in the general Asian population.</p><p><strong>Methods and results: </strong>We followed 2,703 community-dwelling Japanese residents aged ≥40 years who had serum NT-proBNP concentrations measured in both 2002-2003 and 2007-2008 over a median period of 10.3 years. Changes in NT-proBNP were categorized as decreasing (change ≤-25%), no change (-25%<change<+25%), or increasing (change ≥+25%). Mortality hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models. During the follow-up period, 497 deaths occurred (108 cardiovascular, 389 non-cardiovascular). Compared with the no-change group, multivariable-adjusted HRs in the increasing group were 1.73 (95% CI 1.37-2.17), 1.76 (95% CI 1.08-2.87), and 1.71 (95% CI 1.32-2.22) for all-cause, cardiovascular, and non-cardiovascular mortality, respectively. Subgroup analyses by baseline serum NT-proBNP concentration (2002-2003) showed consistent associations with all-cause mortality in both lower (<125 pg/mL) and higher (≥125 pg/mL) NT-proBNP groups, with a tendency towards stronger associations in the higher NT-proBNP group.</p><p><strong>Conclusions: </strong>Changes in serum NT-proBNP concentrations may indicate mortality risk in a community-dwelling Asian population.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1368-1377"},"PeriodicalIF":5.8,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882266","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}

{"title":"Estimated Small Dense Low-Density Lipoprotein Cholesterol Is Independently Associated With Arterial Stiffness　- Large Japanese Screening Study.","authors":"Shuya Shinchi, Yuichi Akasaki, Daisuke Tokutake, Shin Kawasoe, Shota Uebo, Takuro Kubozono, Hironori Miyahara, Koichi Tokusige, Mitsuru Ohishi","doi":"10.1253/circj.CJ-26-0093","DOIUrl":"10.1253/circj.CJ-26-0093","url":null,"abstract":"<p><strong>Background: </strong>Small dense low-density lipoprotein cholesterol (sdLDL-C) is an established atherogenic marker; however, the association between estimated sdLDL-C (EsdLDL-C) and arterial stiffness remains unclear.</p><p><strong>Methods and results: </strong>We analyzed 23,623 participants (13,518 men, 10,105 women). EsdLDL-C was calculated using the Sampson equation, and arterial stiffness was defined as a brachial-ankle pulse wave velocity (baPWV) ≥1,400 cm/s. After adjustment for cardiovascular risk factors, higher EsdLDL-C levels were significantly associated with arterial stiffness in the overall population and in men, whereas the association in women did not reach statistical significance in the continuous analysis. Nevertheless, the risk of arterial stiffness increased in a stepwise manner across EsdLDL-C quartiles; the highest EsdLDL-C quartile had a significantly higher risk than the lowest in both men (odds ratio [OR] 1.91; 95% confidence interval [CI] 1.59-2.29) and women (OR 1.54; 95% CI 1.22-1.95). In a 4-group analysis, high EsdLDL-C significantly increased risk, regardless of whether estimated low-density lipoprotein cholesterol levels were below or above the median. Stratified analysis by systolic blood pressure (SBP; <120, 120-129, 130-139, and ≥140 mmHg) revealed that the association was significant across all categories in men, but was less consistent in women and was significant only in the strict normotensive group (SBP <120 mmHg).</p><p><strong>Conclusions: </strong>EsdLDL-C calculated from standard lipid parameters is significantly associated with arterial stiffness. This association is robust in men and evident in normotensive women, suggesting that EsdLDL-C is a useful indicator for arteriosclerotic risk assessment.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1444-1452"},"PeriodicalIF":5.8,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148860694","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}

{"title":"Low Body Weight as a Marker of Vulnerability in Cancer-Associated Venous Thromboembolism.","authors":"Kazuko Tajiri","doi":"10.1253/circj.CJ-26-0794","DOIUrl":"10.1253/circj.CJ-26-0794","url":null,"abstract":"","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1348-1350"},"PeriodicalIF":5.8,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148809181","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}

{"title":"Defining Sarcopenic Obesity in the Asian Working Group for Sarcopenia 2025 Era: Diagnostic Precision Matters　- Reply.","authors":"Yuta Ozaki","doi":"10.1253/circj.CJ-26-0925","DOIUrl":"10.1253/circj.CJ-26-0925","url":null,"abstract":"","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1572"},"PeriodicalIF":5.8,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882215","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}

{"title":"Targeting Nuclear Factor-κB1 With Andrographolide　- Novel Strategy to Inhibit Vascular Lesions and Aneurysm Formation in Abdominal Aortic Aneurysm.","authors":"Ying Wen, Xing Fu, Zheng Chen, Jianxiang Wang, Yingying Liu, Yixian Ren, Zefeng Lin, Luhao Liu, Wai Ho Tang","doi":"10.1253/circj.CJ-25-0709","DOIUrl":"10.1253/circj.CJ-25-0709","url":null,"abstract":"<p><strong>Background: </strong>Abdominal aortic aneurysm (AAA) is a severe aortic disease with limited pharmacological treatment to prevent its progression. Whether early prevention of aortic lesions inhibits later formation of AAAs remains unclear. Therefore, this study aimed to investigate whether early intervention could prevent aortic lesion progression and AAA formation, and to explore the underlying molecular mechanisms.</p><p><strong>Methods and results: </strong>Genome-wide RNA sequencing of aortas from saline-treated mice and mice treated with angiotensin (Ang: 1,000 ng/kg/min) II via subcutaneously implanted mini-osmotic pumps for 14 or 28 days showed that nuclear factor (NF)-κB signaling contributes to the phenotypic switch and inflammation, and identified Nfkb1 as a potential key gene in vascular smooth muscle cells (VSMCs) for AAA development. Andrographolide (an NF-κB1 inhibitor) was administered via intraperitoneal injection at a dose of 20 mg/kg/day to pre-treat vascular lesions before AAA formation, and transcriptomic and functional studies were performed to explore the underlying mechanisms. In AngII-treated mice, andrographolide significantly attenuated vascular lesions at the early stage (day 14) and reduced AAA formation at later stages of the disease (day 28). Andrographolide also reduced aortic macrophage infiltration, decreased neutrophil recruitment, and suppressed cytokines. Although detailed mechanistic analyses focused on VSMCs due to their structural predominance in early lesions, chromatin immunoprecipitation (ChIP) further demonstrated that NF-κB1 regulates its direct target Krüppel-like factor 4 to induce VSMC dedifferentiation and tumor necrosis factor (TNF)-α to drive inflammation, indicating that NF-κB1 exacerbates inflammation via TNF-α signaling.</p><p><strong>Conclusions: </strong>Our results demonstrate a previously unrecognized role of vascular lesions in AAA development and progression. Andrographolide pretreatment may be a novel therapeutic approach for AAA.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1412-1424"},"PeriodicalIF":5.8,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724178","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}

{"title":"JCS/JPCPHS 2025 Guideline on Pulmonary Hypertension and Pulmonary Embolism/Deep Vein Thrombosis.","authors":"Yuichi Tamura, Kenya Kusunose, Yugo Yamashita, Teiji Akagi, Masanori Atsukawa, Yoshihiro Fukumoto, Ayumi Goda, Shinya Goto, Masaru Hatano, Masataka Ikeda, Keiichi Ishida, Masaharu Kataoka, Masataka Kuwana, Hiromi Matsubara, Makoto Mo, Tetsutaro Nagaoka, Takeshi Ogo, Yoshinori Okada, Seiichiro Sakao, Hirofumi Sawada, Toshiro Shinke, Nobuhiro Tanabe, Norikazu Yamada, Hiroyuki Yamagishi, Shingo Yano, Kohtaro Abe, Shiro Adachi, Kazuya Hosokawa, Nobutaka Ikeda, Takumi Inami, Masahiro Jinzaki, Masaru Kato, Takeshi Kitai, Shigetoyo Kogaki, Jun Koizumi, Yoshiteru Morio, Mari Nishizaki, Yoshito Ogihara, Keiko Ohta-Ogo, Kunihiro Shigematsu, Koichiro Sugimura, Yudai Tamura, Yu Taniguchi, Ichizo Tsujino, Keiko Uchida, Takeshi Yamamoto, Atsushi Yao, Nobuhiro Yaoita, Noriaki Emoto, Hiroaki Kitaoka, Mashio Nakamura, Hitoshi Ogino, Toru Satoh, Hiroshi Watanabe","doi":"10.1253/circj.CJ-25-1144","DOIUrl":"10.1253/circj.CJ-25-1144","url":null,"abstract":"","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1484-1570"},"PeriodicalIF":5.8,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370674","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}

{"title":"Glucose Fluctuations and Epicardial Adipose Tissue　- A New Paradigm for Diabetic Myocardial Damage.","authors":"Takeshi Soeki","doi":"10.1253/circj.CJ-26-0685","DOIUrl":"10.1253/circj.CJ-26-0685","url":null,"abstract":"","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1409-1411"},"PeriodicalIF":5.8,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148725149","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}