Journal of Geriatric Cardiology最新文献

{"title":"Prognostic value of quantitative flow ratio measured immediately after percutaneous coronary intervention for chronic total occlusion.","authors":"Zheng Qiao, Zhang-Yu Lin, Qian-Qian Liu, Rui Zhang, Chang-Dong Guan, Sheng Yuan, Tong-Qiang Zou, Xiao-Hui Bian, Li-Hua Xie, Cheng-Gang Zhu, Hao-Yu Wang, Guo-Feng Gao, Ke-Fei Dou","doi":"10.26599/1671-5411.2025.04.001","DOIUrl":"https://doi.org/10.26599/1671-5411.2025.04.001","url":null,"abstract":"<p><strong>Background: </strong>The clinical impact of post-percutaneous coronary intervention (PCI) quantitative flow ratio (QFR) in patients treated with PCI for chronic total occlusion (CTO) was still undetermined.</p><p><strong>Methods: </strong>All CTO vessels treated with successful anatomical PCI in patients from PANDA III trial were retrospectively measured for post-PCI QFR. The primary outcome was 2-year vessel-oriented composite endpoints (VOCEs, composite of target vessel-related cardiac death, target vessel-related myocardial infarction, and ischemia-driven target vessel revascularization). Receiver operator characteristic curve analysis was conducted to identify optimal cutoff value of post-PCI QFR for predicting the 2-year VOCEs, and all vessels were stratified by this optimal cutoff value. Cox proportional hazards models were employed to calculate the hazard ratio (HR) with 95% CI.</p><p><strong>Results: </strong>Among 428 CTO vessels treated with PCI, 353 vessels (82.5%) were analyzable for post-PCI QFR. 31 VOCEs (8.7%) occurred at 2 years. Mean value of post-PCI QFR was 0.92 ± 0.13. Receiver operator characteristic curve analysis shown the optimal cutoff value of post-PCI QFR for predicting 2-year VOCEs was 0.91. The incidence of 2-year VOCEs in the vessel with post-PCI QFR < 0.91 (<i>n</i> = 91) was significantly higher compared with the vessels with post-PCI QFR ≥ 0.91 (<i>n</i> = 262) (22.0% <i>vs.</i> 4.2%, HR = 4.98, 95% CI: 2.32-10.70).</p><p><strong>Conclusions: </strong>Higher post-PCI QFR values were associated with improved prognosis in the PCI practice for coronary CTO. Achieving functionally optimal PCI results (post-PCI QFR value ≥ 0.91) tends to get better prognosis for patients with CTO lesions.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"22 4","pages":"433-442"},"PeriodicalIF":1.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nonlinear association between serum albumin levels and all-cause mortality in elderly patients with chronic aortic regurgitation.","authors":"Ming-Hui Li, Qing-Rong Liu, Zhen-Yan Zhao, Hai-Yan Xu, Yong-Jian Wu","doi":"10.26599/1671-5411.2025.04.003","DOIUrl":"https://doi.org/10.26599/1671-5411.2025.04.003","url":null,"abstract":"<p><strong>Background: </strong>Low serum albumin levels are established predictors of adverse outcomes in various cardiovascular conditions. However, the role of serum albumin in mortality among elderly patients with chronic aortic regurgitation (AR) has not been thoroughly investigated. This study aims to assess the relationship between serum albumin levels and mortality in this specific patient population.</p><p><strong>Methods: </strong>Our analysis included 873 elderly AR patients from the China Valvular Heart Disease study, with baseline serum albumin measured at enrollment. Mortality outcomes were monitored for two years post-enrollment, employing a Cox proportional hazards model with a two-piecewise Cox proportional hazards framework to investigate the nonlinear relationship between serum albumin levels and all-cause mortality.</p><p><strong>Results: </strong>During the 2-year follow-up period, we observed 63 all-cause deaths. The association between serum albumin levels and all-cause mortality displayed an approximating L-shaped curve, indicating a mortality threshold at 35 g/L. For serum albumin levels below 35 g/L, each 1 g/L decrease was associated with a 25% higher risk of all-cause mortality (HR = 1.25, 95% CI: 1.07-1.45). In contrast, no significant change in mortality risk was observed when serum albumin levels were greater than or equal to 35 g/L. Moreover, when serum albumin is classified as hypoproteinemia (serum albumin < 35 g/L), the higher risks of all-cause death were observed in hypoproteinemic patients (HR = 2.93, 95% CI: 1.50-5.74). More importantly, the association between serum albumin and death was significantly stronger in overweight/obese patients (≥ 24 kg/m² <i>vs.</i> < 24 kg/m², <i>P</i> _interaction = 0.006).</p><p><strong>Conclusions: </strong>In elderly patients with AR, serum albumin levels showed an approximating L-shaped relationship with all-cause death, with thresholds of 35 g/L. Body mass index was significant effect modifiers of the association. These results suggest that serum albumin, as an inexpensive and readily available biochemical marker, may further improve the stratified risk of mortality in older AR patients.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"22 4","pages":"423-432"},"PeriodicalIF":1.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral sceletonized internal mammary arteries for myocardial revascularization in elderly patients.","authors":"Živojin S Jonjev, Ilija Bjeljac, Aleksandar M Milosavljević, Mirko Todić, Strahinja Mrvić, Novica Kalinić","doi":"10.26599/1671-5411.2025.04.004","DOIUrl":"https://doi.org/10.26599/1671-5411.2025.04.004","url":null,"abstract":"<p><strong>Background: </strong>Bilateral internal mammary arteries (BIMAs) as the most advanced surgical option for coronary artery bypass grafting (CABG) are usually recommended for younger patients without traditional risk factors. This study compares outcomes in propensity score-matched patients aged over 70 years who received BIMAs versus those who received a single internal mammary artery (SIMA).</p><p><strong>Methods: </strong>From 2013 to 2024, 8123 patients underwent primary CABG for multivessel coronary artery disease at our institution. BIMA grafting was performed in 1233 patients (15.17%), with <i>in situ</i> BIMA grafting in 290 patients (3.57%). For <i>in situ</i> BIMA group, the right internal mammary artery was used to revascularize the right coronary artery, while the left internal mammary artery was utilized for the left anterior descending artery. BIMA patients aged over 70 years (<i>n</i> = 79) were compared with SIMA patients (<i>n</i> = 79) using propensity score matching. Primary outcome was all-cause mortality at 30 days and 8 years. Secondary outcomes included length of hospital stay, incidence of postoperative major adverse cardiovascular and cerebrovascular events, sternal wound infection and the need for subsequent percutaneous revascularization.</p><p><strong>Results: </strong>There was no difference in immediate postoperative primary and secondary outcomes. Mean follow-up was 8.3 ± 1.0 years with an 8-year freedom from death of 67.08% ± 1.1% in the BIMA group versus 58.22% ± 0.9% in the SIMA group (<i>P</i> < 0.05).</p><p><strong>Conclusions: </strong>BIMAs as <i>in situ</i> grafts can be successfully used in CABG for patients aged 70 years and older. Consequently, the refined techniques for constructing internal mammary artery grafts used in this study challenge traditionally accepted limitations regarding the use of BIMAs.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"22 4","pages":"415-422"},"PeriodicalIF":1.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Convergence of relative apical hypertrophic cardiomyopathy and acute myocardial infarction in an elderly patient: a case report.","authors":"Xiao-Ya Su, Zhong Yin, Wei Dong","doi":"10.26599/1671-5411.2025.04.002","DOIUrl":"https://doi.org/10.26599/1671-5411.2025.04.002","url":null,"abstract":"","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"22 4","pages":"458-462"},"PeriodicalIF":1.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management challenges of aortic fibroelastomas in elderly patients: a dilemma between embolic risk and bleeding risk.","authors":"Nicholas Seton, Samantha Wilson, Maria Gabriela Matta","doi":"10.26599/1671-5411.2025.04.008","DOIUrl":"https://doi.org/10.26599/1671-5411.2025.04.008","url":null,"abstract":"","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"22 4","pages":"463-464"},"PeriodicalIF":1.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The successful implantation of CRT-D using the catheter within catheter technique in a patient with a type IIIA persistent left superior vena cava.","authors":"Bekir Serhat Yildiz, Ramazan Gunduz, Su Ozgur","doi":"10.26599/1671-5411.2025.04.005","DOIUrl":"https://doi.org/10.26599/1671-5411.2025.04.005","url":null,"abstract":"","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"22 4","pages":"465-468"},"PeriodicalIF":1.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Another example of Aslanger' s sign.","authors":"Koji Takahashi, Nobuhisa Yamamura, Mako Yoshino, Daijiro Enomoto, Hiroe Morioka, Shigeki Uemura, Takafumi Okura, Tomoki Sakaue, Katsuji Inoue","doi":"10.26599/1671-5411.2025.04.007","DOIUrl":"https://doi.org/10.26599/1671-5411.2025.04.007","url":null,"abstract":"","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"22 4","pages":"455-457"},"PeriodicalIF":1.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between geriatric nutritional risk index and cardiovascular disease and all-cause mortality in patients with osteoporosis and osteopenia.","authors":"Sheng-Han Wang, Hang Yin, Shan-Shan Zhou","doi":"10.26599/1671-5411.2025.04.006","DOIUrl":"https://doi.org/10.26599/1671-5411.2025.04.006","url":null,"abstract":"<p><strong>Background: </strong>The correlation between geriatric nutritional risk index (GNRI) and the prognosis of patients with osteoporosis or osteopenia has not been studied. This study aims to explore the relationship between GNRI and the cardiovascular disease (CVD) and all-cause mortality rates in elderly patients with osteoporosis or osteopenia.</p><p><strong>Methods: </strong>This study included 4756 patients with osteoporosis and osteopenia from five cycles of the National Health and Nutrition Examination Survey (NHANES). We used multivariable Cox regression and subgroup analyses to investigate the correlation between GNRI and mortality rates. The restricted cubic spline analysis was used to assess the dose-response relationship between GNRI and mortality risk. Mediation analysis was conducted to examine the mediating effect of chronic kidney disease on the relationship between nutritional risk and mortality.</p><p><strong>Results: </strong>During a median follow-up period of 114 months, a total of 1241 deaths (26.09%) occurred, including 300 deaths due to CVD (6.31%). In the fully adjusted Model 3, compared to the no-risk group, the risk group showed significantly increased all-cause mortality risk (HR = 2.05, 95% CI: 1.74-2.40) and CVD mortality risk (HR = 1.88, 95% CI: 1.30-2.71). The restricted cubic spline analysis indicated a non-linear association between GNRI and all-cause mortality risk as well as CVD mortality risk. The mediation analysis results indicated that chronic kidney disease mediates 16.9% of the effect of nutritional risk on all-cause mortality and 25.3% on CVD mortality risk.</p><p><strong>Conclusions: </strong>GNRI can serve as a predictive factor for all-cause and CVD mortality rates in elderly patients with osteoporosis or osteopenia.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"22 4","pages":"443-454"},"PeriodicalIF":1.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between blood pressure traits, hypertension, antihypertensive drugs and calcific aortic valve stenosis: a mendelian randomization study.","authors":"Wen-Hua Lei, Jia-Liang Zhang, Yan-Biao Liao, Yan Wang, Fei Xu, Yao-Yu Zhang, Yanjiani Xu, Jing Zhou, Fang-Yang Huang, Mao Chen","doi":"10.26599/1671-5411.2025.03.008","DOIUrl":"https://doi.org/10.26599/1671-5411.2025.03.008","url":null,"abstract":"<p><strong>Background: </strong>Hypertension is associated with an increased risk of calcific aortic valve stenosis (CAVS). However, the directionality of causation between blood pressure traits and aortic stenosis is unclear, as is the benefit of antihypertensive drugs for CAVS.</p><p><strong>Methods: </strong>Using genome-wide association studies (GWAS) summary statistics, we performed bidirectional two-sample univariable mendelian randomization (UVMR) to assess the causal associations of systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure (PP) with CAVS. Multivariable mendelian randomization (MVMR) was conducted to evaluate the direct effect of hypertension on CAVS, adjusting for confounders. Drug target mendelian randomization (MR) and summary-level MR (SMR) were used to estimate the effects of 12 classes of antihypertensive drugs and their target genes on CAVS risk. Inverse variance weighting was the primary MR method, with sensitivity analyses to validate results.</p><p><strong>Results: </strong>UVMR showed SBP, DBP, and PP have causal effects on CAVS, with no significant reverse causality. MVMR confirmed the causality between hypertension and CAVS after adjusting for confounders. Drug-target MR analyses indicated that calcium channel blockers (CCBs), loop diuretics, and thiazide diuretics via SBP lowering exerted protective effects on CAVS risk. SMR analysis showed that the CCBs target gene <i>CACNA2D2</i> and ARBs target gene <i>AGTR1</i> were positively associated with CAVS risk, while diuretics target genes <i>SLC12A5</i> and <i>SLC12A1</i> were negatively associated with aortic stenosis risk.</p><p><strong>Conclusions: </strong>Hypertension has a causal relationship with CAVS. Managing SBP in hypertensive patients with CCBs may prevent CAVS. ARBs might exert protective effects on CAVS independent of blood pressure reduction. The relationship between diuretics and CAVS is complex, with opposite effects through different mechanisms.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"22 3","pages":"351-360"},"PeriodicalIF":1.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical implication of post-angioplasty quantitative flow ratio in the patients with coronary artery de novo lesions underwent drug-coated balloons treatment.","authors":"Yun-Hui Zhu, Xu-Lin Hong, Tian-Li Hu, Qian-Qian Bian, Yu-Fei Chen, Tian-Ping Zhou, Jing Li, Guo-Sheng Fu, Wen-Bin Zhang","doi":"10.26599/1671-5411.2025.03.006","DOIUrl":"https://doi.org/10.26599/1671-5411.2025.03.006","url":null,"abstract":"<p><strong>Background: </strong>Quantitative flow ratio (QFR) holds significant value in guiding drug-coated balloon (DCB) treatment and enhancing outcomes. However, the predictive capability of post-angioplasty QFR for long-term clinical events in patients with de novo lesions who receive DCB treatment remains uncertain. The aim of this study was to explore the potential significance of post-angioplasty QFR measurements in predicting clinical outcomes in patients underwent DCB treatment for de novo lesions.</p><p><strong>Methods: </strong>Patients who underwent DCB-only intervention for de novo lesions were enrolled. QFR was conducted after DCB treatment. The patients were then categorized based on post-angioplasty QFR. The primary endpoint was major adverse cardiac events (MACE), encompassing all-cause death, cardiovascular death, nonfatal myocardial infarction, stroke, and target vessel revascularization.</p><p><strong>Results: </strong>A total of 553 patients with 561 lesions were included. The median follow-up period was 505 days, during which 66 (11.8%) MACEs occurred. Based on post-procedural QFR grouping, there were 259 cases in the high QFR group (QFR > 0.93) and 302 cases in the low QFR group (QFR ≤ 0.93). Kaplan-Meier analysis revealed a significantly higher cumulative incidence of MACE in the low QFR group (log-rank <i>P</i> = 0.004). The multivariate Cox proportional hazards model demonstrated a significant inverse correlation between QFR and the occurrence of MACEs (HR = 0.522, 95%CI: 0.289-0.942, <i>P</i> = 0.031). Landmark analysis indicated that high QFR had a significant reducing effect on the cumulative incidence of MACEs within 1 year (log-rank <i>P</i> = 0.016) and 1-5 years (log-rank <i>P</i> = 0.026).</p><p><strong>Conclusions: </strong>In patients who underwent DCB-only treatment for de novo lesions, higher post-procedural QFR values (> 0.93) were identified as an independent protective factor against adverse prognosis.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"22 3","pages":"332-343"},"PeriodicalIF":1.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}