Journal of Geriatric Cardiology最新文献

{"title":"An exceptional case of coronary artery collateralization in unilateral pulmonary artery agenesis: implications for right heart failure in the elderly.","authors":"Çağlar Kaya, Nilay Solak","doi":"10.26599/1671-5411.2025.06.008","DOIUrl":"10.26599/1671-5411.2025.06.008","url":null,"abstract":"","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"22 6","pages":"600-602"},"PeriodicalIF":1.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602207","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 prognostic significance of the fibrosis-5 index in patients with acute decompensated heart failure.","authors":"Sefa Tatar, Yunus Emre Yavuz, Hilal Nur Gedik, Abdullah Içli, Hakan Akilli","doi":"10.26599/1671-5411.2025.06.002","DOIUrl":"10.26599/1671-5411.2025.06.002","url":null,"abstract":"<p><strong>Background: </strong>Acute decompensated heart failure (ADHF) is one of the leading causes of mortality, highlighting the importance of early identification of high-risk patients. The fibrosis-5 (FIB-5) index, traditionally used to evaluate hepatic fibrosis, may hold prognostic value in ADHF patients by reflecting systemic congestion, inflammation, and organ dysfunction. The hypothesis of this study is that the FIB-5 index is an independent predictor of 1-month mortality in patients with ADHF.</p><p><strong>Methods: </strong>This retrospective study included 155 patients diagnosed with ADHF between 2020 and 2024. Patients were divided into two groups based on their left ventricular ejection fraction (LVEF ≤ 40% or LVEF > 50%). Survival was monitored for one month, and clinical, biochemical, and echocardiographic parameters were compared between survivors and death. Logistic regression and receiver operating characteristic curve analyses were performed to assess the prognostic value of the FIB-5 index.</p><p><strong>Results: </strong>During the 1-month follow-up, 66 patients (42.6%) died. The mean FIB-5 index was significantly lower in non-survivors (-10.46 ± 6.93) compared to survivors (-8.10 ± 6.67) (<i>P</i> = 0.03). Multivariate regression analysis identified the FIB-5 index as an independent predictor of 1-month mortality (OR = 1.089, 95% CI: 1.022-1.160, <i>P</i> = 0.009). The receiver operating characteristic curve analysis demonstrated an area under the curve of 0.609 (95% CI: 0.51-0.699) with sensitivity of 59.6% and specificity of 63.4%. Kaplan-Meier survival analysis revealed significantly higher mortality rates among patients with lower FIB-5 values (log-rank: 7.887, <i>P</i> = 0.005).</p><p><strong>Conclusions: </strong>The FIB-5 index is an independent predictor of 1-month mortality in ADHF patients. Its low cost, non-invasive nature, and ability to reflect systemic inflammation and congestion make it a promising tool for risk stratification. Prospective studies are needed to validate its utility in clinical practice and evaluate its role in guiding therapeutic decisions.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"22 6","pages":"587-595"},"PeriodicalIF":1.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602220","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":"Berg Balance Scale score is a valuable predictor of all-cause mortality among acute decompensated heart failure patients.","authors":"Yu-Xuan Fan, Jing-Jing Cheng, Zhi-Qing Fan, Jing-Jin Liu, Wen-Juan Xiu, Meng-Yi Zhan, Lin Luo, Guang-He Li, Le-Min Wang, Yu-Qin Shen","doi":"10.26599/1671-5411.2025.06.003","DOIUrl":"10.26599/1671-5411.2025.06.003","url":null,"abstract":"<p><strong>Objective: </strong>To investigate possible associations between physical function assessment scales, such as Short Physical Performance Battery (SPPB) and Berg Balance Scale (BBS), with all-cause mortality in acute decompensated heart failure (ADHF) patients.</p><p><strong>Methods: </strong>A total of 108 ADHF patients were analyzed from October 2020 to October 2022, and followed up to May 2023. The association between baseline clinical characteristics and all-cause mortality was analyzed by univariate Cox regression analysis, while for SPPB and BBS, univariate Cox regression analysis was followed by receiver operating characteristic curves, in which the area under the curve represented their predictive accuracy for all-cause mortality. Incremental predictive values for both physical function assessments were measured by calculating net reclassification index and integrated discrimination improvement scores. Optimal cut-off value for BBS was then identified using restricted cubic spline plots, and survival differences below and above that cut-off were compared using Kaplan-Meier survival curves and the log-rank test. The clinical utility of BBS was measured using decision curve analysis.</p><p><strong>Results: </strong>For baseline characteristics, age, female, blood urea nitrogen, as well as statins, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, or angiotensin receptor-neprilysin inhibitors, were predictive for all-cause mortality for ADHF patients. With respect to SPPB and BBS, higher scores were associated with lower all-cause mortality rates for both assessments; similar area under the curves were measured for both (0.774 for SPPB and 0.776 for BBS). Furthermore, BBS ≤ 36.5 was associated with significantly higher mortality, which was still applicable even adjusting for confounding factors; BBS was also found to have great clinical utility under decision curve analysis.</p><p><strong>Conclusions: </strong>BBS or SPPB could be used as tools to assess physical function in ageing ADHF patients, as well as prognosticate on all-cause mortality. Moreover, prioritizing the improvement of balance capabilities of ADHF patients in cardiac rehabilitation regimens could aid in lowering mortality risk.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"22 6","pages":"555-562"},"PeriodicalIF":1.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602208","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":"From heart to hitchhiker: a rare encounter of anterolateral STEMI, streptococcus oralis endocarditis, and aortic abscess post-TAVR.","authors":"Husam Katib, Eram Chaudhry, Stephen Downing, Mahmoud Elamin, Hamza Yousaf, Sabeeh Islam","doi":"10.26599/1671-5411.2025.05.001","DOIUrl":"10.26599/1671-5411.2025.05.001","url":null,"abstract":"","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"22 5","pages":"547-550"},"PeriodicalIF":1.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12209156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555605","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":"Predictors of length of hospital stay and impact of a TAVI program on management and outcomes of patients undergoing transcatheter aortic valve implantation.","authors":"Albert Ariza-Solé, Rafael Romaguera, Elena Calvo, Isaac Llaó, Guillem Muntané-Carol, Rocío Castillo-Poyo, Victòria Lorente, Rocío Castillo Poyo, David Olivart, Oriol Alegre, Gerard Domene, Joan Antoni Gómez-Hospital","doi":"10.26599/1671-5411.2025.05.002","DOIUrl":"10.26599/1671-5411.2025.05.002","url":null,"abstract":"<p><strong>Background: </strong>The number of transcatheter aortic valve implantation (TAVI) procedures in patients with severe aortic stenosis (AS) is increasing worldwide. We aimed to assess the impact of a TAVI program on clinical profile, management and outcomes of these patients and to describe predictors of length of hospital stay (LoS) in this context.</p><p><strong>Methods: </strong>Retrospective single center study enrolling consecutive AS patients undergoing TAVI and surviving to discharge (January 2018-December 2022). A TAVI program was implemented in may 2021. Baseline clinical characteristics, management and in-hospital complications were registered. Predictors of long hospital stay (> 7 day) were assessed by binary logistic regression.</p><p><strong>Results: </strong>We included 614 patients, with mean age 80.5 years. Most patients (438/614, 71.2%) presented conditions that precluded an early discharge. Mean hospital stay was 7.6 days. Patients admitted after the implementation of the program had a significantly lower burden of comorbidities. The rate of conduction disturbances after TAVI remained stable around 60%. However, permanent pacemaker requirement declined from 30.3% to 22.5% (<i>P</i> = 0.028). LoS was reduced after the implementation of the program both in patients suitable for an early discharge (from 6.5 day to 4 day, <i>P</i> < 0.001) and unsuitable patients (from 9.4 day to 7.7 day, <i>P</i> = 0.014). The final predictive model for LoS included prior pacemaker and availability of TAVI program as protectors and other valvular diseases, day of the week, emergent procedures, and conduction disturbances and other complications as independent predictors of long stay after TAVI.</p><p><strong>Conclusions: </strong>Most patients undergoing TAVI present conditions that preclude an early hospital discharge. The implementation of a TAVI program improved selection of patients, with a lower burden of comorbidities, a lower rate of complications and a marked reduction of hospital stay.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"22 5","pages":"506-515"},"PeriodicalIF":1.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12209153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555665","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":"Factors associated with poor prognosis in elderly patients with congestive heart failure with comorbid cognitive impairment: impact of life circumstances.","authors":"Tomoko Tomioka, Ryoya Sato, Yosuke Ikumi, Shuhei Tanaka, Hiroki Shioiri","doi":"10.26599/1671-5411.2025.06.007","DOIUrl":"10.26599/1671-5411.2025.06.007","url":null,"abstract":"","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"22 6","pages":"603-608"},"PeriodicalIF":1.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602209","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":"Impact of admission-blood-glucose-to-albumin ratio on all-cause mortality and renal prognosis in critical patients with coronary artery disease: insights from the MIMIC-IV database.","authors":"Yong Hong, Bo-Wen Zhang, Jing Shi, Ruo-Xin Min, Ding-Yu Wang, Jiu-Xu Kan, Yun-Long Gao, Lin-Yue Peng, Ming-Lu Xu, Ming-Ming Wu, Yue Li, Li Sheng","doi":"10.26599/1671-5411.2025.06.001","DOIUrl":"10.26599/1671-5411.2025.06.001","url":null,"abstract":"<p><strong>Background: </strong>Blood glucose and serum albumin have been associated with cardiovascular disease prognosis, but the impact of admission-blood-glucose-to-albumin ratio (AAR) on adverse outcomes in critical ill coronary artery disease (CAD) patients was not investigated.</p><p><strong>Methods: </strong>Patients diagnosed with CAD were non-consecutively selected from the MIMIC-IV database and categorized into quartiles based on their AAR. The primary outcome was 1-year mortality, and secondary endpoints were in-hospital mortality, acute kidney injury (AKI), and renal replacement therapy (RRT). A restricted cubic splines model and Cox proportional hazard models assessed the association between AAR and adverse outcomes in CAD patients. Kaplan-Meier survival analysis determined differences in endpoints across subgroups.</p><p><strong>Results: </strong>A total of 8360 patients were included. There were 726 patients (8.7%) died in the hospital and 1944 patients (23%) died at 1 year. The incidence of AKI and RRT was 63% and 4.3%, respectively. High AAR was markedly associated with in-hospital mortality (HR = 1.587, <i>P</i> = 0.003), 1-year mortality (HR = 1.502, <i>P</i> < 0.001), AKI incidence (HR = 1.579, <i>P</i> < 0.001), and RRT (HR = 1.640, <i>P</i> < 0.016) in CAD patients in the completely adjusted Cox proportional hazard model. Kaplan-Meier survival analysis noted substantial differences in all endpoints based on AAR quartiles. Stratified analysis and interaction test demonstrated stable correlations between AAR and outcomes.</p><p><strong>Conclusions: </strong>The results highlight that AAR may be a potential indicator for assessing in-hospital mortality, 1-year mortality, and adverse renal prognosis in critical CAD patients.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"22 6","pages":"563-577"},"PeriodicalIF":1.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602210","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":"Strategies for a patient with severe aortic stenosis affected by appendage thrombosis, atrial fibrillation and coronary artery disease to undergo TAVI.","authors":"Enrico Maria Zardi, Lidia Sada, Matteo Pignatelli, Md Fabrizio Ugo, Andrea Berni, Emanuele Barbato, Domenico Maria Zardi","doi":"10.26599/1671-5411.2025.05.010","DOIUrl":"10.26599/1671-5411.2025.05.010","url":null,"abstract":"","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"22 5","pages":"551-554"},"PeriodicalIF":1.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12209154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555666","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":"TAVR in older adults with cardiogenic shock: current practice and future direction.","authors":"Min Ji Kwak, Jorge A Irizarry-Caro, Paola Rodriguez Martinez, James Going, Jessica Lee, Dana Giza, Nuzah Amjad, Ana Leech, Rachel Jantea, Renee Flores, Nahid Rianon, Abhijeet Dhoble","doi":"10.26599/1671-5411.2025.05.003","DOIUrl":"10.26599/1671-5411.2025.05.003","url":null,"abstract":"<p><p>Aortic stenosis (AS) is one of the most common types of valvular heart disease in older adults, with age being significantly associated with the development of AS. The transcatheter aortic valve replacement (TAVR) procedure, since it was first performed in 2002, has emerged as a preferred treatment option for patients who are at intermediate to high surgical risk due to advanced age or medical comorbidities. Older adults with severe AS may present with acute decompensated heart failure leading to cardiogenic shock (CS). Among patients 65 years and older with AS presenting for TAVR, 4.1% were reportedly in acute CS. Regardless of etiology, mortality from CS itself is high (30%-50%) and increases with advancing age. TAVR for these patients could provide a definite treatment for both AS and CS. There is still limited evidence regarding the safety and efficacy of TAVR in this population, but recent studies are promising, with successful procedural results and a good recovery rate after the procedure. However, particularly for older adults, there are other factors that clinicians should consider during pre- and post-procedural status, such as patient's goals, frailty, polypharmacy, dementia, or delirium. In this article, we reviewed current studies regarding TAVR for older adults with AS and CS, the reason for comprehensive geriatric assessment, and the introduction of appropriate geriatric assessment tools based on the Age-Friendly 4Ms framework that cardiologists can adopt in real-world practice.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"22 5","pages":"525-533"},"PeriodicalIF":1.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12209157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555667","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 of age with adverse events following coronary atherectomy during percutaneous coronary intervention.","authors":"Dae Yong Park, Jiun-Ruey Hu, Sean DeAngelo, Aviral Vij, Yasser Jamil, Golsa Babapour, Zafer Akman, Parsa Pazooki, Abdulla A Damluji, Jennifer Frampton DO, Darrick K Li, Michael G Nanna","doi":"10.26599/1671-5411.2025.05.007","DOIUrl":"10.26599/1671-5411.2025.05.007","url":null,"abstract":"<p><strong>Background: </strong>Coronary atherectomy is used to treat severely calcified coronary artery lesions which are more frequent with increasing age, but its impact in older adults has not been sufficiently examined.</p><p><strong>Methods: </strong>We compared adults ≥ 18 years old who underwent coronary atherectomy during inpatient PCI in 2016-2023 from the Vizient Clinical Data Base and compared outcomes in younger (< 65 years), youngest-old (65-74 years), middle-old (75-84 years), and oldest-old (≥ 85 years) adults. Primary outcome was in-hospital mortality, and secondary outcomes included postprocedural complications.</p><p><strong>Results: </strong>Among 47,337 patients who underwent coronary atherectomy, 19,862 (42.0%) were younger adults and 27,475 (58.0%) were older adults, including 13,583 youngest-old, 10,206 middle-old, and 3,686 oldest-old adults. Compared with younger adults, youngest-old adults had higher mortality (adjusted odds ratio [aOR] = 1.37, <i>P</i> < 0.001), ischemic stroke (aOR = 1.35, <i>P</i> = 0.005), gastrointestinal hemorrhage (GIH) (aOR = 1.44, <i>P</i> < 0.001), acute kidney injury (AKI) (aOR = 1.43, <i>P</i> < 0.001), tamponade (aOR = 1.86, <i>P</i> < 0.001), and pericardiocentesis (aOR = 2.32, <i>P</i> < 0.001). Middle-old adults had higher mortality (aOR = 1.80, <i>P</i> < 0.001), GIH (aOR = 1.42, <i>P</i> = 0.002), AKI (aOR = 1.63, <i>P</i> < 0.001), tamponade (aOR = 2.52, <i>P</i> < 0.001), and pericardiocentesis (aOR = 3.13, <i>P</i> < 0.001). Oldest-old adults had the highest odds for mortality (aOR = 2.03, <i>P</i> < 0.001), GIH (aOR = 1.48, <i>P</i> = 0.016), AKI (aOR = 2.26, <i>P</i> < 0.001), tamponade (aOR = 3.86, <i>P</i> < 0.001), and pericardiocentesis (aOR = 4.21, <i>P</i> < 0.001). There was a significant interaction (P-interaction=0.035) between atherectomy and age groups with regard to the odds of in-hospital mortality.</p><p><strong>Conclusions: </strong>In this large claims-based study, in-hospital mortality, GIH, AKI, tamponade, and pericardiocentesis were higher in older adults compared with younger adults, in a stepwise manner by age group.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"22 5","pages":"497-505"},"PeriodicalIF":1.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12209150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555603","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}