Acta Cardiologica Sinica最新文献

{"title":"The Relationship between Symptom Burden and Myocardial Fibrosis in Patients with Hypertrophic Cardiomyopathy.","authors":"Arda Güler, Irem Türkmen, Selcen Tülüce, Sinem Aydın, Sezgin Atmaca, Hasan Şahin, Mehmet Suna, Mustafa Can Gündogdu, Gökhan Demirci, Meltem Tekin, Nail Guven Serbest, Aysel Türkvatan Cansever, Mehmet Ertürk, Gamze Babur Güler","doi":"10.6515/ACS.202509_41(5).20250531B","DOIUrl":"10.6515/ACS.202509_41(5).20250531B","url":null,"abstract":"<p><strong>Background: </strong>Assessing the risk of sudden cardiac death in hypertrophic cardiomyopathy (HCM) patients is crucial. Cardiac magnetic resonance imaging (CMR) with late gadolinium enhancement (LGE) helps identify fibrosis, a key risk factor for sudden cardiac death. Current American Heart Association guidelines recommend implantable cardioverter-defibrillators for primary prevention in HCM patients with over 15% LGE. However, accurate LGE quantification requires specialized software, which is often unavailable in many centers. Symptom severity is often closely correlated with disease severity. This study investigates the relationship between symptom burden and high fibrosis in HCM patients.</p><p><strong>Methods: </strong>HCM patients from our cardiomyopathy clinic who underwent CMR between October 2021 and May 2023 were included. Symptom burden was assessed with the Kansas City Cardiomyopathy Questionnaire (KCCQ), with a lower score indicating higher symptom burden. High fibrosis was defined as LGE of 15% or more, evaluated by two radiologists.</p><p><strong>Results: </strong>Among 195 patients, 57 had high fibrosis. There were no significant differences in demographic data between groups. However, the high fibrosis group had significantly lower KCCQ scores, higher troponin and N-terminal pro B-type natriuretic peptide levels, lower left ventricular ejection fraction (LVEF), and greater wall thickness and LV mass index (LVMI). Logistic regression identified KCCQ score, LVEF derived from CMR, and CMR-LVMI as independent predictors of high fibrosis. A KCCQ score cut-off of 57.9 predicted high fibrosis with 77.1% sensitivity and 33.3% specificity (area under the curve: 0.717).</p><p><strong>Conclusions: </strong>Lower KCCQ score, reflecting higher symptom burden, was an independent predictor of high fibrosis in the enrolled HCM patients, highlighting its potential utility for fibrosis risk assessment.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"41 5","pages":"612-621"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145184533","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":"Dual Antiplatelet Therapy Duration May Affect the Clinical Outcomes in Older Patients with Acute Coronary Syndrome.","authors":"Can Ramazan Öncel, Cemal Köseoğlu, Ali Çoner","doi":"10.6515/ACS.202509_41(5).20250531A","DOIUrl":"10.6515/ACS.202509_41(5).20250531A","url":null,"abstract":"","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"41 5","pages":"683-684"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145184541","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":"Non-Vitamin K Antagonist Oral Anticoagulants for Thromboembolic Prevention in Patients with Atrial Fibrillation and Concomitant Mitral Stenosis: A Retrospective Observational Study.","authors":"Hao-Tien Liu, Hui-Ling Lee, Yu-Ching Wang, Shih-Chun Chou, Chung-Chuan Chou","doi":"10.6515/ACS.202509_41(5).20250429A","DOIUrl":"10.6515/ACS.202509_41(5).20250429A","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) increases the risks of ischemic stroke and systemic embolism, especially in patients with mitral stenosis (MS). Non-vitamin K antagonist oral anticoagulants (NOACs) are effective in preventing AF-related stroke and systemic embolic events. However, patients with AF and concomitant moderate-to-severe MS have been excluded from previous pivotal studies. We aimed to evaluate and compare the efficacy and safety of NOACs with vitamin K antagonists (VKAs) in this patient group.</p><p><strong>Methods: </strong>This retrospective observational study used data from the Chang Gung Research Database. We enrolled patients with AF and concomitant moderate-to-severe MS between January 2010 and December 2019. Propensity score matching was used to balance covariates between the NOAC and VKA groups. The risks of stroke, systemic embolism, and bleeding events were assessed following treatment.</p><p><strong>Results: </strong>After PSM, 115 patients with AF and concomitant moderate-to-severe MS were analyzed, of whom 32 were treated with NOACs and 83 with VKAs. There were no significant differences in the composite efficacy outcomes and bleeding risk between the NOAC and VKA groups. However, the all-cause mortality incidence rate was significantly lower in the NOAC group. Cox regression analysis showed that CHA₂DS₂-VASc score, but not mitral valve area, was a significant predictor of the composite efficacy outcomes.</p><p><strong>Conclusions: </strong>NOACs were as effective as VKAs in preventing stroke and systemic embolic events, with comparable bleeding risks in AF patients with concomitant moderate-to-severe MS. CHA₂DS₂-VASc score was superior to mitral valve area in predicting composite efficacy outcomes.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"41 5","pages":"622-633"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145184612","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 Efficacy of Aromatherapy in Alleviating Anxiety among Acute Myocardial Infarction Patients: A Systematic Review and Meta-Analysis.","authors":"Jia-Ying Hu, Wei-Cheng Lin, Teh-Fu Hsu, Yu-Chi Chen, Chia-Te Chen, Heng-Hsin Tung","doi":"10.6515/ACS.202509_41(5).20250429B","DOIUrl":"10.6515/ACS.202509_41(5).20250429B","url":null,"abstract":"<p><strong>Background: </strong>The primary aim of this study was to explore the effectiveness of aromatherapy in alleviating hospitalization-related anxiety in patients with acute myocardial infarction (AMI).</p><p><strong>Methods: </strong>A search of PubMed, Ovid Medline, Cochrane Library, CINAHL Database, Taiwan Periodical Literature Index System, and Airiti Library was conducted in October 2023. Following the inclusion and exclusion criteria, randomized controlled trials on aromatherapy in patients with AMI aged 18 years or older were identified. The risk of bias in the retrieved trials was assessed using the revised Cochrane Risk-of-Bias Tool for randomized controlled trials.</p><p><strong>Results: </strong>A total of 14 trials were identified. Aromatherapy was found to significantly reduce anxiety (Hedges's g = -2.087, 95% confidence interval [CI] = -2.8341 to -1.341, p < 0.001), although heterogeneity was notably high (I2 = 96.7%). The effects of different aromatherapies on anxiety were inconsistent. Geranium (Hedges's g = -6.970, 95% CI= -10.283 to -3.675, p < 0.001), M. Chamomile (Hedges's g = -3.735, 95% CI= -6.881 to -0.590, p = 0.002), and C. Aurantium (Hedges's g = -3.614, 95% CI= -5.885 to -1.343, p < 0.001) were found to significantly reduce anxiety. Aromatherapy was found to have a significant effect in lowering systolic blood pressure in these patients (Hedges's g = -0.903, 95% CI = -1.689 to -0.117, p = 0.024).</p><p><strong>Conclusions: </strong>Our findings suggest that clinical staff can apply aromatherapy in the care of AMI patients to alleviate anxiety and improve the quality of care.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"41 5","pages":"583-597"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12464060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145184562","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":"Percutaneous Closure of a Residual Inferior-Type Sinus Venosus Atrial Septal Defect via the Subclavian Vein: An Unique Case Report.","authors":"Mustafa Ucar","doi":"10.6515/ACS.202509_41(5).20250603A","DOIUrl":"10.6515/ACS.202509_41(5).20250603A","url":null,"abstract":"","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"41 5","pages":"676-679"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12464095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145184581","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 Characteristics and Angioplasty Outcomes in Lower Extremity Artery Disease Patients with Normal Ankle-Brachial Index: A Clinical Conundrum.","authors":"Yi-Jia Su, Szu-Han Wang, Po-Wei Chen, Ting-Hsing Chao, Hsien-Yuan Chang","doi":"10.6515/ACS.202509_41(5).20250515A","DOIUrl":"10.6515/ACS.202509_41(5).20250515A","url":null,"abstract":"<p><strong>Background: </strong>The resting ankle-brachial index (ABI) is widely used to diagnose lower extremity artery disease (LEAD). However, some LEAD patients have a normal ABI yet require percutaneous transluminal angioplasty (PTA).</p><p><strong>Methods: </strong>This was a retrospective study of consecutive LEAD patients who underwent PTA. The patients were classified into two groups based on the ABI of the limb that underwent PTA: the ABI-normal group (ABI 0.91-1.40), and ABI-abnormal group (ABI ≤ 0.90 or > 1.40). The primary endpoints were major adverse cardiovascular and cerebral events (MACCEs) and major adverse limb events (MALEs).</p><p><strong>Results: </strong>Of the 334 patients (mean age: 70 ± 12 years, 60% male), 69 (21%) had a normal ABI, and 265 (79%) had an abnormal ABI. After a median follow-up of 1.5 (0.6-3.1) years, 84 (25%) patients reached the primary or secondary endpoints. The ABI-normal group had a higher proportion of males (73% vs. 57%, p = 0.02) and a higher prevalence of chronic kidney disease (78% vs. 56%, p < 0.01). Angiography revealed less severe lesions in the femoropopliteal artery (p < 0.01) and a lower rate of stent deployment (15% vs. 31%, p < 0.01) in the ABI-normal group than in the ABI-abnormal group. However, the incidence rates of MACCEs (29% vs. 24%, p = 0.56) and MALEs (23% vs. 28%, p = 0.63) were comparable in the two groups.</p><p><strong>Conclusions: </strong>LEAD patients with a normal ABI often have less severe above-the-knee artery lesions but similar poor outcomes, highlighting the need for additional hemodynamic assessments and increased clinical attention.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"41 5","pages":"656-665"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12464101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145184615","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":"Two Sides of the Coin: EPAS-1 as a Potential D-Dimer Alternative in Pulmonary Embolism Evaluation.","authors":"Abdullah Icli, Ahmet Taha Sahin, Yakup Alsancak, Sefa Tatar, Ahmet Lutfu Sertdemir, Mustafa Celik, Hakan Akıllı","doi":"10.6515/ACS.202509_41(5).20250428C","DOIUrl":"10.6515/ACS.202509_41(5).20250428C","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to determine changes in endothelial PAS domain protein-1 (EPAS-1) levels, a biomarker proven to increase with hypoxia, at the time of diagnosis and after treatment in addition to laboratory parameters and scoring systems examined at the time of admission in patients with pulmonary thromboembolism.</p><p><strong>Methods: </strong>The study included 60 pulmonary embolism (PE) patients followed at the Cardiology clinic and 60 control participants with similar demographic characteristics. Laboratory parameters determined at the time of admission were examined. PE risk and severity scores were calculated, and EPAS-1 levels were also measured. To determine the response, EPAS-1 levels were checked 3 days later and compared with the control group.</p><p><strong>Results: </strong>There were no differences between the two groups in terms of demographic characteristics and comorbidities. EPAS-1 levels were higher at the time of diagnosis compared to the control group [(3.6 ± 1.42/1.57 ± 0.45), p < 0.001]. EPAS-1 levels were significantly positively correlated with pulmonary embolism severity index (PESI) severity score and risk score in the patient group. EPAS-1 levels decreased after treatment in the patients, and the tendency to decrease was different according to the types of treatment. In the patients who died, EPAS-1 levels continued to increase despite treatment (p = 0.014).</p><p><strong>Conclusions: </strong>Our study is important in that EPAS-1 levels were correlated with scoring systems and other laboratory parameters used in PE patients, and that it can be used as a predictor in the diagnosis of the disease and play a complementary role in the evaluation of treatment response.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"41 5","pages":"647-655"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12464059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145184549","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 Existence of Plaque in Carotid Artery Predicts Cardiovascular Death in Patients with End-Stage Renal Disease on Maintenance Hemodialysis.","authors":"Chieh-Fu Chen, Yu-Sen Peng, Ho-Tsung Hsin","doi":"10.6515/ACS.202509_41(5).20250714A","DOIUrl":"10.6515/ACS.202509_41(5).20250714A","url":null,"abstract":"<p><strong>Background: </strong>Atherosclerosis progresses after starting renal replacement therapy, and it contributes to high cardiovascular mortality. Carotid intima-media thickness (CIMT) and plaque offer a convenient method to explore the status of systemic atherosclerosis. The aim of this cohort study was to determine the significance of carotid plaque and other factors that may impact the clinical outcomes of end-stage renal disease (ESRD) patients.</p><p><strong>Methods: </strong>Two hundred and sixty-five patients who received maintenance hemodialysis for more than 3 months were enrolled in the study and closely followed for 2 years with clinical events recorded. The primary endpoint was cardiovascular death.</p><p><strong>Results: </strong>During the 2-year follow-up period, 11.7% of the patients died from cardiovascular causes; however none were caused by stroke. The patients with carotid plaques were older and had thicker left CIMT and right CIMT, lower serum albumin, higher alanine aminotransferase, higher serum glucose, lower serum creatinine, and higher rates of cardiovascular death and overall mortality. Logistic regression analysis showed that the existence of carotid plaque (odds ratio 3.39, 95% confidence interval: 1.577-7.292, p = 0.002) was significantly correlated with the primary outcome. Plaque also significantly impacted overall survival (log-rank p = 0.024).</p><p><strong>Conclusions: </strong>The presence of carotid plaque was a risk factor for cardiovascular death in patients with ESRD.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"41 5","pages":"666-671"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12464053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145184579","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":"IGF2BP1-Mediates m⁶A Modification of KLF4 and Upregulates ADRM1 to Affect EndMT in Diabetic Atherosclerosis.","authors":"Zhiwen Zhang, Quan Guo, Zhenzhou Zhao, Ming Nie, Qingbo Shi, En Li, Kaiyuan Liu, Haosen Yu, Lixin Rao, Muwei Li","doi":"10.6515/ACS.202509_41(5).20250104A","DOIUrl":"10.6515/ACS.202509_41(5).20250104A","url":null,"abstract":"<p><strong>Background: </strong>Atherosclerosis accelerates the progression of diabetes and metabolic syndrome. Endothelial to mesenchymal transition (EndMT) has been reported to promote the development of atherosclerosis and the generation of extracellular matrix. However, the mechanism of EndMT in diabetic atherosclerosis has not been fully clarified.</p><p><strong>Methods: </strong>Human umbilical vein endothelial cells (HUVECs) were treated with high glucose (HG) and transforming growth factor beta 1 (TGF-β1) to induce EndMT. The levels of insulin-like growth factor 2 mRNA-binding protein (IGF2BP), Krüppel-like factor 4 (KLF4), Adhesion-regulating molecule 1 (ADRM1), CD31, vWF, α-SMA and vimentin were detected by qRT-PCR and Western blot. Correlations among IGF2BP1, KLF4 and ADRM1 were analyzed by RIP and ChIP assays. MeRIP-qPCR was used to detect the m⁶A level. The effect of IGF2BP1 on the stability of KLF4 was detected by RNA stability assay. Wound healing and Transwell assays were used to detect HUVEC migration ability.</p><p><strong>Results: </strong>IGF2BP1, KLF4 and ADRM1 were upregulated in the diabetic atherosclerosis cell model, and IGF2BP1 knockdown inhibited HG combined with TGF-β1-induced EndMT in HUVECs. Mechanically, IGF2BP1 regulated the m⁶A level of KLF4. Functionally, IGF2BP1 upregulated KLF4 to promote HG combined with TGF-β1-induced EndMT in HUVECs. The results proved that IGF2BP1 regulated the KLF4/ADRM1 axis promoting EndMT in diabetic atherosclerosis.</p><p><strong>Conclusions: </strong>This study demonstrated that IGF2BP1-mediated m⁶A modification of KLF4 and upregulated ADRM1 affect EndMT in diabetic atherosclerosis.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"41 5","pages":"598-611"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145184569","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":"Intracardiac Pseudotumor as Initial Presentation of Immunoglobulin G4-Related Disease.","authors":"Ying-Chien Wang, Chao-Han Liu, Yueh-Min Lin, Ying-Cheng Chen, Ying-Chieh Liao, Chien-Hsun Hsia","doi":"10.6515/ACS.202509_41(5).20250617A","DOIUrl":"10.6515/ACS.202509_41(5).20250617A","url":null,"abstract":"","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"41 5","pages":"680-682"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145184576","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}