Acta cardiologica最新文献

{"title":"The role of nutritional status, measured by serum albumin, as a prognostic factor in wild-type transthyretin amyloidosis.","authors":"Santiago Decotto, Pilar Domenech, Rocio Blanco, Emiliano Rossi, María Lourdes Posadas-Martinez, Marcelina Carretero, Adela Aguirre, Elsa Nucifora, Erika Brulc, Mariano Falconi, Rodolfo Pizarro, Diego Perez de Arenaza","doi":"10.1080/00015385.2026.2669696","DOIUrl":"https://doi.org/10.1080/00015385.2026.2669696","url":null,"abstract":"<p><strong>Background: </strong>Nutritional status is a recognised prognostic factor across various diseases, with serum albumin commonly used as a surrogate marker. However, its role in wild-type transthyretin cardiac amyloidosis (ATTRwt) remains underexplored. We aimed to assess the prognostic value of serum albumin at diagnosis in patients with ATTRwt.</p><p><strong>Methods: </strong>Retrospective cohort study of ATTRwt patients included in an institutional registry between 2008 and 2023. Serum albumin was measured at diagnosis. The primary outcome was two-year all-cause mortality. A receiver operating characteristic (ROC) curve was used to identify the optimal albumin cut-off. Patients were stratified accordingly, and survival analysis was performed using Kaplan-Meier curves and Cox regression models adjusted for clinically relevant variables.</p><p><strong>Results: </strong>We included 129 patients (mean age 81 ± 7 years; 86% male). Median serum albumin was 3.97 [3.70-4.20] g/dL. During follow-up, 26% of patients (<i>n</i> = 34) died. The optimal cut-off to predict mortality was 3.88 g/dL (AUC: 0.74; sensitivity: 73.5%; specificity: 75.7%). Patients with serum albumin ≤ 3.88 g/dL (<i>n</i> = 47, 36%) were older and had higher prevalence of heart failure and atrial fibrillation at diagnosis, along with elevated serum creatinine and NT-proBNP levels (all <i>p</i> < .05). Two-year mortality was significantly higher in this group (51% vs. 12%, log-rank <i>p</i> < .001). In multivariable analysis adjusted for age, NT-proBNP, and heart failure at diagnosis, low serum albumin and heart failure remained independently associated with the outcome.</p><p><strong>Conclusion: </strong>Lower serum albumin levels were associated with a higher incidence of all-cause mortality in patients with ATTRwt, underscoring the prognostic value of nutritional status in this population.</p>","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"1-7"},"PeriodicalIF":2.5,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methodological considerations in comparing younger and older patients with acute myocardial infarction undergoing invasive management.","authors":"Saptanil Das, Archana Dhyani, Rajnish Kumar, Heena Arora","doi":"10.1080/00015385.2026.2667546","DOIUrl":"https://doi.org/10.1080/00015385.2026.2667546","url":null,"abstract":"","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"1-2"},"PeriodicalIF":2.5,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MORGAS (<u>MOR</u>tality <u>OR</u>iented <u>G</u>lucose, <u>A</u>ge, <u>S</u>moking, and <u>S</u>tent <u>S</u>core) predicts mortality after percutaneous coronary intervention.","authors":"Mohammadjavad Sotoudeheian","doi":"10.1080/00015385.2026.2664058","DOIUrl":"https://doi.org/10.1080/00015385.2026.2664058","url":null,"abstract":"<p><strong>Background: </strong>Accurate prediction of mortality after percutaneous coronary intervention (PCI) remains a clinical challenge. Existing risk scores often lack specificity or require complex variables, limiting bedside applicability. This study introduces MORGAS (MORtality ORiented Glucose, Age, Smoking, and Stent score), a novel predictive model for post-PCI mortality.</p><p><strong>Methods: </strong>Data from 573 PCI patients in a derivation cohort and 566 patients in an external validation cohort were analysed. Feature selection combined Extreme Gradient Boosting and LASSO regression, identifying four key predictors: age, fasting glucose, smoking status, and number of stents. A logistic regression model incorporating polynomial and interaction terms was developed. Model performance was assessed using area under the curve (AUC), calibration plots, Brier scores, and decision curve analysis.</p><p><strong>Results: </strong>In the derivation cohort, MORGAS achieved an AUC of 0.766, sensitivity 75.6%, specificity 71.2%, and negative predictive value 97.4%. Internal validation confirmed stability (AUC 0.726). External validation showed moderate discrimination (AUC 0.656) with preserved clinical utility across relevant risk thresholds. Calibration analysis indicated slight overestimation at higher predicted risks.</p><p><strong>Conclusions: </strong>MORGAS is a simple, clinically applicable tool integrating four readily available variables to predict mortality after PCI. Its performance and decision-analytic utility suggest potential for guiding individualised post-PCI care and improving risk stratification in diverse clinical settings.</p>","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"1-15"},"PeriodicalIF":2.5,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating ChatGPT's adherence to evidence-based heart failure guidelines: a comparative analysis using the 2023 ESC and 2022 ACC/AHA/HFSA recommendations.","authors":"Mohammed Jassim Alnuwaysir, Abdullah Shaker Aljama, Abdulkarim Kassim Abdulgalil Galib, Wafa Ali Aldawood, Farah Nedal Taiseer AlRatrout, Reem S AlSulaiman, Kawthar Ali AlNasser, Mohammed Taha Al-Hariri","doi":"10.1080/00015385.2026.2668803","DOIUrl":"https://doi.org/10.1080/00015385.2026.2668803","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) remains a major cause of morbidity and mortality worldwide. Large language models (LLMs) such as ChatGPT are emerging as potential clinical decision support tools, but their adherence to specialty guidelines is not well characterised.</p><p><strong>Objectives: </strong>To evaluate the accuracy and guideline concordance of ChatGPT-5 in managing real-world HF scenarios compared with the 2023 European Society of Cardiology (ESC) and 2022 American College of Cardiology (ACC)/American Heart Association (AHA)/Heart Failure Society of America (HFSA) recommendations.</p><p><strong>Methods: </strong>Thirty-eight anonymised HF clinical vignettes spanning reduced, mildly reduced, and preserved ejection fraction phenotypes and varied New York Heart Association (NYHA) classes were presented to ChatGPT-5. Two board-certified cardiologists independently graded each response for concordance with guideline recommendations using a 4-point scale (3 = fully concordant, 2 = partially concordant, 1 = discordant, 0 = unsafe/harmful). Discrepancies were adjudicated by a third reviewer. Descriptive statistics summarised performance and inter-rater agreement.</p><p><strong>Results: </strong>Of the 38 responses, 20 (53%) were fully concordant, 4 (11%) partially concordant, 8 (21%) discordant, and 6 (16%) unsafe/harmful. Most inaccuracies involved vague drug titration guidance, incomplete device therapy recommendations, or omission of guideline-directed medical therapy (GDMT). Unsafe suggestions occurred in complex device or advanced therapy decisions. Inter-rater agreement was high.</p><p><strong>Conclusions: </strong>ChatGPT-5 showed moderate concordance with ESC and ACC/AHA/HFSA HF guidelines, indicating potential value as a tool for knowledge synthesis and preliminary clinical support. However, its outputs require expert validation, and safe clinical integration will depend on future models incorporating guideline-based frameworks, real-time data, and rigorous physician oversight.</p>","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"1-7"},"PeriodicalIF":2.5,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The sarcopenia and frailty conundrum in heart failure: a clinical perspective from the FREE registry.","authors":"José Carlos Arévalo Lorido, Nadia Mayoral Testón, Elena Vazquez Jarén, Maria Reyes González Fernández, Bárbara Cancho Castellano, Nicolas Roberto Robles, Juana Carretero Gómez, Luisa Muñoz Salvador, Daniel Fernández-Bergés","doi":"10.1080/00015385.2026.2664040","DOIUrl":"https://doi.org/10.1080/00015385.2026.2664040","url":null,"abstract":"<p><strong>Aims: </strong>The interplay between sarcopenia and frailty is difficult to delimit and has been little analysed in patients with acute heart failure (HF). This work aims to describe the relationship between sarcopenia and frailty and analyse its impact on congestion and early outcomes.</p><p><strong>Methods: </strong>This is a single-centre observational study. Patients with decompensated HF were classified based on presence of sarcopenia and on presence of frailty. Patients with sarcopenia were analysed in terms of plasma volume variations or natriuretic peptides. A correlation analysis between patients with sarcopenia and functional, cognitive, depression, nutritional and frailty status was performed. The influence of both sarcopenia and frailty on early readmissions was also analysed.</p><p><strong>Results: </strong>A total of 224 patients (mean age 81.2 years (2.9), 48.7% males) were analysed. Of them, 11.2% had sarcopenia and 74.5% had frailty. Natriuretic peptide levels were higher in those with sarcopenia but haematocrit values were lower. Patients with sarcopenia tended to have haemodilution, though this finding was not significant (46.8% vs 37.2%, <i>p</i> = 0.47). The correlation analysis showed a significant relationship between sarcopenia, and time up and go test. Frailty was related to malnourishment, cognitive and depressive disorders, and the Lawton-Brodie index. Only sarcopenia was independently related to early readmissions (OR 3.2, 95%CI 1.2-8.0, <i>p</i> = 0.01).</p><p><strong>Conclusions: </strong>The prevalence of sarcopenia and frailty can vary within a population of patients with HF. Sarcopenia associated with muscle dysfunction but not with other domains of frailty determined a poorer congestive status and a higher early readmission rate.</p>","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"1-11"},"PeriodicalIF":2.5,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimising cinefluoroscopy for accurate evaluation of mechanical prosthetic valves.","authors":"Arda Guler, Busra Kuru Gorgulu, Dilara Pay, Kadir Sadıkoglu, Mehmet Çiçek, Sezgin Atmaca, Gizem Nur Coskun, Bahar Zeynep Cetin, Yusuf Efe, Yunus Emre Erata, Irem Turkmen, Muhammed Mustafa Yıldız, Gamze Babur Guler","doi":"10.1080/00015385.2026.2668746","DOIUrl":"https://doi.org/10.1080/00015385.2026.2668746","url":null,"abstract":"<p><strong>Background: </strong>Accurate assessment of mechanical prosthetic heart valves (PHVs) is essential to ensure proper function and long-term durability. Cinefluoroscopy (CF) enables real-time visualisation of valve leaflet motion but relies heavily on optimal projection angles for diagnostic accuracy. This study aimed to optimise CF imaging parameters to improve the reliability and precision of PHV evaluation.</p><p><strong>Methods: </strong>Between October 2021 and June 2024, 262 patients with mechanical aortic or mitral PHVs underwent CF evaluation based on clinical or echocardiographic indications. Valve motion was evaluated across multiple patient positions (supine, right and left lateral decubitus) and C-arm projections. Imaging was considered optimal when the X-ray beam was perpendicular to the valve plane, allowing accurate visualisation of leaflet motion. If optimal imaging could not be achieved across all standard views, it was classified as non-optimal.</p><p><strong>Results: </strong>A total of 331 mechanical PHVs were evaluated, including 250 aortic and 81 mitral prostheses. Optimal imaging was achieved in 94.8% of aortic and 66.7% of mitral valves. The supine position yielded the best visualisation in both groups (87.8% for aortic, 61.1% for mitral). The most frequent optimal projection was left anterior oblique-cranial for aortic valves and right anterior oblique-cranial for mitral valves.</p><p><strong>Conclusions: </strong>This study demonstrates that CF is an effective imaging modality for mechanical PHVs when appropriate positioning and projection angles are used. Optimal imaging is more readily achieved in aortic valves, while mitral valves require a more tailored approach due to anatomical constraints. Standardising imaging techniques may improve diagnostic accuracy and reduce radiation exposure in clinical practice.</p>","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"1-7"},"PeriodicalIF":2.5,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-invasive imaging of spontaneous coronary artery dissection in an adolescent male: diagnosis and healing.","authors":"Jie Wang, Cheng-Yi Xu, Min Li, Xin-Yu Wang, Ping Hu, Xiao-Jing Ma","doi":"10.1080/00015385.2026.2663652","DOIUrl":"https://doi.org/10.1080/00015385.2026.2663652","url":null,"abstract":"","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"1-2"},"PeriodicalIF":2.5,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the mechanisms and management of sepsis-related cardiac dysfunction.","authors":"Muhammad Shahid Iqbal, Mohd Faiyaz Khan, Sadaf Farooqui, Muhammad Zahid Iqbal, Salah-Ud-Din Khan, Amr Ali Mohamed Abdelgawwad El-Sehrawy","doi":"10.1080/00015385.2026.2664100","DOIUrl":"https://doi.org/10.1080/00015385.2026.2664100","url":null,"abstract":"<p><p>Sepsis-related cardiac dysfunction (SRCD) represents a critical determinant of both acute mortality and long-term cardiovascular morbidity in sepsis survivors. Sepsis-related cardiac dysfunction denotes the spectrum of acute, non-ischemic myocardial impairment occurring in the setting of sepsis, ranging from subclinical myocardial injury detected by biomarkers or strain imaging to overt systolic or diastolic dysfunction, right-ventricular predominance, and, rarely, sepsis-associated cardiogenic shock; SRCD may be transient in many patients but can also seed persistent cardiac vulnerability. Moving beyond the historical view of reversible septic cardiomyopathy, contemporary evidence reveals a heterogeneous syndrome encompassing systolic, diastolic, and right ventricular impairment, often with subclinical myocardial injury. This review synthesises recent mechanistic advances, highlighting mitochondrial dysfunction, dysregulated immune-cardiac crosstalk, and programmed cell death pathways as central drivers. We discuss the limitations of conventional ejection fraction-based assessment and advocate for multimodal phenotyping incorporating strain imaging, tissue characterisation, and novel biomarker panels. Despite current management being anchored in hemodynamic support, emerging mechanism-based strategies, including immunomodulation, metabolic resuscitation, and cell death inhibition, offer promising avenues for precision therapy. The integration of multi-omics data and machine learning may help refine the classification of sepsis cardiomyopathy into biologically coherent endotypes, guiding future trials and personalised care. Ultimately, a shift from syndrome-level to endotype-guided management is imperative to improve both acute outcomes and long-term cardiovascular health in sepsis survivors.</p>","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"1-17"},"PeriodicalIF":2.5,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Available volume for expansion (AVE): a novel volumetric predictor of left atrial reservoir function.","authors":"Dimitrios Ntelios, Anastasia Erythropoulou-Kaltsidou, Efstathios Pagourelias, Olivia Mauromoustaki, Vassilios Vassilikos","doi":"10.1080/00015385.2026.2664247","DOIUrl":"https://doi.org/10.1080/00015385.2026.2664247","url":null,"abstract":"","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"1-2"},"PeriodicalIF":2.5,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of triple trouble: malignant inter-arterial course of RCA with its high transcommissural origin and deep intramyocardial bridging presenting as chest pain.","authors":"Rashmeet Kaur, Resham Singh, Varun Bansal, Lokesh Rana, Narvir Singh Chauhan","doi":"10.1080/00015385.2026.2658910","DOIUrl":"https://doi.org/10.1080/00015385.2026.2658910","url":null,"abstract":"<p><p>Coronary artery anomalies are uncommon in routine clinical practice, but some variants can have important clinical implications when they compromise coronary blood flow. One such pattern is an anomalous origin of the right coronary artery (RCA) with an inter-arterial course with deep intramyocardial bridging and transcommissural origin, which is considered a potentially high-risk configuration. We report a 57-year-old man who presented with exertional chest pain and was diagnosed with non-ST elevation myocardial infarction. To better delineate the anatomy, ECG-gated cardiac computed tomography (CT) angiography was performed. CT angiography demonstrated a high transcommissural origin of the RCA above the sinotubular junction. The RCA then coursed between the aortic root and the right ventricular outflow tract, consistent with an inter-arterial trajectory, with evidence of luminal compression along this segment. A short intramyocardial (myocardial bridging) segment measuring approximately 1.28 cm was also identified, contributing to dynamic narrowing. No significant atherosclerotic stenosis was noted in the other coronary arteries. The coexistence of a high take-off RCA, malignant inter-arterial course, and myocardial bridging likely contributed to the patient's ischaemic symptoms. This case underscores the value of cardiac CT angiography in clearly defining complex coronary anatomy and supporting appropriate clinical decision-making.</p>","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"1-4"},"PeriodicalIF":2.5,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}