Acta cardiologica最新文献

{"title":"Long-term outcomes of rate-dependent left bundle branch block during exercise testing: a single-centre retrospective study.","authors":"Maarten Droogne, Christophe Garweg, Peter Haemers, Joris Ector, Kaatje Goetschalckx, Peter Sinnaeve, Rik Willems, Tomas Robyns, Gábor Vörös, Bert Vandenberk","doi":"10.1080/00015385.2026.2719110","DOIUrl":"https://doi.org/10.1080/00015385.2026.2719110","url":null,"abstract":"<p><strong>Background: </strong>Rate-dependent left bundle branch block (LBBB) during exercise testing is traditionally considered a potential marker of coronary artery disease (CAD), yet the long-term prognosis remains uncertain. This study assessed the long-term outcomes of patients presenting with rate-dependent LBBB during exercise testing.</p><p><strong>Methods: </strong>In this retrospective single-centre cohort study, all bicycle exercise tests performed between 2000 and 2022 were reviewed. Patients with transient LBBB developing during exercise and resolving during recovery were included. Baseline characteristics, diagnostic work-up, and long-term outcomes were collected. The primary endpoint was progression to permanent LBBB. Secondary endpoints included new-onset left ventricular systolic dysfunction, cardiac implantable electronic device (CIED) implantation, and all-cause mortality.</p><p><strong>Results: </strong>Among 46,089 patients undergoing 51,220 exercise tests, 68 patients (0.15%) exhibited rate-dependent LBBB. Median age was 59.7 years (54.6-68.4) and 59.4% were male. CAD was present in 29.4%, while baseline heart failure was present in 11.8%. Rate-dependent LBBB occurred at a median heart rate of 126 bpm. During a median follow-up of 12.8 years (8.7-20.2), permanent LBBB developed in 36 patients (52.9%), with cumulative incidence of 46.5% at 10 years. New-onset systolic dysfunction occurred in 12 patients (17.6%), most often after or concurrent with permanent LBBB. CIED implantation was required in 12 patients (17.6%). All-cause mortality was 29.4% (8.1% at 10 years), with age as only independent predictor.</p><p><strong>Conclusions: </strong>Rate-dependent LBBB is uncommon but frequently progresses to permanent LBBB and is associated with subsequent systolic dysfunction. These findings suggest that rate-dependent LBBB may represent an early manifestation of intrinsic conduction system disease.</p>","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"1-10"},"PeriodicalIF":4.0,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872487","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":"First Belgian experience with large-bore mechanical thrombectomy in acute pulmonary embolism using the FlowTriever^® system: a bi-centre retrospective analysis.","authors":"Sebastien Selleslag, Jesse Marrannes, Lawrence Bonne, Andries Van Holsbeeck, Joost Kager, Johan Ghekiere, Eveline Claus, Jo Peluso, Annouschka Laenen, Thomas Vanassche, Marion Delcroix, Laurent Godinas, Emanuele Muscogiuri, Marijke Peetermans, Peter Verhamme, Pascal Frederiks, Tom Adriaenssens, Tom Verbelen, Peter Vanbrabant, Ken De Smet, Andreas Verstraete, Filip Van Den Brande, Evi Steen, Sarah Deseyne, Veerle Ringoet, Jan Van Der Heyden, Marie De Vos, Geert Maleux","doi":"10.1080/00015385.2026.2698745","DOIUrl":"https://doi.org/10.1080/00015385.2026.2698745","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary embolism (PE) is a major cause of cardiovascular morbidity and mortality. Large-bore mechanical thrombectomy (LBMT) is an emerging treatment for high-risk and intermediate-high-risk PE, particularly in patients with contraindications to thrombolysis. We evaluated the safety, efficacy, and clinical outcomes of LBMT using the FlowTriever^® system in a bi-centre cohort.</p><p><strong>Methods: </strong>We retrospectively analysed patients treated with FlowTriever^® for acute PE between February 2022 and November 2024 at two high-volume Belgian centres. Clinical, hemodynamic, and procedural data were collected. Primary endpoints were reduction in mean pulmonary artery pressure (mPAP), major procedural complications, and 30-day mortality. Secondary endpoints included technical success and length of ICU and hospital stay.</p><p><strong>Results: </strong>Sixty patients (mean age 61.9 ± 13.9 years; 51.7% male) underwent LBMT; 81.7% had intermediate-high-risk and 13.3% high-risk PE. Technical success was achieved in 96.7% of cases. Mean mPAP decreased by 27% (<i>p</i> < 0.0001). Major complications occurred in 5%, including two pulmonary artery perforations in acute-on-chronic PE and one intraoperative cardiac arrest. No major bleeding events were observed. Thirty-day mortality was 5%, and survival to discharge was 93.3%. Median ICU and hospital stays were 3 [2-6] and 7 [5-12] days. Elevated lactate was significantly associated with adverse outcomes (<i>p</i> = 0.009).</p><p><strong>Conclusion: </strong>LBMT with FlowTriever^® achieved rapid hemodynamic improvement and high technical success in selected patients. Careful selection and operator experience are essential. Prospective comparative studies are needed to clarify long-term benefit and optimise treatment strategies.</p>","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"1-11"},"PeriodicalIF":4.0,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817069","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":"Patent foramen ovale closure in adolescents: an anatomical and a knowledge gap.","authors":"Ilire Imeri, Stijn Lochy, Danièle Plein, Xavier Galloo, Philippe Unger","doi":"10.1080/00015385.2026.2723344","DOIUrl":"https://doi.org/10.1080/00015385.2026.2723344","url":null,"abstract":"","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"1-2"},"PeriodicalIF":4.0,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817079","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 long journey of TAVR: from procedural feasibility to integrated clinical and biomechanical predictors of complications.","authors":"Tommaso Viva, Patrizio Lancellottib","doi":"10.1080/00015385.2026.2721692","DOIUrl":"https://doi.org/10.1080/00015385.2026.2721692","url":null,"abstract":"","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"1-2"},"PeriodicalIF":4.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817030","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":"Risk factors for poor prognosis in patients with acute ischaemic stroke: a retrospective study.","authors":"Yan Shi, Yong-Tao Liu, Jing-Jing Sun, Bing Zhao, Su-Zhen Fu, Qing-Fan Xie","doi":"10.1080/00015385.2026.2631266","DOIUrl":"https://doi.org/10.1080/00015385.2026.2631266","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the risk factors for poor prognosis after thrombolysis and their predictive values in patients with large artery atherosclerosis (LAA).</p><p><strong>Methods: </strong>A total of 136 patients with acute ischaemic stroke who underwent intravenous thrombolysis with alteplase for the first time were retrospectively collected and divided into the 'good prognosis' group (<i>n</i> = 70) and the 'poor prognosis' group (<i>n</i> = 66) according to their score on the modified Rankin Scale (<3 or ≥3) at 90 days after admission. Related parameters were collected and compared.</p><p><strong>Results: </strong>The differences between the two groups of patients were statistically significant in age, National Institutes of Health Stroke Scale (NIHSS) scores, hypertension and the level of low-density lipoprotein cholesterol (LDL-C) (all <i>p</i> < 0.05). Older age (95%CI: 1.010-1.082) and higher NIHSS scores after thrombolysis (95%CI: 1.093-1.312) were risk factors for poor prognosis after thrombolysis in patients with LAA. The area under the curve to predict these poor prognoses after thrombolysis was 0.657 (95%CI: 0.562-0.746) for age, with a cut-off value of 66.50 years, and 0.730 (95%CI: 0.646-0.814) for the NIHSS score, with a cut-off value of 5.50 points.</p><p><strong>Conclusions: </strong>Older age and higher NIHSS scores after thrombolysis are risk factors for poor prognosis in patients with LAA, with certain predictive values.</p>","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"1-10"},"PeriodicalIF":4.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148811621","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 null finding is not a negative finding: intramuscular penicillin prophylaxis and the perils of underpowered inference in mild rheumatic heart disease.","authors":"Minahil Iqbal","doi":"10.1080/00015385.2026.2722414","DOIUrl":"https://doi.org/10.1080/00015385.2026.2722414","url":null,"abstract":"","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"1-2"},"PeriodicalIF":4.0,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808161","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":"Impact of systemic inflammation on exercise haemodynamics in unexplained dyspnoea and heart failure with preserved ejection fraction.","authors":"Giulio M Mondellini, Jannik Heemann, Xavier Galloo, Daniele Plein, Lucie Soens, Barry A Borlaug, Marco Guazzi, Frederik H Verbrugge","doi":"10.1080/00015385.2026.2721796","DOIUrl":"https://doi.org/10.1080/00015385.2026.2721796","url":null,"abstract":"<p><strong>Aim: </strong>Systemic inflammation in heart failure with preserved ejection fraction (HFpEF) predicts worse outcomes. This study investigates its impact on exercise haemodynamics in patients with unexplained dyspnoea.</p><p><strong>Methods: </strong>This prospective cohort study includes subjects referred for unexplained dyspnoea to a multidisciplinary dyspnoea clinic between January 2021 and August 2023 for cardiopulmonary exercise testing with concomitant exercise echocardiography. Systemic inflammation was defined as a high-sensitivity C-reactive protein level ≥2 mg/L. HFpEF was diagnosed with an H₂FPEF score ≥6, HFA-PEFF score ≥5, or in case of exercise pulmonary hypertension together with a left atrial reservoir strain <24.5% at rest or positive diastolic stress test during exercise.</p><p><strong>Results: </strong>A total of 70/191 consecutively evaluated subjects (37%) had systemic inflammation, which was linked with anthropometrics of increased adiposity. Subjects with vs. without systemic inflammation had smaller end-diastolic volume indices (40.9 ± 9.7 vs. 47.2 ± 13.3 mL/m², respectively; <i>p</i> = .002), a lower tricuspid annular plane systolic excursion over pulmonary artery systolic pressure ratio [0.96 (0.75-1.10) vs. 1.04 (0.85-1.28) mm/mmHg, respectively; <i>p</i> = .033], but otherwise similar echocardiography findings at rest. For a similar respiratory exchange ratio at peak exercise, they had lower peak oxygen consumption (16.9 ± 5.3 vs. 20.6 ± 6.6 mL/min/kg, respectively; <i>p</i> < .001). The right ventricular end-systolic pressure area ratio change with exercise indicated less right ventricular contractile reserve when systemic inflammation was present. In the HFpEF subgroup, patients with vs. without systemic inflammation had a decreased cardiac output reserve with exercise.</p><p><strong>Conclusion: </strong>In subjects with dyspnoea, systemic inflammation is linked to increased adiposity and lower exercise capacity because of impaired right ventricular reserve.</p>","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"1-12"},"PeriodicalIF":4.0,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808183","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":"Combined PAPi-PAC phenotyping after TAVI: interpretive and translational considerations.","authors":"Amna Faiz, Wazzuha Gulalai","doi":"10.1080/00015385.2026.2721764","DOIUrl":"https://doi.org/10.1080/00015385.2026.2721764","url":null,"abstract":"","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"1-2"},"PeriodicalIF":4.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148786893","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":"Population strategies and precision therapies in cardiovascular medicine.","authors":"Patrizio Lancellotti, Thibault-Marie Azevedo Mendes","doi":"10.1080/00015385.2026.2721794","DOIUrl":"https://doi.org/10.1080/00015385.2026.2721794","url":null,"abstract":"","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"1-5"},"PeriodicalIF":4.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148786901","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":"Joint association between FIB-4 index and advanced cardiovascular-kidney-metabolic syndrome with aortic valve calcification: a community cohort in China.","authors":"Yunteng Fang, Jiayi Shen, Junqiu Zhao, Xingwei Wei, Qiwen Huang, Guanyu Niu, Zhilin Wang, Haoxiang Xu, Xuan Wang, Yuesong Pan, Tiemin Wei, Lingchun Lv","doi":"10.1080/00015385.2026.2704739","DOIUrl":"https://doi.org/10.1080/00015385.2026.2704739","url":null,"abstract":"<p><strong>Background and aims: </strong>Aortic valve calcification (AVC) is common during the process of ageing. Based on available research, liver fibrosis, cardiovascular risk factors and impaired kidney function have been associated with AVC. This study aimed to analyse the relationship between fibrosis-4 (FIB-4) index and advanced Cardiovascular-Kidney-Metabolic (CKM) syndrome with AVC respectively and their joint effects on AVC.</p><p><strong>Methods: </strong>This study included 2884 participants from middle-aged and elderly Chinese population. AVC was evaluated by echocardiography and advanced CKM syndrome was defined by standard guidelines. We assessed associations between FIB-4 index, advanced CKM syndrome and AVC using logistic regression models. Combined effects were calculated by dividing the two indicators into four groups and 1.39 was the cut-off value of FIB-4 index. Subgroup analyses were performed to stratify results efficiently and investigate interaction effects in the relationships between the FIB-4 index, advanced CKM syndrome and AVC.</p><p><strong>Results: </strong>Of 2884 participants, the mean age was 61.22 ± 6.66 and 45.42% were male, with 257 AVC events. After covariates adjustment, advanced CKM syndrome was significantly associated with AVC with odds ratio (OR) of 1.28(1.13-1.45). As a continuous variable, FIB-4 index correlated with AVC with OR of 2.03(1.43-2.90). As a categorical variable, FIB-4 index also was connected with AVC. The joint effects of advanced CKM syndrome and FIB-4 index showed stronger association with AVC after adjusting for variables. Furthermore, the FIB-4 index exhibited a nonlinear association with AVC.</p><p><strong>Conclusion: </strong>Elevated FIB-4 index and advanced CKM syndrome were both related with AVC among middle-aged and elderly populations. Moreover, the combined exposure to elevated FIB‑4 and advanced CKM syndrome conferred a stronger correlative relationship with AVC.</p>","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"1-11"},"PeriodicalIF":4.0,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148786863","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}