Acta cardiologica最新文献

{"title":"How important is the risk of medical malpractice litigations against cardiologists in Belgium?","authors":"Nathalie Meyten, Tom G Moreels","doi":"10.1080/00015385.2025.2516943","DOIUrl":"https://doi.org/10.1080/00015385.2025.2516943","url":null,"abstract":"<p><strong>Background: </strong>Medical malpractice litigations represent an increasing reality for clinical physicians. No malpractice claims data are available on cardiologists in Belgium.</p><p><strong>Aim: </strong>We calculated the number of malpractice claims against cardiologists in Belgium based on the annual reports of the Fund for Medical Accidents (FMA).</p><p><strong>Methods: </strong>FMA annual reports are available online in the public domain from 2012 onwards, and they were reviewed focussing on Cardiology.</p><p><strong>Results: </strong>A total of 6884 applications for malpractice litigations were filed through the FMA, resulting in a final decision for 3185 health providers between 2014 and 2023. In this 10 year period, claims were filed against 73 cardiologists, ranking them in the top 15 specialities at risk for malpractice litigations. There are currently 1237 practicing cardiologists in Belgium, indicating that the cumulative 10 year risk of malpractice litigation through the FMA alone is 6%. This is lower than expected based on data in the literature, showing that missed diagnosis (myocardial infarction) and complications of interventional cardiology procedures represent the most common types of malpractice litigations against cardiologists. Compared to Gastroenterology, another interventional speciality within the field of Internal Medicine, Belgian cardiologists seem less prone to malpractice litigations. A total of 92 claims were filed through the FMA on a total of 777 practicing gastroenterologists (12%; <i>p</i> < 0.001 Chi-square).</p><p><strong>Conclusions: </strong>Based on the FMA annual reports, Belgian cardiologists face only a moderate risk of malpractice litigations reaching 6% over a 10 year time period, as compared to 12% cumulative risk of gastroenterologists.</p>","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"1-6"},"PeriodicalIF":2.1,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273849","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":"Aetiology, clinical characteristics, and risk factors influencing mortality in patients with infective endocarditis: a retrospective study.","authors":"Özkan Vural, Özcan Yılmaz, Ömer Gedikli, Alperen Taş","doi":"10.1080/00015385.2025.2511519","DOIUrl":"https://doi.org/10.1080/00015385.2025.2511519","url":null,"abstract":"<p><strong>Introduction: </strong>Infective endocarditis is defined as an infection of the endothelial surfaces in the heart (valves and endocardium), prosthetic heart valves, and intracardiac devices (such as pacemaker leads and ventricular assist devices). Due to diagnostic challenges, determining the true incidence of infective endocarditis is difficult. Despite advancements in diagnosis and treatment, incidence and mortality rates have not decreased. In this study, we evaluated the clinical and laboratory parameters of patients with infective endocarditis followed in our hospital between 2005 and 2018 and assessed their relationship with in-hospital and one-year mortality.</p><p><strong>Methods: </strong>This study retrospectively analysed 145 patients aged ≥18 years who were diagnosed with infective endocarditis and followed in our hospital between 2005 and 2018. Data were analysed using IBM SPSS V23. Statistical analyses included the Shapiro-Wilk test, T-test, Mann-Whitney U test, and Chi-square test.</p><p><strong>Results: </strong>The average age of the patients was 53 (18-86), and 52.4% (<i>n</i> = 76) were male. In 34% (<i>n</i> = 37) of our patients, the predisposing factor for infective endocarditis was rheumatic valve disease. In-hospital mortality was 31.7%, and one-year mortality was 40.6%. A statistically significant difference in in-hospital mortality was found between combination therapy (23%) and medical therapy (40.8%). Mitral valve involvement was the most common, occurring in 48.3% of patients. Staphylococci were the most frequently isolated microorganisms in blood cultures (41.4%). Heart failure was the most common complication and was associated with the highest mortality rate (23.4%). NYHA was an independent predictor of in-hospital mortality.</p><p><strong>Conclusion: </strong>In our study, surgical intervention, i.e. combination therapy, applied after two weeks of antibiotic treatment, was found to be more effective. Early combination therapy may be life-saving.</p>","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"1-8"},"PeriodicalIF":2.1,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207350","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":"Torsemide vs. furosemide in congestive heart failure: a systematic-review and meta-analysis on mortality and rehospitalization.","authors":"Nino Gudushauri, Edgar Theodore Polintan, Irakli Lemonjava, Rajiv Hans Menghrajani, Pia Gabrielle Alfonso, Samir Shah, Zurab Azmaiparashvili, Kevin Bryan Lo, Janani Rangaswami","doi":"10.1080/00015385.2025.2460406","DOIUrl":"10.1080/00015385.2025.2460406","url":null,"abstract":"<p><strong>Background: </strong>Current guidelines suggest the use of loop diuretics as the preferred agent for decongestion in patients with heart failure. However, there is no clear evidence as to superiority of one loop diuretic over the other. The understanding of pharmacokinetic and pharmacodynamic superiority of torsemide over furosemide has generated the hypothesis that these features could result in better clinical outcomes.</p><p><strong>Objectives: </strong>To determine whether the use of torsemide is associated with reduced risk for mortality and rehospitalizations in comparison to furosemide among patients with heart failure.</p><p><strong>Methods: </strong>The study involves a comprehensive search of literature from PubMed, Cochrane CENTRAL, and ClinicalTrials.gov of clinical trials addressing the use of torsemide vs. furosemide in patients with heart failure. Pooled risk ratios (RR) were used to measure association for all outcomes with inverse-variance weighting and random effects model.</p><p><strong>Results: </strong>The literature search included 188 studies that were screened individually. A total of 24 studies were identified out of which 12 were excluded. The pooled risk ratio (RR) revealed all-cause mortality of 0.98 [0.87 to 1.10] with 0% heterogeneity, all cause rehospitalization of 0.95 [0.88 to 1.02] with 5% heterogeneity, and heart failure rehospitalization of 0.85 [0.52 to 1.38] with 55% heterogeneity.</p><p><strong>Conclusion: </strong>Considering the evidence from pooled randomised trials, the use of torsemide compared to furosemide did not result in statistically significant differences in all-cause mortality or rehospitalization rates.</p>","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"351-357"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254228","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 late presentation of congenital heart defect: sinus venosus ASD with PAPVR.","authors":"Maria Gabriela Matta, Nicholas Seton, Brad Hefford, Selvanayagam Niranjan, Ian Agahari, Rowena Solayar, Sylvio Carvalho Junior Provenzano","doi":"10.1080/00015385.2025.2459452","DOIUrl":"10.1080/00015385.2025.2459452","url":null,"abstract":"","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"412-414"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143187727","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":"Application of an interpretable machine learning method to predict the risk of death during hospitalization in patients with acute myocardial infarction combined with diabetes mellitus.","authors":"Zhijun Bu, Siyu Bai, Chan Yang, Guanhang Lu, Enze Lei, Youzhu Su, Zhaoge Han, Muyan Liu, Jingge Li, Linyan Wang, Jianping Liu, Yao Chen, Zhaolan Liu","doi":"10.1080/00015385.2025.2481662","DOIUrl":"10.1080/00015385.2025.2481662","url":null,"abstract":"<p><strong>Background: </strong>Predicting the prognosis of patients with acute myocardial infarction (AMI) combined with diabetes mellitus (DM) is crucial due to high in-hospital mortality rates. This study aims to develop and validate a mortality risk prediction model for these patients by interpretable machine learning (ML) methods.</p><p><strong>Methods: </strong>Data were sourced from the Medical Information Mart for Intensive Care IV (MIMIC-IV, version 2.2). Predictors were selected by Least absolute shrinkage and selection operator (LASSO) regression and checked for multicollinearity with Spearman's correlation. Patients were randomly assigned to training and validation sets in an 8:2 ratio. Seven ML algorithms were used to construct models in the training set. Model performance was evaluated in the validation set using metrics such as area under the curve (AUC) with 95% confidence interval (CI), calibration curves, precision, recall, F1 score, accuracy, negative predictive value (NPV), and positive predictive value (PPV). The significance of differences in predictive performance among models was assessed utilising the permutation test, and 10-fold cross-validation further validated the model's performance. SHapley Additive exPlanations (SHAP) and Local Interpretable Model-agnostic Explanations (LIME) were applied to interpret the models.</p><p><strong>Results: </strong>The study included 2,828 patients with AMI combined with DM. Nineteen predictors were identified through LASSO regression and Spearman's correlation. The Random Forest (RF) model was demonstrated the best performance, with an AUC of 0.823 (95% CI: 0.774-0.872), high precision (0.867), accuracy (0.873), and PPV (0.867). The RF model showed significant differences (<i>p</i> < 0.05) compared to the K-Nearest Neighbours and Decision Tree models. Calibration curves indicated that the RF model's predicted risk aligned well with actual outcomes. 10-fold cross-validation confirmed the superior performance of RF model, with an average AUC of 0.828 (95% CI: 0.800-0.842). Significant Variables in RF model indicated that the top eight significant predictors were urine output, maximum anion gap, maximum urea nitrogen, age, minimum pH, maximum international normalised ratio (INR), mean respiratory rate, and mean systolic blood pressure.</p><p><strong>Conclusion: </strong>This study demonstrates the potential of ML methods, particularly the RF model, in predicting in-hospital mortality risk for AMI patients with DM. The SHAP and LIME methods enhance the interpretability of ML models.</p>","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"358-375"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802203","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":"Anomalous inferior vena cava unmasked 48 years later: a rare case of hypoxaemia in an adult with repaired atrial septal defect.","authors":"Maria Gabriela Matta, Rahul Lambert, Robert Park, Ian Agahari, Rowena Solayar","doi":"10.1080/00015385.2024.2436695","DOIUrl":"10.1080/00015385.2024.2436695","url":null,"abstract":"","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"410-411"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794225","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":"Effect of dapagliflozin on the no-reflow phenomenon in patients with acute myocardial infarction and type II diabetes mellitus.","authors":"Alaa Quisi, Nur Selin Nacar Quisi, Gökhan Alıcı, İdil Donma, Abdullah Yıldırım, Ömer Genç","doi":"10.1080/00015385.2025.2500892","DOIUrl":"10.1080/00015385.2025.2500892","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the effect of dapagliflozin on the no-reflow phenomenon in patients with type II diabetes mellitus (T2DM) and acute myocardial infarction (AMI) who underwent percutaneous coronary intervention (PCI).</p><p><strong>Methods: </strong>This single-center, observational cohort study included a total of 829 consecutive T2DM patients who were diagnosed with AMI and underwent PCI within 24 h of the onset of symptoms. Only patients using dapagliflozin (10 mg per day) for more than one year were considered as patients using dapagliflozin. The no-reflow phenomenon was defined as inadequate myocardial perfusion within a segment of the coronary circulation without angiographic evidence of mechanical vessel obstruction, dissection, or residual stenosis after PCI.</p><p><strong>Results: </strong>Four hundred and thirty-four patients were diagnosed with ST-segment elevation myocardial infarction (STEMI), and 395 patients were diagnosed with non-ST-segment elevation myocardial infarction (NSTEMI). Forward conditional logistic regression analysis demonstrated that the estimated glomerular filtration rate (OR = 0.940, 95% CI: 0.900 to 0.982, <i>p</i> = 0.006), SYNTAX score I (OR = 1.338, 95% CI: 1.179 to 1.520, <i>p</i> < 0.001), and dapagliflozin use (OR = 0.030, 95% CI: 0.004 to 0.228, <i>p</i> = 0.001) were independent predictors of the no-reflow phenomenon in STEMI. However, dapagliflozin use (OR = 0.112, 95% CI: 0.013 to 0.933, <i>p</i> = 0.043) was the only independent predictor of the no-reflow phenomenon in NSTEMI.</p><p><strong>Conclusion: </strong>Lower rates of the no-reflow phenomenon were observed in T2DM patients taking dapagliflozin, diagnosed with AMI, and underwent PCI. However, this finding requires further investigation.</p>","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"394-402"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954830","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":"Relationship between predictive factors and atrial high-rate episodes in heart failure with reduced ejection fraction patients with cardiac implantable electronic devices.","authors":"Özge Çakmak Karaaslan, Ekrem Şahan, Mustafa Karanfil, Ümit Güray","doi":"10.1080/00015385.2024.2443295","DOIUrl":"10.1080/00015385.2024.2443295","url":null,"abstract":"<p><strong>Objective: </strong>Atrial high-rate episodes (AHRE) are atrial tachyarrhythmia episodes detected by implanted cardiac devices, characterised by an atrial rate exceeding 180-190 beats per minute. Recent studies have linked AHRE to the development of atrial fibrillation (AF) and increased stroke risk, especially when episodes last longer than 5-6 min. This study aimed to evaluate the relationship between predictive factors and the occurrence of AHRE in heart failure with reduced ejection fraction (HFrEF) patients with cardiac implantable electronic devices (CIEDs).</p><p><strong>Methods: </strong>This single-centre, retrospective study included a cohort of 155 consecutive HFrEF patients with CIEDs, but without a diagnosis of AF, enrolled between January 2023 and December 2023. Patients were stratified based on the presence of AHRE detected during device interrogation.</p><p><strong>Results: </strong>The average age of the patients was 54 ± 14 years, and 83.2% of the study population were male. Patients with AHRE had a reduced left ventricular ejection fraction (LVEF) (<i>p</i> = 0.026) and an increased left atrial diameter (<i>p</i> < 0.001) compared to the group without AHRE. Patients with AHRE had elevated levels of creatinine, uric acid, and TSH compared to those without AHRE (<i>p</i> = 0.006, <i>p</i> = 0.021, <i>p</i> = 0.009, respectively). In the univariable logistic regression analysis, LVEF (HR = 0.690, 95% CI = 0.610-0.913, <i>p</i> = 0.013), left atrial diameter (HR = 8.215, 95% CI = 1.557-43.34, <i>p</i> < 0.001), creatinine (HR = 7.369, 95% CI = 1.749-31.05, <i>p</i> = 0.006), uric acid (HR = 1.073, 95% CI = 1.062-1.196, <i>p</i> = 0.020), total cholesterol (HR = 0.989, 95% CI = 0.979-0.999, <i>p</i> = 0.031), and C-reactive protein levels (HR = 1.146, 95% CI = 1.002-1.131, <i>p</i> = 0.047) were identified as independent predictors of AHRE. In multivariable logistic regression analysis, left ventricular ejection fraction (HR = 0.890, 95% CI = 0.795-0.998, <i>p</i> = 0.046), left atrial diameter (HR = 8.215, 95% CI = 1.557-43.34, <i>p</i> < 0.001), and uric acid concentration (HR = 1.650, 95% CI = 1.063-2.561, <i>p</i> = 0.025) were identified as predictors of atrial high-rate events.</p><p><strong>Conclusion: </strong>LVEF, left atrial diameter, and uric acid level were found to be independent predictors of AHRE in patients with HFrEF. Identifying AHRE is crucial for risk stratification and guiding therapeutic decisions to improve patient outcome.</p>","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"334-341"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852026","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":"Predicting heart failure mortality using the Danish Comorbidity Index for Acute Myocardial Infarction (DANCAMI).","authors":"Usama Sikandar, Kasper Bonnesen, Uffe Heide-Jørgensen, Morten Schmidt","doi":"10.1080/00015385.2025.2452131","DOIUrl":"10.1080/00015385.2025.2452131","url":null,"abstract":"<p><strong>Background: </strong>Patients with congestive heart failure (HF) are often burdened with comorbidities that increase mortality. Comorbidity indices provide a standardised method to measure comorbidity burden and predict prognosis. We aimed to investigate whether the Danish Comorbidity Index for Acute Myocardial Infarction (DANCAMI) can discriminate mortality in patients with HF.</p><p><strong>Methods: </strong>We conducted a population-based cohort study of all adult Danish patients with first-time HF during 1995-2020 (<i>N</i> = 311,628). We used logistic regression to calculate the area under the receiver operating characteristic curve (AUC) for cardiovascular and all-cause mortality within 30 days, 1 year, and 10 years of diagnosis. The AUCs were computed for a model including age and sex (baseline) and models also including the DANCAMI, the Charlson Comorbidity Index (CCI), or the Elixhauser Comorbidity Index (ECI).</p><p><strong>Results: </strong>For all-cause mortality, the AUCs were higher for the DANCAMI than for the baseline model (30-day: 0.688 vs. 0.662; 1-year: 0.715 vs. 0.680; 10-year: 0.840 vs. 0.810). For cardiovascular mortality, the AUCs were comparable between the DANCAMI and the baseline model (30-day: 0.683 vs. 0.676; 1-year: 0.690 vs. 0.684; 10-year: 0.659 vs. 0.658). For both 30-day, 1-year, and 10-year all-cause and cardiovascular mortality, the AUCs for the CCI and the ECI were comparable to those for the DANCAMI.</p><p><strong>Conclusions: </strong>Adding the DANCAMI to a model including patient age and sex improved discrimination of short and long-term all-cause mortality but not of cardiovascular mortality.</p>","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"342-350"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075272","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":"Pulmonary artery pulsatility index as a prognostic marker in heart failure with preserved ejection fraction.","authors":"Muhammad Osama, Safiyyah Ubaid, Ubaid Ullah, Maryam Ubaid","doi":"10.1080/00015385.2024.2412372","DOIUrl":"10.1080/00015385.2024.2412372","url":null,"abstract":"","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"425-426"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455470","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}