Acta cardiologica最新文献

{"title":"Acetazolamide, residual congestion and clinical outcomes in acute heart failure - a prespecified analysis of the ADVOR trial.","authors":"Evelyne M Meekers, Pieter Martens, Jeroen Dauw, Sebastiaan Dhont, Frederik H Verbrugge, Petra Nijst, Katrien Tartaglia, Fabien Chenot, Samer Moubayed, Riet Dierckx, Philippe Blouard, Pierre Troisfontaines, David Derthoo, Walter Smolders, Michaël Hulselmans, Stijn Lochy, Bavo Ector, David Raes, Hans Vandekerckhove, Emeline Van Craenenbroeck, Pieter-Jan Hofkens, Kathleen Goossens, Anne-Catherine Pouleur, Michel De Ceuninck, Philippe Timmermans, Laurence Gabriel, Walter Droogne, Edgard Prihadi, Frederik Van Durme, Michel De Pauw, Delphine Vervloet, Els Viaene, Jean-Luc Vachiery, Matthias Dupont, Wilfried Mullens","doi":"10.1080/00015385.2026.2704235","DOIUrl":"https://doi.org/10.1080/00015385.2026.2704235","url":null,"abstract":"<p><strong>Aims: </strong>Acetazolamide, an inhibitor of proximal tubular sodium reabsorption, improves decongestion in acute heart failure (AHF). The aim of the current subanalysis is to evaluate which factors influence decongestion success and the impact of acetazolamide on 3-month clinical outcomes.</p><p><strong>Methods: </strong>This analysis of the Acetazolamide in Decompensated heart failure with Volume OveRload (ADVOR) trial, that randomised 519 patients with AHF to intravenous acetazolamide or matching placebo, assessed the relationship between acetazolamide treatment, residual congestion, and all-cause mortality and/or heart failure hospitalisation (HFH).</p><p><strong>Results: </strong>After 90 days, 148 patients (28.7%) experienced the combined endpoint of all-cause mortality and HFH. Predictors of the occurrence of this endpoint were higher baseline doses of loop diuretics (HR = 1.60; 95% CI = [1.26-2.03]; <i>p</i> < 0.001) and higher natriuretic peptide levels (HR = 1.34; 95% CI = [1.09-1.65]; <i>p</i> = 0.006). Acetazolamide lowered the risk of residual congestion (OR = 0.54, 95% CI = [0.36-0.82]), and residual congestion at day 4 (HR = 1.70, 95% CI = [1.18-2.43], <i>p</i> = 0.004) and at discharge (HR = 2.43, 95% CI = [1.76-3.36], <i>p</i> < 0.001) were associated with a worse clinical outcome. The presence of residual congestion despite use of acetazolamide was associated with the highest event rate for all-cause mortality or HFH (<i>p</i> = 0.019).</p><p><strong>Conclusions: </strong>Residual congestion after decongestive treatment for AHF is associated with an increased risk of all-cause mortality and HFH. The upfront addition of acetazolamide reduced the incidence of residual congestion. However, patients with residual congestion despite acetazolamide use are at excessive risk for mortality and HFH, identifying a subset of patients requiring specialised heart failure care.</p>","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"1-8"},"PeriodicalIF":4.0,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148597448","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":"Circulating free fatty acid signatures discriminate myocardial infarction and systemic arterial hypertension.","authors":"Simone Baldi, Luis Alejandro Constantino-Jonapa, Samuel Jaimez Alvarado, Francesco Cei, Ingrid Lamminpää, Marta Menicatti, Gianluca Bartolucci, Nydia Ávila-Vanzzini, Luis Manuel Amezcua-Guerra, Amedeo Amedei, María Magdalena Aguirre-García","doi":"10.1080/00015385.2026.2704761","DOIUrl":"https://doi.org/10.1080/00015385.2026.2704761","url":null,"abstract":"<p><strong>Background: </strong>Gut microbiome (GM) dysbiosis and altered circulating free fatty acid (FFA) profiles have been implicated in cardiovascular diseases (CVDs), including systemic arterial hypertension (SAH) and ST-segment elevation myocardial infarction (STEMI). This study evaluated serum short-, medium-, and long-chain fatty acids (SCFAs, MCFAs, and LCFAs) in patients with SAH and STEMI compared with healthy controls (HCs), aiming to identify candidate biomarkers and potential mechanistic links between FFAs, the GM, and cardiovascular health.</p><p><strong>Methods: </strong>Serum samples from 47 STEMI patients, 17 SAH patients, and 28 HCs were analysed using gas chromatography-mass spectrometry.</p><p><strong>Results: </strong>Principal coordinates analyses (PCoA) showed significant group separation based on FFA profiles. Both STEMI and SAH patients exhibited increased total SCFA levels, with higher acetic, propionic, 2-methylbutyric, and isovaleric acids compared with HCs. Conversely, STEMI patients showed reduced isobutyric and valeric acids versus both HCs and SAH, and lower 2-methylbutyric acid relative to SAH. STEMI patients also had lower total MCFA levels, mainly due to reduced octanoic acid, while both patient groups showed increased hexanoic acid versus HCs. Additionally, STEMI patients showed elevated hexadecanoic acid and reduced octadecanoic acid compared with the other groups.Sparse partial least squares discriminant analysis (sPLS-DA) confirmed distinct FFA signatures: STEMI was characterised by increased propionic, hexadecanoic, and tetradecanoic acids, whereas SAH showed reduced isovaleric, 2-methylbutyric, hexanoic, and isobutyric acids.</p><p><strong>Conclusions: </strong>These findings indicate disease-specific circulating FFA patterns that may reflect metabolic alterations and underlying pathophysiological mechanisms.</p>","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"1-9"},"PeriodicalIF":4.0,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148597478","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":"Epidemiology and clinical features of acute coronary syndrome patients in selected hospitals in Greece: the CALLINICUS-Hellas registry.","authors":"Demosthenes Panagiotakos, Donatos Tsamoulis, Vasileios Bouratzis, Ioannis Leventis, Charalampos Kalantzis, Dimitrios Tasoulas, Petros Kalogeras, Belkis Malkots, Stylianos Daios, Georgios Zormpas, Despina Benetou, Andriani Nikolaou, Andreas Ntalaoutis, Alexandros Sianis, Sofia Xanthopoulou, Zinovia Tsantikidi, Anastasios Papoutsoglou, Stylianos Rallidis, Pantelis Gounopoulos, Evagelos Zacharis, Konstantinos Kostopoulos, Sotirios Patsilinakos, Athanasios Trikas, Christodoulos Papadopoulos, Antonios Ziakas, Kimon Stamatelopoulos, Katerina Naka, Dimitrios Tziakas, Ioannis Skoularigis, Charalambos Vlachopoulos, Loukianos S Rallidis","doi":"10.1080/00015385.2026.2706281","DOIUrl":"https://doi.org/10.1080/00015385.2026.2706281","url":null,"abstract":"<p><strong>Background: </strong>the aim of this study is to evaluate features of acute coronary syndrome (ACS) patients, in Greece, using information from a nationwide registry, the Clinical events and Adherence to Lipid LowerINg therapy In aCUte coronary Syndrome (CALLINICUS)-Hellas registry.</p><p><strong>Methods: </strong>CALLINICUS-Hellas Registry is an ongoing, national, multicentre observational registry that aims to evaluate features and incidence of ACS patients in Greece. From January 2022 to December 2025, 2,661 consecutive ACS patients (2,151 males, 60 ± 11 years, 510 females, 63 ± 11 years) were enrolled in the selected collaborating cardiology clinics (15-55% participation rate). Four-point Major Adverse Cardiovascular Event (MACE) including cardiovascular death, myocardial infarction (ST-elevation myocardial infarction [STEMI] and non-STEMI [NSTEMI]), ischaemic stroke and unstable angina (UA) requiring hospitalisation was the outcome of interest at 6-months follow-up.</p><p><strong>Results: </strong>The most common ACS manifestation was NSTEMI (48%) in both sexes, followed by STEMI (37.4%) and UA (13.1%). The male-to-female ratio was approximately 4-to-1. The sex ratio favours males before age 60 years but shifts towards females thereafter. The mean age of ACS was 60 years in males, and 63 years in females. Almost 1 in 4 male and 1 in 6 female ACS patients had a previous cardiovascular event. At 6-months follow-up of 2,068 patients, MACE was observed in 120 patients (5.8%), and the most common manifestation was NSTEMI followed by UA.</p><p><strong>Conclusions: </strong>By addressing the lack of recent registry data, the present study provides an updated description of the demographic, lifestyle, clinical, and healthcare characteristics of ACS patients treated in selected Greek hospitals, offering contemporary insights that may inform future research and healthcare planning.</p>","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"1-10"},"PeriodicalIF":4.0,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148560537","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":"Inclisiran-based treatment strategy in <i>very high</i> cardiovascular risk patients with statin intolerance. Is the game worth the candle?","authors":"Beatrice Dal Pino, Francesco Sbrana","doi":"10.1080/00015385.2026.2704312","DOIUrl":"https://doi.org/10.1080/00015385.2026.2704312","url":null,"abstract":"","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"1-3"},"PeriodicalIF":4.0,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547600","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":"Diagnostic value of ST-segment elevation in lead aVR exceeding V1 for identifying significant left main coronary artery disease in acute coronary syndrome.","authors":"Omur Kuru, Deniz Seleci","doi":"10.1080/00015385.2026.2705038","DOIUrl":"https://doi.org/10.1080/00015385.2026.2705038","url":null,"abstract":"<p><strong>Background: </strong>Left main coronary artery (LMCA) disease carries high morbidity and mortality and requires early identification. Although ST-segment elevation in lead aVR has been associated with severe coronary artery disease, its diagnostic value relative to lead V1 remains unclear.</p><p><strong>Methods: </strong>This cross-sectional study included 180 patients with acute coronary syndrome undergoing coronary angiography. Patients were stratified according to ST-segment elevation in lead aVR greater than V1 versus ≤ V1. Significant LMCA stenosis was defined as ≥50% luminal narrowing. Diagnostic performance was evaluated using validity measures, receiver operating characteristic (ROC) analysis, and multivariable logistic regression.</p><p><strong>Results: </strong>Significant LMCA involvement was more frequent in patients with aVR elevation exceeding V1 (91.1% vs. 20.0%, <i>p</i> < 0.001). The ECG criterion showed 82.0% sensitivity, 90.0% specificity, 85.6% accuracy, 91.1% positive predictive value, and 80.0% negative predictive value. ROC analysis demonstrated good discrimination (AUC 0.86; 95% CI 0.806-0.914). After adjustment for clinical confounders, aVR elevation greater than V1 remained independently associated with LMCA disease (adjusted OR 41.0; 95% CI 16.0-100.0; <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>ST-segment elevation in lead aVR exceeding that in lead V1 was independently associated with LMCA disease in patients with acute coronary syndrome and provided effective diagnostic stratification in this cohort. This simple ECG finding may assist early risk stratification and prompt consideration of urgent invasive evaluation, although external validation in larger prospective studies is warranted.</p>","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"1-9"},"PeriodicalIF":4.0,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547641","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":"Cinefluoroscopy: the Tom Thumb or the David of cardiovascular imaging for mechanical heart valves?","authors":"Thierry Le Tourneau, Romain Capoulade, Patrice Guérin","doi":"10.1080/00015385.2026.2698765","DOIUrl":"https://doi.org/10.1080/00015385.2026.2698765","url":null,"abstract":"","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"1-2"},"PeriodicalIF":4.0,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547677","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":"Implementation opportunities for sodium-glucose Co-transporter-2 inhibitors in the Belgian heart failure landscape.","authors":"Frederik H Verbrugge, Jean-Luc Vachiery, Wilfried Mullens","doi":"10.1080/00015385.2026.2704798","DOIUrl":"https://doi.org/10.1080/00015385.2026.2704798","url":null,"abstract":"","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"1-2"},"PeriodicalIF":4.0,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547608","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":"Evaluation of the feasibility and safety of cangrelor in out-of-hospital cardiac arrest undergoing percutaneous coronary intervention.","authors":"Manveer Singh, Fabien Picard, Alain Cariou, Olivier Varenne, Vincent Pham","doi":"10.1080/00015385.2026.2684352","DOIUrl":"https://doi.org/10.1080/00015385.2026.2684352","url":null,"abstract":"<p><strong>Background: </strong>In out-of-hospital cardiac arrest (OHCA) patients undergoing urgent percutaneous coronary intervention (PCI), the use of oral P2Y12 inhibitors is challenging due to delayed absorption. Cangrelor provides immediate and reversible platelet inhibition and may address these challenges.</p><p><strong>Aims: </strong>This study aimed to evaluate the association between the use of cangrelor and clinical outcomes in OHCA patients undergoing PCI.</p><p><strong>Methods: </strong>This observational, single-center study included all consecutive patients with OHCA who underwent PCI between May 2016 and August 2022. The primary endpoint was all-cause mortality at 18 months.</p><p><strong>Results: </strong>Among 140 enrolled patients, cangrelor was used in 56 patients (40.0%). At 18 months, all-cause mortality occurred in 49 patients (35.0%), with no significant difference between cangrelor and non-cangrelor groups (28.6% vs 39.3%; <i>p</i> = 0.19). There was no association between cangrelor use and 18-month all-cause mortality (adjusted HR [95% CI]: 0.66 [0.32-1.38]; <i>p</i> = 0.30). This was consistent in the propensity-matched population and across subgroups. Similar results were found for in-hospital events. Patients treated with cangrelor had fewer overall bleeding events, with no excess in major bleeding. However, the risk of major bleeding was similar between groups (adjusted OR [95% CI]: 0.75 [0.23-2.28]; <i>p</i> = 0.60).</p><p><strong>Conclusion: </strong>In this observational study of OHCA patients undergoing PCI, cangrelor was not significantly associated with improved 18-month all-cause mortality or in-hospital events. Additionally, cangrelor was safe, with fewer overall bleeding events and no increase in major bleeding. These findings underscore the need for further investigation in larger, randomised trials.</p>","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"1-10"},"PeriodicalIF":4.0,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547685","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":"Assessment of left atrial mechanical dispersion by real-time 3D echocardiography combined with DR-FLASH score for predicting late recurrence after ablation in paroxysmal atrial fibrillation.","authors":"Tuğba Çetin","doi":"10.1080/00015385.2026.2704304","DOIUrl":"https://doi.org/10.1080/00015385.2026.2704304","url":null,"abstract":"","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"1-2"},"PeriodicalIF":4.0,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148443652","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":"When function improves before biomarkers: implications for interpreting exercise response in heart failure.","authors":"Salih Topal","doi":"10.1080/00015385.2026.2703159","DOIUrl":"https://doi.org/10.1080/00015385.2026.2703159","url":null,"abstract":"","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"1-2"},"PeriodicalIF":4.0,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148434579","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}