American heart journal plus : cardiology research and practice最新文献

{"title":"Three different indications for left ventricular unloading in one patient with severe heart failure","authors":"Thomas Gausepohl ,&nbsp;Ulrike Flierl ,&nbsp;Vera Garcheva ,&nbsp;Marcel Ricklefs ,&nbsp;Bernd Schwedhelm ,&nbsp;Johann Bauersachs ,&nbsp;Tobias J. Pfeffer ,&nbsp;Andreas Schäfer","doi":"10.1016/j.ahjo.2026.100716","DOIUrl":"10.1016/j.ahjo.2026.100716","url":null,"abstract":"<div><h3>Background</h3><div>The percutaneous microaxial flow pump (mAFP) is an established mechanical circulatory support (MCS) device for cardiogenic shock (CS) and can also stabilize hemodynamics during cardiac and noncardiac procedures. This case series describes the safety and feasibility of repeated mAFP use for three indications in a single patient.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed three consecutive mAFP deployments in one patient enrolled in the Hannover-Cardiac-Unloading-REgistry between October 2021 and August 2023. Indications included acute myocardial infarction–related CS (AMI-CS), ventricular tachycardia (VT) ablation one year later, and elective thyroidectomy for amiodarone-induced hyperthyroidism another year later.</div></div><div><h3>Results</h3><div>A 62-year-old patient with ischemic cardiomyopathy (initial LVEF 34%) achieved hemodynamic stabilisation during AMI-CS, successful protected VT ablation without compromise, and stable perioperative support during thyroidectomy. No major adverse events occurred.</div></div><div><h3>Conclusions</h3><div>Repeated mAFP use for AMI-CS, VT ablation, and high-risk surgery was feasible and safe, supporting its versatility in complex clinical care.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"62 ","pages":"Article 100716"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of nutritional status on outcome of patients of acute coronary syndrome","authors":"Bashir Ahmed Joy ,&nbsp;Md. Fakhrul Islam Khaled ,&nbsp;Deepta Majumder ,&nbsp;Sujoy Kumar Saha ,&nbsp;Saleha Salahuddin Asha ,&nbsp;Ariful Islam Joarder ,&nbsp;Dipal Krishna Adhikary ,&nbsp;Sheikh Ahmedul Haque ,&nbsp;Md. Monir Hossain Shimul","doi":"10.1016/j.ahjo.2026.100725","DOIUrl":"10.1016/j.ahjo.2026.100725","url":null,"abstract":"<div><h3>Background</h3><div>Acute Coronary Syndrome (ACS) remains a leading cause of mortality in Bangladesh, where malnutrition is prevalent but often overlooked in clinical care. Malnourished ACS patients may experience worse outcomes, yet nutritional assessment is rarely routine. This study evaluates the impact of nutritional status on short-term outcomes using CONUT scoring.</div></div><div><h3>Methods</h3><div>This prospective cohort study was conducted at the Department of Cardiology, Bangladesh Medical University, Dhaka, Bangladesh, over 18 months. A total of 100 adult ACS patients were included in the final analysis and stratified into nutritional status categories using the Controlling Nutritional Status (CONUT) scoring system. Key outcomes included in-hospital mortality and length of stay. Statistical analyses were performed using SPSS version 29.0.2.0, employing ANOVA, Fisher's exact test, and regression models to examine associations between nutritional status and clinical outcomes.</div></div><div><h3>Results</h3><div>Among the patients, 43% had mild malnutrition, 24% had moderate malnutrition, and 33% had no malnutrition. Nutritional status was significantly associated with both duration of hospital stay (<em>p</em> &lt; .001) and mortality (<em>p</em> = .003). Patients with moderate malnutrition had significantly longer hospital stays (β = 4.388, <em>p</em> &lt; .001) and higher mortality odds (β = 0.167, p &lt; .001) compared to those without malnutrition.</div></div><div><h3>Conclusion</h3><div>Nutritional status, particularly moderate malnutrition as assessed by CONUT scoring, is a significant predictor of adverse clinical outcomes in ACS patients. Integrating nutritional assessment in ACS management protocols may improve prognosis and reduce healthcare burdens.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"62 ","pages":"Article 100725"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial disparities in transcatheter aortic valve replacement: A contemporary nationwide analysis","authors":"Charley Sun ,&nbsp;Michael Zhu ,&nbsp;Daniel McGrath ,&nbsp;Patrick Warner ,&nbsp;Michael Dacey ,&nbsp;Benjamin Wessler ,&nbsp;Yong Zhan","doi":"10.1016/j.ahjo.2026.100720","DOIUrl":"10.1016/j.ahjo.2026.100720","url":null,"abstract":"<div><h3>Background</h3><div>Racial disparities have been reported in the management of cardiovascular diseases. Transcatheter aortic valve replacement (TAVR) volume continues to increase with evolving indications and practice changes.</div></div><div><h3>Objectives</h3><div>This study aims to provide insight regarding procedure access and outcomes to evaluate for potential racial disparities in the contemporary era of TAVR.</div></div><div><h3>Methods</h3><div>TAVR patients (aged ≥18) were identified in the National Inpatient Sample from 2016 to 2019 and grouped by race. Baseline characteristics and in-hospital outcomes were compared between White and non-White patients before and after propensity-score matching. Primary outcomes were in-hospital mortality and a composite outcome. The individual components of the composite outcome served as secondary outcomes.</div></div><div><h3>Results</h3><div>Of 42,877 total TAVR patients, 37,319 were White and 5558 were non-White. Annual procedure volume in both groups increased significantly (<em>Ptrend</em> &lt; 0.001 for both). The proportions of White and non-White patients remained steady over time (12.5%–13.5% non-White, <em>Ptrend</em> = 0.117). The characteristics of White and non-White patients differed significantly. There was no difference in in-hospital mortality (1.5% vs 1.6%, <em>P</em> <em>=</em> 0.585) or composite outcome (23.8% vs 24.6%, <em>P</em> <em>=</em> 0.316). Non-White race was associated with higher rates of acute renal failure (odds ratio [OR]:1.21, 95% confidence interval [CI]:1.10–1.33, <em>P</em> <em>&lt;</em> 0.001), transfusion (OR:1.18, 95%CI:1.05–1.32, <em>P</em> <em>=</em> 0.006), and vascular complications (OR:1.62, 95%CI:1.29–2.04, <em>P</em> <em>&lt;</em> 0.001), but lower rates of permanent pacemaker implantation (OR:0.83, 95%CI:0.75–0.93, <em>P</em> <em>=</em> 0.001).</div></div><div><h3>Conclusion</h3><div>TAVR remains safe in both White and non-White patients with comparable in-hospital mortality and overall outcomes. Differences in baseline characteristics and individual complications indicate the presence of racial disparities in procedure accessibility and outcomes.</div><div>Meeting presentation: Presented at the Transcatheter Cardiovascular Therapeutics (TCT) 2024, October 27–30, 2024, Washington D.C.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"62 ","pages":"Article 100720"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary artery calcium score of zero does not rule out obstructive CAD in young adults","authors":"O. Smettei ,&nbsp;R.M. Abazid ,&nbsp;J.G. Romsa ,&nbsp;C. Akincioglu ,&nbsp;J.C. Warrington ,&nbsp;T.B. Alshaar ,&nbsp;P.J. Teefy ,&nbsp;S. De ,&nbsp;N. Tzemos ,&nbsp;R. Zareardalan ,&nbsp;M. Badreddine ,&nbsp;Y. Bureau ,&nbsp;W.C. Vezina","doi":"10.1016/j.ahjo.2025.100707","DOIUrl":"10.1016/j.ahjo.2025.100707","url":null,"abstract":"<div><h3>Purpose</h3><div>Young adults are more likely to have non-calcified coronary plaques. Purpose to assess the predictive value of a zero-coronary artery calcium (CAC) score in young adults and to determine which clinical characteristics are associated with obstructive coronary heart disease.</div></div><div><h3>Methods</h3><div>6775 patients were prospectively entered a registry. They all had a CAC. Mean age 63 +/− 18 years. 56.2 % males. 3525 patients underwent coronary CT angiography (CCTA). 3250 patients underwent single photon emission tomography (SPECT). SPECT patients were mainly outpatients. CCTA patients also were almost exclusively outpatients. Thus, the population was generally a low-risk population.</div></div><div><h3>Results</h3><div>Among the CCTA patients, 1888 had a 0 CAC score. 175/1888 (9 %) had less than 70 % stenosis, while 41/1888 (2.2 %) had ≥70 % stenosis. Patients with ≥70 % stenosis: were younger 45 ± 12 yr versus 59 ± 11 yr, <em>p &lt;</em> <em>0.001,</em> predominantly males <em>(51.2</em> <em>%</em> versus <em>38.8</em> <em>% p</em> <em>&lt; 0.001),</em> had a slightly greater prevalence of family history of CAD (58.5 % vs 57.9 % <em>p</em> = 0.04), smoking history (68.3 % VS.44.6 % <em>p</em> &lt; 0.001), hypertension (61 % versus 39.2 % <em>p</em> = 0.004), dyslipidemia (56.1 % versus 36.2 % p &lt; 0.001), and obesity (70.7 % VS 11.7 % p &lt; 0.001). 3250 patients had CAC and SPECT. Of these, 1161 had a zero CAC score. Of these 42 patients had significant ischemia &gt;10 % of LV, Patients with ischemia &gt;10 % of LV mass, and they were younger 44 ± 10 yr versus 60 ± 12 yr, <em>p &lt; 0.001,</em> had a slightly greater prevalence of family history of CAD 61 % versus 57 % <em>p</em> = 0.07, smoking history (64.3 % versus 48.5 % <em>p</em> = 0.045), hypertension (69 % versus 45.5 % <em>p</em> = 0.003), obesity 19 % versus 11.7 %, and diabetes (35.7 % versus 14.5 % <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>A zero CAC does not rule out significant CAD in young adults with chest pain with CAD risk factors. These patients may need further investigations.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"62 ","pages":"Article 100707"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145929170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beta-blocker therapy after myocardial infarction with preserved LVEF (≥50%): a systematic review and Bayesian meta-analysis with time-to-event reconstruction","authors":"Ali Saad Al-Shammari ,&nbsp;Yousif Hameed Kurmasha ,&nbsp;M Rafiqul Islam ,&nbsp;Bara M. Hammadeh ,&nbsp;Nabeel Ibraheem Khaleel ,&nbsp;Belal Mohamed Hamed ,&nbsp;Haider Altaii ,&nbsp;Nihar Jena ,&nbsp;Jennifer Gerdes ,&nbsp;George Sokos ,&nbsp;Ramesh Daggubati ,&nbsp;Yasar Sattar ,&nbsp;Marwan Refaat","doi":"10.1016/j.ahjo.2025.100706","DOIUrl":"10.1016/j.ahjo.2025.100706","url":null,"abstract":"<div><h3>Background</h3><div>The role of β-blockers in MI with preserved LVEF (≥50%) remains unclear. This Bayesian meta-analysis assessed their effect on mortality and major cardiovascular outcomes.</div></div><div><h3>Methods</h3><div>A systematic search was performed in PubMed, Embase, and Scopus from database inception to September 2025 for studies assessing BB use in post-MI patients with preserved LVEF. All-cause mortality was the primary outcome. A Bayesian random-effects model was applied using the bayesmeta package in RStudio, with effect sizes expressed as risk ratios (RRs) and 95% credible intervals (CrIs). Between-study heterogeneity was assessed through posterior τ estimates. Time-to-event outcomes were analyzed using reconstructed individual patient data from published Kaplan-Meier curves.</div></div><div><h3>Results</h3><div>Six studies, including 17,068 patients, met the inclusion criteria. BB therapy was associated with a posterior risk ratio (RR 0.79; 95% CrI 0.55–1.06) suggesting a possible reduction in all-cause mortality; however, the credible interval included the null, indicating uncertainty in the magnitude or direction of effect. The posterior estimates for cardiovascular death (RR 0.84; 95% CrI 0.55–1.23), stroke (RR 0.92; 95% CrI 0.58–1.49), myocardial infarction (RR 1.04; 95% CrI 0.80–1.40), heart failure (RR 0.84; 95% CrI 0.55–1.23), MACE (RR 1.09; 95% CrI 0.76–1.51), and unplanned revascularization (RR 1.06; 95% CrI 0.75–1.48) also showed wide credible intervals overlapping 1.0, reflecting uncertainty in potential treatment effects. Heterogeneity across outcomes was generally low to moderate. In time-to-event analyses, the frequentist stratified model showed a statistically significant survival benefit with β-blockers (HR 0.87; 95% CI 0.81–0.92), whereas the Bayesian model indicated a similar trend, but the credible interval (HR 0.60; 95% CrI 0.26–1.41) included the null, suggesting no strong evidence of effect.</div></div><div><h3>Conclusion</h3><div>β-blockers were not associated with a clear reduction in all-cause mortality or other outcomes, as credible intervals included the null. Large, randomized trials are needed to define their long-term role in this population.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"62 ","pages":"Article 100706"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “The controversies in the clinical management of β-blockers in acute heart failure induced by rapid atrial fibrillation: A narrative review” [AHJO_100655]","authors":"Wenfang Zhu,&nbsp;Jinpeng Xu,&nbsp;Liang Zhang","doi":"10.1016/j.ahjo.2025.100711","DOIUrl":"10.1016/j.ahjo.2025.100711","url":null,"abstract":"","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"62 ","pages":"Article 100711"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Symptom phenotypes and coronary microvascular function in non-obstructive coronary artery disease: Insights beyond epicardial ischemia","authors":"Kotaro Matsumoto ,&nbsp;Kenichiro Otsuka ,&nbsp;Shunsuke Kagawa ,&nbsp;Hiroki Yamaura ,&nbsp;Tsubasa Miura ,&nbsp;Kazuya Sugioka ,&nbsp;Wataru Saitoh ,&nbsp;Akihiro Okamoto ,&nbsp;Go Kajio ,&nbsp;Naoki Fujisawa ,&nbsp;Tomohiro Yamaguchi ,&nbsp;Takenobu Shimada ,&nbsp;Yusuke Hayashi ,&nbsp;Atsushi Shibata ,&nbsp;Asahiro Ito ,&nbsp;Takanori Yamazaki ,&nbsp;Daiju Fukuda","doi":"10.1016/j.ahjo.2026.100714","DOIUrl":"10.1016/j.ahjo.2026.100714","url":null,"abstract":"<div><h3>Study objective</h3><div>To examine the relationship between coronary microvascular dysfunction (CMD) indices and chest pain presentation in patients with non-obstructive coronary artery disease (NOCA).</div></div><div><h3>Design and setting</h3><div>Retrospective, single-center observational study.</div></div><div><h3>Participants</h3><div>Patients with angiographically intermediate left anterior descending artery (LAD) stenosis and preserved epicardial physiology (fraction flow reserve, FFR &gt;0.80), with no significant stenosis in vessels other than the LAD.</div></div><div><h3>Interventions</h3><div>Invasive CMD assessment using coronary flow reserve (CFR), index of microcirculatory resistance (IMR), and myocardial resistance reserve (MRR).</div></div><div><h3>Main outcome measures</h3><div>Associations between symptom phenotypes and physiological indices, and the diagnostic performance of symptom-based assessment for detecting CMD.</div></div><div><h3>Results</h3><div>Among 59 patients (mean age 69.2 years; 71 % male), CFR and MRR differed significantly across symptom phenotypes (both <em>p</em> &lt; 0.001), whereas IMR did not. Patients with typical angina exhibited the lowest CFR and MRR, indicating impaired microvascular vasodilatory reserve despite preserved epicardial physiology. Conversely, patients with atypical symptoms had the highest CFR and MRR, whereas asymptomatic patients had intermediate values. FFR was comparable across groups (median 0.89, <em>p</em> = 0.21). In age-adjusted analyses, symptom severity was inversely associated with CFR (β = −1.085, <em>p</em> = 0.004) and MRR (β = −1.062, <em>p</em> = 0.003), but not with IMR. Symptom-based assessment showed higher specificity than sensitivity across CMD definitions and performed best for impaired MRR (sensitivity 60.9 %, specificity 80.6 %). Functional CMD was observed even in asymptomatic patients.</div></div><div><h3>Conclusion</h3><div>In patients with NOCA, coronary microvascular vasodilatory reserve varies according to symptom phenotype, highlighting the limited reliability of symptom assessment alone and underscoring the importance of objective physiological evaluation for characterizing CMD.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"62 ","pages":"Article 100714"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145929171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A risk model to predict atrial fibrillation in diabetes using machine learning: The ACCORD study","authors":"Erik J. Offerman ,&nbsp;Joseph Phan ,&nbsp;Sarah Harirforoosh ,&nbsp;Wenjun Fan ,&nbsp;Nathan D. Wong ,&nbsp;David M. Donaldson","doi":"10.1016/j.ahjo.2026.100715","DOIUrl":"10.1016/j.ahjo.2026.100715","url":null,"abstract":"<div><h3>Background</h3><div>Machine learning (ML) may improve prediction of atrial fibrillation (AF), but its value compared with traditional models such as Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE-AF) in patients with diabetes remains unclear.</div></div><div><h3>Methods</h3><div>Among 9,307 patients in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) with type 2 diabetes and no prior AF, a random forest (RF) classifier using clinical and metabolic variables was compared with a CHARGE-AF Cox model. Discrimination was assessed by five-fold cross-validated area under receiver operating curve (AUC).</div></div><div><h3>Results</h3><div>Over 6.26 years, 175 patients developed AF. The RF model (AUC = 0.731) performed comparably to CHARGE-AF (AUC = 0.756; <em>p</em> = 0.18). Age, waist circumference, race, total cholesterol, and estimated glomerular filtration rate were the top predictors.</div></div><div><h3>Conclusion</h3><div>ML matched CHARGE-AF performance and revealed distinct predictors supporting personalized AF risk prevention.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"62 ","pages":"Article 100715"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145929172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of caffeine levels with myocardial perfusion during pharmacological stress cardiac magnetic resonance imaging","authors":"Ana Iribarren ,&nbsp;Okezi Obrutu ,&nbsp;Jenna Maughan ,&nbsp;Galen Cook-Wiens ,&nbsp;C. Noel Bairey Merz ,&nbsp;Debiao Li ,&nbsp;Daniel S. Berman ,&nbsp;Alan C. Kwan ,&nbsp;Janet Wei","doi":"10.1016/j.ahjo.2025.100709","DOIUrl":"10.1016/j.ahjo.2025.100709","url":null,"abstract":"<div><h3>Background</h3><div>Caffeine, a nonselective adenosine A2 receptor antagonist, blunts adenosine-induced coronary hyperemia. Despite recommended abstinence before adenosine stress cardiac magnetic resonance imaging (CMRi), residual caffeine may affect myocardial perfusion reserve index (MPRI), a marker of coronary microvascular dysfunction.</div></div><div><h3>Methods</h3><div>Symptomatic patients without obstructive coronary artery disease underwent adenosine stress-rest CMRi after 48-h abstinence from caffeine and vasoactive medications. Plasma caffeine was measured pre-scan and subjects were categorized into 2 groups according to caffeine levels (&lt;1 mg/L and ≥ 1 mg/L). Hemodynamics, MPRI and splenic switch-off were compared to assess adequate adenosine stress response during imaging.</div></div><div><h3>Results</h3><div>Of 109 patients studied, 15 (14 %) had detectable caffeine level. Other than sex, there were no significant differences between the two groups. Transmyocardial MPRI did not correlate with caffeine level ≥ 1 mg/L (<em>r</em> = 0.12, <em>p</em> = 0.66).</div></div><div><h3>Conclusion</h3><div>Mildly elevated plasma levels of caffeine did not affect measures of adequacy of response to adenosine during stress CMRi.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"62 ","pages":"Article 100709"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Initiation, titration, and safety of vericiguat for treatment of heart failure in United States clinical practice","authors":"Stephen J. Greene ,&nbsp;Alexander Michel ,&nbsp;Coralie Lecomte ,&nbsp;Paolo Manca ,&nbsp;Katsiaryna Holl ,&nbsp;Michele Senni","doi":"10.1016/j.ahjo.2026.100721","DOIUrl":"10.1016/j.ahjo.2026.100721","url":null,"abstract":"<div><h3>Study objective</h3><div>To evaluate the following among new users of vericiguat: up-titration patterns, factors associated with up-titration, occurrence of hypotension/syncope, predictors of hypotension/syncope.</div></div><div><h3>Design</h3><div>Retrospective cohort study (linked claims and electronic health record data).</div></div><div><h3>Setting</h3><div>US clinical practice.</div></div><div><h3>Participants</h3><div>1361 new users of vericiguat.</div></div><div><h3>Interventions</h3><div>N/A.</div></div><div><h3>Main outcome measures</h3><div>Vericiguat starting dose, up-titration patterns and predictors, occurrence and predictors of hypotension/syncope, over a 3-month follow-up period.</div></div><div><h3>Results</h3><div>Among 1361 new users of vericiguat, 770 (57%) initiated a starting dose of 2.5 mg/day, 330 (24%) initiated a dose of 5 mg/day, and 261 (19%) initiated a dose of 10 mg/day. Over 3-month follow-up, the 10 mg target dose was reached by 349 (26%) patients. Among these patients, the median time to reach the 10 mg dose was 60 days among 2.5 mg/day starters, and 41 days among 5 mg/day starters. Among the 2.5 mg starters, 68% had no up-titration. Among patients initiating either the 2.5 mg/day or 5 mg/day dose, a starting dose of 5 mg (vs. 2.5 mg) was the only significant predictor for reaching the 10 mg dose; adjusted hazard ratio 2.89 (95% CI: 1.86, 4.49, <em>p</em> &lt; 0.0001). Overall, 130 patients (9.6%) had a hypotension event and 67 patients (4.9%) had a syncope event. History of hypotension was the strongest independent predictor of hypotension/syncope events (adj. HR 2.85, 95% CI: 1.96, 4.13, <em>p</em> &lt; 0.0001). A &gt; 2.5 mg/day vericiguat starting dose was not associated with the occurrence of hypotension/syncope (vs. 2.5 mg/day); adj. HR 0.82, 95% C.I. (0.58, 1.16).</div></div><div><h3>Conclusion</h3><div>Vericiguat users initiated on the 5 mg/day dose were considerably more likely to reach the target dose of 10 mg/day vs. those started on the recommended 2.5 mg/day dose, without excess risk of hypotension or syncope.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"62 ","pages":"Article 100721"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}