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

{"title":"Establishment of a nomogram that predicts the risk of heart failure in hemodialysis patients","authors":"Jie Luo,&nbsp;Zhangru Rui,&nbsp;Yun He,&nbsp;Hui Li,&nbsp;Yang Yuan,&nbsp;Wenhong Li","doi":"10.1016/j.ahjo.2024.100487","DOIUrl":"10.1016/j.ahjo.2024.100487","url":null,"abstract":"<div><div>Chronic kidney disease (CKD) is expected to become the fifth leading cause of death globally by 2040. Cardiovascular disease (CVD), particularly heart failure (HF), is a severe complication in CKD patients on hemodialysis. This study aimed to develop a nomogram to predict the risk of heart failure hospitalization in hemodialysis patients, providing a valuable tool for clinical decision-making. We retrospectively analyzed data from 196 patients at Kunming Yanan Hospital's hemodialysis center, including demographic, dialysis-related, and laboratory information. Significant HF predictors identified through univariate and multivariate logistic regression were age, diabetes, dialysis duration, left ventricular mass index (LVMI), albumin (ALB), and ejection fraction (EF). These predictors formed the basis of the nomogram, which demonstrated good discrimination (AUC = 0.728) and calibration (Hosmer-Lemeshow test, <em>P</em> = 0.463). Decision curve analysis confirmed the nomogram's clinical utility across various threshold probabilities. This study's findings can help clinicians identify high-risk patients, improving management strategies and potentially reducing HF-related hospitalizations in the hemodialysis population.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"49 ","pages":"Article 100487"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing predictive risk to actual presence of coronary atherosclerosis on coronary computed tomography angiography","authors":"Emma Playford ,&nbsp;Simon Stewart ,&nbsp;Gerard Hoyne ,&nbsp;Geoff Strange ,&nbsp;Girish Dwivedi ,&nbsp;Christian Hamilton-Craig ,&nbsp;Gemma Figtree ,&nbsp;David Playford","doi":"10.1016/j.ahjo.2024.100493","DOIUrl":"10.1016/j.ahjo.2024.100493","url":null,"abstract":"<div><h3>Background</h3><div>There is limited data showing the predictive accuracy of traditional cardiovascular risk scores (CVRS) to predict asymptomatic coronary artery disease (CAD) determined by coronary computed tomography angiography (CCTA).</div></div><div><h3>Methods</h3><div>Asymptomatic individuals without known CAD undergoing a screening CCTA and sufficient data to calculate their CVRS, were extracted retrospectively. Atherosclerosis was extracted using natural language processing of the CCTA report, including the coronary artery calcium score (CACS) and the extent and severity of CAD. Absence of atherosclerosis was defined as both zero plaque and zero CACS, and atherosclerosis was defined as low, moderate, or extensive by location and extent of plaque-burden. CVRS was categorized as high (&gt;15 %), moderate (10–15 %), low (1–9 %) and “zero” (&lt;1 %) risk.</div></div><div><h3>Results</h3><div>828 individuals (median age 58.6, IQR = 52.0, 65.3 years, 57 % male) met inclusion criteria, and a zero, low, moderate, and high CVRS was identified in 13, 483, 113 and 219 individuals (8 %, 49 %, 74 %, 66 % male), respectively. Predominantly low plaque-burden atherosclerosis was detected in 548 scans (67 % male). However, of the 137 males and 68 females with extensive atherosclerosis, 47 (34 %) and 38 (56 %) respectively had low CVRS classification. Overall, 23 % of males and 31 % of females had CAD predicted by CVRS (Monte Carlo: females, <em>p</em> = 0.024; males, <em>p</em> &lt; 0.001), but there was little to no agreement between CVRS and atherosclerosis burden (Cohen's kappa: males, <em>κ</em> = 0.149; females, <em>κ</em> = 0.096).</div></div><div><h3>Conclusions</h3><div>In asymptomatic individuals without known CAD, a low CVRS does not exclude extensive CAD. Newer tools incorporating additional markers may be helpful in risk prediction in such individuals.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"49 ","pages":"Article 100493"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11698937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cathepsin-D and outcomes in peripartum cardiomyopathy: Results from IPAC","authors":"Vincenzo B. Polsinelli ,&nbsp;Karen Hanley-Yanez ,&nbsp;Charles F. McTiernan ,&nbsp;Kalgi Modi ,&nbsp;Jennifer Haythe ,&nbsp;Hal Skopicki ,&nbsp;Uri Elkayam ,&nbsp;Leslie T. Cooper Jr ,&nbsp;James D. Fett ,&nbsp;Dennis M. McNamara ,&nbsp;for the IPAC investigators","doi":"10.1016/j.ahjo.2024.100489","DOIUrl":"10.1016/j.ahjo.2024.100489","url":null,"abstract":"<div><h3>Objective</h3><div>Evaluate the relationship of cathepsin-D (CD) on disease severity and clinical outcomes for women with peripartum cardiomyopathy.</div></div><div><h3>Background</h3><div>Cathepsin-D is a protease released during oxidative stress that cleaves prolactin (PRL) generating a 16 kDa fragment that is pro-apoptotic, anti-angiogenic, and has been implicated in the pathogenesis of peripartum cardiomyopathy (PPCM).</div></div><div><h3>Methods</h3><div>In 99 women with newly diagnosed PPCM enrolled in the Investigation in Pregnancy Associated Cardiomyopathy (IPAC) study, CD levels were assessed by ELISA from serum obtained at study entry. Left ventricular ejection fraction (LVEF) was assessed by echocardiography at entry, 6, and 12-months. CD levels were compared to healthy PP and non-PP controls. Survival free from major cardiovascular events (death, transplantation, or left ventricular assist device) was determined up to 12 months post-partum (PP).</div></div><div><h3>Results</h3><div>Mean age was 30 ± 6 years, with a baseline LVEF of 34 % ± 10. Cathepsin-D levels were higher in PPCM women (278 ± 114 ng/ml) than in healthy PP (190 ± 74, <em>p</em> = 0.02) and healthy non-PP controls (136 ± 79, <em>p</em> &lt; 0.001). There was no association of CD with age, breastfeeding status, or time from delivery to the presentation. Cathepsin-D levels were higher in women with higher New York Heart Association (NYHA) functional class (<em>p</em> = 0.001). Higher tertiles of CD levels were associated with lower event-free survival (<em>p</em> = 0.008).</div></div><div><h3>Conclusions</h3><div>In this prospective cohort of women with PPCM, higher CD levels at the time of diagnosis were associated with worse symptoms, less recovery of LVEF, and worse clinical outcomes. Circulating CD may contribute to the development of PPCM and influence disease severity, myocardial recovery, and clinical outcomes.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"49 ","pages":"Article 100489"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical recommendations for telehealth and electronic consultations in the veterans health administration referral coordination initiative","authors":"David E. Winchester ,&nbsp;Lisa Arfons","doi":"10.1016/j.ahjo.2024.100492","DOIUrl":"10.1016/j.ahjo.2024.100492","url":null,"abstract":"<div><div>Telemedicine</div><div>Veterans health services</div><div>Cardiology</div><div>Referral</div><div>Consultation</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"49 ","pages":"Article 100492"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11696744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leveraging the postpartum period to reduce racial disparities in postpartum hypertension care","authors":"Malamo E. Countouris ,&nbsp;Jared W. Magnani","doi":"10.1016/j.ahjo.2024.100490","DOIUrl":"10.1016/j.ahjo.2024.100490","url":null,"abstract":"<div><div>Pregnancy provides a window of opportunity for management of hypertension care. Particularly in the postpartum period – the so-called “4th trimester” – individuals of Black race are at increased risk for hypertension-related morbidity and mortality. Telehealth interventions, such as remote blood pressure monitoring programs and virtual postpartum visits, can reduce racial disparities in the delivery of recommended care. System and policy changes can address social factors that impact postpartum care as well. Cardiovascular clinicians have a key role to play in managing hypertension and addressing cardiovascular disease prevention strategies during reproductive years.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"49 ","pages":"Article 100490"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11698970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The uses of right heart catheterization in cardio-pulmonary disease: State-of-the-art","authors":"Bhavesh Katbamna ,&nbsp;Lingling Wu ,&nbsp;Mario Rodriguez ,&nbsp;Phillip King ,&nbsp;Joel Schilling ,&nbsp;Jamal Mahar ,&nbsp;Ajith P. Nair ,&nbsp;Hani Jneid ,&nbsp;Elizabeth S. Klings ,&nbsp;Gerald L. Weinhouse ,&nbsp;Sula Mazimba ,&nbsp;Marc A. Simon ,&nbsp;Markus Strauss ,&nbsp;Chayakrit Krittanawong","doi":"10.1016/j.ahjo.2024.100488","DOIUrl":"10.1016/j.ahjo.2024.100488","url":null,"abstract":"<div><div>The right heart catheterization (RHC) remains an important diagnostic tool for a spectrum of cardiovascular disease processes including pulmonary hypertension (PH), shock, valvular heart disease, and unexplained dyspnea. While it gained widespread utilization after its introduction, the role of the RHC has evolved to provide valuable information for the management of advanced therapies in heart failure (HF) and cardiogenic shock (CS) to name a few. In this review, we provide a comprehensive overview on the indications, utilization, complications, interpretation, and calculations associated with RHC.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"49 ","pages":"Article 100488"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of severe aortic stenosis by clinicians versus artificial intelligence: A retrospective clinical cohort study","authors":"Geoffrey A. Strange ,&nbsp;Michael P. Feneley ,&nbsp;David Prior ,&nbsp;David Muller ,&nbsp;Prasanna Venkataraman ,&nbsp;Yiling Situ ,&nbsp;Simon Stewart ,&nbsp;David Playford","doi":"10.1016/j.ahjo.2024.100485","DOIUrl":"10.1016/j.ahjo.2024.100485","url":null,"abstract":"<div><div>Many severe aortic stenosis (AS) cases are undetected and/or not considered for potentially life-saving treatment, with a persistent male-bias reported among those undergoing aortic valve replacement (AVR). We evaluated the clinical value of a validated artificial intelligence automated alert system (AI-AAS) that detects severe AS from routine echocardiographic measurements. In a retrospective, clinical cohort of 21,749 adults investigated with transthoracic echocardiography at two tertiary-referral centres, we identified 4057 women (aged 61.6 ± 18.1 years) and 5132 men (60.8 ± 17.5 years) with native aortic valves. We firstly applied the AI-AAS to the cardiologists' reported echo measurements, to detect all AS cases, including guideline-defined severe AS. Two expert clinicians then independently reviewed the original clinical diagnosis/management based on the initial report. Initially, 218/9189 (2.4 %, 95%CI 2.1–2.7 %) severe AS cases were diagnosed. The AI-AAS subsequently increased this number by 158 (52 % women) to 376 cases (4.1 %, 95%CI 3.7–4.5 %) of severe guideline-defined AS. Overall, more women were under-diagnosed (92/169 [54.4 %] versus 80/207 [38.6 %] men – adjusted odds ratio [aOR] 0.21, 95%CI 0.10–0.45). Even when accounting for potential contraindications to valvular intervention, women were persistently less likely to be considered for valvular intervention (aOR 0.54, 95%CI 0.31–0.95) and/or underwent AVR (aOR 0.29, 95%CI 0.09–0.74). Our study suggests an AI-AAS application that is agnostic to gender, haemodynamic bias, symptoms, or clinical factors, provides an objective alert to severe forms of AS (including guideline-defined severe AS) following a routine echocardiogram, and has the potential to increase the number of people (especially women) directed towards more definitive treatment/specialist care.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"48 ","pages":"Article 100485"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective registry of heart failure with preserved ejection fraction in México: EDIFICE-Mx","authors":"Diego Araiza-Garaygordobil ,&nbsp;Oscar-Ulises Preciado-Gutierrez ,&nbsp;Jorge Daniel Sierra-Lara Martinez ,&nbsp;Hector Gonzalez-Pacheco ,&nbsp;Rodrigo Gopar-Nieto ,&nbsp;Ximena Latapi-Ruiz Esparza ,&nbsp;Sarai Hernandez-Pastrana ,&nbsp;Braiana-Angeles Diaz-Herrera ,&nbsp;Amada Alvarez-Sangabriel ,&nbsp;Antonio Jordan-Rios ,&nbsp;Alexandra Arias-Mendoza","doi":"10.1016/j.ahjo.2024.100486","DOIUrl":"10.1016/j.ahjo.2024.100486","url":null,"abstract":"<div><h3>Background and aims</h3><div>Heart failure with preserved ejection fraction (HFpEF) is an increasingly common clinical syndrome, estimated to constitute approximately 50 % of all heart failure (HF) cases. Nonetheless, registries from specific geographic areas, as Latin America, are lacking. The present study aims to report the underlying causes, comorbidities, treatment patterns and outcomes of patients with HFpEF in a large cardiovascular center in Mexico City.</div></div><div><h3>Methods</h3><div>The present is a prospective, longitudinal, observational study, including female and male patients over 18 years of age, who presented to the emergency department, coronary care unit or outpatient department of the National Institute of Cardiology Ignacio Chavez in Mexico City with HFpEF. Patients were classified according to different phenotypes and current literature. The primary outcome was the composite total HFpEF hospitalization and all-cause mortality.</div></div><div><h3>Results</h3><div>Within a median follow-up of 472 (IQR 425–518) days, total mortality was 14.56 %, with 10.68 % attributed to cardiovascular causes. HF hospitalization was 7.77 %. Atrial fibrillation showed a notable association with outcomes (adjusted HR 2.87, P = 0.028). Beta-blocker showed a non-significant trend towards benefit, while mineralocorticoid receptor antagonists (MRA) significantly influenced outcomes (adjusted HR 3.30, P = 0.018). The primary composite endpoint occurred in 19.42 % of patients, with no significant difference among phenotypes (P = 0.536).</div></div><div><h3>Conclusions</h3><div>We observed a substantial comorbidity burden impacting quality of life, as indicated by KCCQ scores. There was a high incidence of hard endpoints, including cardiovascular death and hospitalizations, alongside significant variability in treatment utilization. Future research should focus on elucidating individual healthcare trajectories in HFpEF patients and promoting wider adoption of evidence-based therapies.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"48 ","pages":"Article 100486"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142758843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CMR and adverse clinical outcomes in peripartum cardiomyopathy","authors":"Agnes Koczo ,&nbsp;Deeksha Acharya ,&nbsp;Benay Ozbay ,&nbsp;Rami Alharethi ,&nbsp;Michael M. Givertz ,&nbsp;Uri Elkayam ,&nbsp;Erik B. Schelbert ,&nbsp;Dennis M. McNamara ,&nbsp;Timothy C. Wong","doi":"10.1016/j.ahjo.2024.100484","DOIUrl":"10.1016/j.ahjo.2024.100484","url":null,"abstract":"<div><h3>Background</h3><div>Peripartum cardiomyopathy (PPCM) is associated with significant morbidity and mortality. Recent studies show recovery of left ventricular ejection fraction (LVEF) can still be associated with longitudinal adverse clinical outcomes. Cardiac MRI (CMR) may yield additional prognostic parameters of serious adverse outcomes (SAE) beyond LVEF.</div></div><div><h3>Methods</h3><div>Individuals with PPCM and CMR within 3 months of diagnosis were analyzed from the Investigations in Pregnancy Associated Cardiomyopathy (IPAC) trial and our institution from 2010-present. Indexed left ventricular (LV) mass, ventricular volumes, cardiac output, global longitudinal strain (GLS), extracellular cellular volume (ECV) as well as epicardial fat volume (EFV) were analyzed. SAEs included left ventricular assist device (LVAD), heart transplant and death. CMR parameters were compared between SAE and no SAEs groups by non-parametric techniques.</div></div><div><h3>Results</h3><div>Among 51 individuals with mean age of 31 years at diagnosis, 6/51 (12 %) experienced 11 adverse outcomes. EF at time of CMR (15.0 vs 37.3 %, <em>p</em> &lt; 0.001), peak LV GLS (−4.1 % vs −10.0, <em>p</em> = 0.002) ECV (43.6 vs 28.2, <em>p</em> = 0.02) and stroke volume differed significantly among groups. In univariate regression analysis, worse LVEF, lower peak GLS and greater LVESVi were predictive of adverse outcomes.</div></div><div><h3>Conclusion</h3><div>Prior studies found baseline LVEF by echo is a predictor of serious adverse outcomes. CMR identified significantly different baseline LVESVi peak LV GLS and ECV among PPCM with SAEs vs no SAEs. If confirmed in larger studies, diffuse myocardial fibrosis may represent a therapeutic target in PPCM.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"48 ","pages":"Article 100484"},"PeriodicalIF":1.3,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142651794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and risk factors associated with decompensated heart failure after successful elective cardioversion for atrial fibrillation and atrial flutter","authors":"Christina Healy,&nbsp;Palwinder Sodhi,&nbsp;Annabelle Barnett,&nbsp;Timothy Hess,&nbsp;Jennifer M. Wright","doi":"10.1016/j.ahjo.2024.100480","DOIUrl":"10.1016/j.ahjo.2024.100480","url":null,"abstract":"<div><h3>Study objective</h3><div>To determine the incidence of and risk factors for HF after successful electrical and ablative cardioversion (CV) of atrial fibrillation (AF) and atrial flutter (AFL).</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Setting</h3><div>Single center academic institution.</div></div><div><h3>Participants</h3><div>Seven hundred fifty-five patients underwent successful elective CV from July 1, 2018 to May 20, 2019. Patients presenting in arrhythmias other than AF or AFL, those who developed HF due to alternative etiologies, and those who developed arrhythmia recurrence within 30 days were excluded. Medical records of the remaining 451 patients were reviewed before and after CV.</div></div><div><h3>Main outcomes measured</h3><div>Development of heart failure despite sinus rhythm following CV and the risk factors associated with this outcome.</div></div><div><h3>Results</h3><div>Thirty-three (7.3 %) of 451 patients who met inclusion criteria for our study developed new or worsening HF symptoms while maintaining sinus rhythm (SR) after successful CV. Symptoms were reported an average of 5.1 days following CV (range 0–17 days, SD 4.71). Following a multivariate stepwise logistic regression model, prior HF hospitalization (OR 3.91, 95 % CI 1.82–8.39), BMI (OR 1.06, 95 % CI 1.02–1.11), and valve disease (OR 2.51, 95 % CI 1.12–5.60) remained significant risk factors, and anti-arrhythmic drug (AAD) use was marginally significant (OR 2.02, 95 % CI 0.95–4.31).</div></div><div><h3>Conclusion</h3><div>Despite maintenance of SR, 7.3 % of patients developed decompensated HF in the 30 days following successful CV of AF or AFL, indicating this complication may be more frequent than previously believed. Predictors of HF post-CV included elevated BMI, valve disease, previous HF hospitalization, and prior AAD use.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"47 ","pages":"Article 100480"},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142571947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}