The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology最新文献

{"title":"Consistency over intensity: atorvastatin 40 mg plus ezetimibe 10 mg versus atorvastatin 80 mg in ACS patients: a comparative study of efficacy, tolerability, and cardiovascular outcomes.","authors":"Ahmad Samir, Kareem Mahmoud, Mohamed Ashraf, Hossam Elhossary, Hesham Salah Eldin Taha","doi":"10.1186/s43044-025-00708-1","DOIUrl":"10.1186/s43044-025-00708-1","url":null,"abstract":"<p><strong>Background: </strong>Despite guideline recommendations for high-intensity statins in acute coronary syndrome (ACS) patients, real-world data show underutilization and suboptimal low-density lipoprotein cholesterol (LDL-C) target achievement. The statin-associated muscle symptoms (SAMS) is often a major limitation to drug compliance and hence to achieving LDL-C targets.</p><p><strong>Methods: </strong>In this prospective, open label, randomized controlled trial, 502 ACS patients were randomized 1:1 to atorvastatin 80 mg monotherapy (Group A) versus atorvastatin 40 mg plus ezetimibe 10 mg (Group AE), aiming to compare the efficacy, safety, and tolerability of both treatment arms. Lipid profiles, safety, and clinical outcomes were assessed at baseline, 6 weeks, 6 months, and 12 months. The primary endpoints were LDL-C reduction, SAMS, and major adverse cardiovascular events (MACE).</p><p><strong>Results: </strong>The mean age of participants was 56 ± 10 years, with 83% males, 55% diabetics, and 77% hypertensives. Baseline characteristics were comparable between groups. Group AE demonstrated superior LDL-C reduction at all timepoints (p < 0.01), with greater improvements in high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG). Group AE also showed significantly fewer events of treatment discontinuation (DC) or dose reduction (DR) (OR 0.50; 95% CI 0.31-0.81) and a 25.7% relative risk reduction (RRR) in the composite of MACE compared to Group A. SAMS and non-limiting muscle aches were significantly lower in Group AE (p < 0.05), with no cases of rhabdomyolysis reported. Subgroup analysis confirmed consistent benefits of Group AE in both diabetic and non-diabetic patients.</p><p><strong>Conclusion: </strong>Atorvastatin 40 mg plus ezetimibe 10 mg demonstrated superior LDL-C reduction, improved tolerability, and fewer MACE compared to atorvastatin 80 mg monotherapy in ACS patients. These findings support the use of combination therapy as a viable starting alternative to atorvastatin 80 mg monotherapy following ACS, particularly in patients likely to have statin intolerance.</p>","PeriodicalId":74993,"journal":{"name":"The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology","volume":"77 1","pages":"110"},"PeriodicalIF":0.0,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12701100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145746141","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":"Association between hemoglobin-to-creatinine ratio and all-cause mortality in patients with coronary artery disease.","authors":"Bo Kang, Chun Zhang, Jie Li, Liang Chen","doi":"10.1186/s43044-025-00707-2","DOIUrl":"10.1186/s43044-025-00707-2","url":null,"abstract":"<p><strong>Background: </strong>Although the hemoglobin-to-creatinine ratio (HCR) has been recognized as a predictor for various diseases, its prognostic value in patients with coronary artery disease (CAD) remains unclear. This study aimed to examine the association between HCR and all-cause mortality in general CAD patients using data from the National Health and Nutrition Examination Survey (NHANES) database.</p><p><strong>Methods: </strong>A total of 3701 adult patients with CAD, which was identified through self-report in questionnaires, were included and followed for a mean of 79 months. The association between HCR and all-cause mortality was evaluated using smooth curve fitting, threshold effect analysis, and a competing risk regression model.</p><p><strong>Results: </strong>A nonlinear association was observed between HCR and all-cause mortality among CAD patients, characterized by an inflection point at 18.32. Below this threshold, each unit decrease in HCR was associated with a 6% reduction in all-cause mortality (HR = 0.94, 95%CI: 0.92-0.97, p < 0.001). Above the inflection point, each unit increase in HCR corresponded to a 7% increase in mortality risk (HR =1.07, 95%CI: 1.02-1.12, p = 0.005). The competing risk model revealed a similar association between HCR and cardiac mortality.</p><p><strong>Conclusions: </strong>Utilizing data from the nationally representative NHANES database, this study identified a nonlinear correlation between HCR and all-cause mortality in a general population of patients with CAD. Specifically, mortality risk initially decreased and subsequently increased with rising HCR levels, highlighting the broad relevance of these findings to community-based CAD management.</p>","PeriodicalId":74993,"journal":{"name":"The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology","volume":"77 1","pages":"109"},"PeriodicalIF":0.0,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12680590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145679772","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":"Endovascular repair of infrarenal aortic aneurysm and severe stenosis in Type V Takayasu arteritis: a rare case report and clinical insights.","authors":"Much Muzakky Misbachul Firdaus, Zakiyyatul Aflakha, Yusuf Aji Samudera Nurrobi, Johannes Nugroho Eko Putranto","doi":"10.1186/s43044-025-00702-7","DOIUrl":"10.1186/s43044-025-00702-7","url":null,"abstract":"<p><p>BACKGROUND: Takayasu arteritis (TA) is a rare, chronic vasculitis affecting the aorta and its major branches, leading to stenosis, aneurysm, and ischemic complications. It primarily affects young adults and may progress to critical ischemia, necessitating revascularization strategies. Endovascular aneurysm repair (EVAR) is increasingly recognized as an effective, minimally invasive intervention for managing TA-associated complications. CASE DESCRIPTION: A 28-year-old male presented with a three-month history of progressive bilateral lower limb discomfort and tingling exacerbated by activity, intermittent abdominal cramps, and fatigue. Physical examination revealed a significant blood pressure discrepancy between the upper limbs (right: 193/66 mmHg, left: 100/71 mmHg), reduced lower limb pressures (right ankle: 66/41 mmHg, left ankle: 72/42 mmHg), pulse deficits, and diminished ankle-brachial indices (right: 0.34; left: 0.37). Transthoracic echocardiography (TTE) demonstrated all-chamber dilatation, reduced systolic function (EF: 38%), severe mitral regurgitation, moderate aortic regurgitation, and a large right atrial thrombus (3.0 × 1.9 cm). Computed tomography angiography (CTA) revealed critical mid-aortic stenosis (6.9 × 11.9 mm), a post-stenotic saccular aneurysm (20.6 × 22.4 mm), and severe narrowing of the left subclavian and axillary arteries. The patient underwent endovascular aneurysm repair (EVAR), with a thoracic stent graft (24 × 80 mm) successfully deployed. Six months post-procedure, the patient experienced complete resolution of symptoms, with improved ABI values (right: 0.94; left: 0.73) and significant regression of the aneurysm (13.1 × 13.1 mm). CONCLUSION: EVAR may represent a feasible option for carefully selected TA patients with focal lesions and high surgical risk, although open repair remains necessary for more complex disease. Lifelong surveillance and further research are essential to optimize management strategies in this rare condition. </p>","PeriodicalId":74993,"journal":{"name":"The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology","volume":"77 1","pages":"108"},"PeriodicalIF":0.0,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12675888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145673134","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":"Trials evaluating nicorandil renoprotection against contrast-induced nephropathy after coronary angiography or percutaneous coronary intervention: a systematic review and meta-analysis.","authors":"Nestor Lemos Ferreira, Débora Regina Aguiar, Sachin G Nair, Mohamed Ashraf Shehab, Abiodun Bamidele Adelowo, Mohammad Rafi Damirchi, Dan Jones, Krishna Rathod, Zahid Khan","doi":"10.1186/s43044-025-00705-4","DOIUrl":"10.1186/s43044-025-00705-4","url":null,"abstract":"<p><strong>Background: </strong>Ischaemic heart disease (IHD) is a leading cause of mortality and morbidity globally. Coronary angioplasty has a vital role in treating coronary artery disease. However, this is associated with a small risk of serious side effects, including contrast-induced nephropathy, vascular complications and arrhythmia. Contrast-induced nephropathy (CIN) is a serious and common complication of coronary angioplasty that can lead to renal failure and major adverse cardiac and renal outcomes.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis by searching multiple databases, including PubMed, Scopus, Embase, Google Scholar, and ScienceDirect, as well as other sources. The inclusion and exclusion criteria are described in detail later in this article. Two independent reviewers performed the literature search in September 2024 and identified 282 articles. The study was conducted following the population, intervention, comparator, and outcome (PICO) framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 17 studies were included in the final analysis after applying the inclusion and exclusion criteria. The exclusion criteria were guidelines, case reports, qualitative research, and letters to the editor, commentaries, conference proceedings, gray literature, opinions, policy papers, and case series. Articles published after 2010 were included in this meta-analysis, and data analysis was performed using Rayyan statistical software.</p><p><strong>Results: </strong>This study demonstrated that nicorandil was associated with protective effects against CIN. The total number of patients in the Nicorandil and placebo groups were 3836 and 3858 respectively. The occurrence of CIN was 5.14% in the nicorandil group, compared with 13.15% in the control group. This study also confirmed the dose-dependent effect of nicorandil on CIN. Among 662 patients enrolled in three studies, 3,9% in the double dose (DD) group presented with CIN, compared with 8,4% in the standard dose (SD) group. The occurrence of MACE was 5.7% in the Nicorandil group and 8.2% in the control group. However, there was no statistically significant protective effect against major adverse cardiovascular events (MACE) or major adverse kidney events (MAKE). Only a few studies measured the impact on MAKE, and the findings may not be truly representative of its effects.</p><p><strong>Conclusion: </strong>This study demonstrated the renoprotective effects of nicorandil in preventing CIN in patients undergoing coronary angioplasty, and this relationship was also evident from the double-dose response. Further larger size randomised controlled trials are recommended to assess the efficacy of nicorandil in preventing CIN in patients undergoing coronary angioplasty.</p>","PeriodicalId":74993,"journal":{"name":"The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology","volume":"77 1","pages":"107"},"PeriodicalIF":0.0,"publicationDate":"2025-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12620340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145533848","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":"A dislodged coronary stent migrating over a guiding catheter: a \"Muckers-type\" stent loss retrieved using a snare technique.","authors":"Michał Kuzemczak, Wojciech Suślik, Michał Stachura","doi":"10.1186/s43044-025-00703-6","DOIUrl":"10.1186/s43044-025-00703-6","url":null,"abstract":"<p><p>BACKGROUND: Coronary stent dislodgement is a rare complication of percutaneous coronary interventions with potentially serious clinical sequelae. There are several scenarios for the dislodgement and various techniques to deal with this complication. A dislodged stent migrating retrogradely over a guiding catheter and retrieved with a snare system has never been reported. We present the first reported case of a dislodged coronary stent passing over a guiding catheter which was successfully retrieved with a snare system. CASE REPORT: A 76-year-old patient with unstable angina was admitted for a coronary angiography. It revealed in-stent restenosis in the mid portion of the left anterior descending artery (LAD) and within the ostium of the left main coronary artery (LM). Following an uncomplicated PCI of the LAD and during subsequent stent deployment in the LM, the balloon with a mounted stent popped out to the aorta. After the balloon had been pulled back, the stent migrated over the guiding catheter. Consequently, another longer stent was successfully implanted into the LM, and afterwards the dislodged stent was snared and retrieved using an ipsilateral femoral access. The patient was discharged after two days of uneventful hospital stay. CONCLUSIONS: The case report demonstrates an unusual course of stent dislodgement passing over a guiding catheter which was successfully retrieved with a snare technique. It underscores the importance of optimal lesion preparation and meticulous vigilance when implanting short stents into LM. </p>","PeriodicalId":74993,"journal":{"name":"The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology","volume":"77 1","pages":"106"},"PeriodicalIF":0.0,"publicationDate":"2025-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12620342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145535165","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":"Peripartum aortic dissection: a rare case of Stanford type B dissection triggered by severe labor pain.","authors":"Yun Lu, Zhu Wang, Hu Zhang, Zhongxin Zhou, Jun Wei, Hao Zhang","doi":"10.1186/s43044-025-00704-5","DOIUrl":"10.1186/s43044-025-00704-5","url":null,"abstract":"<p><strong>Background: </strong>Peripartum aortic dissection (AD) is an uncommon yet significant complication during pregnancy and delivery, characterized by a tear in the aortic intima that can lead to severe maternal morbidity and mortality. This case report describes a rare instance of Stanford Type B aortic dissection occurring in a pregnant woman, emphasizing that acute, severe labor pain can obscure the diagnosis of AD, often leading to misattribution of symptoms to more common obstetric complications.</p><p><strong>Case presentation: </strong>This report highlights the case of a 36-year-old primigravida who presented with acute chest pain during labor, initially misdiagnosed until imaging revealed the dissection post-delivery. The critical interplay between labor-induced hemodynamic stress and pre-existing vascular weaknesses, such as those found in connective tissue disorders, raises concerns about the cardiovascular risks faced by pregnant individuals. The importance of a multidisciplinary approach, involving obstetricians, cardiologists, and anesthesiologists, is underscored, as effective management strategies are essential to ensure maternal and fetal safety.</p><p><strong>Conclusion: </strong>This case underscores the necessity for healthcare providers to maintain a high index of suspicion for atypical thoracic pain in pregnant patients and advocates for enhanced screening protocols for aortic disease. The findings advocate for regular cardiovascular assessments in women of childbearing age with known risk factors to improve early diagnosis and intervention, thereby potentially reducing the associated morbidity and mortality from this rare but critical condition. Further research is needed to develop evidence-based guidelines for managing AD in the peripartum setting, aiming to refine clinical protocols and optimize patient outcomes.</p>","PeriodicalId":74993,"journal":{"name":"The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology","volume":"77 1","pages":"105"},"PeriodicalIF":0.0,"publicationDate":"2025-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12620343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145535197","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":"Left atrial functional remodeling following percutaneous closure of atrial septal defect secundum in adult patients.","authors":"Pramadya Vardhani Mustafiza, Lucia Kris Dinarti, Real Kusumanjaya Marsam, Hasanah Mumpuni, Dyah Wulan Anggrahini","doi":"10.1186/s43044-025-00700-9","DOIUrl":"10.1186/s43044-025-00700-9","url":null,"abstract":"<p><p>BACKGROUND: Atrial septal defect secundum (ASDs) is one of the congenital heart diseases that is common in adults and frequently associated with volume overload and functional impairment of the right heart. Percutaneous device closure has become the preferred treatment because of its efficacy and lower complication rates. While right heart remodeling post-closure is well established, the effects on left atrial (LA) function, especially phasic components involving reservoir, conduit, and contraction strain, remain less understood. Two-dimensional speckle tracking echocardiography (2D STE) enables early and sensitive detection of LA functional changes. METHOD: This retrospective cohort study included adult patients (aged 18–65 years) with ASDs who underwent percutaneous device closure between December 2022 and October 2023 at Dr. Sardjito Hospital, Yogyakarta, Indonesia. Echocardiographic evaluations, including LA strain analysis (LASr, LAScd, LASc), were performed pre-closure, within 6 months (1st semester), and between ≥ 6–12 months (2nd semester) post-device closure. Patients with significant valvular disease, persistent arrhythmias, or suboptimal acoustic windows were excluded. Statistical analysis was conducted using repeated measures ANOVA or Friedman tests with Bonferroni correction. RESULT: A total of 21 patients (mean age 40.86 ± 14.74 years; 76% female) were included. LA reservoir strain (LASr) significantly declined in the 1st semester post-device closure compared to baseline (p = 0.003) and showed partial recovery by the 2nd semester (p = 0.016 vs. baseline). LA conduit strain (LAScd) and contraction strain (LASc) also significantly decreased in the 1st semester (p = 0.030 and p = 0.025, respectively), while LASc did not significantly improve at the 2nd semester follow-up. No significant changes were observed in LA geometry. Interobserver agreement for all strain measurements was excellent (ICC ≥ 0.99). CONCLUSION: LA functional impairment was observed in the 1st semester after percutaneous device closure, marked by a noticeable decline in all strains of the LA (LASr, LAScd, and LASc). Partial recovery of LASr was observed at one year, whereas LASc did not show significant improvement after the initial reduction. These findings highlight that the LA strain may be a sensitive marker for predicting the development of LA dysfunction post-device closure follow-up. </p>","PeriodicalId":74993,"journal":{"name":"The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology","volume":"77 1","pages":"104"},"PeriodicalIF":0.0,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12615882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145508349","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 presentation, microbiological profile, and management challenges of infective endocarditis: a retrospective study from a high volume cardiac centre in Pakistan.","authors":"Muhammad Wali Saleem, Maha Amjad, Ihsan Ullah, Rafi Ullah Jan, Muhammad Ishaq Khan, Ummad Israr","doi":"10.1186/s43044-025-00699-z","DOIUrl":"10.1186/s43044-025-00699-z","url":null,"abstract":"<p><strong>Background: </strong>Infective endocarditis (IE) is a potentially fatal condition with high morbidity and mortality. This single center study was designed to assess the clinical presentation, causative organisms, antibiotic resistance, and clinical outcomes of IE in patients treated at a tertiary care cardiac center in Pakistan.</p><p><strong>Methods: </strong>A retrospective observational study was conducted at a large tertiary care cardiology center in Peshawar, Pakistan from July 2021 to July 2023. Data was collected from hospital records, including demographic, clinical, and laboratory parameters. Statistical analysis was performed using Stata version 14.2.</p><p><strong>Results: </strong>Among 84 patients, 41.7% were male with a mean population age of 49.17 ± 18.55 years, and an average BMI of 27.72 ± 4.37 kg/m². Hypertension was the most common comorbidity, found in 47.6% patients, followed by diabetes in 36.9% patients. Streptococcus Viridans (25%) was the most common organism isolated, followed closely by Staphylococcus aureus at 22.6%. Surprisingly, 32.1% of the patients had negative cultures. Antibiotic resistance was observed in 25/57 (43.9%) of culture positive cases, and Major Adverse Cardiovascular Events (MACE) occurred in 56%. Acute kidney injury was observed in 48.8% of the patients.</p><p><strong>Conclusion: </strong>IE presents diverse etiologies and outcomes, necessitating targeted management strategies to reduce antibiotic resistance and improve outcomes in such a challenging subsets of patients.</p>","PeriodicalId":74993,"journal":{"name":"The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology","volume":"77 1","pages":"103"},"PeriodicalIF":0.0,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12602776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145484196","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 long-term impact of the tricuspid valve intervention after Fontan completion.","authors":"Yuriy Kulyabin, Ilya Soynov, Timothy Lancaster, Vikram Sood, Jennifer Romano, Richard Ohye, Jiyong Moon","doi":"10.1186/s43044-025-00701-8","DOIUrl":"10.1186/s43044-025-00701-8","url":null,"abstract":"<p><strong>Background: </strong>The incompetence of the tricuspid valve (TV) may predispose to unfavorable results of Fontan palliation in patients with single right ventricle (RV). This study aims to reveal the effect of TV intervention in patients with single RV on long-term outcomes after Fontan completion.</p><p><strong>Methods: </strong>A single-center retrospective cohort study was conducted with patients who underwent Fontan completion from 1985 to 2017. There was a total of 678 patients with single RV. A total of 128 patients (18.8%) underwent TV intervention at any stage (TVI group); 30 of them (23.4%) underwent repeat TV surgery (repeat TVI subgroup). The control group comprises 550 patients (81.2%) who had no TV surgery regardless of the degree of TR (non TVI group).</p><p><strong>Results: </strong>The median follow-up was 8.8 (± 7.6) years. Overall transplant- and Fontan takedown-free survival was 62.5% (95% CI 59.2%-64.9%) at 20 years. The repeat TVI group had significantly lower transplant and takedown-free survival rates (Non TVI 76.5% vs. Single TVI 75.3% vs. repeat TVI 56.0% at 15 years, P = 0.02). The younger age at Fontan (1.12 [95% CI 1.02-1.22], p = 0.019), repeat TVI (3.33 [95% CI 1.57-7.04], p = 0.002), TV intervention after Fontan (6.14 [95% CI 2.60-14.50], p < 0.001), significant ventricular dysfunction before Fontan (3.12 [95% CI 1.12-8.30], p = 0.028) and any concomitant procedure at Fontan (1.98 [95% CI 1.16-3.37], p = 0.013) were the significant risk factors for transplant and takedown free- survival.</p><p><strong>Conclusions: </strong>Repeat TV intervention during the Fontan was associated with inferior outcomesin patients with morphologic systemic RV. Successful TV intervention could provide comparable long-term survival outcomes to non-TV intervention patients.</p>","PeriodicalId":74993,"journal":{"name":"The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology","volume":"77 1","pages":"102"},"PeriodicalIF":0.0,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12589728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145446839","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":"Atrial fibrillation recurrence risk after single catheter ablation in patients with history of hyperthyroidism: systematic review and meta-analysis.","authors":"Rivaldo Rivaldo, Kevin Tjoa, Peter Parulian, Michael Sugiyanto, Henrico Catrawijaya, Birry Karim","doi":"10.1186/s43044-025-00696-2","DOIUrl":"10.1186/s43044-025-00696-2","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is the most common arrhythmias. Other than pharmacotherapy, catheter ablation is preferred especially for symptomatic paroxysmal AF or persistent AF. However, recurrence of atrial fibrillation following catheter ablation can occur due to several factors. Hyperthyroidism is known as a factor in atrial fibrillation pathogenesis but its role in AF recurrence following ablation is not known yet. Therefore, we aimed to assess the recurrence risk after catheter ablation in patients with a history of hyperthyroidism.</p><p><strong>Methods: </strong>Systematic searching was performed through three databases: MEDLINE, EMBASE, and SCOPUS for studies reporting the recurrence of AF (hazard ratio) following catheter ablation in patients with a history of hyperthyroidism. The risk of bias assessment of included studies was performed using quality in prognosis studies (QUIPS). Meta-analysis (random effect model and inverse variance) was conducted using RevMan software version 5.4.</p><p><strong>Results: </strong>Four studies involving 837 subjects were included. Pooled analysis shows a higher risk of recurrence of atrial fibrillation following catheter ablation in patients with history of hyperthyroidism (HR 1.86 [CI 95% 1.26-2.75]; I² 38%). Subgroup analysis showed patients with amiodarone-induced hyperthyroidism (AIH) had a higher risk of atrial fibrillation recurrence (HR 2.31; CI 95% 1.49-3.58; I² 0%) compared to non-AIH. However, two studies on AIH showed moderate risk of bias.</p><p><strong>Conclusions: </strong>History of hyperthyroidism was found as the risk of recurrence of atrial fibrillation after a single ablation procedure. Patients with amiodarone-induced hyperthyroidism have a higher recurrence risk. Further studies with larger participants are needed for subgroup analysis on specific parameters of the ablation.</p>","PeriodicalId":74993,"journal":{"name":"The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology","volume":"77 1","pages":"101"},"PeriodicalIF":0.0,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12575886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145410945","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}