BMC Cardiovascular Disorders最新文献

{"title":"Methodological discordance between apical four-chamber and biplane Simpson's method for left ventricular ejection fraction: a retrospective study of a credentialed echocardiographic dataset.","authors":"Hasan Burak İşleyen, Sevil Tugrul Yavuz, Sercan Bulut, Fatih Kizkapan, Cevahir Alioglu, Necla Zeynep Eren, Ali Arda Sozen, Mahsa Khanmohammadi","doi":"10.1186/s12872-026-05952-0","DOIUrl":"https://doi.org/10.1186/s12872-026-05952-0","url":null,"abstract":"<p><strong>Background: </strong>Left ventricular ejection fraction (LVEF) remains central to heart failure phenotyping and device-based decision-making, yet the degree to which apical four-chamber (A4C) and biplane Simpson measurements diverge at clinically actionable thresholds is not well defined.</p><p><strong>Methods: </strong>We analysed 1,022 unique algorithmically derived echocardiographic studies from 784 patients in the credentialed MIMIC-IV-ECHO-Ext-LVVOLUMES-A4C-ROI resource. Each study contained paired A4C and biplane volumetric labels derived from the same annotated DICOM sequence. Discordance was defined primarily at the HFrEF threshold (LVEF < 40%). Agreement was assessed with Bland-Altman analysis, and independent predictors were evaluated using multivariable logistic regression with cluster-robust standard errors.</p><p><strong>Results: </strong>LVEF discordance at the HFrEF threshold occurred in 48 of 1,022 studies (4.7%, 95% CI 3.5-6.2%). At the ICD threshold (LVEF < 35%), discordance was present in 32 studies (3.1%). In the prespecified borderline zone (A4C LVEF 35-45%; n = 81), discordance rose to 30.9% (95% CI 21.9-41.6%). Mean bias was 0.11%, but the 95% limits of agreement were wide (- 13.5% to + 13.7%). LV end-diastolic volume was the only independent predictor of discordance (OR 1.61 per SD, 95% CI 1.27-2.05; p = 0.0001), and this association persisted after adjustment for acquisition variables.</p><p><strong>Conclusions: </strong>Discordance between A4C and biplane Simpson LVEF is uncommon across an unselected cohort but becomes frequent near therapeutic cut-offs. LV dilatation is the dominant driver. These findings support continued preference for biplane quantification when the ventricle is enlarged or the measured LVEF falls near a treatment threshold.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the efficacy of photoplethysmography-derived stiffness index, sine-waveform ratio, and heart rate variability total power for cardiovascular health assessment.","authors":"Lei Wang, Meng-Yu Hsiao, Zi-Jun Chen, Ruo-Jhen Wu, Meng-Ting Wu","doi":"10.1186/s12872-026-05914-6","DOIUrl":"https://doi.org/10.1186/s12872-026-05914-6","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to predict risk of cardiovascular disease (CVD) in participants unaware of their cardiovascular health using a convenient approach.</p><p><strong>Methods: </strong>Continuous 100-second photoplethysmography (PPG) signals were recorded from 144 participants. The subjects were subsequently categorized based on the presence or absence of CVD. The proportions of abnormal stiffness index (SI), the sine-waveform ratio (SIN ratio), a morphological index of PPG waveform regularity used as a marker for cardiovascular pathological aging, and total power (TP), derived from heart rate variability (HRV) frequency-domain analysis to reflect autonomic nervous system activity, were compared.</p><p><strong>Results: </strong>A total of 144 participants were enrolled in this study (CVD group, n = 54; healthy control group, n = 90). CVD group had higher SIN ratio (37.4 ± 27.8% vs. 21 ± 23.9%) and lower TP (1587.0 ± 262.9 vs. 1804.7 ± 261.7ms²) compared to healthy controls (p < 0.001). CVD group had higher rates of abnormal SI (46% vs. 24%) and SIN ratio > 40% (42.6% vs. 23.5%), all p < 0.01. The combination of abnormal SI values, SIN ratio > 40%, and TP < 1500 ms² indicated a high likelihood of CVD (p < 0.001).</p><p><strong>Conclusion: </strong>PPG-derived SI, SIN ratio, and TP are valuable indicators that are potentially associated with cardiovascular health. Our results provided a convenient, inexpensive, and automated approach for preliminary assessment of the presence of CVD. Further large-scale studies are needed to validate these findings.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147863659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-based disparities in postoperative outcomes after catheter ablation for atrial fibrillation: a systematic review and meta-analysis of propensity-matched studies.","authors":"Ogechukwu Samuel Obi, Alysa Malik, Ilias Koziakas, Muhammad Hamza, Ahmed W Hageen, Paweł Łajczak, Muhammad Khan, Uchenna Diane Nweze, Somtochukwu Susan Muogbo, Kamil Ahmad Kamil, Michel Pompeu Sá","doi":"10.1186/s12872-026-05942-2","DOIUrl":"https://doi.org/10.1186/s12872-026-05942-2","url":null,"abstract":"<p><strong>Background and aim: </strong>Sex-related differences in outcomes after catheter ablation for atrial fibrillation (AF) remain incompletely understood, particularly regarding long-term arrhythmia recurrence and procedural safety. Current guidelines do not provide sex-specific recommendations. This systematic review and meta-analysis aimed to evaluate sex-based differences in efficacy, safety, and long-term outcomes following AF catheter ablation.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis in accordance with PRISMA guidelines and the Cochrane Handbook, with prospective registration in PROSPERO (CRD420251168422). PubMed, Embase, Web of Science, and the Cochrane Library were searched from inception to December 2025. Only studies adjusting for baseline differences using propensity score-based methods were included. Risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using a restricted maximum likelihood random-effects model. Risk of bias was assessed using ROBINS-I, and certainty of evidence was evaluated using GRADE.</p><p><strong>Results: </strong>A total of 21 studies involving 103,619 patients undergoing AF ablation were included, of whom approximately 32% were female. There were no significant sex-based differences in AF recurrence at 1 year (RR 1.22, 95% CI [0.78, 1.91], I² = 51.5%, τ²=0.0814, p = 0.3807), AF / atrial tachycardia (AT) recurrence at 1 year (RR 1.13, 95% CI [0.91, 1.39], I² = 0%, τ²=0, p = 0.2659), AT / atrial flutter (AFL) / AT recurrence at 1 year (RR 1.03, 95% CI [0.68, 1.58], I² = 79%, τ²=0.1067, p = 0.8744), early all-cause mortality (RR 1.07, 95% CI [0.50, 2.29], I² = 0%, τ²=0, p = 0.8575), 1-year all-cause mortality (RR 0.49, 95% CI [0.14, 1.67], I² = 56.4%, τ²=0.6668, p = 0.2523), follow-up stroke/TIA (RR 1.12, 95% CI [0.72, 1.76], I² = 0%, τ²=0, p = 0.6107), follow-up repeat ablation (RR 1.03, 95% CI [0.86, 1.22], I² = 0%, τ²=0, p = 0.7755). However, women had a higher risk of AF / AT recurrence at 2 years (RR 1.22, 95% CI [1.04, 1.42], I² = 0.0%, τ²<0.0001, p = 0.0120), early complication rate (RR 1.37, 95% CI [1.10, 1.70], I² = 59.6%, τ²=0.0368, p = 0.0051), early cardiac tamponade (RR 2.46, 95% CI [1.49, 4.07], I² = 0.0%, τ²=0, p = 0.0004), and follow-up cardiac failure (RR 2.80, 95% CI [1.45, 5.38], I² = 0%, τ²=0, p = 0.0020).</p><p><strong>Conclusion: </strong>Catheter ablation yields similar short-term rhythm control and mortality in women and men with AF. However, women have higher early procedural complications and worse long-term outcomes, including increased 2-year AF/AT recurrence and heart failure, highlighting the need for tailored strategies and closer follow-up in female patients.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of heart rate trajectories on mortality in critically Ill patients with atrial fibrillation and heart failure: a longitudinal cohort study.","authors":"Qian Ni, Jialin Qi, Qinghe Wang, Chen Tang, Zishun Liang, Jing Cai, Tong Qiao, Baoyan Wang","doi":"10.1186/s12872-026-05947-x","DOIUrl":"https://doi.org/10.1186/s12872-026-05947-x","url":null,"abstract":"<p><strong>Background: </strong>This study investigated the prognostic significance of dynamic heart rate trajectories and heart rate coefficient of variation (CV) in critically ill patients with atrial fibrillation and heart failure (AF-HF).</p><p><strong>Methods: </strong>This retrospective multicenter cohort study included 8,356 ICU patients with AF-HF from the MIMIC-IV and eICU databases. We applied a Joint Latent Class Model (JLCM), which simultaneously identifies distinct longitudinal heart rate trajectories and estimates their associations with survival, to classify patients into different heart rate trajectory groups over the first 30 days after ICU admission. Multivariable Cox models were used to evaluate the associations between heart rate patterns and 30-day all-cause mortality. A Bayesian joint model was further developed for dynamic risk prediction.</p><p><strong>Results: </strong>Compared with a baseline heart rate < 80 bpm, the fully adjusted HRs were 1.13 (95% CI: 1.01-1.26) for 80-110 bpm and 1.28 (95% CI: 1.10-1.49) for > 110 bpm. Three distinct heart rate trajectory groups were identified, with a progressively increasing trajectory associated with higher mortality (HR = 2.96, 95% CI: 2.24-3.92). Similarly, patients with increasing heart rate CV trajectories had higher mortality than those with stable CV patterns (HR = 3.11, 95% CI: 2.40-4.03). Subgroup analyses showed significant interactions by renal function and mechanical ventilation status (P for interaction < 0.05). Dynamic prediction models showed improved discrimination with longer observation windows.</p><p><strong>Conclusions: </strong>Heart rate trajectories were associated with short-term mortality in ICU patients with AF-HF, and similar associations were observed for heart rate variability trajectories in exploratory analyses. These findings suggest that longitudinal heart rate monitoring may have value for short-term risk stratification, although further validation is required.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147863621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting atrial fibrillation recurrence after radiofrequency ablation using the AIFV system: a prospective observational study.","authors":"Yingrong Xin, Jingchao Li, Huihui Song, Luqian Cui, Haijia Yu, Yingjie Chu, Shujuan Dong","doi":"10.1186/s12872-026-05860-3","DOIUrl":"https://doi.org/10.1186/s12872-026-05860-3","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary vein isolation (PVI) has become the cornerstone of atrial fibrillation (AF) treatment. Nevertheless, the efficacy of radiofrequency ablation remains limited by a substantial rate of recurrence. The selection of anesthesia, the surgeon's operative experience and medical expertise, as well as the ablation surgery strategy, all have an impact on the recurrence after atrial fibrillation surgery. Our research aims to explore a novel method for predicting atrial fibrillation (AF) recurrence.</p><p><strong>Methods: </strong>This study enrolled 148 patients with atrial fibrillation (AF) undergoing first-time radiofrequency ablation. Based on the data from the AIFV system (an artificial intelligence-based ablation quality analysis system that generates structured Vistag scores from CARTO3 mapping data), patients were divided into two groups: the high-score group(Vistag analysis scores ≥ V5) and the low-score group(scores < V5). Baseline characteristics, intraoperative parameters, and AIFV system-related data were collected. Multivariate logistic regression analysis was performed to identify factors associated with atrial fibrillation (AF) recurrence.</p><p><strong>Results: </strong>Among the 148 enrolled patients, 84 were categorized into the high-score group and 64 into the low-score group. Patients in the low-score group had significantly higher Left Ventricular End-Diastolic Volume (LVEDV), Left Ventricular Ejection Fraction (LVEF), and Left Ventricular End-Systolic Volume (LVESV), as well as a higher prevalence of diabetes (29.5% vs. 9.5%, p = 0.002). During a minimum follow-up of 365 days, 11 patients (13.1%) in the high-score group experienced recurrence of atrial arrhythmia, compared to 19 patients (29.7%) in the low-score group. Kaplan-Meier analysis revealed a significantly higher atrial arrhythmia-free survival rate in the high-score group (log-rank test, P = 0.012). Multivariate logistic regression analysis revealed that being in the high-score group was an independent protective factor against AF recurrence (OR = 0.383, 95% CI 0.160-0.912, P = 0.030).</p><p><strong>Conclusions: </strong>The AIFV system was used to evaluate six procedural parameters in each atrial fibrillation procedure, which could play a crucial role in predicting the recurrence of atrial fibrillation.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147863632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TAPSE/PAi, a practical echocardiographic functional-structural index, better reflects functional severity than TAPSE/sPAP in pulmonary hypertension.","authors":"Yunus Emre Yavuz, Yakup Alsancak, Sefa Tatar, Cem Korucu, Hasan Kan, Hakan Akilli, Abdullah İçli̇","doi":"10.1186/s12872-026-05920-8","DOIUrl":"https://doi.org/10.1186/s12872-026-05920-8","url":null,"abstract":"<p><strong>Background: </strong>We evaluated TAPSE/PAi, defined as the ratio of tricuspid annular plane systolic excursion to the indexed main pulmonary artery diameter, as a pragmatic functional-structural index and compared it with TAPSE/sPAP.</p><p><strong>Methods: </strong>In this retrospective study, 53 patients with PAH were analyzed. Associations of TAPSE/PAi and TAPSE/sPAP with clinical, biomarker, and invasive hemodynamic variables were assessed. Discrimination for WHO-FC ≥ 3, 6MWD < 165 m, and PVR > 5 WU was evaluated by direction-aligned ROC analysis with Youden-optimal thresholds. Age- and sex-adjusted logistic regression models reported odds ratios (ORs) per 1-SD increase.</p><p><strong>Results: </strong>TAPSE/PAi correlated more strongly than TAPSE/sPAP with WHO-FC (ρ=-0.592 vs. -0.384) and 6MWD (ρ = 0.493 vs. 0.378), whereas TAPSE/sPAP correlated more strongly with NT-proBNP/proBNP (ρ=-0.619 vs. -0.484) and with mPAP/PVR. TAPSE/PAi showed better discrimination for WHO-FC ≥ 3 and 6MWD < 165 m while TAPSE/sPAP performed modestly better for PVR > 5 WU The Youden-optimal TAPSE/PAi threshold was ≤ 1.296 for both WHO-FC ≥ 3 and 6MWD < 165 m. The higher TAPSE/PAi remained associated with lower odds of WHO-FC ≥ 3 and 6MWD < 165 m after age- and sex-adjustment.</p><p><strong>Conclusions: </strong>TAPSE/PAi better reflects functional severity and exercise limitation, whereas TAPSE/sPAP is more closely related to biomarker/hemodynamic burden. The indices appear complementary, and TAPSE/PAi may be a practical TR-independent severity marker in PAH.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nomogram-based prediction of postoperative kinesiophobia in patients with coronary heart disease.","authors":"Li-Na Luo, Chun-Fei Li","doi":"10.1186/s12872-026-05932-4","DOIUrl":"https://doi.org/10.1186/s12872-026-05932-4","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to identify the factors influencing postoperative kinesiophobia in patients with coronary heart disease (CHD) and to develop a risk nomogram model to assist in preliminary clinical risk assessment.</p><p><strong>Methods: </strong>A prospective observational study was conducted among 225 patients with CHD who underwent surgical interventions (such as coronary angiography, percutaneous transluminal coronary angioplasty, or intracoronary stenting) at a tertiary general hospital in Anhui Province between January and December 2025. Participants were selected using a convenience sampling method. The Chinese version of the Tampa Scale for Kinesiophobia-Heart (TSK-SV Heart) was employed to evaluate the levels of kinesiophobia. Patients were categorized into two groups: the kinesiophobia group (≥ 37 points) and the non-kinesiophobia group (< 37 points). LASSO regression was utilized for variable selection, while multivariate logistic regression analysis was performed to identify independent factors influencing kinesiophobia and to construct a nomogram. The model's discrimination, accuracy, and potential clinical utility were assessed using receiver operating characteristic (ROC), calibration, and decision curve analysis (DCA). Internal validation was performed through 10-fold cross-validation and bootstrap resampling (1000 iterations).</p><p><strong>Results: </strong>Of the 225 patients included, 136 individuals (60.44%) exhibited postoperative kinesiophobia. Multivariate logistic regression identified hypertension (OR = 3.336), cerebrovascular disease (OR = 5.695), and pain score (OR = 2.350) as independent risk factors. Conversely, higher scores on the Herth Hope Index (HHI) (OR = 0.897) and the Family Care Index (APGAR) (OR = 0.792) were independent protective factors. The model demonstrated an area under the curve (AUC) of 0.798 (95% CI: 0.740-0.855), with a calibration curve indicating strong concordance between predicted probabilities and observed outcomes (P = 0.477). Internal validation yielded a mean cross-validated AUC of 0.785 and a bootstrap-validated C-statistic of 0.781. DCA showed that the model offered a net benefit within a threshold probability range of 0.22 to 0.94.</p><p><strong>Conclusion: </strong>Postoperative kinesiophobia is prevalent among patients with CHD. The developed nomogram exhibited robust internal predictive performance and potential clinical utility. In the absence of external validation, this model should be considered exploratory and hypothesis-generating, serving as a scientific basis to assist healthcare professionals in the early identification of high-risk patients, facilitating targeted interventions to enhance pain management, hope and family support. However, further multicenter studies are required for external validation.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stent deformation and dislodgment into the aorta during mini-crush bifurcation PCI: a rare complication leading to emergency CABG.","authors":"Ezgi Çamlı Babayiğit, Alper Selim Kocaoğlu, Halit Emre Yalvaç, Erdi Babayiğit","doi":"10.1186/s12872-026-05955-x","DOIUrl":"https://doi.org/10.1186/s12872-026-05955-x","url":null,"abstract":"<p><strong>Background: </strong>Stent dislodgment during percutaneous coronary intervention (PCI) has become exceedingly rare with modern stent designs; however, it may still occur in complex bifurcation interventions. When the event involves the left main coronary artery (LMCA), the consequences may be catastrophic. A 65-year-old woman presented with anterolateral myocardial infarction. Coronary angiography revealed severe LAD-D1 bifurcation disease (LAD 90% after D1, D1 total occlusion) without significant calcification (Fig. 1). A mini-crush technique was planned using a 7 F JL4 guiding catheter. Following predilatation, a 2.75 × 13 mm DES was successfully deployed in D1, while a 2.75 × 18 mm DES had been pre-positioned (\"parked\") in the LAD at the D1 level (Fig. 2). During withdrawal of the D1 stent balloon, the pre-positioned LAD stent became deformed, slipped from the balloon, and partially dislodged, hanging from the LMCA into the aorta (Fig. 3). Multiple retrieval attempts using LCB, EBU4, EBU3.5, and JL3.5 guide catheters and micro and macro snare systems were unsuccessful (Fig. 4). Heart team consultation recommended emergency coronary artery bypass grafting (CABG). The patient underwent LIMA-LAD, Ao-saphenous vein graft (SVG) to OM2, and Ao-SVG to D1. Intraoperative findings revealed that the slipped LAD stent was tightly embedded within the D1 stent and fractured during removal attempts. At 7-month follow-up, the patient remained asymptomatic with preserved LV function (EF 55%).</p><p><strong>Discussion: </strong>This case highlights an important complication of bifurcation PCI. Pre-positioning (\"parking\") of the main-vessel stent during mini-crush may carry an underrecognized risk of deformation and loss during side-branch balloon withdrawal, even in the absence of calcification or tortuosity.</p><p><strong>Conclusion: </strong>Operators should be aware that stent parking in bifurcation PCI can predispose to balloon-stent interactions that may result in deformation, dislodgment, or embolization.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bidirectional associations between anxiety disorders and myocardial infarction: a retrospective longitudinal cohort study.","authors":"Hui-Fen Fang, Yi-Hsuan Hsu, Tirza Jo Lawrence, Tsai-Wei Huang, Min-Huey Chung","doi":"10.1186/s12872-026-05532-2","DOIUrl":"https://doi.org/10.1186/s12872-026-05532-2","url":null,"abstract":"<p><strong>Background: </strong>Despite anxiety and coronary heart disease being associated, longitudinal research investigating the bidirectional relationship between the formal diagnosis of anxiety disorders and myocardial infarction (MI) remains scarce.</p><p><strong>Objective: </strong>To investigate the bidirectional relationship between anxiety disorders and MI through a 15-year (2002-2016) longitudinal population-based retrospective cohort study using the National Health Insurance Research Database.</p><p><strong>Methods: </strong>We selected 34,979 patients diagnosed with an anxiety disorder based on their claim records during 2002-2004 and 5,189 patients with a diagnosis of MI based on their claim records during 2002-2004. In both analyses, the size of the comparison group was four times larger than that of the exposed group. A Cox proportional hazards model was used to estimate adjusted hazard ratios for developing anxiety disorders or MI after adjusting for sociodemographic factors.</p><p><strong>Results: </strong>In the first analysis, patients with anxiety disorders had a statistically significant 1.28-fold higher risk of MI than those without. Among the patients with anxiety, those with higher age, male sex, or lower comorbidity had a significantly higher risk of MI after adjusting for sociodemographic variables. In the second analysis, patients with MI had a statistically significantly 2.08-fold higher risk of anxiety disorders than those without MI. Among the patients with MI, women and patients with lower comorbidities had a significantly higher risk of anxiety disorders after adjusting for sociodemographic variables.</p><p><strong>Conclusion: </strong>Our results demonstrate a meaningful connection between anxiety disorders and MI. By recognizing this relationship, healthcare providers can develop constructive strategies to effectively manage both conditions and improve patient outcomes.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early prediction of in-hospital mortality in ICU patients with heart failure using an interpretable machine learning model: a retrospective study based on MIMIC-IV.","authors":"Meiqi Sun, Ping Lu, Jing Cheng, Linzhi Zhao, Junyang Ma","doi":"10.1186/s12872-026-05943-1","DOIUrl":"https://doi.org/10.1186/s12872-026-05943-1","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) remains a major cause of morbidity and mortality worldwide, and acute decompensation frequently necessitates intensive care. Early identification of high-risk patients is essential, yet traditional HF risk scores were developed largely in chronic or ward-based cohorts and often fail to capture early physiologic deterioration in the ICU. Explainable machine-learning (ML) models may improve early risk stratification.</p><p><strong>Methods: </strong>Using the MIMIC-IV v3.1 database, we conducted a retrospective study of adult ICU patients with heart failure identified by ICD-10 codes (I50.x) between October 1, 2015 and 2022. Predictors included demographics, comorbidities, pre-ICU cardiovascular medications, and vital signs and laboratory tests obtained within 0-6 h of ICU admission. Implausible values were removed; missing data were imputed using medians or modes. An XGBoost classifier was trained with an 80/20 stratified split and class weighting. Performance in the test cohort was assessed using AUC, average precision, sensitivity, specificity, F1-score, and Brier score. SHapley Additive exPlanations (SHAP) were used for global and feature-level interpretability.</p><p><strong>Results: </strong>A total of 12,110 ICU patients with HF were included, of whom 2,041 (16.9%) died in hospital. In the test cohort (n = 2,422), the model achieved an AUC of 0.797 (95% CI, 0.772-0.822) and an average precision of 0.491. Sensitivity and specificity were 0.632 and 0.793 at the default threshold; using the Youden-optimal threshold increased sensitivity to 0.708. Kaplan-Meier analysis demonstrated significant separation of survival curves across predicted risk quartiles (log-rank P < 0.001), supporting the survival stratification of early risk predictions. SHAP analysis identified FiO₂, age, lactate, Charlson comorbidity index, BUN, and systolic blood pressure as the strongest predictors, revealing clinically coherent non-linear relationships and interactions.</p><p><strong>Conclusion: </strong>These findings suggest that an interpretable model based on routinely available early ICU data may facilitate structured and quantitative risk stratification within the first hours of admission, thereby assisting clinicians in identifying high-risk patients who may benefit from closer monitoring and timely escalation of supportive care, rather than replacing clinical judgment.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}