BMC Cardiovascular Disorders最新文献

{"title":"Telmisartan-based monotherapy and combination regimens for blood pressure control in adults with hypertension: a systematic review, meta-analysis, and GRADE assessment.","authors":"Baraah Abu Alsel, Muzun Saleh Alturqi Alanazi, Aryam Salem Mgairan Alrawaili, Shahad Ayed Alenezi, Safya E Esmaeel, Manal S Fawzy, Yehia Nabil","doi":"10.1186/s12872-026-06488-z","DOIUrl":"10.1186/s12872-026-06488-z","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the efficacy, safety, and certainty of evidence for telmisartan-based antihypertensive regimens in adults with hypertension.</p><p><strong>Methods: </strong>This systematic review and meta-analysis followed PRISMA 2020. PubMed/MEDLINE, Scopus, Web of Science, and Cochrane CENTRAL were searched from inception to 2026. Eligible studies enrolled adults with hypertension and compared telmisartan monotherapy or telmisartan-containing combinations with placebo, usual care, non-telmisartan antihypertensive agents, or alternative telmisartan-based regimens. Continuous outcomes were pooled as mean differences (MDs) and dichotomous outcomes as risk ratios (RRs), both with 95% confidence intervals (CIs), using random-effects models, with additional subgroup analyses conducted by comparator type. Risk of bias was assessed using RoB 2, and certainty of evidence was evaluated using GRADE.</p><p><strong>Results: </strong>Twenty-five included reports (24 unique trials, since two reports present secondary outcomes from the same underlying trial) involving 6,521 participants were included, spanning placebo-controlled, usual-care-controlled, active-comparator, and telmisartan-combination-versus-telmisartan-monotherapy designs. Telmisartan-based therapy significantly reduced office systolic blood pressure (MD - 6.39 mm Hg; 95% CI - 7.86 to - 4.93; low certainty) and office diastolic blood pressure (MD - 4.88 mm Hg; 95% CI - 6.67 to - 3.09; low certainty), although the magnitude of effect was comparator-dependent. Based on only two trials, 24-h ambulatory systolic blood pressure (MD - 7.16 mm Hg; 95% CI - 10.61 to - 3.72) and ambulatory diastolic blood pressure (MD - 4.42 mm Hg; 95% CI - 6.36 to - 2.48) were reduced with moderate certainty. Telmisartan-based regimens improved blood pressure response (RR 1.68; 95% CI 1.31 to 2.16; moderate certainty) but not blood pressure control achievement (RR 1.44; 95% CI 0.92 to 2.24; very low certainty). Overall adverse events, dizziness, and headache were comparable (very low to low certainty), while edema was less frequent with telmisartan-based therapy (RR 0.33; 95% CI 0.15 to 0.73; moderate certainty).</p><p><strong>Conclusion: </strong>Telmisartan-based regimens, particularly fixed-dose and multidrug combinations, effectively reduce office and ambulatory blood pressure and improve blood pressure response, with broadly comparable short-term safety and less edema. These effect sizes are comparator-dependent, and certainty of evidence for absolute blood pressure control achievement and for major adverse events is very low; heterogeneity, limited long-term data, and a predominance of Asian-population trials warrant cautious interpretation pending larger, higher-quality, and more geographically diverse confirmatory studies.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between empagliflozin exposure and skeletal muscle degeneration in patients with heart failure.","authors":"Tatsuya Nishikawa, Nobuto Nakanishi, Kayo Osawa, Junko Mizuno, Yuko Ono, Ayaki Shirahata, Takumi Hirabayashi, Mikio Shiba, Ryohei Fujiwara, Itsuki Kanemitsuya, Yuki Hoshi, Hodaka Noda, Hibiki Kadohara, Yuya Ohga, Motohiro Shingu, Yuto Osumi, Kenta Ishibashi, Toshimitsu Ishii, Mana Hiraishi, Mitsuo Kinugasa, Yasutaka Hirayama, Toshio Shimokawa, Masafumi Matuo, Koichi Tamita","doi":"10.1186/s12872-026-06003-4","DOIUrl":"10.1186/s12872-026-06003-4","url":null,"abstract":"<p><strong>Background: </strong>Sodium-glucose co-transporter 2 inhibitors (SGLT2i) have become essential in the management of heart failure. Their prognostic benefits are consistent across older adults, frail, and underweight patients, but there may be potential adverse effects on the skeletal muscle.</p><p><strong>Methods: </strong>In this prospective single-centre observational study, 117 patients with stable congestive heart failure received 10 mg of empagliflozin daily between February 2023 and October 2024. At baseline and again after 6 months, we measured the following nutritional, frailty, and quality-of-life indices (GNRI, CONUT, mini nutritional assessment (MNA), KCCQ-12, Barthel index, clinical frailty scale) and urinary titin N-fragment (U-titin), a biomarker of skeletal muscle degradation.</p><p><strong>Results: </strong>After exclusion, 93 patients (median age 79 years; 40% women) were analysed. Baseline U-titin showed weak correlations with GNRI, MNA, and KCCQ-12 scores (p < 0.05). Median U-titin increased significantly from 1.7 (IQR 1.1-3.5) at baseline to 2.4 (IQR 1.3-4.2) pmol/mg Cr at 6 months (p = 0.040). The GNRI, MNA, KCCQ-12, body mass index, and NT-proBNP levels improved significantly, whereas the CONUT, Barthel index, and frailty scores remained unchanged. Left ventricular ejection fraction ≥50% independently predicted  ≥50% U-titin increase (OR 3.31, 95% CI 1.23-9.52, p = 0.017).</p><p><strong>Conclusions: </strong>Baseline U-titin levels seem to reflect nutritional and functional status in patients with heart failure. U-titin levels increased during empagliflozin treatment, suggesting a possible association with skeletal muscle degradation.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of albumin-bilirubin score with clinical severity and outcome in patients with decompensated heart failure: a retrospective cohort study.","authors":"Seyed-Hosein Mahdizade, Fateme Seighali, Mandana Ebrahimzade, Hadis Rastad, Tahereh Sadeghi, Niloofar Seighali, Fahime Salehi","doi":"10.1186/s12872-026-06237-2","DOIUrl":"https://doi.org/10.1186/s12872-026-06237-2","url":null,"abstract":"<p><strong>Background: </strong>The Albumin-Bilirubin (ALBI) score is a simple marker of hepatic function that may reflect systemic congestion in heart failure. Therefore, the present retrospective cohort study aimed to investigate the association between ALBI score and clinical severity, echocardiographic findings, and hospitalization outcomes in patients admitted with decompensated heart failure. Exploratory analyses were additionally performed to examine potential associations between ALBI score and in-hospital mortality.</p><p><strong>Methods: </strong>This retrospective cohort study included adults (≥ 18 years) admitted with decompensated heart failure with reduced or mildly reduced ejection fraction at Rajaiee Hospital, Alborz University of Medical Sciences, Karaj, Iran, from March 2022 to March 2025. 152 patients met the inclusion criteria after excluding those with preserved ejection fraction, liver or renal disease, malignancy, or incomplete data. Clinical, laboratory, and echocardiographic data were extracted. The ALBI score was calculated using serum albumin and bilirubin. Statistical analysis included correlation, t-tests, multivariable linear regression, and ROC curve analysis.</p><p><strong>Results: </strong>A total of 152 patients (47.4% female) with a mean age of 66.70 ± 12.73 years were included. Mean left ventricular ejection fraction (LVEF) was 27.34 ± 13.15%. Because only three in-hospital deaths occurred, mortality-related analyses were considered exploratory. In-hospital mortality occurred in 3 patients (2%), whereas other patients were discharged, with no significant difference in ALBI score between survivors and non-survivors (p = 0.709). Mean hospitalization duration was 7.85 ± 5.59 days. The mean ALBI score was - 2.79 ± 0.45 in females and - 2.64 ± 0.46 in males (p = 0.040). Patients with LVEF ≤ 30% had significantly higher ALBI scores than those with LVEF > 30% (- 2.65 ± 0.44 vs. - 2.83 ± 0.46, p = 0.022). However, no significant correlation was found between age and ALBI score (r = - 0.055, p = 0.499), but multivariable analysis showed that presenting comorbidity of hypertension (β = -0.187, p = 0.009) was independently associated with ALBI score. Analysis showed a small, significant association of AST (β = -0.006, p = 0.035) and ALP (β = 0.001, p = 0.030) with ALBI score as well. Through the analysis, ALBI showed weak predictive ability for prolonged hospitalization (AUC = 0.58, 95% CI: 0.49-0.68, p = 0.078).</p><p><strong>Conclusion: </strong>The ALBI score was associated with sex and heart failure severity, whereas analyses of in-hospital mortality remained exploratory because of the low number of events. Larger studies are needed to confirm its clinical utility.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13483829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative outcomes of balloon-expandable versus self-expanding transcatheter aortic valves: insights from a large-scale German registry.","authors":"Klaus Kaier, Derek Hazard, Martin Czerny, Jonathan Rilinger, Ingo Hilgendorf, Dennis Wolf, Dirk Westermann, Constantin von Zur Mühlen, Christian Valina","doi":"10.1186/s12872-026-06462-9","DOIUrl":"https://doi.org/10.1186/s12872-026-06462-9","url":null,"abstract":"<p><strong>Background: </strong>While transcatheter aortic valve replacement (TAVR) has become an established alternative to surgical aortic valve replacement (SAVR), the comparative outcomes of balloon-expandable (BE) and self-expanding (SE) valve technologies remain an area of ongoing investigation.</p><p><strong>Methods: </strong>Using the German DESTATIS database, we analyzed 48,565 transfemoral TAVR procedures performed between 2021 and 2022. Outcomes were compared between BE (n = 23,412) and SE (n = 25,153) valves using a double/debiased machine learning estimator to account for potential confounding. Key endpoints included in-hospital mortality, major bleeding, stroke, acute kidney injury, mechanical ventilation > 48 h, postoperative delirium, permanent pacemaker implantation (PPI), length of hospital stay, and reimbursement.</p><p><strong>Results: </strong>Descriptively, SE valves were associated with significantly lower in-hospital mortality (1.6% vs. 2.0%, p < 0.001) and major bleeding (1.4% vs. 2.1%, p < 0.001) but a higher risk of stroke (2.4% vs. 1.9%, p < 0.001). A trend towards higher risk of PPI was observed (p = 0.078). After adjustment, patients with SE valves are at lower risk for in-hospital mortality (RR 0.85, p = 0.049) and major bleeding (RR 0.78, p = 0.006), but had a higher risk of stroke (RR 1.35, p < 0.001) and permanent pacemaker implantation (RR 1.09, p = 0.028). Subgroup analysis indicated that older and high-risk patients, particularly those aged ≥ 85 years, showed a stronger association with lower in-hospital mortality for SE valves, whereas younger patients exhibited a trend favouring BE valves. BE valves were also associated with a modestly higher reimbursement (€209 per case, p = 0.004).</p><p><strong>Conclusion: </strong>In this large, real-world cohort, self-expanding valves were associated with lower in-hospital mortality and major bleeding but a higher risk of stroke and permanent pacemaker implantation compared with balloon-expandable valves. Because prosthesis choice in routine practice is highly individualized and driven by anatomical and procedural factors not captured in administrative data, these associations are hypothesis-generating and cannot support device-selection recommendations.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inclisiran-induced LDL-cholesterol reduction with and without concomitant statin therapy: a real-world analysis.","authors":"Maximilian Seidel, Felix S Seibert, Moritz Anft, Ulrik Stervbo, Nina Babel, Timm H Westhoff, Sebastian Bertram","doi":"10.1186/s12872-026-06429-w","DOIUrl":"https://doi.org/10.1186/s12872-026-06429-w","url":null,"abstract":"<p><p>Inclisiran lowers LDL-cholesterol (LDL-C) by inhibiting hepatic PCSK9 synthesis. Whether concomitant statin therapy modifies the magnitude of inclisiran-associated LDL-C reduction in routine clinical practice remains uncertain. In this retrospective single-center observational study, 67 patients treated with inclisiran for at least 9 months were analyzed. Patients previously treated with PCSK9 monoclonal antibodies were excluded. LDL-C values were assessed longitudinally and stratified by concomitant statin therapy. Multivariable linear mixed-effects models were used to evaluate inclisiran-associated percentage LDL-C reduction over time. Thirty-seven patients received concomitant statin therapy and 30 patients did not. Median follow-up was 18 months (IQR 12.5-28). Median LDL-C reduction ranged from approximately - 25% to - 40% across follow-up visits. At 9 months, 10 of 59 patients (16.9%) achieved a ≥ 50% LDL-C reduction. In the primary multivariable longitudinal mixed-effects model, concomitant statin use was not significantly associated with percentage LDL-C reduction (β for no statin vs. statin: 33.1% points; 95% CI - 4.6 to 70.7; p = 0.085). Statin intensity was also not significantly associated with LDL-C reduction (β - 0.11 per percentage point of maximum approved dose; 95% CI - 0.60 to 0.37; p = 0.644). In an exploratory responder analysis, concomitant statin therapy was associated with higher odds of achieving ≥ 50% LDL-C reduction at 9 months (OR 7.69; 95% CI 1.28-45.45; p = 0.026). During follow-up, 18 patients (26.9%) discontinued inclisiran, predominantly due to insufficient LDL-C reduction. In routine clinical practice, neither concomitant statin use nor statin intensity was significantly associated with the magnitude of LDL-C reduction observed during inclisiran therapy. However, responder and attrition sensitivity analyses suggested a possible association between concomitant statin therapy and a more pronounced inclisiran-associated LDL-C response. These findings support the clinical use of inclisiran in heterogeneous real-world populations, while highlighting the potential benefit of maintaining concomitant statin therapy whenever tolerated.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13487929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CMR-based aortic stiffness parameters in a symptomatic high risk obstructive sleep apnea cohort: results from the population-based Hamburg City Health Study.","authors":"Katharina Alina Riedl, Konrad Reuter, Arne Böttcher, Markus Hüllebrand, Anja Hennemuth, Ersin Cavus, Rickmer Braren, Paulus Kirchhof, Stefan Blankenberg, Christian S Betz, Gunnar Lund, Kai Muellerleile, Anna Sophie Hoffmann","doi":"10.1186/s12872-026-06450-z","DOIUrl":"10.1186/s12872-026-06450-z","url":null,"abstract":"<p><strong>Background: </strong>Aortic stiffness (AS) parameters as pulse wave velocity (PWV), aortic distensibility of the ascending and descending aorta (AD AoAsc, AD AoDesc) and pulse pressure (PP) are marker for vascular ageing, whereas data concerning obstructive sleep apnea (OSA) in population-based cohorts are sparse. Thus, we aimed to identify possible associations of AS with OSA in the Hamburg City Health Study (HCHS) cardiovascular magnetic resonance (CMR) cohort.</p><p><strong>Methods: </strong>HCHS is a population-based cohort-study quantifying PWV and AD by 2D-phase-contrast-CMR-measuring-methods and PP by blood pressure. OSA was defined as self-reported OSA by HCHS-study-interviews and/or a combination of snoring, respiratory arrest and Epworth-Sleepiness-Scale (ESS) > 10. Logistic regression analyses with adjustments were performed.</p><p><strong>Results: </strong>In the cohort of 1,498 participants (median age 66 years, 39.0% female), 143 (9.5%) participants were identified as symptomatic high risk OSA cohort with significantly higher rates of males (p < 0.001), hypertension (p < 0.001), and coronary artery disease (p = 0.037). Median PWV and AD (p = 0.741, p = 0.145, p = 0.191) were not significantly different, but median PP was significantly higher in this OSA cohort (p = 0.003). In male OSA participants, median AD AoAsc and AD AoDesc were significantly lower and median PP significantly higher (p = 0.006, p = 0.015, p < 0.001). After adjustment for age, sex, cardiovascular risk factors (CVRF), diseases (CVD) and antihypertensive medication, OSA remained significantly associated with PP (p = 0.045), but not with PWV, AD AoAsc and AD AoDesc (p = 0.633, p = 0.503, p = 0.171).</p><p><strong>Conclusions: </strong>Higher PP was associated with OSA after adjustment for age, sex, CVRF, CVD and medication. Therefore, PP might be used to identify individuals at risk for OSA.</p><p><strong>Trial registration: </strong>The study has been registered at ClinicalTrial.gov (NCT03934957), retrospectively registered at 01/04/2019.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13471597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148722137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes following major dysvascular lower limb amputation: an updated systematic review.","authors":"Shashank Ghai, Sander L Hitzig, Maha Edrees, Amanda L Mayo, Virginie Blanchette, Natalie Habra, Audrey Zucker-Levin, Diana Zidarov","doi":"10.1186/s12872-026-06377-5","DOIUrl":"10.1186/s12872-026-06377-5","url":null,"abstract":"<p><strong>Background: </strong>Adults with major lower limb amputation (LLA) due to dysvascular etiology often experience diverse health outcomes. However, the absence of standardized outcome reporting limits the ability to synthesize evidence, evaluate care models, and develop consistent clinical pathways. This review updates a systematic review on outcome measures and indicators reported in this population.</p><p><strong>Methods: </strong>A systematic review update was conducted across six databases (MEDLINE, EMBASE, EBM Reviews, PsycINFO, Web of Science, and CINAHL) from 20 April 2017 to 1 December 2022. All study designs were eligible; however, the articles needed to report outcome measures and indicators on at least 50% of the adult population with major dysvascular LLAs. The extracted outcome measures and indicators were organized according to Dodd's framework and then reclassified alongside those reported in the study by Ambler and colleagues. The pilot phase of data extraction was carried out independently by multiple reviewers, after which a single reviewer completed the data extraction.</p><p><strong>Results: </strong>Of the 12,557 articles, 160 studies reporting data on 228,116 individuals with major dysvascular LLA met the inclusion criteria. Combining these with the 440 studies from the previous review, 2,466 outcome measures and indicators were categorized in five core areas: life impact (25.7%), physiological/clinical (23.4%), death (18.7%), resource use (17.6%), and adverse events (14.6%). In terms of the outcome domains, mortality/survival was the most commonly reported domain, followed by physical functioning (e.g. prosthesis fit, use), skin (e.g., stump wound healing), nervous system outcomes (e.g., residual limb pain), need for further interventions (e.g., prescription of medications), hospital outcomes (e.g., duration of stay, discharge), and adverse events.</p><p><strong>Conclusion: </strong>This study builds on a previous review by identifying and categorizing outcome measures and indicators in adults with major dysvascular LLA, highlighting inconsistencies in outcome reporting across studies. The absence of a standardized set of outcome measures and indicators limits the ability to conduct meta-analyses or systematic reviews, evaluate the effectiveness of care models, and establish clinical pathways. Developing a core outcome set tailored to the needs of individuals with dysvascular LLA could help address these challenges by promoting consistency in outcome reporting and enabling meaningful comparisons across studies. Ultimately, this could contribute to improving the quality, efficiency, and person-centeredness of care.</p><p><strong>Trial registration: </strong>PROSPERO (CRD42023388570).</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13450402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148688595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomarkers of systemic disease burden and outcomes after transcatheter tricuspid edge-to-edge repair.","authors":"Johannes Schlegl, Marwin Bannehr, Michael Lichtenauer, Tanja Kücken, Alexander Krutz, Vera Paar, Michael Neuß, Anja Haase-Fielitz, Christian Butter, Christoph Edlinger","doi":"10.1186/s12872-026-06392-6","DOIUrl":"10.1186/s12872-026-06392-6","url":null,"abstract":"<p><strong>Background: </strong>Risk stratification after transcatheter tricuspid edge-to-edge repair (T-TEER) remains challenging, particularly in patients with advanced right-sided heart failure and systemic disease burden. Biomarkers reflecting inflammation, stress response and multiorgan dysfunction may provide additional prognostic information in this setting.</p><p><strong>Methods: </strong>This prospective single-centre cohort study included 84 consecutive patients undergoing T-TEER for severe tricuspid regurgitation using the TriClip or PASCAL system. Baseline concentrations of growth differentiation factor-15 (GDF-15), soluble urokinase plasminogen activator receptor (suPAR), and NT-proBNP were measured prior to intervention. The primary endpoint was all-cause mortality at 12 months. Secondary endpoints included cardiovascular rehospitalisation and a combined cardiovascular endpoint. Prognostic performance was assessed using receiver operating characteristic and tertile-based Kaplan-Meier analyses. Owing to the limited number of events, all analyses were considered exploratory.</p><p><strong>Results: </strong>During 12-month follow-up, all-cause mortality occurred in 10 patients (11.9%), while cardiovascular rehospitalisation was observed in 29 patients (34.5%). GDF-15 demonstrated good discriminative performance for all-cause mortality (AUC 0.823, 95% CI 0.714-0.932, p = 0.001), whereas suPAR showed moderate prognostic discrimination (AUC 0.742, 95% CI 0.605-0.878, p = 0.013). In contrast, NT-proBNP showed no significant discrimination for all-cause mortality (AUC 0.535, 95% CI 0.362-0.709, p = 0.720). Higher tertiles of both GDF-15 and suPAR were associated with reduced overall and rehospitalisation-free survival.</p><p><strong>Conclusion: </strong>Baseline GDF-15 and suPAR were associated with adverse outcomes after T-TEER and demonstrated greater prognostic discrimination than NT-proBNP in this exploratory cohort. These exploratory findings support further investigation of systemic stress and inflammation biomarkers for risk stratification in patients with severe tricuspid regurgitation.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13435473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148668378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of pulmonary hypertension with pulmonary vascular surface volume ratio by non-contrast CT.","authors":"Qing Yu, Yating Zhao, Yini Huang, Mingya Zhang, Gulinigaer Wufulihasimu, Yijia Zhou, JiaJia Zhang, Xiaopeng Xu, Wei Zhang, Yanxi Zeng, Wenhui Peng, Yunshan Cao","doi":"10.1186/s12872-026-06078-z","DOIUrl":"10.1186/s12872-026-06078-z","url":null,"abstract":"<p><strong>Background: </strong>The diagnosis of pulmonary hypertension (PH) relies primarily on invasive right heart catheterization (RHC). Although imaging modalities, including echocardiography, computed tomography angiography (CTA) and computed tomography (CT), offer clinical utility, their effectiveness in early detection remains limited.</p><p><strong>Objectives: </strong>To clarify the relationship between group 1/2 PH and radiomic-morphological features of the pulmonary vasculature derived from non-contrast CT.</p><p><strong>Methods: </strong>We retrospectively enrolled control patients and patients with group 1 PH (PAH) and group 2 PH (PH-LHD) from two centers. All participants underwent RHC and chest CT. We extracted the radiomic features from pulmonary arteries and veins, identifying key radiomics markers and further exploring their association with early pathological changes through animal experiments. Subsequently, we analyzed morphological characteristics from 95,197 vascular centerlines. Multivariable models were employed to evaluate their efficacy in identifying PH and discriminating PH-LHD in validation cohort.</p><p><strong>Results: </strong>The training cohort included 49 patients (20 controls, 13 with PAH, 16 with PH-LHD), and validation cohort included 30 patients. Among 212 radiomics features analysis, the pulmonary arterial surface volume ratio (SVR) correlated strongly with mean pulmonary artery pressure (mPAP) (r = -0.602, P < 0.001), while the venous SVR showed a strong correlation with pulmonary artery wedge pressure (PAWP) (r = -0.651, P < 0.001). In animal models, venous SVR demonstrated the ability to reflect early pulmonary venous remodeling in PH-LHD prior to hemodynamic changes. Morphologically, PH-LHD patients showed increased distal vessel tortuosity with reduced torsion and curvature (all P < 0.001). SVR and models combining morphological features demonstrated promising performance for identifying PH (AUC 0.895 (95%CI (0.731-1.000)) vs. 0.890 (95%CI (0.736-1.000)) and distinguishing PH-LHD (AUC 0.868 (95%CI (0.672-1.000) vs. 0.846 (95%CI 0.639-0.990)) in validation cohort.</p><p><strong>Conclusion: </strong>CT-based radiomic-morphological analysis provides a basis for identifying PH and distinguishing its subtypes. Specifically, arterial SVR aids in PH detection, while venous SVR helps differentiate PH-LHD from PAH, together forming a clinically useful screening pathway. Preclinical evidence additionally links venous SVR to venous remodeling that may precede hemodynamic changes. These findings require validation in larger PH populations.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13412298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148599061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interaction of a genetic sum score of risk alleles associated with coronary artery disease by physical activity in the Heinz Nixdorf Recall study.","authors":"Johannes Penther, Nicola Wilkening, Laven Mavarani, Raimund Erbel, Börge Schmidt","doi":"10.1186/s12872-026-06340-4","DOIUrl":"10.1186/s12872-026-06340-4","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the interaction between a genetic risk score for coronary artery disease (CAD) and measures of physical activity on coronary artery calcification (CAC) in a population-based cohort. Specifically, it sought to determine whether physical exercise, known to be protective against high CAC, influences the expression of genetic risk factors for CAD.</p><p><strong>Methods: </strong>Data were obtained from the Heinz Nixdorf Recall study, including 3938 participants aged 45-74 years with European ancestry. CAC was measured using electron beam computed tomography. The genetic risk score (GRS_CAD) was calculated using 158 CAD-related genetic loci. Physical activity during the last four weeks was assessed through standardized interviews, resulting in measures of (1) engagement in physical exercise and (2) the total metabolic equivalents of general physical activity per week (METh/week). Linear regression models were used to analyze the associations of physical activity and genetic risk with log-transformed CAC, adjusting for confounders age, sex, and education.</p><p><strong>Results: </strong>Participants not engaging in physical exercise had a 1.336-fold (95%-CI: 1.171 to 1.533) higher CAC compared to those who exercised. No association was found between METh/week and CAC. The GRS_CAD was associated with a 1.206-fold (95%-CI: 1.130 to 1.287) higher CAC per standard deviation. Interaction analyses indicated that the genetic effect on CAC was slightly stronger in participants with higher METh/week levels, showing a 1.306-fold (95%-CI: 1.145 to 1.490) higher CAC per standard deviation of the GRS_CAD in the highest METh/week quartile compared to 1.109-fold (95%-CI: 0.978 to 1.259) higher CAC in the lowest quartile. No interaction was observed for engagement in physical exercise.</p><p><strong>Conclusions: </strong>While physical activity in sum was associated with lower levels of CAC, individuals reporting higher physical activity levels may also be less exposed to other non-genetic risk factors for CAD, leading to a slightly stronger association of genetic factors with CAC.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13401783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148590131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}