BMC Cardiovascular Disorders最新文献

{"title":"Exploring sex differences in infective endocarditis - a prospective, observational study from Western Norway.","authors":"Stina Jordal, Helga Midtbø, Einar Skulstad Davidsen, Eli Leirdal Hoem, Øystein Alexander Power, Rune Haaverstad, Pirjo-Riitta Salminen, Øyvind Kommedal, Bård Reiakvam Kittang","doi":"10.1186/s12872-025-04631-w","DOIUrl":"https://doi.org/10.1186/s12872-025-04631-w","url":null,"abstract":"<p><strong>Background: </strong>We aimed to investigate sex-differences among patients with infective endocarditis (IE) in Western Norway, focusing on clinical presentation, treatment strategies, and outcomes.</p><p><strong>Methods: </strong>This prospective observational study included 131 females, and 366 males diagnosed with IE between 2016 and 2022. Clinical and microbiological characteristics were analysed using chi-squared or Fisher's exact tests, while survival data were assessed via Kaplan-Meier estimates and multiple Cox regression models.</p><p><strong>Results: </strong>The mean age was 69 years for females and 66 years for males (p = 0.317).</p><p><strong>Primary outcomes: </strong>Mortality rates were significantly higher in females at 30 days (13% vs. 7%, p = 0.028), at 90 days (19% vs. 11%, p = 0.016), and overall (46% vs. 36%, p = 0.016), with a mean follow-up of 3.2 years (± 2.3 years).</p><p><strong>Secondary outcomes: </strong>The mitral valve was more frequently affected in females than in males (31% vs. 17%, p < 0.001), and Staphylococcus aureus more often the microbial cause (36% vs. 27%, p = 0.049). While surgical treatment rates were similar (26% of females and 34% of males, p = 0.075), females with aortic valve IE underwent surgery at a significantly lower rate (23% vs. 39%, p = 0.001) and experienced longer delays before surgery (median 25 vs. 21 days, p = 0.043). Multivariable analysis identified higher age (HR 1.02, 95% CI 1.00-1.04, p = 0.014) and mitral valve infection (HR 2.88, 95% CI 1.57-5.29, p < 0.001) as independent predictors of 90-day mortality, while surgery significantly improved survival (HR 0.38, 95% CI 0.17-0.81, p = 0.013).</p><p><strong>Conclusions: </strong>Mitral valve IE was more common in females and strongly associated with higher mortality. Females with IE had higher mortality rates, more frequent mitral valve involvement, and a greater incidence of S. aureus infections. Despite the clear survival benefit of surgery, females with aortic valve IE underwent fewer and later surgeries. These findings highlight potential sex disparities in IE management and emphasize the need for further research into sex-based differences in treatment strategies and outcomes.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"200"},"PeriodicalIF":2.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669050","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":"Correction: Exosomes activate hippocampal microglia in atrial fibrillation through long-distance heart-brain communication.","authors":"Xuewen Wang, Yuanjia Ke, Zhen Cao, Yuntao Fu, Yanni Cheng, Dishiwen Liu, Huiyu Chen, Kexin Guo, Yajia Li, Mei Yang, Qingyan Zhao","doi":"10.1186/s12872-025-04645-4","DOIUrl":"https://doi.org/10.1186/s12872-025-04645-4","url":null,"abstract":"","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"203"},"PeriodicalIF":2.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669049","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":"Immunotherapy and vaccine-based approaches for atherosclerosis prevention: a systematic review study.","authors":"Mansoureh Shekarchizadeh Esfahani, Mansour Siavash, Raheleh Sadat Sajad, Amirhossein Ramezani Ahmadi, Mozhgan Karimifar, Mojtaba Akbari, Masood Shekarchizadeh","doi":"10.1186/s12872-025-04634-7","DOIUrl":"https://doi.org/10.1186/s12872-025-04634-7","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiovascular disease is a major global health issue, and atherosclerosis is a leading cause of cardiovascular conditions. Traditional approaches for managing atherosclerosis have limitations, creating a need for alternative preventive strategies such as vaccines.</p><p><strong>Methods: </strong>The authors conducted a systematic review following Cochrane Handbook and PRISMA guidelines. They searched multiple databases for studies on preventive vaccines against atherosclerosis, including clinical trials and experimental models. The search period was from 1950 to August 2024.</p><p><strong>Results: </strong>After screening and evaluation, 47 studies were included in the systematic review. The studies investigated various vaccine candidates and immunization strategies. Vaccination goals involve targeting proteins that are found in higher quantities in individuals with atherosclerosis, such as oxidized low-density lipoprotein (LDL), apolipoprotein B-100, proprotein convertase subtilisin/kexin type-9 serine protease (PCSK9), cholesteryl ester transfer protein (CETP), and heat shock proteins HSP60 and HSP65. The review highlights the potential of vaccines in preventing atherosclerosis by targeting specific antigens, modulating lipoprotein metabolism, and enhancing immune responses. Promising approaches included PCSK9 inhibitors, virus-like particle (VLP)-based vaccines, and gene-editing techniques. Monoclonal antibodies like alirocumab, designed to inhibit PCSK9, were also effective in reducing LDL cholesterol levels.</p><p><strong>Conclusion: </strong>This systematic review provides insights into the progress, challenges, and future directions of preventive vaccine research against atherosclerosis. The findings support the development of effective vaccines to complement existing preventive strategies and reduce the global burden of cardiovascular diseases.</p><p><strong>Clinical trial number: </strong>It is not applicable.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"201"},"PeriodicalIF":2.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669053","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":"Quantitative evaluation of radiation-induced heart disease in beagle dogs by speckle tracking echocardiography.","authors":"Zi-Ying Wang, Long Huang, Li-Qun Li, Chun-Quan Zhang, Liang-Yun Guo, Yan-Na Liu, Ling-Min Liao","doi":"10.1186/s12872-025-04636-5","DOIUrl":"10.1186/s12872-025-04636-5","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to detect early changes in left ventricular systolic function in Beagle dogs after radiotherapy using two-dimensional speckle tracking echocardiography and to explore its potential value in evaluating radiation-induced heart disease.</p><p><strong>Methods: </strong>Thirty-six Beagle dogs were randomized into a control group (n = 18) and an irradiation group (n = 18). The irradiation group received a single dose of 20 Gy to the left ventricular anterior wall, while controls underwent sham irradiation. Conventional echocardiography and 2D speckle tracking echocardiography were performed at baseline and 3, 6, and 12 months post-procedure. Additionally, six dogs were randomly selected from each group and euthanized at 3-, 6-, and 12-month post-irradiation, and their hearts were collected for histopathological testing.</p><p><strong>Results: </strong>In the irradiation group, the global longitudinal strain of the left ventricle and regional strain in the irradiated area were significantly reduced versus baseline and controls by 3 months, with progressive decline at 6 and 12 months. Strain reduction correlated spatially with pathological injury. Conversely, there were no substantial differences in conventional echocardiographic parameters between the groups after 3 months. Conventional parameters (e.g., LVEF) showed differences only at later timepoints. Histopathology revealed progressive cardiomyocyte damage, fibrosis, and microvascular injury in irradiated regions, extending to the posterior wall by 12 months.</p><p><strong>Conclusion: </strong>Two-dimensional speckle tracking echocardiography-derived strain parameters spatially correlate with radiation-induced pathological changes and detect subtle systolic dysfunction prior to irreversible remodeling. Speckle tracking may localize regions of peak radiation dose delivery.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"199"},"PeriodicalIF":2.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662617","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":"Clinical outcomes of His bundle pacing vs. right ventricular pacing in patients with conduction disturbances following transcatheter aortic valve replacement.","authors":"Donghui Zhang, Qi Zhao, Shenglong Hou, Chao Qu, Ruoxi Zhang, Yanhui Gao, Ou Yang, Huimin Xian","doi":"10.1186/s12872-025-04643-6","DOIUrl":"https://doi.org/10.1186/s12872-025-04643-6","url":null,"abstract":"<p><strong>Objective: </strong>To assess and compare the clinical outcomes of His bundle pacing (HBP) versus right ventricular pacing (RVP) in patients who develop conduction disturbances following transcatheter aortic valve replacement (TAVR).</p><p><strong>Methods: </strong>In this retrospective study, 120 patients who developed CD following TAVR were enrolled, and were implanted with HBP or RVP between January 2015 and December 2024. To adjust for variations in initial risk factors and baseline characteristics between patients who underwent HBP or RVP, we employed the propensity score matching. Each patient was matched in a 1:1 ratio with replacement. Patients who either received HBP or RVP, but could not be adequately matched, were excluded from the study population. Procedural and clinical outcomes were compared among different modalities at pacing implantation and12-month follow-up.</p><p><strong>Results: </strong>Paced QRS duration, R-wave amplitude at implantation and at follow-up, impedance at follow-up were lower in HBP group compared to RVP group. At12-month follow-up, the decrease in pacing burden was significantly greater in the HBP group than in the RVP group. Pacing threshold at implantation and at follow-up and capture threshold at implantation and at follow-up were higher in HBP group compared to RVP group. During follow-up, the left ventricular ejection fraction (LVEF) and tricuspid regurgitation (TR) area in the HBP group showed a significant improvement compared to preoperative values, while no significant increase in LVEF was observed in the RVP group, with a clear statistical difference between the two groups. At 12-month follow-up, NT-proBNP levels in the HBP group were significantly lower than those in the RVP group. The rates of NYHA functional class II were higher, while the rates of NYHA functional class III and MACE were lower in the HBP group compared to the RVP group during follow-up.</p><p><strong>Conclusions: </strong>HBP was feasible and safe in patients after TAVR, demonstrating a reduction in the composite outcome of MACE and better cardiac function compared to RVP.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"202"},"PeriodicalIF":2.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669047","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":"Soluble suppression of tumorigenicity 2 associated with left ventricular thrombosis in patients with ST-segment elevation myocardial infarction.","authors":"Xinjia Du, Perkash Kumar, Chen Liu, Jiahua Liu, Lei Chen, Yuan Lu, Zhuoqi Zhang","doi":"10.1186/s12872-025-04667-y","DOIUrl":"https://doi.org/10.1186/s12872-025-04667-y","url":null,"abstract":"<p><strong>Background: </strong>Left ventricular thrombosis (LVT) after acute ST-segment elevation myocardial infarction (STEMI) is closely related to inflammation. Soluble Suppression of Tumorigenicity 2 (sST2) expressed as a novel inflammatory marker, has received much attention in recent years. However, the relationship between sST2 and LVT is unclear. This study aimed to investigate the correlation between sST2 and LVT formation after emergency PCI (pPCI) in STEMI patients.</p><p><strong>Methods: </strong>293 patients with STEMI who were tested for sST2 at admission within 24 h at the Affiliated Hospital of Xuzhou Medical University from June 2018 to August 2023 were consecutively enrolled and evaluated for myocardial infarction characteristics and the presence of LVT by cardiac magnetic resonance imaging (CMR). The diagnosis of LVT was defined as a left ventricular cavity in the late gadolinium enhancement (LGE) of CMR with a low signal intensity mass.</p><p><strong>Results: </strong>A total of 38 patients developed LVT after STEMI, multivariable logistic regression analysis showed that sST2 [P = 0.002, OR = 1.01 (1.01 ~ 1.02)] an independent predictor of LVT formation. The results of the net reclassification index (NRI) and Integrated Discrimination Improvement Index (IDI) suggested that sST2 could improve the conventional model of LVT. A linear relationship between sST2 and LVT was fitted using a restricted cubic spline (RCS).</p><p><strong>Conclusion: </strong>sST2 was independently associated with LVT formation after pPCI in STEMI patients, and sST2 improved the risk modeling of LVT.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"204"},"PeriodicalIF":2.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669054","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":"Comparison of machine learning and nomogram to predict 30-day in-hospital mortality in patients with acute myocardial infarction combined with cardiogenic shock: a retrospective study based on the eICU-CRD and MIMIC-IV databases.","authors":"Caiyu Shen, Shuai Wang, Ruiheng Huo, Yuli Huang, Shu Yang","doi":"10.1186/s12872-025-04628-5","DOIUrl":"10.1186/s12872-025-04628-5","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the predictive utility of machine learning and nomogram in predicting in-hospital mortality in patients with acute myocardial infarction complicated by cardiogenic shock (AMI-CS), and to visualize the model results in order to analyze the impact of these predictors on the patients' prognosis.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 332 adult patients who were diagnosed with AMI-CS and admitted to the ICU for the first time within the eICU Collaborative Research Database (eICU-CRD). AdaBoost, XGBoost, LightGBM, Random Forest and logistic regression nomogram were developed utilizing the random forest recursive elimination (RF-RFE) and least absolute shrinkage and selection operator (LASSO) algorithms for feature selection.</p><p><strong>Results: </strong>Compared to the machine learning models, the nomogram demonstrated superior predictive accuracy for mortality in patients with AMI-CS, with an AUC value of 0.869 (95% CI: 0.803, 0.883) and an F1 score of 0.897 for the internal test set of nomogram, and an AUC of 0.770 (95% CI: 0.702, 0.801) and an F1 score of 0.832 for the external validation set.</p><p><strong>Conclusions: </strong>Nomogram enhance the interpretability and transparency of the models, leading to more reliable prognostic predictions for AMI-CS patients. This facilitates clinicians in making precise decisions, thereby enhancing patient prognosis.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"197"},"PeriodicalIF":2.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662615","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":"Recurrent subacute stent thrombosis after drug-eluting stent implantation: a case report.","authors":"Yang Yang, Jinxin Jiang, Zhihao Chen, Changqing Fan","doi":"10.1186/s12872-025-04658-z","DOIUrl":"10.1186/s12872-025-04658-z","url":null,"abstract":"<p><strong>Background: </strong>While drug-eluting stents (DESs) have revolutionized percutaneous coronary intervention (PCI), early stent-related complications remain challenging. We present a rare case of recurrent subacute stent thrombosis (ST) following DES implantation.</p><p><strong>Case presentation: </strong>A 51-year-old female with acute inferior-posterior myocardial infarction underwent primary PCI with everolimus-eluting stent deployment in the left circumflex artery (LCX). Despite dual antiplatelet therapy, she developed recurrent LCX occlusion at 8 days (subacute ST confirmed by intravascular ultrasound) and 25 days post-PCI. Serial interventions included additional stenting and drug-coated balloon angioplasty. Elevated platelet counts and negative autoimmune marker results suggest potential inadequate platelet inhibition or hypersensitivity reactions.</p><p><strong>Conclusions: </strong>This case highlights the diagnostic challenges in differentiating ST from restenosis, emphasizes the role of intravascular imaging, and underscores the need for personalized antiplatelet regimens. Hypersensitivity reactions to stent components and Kounis syndrome should be considered in refractory cases.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"198"},"PeriodicalIF":2.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662618","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":"Neurogenic differentiation 2 promotes inflammatory activation of macrophages in doxorubicin-induced myocarditis via regulating protein kinase D.","authors":"Xinyu Tan, Changyu Yan, Gang Zou, Ran Jing","doi":"10.1186/s12872-025-04626-7","DOIUrl":"https://doi.org/10.1186/s12872-025-04626-7","url":null,"abstract":"<p><strong>Background: </strong>Although it has been established that protein kinase D (PKD) plays a crucial role in various diseases, its precise role in myocarditis remains elusive.</p><p><strong>Methods: </strong>To investigate PKD's involvement in myocarditis, we established a mouse model of myocarditis using doxorubicin (DOX) to assess cardiac function, observe pathological changes, and quantify inflammatory cytokine levels in heart tissues. Additionally, macrophages were isolated from heart tissues of both control and DOX-treated groups to assess PKD expression and inflammatory cytokines in these macrophages. We explored the molecular mechanism of Neurogenic Differentiation 2 (NeuroD2) in myocarditis by utilizing NeuroD2 overexpression plasmids and NeuroD2 small interfering RNA (siRNA). Furthermore, we conducted dual-luciferase reporter and chromatin immunoprecipitation (ChIP) assays to investigate the interaction between NeuroD2 and PKD.</p><p><strong>Results: </strong>We observed significant upregulation of PKD in macrophages and heart tissues induced by DOX. The administration of a PKD inhibitor reduced inflammatory cytokine levels, improved cardiac function, and mitigated pathological changes in myocarditis-afflicted mice. Mechanistically, we found upregulated expression of NeuroD2 in both macrophages and heart tissues exposed to DOX. NeuroD2 could directly target PKD, enhancing the NLRP3/NF-κB signaling pathway and exacerbating macrophage inflammation.</p><p><strong>Conclusions: </strong>Our study demonstrates that NeuroD2 can directly bind to the PKD promoter, potentially promoting inflammatory activation of macrophages in DOX-induced myocarditis via the NLRP3/NF-κB pathway. This suggests that the NeuroD2/PKD axis may hold promise as a potential therapeutic approach for treating DOX-induced myocarditis.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"195"},"PeriodicalIF":2.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656124","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":"The clinical classification of patients with acute heart failure at emergency department and its relation with management and outcome: a cross sectional study from Syria.","authors":"Mohammad Aldli, Mohammad Alsultan, MhdAmin Alkhatib","doi":"10.1186/s12872-025-04644-5","DOIUrl":"https://doi.org/10.1186/s12872-025-04644-5","url":null,"abstract":"<p><strong>Introduction: </strong>To compare the clinical characteristics and outcomes of patients with acute heart failure (AHF) according to the 2016 European Society of Cardiology (ESC) guidelines taking into account isolated right HF (RHF) with left HF (LHF) phenotypes. Volume status was assessed by the clinical manifestations and lung ultrasound (LUS). The secondary aim was to study the role of echocardiography in congestion based on LUS and their relations with outcomes.</p><p><strong>Methods: </strong>This study included AHF patients, who referred to the emergency department (ED) at AL-Mouwasat and AL-Assad University Hospitals in Syria between May and August 2024. The same cardiologist reviewed medical reports, signs/ symptoms of decompensation, echocardiographic assessment, diagnosis, and treatment therapies.</p><p><strong>Results: </strong>Of 100 patients, 10 patients (10%) had isolated RHF and 90 patients (90%) had LHF, including warm-wet (n = 65, 65%), followed by cold-wet (n = 13, 13%), warm-dry (n = 10, 10%), and cold-dry (n = 2, 2%). Most discharged patients without admission were Warm-dry, meanwhile most of patients with cold-wet (76.9%) were admitted to intensive care unit (ICU). The longest in-hospital stays were in cold-wet (11.9 days) followed by isolated RHF (7.5 days). While in-hospital mortality was mainly in cold-wet (38.5%) followed by isolated RHF (20%). Diuretics dose was highest in cold-wet followed by isolated RHF, while hydration was predominantly in cold-wet. Using vasopressors and inotropes were predominantly in cold-wet. Systolic blood pressure (SBP), hemoglobin (Hb), sodium (Na), proximal right ventricular outflow tract (RVOT1), left ventricular end-diastolic internal diameter (LVIDd), Tricuspid annular systolic plane excursion (TAPSE), and systolic pulmonary atrial pressure (SPAP) correlated with hospital stays, while only SBP and Cr correlated with in-hospital mortality. The cut-off values of E/e' ratio, isovolumic relaxation time (IVRT), and deceleration time (DT) were (12.5, 55ms, and 131.5 ms; respectively) and could predict congestion (guided by LUS) with sensitivities of (96%, 74%, and 62%; respectively) and specificities of (53%, 92%, and 84%; respectively).</p><p><strong>Conclusion: </strong>Classifying AHF patients into these five groups, based on clinical examination supporting by echocardiography and LUS evaluation can give better assessment of the AHF phenotypes and gives more details for management. The bedside diagnostic assessment by LUS and echocardiography is an easy tool and seems to be of great benefit in detecting congestion that enhances the treatment protocols.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"194"},"PeriodicalIF":2.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656084","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}