BMC Cardiovascular Disorders最新文献

{"title":"Factors influencing unplanned readmission within 30 days in patients with heart failure and their predictive value: a prospective study.","authors":"Lingling Cui, Xiaolei Wei, Tao Liang, Rui Yan, Minyu Du, Tusiyiti Alimire, Yuyang Huang, Hua Wang","doi":"10.1186/s12872-025-04674-z","DOIUrl":"https://doi.org/10.1186/s12872-025-04674-z","url":null,"abstract":"<p><strong>Background: </strong>Heart failure imposes a significant healthcare burden, with early unplanned readmissions post-discharge linked to poor outcomes. Identifying risk factors and their predictive value is crucial for targeted interventions.</p><p><strong>Objective: </strong>To investigate gender differences in cumulative hazard function and the factors influencing 30-day unplanned readmissions in heart failure patients, and to compare their predictive value.</p><p><strong>Methods: </strong>A prospective study of heart failure patients hospitalized in Beijing Hospital from October 2023 to March 2024. Patients' nutritional status was assessed using the Mini-Nutritional Assessment Scale Short Version (MNA-SF), frailty was evaluated using the Groningen Frailty Index (GFI), and the Appendicular Skeletal Muscle Mass Index (ASMI) was calculated. Multifactorial Cox regression analysis was conducted, and ROC curves were plotted for predictive modeling.</p><p><strong>Results: </strong>A total of 121 heart failure patients (60.3% males), aged (69.87 ± 11.9) years were included. With a median follow-up duration of 30 days, 25 (20.7%) patients with readmission. COX regression analysis stratified by gender showed that age, regular smoking, nutritional status, left ventricular ejection fraction(LVEF), brain natriuretic peptide(BNP), GFI, and ASMI were independent predictors of readmission within 30 days in patients with heart failure (P < 0.050). ROC curve analysis showed that age, BNP, ASMI, smoking status, LVEF, nutritional status, and GFI individually as well as in combination predicted readmission within 30 days in patients with heart failure; the joint model performed optimally, with an AUC value reaching 0.877 (95%CI 0.801 ∼ 0.952, P < 0.001), with a sensitivity of 0.920 and a specificity of 0.729.</p><p><strong>Conclusion: </strong>A multifactorial approach including age, BNP, ASMI, smoking status, LVEF, nutritional status, and GFI predicts 30-day readmission risk, offering a basis for clinical intervention strategies to improve patient outcomes.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"269"},"PeriodicalIF":2.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810519","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 complications and morbidities in PAD patients through lower extremity compositions with dual-energy CT and material decomposition: a 2-year follow-up observational study.","authors":"Dao-Chen Lin, Pei-Shan Tsai, Tzu-Lin Lin, Wen-Hui Huang, Yu-Peng Liu, Tung-Hsin Wu, Cheng-Ting Shih","doi":"10.1186/s12872-025-04695-8","DOIUrl":"10.1186/s12872-025-04695-8","url":null,"abstract":"<p><strong>Background: </strong>Peripheral artery disease (PAD) is associated with various morbidities. This study aims to investigate the correlation between different lower extremity compositions and development of morbidities in PAD patients.</p><p><strong>Methods: </strong>Between January 2018 and December 2020, 108 subjects diagnosed of PAD were enrolled (mean age of 64.1 ± 13.5 years) and utilized dual-energy computed tomography (DECT) with material decomposition to measure the vessel volume, muscle volume, fat volume, and cortical-bone volume in lower extremity respectively. The association between each leg composition and developing complications or morbidities in PAD patients was analyzed over a two-year follow-up.</p><p><strong>Results: </strong>Fontaine stage 3 and 4 had lower muscle mass compared to stages 1 and 2. More severe vascular stenosis was associated with lower muscle, fat, and cortical-bone volume. Patients with severe Fontaine stages (3 and 4) and lower-leg vascular stenosis had a higher risk of developing infection or inflammation (OR 45.5, 95% CI: 13.5-166.7, and OR 11.7, 95% CI: 2.8-50, P < 0.05) and amputation (OR 18.2, 95% CI: 2.2-142.8, and OR 10.7, 95% CI: 1.11-100, P < 0.05). Lower thigh cortical-bone volume was associated with an increased risk of falls resulting in fractures (OR: 1.39, 95% CI: 1.13-2.19, P < 0.01). Thigh cortical-bone volume below 64.5 cm³ was identified as the cut-off value to predict fall-related fractures, with a sensitivity of 100% and specificity of 92%.</p><p><strong>Conclusions: </strong>This study demonstrates the potential of DECT with material decomposition to assess lower extremity composition and its relevance in predicting complications and morbidities in PAD patients. Severe vascular stenosis may contribute to muscle wasting and subsequent complications, while lower thigh cortical-bone mass may serve as a predictor of fall-related fractures.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"268"},"PeriodicalIF":2.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802458","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":"Factors analysis of lower probability of receiving bystander CPR in females: a web-based survey.","authors":"Wangxinjun Cheng, Jingshuang Liu, Chufan Zhou, Xuzhen Wang","doi":"10.1186/s12872-025-04709-5","DOIUrl":"https://doi.org/10.1186/s12872-025-04709-5","url":null,"abstract":"<p><strong>Background: </strong>Women are less likely to receive bystander cardiopulmonary resuscitation (CPR) during out-of-hospital cardiac arrest (OHCA) compared to men. This study aims to identify the factors influencing the willingness to perform CPR on women, providing insights to improve training and public awareness.</p><p><strong>Methods: </strong>A cross-sectional web-based survey was conducted among medical and non-medical populations in southeastern China. The questionnaire assessed demographics, CPR training experience, and attitudes toward gender-related CPR concerns. A total of 450 responses were collected, with 433 valid responses included after quality control. Statistical analyses were performed using R4.3.2 to evaluate the impact of gender, age, occupation, and education on CPR willingness.</p><p><strong>Results: </strong>Women exhibited a higher willingness to perform CPR on female victims compared to men. Many male respondents hesitated due to concerns about physical contact, particularly regarding removing clothing during resuscitation. Younger individuals (18-35 and 36-50 years) showed greater willingness to provide CPR than older respondents (51-75 years), who were more cautious due to privacy concerns and traditional beliefs. Healthcare professionals and non-medical workers were more likely to perform CPR than medical students, who, despite receiving CPR training, expressed hesitation due to a lack of confidence and practical experience. Higher education levels were associated with increased willingness to perform CPR on women, with postgraduate respondents being the most willing. Additionally, most participants had never practiced on female CPR mannequins, despite widespread support-especially among women-for incorporating female models into training.</p><p><strong>Conclusion: </strong>The lower likelihood of women receiving CPR is influenced by gender bias, societal norms, and training limitations. Addressing this issue requires public education to eliminate gender-based hesitation, improvements in CPR training programs to include female mannequins, and enhanced legal protections to reduce rescuer concerns. These measures can be combined with other key factors such as community-wide CPR training programs and increasing the availability of automated external defibrillators (AEDs) to help promote equity in access to life-saving interventions. Targeted interventions can promote gender equity in emergency response, ultimately improving survival outcomes for women.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"270"},"PeriodicalIF":2.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810516","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":"Assessing level of awareness of atrial fibrillation among general public: a cross-sectional study.","authors":"Arbindra Joshi, Durga Bista, Rajani Shakya","doi":"10.1186/s12872-025-04720-w","DOIUrl":"10.1186/s12872-025-04720-w","url":null,"abstract":"<p><strong>Background: </strong>Patients with atrial fibrillation (AF) are at increased risk of stroke. Poor knowledge of AF in general population contributes to under-detection and treatment delay. Therefore, this study aimed to assess level of awareness of AF among general public in Dhulikhel municipality, Nepal.</p><p><strong>Methods: </strong>This was a cross sectional study involving quantitative approach using self-administered questionnaire. Participants of age ≥ 50 years from wards 4, 5, 6 and 7 of Dhulikhel municipality were enrolled. English version of AFKAT (Atrial Fibrillation Knowledge Assessment Tool) was translated and validated which was then used to assess the level of awareness of AF.</p><p><strong>Results: </strong>In total 355 respondents were recruited. The mean age group was found to be 65.57 ± 9.99 years. Mean percentage score of level of awareness of AF was found to be only 2.61%, which was very poor. Only 2.54% (n = 9) had good level of knowledge about AF. 95.77% (n = 340) had very poor level of awareness. Significant difference of mean awareness level was found between group with AF and without AF. Respondent with AF had 58.70% score compared with just 2.29% score of non-AF group. Knowledge deficits were more in older participants. The knowledge score of AF was found to be 3.55%, 4.21%, 0.05%, 1.21% and 0% among age groups 50-59 years, 60-69 years, 70-79 years, 80-89 years and ≥ 90 years respectively. Only 2.54% (9 out of 355) correctly identified that AF can lead to blood clot and stroke. Just 2.82% (10 out of 355) respondents recognized that anticoagulants are used to prevent stroke in AF patients.</p><p><strong>Conclusions: </strong>The level of awareness of AF among general public of Dhulikhel was found to be very poor. Appropriate interventions need to be applied to educate risk groups about AF to reduce future risk of stroke and minimize public health burden.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"265"},"PeriodicalIF":2.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11974035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794535","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":"Clinical characteristics, adherence to anticoagulation therapy and prognosis in patients with atrial fibrillation: a real-life study.","authors":"Fenglin Qi, JiaCan Wu, Zhen Xia, Siyuan Xie, Xianya Chen, Huanjie Zheng, Zhuo Li, Naiyue Bao, Chengcheng Li, Hua Xiao","doi":"10.1186/s12872-025-04703-x","DOIUrl":"10.1186/s12872-025-04703-x","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is a prevalent tachyarrhythmia, and a comprehensive understanding of its clinical features is essential for optimizing therapeutic management. However, the unregulated use of anticoagulants in AF remains a concern, as their efficacy and safety profiles are not yet fully understood.</p><p><strong>Methods: </strong>Data from AF patients were collected in 2013, 2018, and 2023. First, cross-sectional data on AF patients were gathered during each period to longitudinally evaluate long-term trends in AF characteristics and the progression of anticoagulation therapy. Additionally, predictors of non-regulated dosing of oral anticoagulants (OAC) were analyzed. Second, patients with non-valvular atrial fibrillation (NVAF) were prospectively followed for 24 and 60 months with different NOAC doses to assess the risk of clinical outcome events and to analyze independent risk factors for clinical outcomes.</p><p><strong>Results: </strong>This study included 2825 AF patients, with 394 patients undergoing longitudinal follow-up. Paroxysmal AF (49.70%) and non-valvular atrial fibrillation (NVAF) (86.30%) were the most prevalent forms with advanced age being a prominent characteristic. Independent predictors of unregulated NOAC use included age, renal insufficiency, BMI, diabetes, hypertension, and bleeding risk. At the 24-month follow-up, patients who received overdosed NOAC exhibited a higher mortality rate compared to those who were inappropriately underdosed (18.75 vs.10.92 events/patient-year, P = 0.017). At the 60-month follow-up, both all-cause mortality (10.00 vs. 6.49 events per patient-year, P = 0.019; 10.00 vs. 6.21 events per patient-year, P = 0.005) and the composite endpoint event rate (12.50 vs. 9.61 events per patient-year, P = 0.017; 12.50 vs. 9.32 events per patient-year, P = 0.013) were significantly higher in the overdosing group compared to standard and underdosing groups. Age and anemia were identified as risk factors for all-cause mortality, while renal insufficiency was associated with an increased risk of composite endpoint events.</p><p><strong>Conclusion: </strong>AF remains a major disease burden, especially in elderly patients. For Asians, NOAC underdosing was still effective in preventing stroke, but its efficacy and safety need to be further validated through larger-scale clinical trials. Meanwhile, overdosing of NOAC should be avoided.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"263"},"PeriodicalIF":2.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11974184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794558","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":"The global burden of heart failure attributable to interstitial lung diseases: insights from the global burden of disease study 2021.","authors":"Rui-Ling Lu, Qin Huang, Tian-Tian Yu, Dong-Zhou Liu, Xiao-Ping Hong","doi":"10.1186/s12872-025-04702-y","DOIUrl":"10.1186/s12872-025-04702-y","url":null,"abstract":"<p><strong>Background: </strong>The burden of interstitial lung disease (ILD)-associated heart failure (HF) poses a significant challenge to the prognosis of ILD patients. This study aimed to characterize the disease burden and analyse future trends of ILD-associated HF, offering valuable insights to inform targeted prevention and control strategies.</p><p><strong>Methods: </strong>Data on the prevalence and years lived with disability (YLDs) of ILD-associated HF were retrieved from the Global Burden of Disease (GBD) database for the period 1990-2021. Trends in ILD-associated HF were evaluated using average annual percentage change (AAPC) and percentage change analyses. Future prevalence data were projected up to 2050 using predictive modelling.</p><p><strong>Results: </strong>Globally, the number of patients with ILD-associated HF increased from 20,229 in 1990 to 104,059 in 2021, with the prevalence rising from 0.53 to 1.41 per 100,000 population. Prevalence rates were disproportionately higher in older populations, with individuals over 95 years experiencing a 17.78-fold increase over the study period. Additionally, a positive correlation was observed between higher socioeconomic development index (SDI) levels and ILD-associated HF prevalence. Among 204 countries, 71.1% exhibited an increasing trend in prevalence. However, Bayesian age-period-cohort (BAPC) modelling predicts a declining trend over the next 28 years.</p><p><strong>Conclusion: </strong>Over the past three decades, the global burden of ILD-associated HF has escalated, particularly among individuals aged over 65 and in regions with high SDI levels. These findings underscore the need for region-specific, personalized intervention strategies to mitigate disease progression and enhance the quality of life for ILD patients.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"262"},"PeriodicalIF":2.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11974060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794577","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":"Evaluation of machine learning methods for prediction of heart failure mortality and readmission: meta-analysis.","authors":"Hamed Hajishah, Danial Kazemi, Ehsan Safaee, Mohammad Javad Amini, Maral Peisepar, Mohammad Mahdi Tanhapour, Arian Tavasol","doi":"10.1186/s12872-025-04700-0","DOIUrl":"10.1186/s12872-025-04700-0","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) impacts nearly 6 million individuals in the U.S., with a projected 46% increase by 2030, is creating significant healthcare burdens. Predictive models, particularly machine learning (ML)-based models, offer promising solutions to identify patients at greater risk of adverse outcomes, such as mortality and hospital readmission. This review aims to assess the effectiveness of ML models in predicting HF-related outcomes, with a focus on their potential to improve patient care and clinical decision-making. We aim to assess how effectively machine learning models predict mortality and readmission in heart failure patients to improve clinical outcomes.</p><p><strong>Method: </strong>The study followed PRISMA 2020 guidelines and was registered in the PROSPERO database (CRD42023481167). We conducted a systematic search in PubMed, Scopus, and Web of Science databases using specific keywords related to heart failure, machine learning, mortality and readmission. Extracted data focused on study characteristics, machine learning details, and outcomes, with AUC or c-index used as the primary outcomes for pooling analysis. The PROBAST tool was used to assess bias risk, evaluating models based on participants, predictors, outcomes, and statistical analysis. The meta-analysis pooled AUCs for different machine learning models predicting mortality and readmission. Prediction accuracy data was categorized by timeframes, with high heterogeneity determined by an I² value above 50%, leading to a random-effects model when applicable. Publication bias was assessed using Egger's and Begg's tests, with a p-value below 0.05 considered significant RESULT: A total of 4,505 studies were identified, and after screening, 64 were included in the final analysis, covering 943,941 patients. Of these, 40 studies focused on mortality, 17 on readmission, and 7 on both outcomes. In total, 346 machine learning models were evaluated, with the most common algorithms being random forest, logistic regression, and gradient boosting. The neural network model achieved the highest overall AUC for mortality prediction (0.808), while the support vector machine performed best for readmission prediction (AUC 0.733). The analysis revealed a significant risk of bias, primarily due to reliance on retrospective data and inadequate sample size justification.</p><p><strong>Conclusion: </strong>In conclusion, this review emphasizes the strong potential of ML models in predicting HF readmission and mortality. ML algorithms show promise in improving prognostic accuracy and enabling personalized patient care. However, challenges like model interpretability, generalizability, and clinical integration persist. Overcoming these requires refined ML techniques and a robust regulatory framework to enhance HF outcomes.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"264"},"PeriodicalIF":2.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11974104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794566","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":"Spinal cord protection by normothermic artery bypass and visceral-anastomosis-first strategy in thoracoabdominal aortic aneurysm repair.","authors":"Shuai Zhang, Yuan Li, Yongkang Zhou, Cuntao Yu, Xiaogang Sun, Hongwei Guo, Yi Chang, Dong Zhao, Jing Sun, Xiangyang Qian","doi":"10.1186/s12872-025-04710-y","DOIUrl":"10.1186/s12872-025-04710-y","url":null,"abstract":"<p><strong>Background: </strong>Spinal Cord Injury is a disastrous complication of thoracoabdominal aortic aneurysm surgery. This study is to assess the effectiveness and safety normothermic artery bypass and visceral-anastomosis-first strategy for thoracoabdominal aortic aneurysm repair.</p><p><strong>Methods: </strong>Normothermic artery bypass and visceral-anastomosis-first strategy prioritizes the reconstruction of visceral and other distal vessels, with intercostal arteries serving as the physiological blood supply at high pressure during this period. Reconstruction of intercostal arteries and proximal anastomosis is then performed, ensuring the longest possible physiological blood supply to the spinal cord. From July 2019 to December 2023, we retrospectively analyzed early postoperative complications in two groups of patients undergoing thoracoabdominal aortic aneurysm repair using the new strategy compared to normothermic iliac artery perfusion, clarifying the protective effects of the new strategy on visceral organs, especially the spinal cord.</p><p><strong>Results: </strong>The incidence of paraplegia was significantly lower in the NABP group than in the normothermic iliac perfusion (NIP) group (0.00% vs. 9.72%, p = 0.047), and the duration of postoperative mechanical ventilation was significantly lower in the NABP group than in the NIP group (p = 0.004). In addition, we found that the incidence of gastrointestinal adverse events was significantly lower in the NABP group than in the NIP group (7.32% vs. 45.83%, p < 0.001). Typically, patients' lactate levels returned to normal within approximately 48 h postoperatively. Although not statistically significant, lactate fell to normal more quickly in the NABP group after surgery.</p><p><strong>Conclusions: </strong>The treatment of thoracoabdominal aortic aneurysm through open surgery is still an important method and remains difficult. The data we have suggests that our approach of normothermic artery bypass and visceral-anastomosis-first strategy can lower the risk of spinal cord injury complications.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"261"},"PeriodicalIF":2.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11974105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794573","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":"Application of insertable cardiac monitors in the real world: an observational cohort study in China.","authors":"Beibing Di, Lifeng Liang, Wangyang Yang, Nixiao Zhang, Xiaona Liu, Hui Peng, Zhijun Sun","doi":"10.1186/s12872-025-04707-7","DOIUrl":"10.1186/s12872-025-04707-7","url":null,"abstract":"<p><strong>Background: </strong>Insertable cardiac monitors (ICMs) are increasingly used for long-term electrocardiographic monitoring. However, the data on ICMs remains limited in China.</p><p><strong>Methods: </strong>In this retrospective observational study, we evaluated the real-world use and outcomes of patients consecutively receiving Reveal LINQ (Medtronic Ltd, Minneapolis, MN) devices from 2020 to 2022 at the Cardiovascular Center of Beijing Friendship Hospital. Patient characteristics, ECG parameters, ICM indications and follow-up data were collected. The outcomes including symptom documentation, arrhythmia detection and ICM-guided interventions were identified.</p><p><strong>Results: </strong>A total of 200 patients (age 64 ± 14 years; 52% males) receiving ICMs were enrolled (134 syncopes, 59 unexplained palpitations, 7 cryptogenic strokes). During median follow-up of 28 months, 98 patients (49%) had documented clinically significant arrhythmia. After ICM diagnosis, 89 (44.5%) of patients had ICM-guided actionable events. Pacemaker/defibrillator implantation (48, 24%), catheter ablation (27, 13.5%) and mediation management (11, 5.5%) were the majority of ICM-derived management. For syncope, age > 65 years (HR 1.032, p = 0.017), asymptomatic sinus bradycardia (45-55 beats / min) (HR 2.106, p = 0.043) and RR interval exceeding 2 s (HR 3.625, p < 0.001) were significantly associated with actionable events. The risk of arrhythmia requiring management changes was significantly stepwise higher with the prevalence of more risk factors (P < 0.001 by log-rank).</p><p><strong>Conclusions: </strong>ICM utilization is associated with high efficacy in diagnoses and triggers important and optimal management in China. Age > 65 years, asymptomatic sinus bradycardia (45-55 beats / min) and RR interval exceeding 2 s are independent clinical predictors of ICM-guided clinical management for syncope.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"267"},"PeriodicalIF":2.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802456","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":"ECG-based heart arrhythmia classification using feature engineering and a hybrid stacked machine learning.","authors":"Raiyan Jahangir, Muhammad Nazrul Islam, Md Shofiqul Islam, Md Motaharul Islam","doi":"10.1186/s12872-025-04678-9","DOIUrl":"10.1186/s12872-025-04678-9","url":null,"abstract":"<p><p>A heart arrhythmia refers to a set of conditions characterized by irregular heart- beats, with an increasing mortality rate in recent years. Regular monitoring is essential for effective management, as early detection and timely treatment greatly improve survival outcomes. The electrocardiogram (ECG) remains the standard method for detecting arrhythmias, traditionally analyzed by cardiolo- gists and clinical experts. However, the incorporation of automated technology and computer-assisted systems offers substantial support in the accurate diagno- sis of heart arrhythmias. This research focused on developing a hybrid model with stack classifiers, which are state-of-the-art ensemble machine-learning techniques to accurately classify heart arrhythmias from ECG signals, eliminating the need for extensive human intervention. Other conventional machine-learning, bagging, and boosting ensemble algorithms were also explored along with the proposed stack classifiers. The classifiers were trained with a different number of features (50, 65, 80, 95) selected by feature engineering techniques (PCA, Chi-Square, RFE) from a dataset as the most important ones. As an outcome, the stack clas- sifier with XGBoost as the meta-classifier, trained with 65 important features determined by the Principal Component Analysis (PCA) technique, achieved the best performance among all the models. The proposed classifier achieved a perfor- mance of 99.58% accuracy, 99.57% precision, 99.58% recall, and 99.57% f1-score and can be promising for arrhythmia diagnosis.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"260"},"PeriodicalIF":2.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11974107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794563","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}