BMC Cardiovascular Disorders最新文献

{"title":"Prevalence and associated factors of atrial fibrillation among acute stroke patients at public referral hospitals in Bahir Dar, Ethiopia, 2024: a cross-sectional study.","authors":"Elias Molla, Yihealem Yabebal Ayele, Tewodros Ayenew, Alemtsehay Mekonen, Agerye Kassa Yirdaw","doi":"10.1186/s12872-025-04839-w","DOIUrl":"https://doi.org/10.1186/s12872-025-04839-w","url":null,"abstract":"<p><strong>Background: </strong>Stroke prevalence and disability-adjusted life years (DALYs) lost are rising in Sub-Saharan Africa, where atrial fibrillation (AF) commonly associated with rheumatic valvular heart disease is prevalent. Despite this, there is a paucity of data regarding the association between atrial fibrillation and acute stroke in this region.</p><p><strong>Objective: </strong>To assess the prevalence of atrial fibrillation and associated factors in acute stroke patients admitted to public referral hospitals from 2020 to 2023, Bahir Dar, Ethiopia.</p><p><strong>Methods: </strong>Institution based retrospective cross-sectional study was conducted, using sample size of 326, among acute stroke patients who were admitted to two public hospitals, from January 2020 to December 2023, Bahir Dar, Ethiopia. Pre-developed check list was used to extract data from the medical registry. Data were entered using Epi data manager version 4.6 and analyzed using SPSS version 27. Multivariate logistic regression analysis was used, considering a p-value of < 0.05 as statically significant, with a 95% confidence interval.</p><p><strong>Results: </strong>The proportion of atrial fibrillation among acute stroke patients was 29.1% (95% CI, 24.3-34.4%). The mean age of the participants was 61.63 years [SD ± 16.24]. Age ≥ 65 years (AOR = 4.37, 95% CI 1.618-11.8), hypertension (AOR = 2, 95% CI 1.12-3.5), heart failure (AOR = 4.95, 95% CI 1.7-14.3) and rheumatic heart disease (AOR = 5.7, 95% CI 1.7-18.8) were significant factors associated with atrial fibrillation in acute stroke patients.</p><p><strong>Conclusion: </strong>This study found a high prevalence of atrial fibrillation among acute stroke patients, with many cases newly diagnosed at presentation. It recommends targeted policies and screening programs to address atrial fibrillation risk factors, particularly in high-risk groups. Further large-scale research is needed to better understand the association between atrial fibrillation and stroke.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"424"},"PeriodicalIF":2.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198272","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 the prognosis of diabetic patients undergoing percutaneous coronary intervention: the value of the Naples prognostic score in a real-world clinical study.","authors":"Mengzhu Zhou, Xue Zhang, Xiaohua Guo, Junying Duan, Haifeng Zhang, Xing Liu, Tong Liu, Kangyin Chen, Changle Liu","doi":"10.1186/s12872-025-04849-8","DOIUrl":"https://doi.org/10.1186/s12872-025-04849-8","url":null,"abstract":"<p><strong>Background: </strong>The Naples prognostic score (NPS) evaluates the body's systemic inflammatory and metabolic status. However, its relevance for patients with diabetes mellitus (DM) undergoing percutaneous coronary intervention (PCI) is uncertain.</p><p><strong>Methods: </strong>This study involved 1,485 diabetes patients following PCI from 2019 to 2023. Participants were divided into two groups based on their NPS. The primary endpoint was major adverse cardiovascular events (MACE). Secondary endpoints included components of MACE [all-cause mortality, recurrent myocardial infarction (MI), target vessel revascularization (TVR)], as well as cardiac death and stroke.</p><p><strong>Results: </strong>The novel NPS model demonstrated greater predictive capacity for cardiac death in comparison to the conventional diabetes risk score (AUC: 0.711 vs. 0.560, ∆AUC: +0.151, P = 0.044).The NPS model exhibited comparable predictive power to the GRACE score with respect to MACE events, with the difference proving to be statistically non-significant (∆AUC: -0.002, P = 0.940). Kaplan-Meier analysis revealed higher incidences of MACE (8.0% vs. 3.6%, P < 0.001), all-cause mortality (4.1% vs. 1.0%, P < 0.001), cardiac death (2.9% vs. 0.4%, P < 0.001), and stroke (4.1% vs. 2.2%, P = 0.035) in the high-risk NPS group compared to the low-risk group. Multivariate analysis identified high-risk NPS as an independent predictor of MACE (HR: 2.34; 95% CI: 1.50-3.67; P < 0.001), all-cause mortality (HR: 4.20; 95% CI: 1.95-9.04; P < 0.001), and cardiac death (HR: 6.68; 95% CI: 2.25-19.85; P < 0.001). These associations remained significant after adjusting for multiple risk factors.</p><p><strong>Conclusion: </strong>High-risk NPS correlates with a higher incidence of cardiovascular events in diabetic patients following PCI. Additionally, NPS is a more reliable predictor of survival outcomes than other inflammatory and metabolic indicators.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"425"},"PeriodicalIF":2.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198271","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":"Long-term safety and efficacy of ivabradine after direct percutaneous coronary intervention in patients with acute myocardial infarction complicated by heart failure: a single-center retrospective study.","authors":"Xiaohua Guo, Wenwen Yang, Yingchao Cui, Rongxin Guo, Yangyang Zhu, Tong Liu, Kangyin Chen, Changle Liu","doi":"10.1186/s12872-025-04854-x","DOIUrl":"https://doi.org/10.1186/s12872-025-04854-x","url":null,"abstract":"<p><strong>Background: </strong>There are few studies on the long-term efficacy and safety of ivabradine in patients with acute myocardial infarction (AMI) complicated by heart failure. We aimed to assess the above questions and provide clinical experience.</p><p><strong>Methods: </strong>The study enrolled patients with AMI complicated by heart failure who underwent percutaneous coronary intervention (PCI) from January 2022 to June 2023. Based on the discharge medications, patients were stratified into two groups: (1) the ivabradine group (receiving ivabradine with or without β-blockers) and (2) the β-blocker monotherapy group (control). Efficacy effects included in-hospital heart rate control, all-cause mortality, and heart failure readmission. Safety effects comprised recurrent myocardial infarction and recurrent angina rehospitalization. The initial cohort comprised 517 patients, excluding 62 who discontinued ivabradine, leaving 455 for analysis  (ivabradine group: n = 101; β-blocker group: n = 354). Following 1:1 propensity score matching (PSM), 92 matched pairs were available for analysis. Potential confounding variables were adjusted through robust Cox proportional hazards regression modeling.</p><p><strong>Results: </strong>Post-treatment, heart rate at discharge significantly decreased in both groups, with the ivabradine group demonstrating lower values than the β-blocker group (P < 0.05). At 2-year follow-up (post- PSM), the ivabradine group showed a reduced risk of heart failure readmission compared to the β-blocker group (hazard ratio [HR]: 0.32; 95% confidence interval [CI]: 0.13-0.77; P = 0.012). However, no significant intergroup difference was observed in all-cause mortality (HR: 1.04; 95% CI: 0.41-2.61; P = 0.937). No significant differences were observed between the two groups in the safety endpoints, including recurrent myocardial infarction or rehospitalization for angina.</p><p><strong>Conclusion: </strong>Early administration of ivabradine following PCI in patients with AMI complicated by heart failure can lower resting heart rate and is beneficial in reducing the risk of rehospitalization for heart failure. However, these findings support further investigation in future large prospective studies.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"422"},"PeriodicalIF":2.0,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191477","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":"Mechanism of adenosine monophosphate-activated protein kinase promoting lower extremity varicose veins development via cytoskeletal dynamics.","authors":"Yongmei Zhang, Zhinan Ju, Kanghui Dai, Liqun Wan, Guangmao Zhou, Yanchun Ji, Jiehua Qiu","doi":"10.1186/s12872-025-04821-6","DOIUrl":"10.1186/s12872-025-04821-6","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the potential involvement of 5'-AMP-activated protein kinase (AMPK) in the pathogenesis of lower-extremity varicose veins (VV).</p><p><strong>Methods: </strong>In this study, 8 patients with CEAP stage C6 chronic venous disease and 8 age-matched healthy controls were prospectively recruited to collect samples for preparation of subsequent experiments.None of the patients included in the molecular analyses were diagnosed with diabetes, as our analysis of 73,313 patients demonstrated that diabetes is generally not associated with VV. Western blotting was employed to quantify the levels of p-AMPK, G-actin, p-tubulin, p-HSP20, and 14-3-3 proteins in each sample.</p><p><strong>Results: </strong>Epidemiological analyses revealed 5,262 patients with VVs among 714,789 inpatients. Of these patients, only 351 VV patients were diagnosed with type 2 DM, while 4,911 were not diagnosed with DM. Higher levels of AMPK activation were evident in VV samples in molecular analyses, with the p-AMPK level in the VV group being 1.98 ± 0.56 times higher than that in the NV group (n = 3, P < 0.001). G-actin levels in VV samples were additionally 2.14 ± 0.60 times higher than those in NV samples (n = 3, P < 0.001). Increased cofilin activation was also observed in VV samples, as evidenced by p-cofilin levels in the VV group that were 0.63 ± 0.10 times those in the NV group (n = 3, P < 0.001), with VV samples additionally exhibiting p-HSP20 levels that were 2.02 ± 0.59 times higher than those in NV samples (n = 3, P < 0.001).</p><p><strong>Conclusion: </strong>These results suggest that AMPK Is likely to be involved lower extremity VV development, potentially by inducing vasodilation through the dysregulation of F-actin cytoskeletal dynamics in VSMCs, increasing cofilin activation, the displacement of which from 14-3-3 can lead to dephosphorylation mediated by HSP20,and then causes its dephosphorylation and increased activity, and thereby reducing cytoskeletal actin homeostasis and promoting vascular relaxation.These findings elucidate the possible regulatory role of AMPK phosphorylation in vein wall degeneration and provide a theoretical basis for further studies.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"423"},"PeriodicalIF":2.0,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191478","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":"Optimizing statin therapy in HIV-infected patients: a review of pharmacotherapy considerations.","authors":"Ramin Ansari, Hossein Khalili, Keyhan Mohammadi","doi":"10.1186/s12872-025-04887-2","DOIUrl":"https://doi.org/10.1186/s12872-025-04887-2","url":null,"abstract":"<p><strong>Background: </strong>People living with HIV (PLWH) are more vulnerable to cerebrovascular disease, including coronary artery disease. Dyslipidemia is a risk factor for major adverse cardiovascular events in this population as a whole. Dyslipidemia might result from general risk factors, HIV itself, or the adverse effects of the antiretroviral drug, which have different effects on lipid profile. The present study aims to review the latest studies regarding the role of statin initiation in this population and clinically significant drug interactions in the field.</p><p><strong>Methods: </strong>Databases, including Scopus, PubMed, Google Scholar, EMBASE, and Web of Science, were searched for relevant literature on the role of statins in primary/secondary prevention of CVD in PLWH based on the PICO search strategy. Moreover, ARTs-statin drug interactions were investigated and summarized based on the University of Liverpool's website.</p><p><strong>Results: </strong>Nearly 70 studies were found and summarized. Guidelines recommendations for using statins in PLWH and current practice, as well as the role and potential mechanism of statins in PLWH, were investigated. Based on the available data, we developed a practical algorithm that clinicians can use to optimize statin therapy in PLWH.</p><p><strong>Conclusion: </strong>More studies are required to fully define the role of statins in HIV patients, including time to initiate and proper dosing. Moreover, a marked inconsistency exists between clinical guidelines and actual practice, mainly due to irrational concerns regarding antiretroviral-statin drug interactions.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"421"},"PeriodicalIF":2.0,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191479","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":"Association between serum uric acid and cardiometabolic syndrome: a cross-sectional study from NHANES 1999-2020.","authors":"Dian Yin, Qibing Zhang, Yi Lu, Jianning Li, Qian Chen, Guoxin Zhang, Wenwen Xu","doi":"10.1186/s12872-025-04884-5","DOIUrl":"10.1186/s12872-025-04884-5","url":null,"abstract":"<p><strong>Background and aims: </strong>The relationship between serum uric acid (SUA) levels and cardiometabolic syndrome (CMS) remains controversial. This study aims to investigate the association between SUA and CMS in a large, nationally representative US population.</p><p><strong>Methods: </strong>This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2020. Logistic regression models were used to evaluate the association between SUA and CMS, while restricted cubic spline analysis explored the dose-response relationship. Subgroup analyses were conducted to examine effect modifications by demographic and socioeconomic factors.</p><p><strong>Results: </strong>The study included 12,638 participants. After adjusting for multiple confounders, higher SUA levels were significantly associated with increased odds of CMS (OR: 1.37, 95% CI: 1.31-1.42). This association remained consistent across different SUA quartiles, with the highest quartile showing the strongest association (OR: 2.72, 95% CI: 2.34-3.16). Restricted cubic spline analysis revealed a nonlinear dose-response relationship between SUA and CMS. Subgroup analyses showed that the association was stronger in females (OR: 1.78, 95% CI: 1.69-1.87) compared to males (OR: 1.47, 95% CI: 1.41-1.54), and varied across education levels and racial/ethnic groups.</p><p><strong>Conclusion: </strong>Our findings indicate a significant positive association between SUA levels and CMS in the US adult population. This relationship appears to be linear and is influenced by factors such as sex, education level, and race/ethnicity. These results suggest that SUA levels may be a useful marker for CMS assessment and potential intervention strategies.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"419"},"PeriodicalIF":2.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186578","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":"Correction: Application of the comprehensive complication index and Clavien-Dindo complication classification in cardiac surgery: a retrospective study.","authors":"Zhen-Rong Zhang, Yang-Zheng Li, Xiao-Qing Wu, Wen-Jun Chen, Jie-Yang Yuan, Min Yan","doi":"10.1186/s12872-025-04885-4","DOIUrl":"10.1186/s12872-025-04885-4","url":null,"abstract":"<p><strong>Background: </strong>Standardized tools are needed to accurately assess the severity of postoperative complications in cardiac surgery, which is critical for patient management and outcome evaluation. This study aims to evaluate the application of the Clavien Dindo Complications Classification (CDCC) and Comprehensive Complications Index (CCI) in cardiac surgery.</p><p><strong>Methods: </strong>A single-center retrospective analysis was conducted on 738 patients who underwent cardiac surgery between January 2021 and December 2023. The CDCC and CCI were used to evaluate postoperative complications. The age-adjusted Charlson comorbidity index (ACCI) and LVEF were also evaluated. Multivariate regression models according to the most severe complications (CDCC ≥ IIIb grade) were tested. We compared the CDCC and CCI with the patient's surgical condition and economic burden and calculated the sample size required for different evaluation types.</p><p><strong>Results: </strong>563 patients (76.3%) had at least one complication. The mean CCI was 22.5 ± 19.3. Patients who underwent more complex surgeries had higher CDCC grades and CCI scores. Hospitalization cost and length of stay increased with increasing CDCC grade and CCI score. The ACCI (OR: 1.334 [1.109-1.606], p = 0.002) and LVEF (OR: 0.965 [0.943- 0.987], p = 0.002) were associated factors for the most severe complications. The CCI may reduce the required sample size by 20.5 times and 19.6 times compared with the most severe complication or major adverse cardiovascular and cerebrovascular events, respectively, as an endpoint.</p><p><strong>Conclusion: </strong>The CCI and CDCC can help reflect the complexity of cardiac surgery and the burden of hospitalization, providing a more accurate assessment of surgical complications. This may reduce the sample size needed for clinical trials, thus facilitating research in cardiac surgery.</p><p><strong>Clinical trial registration: </strong>Chinese Clinical Trial Registry (No. ChiCTR2400084925) on May 28th, 2024. https://www.chictr.org.cn/showproj.html?proj=228499 .</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"415"},"PeriodicalIF":2.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180751","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":"Electrogram transition patterns in left bundle branch pacing: a case report.","authors":"Jiabo Shen, Longfu Jiang, Hao Wu, Hengdong Li","doi":"10.1186/s12872-025-04895-2","DOIUrl":"10.1186/s12872-025-04895-2","url":null,"abstract":"<p><strong>Introduction: </strong>Left bundle branch (LBB) pacing (LBBP) demonstrates clinical potential but faces challenges in confirming selective capture via dynamic electrogram (EGM) criteria.</p><p><strong>Case report: </strong>A 69-year-old male with a complete atrioventricular block underwent LBBP implantation. Real-time EGM monitoring (high-pass/low-pass filters: 200/500 Hz) revealed an abrupt shortening of stimulus-to-V6 R-wave peak time (Sti-V6 RWPT) from 87 to 69 ms during lead deployment, indicating a transition from septal pacing to LBBP. Output reduction (1.6 V → 1.5 V/0.5 ms) eliminated myocardial excitation notches, yielding isoelectric EGMs confirming selective LBB capture. Further output reduction (1.4 V → 1.3 V/0.5 ms) prolonged Sti-V6 RWPT to 90 ms with an isoelectric interval, suggesting fascicular-level conduction delay.</p><p><strong>Conclusion: </strong>This case report illustrates the electrophysiological features of a diseased conduction system via dynamic EGM analysis, despite technical limitations such as signal artifacts. While EGM morphological patterns assist in differentiating pacing modalities, further validation of these electrophysiological observations is necessary.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"420"},"PeriodicalIF":2.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186580","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 contribution of a short electrocardiographic diastolic interval to diastolic dysfunction and HFpEF.","authors":"A M L N van Ommen, L R Bear, C Carlos Sampedrano, N C Onland-Moret, M J Cramer, F H Rutten, E Dal Canto, I I Tulevski, G A Somsen, N K Sweitzer, R Coronel, H M den Ruijter","doi":"10.1186/s12872-025-04879-2","DOIUrl":"10.1186/s12872-025-04879-2","url":null,"abstract":"<p><strong>Background: </strong>Women are prone to develop heart failure with preserved ejection fraction (HFpEF) and have a longer QT interval compared to men at comparable heart rates, which results in shorter electrical and mechanical diastole. We hypothesize that a shorter electrical diastole increases HFpEF risk, independent of heart rate.</p><p><strong>Methods: </strong>In 85,145 women and men visiting the Cardiology Centers of the Netherlands between 2007 and 2018, we calculated electrical diastolic intervals (TQ and TP) by subtracting the QT interval, or the sum of the QT- and PQ intervals, respectively, from the RR interval using 12-lead ECG recordings. Electrical diastolic intervals were compared between patients with prevalent left ventricular diastolic dysfunction (LVDD), HFpEF and controls. We validated the TQ interval's association with diastolic function using right atrial pacing and sotalol infusion in a pig model (n = 6).</p><p><strong>Results: </strong>TQ intervals were approximately 30 ms shorter in women than men. Patients with LVDD or HFpEF had shorter TQ intervals compared to controls (LVDD: 479 ± 128ms, HFpEF: 485 ± 138ms and controls: 523 ± 137ms). Shorter TQ intervals increased the risk of prevalent LVDD/HFpEF (per SD decrease in TQ: OR = 1.37, 95%CI: 1.28, 1.45 and 1.16, 95%CI: 1.01, 1.35, respectively) in fully adjusted models in both sexes. After a median follow-up of 8 [IQR = 6-10] years, shorter TQ intervals were associated with a significant higher risk of death (HR = 1.13, 95%CI:1.02, 1.25) in patients with LVDD and HFpEF. In the subgroup with \"delayed relaxation\", beta-blocker use was associated with a significantly lower risk of death, which was not observed in those with \"stiff\" ventricles showing pseudonormalization or restrictive inflow patterns. Findings were independent of heart rate, and not exclusive to women. In pigs, paced at 100 bpm, sotalol infusion decreased the TQ interval, and TQ shortening was correlated to decreasing e'/a' ratio (r = 0.371, p = 0.018) and E/A ratio (r = 0.337, p = 0.030).</p><p><strong>Conclusion: </strong>A short electrical diastole is associated with a higher risk of prevalent LVDD and HFpEF in both women and men at cardiovascular risk, independent of heart rate. Experimental shortening of the electrical diastole induced functional diastolic abnormalities in pigs. This overlooked mechanism of electrical diastolic shortening may contribute to the complex HFpEF syndrome, with beta-blockers potentially benefiting selected groups.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"417"},"PeriodicalIF":2.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186581","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":"Transcatheter repair for papillary muscle rupture Post-AMI.","authors":"Fei Guo, Guanghui Zhu, Dongmei Yang, Jing Zhu, Jianfeng Luo, Jian Xu","doi":"10.1186/s12872-025-04877-4","DOIUrl":"10.1186/s12872-025-04877-4","url":null,"abstract":"<p><strong>Background: </strong>Rupture of the papillary muscle is a serious complication of acute myocardial infarction (AMI), usually leading to mitral valve dysfunction and severe regurgitation, which in turn causes acute heart failure, posing a significant threat to the patient's life.</p><p><strong>Case presentation: </strong>This case report aims to explore the feasibility and effectiveness of the DragonFly™ system in patients with papillary muscle rupture following AMI. We describe a 71-year-old male patient who was admitted due to chest tightness and chest pain, and upon examination, severe mitral regurgitation and papillary muscle rupture were found. Although the patient had missed the opportunity for emergency reperfusion, due to significant symptoms and heart failure, the cardiac team decided to perform a transcatheter edge-to-edge repair (TEER) of the mitral valve. During the procedure, guided by ultrasound and imaging, two valve clips were successfully implanted, significantly improving the mitral regurgitation. Postoperative assessment showed a reduction in regurgitation from 4 + to 1+, and the patient was discharged smoothly.</p><p><strong>Conclusions: </strong>Patients with AMI accompanied by papillary muscle rupture have poor condition.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"418"},"PeriodicalIF":2.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186582","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}