BMC Cardiovascular Disorders最新文献

{"title":"Appendiceal-source Klebsiella pneumoniae iliac pseudoaneurysm with rupture risk: a three-case series highlighting post-EVAR reassessment.","authors":"Bingjing Chen, Jingyu Ji, Yiqing Li, Qin Li, Chao Yang, Yujie Wang","doi":"10.1186/s12872-026-06303-9","DOIUrl":"10.1186/s12872-026-06303-9","url":null,"abstract":"<p><strong>Background: </strong>Infective native aorto-iliac aneurysms and pseudoaneurysms are uncommon but life-threatening vascular infections. In rupture-prone presentations, emergency endovascular aneurysm repair (EVAR) may be required to reduce the immediate risk of hemorrhage, but technical exclusion of the aneurysm does not establish infection control.</p><p><strong>Case presentation: </strong>We report three patients with rupture or impending rupture of infective native aorto-iliac aneurysms who underwent emergency EVAR followed by post-procedural reassessment for residual infection. Case 1 was a 66-year-old woman with type 2 diabetes who presented with lower abdominal pain, leukocytosis, elevated C-reactive protein, and a gas-containing left common iliac pseudoaneurysm. Blood anaerobic culture grew Klebsiella pneumoniae with susceptibility to imipenem, meropenem, ceftazidime, cefoperazone-sulbactam, and ceftazidime-avibactam, while urine cultures were negative. Although endovascular exclusion was technically successful, persistent inflammatory signals prompted reassessment and subsequent source-control management. Perforated appendicitis with retroperitoneal contamination supported appendiceal-source contiguous spread to the iliac artery. Case 2 involved a distal abdominal aortic infected pseudoaneurysm with rupture near the inferior mesenteric artery origin; persistent peri-aortic fluid after EVAR required laparoscopic hematoma evacuation and lesion resection. Case 3 involved an infrarenal infected aortic pseudoaneurysm with bilateral common iliac involvement; delayed fever, Escherichia coli bacteremia, and right iliac limb occlusion led to thrombectomy, which retrieved inflammatory fibrinous debris.</p><p><strong>Conclusions: </strong>In infective native aorto-iliac aneurysms, emergency EVAR can control the immediate risk of rupture, but exclusion of the aneurysm does not eradicate infection. After EVAR, persistent fever, pain, elevated inflammatory markers, bacteremia, or peri-graft fluid or gas should prompt a search for a residual or occult gastrointestinal, retroperitoneal, or urinary source. An appendiceal source of Klebsiella pneumoniae iliac pseudoaneurysm is rare, and recognizing it may allow timely source control. The short follow-up and small number of patients limit broader conclusions.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13673834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535282","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":"Prognostic value of the triglyceride-glucose index in patients with premature acute coronary syndrome.","authors":"Yifan Sun, Jibin Chen, Nianzu Wei, Ming Zhang, Chunquan Zhang, Wei Xia, Lei Zhang, Yibing Shao, Bin Wang","doi":"10.1186/s12872-026-06263-0","DOIUrl":"10.1186/s12872-026-06263-0","url":null,"abstract":"<p><strong>Background: </strong>The triglyceride-glucose (TyG) index has been proposed as an accessible indicator of insulin resistance and cardiometabolic risk. However, its prognostic relevance in patients with premature acute coronary syndrome has not been well defined. We therefore examined baseline clinical features and long-term cardiovascular outcomes in patients with premature acute coronary syndrome (PACS) stratified by TyG status.</p><p><strong>Methods: </strong>This retrospective cohort study screened 820 consecutive patients hospitalized with PACS, of whom 804 had complete fasting triglyceride and fasting plasma glucose measurements for TyG calculation. TyG was calculated as ln [fasting triglycerides (mg/dL) × fasting plasma glucose (mg/dL) / 2]. Patients were categorized into high and low TyG groups using the 66.7th percentile as the cutoff. The primary outcome was major adverse cardiovascular and cerebrovascular events (MACCE).</p><p><strong>Results: </strong>Among 804 eligible patients, 268 (33.3%) were assigned to the high TyG group and 536 (66.7%) to the low TyG group. Patients with high TyG showed a more unfavorable cardiometabolic profile and a higher coronary disease burden at baseline than those with low TyG. During follow-up, MACCE occurred in 17.2% of patients in the high TyG group and in 10.4% of those in the low TyG group. After multivariable adjustment, high TyG remained associated with a higher risk of MACCE (adjusted HR 1.61, 95% CI 1.05-2.47; P = 0.029). TyG analyzed as a standardized continuous variable was also independently associated with MACCE (adjusted HR 1.306, 95% CI 1.039-1.643; P = 0.022). Landmark analysis indicated that the association was more prominent after 365 days.</p><p><strong>Conclusion: </strong>In this PACS cohort, elevated TyG was independently associated with an increased risk of MACCE, particularly during longer-term follow-up. TyG may provide a simple adjunctive marker for identifying residual cardiometabolic risk in relatively young patients after ACS.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13679251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535208","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: Trends in mortality and major adverse cardiovascular events following incident acute myocardial infarction.","authors":"Steven Scholfield, Salwa S Zghebi, Martin K Rutter, Mamas A Mamas, Evangelos Kontopantelis","doi":"10.1186/s12872-026-06290-x","DOIUrl":"10.1186/s12872-026-06290-x","url":null,"abstract":"","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13386869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535119","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 impact of diabetes on clinical outcomes in acutely ill patients - a study on patients admitted to the emergency department.","authors":"Per Wändell, Kean Tang, Emma Kwon, Marcelina Wierzbicka, Karolina Sigurdsson, Caroline Wachtler, Axel C Carlsson, Torgny Wessman, Olle Melander, Ulf Ekelund, Anders Björkelund, Peter M Nilsson, Patrik Rydén, Toralph Ruge","doi":"10.1186/s12872-026-06311-9","DOIUrl":"10.1186/s12872-026-06311-9","url":null,"abstract":"<p><strong>Background: </strong>Individuals with diabetes have an increased risk of cardiovascular disease, infection, hospitalization, and premature mortality. However, less is known about how diabetes shapes the broader pattern of emergency department (ED) presentations, acute care use, clinical complexity, and short-term mortality in an unselected ED population. We aimed to describe ED presentation patterns and outcomes among individuals with and without diabetes in a large regional cohort.</p><p><strong>Methods: </strong>We conducted a population-based cohort study including all adult ED visits to nine hospitals in Region Skåne, Sweden, between 2017 and 2018. ED visits for patients with a registered diabetes diagnosis (n = 60,654) were compared with those without diabetes (n = 502,800). We analysed ED visit frequency, recurrent ED use, arrival by ambulance, triage priority, length of stay, comorbidity burden, presenting complaints, and mortality after ED presentation.</p><p><strong>Results: </strong>The most common presenting complaints were broadly similar in both groups, with dyspnoea, chest pain, and abdominal pain among the leading causes of ED presentation. However, diabetes visits were characterized by greater acute care complexity. Compared with visits by individuals without diabetes, visits by individuals with diabetes more often involved a previous ED visit within 90 days, higher triage priority, ambulance arrival, longer ED stay, and substantially higher comorbidity burden. Early mortality after ED presentation was also higher among individuals with diabetes and occurred at younger ages, particularly among men. Mortality diagnoses differed between groups, with cardiovascular causes more prominent among individuals with diabetes.</p><p><strong>Conclusions: </strong>In this large population-based ED cohort, individuals with diabetes presented with broadly similar symptom categories as those without diabetes, but with markedly greater clinical complexity, higher acuity, recurrent acute care use, and earlier mortality. Diabetes in emergency care may therefore identify a patient group with substantial multimorbidity, reduced physiological reserve, and increased vulnerability during acute illness.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13379973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469080","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":"Stage-specific predictors of exercise adherence after percutaneous coronary intervention: a prospective multicenter study.","authors":"Chengyu Xia, Liuxia Ji, Hao Guo, Yuheng Du, Yingjun Zheng, Hui Liu","doi":"10.1186/s12872-026-06291-w","DOIUrl":"10.1186/s12872-026-06291-w","url":null,"abstract":"<p><strong>Background: </strong>The efficacy of exercise after Percutaneous Coronary Intervention (PCI) is compromised by poor long-term adherence. Although multiple influencing factors are recognized, their dynamic evolution and relative importance across different stages remain unclear, hindering the development of targeted interventions.</p><p><strong>Objective: </strong>To characterize longitudinal patterns of exercise adherence and identify stage-specific predictors within 6 months post-PCI using machine learning (ML).</p><p><strong>Design: </strong>A prospective longitudinal study.</p><p><strong>Methods: </strong>600 post-PCI patients were assessed at baseline (T0), 1 month (T1), 3 months (T2), and 6 months (T3) after discharge. We developed concurrent-model and longitudinal prediction models using Random Forest, LightGBM, and Lasso Regression, with interpretability enabled by feature importance analysis and Partial Dependence Plots. A tiered benchmarking strategy, including a linear model trained on the full feature set, was employed to isolate the added value of ML algorithms.</p><p><strong>Results: </strong>Exercise adherence showed significant longitudinal changes, remaining stable from T0 to T1, sharply declining at T2, and partially recovering at T3. All ML models performed well, with concurrent-model R² values ranging from 0.503 to 0.745 and longitudinal R² values ranging from 0.5 to 0.723, and substantially outperforming linear benchmarks. Feature importance analysis revealed a dynamic evolution of stage-specific predictors: action self-efficacy and kinesiophobia dominated the initiation phase (T0), while maintenance self-efficacy and coping planning became the paramount predictors thereafter. Critically, the level of maintenance self-efficacy at T1 served as a strong and consistent prospective predictor and was associated with long-term adherence at T2 and T3.</p><p><strong>Conclusions: </strong>This study suggests that exercise adherence after PCI follows a dynamic trajectory, with the relative predictive relevance of psychological and behavioral factors varying across stages. The shift from initiation-related predictors to maintenance-focused predictors, together with the sustained predictive association of early maintenance self-efficacy, may inform the development of phased assessment and intervention strategies. However, these findings should be interpreted as predictive associations rather than causal mechanisms and require external validation before clinical implementation.</p><p><strong>Trial registration: </strong>Not applicable as a clinical trial. This study was a prospective observational cohort study without investigator-assigned intervention allocation and was not prospectively registered.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497110","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":"Angiography-derived versus pressure-wire-based physiological assessment to guide percutaneous coronary intervention: a systematic review and meta-analysis of randomised controlled trials.","authors":"Mahwish Sarwar, Shaikh Muhammad Daniyal, Shaheer Bin Shafiq, Naveen Murad Khatoon, Amna Noor, Muhammad Tahir, Minahil Riaz, Ayan Khalid, Fizza Batool, Minaam Farooq, Augustine George, Romal Jabarkhil","doi":"10.1186/s12872-026-06305-7","DOIUrl":"10.1186/s12872-026-06305-7","url":null,"abstract":"<p><strong>Introduction: </strong>Angiography-derived fractional flow reserve (FFR) has emerged as a wire-free alternative to pressure-wire-based physiological assessment for guiding percutaneous coronary intervention (PCI). However, comparative clinical outcomes and procedural implications remain uncertain.</p><p><strong>Methods: </strong>A systematic review and meta-analysis of randomised controlled trials (RCTs) was conducted in accordance with PRISMA guidelines. Databases were searched from inception to April 2026. Studies comparing angiography-derived FFR with pressure-wire-based strategies in patients undergoing PCI were included. Risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs) were pooled using a random-effects model. Pre-specified subgroup analyses were performed based on technology type and comparator composition.</p><p><strong>Results: </strong>Three RCTs were included. Angiography-derived strategies demonstrated no significant difference compared with wire-based approaches for the primary composite outcome (RR: 1.14; 95% CI: 0.85 to 1.55), all-cause mortality, cardiac mortality, myocardial infarction (MI), or revascularization. However, angiography-derived guidance significantly reduced procedural time (MD: - 2.83 min; 95% CI: - 4.94 to - 0.72), fluoroscopy time (MD: - 2.50 min; 95% CI: - 3.38 to - 1.61), and contrast volume (MD: - 6.99 mL; 95% CI: - 11.57 to - 2.40).</p><p><strong>Conclusions: </strong>Angiography-derived physiological assessment provides comparable 1-year clinical outcomes to pressure-wire-based strategies while improving procedural efficiency. However, outcomes may vary by platform, highlighting the importance of technology-specific evaluation in future research.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497196","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 correlates of early post-PCI left ventricular ejection fraction in patients with STEMI: a single-center retrospective study.","authors":"Weicheng Lai, Liangxiu Wu, Xueer He, Xin Li, Lei Zhang, Liangyan Wu, Shenshen Du, Hairong Tang","doi":"10.1186/s12872-026-06309-3","DOIUrl":"10.1186/s12872-026-06309-3","url":null,"abstract":"<p><strong>Introduction: </strong>Early left ventricular systolic dysfunction after primary percutaneous coronary intervention (PCI) remains common in ST-segment elevation myocardial infarction (STEMI) and is associated with adverse remodeling and heart failure. The clinical relevance of lipid markers and lipid ratios for characterizing early post-PCI ventricular dysfunction beyond angiographic and hemodynamic features remains uncertain.</p><p><strong>Methods: </strong>We conducted a single-center retrospective study of consecutive patients with STEMI undergoing emergency PCI at Nanjing BenQ Hospital (2014-2023). LVEF was assessed by transthoracic echocardiography 24-72 h post-PCI, and reduced LVEF was defined as < 50%. Lipids were measured from the first blood sample obtained on admission, and LDL-C/HDL-C and TG/HDL-C were calculated. Multivariable linear and logistic regression models with hierarchical adjustment (Model 2 additionally including log1p-transformed troponin I measured from the first blood sample obtained on admission) were used to identify factors associated with LVEF and reduced LVEF. Discrimination of lipid markers was evaluated using ROC analysis.</p><p><strong>Results: </strong>Among 254 patients, 45 (17.7%) had reduced LVEF. LAD as the infarct-related artery (IRA) was more frequent in the reduced-LVEF group (73.3% vs. 48.3%, P = 0.002). LAD-IRA was independently associated with lower LVEF (β = -5.240; P < 0.001) and higher odds of reduced LVEF (OR = 4.005; P < 0.001). Higher systolic blood pressure was associated with lower odds of reduced LVEF (P = 0.026). TG/HDL-C showed modest discrimination (AUC = 0.605), whereas LDL-C showed no meaningful discrimination (AUC = 0.492).</p><p><strong>Conclusion: </strong>In PCI-treated STEMI, LAD culprit territory and admission systolic blood pressure were the main clinical correlates of early post-PCI LV dysfunction, whereas TG/HDL-C showed only modest discrimination and limited standalone clinical utility. These findings should be considered exploratory and hypothesis-generating.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497191","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":"Stakeholder experiences and expectations of transition of care services to reduce medication-related hospital readmission for cardiology patients.","authors":"Shelley A Wilkinson, Centaine Snoswell, Liza Raggatt, Ian Coombes, Kelvin Robertson, Jared Miles, William Y S Wang, John J Atherton, Chariclia Paradissis, Sue Carson, Andrew Jones, Estelle Jensen, Michael Barras, Nazanin Falconer","doi":"10.1186/s12872-026-06294-7","DOIUrl":"10.1186/s12872-026-06294-7","url":null,"abstract":"<p><strong>Background: </strong>Transition of care (ToC) for patients with cardiovascular diseases is a complex, high-risk period often leading to medication-related harm (MRH) and hospital readmissions. While specialised programs exist, a gap in individualised medication management services exist for specific cardiology patient populations. Pharmacist-led, interdisciplinary ToC services have demonstrated a positive impact on patient outcomes. The REducing hospital re-admission for high-risk CARDiology patients (RECARD) program aims to address this by co-designing, implementing, and evaluating a new pharmacist-led ToC service in post-acute myocardial infarction (AMI) or cardiac surgery patients. The current study focuses on understanding the experiences and expectations of patients and clinicians to inform the development of this service.</p><p><strong>Methods: </strong>This qualitative study utilised semi-structured interviews and focus groups to gather data from patients and hospital and community clinicians aligned with three Queensland hospitals and surrounding primary and community care settings. Patients who had experienced an AMI or cardiac surgery in the past three months were interviewed via telephone or Microsoft TEAMS. Clinicians participated in focus groups or individual interviews. Data were audio-recorded, transcribed, and analysed using the six-phase thematic analysis method by Braun and Clarke, guided by Bradshaw's model of need to understand stakeholders' expressed and comparative needs.</p><p><strong>Results: </strong>Data were obtained from 13 patient interviews and 40 clinicians, through seven focus groups and one interview. Three main themes, with associated subthemes, emerged from the data; Patient-level issues, System and process issues and Interprofessional collaboration. Patients described information overload, medication uncertainty, and anxiety at discharge, while clinicians identified delayed discharge summaries, fragmented communication with primary care, and service gaps - particularly impacting rural patients- as key risks for medication‑related harm.</p><p><strong>Conclusions: </strong>The study's findings highlight the critical need for a patient-centred, pharmacist-led interdisciplinary ToC service that addresses patient knowledge deficits, psychosocial barriers, and the communication gaps between hospital and community care settings. The results from this study will inform the development of the RECARD program's \"Adaptive ToC Pathway,\" ensuring it is tailored to meet the specific needs and expectations of both patients and clinicians, ultimately aiming to reduce MRH and hospital readmissions.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13673588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469093","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":"Integrating multiple hematologic inflammatory indices into a principal component analysis-derived inflammatory burden score for coronary artery disease.","authors":"Mert Deniz Savcilioglu, İrfan Veysel Düzen, Ertan Vuruşkan, Murat Sucu","doi":"10.1186/s12872-026-06315-5","DOIUrl":"10.1186/s12872-026-06315-5","url":null,"abstract":"<p><strong>Background: </strong>Complete blood count-derived inflammatory indices have been associated with coronary artery disease (CAD), but their substantial overlap may limit interpretability when assessed individually. We used principal component analysis (PCA) to integrate six commonly used inflammatory indices into a composite Inflammatory Burden Score (IBS) and evaluated its association with angiographically confirmed CAD alongside the Prognostic Nutritional Index (PNI).</p><p><strong>Methods: </strong>This retrospective cross-sectional study included 1,261 individuals (477 with CAD and 784 without CAD) who underwent invasive coronary angiography at a tertiary referral center. PCA was applied to six standardized inflammatory indices, and the first principal component was retained as the IBS. Hierarchical logistic regression models were constructed to evaluate the incremental contribution of IBS and PNI beyond conventional cardiovascular risk factors. Model discrimination was assessed using the area under the receiver operating characteristic curve (AUC), calibration metrics, and likelihood-ratio testing. XGBoost and SHAP analyses were performed as complementary explainable machine-learning approaches.</p><p><strong>Results: </strong>The first principal component explained 68.1% of the total variance across inflammatory indices, with all variables contributing positively to the composite score. IBS was significantly higher among participants with CAD (p < 0.001). In univariable analyses, both IBS (OR 1.11, 95% CI 1.05-1.17, p < 0.001) and PNI (OR 0.05, 95% CI 0.02-0.14, p < 0.001) were associated with CAD. After adjustment for conventional cardiovascular risk factors, IBS (OR 1.12, 95% CI 1.06-1.19) and PNI (OR 0.06, 95% CI 0.02-0.20) remained independently associated with CAD. Addition of either IBS or PNI significantly improved model fit (both likelihood-ratio test p < 0.001). The AUC increased from 0.727 in the conventional risk-factor model to 0.734 after inclusion of IBS and to 0.737 after inclusion of PNI. The XGBoost model achieved an AUC of 0.802, while SHAP analysis identified age and sex as the dominant predictors, followed by IBS and PNI.</p><p><strong>Conclusions: </strong>In this single-center cross-sectional cohort, a PCA-derived inflammatory burden score and the Prognostic Nutritional Index were independently associated with angiographically confirmed CAD beyond conventional cardiovascular risk factors. Both measures contributed similarly in explainable machine-learning analyses. These findings are exploratory and require prospective external validation before clinical application.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469048","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 value of RT-3DE in evaluating mitral valve configuration and the occurrence of VFMR in patients with ischemic cardiomyopathy: a clinical investigation.","authors":"Wenshu Hu, Xingyu Liu, Chang Zhou, Shiyi Huang, Runyu Zhu, Xinyi Li, Haotian Hu, Dian Shen, Aoyi Zhang","doi":"10.1186/s12872-026-06296-5","DOIUrl":"10.1186/s12872-026-06296-5","url":null,"abstract":"<p><strong>Purpose: </strong>This study used real-time three-dimensional echocardiography (RT-3DE) to obtain three-dimensional (3D) geometric parameters of the mitral annulus and leaflets, including annular structural indices, leaflet angles, and tenting volume (VTent). We further compared the remodeling patterns between atrial functional mitral regurgitation (AFMR) and ventricular functional mitral regurgitation (VFMR). In addition, RT-3DE combined with speckle tracking imaging (STI) was applied to evaluate structural and functional changes of the left ventricular (LV) and mitral valve (MV) in patients with ischemic cardiomyopathy (ICM) and to identify factors associated with VFMR.</p><p><strong>Methods: </strong>In this cross-sectional observational imaging study, 143 patients diagnosed with ICM admitted between July 2022 and November 2023 were enrolled and classified into a VFMR group (n = 68) and a non-VFMR group (n = 75). Another 53 patients with AFMR and 50 healthy controls were also recruited. MV geometry and LV strain parameters were measured via RT-3DE and STI. Multivariable logistic regression analysis was performed to identify the independent predictors of VFMR.</p><p><strong>Results: </strong>Compared with healthy controls, patients with AFMR and VFMR had reduced left ventricular ejection fraction (LVEF), increased LV volumes, and enlarged left atrial diameter. Patients with VFMR presented higher levels of low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG). Both functional mitral regurgitation (FMR) subtypes showed significant alterations in mitral annular and leaflet geometry, with VFMR demonstrating greater annular circularity and VTent. Impaired global longitudinal strain (GLS), reduced LV twist, and increased mitral VTent were identified as independent predictors of VFMR. The combined model incorporating these parameters yielded an area under the curve (AUC) of 0.814, indicating moderate predictive performance.</p><p><strong>Conclusion: </strong>RT-3DE allows non-invasive evaluation of mitral annular and leaflet geometry and facilitates objective comparison of remodeling patterns between AFMR and VFMR. AFMR is characterized by a larger posterior leaflet angulation, whereas VFMR exhibits more pronounced annular circularity and leaflet tenting. In patients with ICM, impaired LV longitudinal strain, reduced LV twist, and increased VTent are independent factors associated with VFMR.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468856","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}