BMC Cardiovascular Disorders最新文献

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

{"title":"Surgical outcomes of constrictive pericarditis and exploratory associations with inflammatory features: a 17-year single-center experience.","authors":"Cigdem Tel Ustunisik, Berk Arapi, Lara Yagci, Abdulgani Orhun Yenigun, Omer Faruk Soydas, Ergida Albrahimi, Asem Tumeh, Ozan Onur Balkanay, Deniz Goksedef, Suat Nail Omeroglu","doi":"10.1186/s12872-026-06535-9","DOIUrl":"https://doi.org/10.1186/s12872-026-06535-9","url":null,"abstract":"<p><strong>Background: </strong>Constrictive pericarditis (CP) remains a challenging disease with evolving etiological patterns and increasing emphasis on phenotype-based management. Pericardiectomy is the definitive treatment for CP. However, contemporary data on the etiological spectrum and the clinical relevance of inflammatory phenotypes in patients undergoing pericardiectomy are limited. We report the etiological spectrum, clinical phenotypes, and short- and long-term outcomes of pericardiectomy at a single center and explore whether a preoperative inflammatory phenotype is associated with adverse perioperative outcomes.</p><p><strong>Methods: </strong>We retrospectively analyzed 36 consecutive patients who underwent pericardiectomy for CP between 2007 and 2024. A study-defined inflammatory phenotype-preoperative pericardial effusion plus C-reactive protein > 10 mg/L (n = 16)-was compared with all remaining patients (n = 20). Patients were evaluated according to etiology, radiologic morphology, inflammatory status, perioperative outcomes, and long-term survival. Survival was estimated by the Kaplan-Meier method.</p><p><strong>Results: </strong>The mean age was 46.1 ± 17.6 years and 69.4% were male. Idiopathic disease was the most common etiology (44.4%), followed by tuberculosis (22.2%), while several uncommon causes, including familial Mediterranean fever, post-transplantation, sarcoidosis, Erdheim-Chester disease and post-COVID pericarditis, were identified. Hypoalbuminemia was more frequent in the inflammatory phenotype group (62.5% vs. 20.0%; p = 0.016). The inflammatory phenotype was also associated with a higher incidence of postoperative LCOS (p = 0.038). In-hospital mortality was observed in two patients (5.6%). After a median follow-up of 86.8 months, overall survival was 94.4%, 87.4% and 82.0% at 1, 5, and 10 years, respectively.</p><p><strong>Conclusion: </strong>Pericardiectomy for constrictive pericarditis provided favorable short- and long-term outcomes in this single-center cohort. A study-defined preoperative inflammatory phenotype was associated with higher perioperative risk in this exploratory cohort. These preliminary findings highlight the potential role of perioperative inflammatory assessment in surgical patients, though validation in larger prospective registries is required.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative effectiveness of dietary supplements in dilated cardiomyopathy: a systematic review and network meta-analysis.","authors":"Yiying Liu, Ruikang Liu, Jun Li, Kai Yang, Yongmei Liu, Fuyuan Zhang, Guancheng Ye, Yulian Yuan","doi":"10.1186/s12872-026-06509-x","DOIUrl":"10.1186/s12872-026-06509-x","url":null,"abstract":"<p><strong>Background: </strong>Dilated cardiomyopathy (DCM) is a major cause of heart failure and cardiovascular mortality, partly due to impaired myocardial energy metabolism. Dietary supplements may offer benefits through improved mitochondrial function and antioxidant effects, and randomized controlled trials (RCTs) suggest they can enhance cardiac function in DCM. However, direct comparisons among supplements are lacking, and the optimal strategy and dose-response relationship remain undetermined.</p><p><strong>Methods: </strong>Eight databases were searched for RCTs evaluating dietary supplements in DCM. Continuous outcomes were analysed by frequentist random-effects network meta-analysis (NMA; Stata/MP 18.0); N-terminal pro-B-type natriuretic peptide (NT-proBNP) and New York Heart Association (NYHA) class were synthesised by pairwise meta-analysis. Risk of bias was assessed with the Cochrane Risk-of-Bias 2 (RoB 2) tool and certainty of evidence with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.</p><p><strong>Results: </strong>Fourteen RCTs (1,259 participants) were included. For left ventricular ejection fraction (LVEF), coenzyme Q₁₀ (CoQ₁₀) 150 mg/d produced the largest improvement versus conventional treatment (CT) (mean difference [MD] = 11.26, 95% confidence interval [CI] 8.55 ~ 13.98; surface under the cumulative ranking curve [SUCRA] 93.4%), followed by taurine and CoQ₁₀ 90 mg/d. CoQ₁₀ 150 mg/d also ranked first for reducing left ventricular end-diastolic diameter (LVEDD; -5.40, - 8.14 ~ - 2.66) and end-systolic diameter (LVESD; -6.31, - 8.60 ~ - 4.01). For heart rate, n-3 polyunsaturated fatty acids (n-3 PUFAs) gave the most robust reduction (- 3.94 bpm, - 5.11 ~ - 2.77). In pairwise meta-analysis, CoQ₁₀ lowered NT-proBNP and improved NYHA status (risk ratio [RR] for ≥ 1-class improvement 1.23, 1.10 ~ 1.38). Network inconsistency was significant for LVESD (P = 0.008). Certainty of evidence (GRADE) was low to very low, and moderate only for n-3 PUFAs; all supplements were well tolerated.</p><p><strong>Conclusions: </strong>In this network, higher-dose CoQ₁₀ (150 mg/d) showed the most favourable overall profile for systolic function and ventricular dimensions, while n-3 PUFAs offered the most reliable benefit for heart rate. Given small samples, predominantly Chinese open-label trials, a heterogeneous and time-varying CT comparator, local inconsistency, and poor safety reporting, these findings should be regarded as hypothesis-generating and require confirmation in larger, well-designed international RCTs with longer follow-up.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between triglyceride-glucose-related indices and cardiovascular disease risk in population with cardio-kidney-metabolic syndrome stages 0-3: a systematic review and meta-analysis.","authors":"Yanxu Chen, Bo Dai, Jieyu Zhang, Zhenru Liu, Haotian Qi, Yang Xiao, Hezeng Dong, Ziqiang Chen, Qinghai Long, Shengxian Xu, Jian Sun","doi":"10.1186/s12872-026-06534-w","DOIUrl":"10.1186/s12872-026-06534-w","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review and meta-analysis aimed to compare the associations of four triglyceride-glucose (TyG)-derived indices (TyG, TyG-BMI, TyG-WC, TyG-WHtR) with incident cardiovascular disease (CVD) risk among individuals with stage 0-3 cardio-kidney-metabolic (CKM) syndrome, and explore potential sources of inter-study heterogeneity using pre-specified subgroup analyses and exploratory meta-regression analyses.</p><p><strong>Methods: </strong>We systematically searched PubMed, Embase, Web of Science, and the Cochrane Library from database inception to May 1, 2026. Two independent reviewers completed study screening, data extraction, and quality assessment using the Newcastle-Ottawa Scale (NOS). Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were synthesized using fixed- or random-effects models according to between-study heterogeneity, which was quantified by Cochran's Q test and the I² statistic. Subgroup analyses, exploratory univariable meta-regression analyses, leave-one-out sensitivity analyses, and publication bias assessments were performed to investigate potential sources of heterogeneity and evaluate the robustness of the findings.</p><p><strong>Results: </strong>Nine high-quality prospective cohort studies were ultimately included. Participants in the highest versus lowest quantiles of each index had significantly elevated CVD risk: TyG (HR = 1.24, 95% CI 1.16-1.33, I² = 76%), TyG-BMI (HR = 1.44, 95% CI 1.26-1.66, I² = 93%), TyG-WC (HR = 1.42, 95% CI 1.21-1.67, I² = 96%), and TyG-WHtR (HR = 1.45, 95% CI 1.28-1.65, I² = 91%). Exploratory meta-regression suggested that follow-up duration may contribute to heterogeneity in TyG, whereas age may contribute to heterogeneity in TyG-WHtR; substantial residual heterogeneity remained for TyG-WC and TyG-WHtR. Sensitivity analyses supported the robustness of the findings. No significant publication bias was detected, but statistical power was limited by fewer than 10 studies per index.</p><p><strong>Conclusions: </strong>This meta-analysis suggests that elevated TyG-derived indices are significantly associated with increased incident CVD risk among individuals with stage 0-3 CKM syndrome. Composite TyG-derived indices showed numerically higher pooled effect estimates than the TyG index; however, overlapping confidence intervals and the absence of direct statistical comparisons prevent conclusions regarding the superiority of any specific index. Given the observational nature of the included studies, limited population diversity, and substantial residual heterogeneity, these findings should be interpreted cautiously. TyG-derived indices may represent potential auxiliary markers for CVD risk stratification, and further large-scale multi-ethnic prospective studies are warranted to evaluate their clinical utility.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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

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

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

{"title":"Preoperative Naples Prognostic Score and outcomes after isolated coronary artery bypass grafting: a retrospective cohort study.","authors":"Mehmet Sengor, Aykun Hakgor, Ramazan Akal, Sayagat Musayeva, Ahmet Masrioglu, Muhittin Calim, Busra Guvendi Sengor, Bekir Inan, Unal Aydin","doi":"10.1186/s12872-026-06427-y","DOIUrl":"10.1186/s12872-026-06427-y","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory and nutritional status may refine risk assessment before coronary artery bypass grafting (CABG). This study evaluated the association between preoperative Naples Prognostic Score (NPS) and early and follow-up outcomes after isolated CABG.</p><p><strong>Methods: </strong>This single-center retrospective cohort included adults who underwent isolated CABG between 2020 and 2023. Patients without a recorded preoperative NPS were excluded. The recorded NPS (0-4) was categorized as low (score 0), intermediate (scores 1-2), or high (scores 3-4). Outcomes were institutionally recorded binary event indicators. Logistic regression evaluated associations with 30-day major adverse cardiac and cerebrovascular events (MACCE), follow-up MACCE, and follow-up all-cause death.</p><p><strong>Results: </strong>The analytic cohort included 332 patients: 16 low-NPS, 193 intermediate-NPS, and 123 high-NPS patients. Follow-up all-cause death occurred in 25 patients (7.5%) and was more frequent in the high-, intermediate-, and low-NPS groups, respectively (15.4%, 3.1%, and 0.0%; exact P < 0.001). Any follow-up MACCE occurred in 45 patients (13.6%; 18.7%, 11.4%, and 0.0% across the same groups; exact P = 0.050). Thirty-day MACCE occurred in 11 patients (3.3%); its analyses were exploratory. Per 1-point increase in NPS, the adjusted odds ratio for follow-up all-cause death was 1.69 (95% CI 1.00-2.84; P = 0.048) in the clinical model and 2.06 (95% CI 1.25-3.39; P = 0.005) in the EuroSCORE II complete-case model.</p><p><strong>Conclusions: </strong>Higher preoperative NPS was associated with greater follow-up all-cause mortality after isolated CABG. Associations with composite MACCE were less consistent after adjustment. NPS may support inflammatory-nutritional risk interpretation alongside established surgical risk assessment, but the findings require confirmation in cohorts with standardized follow-up and time-to-event data.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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

{"title":"Prognostic value of RDW and its derivatives in ICU patients with hypertensive chronic kidney disease.","authors":"Lin Li, Yanyu Lin, Shaoyang Zhang, Yuzhi Liu","doi":"10.1186/s12872-026-06423-2","DOIUrl":"10.1186/s12872-026-06423-2","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) complicated with hypertension constitutes a major global public health burden. Early identification of reliable prognostic biomarkers is essential to optimize clinical management and reduce mortality among these patients.</p><p><strong>Methods: </strong>A total of 6,731 intensive care unit (ICU) patients with hypertensive CKD were enrolled from the MIMIC-IV database. Three hematological markers were analyzed: red blood cell distribution width (RDW), hemoglobin to RDW ratio (HRR), and RDW to platelet ratio (RPR). Cox regression, Kaplan-Meier, and restricted cubic spline analyses were used to evaluate associations with prognosis. ROC curves, C-index, NRI, and IDI assessed predictive performance and incremental value, and decision curve analysis (DCA) evaluated clinical net benefit. Subgroup and sensitivity analyses were also performed.</p><p><strong>Results: </strong>Among 6,731 patients with hypertensive CKD, 2,505 (37.2%) died within one year. After multivariate adjustment, elevated RDW was associated with an increased risk of one-year all-cause mortality (HR = 1.19, 95% CI: 1.16-1.21, P < 0.001), while a higher HRR correlated with reduced mortality risk (HR = 0.89, 95% CI: 0.87-0.91, P < 0.001). The RPR showed a U-shaped correlation with one-year all-cause mortality. The areas under the ROCs for RDW, HRR and RPR were 0.668, 0.600 and 0.515, respectively. RDW and HRR can improve the predictive performance of conventional risk models, while the incremental value of RPR was heterogeneous and limited to specific scoring systems. DCA demonstrated that RDW, HRR, and RPR all provided favorable clinical net benefits across a wide range of high-risk thresholds, suggesting their potential clinical applicability. Subgroup analyses demonstrated significant interactions of RDW with CRRT use and CKD stage (P < 0.001), as well as a notable interaction between HRR and CRRT (P < 0.001). Sensitivity analysis verified the robustness of the present findings.</p><p><strong>Conclusions: </strong>RDW, HRR and RPR are associated with one-year mortality in ICU patients with hypertensive CKD. RDW exhibited modest predictive discrimination among the three markers and provides supplementary information for risk stratification when combined with established clinical risk scores. Prospective studies with external validation are warranted to confirm these findings and elucidate underlying mechanisms.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149058345","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}