BMC Cardiovascular Disorders最新文献

{"title":"Outcomes following major dysvascular lower limb amputation: an updated systematic review.","authors":"Shashank Ghai, Sander L Hitzig, Maha Edrees, Amanda L Mayo, Virginie Blanchette, Natalie Habra, Audrey Zucker-Levin, Diana Zidarov","doi":"10.1186/s12872-026-06377-5","DOIUrl":"10.1186/s12872-026-06377-5","url":null,"abstract":"<p><strong>Background: </strong>Adults with major lower limb amputation (LLA) due to dysvascular etiology often experience diverse health outcomes. However, the absence of standardized outcome reporting limits the ability to synthesize evidence, evaluate care models, and develop consistent clinical pathways. This review updates a systematic review on outcome measures and indicators reported in this population.</p><p><strong>Methods: </strong>A systematic review update was conducted across six databases (MEDLINE, EMBASE, EBM Reviews, PsycINFO, Web of Science, and CINAHL) from 20 April 2017 to 1 December 2022. All study designs were eligible; however, the articles needed to report outcome measures and indicators on at least 50% of the adult population with major dysvascular LLAs. The extracted outcome measures and indicators were organized according to Dodd's framework and then reclassified alongside those reported in the study by Ambler and colleagues. The pilot phase of data extraction was carried out independently by multiple reviewers, after which a single reviewer completed the data extraction.</p><p><strong>Results: </strong>Of the 12,557 articles, 160 studies reporting data on 228,116 individuals with major dysvascular LLA met the inclusion criteria. Combining these with the 440 studies from the previous review, 2,466 outcome measures and indicators were categorized in five core areas: life impact (25.7%), physiological/clinical (23.4%), death (18.7%), resource use (17.6%), and adverse events (14.6%). In terms of the outcome domains, mortality/survival was the most commonly reported domain, followed by physical functioning (e.g. prosthesis fit, use), skin (e.g., stump wound healing), nervous system outcomes (e.g., residual limb pain), need for further interventions (e.g., prescription of medications), hospital outcomes (e.g., duration of stay, discharge), and adverse events.</p><p><strong>Conclusion: </strong>This study builds on a previous review by identifying and categorizing outcome measures and indicators in adults with major dysvascular LLA, highlighting inconsistencies in outcome reporting across studies. The absence of a standardized set of outcome measures and indicators limits the ability to conduct meta-analyses or systematic reviews, evaluate the effectiveness of care models, and establish clinical pathways. Developing a core outcome set tailored to the needs of individuals with dysvascular LLA could help address these challenges by promoting consistency in outcome reporting and enabling meaningful comparisons across studies. Ultimately, this could contribute to improving the quality, efficiency, and person-centeredness of care.</p><p><strong>Trial registration: </strong>PROSPERO (CRD42023388570).</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13450402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148688595","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":"Biomarkers of systemic disease burden and outcomes after transcatheter tricuspid edge-to-edge repair.","authors":"Johannes Schlegl, Marwin Bannehr, Michael Lichtenauer, Tanja Kücken, Alexander Krutz, Vera Paar, Michael Neuß, Anja Haase-Fielitz, Christian Butter, Christoph Edlinger","doi":"10.1186/s12872-026-06392-6","DOIUrl":"10.1186/s12872-026-06392-6","url":null,"abstract":"<p><strong>Background: </strong>Risk stratification after transcatheter tricuspid edge-to-edge repair (T-TEER) remains challenging, particularly in patients with advanced right-sided heart failure and systemic disease burden. Biomarkers reflecting inflammation, stress response and multiorgan dysfunction may provide additional prognostic information in this setting.</p><p><strong>Methods: </strong>This prospective single-centre cohort study included 84 consecutive patients undergoing T-TEER for severe tricuspid regurgitation using the TriClip or PASCAL system. Baseline concentrations of growth differentiation factor-15 (GDF-15), soluble urokinase plasminogen activator receptor (suPAR), and NT-proBNP were measured prior to intervention. The primary endpoint was all-cause mortality at 12 months. Secondary endpoints included cardiovascular rehospitalisation and a combined cardiovascular endpoint. Prognostic performance was assessed using receiver operating characteristic and tertile-based Kaplan-Meier analyses. Owing to the limited number of events, all analyses were considered exploratory.</p><p><strong>Results: </strong>During 12-month follow-up, all-cause mortality occurred in 10 patients (11.9%), while cardiovascular rehospitalisation was observed in 29 patients (34.5%). GDF-15 demonstrated good discriminative performance for all-cause mortality (AUC 0.823, 95% CI 0.714-0.932, p = 0.001), whereas suPAR showed moderate prognostic discrimination (AUC 0.742, 95% CI 0.605-0.878, p = 0.013). In contrast, NT-proBNP showed no significant discrimination for all-cause mortality (AUC 0.535, 95% CI 0.362-0.709, p = 0.720). Higher tertiles of both GDF-15 and suPAR were associated with reduced overall and rehospitalisation-free survival.</p><p><strong>Conclusion: </strong>Baseline GDF-15 and suPAR were associated with adverse outcomes after T-TEER and demonstrated greater prognostic discrimination than NT-proBNP in this exploratory cohort. These exploratory findings support further investigation of systemic stress and inflammation biomarkers for risk stratification in patients with severe tricuspid regurgitation.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13435473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148668378","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":"Mean platelet volume is independently associated with systolic and diastolic blood pressure: a retrospective cross-sectional study.","authors":"Kemal Ozan Lule, Omer Yildirim, Ozge Ozsoy, Hamit Yildiz","doi":"10.1186/s12872-026-06381-9","DOIUrl":"10.1186/s12872-026-06381-9","url":null,"abstract":"<p><strong>Background: </strong>Blood pressure-related cardiovascular risk follows a continuous pattern rather than a dichotomous threshold-based model. In this context, the 2024 European Society of Cardiology (ESC 2024) guidelines emphasize elevated blood pressure as an intermediate-risk category. Low-grade systemic inflammation has been implicated in the pathogenesis of hypertension; however, data regarding inflammatory alterations in individuals with elevated blood pressure remain limited.</p><p><strong>Methods: </strong>This retrospective cross-sectional study included adults aged 18-65 years attending a general internal medicine outpatient clinic. Participants were classified into three groups based on office blood pressure measurements according to the 2024 ESC guidelines: non-elevated blood pressure, elevated blood pressure, and newly diagnosed hypertension (NDH). Inflammatory and hematological markers, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), mean platelet volume (MPV), and C-reactive protein (CRP), were compared across groups. Multivariable linear regression analyses were performed to identify independent associations with systolic and diastolic blood pressure.</p><p><strong>Results: </strong>A total of 284 individuals were included (mean age 46.7 ± 12.0 years; 65.5% male). Nearly half of the cohort was classified as having elevated blood pressure, while 27.5% had NDH. Age, MPV, and CRP differed significantly across blood pressure categories. MPV was significantly higher in the NDH group and remained independently associated with both systolic and diastolic blood pressure after adjustment for age and NLR. NLR showed weak correlations with systolic blood pressure but was not independently associated in multivariable analyses, while PLR and MLR did not differ significantly across blood pressure categories.</p><p><strong>Conclusion: </strong>Inflammatory and hematological differences were most evident in newly diagnosed hypertension. Mean platelet volume was independently associated with both systolic and diastolic blood pressure. The temporal and mechanistic significance of this association cannot be determined from this cross-sectional study and requires confirmation in longitudinal research. The 2024 ESC blood pressure classification highlights elevated blood pressure as a clinically relevant intermediate-risk state and underscores the potential value of readily available hematological markers in early cardiovascular risk stratification.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148954891","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":"Flecainide- and isoproterenol-induced alterations in heart rate variability and DFA-derived physiological complexity in anesthetized mice.","authors":"Hasan Fehmi Ozel, Mustafa Ozbek, Hasan Kazdağlı, Şeyda Avcıl","doi":"10.1186/s12872-026-06236-3","DOIUrl":"10.1186/s12872-026-06236-3","url":null,"abstract":"<p><strong>Background: </strong>Heart rate variability (HRV) provides insight into cardiac autonomic regulation, while nonlinear HRV indices may capture dynamic features of cardiac rhythm that are not fully reflected by conventional time- and frequency-domain parameters. Flecainide and isoproterenol influence cardiac rhythm through different mechanisms, sodium-channel blockade and β-adrenergic stimulation, respectively. This study investigated whether these pharmacological perturbations alter HRV and RR interval fractal organization in mice.</p><p><strong>Methods: </strong>Twenty-four adult male mice were assigned to control (CNT, n = 9), flecainide (FLE, n = 8), or isoproterenol (ISO, n = 7) groups. Electrocardiographic recordings were obtained under anesthesia before and after drug administration. HRV analysis was performed using RR interval series. Time-domain, frequency-domain, Poincaré plot, and detrended fluctuation analysis (DFA) parameters were calculated. Fractal complexity loss was assessed using DFA-derived area-based indices, including dS1, dS2, and total deviation score (TdS). Pre- and post-drug values were compared using a two-way mixed-design ANOVA (Group × Time) with Šídák-corrected post-hoc tests.</p><p><strong>Results: </strong>A significant Group × Time interaction was observed for mean heart rate (p < 0.001) and mean RR interval (p = 0.013). Post hoc analyses showed that isoproterenol markedly increased heart rate from 391 to 548 BPM (p = 0.002), whereas flecainide produced no significant change in heart rate. DFAα1 also demonstrated a strong Group × Time interaction (p < 0.001), increasing after isoproterenol but decreasing after flecainide. All DFA-derived complexity-loss indices showed significant Group × Time interactions, including dS1 (p < 0.001), dS2 (p = 0.002), and TdS (p = 0.001). Flecainide increased fractal complexity loss, whereas isoproterenol reduced it; accordingly, post-drug complexity-loss values were higher in the flecainide group than in both the isoproterenol and control groups. In contrast, conventional HRV magnitude-based indices, including SDNN, spectral power measures, stress index, and DFAα2, did not show significant Group × Time interactions.</p><p><strong>Conclusion: </strong>Flecainide and isoproterenol produced distinct alterations in cardiac rhythm dynamics in anesthetized mice. DFAα1 and DFA-derived area-based indices, particularly dS1 and TdS, provided complementary information about drug-induced changes in RR interval fractal organization. These findings should be interpreted as exploratory evidence of altered rhythm organization rather than as diagnostic evidence of specific arrhythmia types or cardiac health status.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13602675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149029850","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":"Assessment of Cardiovascular Disease-Related Distress and Psychosocial Determinants: A Prospective Observational Study.","authors":"Harshit Prashant Desai, Sakshi Tusharbhai Kapadia, Devanshi Pareshkumar Bhatt, Jay Navnitbhai Sharma, Arshi Panchal, Kushal Pujara, Anita Mehta, Tejal Gandhi, Akshay Shah","doi":"10.1186/s12872-026-06329-z","DOIUrl":"10.1186/s12872-026-06329-z","url":null,"abstract":"<p><strong>Introduction: </strong>Acute Coronary Syndrome (ACS) imposes substantial psychological and cardiovascular disease-related distress, influenced by socioeconomic and psychosocial determinants. Identifying these determinants is essential for improving patient outcomes and delivering holistic patient-centered care.</p><p><strong>Objectives: </strong>This study aimed to assess cardiovascular disease-related distress among patients with Acute Coronary Syndrome (ACS) and examine its association with psychosocial and socioeconomic determinants.</p><p><strong>Methodology: </strong>A prospective observational study was conducted over five months at a tertiary care hospital after obtaining ethical approval. A total of 105 adult patients diagnosed with ACS by a cardiologist were enrolled. Patients aged ≥ 18 years, of either gender, who provided written informed consent were included in the study. Socio-demographic characteristics, clinical parameters, and cardiovascular disease-related distress were assessed using a structured distress assessment tool comprising domains including Fear and Uncertainty, Changes to Role and Responsibilities, Economic Impact, and Overwhelm and Depletion. Data regarding psychosocial and socioeconomic determinants were collected and analyzed to evaluate their association with distress levels.</p><p><strong>Results: </strong>The highest distress scores were observed in the domains of changes in roles and relationships, overwhelm and depletion, and fear and uncertainty. Significant associations were identified between cardiovascular distress and socioeconomic status, age, gender, and polypharmacy (p < 0.05). Patients from lower socioeconomic classes and rural areas demonstrated higher psychosocial and economic distress, while female participants reported significantly greater distress in role-related and medication-management domains. No significant association was observed between distress and ACS subtype or comorbidity burden.</p><p><strong>Conclusion: </strong>Cardiovascular disease-related distress among ACS patients varied across specific psychosocial domains rather than uniformly affecting all aspects of patient well-being. Distinct patterns of distress were observed across socioeconomic groups, highlighting the influence of psychosocial and socioeconomic determinants on cardiovascular distress. These findings emphasize the importance of identifying domain-specific distress to facilitate targeted and individualized patient care.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073239","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 ACE2 gene polymorphisms with risk of pulmonary arterial hypertension in neonates with congenital heart disease.","authors":"Youfang Chen, Cuiling Wang, Qingfan Lin, Jin Chen, Li Lin, Shimu Luo, Yinshuang Li, Lifeng Deng","doi":"10.1186/s12872-026-06368-6","DOIUrl":"10.1186/s12872-026-06368-6","url":null,"abstract":"<p><strong>Background: </strong>Studies have confirmed a correlation between angiotensin-converting enzyme 2 (ACE2) gene polymorphisms and the risk of hypertension; however, its correlation with congenital heart disease (CHD)-related-pulmonary arterial hypertension (PAH) risk in neonates has not been reported.</p><p><strong>Methods: </strong>The study enrolled 321 Han Chinese neonates, comprising 113 healthy controls and 208 patients with left-to-right shunt CHD. Among the CHD patients, 98 cases were classified as the PAH subtype [CHD PAH (+)]. Tag SNP genotyping was performed using Sanger sequencing. Associations between three ACE2 SNPs (rs2074192, rs2285666, and rs2106809) and CHD PAH (+) neonates were assessed via sex-stratified logistic regression. Differences in circulating ACE2 and angiotensin1-7 [Ang(1-7)] levels across ACE2 haplotypes were compared using analysis of variance (ANOVA).</p><p><strong>Results: </strong>No significant associations were observed between the three ACE2 SNPs and susceptibility to CHD or the risk of PAH in either univariable or multivariable analyses. In females, the CCT haplotype showed a nominally suggestive association with CHD-PAH in both the univariable model (OR = 0.216, 95% CI: 0.047-0.740; P = 0.025; FDR_P = 0.074) and the multivariable model (OR = 0.187, 95% CI: 0.039-0.670; P = 0.018; FDR_P = 0.053). A nominal difference in circulating Ang-(1-7) levels was also observed across haplotypes among females, with higher levels in CCT haplotype carriers than in those carrying the CTC or TCT haplotypes (160.16 ± 19.24 pg/mL vs. 140.54 ± 28.40 pg/mL and 139.77 ± 29.85 pg/mL, respectively; P = 0.037). However, this difference did not survive FDR correction (FDR_P = 0.074).</p><p><strong>Conclusions: </strong>Our study showed that there was no significant association between ACE2 SNPs or haplotypes and the risk of CHD-PAH in neonates.</p><p><strong>Trial registration: </strong>Our study is an observational study. According to the International Committee of Medical Journal Editors (ICMJE), purely observational studies (in which the allocation of medical interventions is not under the investigator's discretion) do not require registration.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13587371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001211","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":"Identification of pulmonary hypertension with pulmonary vascular surface volume ratio by non-contrast CT.","authors":"Qing Yu, Yating Zhao, Yini Huang, Mingya Zhang, Gulinigaer Wufulihasimu, Yijia Zhou, JiaJia Zhang, Xiaopeng Xu, Wei Zhang, Yanxi Zeng, Wenhui Peng, Yunshan Cao","doi":"10.1186/s12872-026-06078-z","DOIUrl":"10.1186/s12872-026-06078-z","url":null,"abstract":"<p><strong>Background: </strong>The diagnosis of pulmonary hypertension (PH) relies primarily on invasive right heart catheterization (RHC). Although imaging modalities, including echocardiography, computed tomography angiography (CTA) and computed tomography (CT), offer clinical utility, their effectiveness in early detection remains limited.</p><p><strong>Objectives: </strong>To clarify the relationship between group 1/2 PH and radiomic-morphological features of the pulmonary vasculature derived from non-contrast CT.</p><p><strong>Methods: </strong>We retrospectively enrolled control patients and patients with group 1 PH (PAH) and group 2 PH (PH-LHD) from two centers. All participants underwent RHC and chest CT. We extracted the radiomic features from pulmonary arteries and veins, identifying key radiomics markers and further exploring their association with early pathological changes through animal experiments. Subsequently, we analyzed morphological characteristics from 95,197 vascular centerlines. Multivariable models were employed to evaluate their efficacy in identifying PH and discriminating PH-LHD in validation cohort.</p><p><strong>Results: </strong>The training cohort included 49 patients (20 controls, 13 with PAH, 16 with PH-LHD), and validation cohort included 30 patients. Among 212 radiomics features analysis, the pulmonary arterial surface volume ratio (SVR) correlated strongly with mean pulmonary artery pressure (mPAP) (r = -0.602, P < 0.001), while the venous SVR showed a strong correlation with pulmonary artery wedge pressure (PAWP) (r = -0.651, P < 0.001). In animal models, venous SVR demonstrated the ability to reflect early pulmonary venous remodeling in PH-LHD prior to hemodynamic changes. Morphologically, PH-LHD patients showed increased distal vessel tortuosity with reduced torsion and curvature (all P < 0.001). SVR and models combining morphological features demonstrated promising performance for identifying PH (AUC 0.895 (95%CI (0.731-1.000)) vs. 0.890 (95%CI (0.736-1.000)) and distinguishing PH-LHD (AUC 0.868 (95%CI (0.672-1.000) vs. 0.846 (95%CI 0.639-0.990)) in validation cohort.</p><p><strong>Conclusion: </strong>CT-based radiomic-morphological analysis provides a basis for identifying PH and distinguishing its subtypes. Specifically, arterial SVR aids in PH detection, while venous SVR helps differentiate PH-LHD from PAH, together forming a clinically useful screening pathway. Preclinical evidence additionally links venous SVR to venous remodeling that may precede hemodynamic changes. These findings require validation in larger PH populations.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13412298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148599061","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 CML/esRAGE ratio as a potential biomarker of early diastolic impairment in asymptomatic type 1 diabetic patients without overt heart disease.","authors":"Daiming Wang, Jing Lin, Shiyi Chen","doi":"10.1186/s12872-026-06361-z","DOIUrl":"https://doi.org/10.1186/s12872-026-06361-z","url":null,"abstract":"<p><strong>Background: </strong>Heart failure is a prevalent complication of diabetic microangiopathy, and early identification of myocardial dysfuntion is crucial. Advanced glycation end products (AGEs) bind to their receptor RAGE and further promote diabetic late complications as well as heart failure. Two soluble RAGE isoforms, endogenous secretory RAGE (esRAGE) and the cleaved extracellular fragment of membrane RAGE (collectively termed sRAGE), are believed to exert cardioprotective effects by acting as RAGE decoy receptors. This pilot study aimed to investigate the associations of AGEs, sRAGE and esRAGE with early cardiac dysfunction identified via advanced echocardiography.</p><p><strong>Methods: </strong>We enrolled 29 type 1 diabetic patients without known heart disease(EF ≥ 50%) and 31 healthy controls. Plasma levels of two major AGEs, carboxymethyllysine(CML) and methylglyoxal-derived hydroimidazolone 1(MG-H1), as well as sRAGE and esRAGE were measured using immunoassay. Conventional, tissue Doppler, and speckle-tracking echocardiography were performed.</p><p><strong>Results: </strong>In the diabetic group, global longitudinal strain (GLS) and peak early diastolic velocity at the lateral mitral annulus [e(lat)] were significantly lower, while E/e(lat) was higher. CML levels and CML/esRAGE ratio were increased, and esRAGE was decreased in the diabetic group. Pearson correlation analysis showed GLS was significantly associated with disease duration, total cholesterol (TC), HbA1c, esRAGE, and CML/esRAGE ratio; Univariate linear regression confirmed that higher CML/esRAGE ratio was associated with lower e(lat) (β = -0.006, P = 0.047).Variables with P < 0.1 in univariate regression together with pre-specified clinical covariates including age, gender, HbA1c, disease duration, and heart rate were incorporated into stepwise multiple regression; the model demonstrated that CML/esRAGE was independently associated with e(lat) (β = -0.006, 95%CI: [-0.012, -0.001], P = 0.049).</p><p><strong>Conclusion: </strong>Elevated CML/esRAGE ratio is associated with impaired left ventricular diastolic function, and may represent a candidate biomarker for early diastolic dysfunction. Our study also suggest that CML/esRAGE ratio may not associated with GLS abnormalities reflecting subclinical systolic dysfunction. All observations from this pilot study require further validation in large independent prospective cohorts.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227291","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":"Interaction of a genetic sum score of risk alleles associated with coronary artery disease by physical activity in the Heinz Nixdorf Recall study.","authors":"Johannes Penther, Nicola Wilkening, Laven Mavarani, Raimund Erbel, Börge Schmidt","doi":"10.1186/s12872-026-06340-4","DOIUrl":"10.1186/s12872-026-06340-4","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the interaction between a genetic risk score for coronary artery disease (CAD) and measures of physical activity on coronary artery calcification (CAC) in a population-based cohort. Specifically, it sought to determine whether physical exercise, known to be protective against high CAC, influences the expression of genetic risk factors for CAD.</p><p><strong>Methods: </strong>Data were obtained from the Heinz Nixdorf Recall study, including 3938 participants aged 45-74 years with European ancestry. CAC was measured using electron beam computed tomography. The genetic risk score (GRS_CAD) was calculated using 158 CAD-related genetic loci. Physical activity during the last four weeks was assessed through standardized interviews, resulting in measures of (1) engagement in physical exercise and (2) the total metabolic equivalents of general physical activity per week (METh/week). Linear regression models were used to analyze the associations of physical activity and genetic risk with log-transformed CAC, adjusting for confounders age, sex, and education.</p><p><strong>Results: </strong>Participants not engaging in physical exercise had a 1.336-fold (95%-CI: 1.171 to 1.533) higher CAC compared to those who exercised. No association was found between METh/week and CAC. The GRS_CAD was associated with a 1.206-fold (95%-CI: 1.130 to 1.287) higher CAC per standard deviation. Interaction analyses indicated that the genetic effect on CAC was slightly stronger in participants with higher METh/week levels, showing a 1.306-fold (95%-CI: 1.145 to 1.490) higher CAC per standard deviation of the GRS_CAD in the highest METh/week quartile compared to 1.109-fold (95%-CI: 0.978 to 1.259) higher CAC in the lowest quartile. No interaction was observed for engagement in physical exercise.</p><p><strong>Conclusions: </strong>While physical activity in sum was associated with lower levels of CAC, individuals reporting higher physical activity levels may also be less exposed to other non-genetic risk factors for CAD, leading to a slightly stronger association of genetic factors with CAC.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13401783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148590131","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 the TyG-related indices with hypertension-diabetes comorbidity in middle-aged and older adults: a suburban community-based study.","authors":"Fanlian Kong, Yanting Ma, Junchang Zhao, Junying Tan, Shou Liu, Zhancui Dang","doi":"10.1186/s12872-026-06313-7","DOIUrl":"10.1186/s12872-026-06313-7","url":null,"abstract":"<p><strong>Background: </strong>To investigate the associations between TyG-related indices and hypertension-diabetes comorbidity (HTN-DM) among middle-aged and older adults.</p><p><strong>Methods: </strong>A total of 2854 participants (aged ≥ 45 years) living in a suburban community were included in this study. The collected information comprised three parts: baseline information, physical examination, and laboratory testing. Multivariable logistic regression was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between TyG-related indices (TyG, TyG-BMI, and TyG-BRI) and HTN-DM. Restricted cubic splines (RCS) were used to model the dose-response relationships. Receiver operating characteristic (ROC) curves were applied to evaluate the discriminative performance of these indices.</p><p><strong>Results: </strong>Among 2,854 participants, each 1-SD increment in TyG, TyG-BMI, and TyG-BRI conferred multivariable-adjusted ORs (95% CIs) of 3.16(2.75-3.64), 1.39(1.15-1.66), and 1.37(1.22-1.54), respectively (all P < 0.001). Corresponding ORs (95% CIs) comparing the highest versus lowest quartile were 30.99(16.97-62.97), 6.42(4.20-10.14), and 6.43(4.21-10.17), with significant dose-response trends (all P for trend < 0.001). RCS analysis revealed a linear relationship for TyG and nonlinear associations for TyG-BMI and TyG-BRI with HTN-DM. TyG showed the highest observed AUC (0.786) among the evaluated indices, followed by TyG-BMI (0.679) and TyG-BRI (0.633).Across all subgroup analyses, TyG remained consistently and positively associated with HTN-DM prevalence, and the interaction with sex was significant (P = 0.045).</p><p><strong>Conclusions: </strong>This study revealed that TyG-related indices were associated with HTN-DM. RCS analysis indicated a linear association for TyG but nonlinear associations for TyG-BMI and TyG-BRI. Among the three indices, TyG showed the highest observed AUC. This finding suggests that composite indices incorporating BMI or BRI may not necessarily improve discriminative ability beyond TyG alone.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149058484","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}