BMC Cardiovascular Disorders最新文献

{"title":"Educational level and cardiovascular outcomes in patients hospitalized with first-detected atrial fibrillation: a Swedish nationwide cohort study.","authors":"Áron Sztaniszláv, Anna Björkenheim, Anders Magnuson, Nils Edvardsson, Dritan Poçi","doi":"10.1186/s12872-026-06095-y","DOIUrl":"10.1186/s12872-026-06095-y","url":null,"abstract":"<p><strong>Background: </strong>Socioeconomic factors are associated with cardiovascular morbidity. We investigated the association between education level and incident heart failure (HF), acute coronary events (AMI), and cerebrovascular events (stroke) following hospitalization with first-detected atrial fibrillation (AF).</p><p><strong>Methods: </strong>In this nationwide retrospective observational cohort study using linked Swedish national registers, we included patients who received a first diagnosis of AF during hospitalization from 1995 to 2008. Education levels were categorized as primary, secondary, or academic, and patients were followed for up to five years. Outcomes were first hospitalization for HF, AMI, or stroke. Associations were assessed using cause-specific Cox proportional hazard models, for men and women separately. Models were adjusted for age, calendar year of AF diagnosis, whether AF was the primary or secondary admission diagnosis, comorbidity diagnoses and thromboembolic risk.</p><p><strong>Results: </strong>The cohort comprised 263,172 patients (mean age 72.5 ± 10.4 years; 56.2% male). Compared with primary education, secondary and academic education levels were associated with lower adjusted risks of HF and AMI in both females and males. For HF, adjusted hazard ratios (HR) were 0.96 (95% CI 0.93-1.00) for secondary and 0.82 (95% CI 0.77-0.87) for academic education in females, and 0.93 (95% CI 0.90-0.96) and 0.76 (95% CI 0.72-0.80), respectively, in males. For AMI, adjusted HRs were 0.89 (95% CI 0.85-0.93) and 0.71 (95% CI 0.65-0.77) in females, and 0.91 (95% CI 0.87-0.94) and 0.75 (95% CI 0.71-0.80) in males. For stroke, lower adjusted risks were observed only in the academic education group. Baseline comorbidity burden and thromboembolic risk were higher in lower education groups.</p><p><strong>Conclusions: </strong>In this large nationwide cohort of patients hospitalized with AF, higher education level was associated with lower adjusted hazards of incident HF and AMI over five years, while the association with stroke was weaker. Education level may be considered a risk marker when planning follow-up and preventive care after hospitalization with AF.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879083","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 effect of polypharmacy in ambulatory patients with heart failure: a machine learning-based analysis.","authors":"Zahra Hooshanginezhad, Houshang Bavandpour Karvane, Babak Mohammadi, Sepehr Nemati","doi":"10.1186/s12872-026-06347-x","DOIUrl":"10.1186/s12872-026-06347-x","url":null,"abstract":"<p><strong>Background: </strong>Managing heart failure often involves polypharmacy, reflecting the challenge of balancing multiple treatments to achieve the best outcomes for patients. We aimed to investigate the effect of polypharmacy on survival in ambulatory patients with heart failure and identify key predictors of survival.</p><p><strong>Methods: </strong>We conducted a secondary analysis of data from 1375 ambulatory patients with heart failure managed at a heart failure clinic in Spain between 2006 and 2016. Patients were stratified into low polypharmacy (< 5 cardiovascular medications) and high polypharmacy groups (≥ 5 cardiovascular medications). Survival was evaluated using Kaplan-Meier curves, log-rank tests, and a multivariable random forest Cox regression model adjusting for demographic and clinical confounders using propensity scores.</p><p><strong>Results: </strong>There was a significant relationship between the number of medications used and survival (log-rank test, P = 0.017) with the most pronounced risk observed in those with seven or more medications. Additionally, patients in the high polypharmacy group showed significantly reduced survival probabilities than those in the low polypharmacy group (P = 0.016). The top important predictors of survival were age, N-terminal pro B-type natriuretic peptide, New York Heart Association functional class, heart failure duration, sacubitril-valsartan, β-blockers, and angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (all P < 0.001). Multivariable analysis (C-index = 0.804) showed that high polypharmacy was independently associated with reduced survival (P < 0.001).</p><p><strong>Conclusions: </strong>High polypharmacy is associated with reduced long-term survival in patients with heart failure. This highlights the need for personalized prescribing strategies to minimize the risks associated with polypharmacy while maximizing therapeutic benefits.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149058177","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":"Clevidipine vs. nicardipine in hypertensive crisis: a systematic review and meta-analysis.","authors":"Hassaan Abid, Syed Mohamin Abbas Shah, Amina Zia Rashid, Bisma Tasawar, Rimsha Adnan, Sohana Memon, Gaaitri Lohano, Muhammad Jawad, Muhammad Vazaym, Muhammad Junaid","doi":"10.1186/s12872-026-06345-z","DOIUrl":"10.1186/s12872-026-06345-z","url":null,"abstract":"<p><strong>Background: </strong>Clevidipine and nicardipine are commonly used intravenous calcium channel blockers for the management of hypertensive crises. However, comparative evidence regarding their efficacy and safety remains limited.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis of randomized controlled trials and observational studies comparing intravenous clevidipine and nicardipine in adults with hypertensive crises. The primary outcome was achievement of target blood pressure reduction. Secondary outcomes included medication volume and blood pressure over-reduction. Random-effects models were used, and certainty of evidence was assessed using the GRADE framework.</p><p><strong>Results: </strong>Three studies involving 599 patients were included. Clevidipine and nicardipine demonstrated comparable achievement of target blood pressure reduction (OR 0.96, 95% CI 0.48-1.94; I² = 60%; very low-certainty evidence). Clevidipine was associated with lower odds of blood pressure over-reduction (OR 0.44, 95% CI 0.21-0.93; I² = 0%) and lower medication volume (MD - 258.43 mL, 95% CI - 313.38 to - 203.48 mL; I² = 0%).</p><p><strong>Conclusion: </strong>Clevidipine and nicardipine demonstrated comparable efficacy in achieving target blood pressure reduction in hypertensive crises. Although clevidipine was associated with lower odds of blood pressure over-reduction and lower medication volume, the evidence base was limited and the certainty of evidence for the primary outcome was very low. These findings should be interpreted cautiously and considered hypothesis-generating until confirmed by larger, high-quality randomized controlled trials.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13681746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223224","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":"Neutrophil to high-density lipoprotein cholesterol ratio is positively associated with congestive heart failure among hypertensive adults: a population-based study.","authors":"Kang Huang, Bo Wu, Xin Hong, Shuai-Shuai Zhao, Cheng-Tao Peng, Hai-Chang Xu, Chuan Yuan, Wen-Jing Wang, Qi-Cai Wu, Xue-Liang Zhou","doi":"10.1186/s12872-026-06177-x","DOIUrl":"10.1186/s12872-026-06177-x","url":null,"abstract":"<p><strong>Background: </strong>Congestive heart failure (CHF) continues to pose a substantial global health issue. The neutrophil-to-high-density lipoprotein cholesterol ratio (NHR), a novel biomarker reflecting systemic inflammatory balance, has been linked to cardiovascular outcomes, yet its relationship with CHF in hypertensive individuals is unclear.</p><p><strong>Methods: </strong>A cross-sectional investigation was adopted using data obtained from the National Health and Nutrition Examination Survey (NHANES) spanning the years 1999 to 2018. Weighted multivariate logistic regression was used to evaluate the independent correlation between NHR and CHF. Weighted restricted cubic spline (RCS) curves were applied to explore possible nonlinearities in the overall population and across subgroups. Weighted stratified comparison and interaction tests were executed for robustness. Mediation analysis assessed potential intermediaries. Seven machine learning (ML) models were developed to forecast CHF probability, with performance measured by Receiver Operating Characteristic (ROC) analysis, among others.</p><p><strong>Results: </strong>A total of 19,820 individuals with hypertension were included. Elevated NHR was correlated with higher CHF prevalence. After full adjustment, NHR remained independently associated with CHF (odds ratio [OR] = 1.15, 95% confidence interval [CI]: 1.10-1.21). Individuals in the highest quartile of NHR exhibited a 69% increased prevalence (OR = 1.69, 95% CI: 1.34-2.13) of CHF when benchmarked against the lowest quartile. Weighted subgroup analyses showed consistent associations without significant interactions. Mediation analysis indicated serum albumin mediated 4.18% of the NHR-CHF association. Among ML models, Extreme Gradient Boosting (XGBoost) showed the optimal predictive efficacy [validation set Area Under the Curve (AUC) = 0.781, 95% CI: 0.758-0.803].</p><p><strong>Conclusions: </strong>Among hypertensive adults, NHR was independently associated with CHF prevalence. These findings suggest that NHR may be a relevant inflammatory marker in this population. However, the findings should be interpreted cautiously because of the cross-sectional design and the reliance on self-reported CHF.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13682066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223292","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":"Medication non-adherence among heart failure patients: a multi-hospital, multi-dimensional analytical study in Punjab, Pakistan.","authors":"Muhammad Arshed, Hafsa Arshad, Mehwish Kiran, Hina Lateef, Syed Mehmood Ul Hassan, Syed Muhammad Fauzan Ali, Muhammad Farooq Umer, Javeria Saleem, Ali Hassan Gillani, Ali Jawa, Yu Fang","doi":"10.1186/s12872-026-06142-8","DOIUrl":"10.1186/s12872-026-06142-8","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) has been a significant health problem among the population, with a significant impact on morbidity, mortality, and health care expenditure across the world. In Pakistan, HF-specific non-adherence data are limited, which restricts clinicians to come up with interventions that can be used to address the at-risk population. Accordingly, the newly-conducted study intended to determine the incidence of medication non-adherence and predictors at various levels (sociodemographic, clinical, treatment-related, and behavioral) among heart failure patients.</p><p><strong>Methods: </strong>This survey was a cross-sectional questionnaire survey among 9,377 eligible patients between January 2024 and April 2025 in 20 public and private healthcare facilities across Punjab, Pakistan. The primary outcome was non-adherence to medications assessed through the Self-Efficacy for Appropriate Medication Scale (SEAMS) and self-reported number of pills. Study variables were summarized using descriptive statistics. Chi-square/Fisher's exact test, independent t-test/ANOVA, and a generalized linear model (GLM) with a logit link function (multivariable logistic regression) were employed to assess associations with demographic characteristics. Seaborn and Matplotlib were used to create a heatmap and an odds ratio plot, respectively.</p><p><strong>Results: </strong>Non-adherence to medication is alarmingly prevalent among heart failure (Hf) patients in Punjab, Pakistan (50.1%), and the mean SEAMS score was 31.65 ± 7.69, indicating moderate to high levels of self-efficacy in medication-taking behavior. Socio-demographic predictors including female gender (AOR = 1.415, 95% CI: 1.039 - 1.926), primary and secondary education (AOR = 1.285, 95% CI: 1.074-1.481), monthly income 10,000-25000 (AOR = 1.292, 95% CI: 0.616-0.993), no health insurance (AOR = 1.276, 95% CI: 1.138-1.430) had increased odds of non-adherence. Clinical and health-related predictors such as the presence of comorbidities, especially diabetes (AOR = 1.164, 95% CI: 1.0511.428), and non-hospitalized patients (AOR = 1.236, 95% CI: 1.122-1.362).</p><p><strong>Conclusion: </strong>Non-adherence to medication is extremely common in heart failure patients and depends on various sociodemographic, clinical, and behavioral factors. Specific interventions to deal with these determinants can aid in improving adherence and clinical outcomes.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13679212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219906","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":"Predictive value of the C-reactive protein-triglyceride-glucose index for late atrial fibrillation recurrence after radiofrequency catheter ablation: a retrospective cohort study.","authors":"Su-Yuan He, Ming-Hu Zhao, Yuan Qin, Ju-Gang Chen","doi":"10.1186/s12872-026-06238-1","DOIUrl":"10.1186/s12872-026-06238-1","url":null,"abstract":"<p><strong>Background: </strong>The C-reactive protein-triglyceride-glucose index (CTI) has been reported to be positively associated with cardiovascular disease, stroke, and other adverse outcomes. However, the association between CTI and late atrial fibrillation (AF) recurrence after radiofrequency catheter ablation (RFCA) has not been well established.</p><p><strong>Methods: </strong>A total of 591 patients with AF who underwent RFCA were retrospectively enrolled. CTI was calculated using triglycerides, fasting plasma glucose, and C-reactive protein. The primary endpoint was late AF recurrence during postoperative follow-up. The association between CTI and late AF recurrence after RFCA was assessed using restricted cubic spline (RCS) analysis and univariate and multivariable logistic regression analyses. Receiver operating characteristic curve analysis and the DeLong test were conducted to assess the predictive performance of CTI. Net reclassification improvement (NRI) and integrated discrimination improvement (IDI) were adopted to evaluate its incremental predictive value. The Hosmer-Lemeshow test and Bootstrap-calibrated curves were used to verify model calibration and goodness-of-fit. Subgroup analyses were conducted to examine potential variations in the association between CTI and AF recurrence across subgroups. Subgroup analyses were conducted to examine potential variations in the association between CTI and AF recurrence across subgroups.</p><p><strong>Results: </strong>All patients were followed for 1 year postoperatively, during which 92 cases of AF recurrence were documented. Higher CTI levels were positively associated with an increased risk of AF recurrence. RCS analysis suggested that the nonlinear test did not reach statistical significance (p for non-linear = 0.072), while a trend toward nonlinearity was observed, which may be explained by the limited number of outcome events. After multivariable adjustment, CTI remained independently and positively associated with AF recurrence, with an odds ratio of 6.20 per one-unit increase in CTI (95% CI: 3.56-10.77; p < 0.001). Subgroup and interaction analyses yielded findings consistent with the primary results.</p><p><strong>Conclusions: </strong>CTI was identified as a potentially valuable predictive indicator for late AF recurrence following RFCA.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13628736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547870","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":"Explainable machine learning and unsupervised anatomical phenotyping of mitral valve prolapse in patients with severe mitral regurgitation.","authors":"Pooya Eini, Homa Serpoush, Mohammad Rezayee","doi":"10.1186/s12872-026-06331-5","DOIUrl":"10.1186/s12872-026-06331-5","url":null,"abstract":"<p><strong>Background: </strong>Mitral annular disjunction (MAD) is increasingly recognized in mitral valve prolapse (MVP), but its anatomical embedding within degenerative MVP remains incompletely defined. We assessed whether explainable supervised learning and unsupervised clustering could identify MAD-associated MVP phenotypes.</p><p><strong>Methods: </strong>We analyzed a public surgical cohort of 979 patients with MVP and clinically significant mitral regurgitation. Etiology was classified as Barlow disease (BD) or fibroelastic deficiency (FED). Logistic regression, Random Forest and XGBoost were evaluated for MAD prediction using nested cross-validation with threshold optimization, and assessed for discrimination, calibration and net benefit (decision-curve analysis). XGBoost explainability was assessed using SHAP. UMAP-based clustering using anatomical and clinical variables (excluding MAD and etiology from the input) was performed, with prespecified cluster-number and stability sensitivity analyses.</p><p><strong>Results: </strong>Unsupervised phenotyping identified three anatomical clusters. The smallest cluster (n = 91, 9.3%) showed the highest MAD prevalence (36.3% vs. 12.0% and 15.8%), marked BD enrichment (95.6%), universal bileaflet prolapse and ≥ 4-scallop involvement, larger MV diameters and less chordal rupture; this phenotype was reproducible across UMAP settings. Supervised models showed only moderate MAD discrimination (XGBoost AUROC 0.695 ± 0.057; PR-AUC 0.314 ± 0.066), with modest calibration (Brier 0.13-0.20; slopes < 1) and limited net benefit, and were therefore interpreted as explanatory rather than diagnostic. SHAP identified BD status as the strongest contributor, followed by number of prolapsing scallops, mitral valve diameters, LV volumes and bileaflet prolapse.</p><p><strong>Conclusion: </strong>Explainable and unsupervised analyses concordantly identified a MAD-enriched, BD-dominant bileaflet/multiscallop MVP phenotype, supporting the concept that MAD is embedded within broader annular-leaflet remodeling rather than being an isolated binary abnormality. These findings require prospective, multimodality, outcome-linked external validation before clinical application.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13673719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191456","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 relationship between C-reactive protein-triglyceride-glucose index and incident cardiometabolic multimorbidity in postmenopausal women: insights from the China Health and Retirement Longitudinal Study (CHARLS).","authors":"Liu Wang, Chun Luo, Yanxiao Shao, Xiaohui Xie, Xiaoqin Huang","doi":"10.1186/s12872-026-06150-8","DOIUrl":"10.1186/s12872-026-06150-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Cardiometabolic multimorbidity (CMM), defined as the coexistence of at least two cardiometabolic diseases, is an increasing public health burden. Postmenopausal women may be particularly vulnerable because menopause-related metabolic and inflammatory changes can intensify cardiometabolic risk. However, simple tools for early CMM risk prediction in this population remain limited. The C-reactive protein-triglyceride-glucose index (CTI) integrates inflammatory status and insulin resistance, but its association with incident CMM in postmenopausal women has not been fully evaluated. We therefore investigated the relationship between CTI and new-onset CMM and assessed its predictive performance and potential clinical utility when combined with other clinical variables.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS). The study included 2972 postmenopausal women (aged ≥45 years) without CMM at baseline, with a mean follow-up duration of 103.53 months. The association between CTI and the risk of CMM was assessed using a multivariate Cox regression model. The dose-response relationship was examined through restricted cubic splines (RCS), and the cumulative incidence of CMM across different CTI level groups was compared using the Kaplan-Meier curve. Subgroup and sensitivity analyses, which included repeated validation with the third wave as the baseline, reanalysis after excluding missing values, and stratification by age and menopausal age, were conducted to confirm the robustness of the findings. The predictive performance and incremental value of CTI were evaluated using the receiver operating characteristic (ROC) curve, net reclassification improvement index (NRI), and integrated discrimination improvement index (IDI). Additionally, a nomogram was constructed based on variables selected through LASSO regression.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 395 participants (13.3%) developed new-onset CMM during follow-up. Multivariate Cox regression analysis indicated that for each 1-unit increase in CTI, the risk of CMM rose by 95% (HR=1.95, 95%CI: 1.66-2.30). In comparison to the lowest quartile group of CTI, the highest quartile group had a higher risk of CMM (HR=3.91, 95%CI: 2.62-5.82, P for trend &lt;0.001). RCS analysis suggested a positive linear association between CTI and the risk of CMM (P-overall &lt;0.001, P-nonlinear = 0.577). The Kaplan-Meier curve showed a higher cumulative incidence of CMM in the high CTI group (log-rank P &lt;0.001). Subgroup analysis indicated that the association between CTI and CMM was more pronounced in postmenopausal women under 60 years of age (interaction P=0.003). The results of the sensitivity analysis were consistent with those of the primary analysis. The AUC of CTI for predicting CMM was 0.649 (95%CI: 0.621-0.678), higher than that of TyG (0.616), CRP (0.612), FBG (0.638), and TG (0.582). Following the inclusion of CTI,","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219960","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 platelet-related inflammatory burden is associated with delayed early hemodynamic recovery following minimally invasive cardiac surgery.","authors":"Bekir Boğachan Akkaya, Enis Burak Gül, Gizem Işık, Abdülkadir Yılmaz, Mustafa Akdi, Sinan Sabit Kocabeyoğlu, Hayrettin Levent Mavioğlu","doi":"10.1186/s12872-026-06341-3","DOIUrl":"10.1186/s12872-026-06341-3","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive cardiac surgery (MICS) is associated with reduced surgical trauma and improved postoperative recovery; however, early hemodynamic recovery remains variable and may be influenced by patient-related biological factors. This study evaluated the association between preoperative inflammatory biomarkers and delayed early postoperative recovery following MICS.</p><p><strong>Methods: </strong>This retrospective observational study included 166 consecutive patients undergoing thoracotomy-based MICS at a single tertiary center between January 2020 and January 2026. Preoperative inflammatory indices, including platelet-to-lymphocyte ratio (PLR) and systemic immune-inflammation index (SII), were calculated from routine laboratory parameters. The primary endpoint was prolonged postoperative inotropic support (> 24 h); vasopressor-only therapy administered for vasoplegia or isolated blood pressure support was not counted. Multivariable complete-case logistic regression (n = 154), receiver operating characteristic (ROC) analysis, and sensitivity analyses were performed.</p><p><strong>Results: </strong>Prolonged inotropic support was needed in 41 patients (24.7%). Patients requiring prolonged support were older, had a higher prevalence of hypertension, and had longer cardiopulmonary bypass duration in univariable comparisons. LVEF was numerically lower but did not reach conventional statistical significance. PLR and SII were significantly higher in these patients (p = 0.003 and p = 0.010, respectively). In separate adjusted models, both PLR > = 142 and SII > = 462 were associated with prolonged support. In the combined complete-case model including both biomarkers, PLR > = 142 remained independently associated with prolonged support (OR 4.18, 95% CI 1.30-13.40, p = 0.016), whereas SII > = 462 did not (OR 1.66, 95% CI 0.52-5.31, p = 0.391). ROC analysis showed modest discrimination (PLR AUC 0.655, 95% CI 0.564-0.753, p = 0.003; SII AUC 0.634, 95% CI 0.538-0.729, p = 0.010). No significant associations were observed between inflammatory biomarkers and early mortality, acute kidney injury, or postoperative atrial fibrillation.</p><p><strong>Conclusion: </strong>Preoperative platelet-related inflammatory burden, as reflected by PLR, was associated with delayed early postoperative hemodynamic recovery following MICS. However, the discriminatory performance of PLR was modest, and this biomarker should be interpreted as a complementary risk indicator rather than a stand-alone decision-making tool. These findings are exploratory and require prospective validation in independent cohorts.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13679022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219933","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":"Analysis of myocardial work in different obesity phenotypes and its association with epicardial adipose tissue.","authors":"Zhenjiang Wang, Chaodi Tan, Zhuoxin Lyu, Zhuzhi Wen, Tao Wu, Dengfeng Geng, Shaoxin Zheng","doi":"10.1186/s12872-026-06298-3","DOIUrl":"10.1186/s12872-026-06298-3","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate subclinical cardiac dysfunction across distinct obesity phenotypes using myocardial work (MW) indices, and to investigate the moderating role of epicardial adipose tissue (EAT) on MW impairment.</p><p><strong>Methods: </strong>One hundred ninety-two participants were categorized by BMI and metabolic status into four groups: metabolically healthy normal weight (MHNW), metabolically healthy obesity (MHO), metabolically unhealthy normal weight (MUNW), and metabolically unhealthy obesity (MUO). MW indices were measured using speckle-tracking echocardiography. EAT volume was quantified from ECG-gated CT scans. Associations were analyzed using ANCOVA and regression models.</p><p><strong>Results: </strong>Despite no significant differences in left ventricular ejection fraction (LVEF) among the groups, MUNW and MUO individuals exhibited significantly impaired MW, characterized by lower global work index (GWI), global constructive work (GCW), and global work efficiency (GWE), alongside higher global waste work (GWW), compared with MHNW controls. MHO patients showed significantly better MW profiles than MUNW and MUO groups. EAT volume was increased in all obesity phenotype groups. Although no direct association was found between EAT volume and MW indices, EAT volume significantly moderated the relationship between Metabolically Unhealthy (MUH) and both GWE and GWW.</p><p><strong>Conclusions: </strong>MW detects subclinical dysfunction earlier than LVEF across obesity phenotypes, with impairment progressively worsening from MHO to MUNW to MUO. In metabolically unhealthy individuals with increased EAT volume, more pronounced reductions in GWE and elevations in GWW were observed.</p><p><strong>Trial rrgistration: </strong>This study has been registered in the Chinese Clinical Trial Registry under the registration number ChiCTR2500100754 (registration date: April 15, 2025).</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13679159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219992","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}