BMC Cardiovascular Disorders最新文献

{"title":"Summary of the best evidence for the management of kinesiophobia in patients after cardiac surgery.","authors":"Zhi Zeng, Li Wan, Jianying Zheng, Yuqi Shen, Huaili Luo, Mei He","doi":"10.1186/s12872-025-04570-6","DOIUrl":"10.1186/s12872-025-04570-6","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to systematically search for relevant evidence on the management of kinesiophobia in patients after cardiac surgery both home and abroad. The evidence was evaluated and integrated to provide reference for clinical practice.</p><p><strong>Methods: </strong>According to the '6S' evidence pyramid model, evidence related to managing kinesiophobia in patients after cardiac surgery were systematically searched from relevant domestic and foreign guideline websites and professional association websites and databases from the date of their establishment to December 31, 2024. The quality of the literature was evaluated by two master's students who had completed their professional training and assessment at the Evidence-based Nursing Center of Fudan University. These students also extracted and summarised the pertinent evidence that met the literature quality evaluation standards.</p><p><strong>Results: </strong>Sixteen studies were included, including two guidelines, three expert consensus, six systematic reviews, two meta-analyses, and threerandomizedcontrolled trials. A total of 20 pieces of evidence were formed in seven aspects: management principles, exercise guidance, pain management, psychological intervention, health education, social support, and follow-up management.</p><p><strong>Conclusions: </strong>The comprehensive evidence summarised in this study for managing kinesiophobia in patients after cardiac surgery can provide resources for clinical translation. These insights can inform the development of kinesiophobia management plans to support the rapid recovery of patients after major surgery.</p><p><strong>Trial registration: </strong>This study was registered at the Center for Evidence-Based Nursing of Fudan University (registration number ES20245486).</p><p><strong>Clinical trial number: </strong>This study was registered at the Center for Evidence-Based Nursing of Fudan University (registration number ES20245486).This study is a summary of the best evidence and does not involve clinical trials and, therefore, no Clinical trial number.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"127"},"PeriodicalIF":2.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490742","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":"Amiodarone use and prolonged mechanical ventilation after cardiac surgery: a single-center analysis.","authors":"Xin Li, Haitao Zhang, Yuanxi Luo, Jiqing Zhu, Dongjin Wang, Li Xu","doi":"10.1186/s12872-025-04576-0","DOIUrl":"10.1186/s12872-025-04576-0","url":null,"abstract":"<p><strong>Background: </strong>Prolonged mechanical ventilation (PMV) after cardiac surgery increases the risk of complications such as pulmonary atelectasis and ventilator-associated pneumonia. This study aims to investigate the risk factors associated with delayed extubation, including the impact of cardiovascular medication.</p><p><strong>Method: </strong>This retrospective, single-center study analyzed 1,976 patients who underwent open heart surgery at Nanjing Drum Tower Hospital from October 2020 to January 2023. Patients were categorized into early extubation (n = 1071) and delayed extubation (n = 905) groups. Multivariate logistic regression was employed to identify risk factors for delayed extubation. Amiodarone were indicated to be associated with delayed extubation. To further address bias, we derived a propensity score predicting the function of Amiodarone on delayed extubation, and matched 228 cases to 684 controls with similar risk profiles.</p><p><strong>Results: </strong>Multivariate analysis confirmed that hypertension, stroke, amiodarone use, age, LVEF, CPB time, and DHCA were significant predictors of delayed extubation. Postoperative use of amiodarone was significantly associated with delayed extubation (OR:1.753, 95%CI: 1.287-2.395, P < 0.001). PSM analysis further confirmed that patients receiving amiodarone had longer ventilation times, prolonged hospital stays, and higher in-hospital mortality.</p><p><strong>Conclusion: </strong>Postoperative use of amiodarone is a significant predictor of delayed extubation, warranting careful consideration in clinical practice. Further research is needed to clarify the causal relationship between amiodarone use and extubation outcomes.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"129"},"PeriodicalIF":2.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11853816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490726","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 efficiency of endocardial suture occlusion of the left atrial appendage at a single institution: MICs vs. sternotomy.","authors":"Chengfeng Huang, Jiawen Huang, Si Shen, Yongheng Li, Yanlin Zhang, Xiaoshen Zhang, Hua Lu","doi":"10.1186/s12872-025-04540-y","DOIUrl":"10.1186/s12872-025-04540-y","url":null,"abstract":"<p><strong>Background: </strong>Most thrombi originate from the left atrial appendage (LAA), preventing thromboembolic stroke is an important aspect of stroke prevention. Previous studies have found that LAA closure is beneficial for preventing thrombosis. Currently, surgical procedures can achieve LAA closure by closing the endocardium or epicardium. LAA endocardial suture technique is performed concomitantly during sternotomy cardiac surgery but can also be performed during right minimally invasive cardiac surgery (MICS).</p><p><strong>Aims: </strong>This study aims to evaluate the efficacy of left atrial appendage closure (LAAC) with MICS.</p><p><strong>Methods: </strong>A total number of 74 patients who underwent LAAC during valve operation between 2017 and 2021 were retrospectively analyzed in this study. LAA was closed by continuous suture through the endocardium of the left atrium during cardiac surgery. 42 patients performed LAA endocardial suture during MICS, while 32 patients performed with the same LAAC technique during sternotomy. Patients underwent cardiac computed tomography (CT) follow-up after surgery to verify the completeness of the LAAC. The heart structure and function were recorded by echocardiography Transthoracic echocardiography (TTE), and the heart rhythm was recorded by electrocardiogram.</p><p><strong>Results: </strong>The LAA closure procedure was successful in 26 cases (81%) in the sternotomy group and 20 cases (48%) in the right minimally invasive group. Residual shunting (failed LAA closure) was more common in the right minimally invasive group (p = 0.003), and no correlation was found between residual shunting and left atrial (LA), left ventricular end-diastolic diameter (LVDD), and left ventricular ejection fraction (LVEF). The incidence of leaks was not associated with mitral valve replacement or valvuloplasty.</p><p><strong>Conclusions: </strong>Compared to sternotomy, residual shunting after MICS was more common. CT imaging analysis of 22 patients with failed closure in the MICS group showed that residual shunting was mainly concentrated on margins of the suture (anterior superior and posterior inferior) (86%), with a middle area accounting for 3 (14%). Based on this finding, reinforcing the suture margins may significantly reduce the incidence of incomplete closure.</p><p><strong>The clinical trial number: </strong>KY-2023-001.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"128"},"PeriodicalIF":2.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490756","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":"Effect of 24-hour heart rate fluctuations on mortality in patients with acute myocardial infarction: based on the MIMIC III database.","authors":"Guihong Zhang, Xiaohe Liu, Yan Zhao, Dan Li, Bo Wu","doi":"10.1186/s12872-025-04575-1","DOIUrl":"10.1186/s12872-025-04575-1","url":null,"abstract":"<p><strong>Background: </strong>Heart rate (HR) was one of the risk factors for cardiovascular disease, but there was insufficient evidence to demonstrate a relationship between heart rate fluctuations and the prognosis of patients with acute myocardial infarction (AMI). The objective of this study is to investigate the relationship between 24-h heart rate fluctuations after admission to the Intensive Care Unit (ICU) and 30-day, 1-year, and 3-year mortality rates in patients with AMI in order to examine its implications for prognosis in AMI patients.</p><p><strong>Methods: </strong>All data were obtained from the Medical Information Mart for Intensive Care III Database (MIMIC III). We calculated heart rate fluctuations using the maximum and minimum values of the patient's heart rate during the first 24 h after ICU admission and divided them into three groups (< 23beats/min, 23-33beats/min, > 33beats/min) according to tertiles. The COX risk regression model was applied to the analysis, and subgroup analyses were performed for use in testing the robustness of the results. Curve fitting was performed to explore whether there was a nonlinear relationship between heart rate fluctuations and mortality. Outcome measures were 30-day, 1-year, and 3-year mortality in patients with AMI.</p><p><strong>Results: </strong>After strict confounding adjustment, COX multifactorial analysis showed that patients' heart rate fluctuations were positively associated with 30-day, 1-year, and 3-year mortality rates (HR = 1.17, 95%CI: 1.11 ~ 1.23; HR = 1.17, 95%CI: 1.12 ~ 1.22; HR = 1.17, 95%CI: 1.12 ~ 1.21). In addition, the high heart rate fluctuation group (> 33 beats/min) had a significantly increased risk of death (HR = 1.76, 95%CI: 1.28 ~ 2.42; HR = 1.59, 95%CI: 1.25 ~ 2.03; HR = 1.43, 95%CI: 1.15 ~ 1.77). In the curve-fitting analysis, a J-shaped curve relationship among heart rate fluctuations and 1- and 3-year mortality was found (p for non-linearity = 0.049; p for non-linearity = 0.004), with an inflection point of 28 beats/min. In subgroup analyses, there was an interaction between heart rate fluctuations and age (P for interaction = 0.041).</p><p><strong>Conclusions: </strong>Heart rate fluctuations within 24 h after ICU admission of AMI patients were associated with 30-day, 1-year, and 3-year mortality, which is a simple and stable predictor of patients' short- and long-term prognosis. Furthermore, 24-h heart rate fluctuations showed a \"J\" curve relationship with 1- and 3-year mortality, with fluctuations of 28 beats/min predicting the best prognosis.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"126"},"PeriodicalIF":2.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472136","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":"Assessing the clinical impact of cardiac intensivists in cardiac intensivecare units: results from the RESCUE registry.","authors":"Dae-Hwan Bae, Sang Yeub Lee, Jang-Whan Bae, Jeong Hoon Yang, Young-Guk Ko, Chul-Min Ahn, Cheol Woong Yu, Woo Jung Chun, Sung Uk Kwon, Hyun-Joong Kim, Bum Sung Kim, Je Sang Kim, Wang Soo Lee, Woo Jin Jang, Jin-Ok Jeong, Sang-Don Park, Seong-Hoon Lim, Sungsoo Cho, Hyeon-Cheol Gwon","doi":"10.1186/s12872-025-04559-1","DOIUrl":"10.1186/s12872-025-04559-1","url":null,"abstract":"<p><strong>Background: </strong>The presence of dedicated intensive care unit (ICU) physicians is associated with reduced ICU mortality. However, the information available on the role of cardiac intensivists in cardiac ICUs (CICUs) is limited. Therefore, we investigated the association of cardiac intensivist-directed care with clinical outcomes in adult patients admitted to the CICU.</p><p><strong>Methods: </strong>In this retrospective study, we extracted data from the SMART-RESCUE registry, a multicenter, retrospective, and prospective registry of patients presenting with cardiogenic shock. Overall, 1,247 patients with CS were enrolled, between January 2014 and December 2018, from 12 tertiary centers in Korea. The patients were categorized into two groups based on the involvement of a cardiac intensivist in their care. The primary outcome was in-hospital mortality rate.</p><p><strong>Results: </strong>The all-cause mortality rate was 33.6%. The in-hospital mortality rate was lower (25.4%) in the cardiac intensivist group than in the non-cardiac intensivist group (40.1%). Cardiac mortality rates were 20.5% and 35.4% in the cardiac intensivist and non-cardiac intensivist groups, respectively. In patients undergoing extracorporeal membrane oxygenation, the mortality rate at centers with cardiac intensivists was 38.0%, whereas that at centers without cardiac intensivists was 62.2%. The dopamine use was lower, norepinephrine use was higher, and vasoactive-inotropic score was lower in the cardiac intensivist group than in the non-cardiac intensivist group.</p><p><strong>Conclusions: </strong>Involvement of a cardiac intensivist in CICU patient care was associated with a reduction in in-hospital mortality rate and the administration of a low dose of vasopressors and inotropes according to the cardiogenic shock guidelines.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"124"},"PeriodicalIF":2.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472140","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 effects of ursodeoxycholic acid on cardiometabolic risk factors: a systematic review and meta-analysis of randomized controlled trials.","authors":"Elaheh Rashidbeygi, Niloufar Rasaei, Mohammad Reza Amini, Marieh Salavatizadeh, Mehdi Mohammadizadeh, Azita Hekmatdoost","doi":"10.1186/s12872-025-04549-3","DOIUrl":"10.1186/s12872-025-04549-3","url":null,"abstract":"<p><strong>Background: </strong>Chronic diseases such as obesity, hypertension, and metabolic syndrome are major health concerns worldwide. Ursodeoxycholic acid (UDCA) is a bile acid that is naturally produced in the liver and has been used for the treatment of various liver disorders. In this systematic review and meta-analysis, we investigated how UDCA might affect inflammation, blood pressure, and obesity.</p><p><strong>Methods: </strong>Five major databases were searched from inception to August 2024. The investigated outcomes included body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α). A random effect was carried out to estimate pooled weighted mean difference (WMD) with 95% confidence intervals (CI). The registration code is CRD42023428064.</p><p><strong>Results: </strong>Of the 7912 articles in the initial search, 12 were included in the systematic review and meta-analysis. UDCA consumption significantly decreased BMI (WMD: -0.29 kg/m², 95% CI: -0.58, -0.01, P = 0.044), and DBP (WMD: -2.16 mmHg, 95% CI: -3.66, -0.66, P = 0.005). It also increased SBP (WMD: 5.50 mmHg, 95% CI: 3.65, 7.35, P < 0.001); however, it was not associated with weight loss (WMD: -0.3 kg, 95% CI: -1.3, 0.71, P = 0.561). Our systematic review showed that UDCA consumption has no effect on IL-6 and TNF-α.</p><p><strong>Conclusion: </strong>This systematic review and meta-analysis suggest that UDCA supplementation may improve BMI and DBP, whereas it may increase SBP and have no effect on weight or inflammation. Further long-term and well-designed RCTs are needed to further assess and confirm these results.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"125"},"PeriodicalIF":2.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472137","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":"Efficacy of sivelestat in alleviating postoperative pulmonary injury in patients with acute aortic dissection undergoing total arch replacement: a retrospective cohort study.","authors":"Zhiyan Mai, Xudong Liu, Weixun Duan, Chen Yang, Yenong Zhou, Tao Chen, Zheng Su, Yang Yang, Jincheng Liu, Zhenxiao Jin","doi":"10.1186/s12872-025-04527-9","DOIUrl":"10.1186/s12872-025-04527-9","url":null,"abstract":"<p><strong>Objective: </strong>Sivelestat may reduce postoperative pulmonary injury after total arch replacement (TAR). This study aimed to evaluate whether the preoperative PaO₂/FiO₂ (P/F) ratio affects the efficacy of sivelestat in reducing postoperative pulmonary injury in patients with acute aortic dissection (AAD) who underwent TAR using deep hypothermic circulatory arrest (DHCA).</p><p><strong>Methods: </strong>Data of patients with AAD who underwent TAR using DHCA in a tertiary hospital between February 1, 2022, and December 30, 2022, were retrospectively reviewed. The patients were divided into the sivelestat and control groups. Three subgroup analyses were performed based on the postoperative P/F ratio. The primary clinical outcomes were assessed to determine the efficacy and safety of sivelestat in managing postoperative pulmonary dysfunction in patients undergoing cardiopulmonary bypass.</p><p><strong>Results: </strong>A total of 187 patients were included, with 95 in the sivelestat group and 92 in the control group. No significant differences were found in the clinical variables between the two groups (all P > 0.05), except for some improvements in the inflammatory biomarker levels (including white blood cell count, neutrophil count, and C-reactive protein). Subgroup analysis revealed that sivelestat treatment significantly increased the P/F ratio on the 4th day and 3rd day after TAR in patients with mild lung injury (P = 0.02) and moderate lung injury (P = 0.03), respectively. Additionally, sivelestat reduced the levels of several postoperative inflammatory biomarkers in both subgroups.</p><p><strong>Conclusions: </strong>Among patients with AAD with mild or moderate preoperative lung injury, defined by a low P/F ratio, sivelestat significantly improved the postoperative P/F ratio and attenuated inflammatory responses after TAR. These findings suggest an important avenue for further research.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"121"},"PeriodicalIF":2.0,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466885","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":"Magnitude and associated factors of atrial fibrillation, and its complications among adult rheumatic heart diseases patients in governmental hospitals in Bahir Dar Town, Northwest Ethiopia 2024.","authors":"Diress Abebe Beyene, Helina Bogale Abayneh, Melese Adane Cheru, Tekalign Markos Chamiso","doi":"10.1186/s12872-025-04562-6","DOIUrl":"10.1186/s12872-025-04562-6","url":null,"abstract":"<p><strong>Introduction: </strong>Atrial fibrillation (AF) is characterized by high frequency stimulation of the atrium, causes dyssynchronous atrial contraction and irregular ventricular excitation. It is the most known cardiac arrhythmia in adults, doubles the risk of stroke five times and is associated with an increasing public health burden. This study was aimed to assess the magnitude and associated factors of atrial fibrillation and its complication among adult rheumatic heart diseases patients in governmental hospitals in Bahir Dar town, Northwest Ethiopia 2024.</p><p><strong>Methods: </strong>An institutional based cross-sectional study design was conducted with a sample size of 421. A simple random sampling technique was used to select participants. The data were entered into the Statistical Package for the Social Sciences (SPSS) version 26 for analysis. Adjusted Odds Ratio (AOR) with a 95% confidence interval was used to determine associated factors of atrial fibrillation. A binary logistic regression model was used, and a P-value < 0.05 in multivariate was considered as a statistically significant.</p><p><strong>Results: </strong>The response rate was 95% and atrial fibrillation was developed in 51.2% of patient. Majority of them were Female (56%). The median age of patients was 41, with an interquartile range (IQR) of 26-51. Age > 50 years old (AOR = 7.20(2.03-25.46)), sever tricuspid regurgitation 4.50(1.18-17.20)), and left ventricular ejection fraction (LVEF) % (AOR = 0.94(0.89-0.99)), left atrium size (AOR = 1.23(1.14-1.33)) were independently associated with atrial fibrillation. For every unit increment of left ventricular ejection fraction in percent, the odds of developing atrial fibrillation decreased by 6%. For every unit increment of left atrial size in millimeter² (mm²), the odds of developing atrial fibrillation increased by 23%. The present study showed that complication related to AF was heart failure (HF) (72.8%), ischemic stroke (34.4%), systemic thromboembolism (12.1).</p><p><strong>Conclusion: </strong>More than half of the study participants were found to have atrial fibrillation in patients with rheumatic heart disease. Being age > 50 years old, left atrium size, severity of tricuspid regurgitation (severe), and LVEF% were associated in developing atrial fibrillation. The atrial fibrillation was linked to an increased risk of ischemic stroke, heart failure, systemic thromboembolism, and death.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"122"},"PeriodicalIF":2.0,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466969","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":"Interacting and joint effects of frailty and inflammation on cardiovascular disease risk and the mediating role of inflammation in middle-aged and elderly populations.","authors":"Zihan Xu, Yingbai Wang, Xiaolin Li, Xuefei Hou, Suru Yue, Jia Wang, Shicai Ye, Jiayuan Wu","doi":"10.1186/s12872-025-04567-1","DOIUrl":"10.1186/s12872-025-04567-1","url":null,"abstract":"<p><strong>Background: </strong>Frailty and inflammation may increase the risk of cardiovascular disease (CVD), but their interacting and joint effects on CVDs remain unclear. To explore the interaction effects of frailty and inflammation on CVDs and the role of inflammation in the relationship between frailty and CVDs to provide better understanding of the underlying pathogenesis of CVD.</p><p><strong>Methods: </strong>A total of 220,608 initially CVD-free participants were recruited from the UK Biobank database and were categorized into non-frailty, pre-frailty, and frailty groups based on Fried's criteria. The participants were also grouped according to the low-grade inflammation (INFLA) score and its components: the neutrophil-lymphocyte ratio, C-reactive protein, white blood cell count, and platelet count. Cox proportional hazards models with hazard ratios (HRs) and 95% confidence intervals (CIs) were used to assess the effects of frailty phenotypes and inflammation on CVD risk. Mediation analysis was used to quantify the role of inflammation in the association between frailty and CVDs. The potential interactions between frailty and inflammation in terms of CVD risk were also evaluated using additive and multiplicative scales.</p><p><strong>Results: </strong>During a median follow-up of 13.3 years, 48,978 participants developed CVDs. After adjusting for various confounders, participants with pre-frailty and frailty had a higher risk of CVDs than those with non-frailty (HRs: 1.20 (95% CI: 1.18-1.23) and 1.80 (95% CI: 1.69-1.91), respectively). A higher risk of CVDs was observed among participants with moderate and high INFLA scores than those with low INFLA scores (HRs: 1.09 (95% CI: 1.07-1.12) and 1.27 (95% CI: 1.24-1.30), respectively). The INFLA score and its components had limited mediating effects in the association between frailty and CVDs. Significant interactions were observed between frailty phenotypes and INFLA scores on CVDs on the multiplicative scale but not on the additive scale.</p><p><strong>Conclusion: </strong>Inflammation may amplify the harmful effect of frailty on the incidence of CVDs. Improving frailty alone might not substantially reduce the risk of CVDs, but effectively controlling inflammation might help to reduce the negative effects of frailty on cardiovascular health.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"118"},"PeriodicalIF":2.0,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466963","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":"Throwing thrombi: noncompaction cardiomyopathy causing renal infarct and catastrophic stroke - a case report.","authors":"Madeeha Javed, Shivani Desai, Nathan DeRon, Miguel Villamil","doi":"10.1186/s12872-024-04439-0","DOIUrl":"10.1186/s12872-024-04439-0","url":null,"abstract":"<p><strong>Background: </strong>Left ventricular noncompaction (LVNC) is a distinct cardiac phenotype characterized by prominent left ventricular trabeculae and deep intertrabecular recesses. It results in thickened myocardium with two layers consisting of non-compacted myocardium and a thin, compacted layer of myocardium. LVNC is a genetic condition associated with various cardiomyopathies, congenital heart disease, and environmental factors.</p><p><strong>Case presentation: </strong>A 60-year-old Afroamerican male with a past medical history of hypertension and chronic kidney disease stage 3a presented to the emergency department (ED) with sudden-onset abdominal pain and associated symptoms of nausea, vomiting, and diarrhea. The patient was provided antiemetics, antihypertensives, and pain control in the ED. An abdominal x-ray showed the small bowel with multiple fluid levels concerning for obstruction. Contrast-enhanced computed tomography of the abdomen showed a wedge-shaped attenuation in the lower pole of the right kidney concerning for infarction but negative for obstruction. There was also a nonocclusive thrombus in the superior mesenteric artery. A transthoracic echocardiogram (TTE) showed a newly reduced left ventricular ejection fraction of 20-25%, moderate dilatation of the left ventricle, and severe global hypokinesis, but did not reveal any thrombus. Cardiology was consulted and recommended a transesophageal echocardiogram (TEE) along with lifelong anticoagulation with apixaban. The TEE revealed a new finding of LVNC without thrombus. The patient underwent a left cardiac catheterization which showed no significant obstructive coronary artery disease. He was discharged on guideline-directed medical therapy (GDMT). Unfortunately, the patient was noncompliant with his GDMT and anticoagulation regimen. He presented approximately six weeks later with right hemiparesis. A repeat TTE showed a large thrombus in the left ventricle. The patient remained aphasic with right hemiparesis without significant recovery before discharge.</p><p><strong>Conclusion: </strong>This case highlights a rare cause of heart failure and catastrophic thromboembolism: noncompaction cardiomyopathy. This case is a prime example and reminder of the potential impact of LVNC on patient morbidity and should encourage medical providers to be conscious of this anomaly and its potential for severe clinical consequences.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"120"},"PeriodicalIF":2.0,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466975","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}