Cardiology最新文献

{"title":"Cardiovascular Outcomes in Diabetic Patients Treated with SGLT2i and GLP1-RA: A Systematic Review and Meta-Analysis.","authors":"Gaetano Marino, Stefania Angela Di Fusco, Alessandro Alonzo, Vito Altamura, Furio Colivicchi","doi":"10.1159/000551686","DOIUrl":"https://doi.org/10.1159/000551686","url":null,"abstract":"<p><p>Introduction Type 2 diabetes mellitus (T2DM) represents a significant public health issue due to its high prevalence and associated complications, particularly the cardiovascular and renal impairments that characterize its natural history. Glucagon-like peptide receptor agonists (GLP1-RA) and sodium-glucose cotransporter-2 inhibitors (SGLT2i) are two new classes of glucose-lowering agents. Large-scale international randomized controlled trials (RCTs) have demonstrated that both GLP1-RA and SGLT2i significantly reduce cardiovascular events in patients with T2DM. This study aims to conduct a systematic review and meta-analysis to evaluate cardiovascular outcomes in diabetic patients treated with GLP1-RA, SGLT2i or their combination. Subgroup analysis were performed for specific populations including older adults and patients with chronic kidney disease (CKD). Methods This meta-analysis was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A systematic search was performed across MEDLINE, WOS (Web of Science), SCOPUS, Embase, PubMed, CENTRAL and clinicaltrials.gov to identify multinational RCTs. The primary cardiovascular outcome was 3P-MACE (3 Point-Major Adverse Cardiovascular Events; nonfatal stroke, nonfatal myocardial infarction and cardiovascular death). Safety outcomes included hypoglycemia, pancreatitis, gastrointestinal disorders and cancer for GLP1-RA; hypoglycemia, ketoacidosis, fractures and genitourinary infections for SGLT2i. Risk of bias was assessed using the Cochrane Risk of Bias tool. Hazard ratio (HR), risk difference (RD) and relative risk (RR) were calculated with a 95% confidence interval using inverse variance-weighted method. A random-effects model was applied to synthesize the effect sizes of the studies assuming inter-study heterogeneity. The protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO; CRD420261306111) Results Seventeen clinical trials met the inclusion criteria; 11 compared GLP1-RA vs placebo and 6 compared SGLT2i vs placebo. Based on the random-effect model, GLP1-RA and SGLT2i significantly reduced 3P-MACE risk with HR of 0.85 (95% CI: [0.80 - 0.90]) and HR 0.87 (95% CI: [0.82 - 0.93]) respectively. No statistically significant differences were observed between combination therapy (GLP1-RA + SGLT2i) vs GLP1-RA monotherapy regarding 3P-MACE (HR 0.76 [0.54 - 1.08] vs HR 0.78 [0.70 - 0.87]; p interaction=0.89) or hospitalization for heart failure (HR 0.58 [0.36 - 0.92] vs HR 0.73 [0.63 - 0.85]; p interaction=0.89). Similarly, combination therapy showed no significant difference compared to SGLT2i monotherapy for 3P-MACE (HR 0.87 [0.66 - 1.15] vs HR 0.89 [0.84 - 0.94]; p interaction=0.87) and heart failure hospitalization (HR 0.82 [0.53 - 1.27] vs HR 0.77 (95% CI: [0.71 - 0.85]; p interaction=0.87). Subgroup analysis revealed that SGLT2i therapy was more effective in reducing 3P-MACE in patient w","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-31"},"PeriodicalIF":1.7,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GLP-1 Receptor Agonist Semaglutide and SGLT2 Inhibitors after Acute Coronary Syndrome in Patients with Diabetes: Real-World Comparative Outcomes from an Observational Registry.","authors":"Ivana Jurin, Karlo Gjuras, Dijana Bešić, Hrvoje Jurin, Jelena Kursar, Tea-Terezija Cvetko, Fran Rode, Tomislav Šipić, Petar Lišnjić, Šime Manola, Kristina Marić Bešić, Jasmina Ćatić","doi":"10.1159/000551964","DOIUrl":"https://doi.org/10.1159/000551964","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with type 2 diabetes (T2D) remain at high cardiovascular risk after acute coronary syndrome (ACS), particularly after myocardial infarction (MI). Evidence on the early post-ACS use of glucagon-like peptide-1 receptor agonists (GLP-1RA), particularly semaglutide, and sodium-glucose cotransporter-2 inhibitors (SGLT2i) is limited.</p><p><strong>Methods: </strong>We analyzed 870 patients in the registry-based T2D cohort discharged after ACS from the single-center CaRD registry (2017-2025). Patients were grouped according to discharge therapy: no GLP-1RA/SGLT2i, GLP-1RA only (semaglutide), SGLT2i only, or combined therapy. Descriptive outcomes included all-cause mortality and a broad registry composite of clinical events. To better address baseline imbalances and unequal group sizes, adjusted Cox models focused on conventional 3-point major adverse cardiovascular events (3P-MACE: cardiovascular death, non-fatal MI, or non-fatal stroke) and included age, sex, ACS type, eGFR, BMI, LVEF, HbA1c, and LDL-C.</p><p><strong>Results: </strong>The median age was 68 years, and 67.5% of participants were male. Discharge therapy included no GLP-1RA/SGLT2i (n = 484), GLP-1RA (n = 35), SGLT2i (n = 277), and combined GLP-1RA+SGLT2i (n = 74), indicating substantial imbalance in subgroup size. During a median follow-up of 37 months, all-cause mortality was highest in the control group (30.2%) and lowest with combined therapy (2.7%), in which no cardiovascular deaths were recorded. However, important baseline differences in BMI, HbA1c, LVEF, age, and socioeconomic characteristics were present across groups. In adjusted 3P-MACE models, adherence to GLP-1RA and/or SGLT2i was associated with lower risk (HR 0.55, 95% CI 0.37-0.82, p = 0.003). When entered separately, SGLT2i remained significant (HR 0.66, 95% CI 0.44-0.99, p = 0.042), whereas GLP-1RA showed a similar direction of association but did not retain statistical significance (HR 0.60, 95% CI 0.28-1.28, p = 0.189).</p><p><strong>Conclusion: </strong>In this single-center observational ACS registry, semaglutide and SGLT2i use were associated with more favorable cardiometabolic profiles and lower event rates after discharge. The apparent benefit of combined therapy should be interpreted cautiously because of small subgroup sizes. These results are hypothesis-generating and support further prospective evaluation of combined cardiometabolic therapy after ACS.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-29"},"PeriodicalIF":1.7,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Potential Role of Palmitoleate as a Risk Factor for Atrial Fibrillation: Findings from a Mendelian Randomization Analysis and a Cross-Sectional Study.","authors":"Guanghong Tao, Xiaoqin Li, Jiacan Wu, Fenglin Qi, Guanglei Chang, Hua Xiao","doi":"10.1159/000550761","DOIUrl":"https://doi.org/10.1159/000550761","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) risk factors are not fully understood. Reportedly, a relationship exists between fatty acid intake and AF occurrence. The relationship between fatty acid levels and AF requires further investigation, which could help to elucidate AF risk factors and provide insights into its primary prevention. We investigated the relationship between serum fatty acids and AF using Mendelian randomization (MR) and Gas chromatography-mass spectrometry (GC-MS).</p><p><strong>Method: </strong>MR was used to investigate the potential effects of fatty acids on AF. Patients hospitalized in the Department of Cardiology between May and June 2024 were enrolled and divided into AF and non-AF groups. Fatty acids were extracted from the serum using the Methanol, n-hexane, methyl tert-butyl ether (MTBE) method and methylated using acetyl chloride. GC-MS analysis was used to separate and quantify these methylated mixtures.</p><p><strong>Results: </strong>Preliminary MR analysis showed that palmitoleic acid and (2 or 3)-decenoic acid are risk factors for AF, while nonadecanoic, oleic, and α/γ-linolenic acids are protective factors. Palmitoleic acid remained a risk factor for AF (OR=1.35, 95% CI=1.19-1.50) after Bonferroni correction, whereas α/γ-linolenic acid remained a protective factor (OR=0.94, 95% CI=0.89-0.98). GC-MS analysis showed that palmitoleic (p=0.028) and stearic (p=0.005) acid levels were significantly higher in the AF group than in the non-AF group. Receiver-operating characteristics curve analysis for palmitoleic acid showed an area under the curve of 0.727, with a sensitivity and specificity of 100% and 50%, respectively.</p><p><strong>Conclusion: </strong>Palmitoleic acid concentrations were higher in these patients. Fatty acids, including palmitoleic acid, may influence this disease.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-19"},"PeriodicalIF":1.7,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147644255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence, Pathophysiologic Mechanisms, and Clinical Outcomes of Tricuspid Regurgitation in the Elderly: Results from the TREY Registry.","authors":"Mohammad Abdelghani, Mahmoud Abdelshafy, Mohamed Muharram, Mohamed Elbadawi, Sheref Mohey, Ahmed M Elnahas, Mohamed Elsoudi, Abdallah Magdy, Bassam Mokhaimar, Ahmed Mohamed Galal, Ahmed Saed, Wael Attia","doi":"10.1159/000551955","DOIUrl":"https://doi.org/10.1159/000551955","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of secondary tricuspid regurgitation (TR) increases with aging. To date, the exact mechanisms and phenotypes of secondary TR in the elderly have not been completely defined. This knowledge would inform patient selection for the evolving transcatheter options.</p><p><strong>Methods: </strong>Consecutive older subjects (≥60-year-old) were enrolled in the prospective Tricuspid Regurgitation in the ElderlY (TREY) Registry (ClinicalTrials.gov ID: NCT05784883). TR severity was determined according to a multiparametric approach, and a detailed analysis of right-heart chambers and tricuspid valve (TV) was systematically conducted. The TH/AD ratio was calculated as TV tenting height divided by diastolic tricuspid annulus diameter.</p><p><strong>Results: </strong>Out of 435 patients (age, 66±6 years; 46% female), 42% had mild and 16% had moderate/severe TR. Even mild TR (as compared with none/trace TR) was associated with TV and right-heart chamber remodeling (including higher tricuspid annulus [TA] diameter, p=0.002; TV leaflet length, p<0.001; right ventricular basal diameter, p=0.001; and right atrial area, p=0.003). On ROC curve analysis, the following criteria of TV remodeling were associated with moderate/severe TR: TA diastolic diameter, TV tenting area, and TV lateral leaflet length (AUC, 0.79[95% CI: 0.73-0.86]; 0.75[95% CI: 0.67-0.82]; and 0.72[95% CI: 0.64-0.79]; respectively). Among those with none (n=181), one (n=138), two (n=43), and all-three criteria (n=29); the frequency of moderate/severe TR was: 5.5%, 18.1%, 25.6%, and 72.4%; respectively. TH/AD ratio could differentiate ventricular (vs. atriogenic) functional TR at a cut-off value of 0.185 (specificity, 100%; sensitivity, 81%; AUC, 0.94[95% CI: 0.88-0.98]); with higher values suggesting a predominant ventricular TR and lower values suggesting an atriogenic mechanism. At a median follow up of 281 days (IQR: 216-614 days), patients with moderate/severe TR had a higher all-cause mortality (41.5%, log rank p=0.035), while the mortality in mild and none/trace TR was not significantly different (21.1% and 17.4%).</p><p><strong>Conclusion: </strong>Significant secondary TR is prevalent among older subjects and is associated with progressive remodeling of right-heart chambers and TV geometry that starts with mild TR, while mortality is increased when TR is ≥moderate. TA dilatation, increased tenting, and leaflet elongation are three major determinants of the development of secondary TR. A novel parameter that integrates leaflet tethering and annular dilatation could differentiate ventricular vs. atriogenic functional TR.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-19"},"PeriodicalIF":1.7,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147644205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Genomic Convergence: Mapping Shared Causal Loci Between Heart Failure and Arrhythmias.","authors":"Zhiheng Xia, Zian Feng, Ang Li, Hao Su","doi":"10.1159/000551373","DOIUrl":"https://doi.org/10.1159/000551373","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) and various arrhythmias frequently co-occur in clinical practice, suggesting shared pathophysiological mechanisms. However, the extent and nature of their common genetic architecture remains incompletely understood. This study aimed to systematically investigate the genetic correlations and shared causal loci between HF-related traits and multiple arrhythmia phenotypes.</p><p><strong>Methods: </strong>We utilized GWAS summary statistics from European cohorts to analyze HF-related traits and ten common arrhythmias. Global genetic correlations were assessed using LDSC and HDL. Local genetic correlations were further investigated using LAVA, HESS, and SUPERGNOVA to identify regional overlaps. Pleiotropic loci were identified using PLACO, with Bayesian colocalization analysis (stringent threshold PP.H4 ≥ 0.75) to assess shared causality. Bidirectional Mendelian randomization (MR) was conducted to explore causal relationships, utilizing a discovery threshold (P < 5×10⁻⁶) and a validation threshold (P < 5×10⁻⁸) with independent FinnGen data.</p><p><strong>Results: </strong>Significant genome-wide genetic correlations were identified between HF and seven arrhythmia traits, with the strongest association for atrial fibrillation (LDSC rg = 0.42, P = 5.1×10⁻¹⁸; HDL rg = 0.63, P = 5.9×10⁻³⁷). Local genetic correlation analyses identified multiple genomic regions of significant overlap, particularly converging on a major hotspot at the 4q25/PITX2/ENPEP locus across all three methods. Pleiotropic analysis identified several high-confidence shared loci, including regions harboring BAG3 (PP.H4 = 0.990) and ZFHX3 (PP.H4 = 0.938). Bidirectional MR revealed significant causal effects of AF on HF development (IVW OR = 1.22, P = 4.83×10⁻¹⁸) and HF on reduced heart rate variability (P = 1.86×10⁻⁴), both validated in independent cohorts.</p><p><strong>Conclusions: </strong>Our findings demonstrate substantial and complex shared genetic architecture between HF and multiple arrhythmia phenotypes. These insights identify specific pleiotropic genes, regional correlation hotspots, and causal pathways, potentially informing future precision medicine approaches for cardiovascular disease prevention and treatment.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-24"},"PeriodicalIF":1.7,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147479872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Utility of Continuous Non-contact Cardiac Function Monitoring via Fiber-Optic Micro-Vibration Sensing System-based Myocardial Performance Index in Heart Failure Patients with Reduced Ejection Fraction.","authors":"Xiaoyan Wu, Jing Zhan, Chenze Li, Xuelei Fu, Chao Zhang, Tao Zhao, Kewei Chen, Michael Katsnelson, Zhengying Li, Zhibing Lu","doi":"10.1159/000551488","DOIUrl":"https://doi.org/10.1159/000551488","url":null,"abstract":"<p><p>Introduction Continuous monitoring of cardiac function may contribute to improving clinical outcomes in heart failure (HF) patients. A fiber-optic micro-vibration sensing system (FO-MVSS) that was previously developed by our group could make possible the non-contact and continuous measurement of the myocardial performance index (MPI) to assess cardiac function. However, the utility of MPI obtained by FO-MVSS (MPIFO-MVSS) in HF patients requires investigation. Methods Utilizing a case-control design, 72 HF patients and 72 control patients matched for age, gender and body mass index were recruited. Both FO-MVSS and echocardiography were used to measure the duration of the various phases of the cardiac cycle, thereby deriving the corresponding MPI. The MPIFO-MVSS of 23 hospitalized patients with HF was continuously monitored to evaluate its predictive value for the improvement of cardiac function. Results The MPIFO-MVSS was in excellent agreement with the MPI obtained by echocardiography (MPIecho) (intra-class correlation coefficient: 0.94, p<0.001). The MPIFO-MVSS exhibited statistically significant correlations with left ventricular ejection fraction (LVEF) (r=-0.78, p<0.001) and N-terminal prohormone brain natriuretic peptide (NT-proBNP) (r=0.66, p<0.001). The MPIFO-MVSS had an excellent performance in discriminating HF patients from control patients, with an area under the curve (AUC) of 0.98 (p<0.001). Moreover, among continuously monitored patients, the change in MPIFO-MVSS was predictive of clinical outcomes (the kappa coefficient: 0.91, p<0.001). Conclusion Our study presents a novel approach to using non-contact MPIFO-MVSS for continuous cardiac function evaluation in patients with HF. The MPIFO-MVSS may serve as an accurate, sensitive, and non-invasive indicator of cardiac dysfunction.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-28"},"PeriodicalIF":1.7,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147467224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive Assessment of Left Ventricular Mass, Its Derived Indices, and Relative Wall Thickness in Ischemic Heart Disease.","authors":"Qiang Zhang, Hui Cai, Jiahao Pan, Yichen Qian, Qingsheng You","doi":"10.1159/000551024","DOIUrl":"10.1159/000551024","url":null,"abstract":"<p><strong>Background: </strong>Ischemic heart disease (IHD) remains a leading cause of global cardiovascular mortality. Left ventricular (LV) remodeling, characterized by changes in LV mass index (LVMI) and relative wall thickness (RWT), is a central pathological process linking myocardial ischemia to adverse clinical outcomes.</p><p><strong>Summary: </strong>This narrative review synthesizes current evidence on the pathophysiological mechanisms, prognostic value, and clinical implications of LVMI and RWT across the IHD spectrum. Convergent findings demonstrate that both LVMI and RWT are robust, independent predictors of adverse cardiovascular events. Among remodeling patterns, concentric hypertrophy (elevated LVMI with elevated RWT) is consistently associated with the highest risk across imaging modalities. These parameters offer incremental prognostic value beyond traditional risk factors, and longitudinal changes provide critical insights into therapeutic response.</p><p><strong>Key messages: </strong>(1) Integrated assessment of LVMI and RWT is essential for accurate risk stratification and personalized management in IHD. (2) Concentric hypertrophy identifies the highest risk phenotype and warrants intensive preventive strategies. (3) Future research should focus on establishing standardized, modality-specific therapeutic thresholds and validating LVMI and RWT as surrogate endpoints in clinical trials.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-12"},"PeriodicalIF":1.7,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147455862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Remote Management in Chronic Heart Failure: A Prospective Cohort Study in Eastern China.","authors":"Yifan Yao, Yucheng Wu, Si Sun, Chuanmeng Zhang, Yin Ren, Hanyue Zhang, Ming Chu, Li Zhu","doi":"10.1159/000551317","DOIUrl":"10.1159/000551317","url":null,"abstract":"<p><strong>Introduction: </strong>In recent years, increasing evidence has highlighted the potential of remote management in cardiovascular diseases, with growing recognition of its feasibility and clinical value supporting its broad future application. This study aimed to investigate the efficacy of remote management for patients with heart failure (HF) in Eastern China.</p><p><strong>Methods: </strong>A single-center, prospective, nonrandomized controlled trial enrolled 433 patients with HF, comprising 52 opting for remote management and 381 receiving usual care. Propensity score matching (1:2) yielded 95 patients (37 intervention and 58 control) for analysis. The intervention comprised a multilevel digital health ecosystem (WeChat mini program and centralized digital health management platform), structured health monitoring (weight, blood pressure, heart rate, and oxygen saturation), and education. The primary outcome includes a composite of cardiovascular mortality and HF-related rehospitalization.</p><p><strong>Results: </strong>The composite primary outcome occurred in 11 (30%) patients receiving intervention and 24 (41%) controls over a maximum 24-month follow-up period. The intervention group demonstrated a statistically significant reduction in the percentage of days lost due to unplanned HF rehospitalization or all-cause death (p = 0.049). Numerically lower rates were observed for HF-related rehospitalization, cardiovascular mortality, and all-cause mortality, along with higher quality of life scores, although with no statistical significance.</p><p><strong>Conclusion: </strong>Remote management demonstrated feasibility and potential clinical benefits, particularly in reducing the cumulative burden of illness. Further, it provides a foundation for integration into primary healthcare systems to optimize resource allocation and improve long-term patient outcomes.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-12"},"PeriodicalIF":1.7,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Value of Existing Prediction Models for Short-Term Outcomes after Percutaneous Intramyocardial Septal Radiofrequency Ablation.","authors":"Jiaqi Yin, Shengjun Ta, Jing Wang, David H Hsi, Bo Shan, Jing Li, Wenxia Li, Rui Hu, Bo Wang, Nan Kang, Lu Yao, Fangqi Ruan, Jiao Liu, Yupeng Han, Xueli Zhao, Liwen Liu","doi":"10.1159/000551275","DOIUrl":"10.1159/000551275","url":null,"abstract":"<p><strong>Introduction: </strong>Percutaneous IntraMyocardial Septal Radiofrequency Ablation (PIMSRA, Liwen procedure) is a novel septal reduction therapy (SRT) for drug-refractory hypertrophic obstructive cardiomyopathy (HOCM) patients. Due to the lack of SRT risk tools, EuroSCORE-II, STS-PROM, and HCM Risk-SCD have been considered as potential alternatives for risk assessment prior to SRT. We aim to evaluate the predictive value of these models for short-term adverse events in HOCM patients undergoing PIMSRA.</p><p><strong>Methods: </strong>A total of 571 HOCM patients treated with PIMSRA in Xijing Hospital from October 2016 to June 2024 were retrospectively enrolled and their risk scores were calculated. The primary outcome was the 30-day incidence of major adverse cardiovascular events (MACEs), including a composite of all-cause death, cardiac tamponade, arrhythmic events, cardiogenic shock, and stroke.</p><p><strong>Results: </strong>During the 30-day follow-up, 61 (10.7%) patients experienced MACE. Multivariate analysis revealed that EuroSCORE-II (OR = 2.30), STS-PROM (OR = 1.18), history of syncope, and peak left ventricular outflow tract (LVOT) gradient were independently associated with MACE risk after PIMSRA. The area under the receiver operating-characteristic curve values were 0.657 (95% CI: 0.581-0.733) for EuroSCORE-II, 0.623 (95% CI: 0.551-0.696) for STS-PROM, and 0.550 (95% CI: 0.469-0.631) for HCM Risk-SCD. Calibration metrics for three models were favorable because of the low incidence of MACE. DCA showed limited benefit to using any score.</p><p><strong>Conclusion: </strong>EuroSCORE-II, STS-PROM, history of syncope, and peak LVOT gradient were independently associated with increased risk of 30-day MACE following PIMSRA. Developing SRT-specific risk prediction models is essential for optimizing SRT risk assessment.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-11"},"PeriodicalIF":1.7,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147347325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of No-Touch versus Conventional Saphenous Vein Harvesting in Coronary Artery Bypass Grafting: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Xiaomei Chen, Xuge Zhang, Xiang Xiang, Xiang Fang, Fei Wei, Ying Liu, Shenghong Feng","doi":"10.1159/000551298","DOIUrl":"10.1159/000551298","url":null,"abstract":"<p><strong>Introduction: </strong>Saphenous vein graft (SVG) failure is a key determinant of long-term outcomes after coronary artery bypass grafting (CABG), particularly in individuals with multivessel disease or diabetes. This meta-analysis aimed to evaluate whether the no-touch SVG harvesting technique reduces graft occlusion and improves cardiovascular outcomes compared with the conventional approach.</p><p><strong>Methods: </strong>A comprehensive literature search of PubMed, Embase, Web of Science, and the Cochrane Library was conducted up to May 2025 to identify randomized controlled trials (RCTs) comparing the no-touch and conventional saphenous vein harvesting techniques in CABG. A random-effects model was used for meta-analysis, and the certainty of evidence was evaluated using the GRADE framework.</p><p><strong>Results: </strong>Eight RCTs involving 4,258 CABG patients (no-touch: 2,144; conventional: 2,114) were included. The no-touch technique significantly reduced the risk of vein graft occlusion (risk ratio, 0.59; 95% CI: 0.47-0.73; p < 0.00001; I2 = 31%). Subgroup analyses confirmed the consistency of this effect across regions and follow-up durations. Although differences in secondary outcomes - including all-cause and cardiovascular mortality, myocardial infarction, stroke, and repeat revascularization - were not statistically significant, most effect estimates favored the no-touch approach. The certainty of evidence was rated as moderate for the primary and several secondary outcomes according to the GRADE assessment.</p><p><strong>Conclusion: </strong>This meta-analysis shows that no-touch saphenous vein harvesting is associated with a lower risk of graft occlusion compared with conventional harvesting in CABG. However, current randomized evidence does not demonstrate a definitive improvement in major cardiovascular outcomes. These findings highlight the need to balance angiographic benefits against potential trade-offs and underscore the need for large-scale, event-driven randomized trials to clarify the net clinical benefit of this technique.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-15"},"PeriodicalIF":1.7,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147316135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}