Cardiology最新文献

{"title":"Correlation of Lactate Dehydrogenase Levels with Arrhythmia in Classic Severe Heatstroke.","authors":"Fujing Liu, Jing Shi, Fang Jin, Lingling Zhang, Ludan Yan, Yun Tang, Lijun Liu","doi":"10.1159/000553437","DOIUrl":"10.1159/000553437","url":null,"abstract":"<p><strong>Introduction: </strong>The incidence and risk factors for arrhythmia in patients with classic severe heatstroke remain poorly understood. This study aimed to investigate the relationship between lactate dehydrogenase (LDH) levels and arrhythmia in these patients.</p><p><strong>Methods: </strong>A retrospective multicenter cohort study was conducted across six hospitals involving patients with classic severe heatstroke. LDH levels were transformed using the natural logarithm, and modified Poisson regression was applied to assess the association between Ln(LDH) and arrhythmia. Receiver operating characteristic (ROC) curve analysis evaluated the predictive performance of LDH alone and in combination with the Sequential Organ Failure Assessment (SOFA) score for arrhythmia incidence. Mediation analysis was used to determine if LDH mediated the relationship between temperature and arrhythmia.</p><p><strong>Results: </strong>Among 261 eligible patients, 80 (30.7%) developed arrhythmia during hospitalization. After adjusting for confounders, modified Poisson regression revealed that higher Ln(LDH) was significantly associated with arrhythmia (adjusted relative risk [aRR] = 1.672, 95% CI = 1.162-2.407). ROC analysis demonstrated favorable predictive performance (AUC = 0.721; 95% CI: 0.657-0.785). The combination of LDH and the SOFA score significantly enhanced predictive accuracy (AUC = 0.789; 95% CI: 0.734-0.845). Mediation analysis showed that LDH partially mediated the relationship between temperature and arrhythmia, explaining 30.5% (95% CI: 15.1%-62.0%) of the association.</p><p><strong>Conclusion: </strong>Elevated LDH is significantly linked to an increased risk of arrhythmia in classic severe heatstroke and demonstrates strong predictive value.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-10"},"PeriodicalIF":1.9,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419036","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":"Reply to Letter.","authors":"Richard Z Lin, Rosanna Tavella, Sepehr Shakib, John F Beltrame","doi":"10.1159/000553412","DOIUrl":"10.1159/000553412","url":null,"abstract":"","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-2"},"PeriodicalIF":1.9,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13461108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148381771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aortic Valve Sclerosis: More than an Incidental Echocardiographic Finding.","authors":"Kenneth Caidahl, Sahrai Saeed","doi":"10.1159/000553214","DOIUrl":"10.1159/000553214","url":null,"abstract":"","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-4"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13466437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148367046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can Resting Segmental Strain Identify Obstructive Coronary Artery Disease in Chronic Coronary Syndrome Patients Referred to Coronary Artery Bypass Grafting?","authors":"Assami Rösner, Didrik Kjønås, Marie Leiros Sandberg, Håvard Dalen, Henrik Schirmer","doi":"10.1159/000553322","DOIUrl":"10.1159/000553322","url":null,"abstract":"<p><strong>Introduction: </strong>Noninvasive identification of patients with chronic coronary syndrome (CCS) with obstructive coronary artery disease (CAD) remains a clinical challenge. Strain imaging enables detection of subtle myocardial dysfunction at rest and may serve as a sensitive marker of multivessel or left main CAD. This study aimed to assess whether segmental systolic strain at rest can identify patients with obstructive CAD referred for coronary artery bypass grafting (CABG) and to compare diagnostic performance of tissue Doppler imaging strain with two-dimensional speckle-tracking echocardiography in a retrospective analysis of a selected CABG-referred cohort.</p><p><strong>Methods: </strong>This retrospective study included 61 patients with CCS and obstructive CAD referred for CABG and 61 age- and sex-matched healthy controls from the population-based Nord-Trøndelag Health Study. All participants underwent echocardiography with both tissue Doppler and speckle-tracking strain analysis. The number of hypokinetic segments within one heart was counted, determined at different segmental peak longitudinal strain thresholds of -8% to -16%. The area under curve (AUC) using receiver operating characteristic analysis was used to evaluate diagnostic performance. Late gadolinium enhancement (LGE) cardiac magnetic resonance imaging (MRI) was used to assess myocardial scarring.</p><p><strong>Results: </strong>LGE MRI confirmed that 78% of patients had no visible myocardial scar and that overall scar burden was low (2.8%). At a hypokinetic strain threshold of -8%, tissue Doppler strain demonstrated excellent diagnostic accuracy for identifying myocardial dysfunction in CABG-referred patients (AUC 0.95, 95% confidence interval [CI]: 0.91-1.00), performing at least as well as speckle-tracking strain (AUC: 0.79, 95% CI: 0.70-0.87). Tissue Doppler strain identified obstructive CAD with 95% sensitivity and 86% specificity. Comparable AUCs were found in a subgroup of 20 patients without coronary occlusion or myocardial scarring, indicating that regional hypokinesia was equally detectable in patients with normal EF and no LGE-defined scars.</p><p><strong>Conclusion: </strong>Segmental strain imaging at rest - by both tissue Doppler and speckle tracking - can detect subclinical regional dysfunction in CABG-referred patients with obstructive CAD, even in patients with preserved global left ventricular function and no evidence of myocardial scarring. Tissue Doppler strain showed at least as high diagnostic accuracy as speckle-tracking strain. These findings underscore the clinical potential of resting segmental strain analysis as a sensitive, noninvasive tool for identifying obstructive CAD in this selected CABG-referred population.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-12"},"PeriodicalIF":1.9,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13485286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148350692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality Impact of Stroke and Major Bleeding across the Ejection Fraction Spectrum in Patients Hospitalized for Acute Heart Failure with Prevalent Atrial Fibrillation.","authors":"Jumpei Yamamoto, Keijiro Nakamura, Hiromasa Hayama, Yoshinari Enomoto, Masaya Yamamoto, Hidehiko Hara, Hisao Hara, Yukio Hiroi","doi":"10.1159/000553289","DOIUrl":"10.1159/000553289","url":null,"abstract":"<p><strong>Introduction: </strong>Whether the mortality impact of ischemic stroke and major bleeding differs across left ventricular ejection fraction (LVEF) categories in patients hospitalized for acute heart failure (AHF) with atrial fibrillation (AF) remains uncertain.</p><p><strong>Methods: </strong>We retrospectively analyzed 716 patients hospitalized for AHF with prevalent AF (mean age: 79 ± 11 years; 49% female). During up to 3 years of follow-up (median: 1.4 years), 53 patients developed stroke and 89 developed major bleeding. Time-dependent Cox models were used to evaluate associations between poststroke and post-major bleeding states and all-cause and cardiovascular mortality, stratified by LVEF category: heart failure with reduced ejection fraction, mildly reduced ejection fraction, and preserved ejection fraction.</p><p><strong>Results: </strong>There were 160 deaths, including 106 cardiovascular deaths. As first qualifying events, 34 were stroke-first, and 74 were bleeding-first, with the remaining patients experiencing death-first or being censored. In time-dependent Cox models, post-major bleeding status was associated with higher all-cause mortality, whereas the poststroke association was imprecise (hazard ratio [HR] 2.00, 95% confidence interval [CI] 1.22-3.28 vs. HR 1.35 [95% CI 0.67-2.70]). For cardiovascular death, neither exposure reached conventional statistical significance (HR 1.97 [95% CI 0.93-4.17] after stroke and 1.69 [0.88-3.26] after bleeding). LVEF-stratified estimates were imprecise, and interaction tests did not support definitive effect modification.</p><p><strong>Conclusion: </strong>In patients hospitalized for AHF with prevalent AF, transition into a post-major bleeding state was associated with higher subsequent all-cause mortality, whereas the poststroke association was imprecise. LVEF-stratified findings were exploratory because interaction tests were not significant and event counts were limited. Bleeding-risk mitigation should accompany continued stroke prevention, not replace it.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-11"},"PeriodicalIF":1.9,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148337850","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":"Impact of Inflammatory Disorders on Outcomes in Acute Heart Failure: A Nationwide Analysis.","authors":"Alon L Roguin, Ofer M Kobo, Ohad Stoler, Arieh Fox, Supriya Shore, Edo Y Birati","doi":"10.1159/000552936","DOIUrl":"10.1159/000552936","url":null,"abstract":"<p><strong>Introduction: </strong>Acute heart failure (AHF) is characterized by rapid symptom deterioration and high mortality. This study evaluates how eight inflammatory disorders, driven by systemic inflammation, immune dysfunction, and antirheumatic cardiotoxicity, impact in-hospital mortality, complications, and length of stay during AHF admissions.</p><p><strong>Methods: </strong>We included patients hospitalized with AHF between 2015 and 18 from the National Inpatient Sample (NIS). The population was compared based on inflammatory disease status. The primary endpoint was in-hospital mortality, with additional endpoints: length of stay and in-hospital complications.</p><p><strong>Results: </strong>A total of 1,042,218 AHF admissions were included in our analysis, of whom 39,485 were diagnosed with CID. Patients with CID were older (72 vs. 71 years, p < 0.001) and more likely to be female (67.8% vs. 47.0%, p < 0.001). In the adjusted multivariable model, CIDs as a whole were not associated with increased in-hospital mortality (OR: 1.05, 95% CI: 0.98-1.12, p = 0.183) or MACE (OR: 1.00, 95% CI: 0.97-1.05, p = 0.765). However, disease-specific analysis revealed that SLE (OR: 1.56, 95% CI: 1.33-1.85, p < 0.001) and SSc (OR: 1.47, 95% CI: 1.14-1.89, p = 0.003) were independently associated with significantly higher mortality. Additionally, MCTD (9.06 days), SSc (6.50 days), and SLE (6.27 days) patients had significantly longer hospitalizations compared to non-CID patients (5.36 days, p < 0.001). Conversely, a significantly lower risk of major bleeding was observed in Ulcerative Colitis (OR: 0.40, 95% CI: 0.24-0.67, p = 0.001), and Sjögren's (OR: 0.43, 95% CI: 0.26-0.72, p = 0.001) cohorts.</p><p><strong>Conclusion: </strong>While CIDs as a whole were not found to impact acute heart failure mortality, specific systemic autoimmune rheumatic diseases, namely SLE and SSc, carry a significantly higher risk for in-hospital death. The substantially longer lengths of stay observed in SLE, SSc, and MCTD patients likely reflect severe multi-organ vulnerability and higher resource intensity rather than isolated acute cardiovascular events. Furthermore, the observed reduction in major bleeding risk among specific subgroups suggests that CIDs should not be managed as a monolithic group. Clinicians should remain aware of disease-specific risks when managing AHF in patients with systemic autoimmune conditions.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-13"},"PeriodicalIF":1.9,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13446872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148327133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors and Clinical Impact of Tricuspid Regurgitation after Pericardiectomy for Constrictive Pericarditis.","authors":"So-Min Lim, Ga Yun Kim, Sung-Ho Jung, Sahmin Lee, Byung Joo Sun, Dae-Hee Kim, Duk-Hyun Kang, Jong-Min Song","doi":"10.1159/000551607","DOIUrl":"10.1159/000551607","url":null,"abstract":"<p><strong>Introduction: </strong>Postoperative progression of tricuspid regurgitation (TR) is an adverse consequence after pericardiectomy in patients with constrictive pericarditis (CP). We aimed to identify predictors, as well as the clinical significance, of TR development following pericardiectomy in CP patients.</p><p><strong>Methods: </strong>A total of 132 CP patients with mild or less TR before pericardiectomy, performed between March 1991 and March 2023, were enrolled. Patients were divided into two groups based on TR severity on pre-discharge echocardiography. Patients who maintained mild or less TR were assigned into the no-TR group, whereas those who showed significant (moderate or greater) TR were assigned into the TR group. The primary endpoint was all-cause death.</p><p><strong>Results: </strong>Among the 132 patients, 110 patients (83.3%) were classified into the no-TR group and 22 patients (16.7%) into the TR group. The median follow-up period was 4.65 years. A low body surface area, presence of diabetes mellitus, large mitral valve (MV) annulus diameter, and left atrial volume index (LAVI) were predictors of significant TR after pericardiectomy. The optimal cutoff values for MV annulus diameter and LAVI were 30.51 mm and 31.65 mL/m2, respectively. All-cause mortality was significantly higher in the TR group than in the no-TR group (hazard ratio 2.26; 95% confidence interval 1.09-4.70; log-rank p = 0.018).</p><p><strong>Conclusion: </strong>An enlarged left atrium is a risk factor for postoperative significant TR resulting in poor survival after pericardiectomy in CP patients. These results may help to identify patients who may benefit from combined tricuspid valve surgery.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-13"},"PeriodicalIF":1.9,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148293435","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":"Time for Holistic Care following Hospital Discharge after Takotsubo Syndrome.","authors":"Birkan Tugrul, Wolfgang Dichtl","doi":"10.1159/000552042","DOIUrl":"https://doi.org/10.1159/000552042","url":null,"abstract":"","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-3"},"PeriodicalIF":1.9,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148283313","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":"Timing Is Everything: From Static to Dynamic Risk Prediction in Cardiogenic Shock.","authors":"Jorge A Ortega-Hernández, Gabriela Rojas-Cruz","doi":"10.1159/000552083","DOIUrl":"https://doi.org/10.1159/000552083","url":null,"abstract":"","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-3"},"PeriodicalIF":1.9,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148283362","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":"Effects of Pharmacologic, Non-Pharmacologic, and Exercise-Based Interventions on Coronary Collateral Circulation: A Scoping Review.","authors":"Shraddha Shah, Lakshman Iyer, Sanjay Ganapathi, Ramachandran Padmakumar, Abraham Samuel Babu, Barry A Franklin","doi":"10.1159/000553146","DOIUrl":"10.1159/000553146","url":null,"abstract":"<p><strong>Introduction: </strong>Coronary collaterals are vascular connections that bridge epicardial arteries and supply blood to the oxygen-deprived myocardium in patients with coronary artery disease (CAD). This comprehensive review aimed to identify and evaluate potential interventions that may enhance the growth of coronary collateral vessels.</p><p><strong>Methods: </strong>We conducted a scoping review of five databases to identify relevant studies that focused on interventions that may promote coronary collateral circulation in patients with CAD.</p><p><strong>Results: </strong>Our search identified 23 studies that met our inclusion criteria. Studies (n = 7) using pharmacologic agents (i.e., angiotensin-converting enzyme inhibitors, granulocyte macrophage colony stimulating factor, statins, human recombinant basic fibroblast growth factor, and granulocyte macrophage colony stimulating factor) were found to improve collateralization, as did the non-pharmacologic studies (n = 13) (i.e., exercise training, electrical stimulation, and enhanced external counterpulsation), which formed most of the studies. Three studies found benefits of a combination of exercise and heparin. Improvements were seen in collateralization as measured by the coronary flow index and Rentrop scores across all interventions. Effect sizes from randomized trials with pharmacologic, non-pharmacologic, and exercise-based interventions ranged between 0.4 and 0.7.</p><p><strong>Conclusion: </strong>This review provides a comprehensive overview and update of the existing literature on interventions that may promote coronary collateralization (CC). In summary, we observed a few pharmacological and non-pharmacological (exercise, electrical stimulation, and enhanced external counterpulsation) interventions that have shown a positive effect on CC. These data provide a framework for more robust trials regarding the proliferation and clinical significance of enhanced CC in cardiovascular outcomes in patients with known or occult CAD.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-18"},"PeriodicalIF":1.9,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13441269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148283341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}