Cardiology Research最新文献

{"title":"Hydroxychloroquine Attenuates Atherosclerosis in Apolipoprotein E Knockout Mice: Role of Endothelial Nitric Oxide Synthase and Hypoxia-Inducible Factor 1-Alpha.","authors":"Eirini Poulakida, Maria Ioannou, Dimitrios Sagris, Erietta Polychronopoulou, Peter K Makaritsis, Spiros Georgopoulos, Andrew Xanthopoulos, Evangelos Kouvaras, Kassiani Kapatou, Eftichia Asprodini, Ioannis A Nanas, Athanasios Konstantinidis, George Κ Koukoulis, George Ν Dalekos, Konstantinos P Makaritsis","doi":"10.14740/cr2186","DOIUrl":"https://doi.org/10.14740/cr2186","url":null,"abstract":"<p><strong>Background: </strong>We aimed to test the effect of hydroxychloroquine (HCQ) treatment on atherosclerosis and plasma lipids in apolipoprotein E deficient (ApoE^-/-) mice, defining the aortic expression of endothelial nitric oxide synthase (eNOS) and hypoxia inducible factor-1 alpha (HIF-1α).</p><p><strong>Methods: </strong>Forty-seven (47) mice were divided into two treatment groups: an HCQ group administered 10 mg/kg/day in drinking water for 16 weeks and a control group with no HCQ. All mice were maintained on a standard chow diet containing 5% fat and had free access to water. At 32 weeks of age, blood was drawn for plasma lipid determination and the proximal aorta was removed to measure the atherosclerotic area and evaluate the expression of eNOS and HIF-1α by immunohistochemistry.</p><p><strong>Results: </strong>The HCQ group consisted of 16 mice (10 males, six females), while the control group consisted of 31 mice (17 males, 14 females). HCQ significantly reduced the atherosclerotic area (mm² ± SEM) in treated mice compared to controls, both in males (0.0456 ± 0.0140 vs. 0.1920 ± 0.0284, P < 0.001, respectively) and females (0.0278 ± 0.005 vs. 0.1765 ± 0.025, P = 0.003, respectively). eNOS expression was significantly increased, whereas HIF-1α expression was significantly decreased in the aortas of HCQ-treated male and female mice compared to controls. No significant reduction in plasma cholesterol levels was observed in HCQ-treated mice compared with controls.</p><p><strong>Conclusion: </strong>HCQ reduces aortic atherosclerosis in ApoE^-/- mice, potentially through modulation of eNOS and HIF-1α expression, without exerting a beneficial effect on plasma cholesterol levels.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"17 2","pages":"94-104"},"PeriodicalIF":1.4,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13094136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevention of Cardiovascular Disease and Cancer Through Early Statin Treatment in Advanced Atherosclerosis: An Observational Study.","authors":"Ansgar Adams, Waldemar Bojara, Michel Romanens","doi":"10.14740/cr2196","DOIUrl":"https://doi.org/10.14740/cr2196","url":null,"abstract":"<p><strong>Background: </strong>The extent of atherosclerosis in healthy men and women was measured using ultrasound on the carotid artery, and it was investigated whether early treatment with statins in subjects with advanced atherosclerosis improves the outcome for cardiovascular disease and cancer.</p><p><strong>Method: </strong>From 2009 to 2017, 5,186 subjects (39.1% women) aged 35-65 with no signs of cardiovascular disease underwent ultrasound examination of the carotid artery. The total plaque area (TPA) and maximum plaque thickness were measured.</p><p><strong>Results: </strong>A follow-up was available for 4,340 (83.7%) participants. The mean follow-up period was 87 months (7.3 years) for men and 79 months (6.6 years) for women. Advanced atherosclerosis (type III, IVb) was present in 506 (11.7%) subjects. Statin treatment was initiated in 186 (36.8%) of the subjects. Events (heart attack, ischemic stroke, coronary artery bypass grafting (CABG), percutaneous transluminal coronary angioplasty (PTCA)) occurred in 170 (3.9%) of the 4,340 subjects with follow-up data. Cancer occurred in 71 (1.7%) of the subjects. The event rate for cardiovascular events was 37.6% in men with advanced atherosclerosis without statin therapy vs. 1.6% (P < 0.0001) in those with low-to-moderate plaque burden; for cancer, the rates were 8.6% vs. 1.2% (P < 0.0001). In women with advanced atherosclerosis, the event rate for cardiovascular events without statin therapy was 14.8% vs. 0.2% (P < 0.0001) in those with low-to-moderate plaque burden; and for cancer, the rates were 7.4% vs. 0.9% (P = 0.002). Treatment of male subjects with advanced atherosclerosis (type III, IVb) with a statin significantly improved the prognosis. The event rate for cardiovascular events was 16.1% in men in the treated group vs. 37.6% (P < 0.0001) in the untreated group, and 2.7% vs. 14.8% (P = 0.077) in women. The event rate for cancer was 2% in men in the treated group vs. 8.6% (P = 0.006) in the untreated group. Due to the low number of cases in women, a statistical evaluation did not make sense. Mortality (from any cause) was significantly lower in men treated with statins (P = 0.008).</p><p><strong>Conclusions: </strong>Treatment with statins in subjects with advanced atherosclerosis of the carotid artery (type III, IVb findings on ultrasound) significantly improved the prognosis in a non-randomized observational study.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"17 2","pages":"120-127"},"PeriodicalIF":1.4,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13094155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demographic and Geographic Disparities in Atrial Fibrillation and Cirrhosis Mortality in the United States: A Twenty-Five-Year Analysis From 1999 to 2023.","authors":"Ahmad Jalil, Fatima Rajab, Varshitha Bandi, Bilal Abaid, Karan Bhatt, Adharsh Ravindran, Vijay Chennareddy, Aleena Mujahid, Mahnoor Mehmood, Atif Ibrahim","doi":"10.14740/cr2194","DOIUrl":"https://doi.org/10.14740/cr2194","url":null,"abstract":"<p><strong>Background: </strong>Cirrhosis and atrial fibrillation (AF) are major public health conditions in the United States, each independently associated with substantial morbidity and mortality. Although AF is increasingly recognized in patients with cirrhosis, national mortality trends related to the coexistence of these conditions have not been well characterized.</p><p><strong>Methods: </strong>We conducted a nationwide ecological time-trend analysis using mortality data from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) from 1999 to 2023. Cirrhosis-related conditions and atrial fibrillation or flutter were identified using the International Classification of Diseases, 10th Revision (ICD-10) codes. Age-adjusted mortality rates (AAMRs) per 100,000 population were used and temporal trends were assessed using Joinpoint regression to estimate annual percent change (APC). Analyses were stratified by age, sex, race and ethnicity, geographic region, urban-rural classification, state, and place of death.</p><p><strong>Results: </strong>From 1999 to 2023, the AAMR associated with cirrhosis and AF increased from 0.2 to 1.7, representing more than an eightfold increase, with 39,957 total deaths recorded. Mortality rates were consistently higher in males than females, with a greater long-term increase among males (average annual percent change (AAPC) 9.25%; 95% confidence interval (CI), 8.35-10.25) compared with females (AAPC 8.61%; 95% CI, 6.18-11.14). Adults aged 65 years or older had substantially higher AAMRs than those aged 25-64 years, with significant increases observed after 2010 in both age groups. Hispanic or Latino individuals experienced the largest long-term increase in mortality (AAPC 9.33%; 95% CI, 7.81-10.89), followed by White individuals and Black or African American individuals. Regionally, the steepest increases occurred in the West (AAPC 10.22%; 95% CI, 9.04-11.33), while the Northeast showed the lowest growth. Urban-rural analyses through 2020 demonstrated the most rapid increases in noncore rural areas (AAPC 9.93%; 95% CI, 8.71-11.18).</p><p><strong>Conclusions: </strong>Mortality associated with the coexistence of cirrhosis and AF has increased substantially in the United States over the past 25 years, with accelerating trends and persistent demographic, geographic, and urban-rural disparities. These findings highlight an increasing public health burden requiring targeted surveillance and population level strategies.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"17 2","pages":"105-119"},"PeriodicalIF":1.4,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13094160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating Findings Into Practice: Assessing External Validity of Congestive Heart Failure Trials.","authors":"Lydia Hashemi, Ryan Langerman, Chance Bratten, Adam Khan, Alec Young, Taylor Gardner, Eli Paul, Gershon Koshy, Alicia Ito Ford, Matt Vassar","doi":"10.14740/cr2191","DOIUrl":"https://doi.org/10.14740/cr2191","url":null,"abstract":"<p><strong>Background: </strong>Congestive heart failure (CHF) remains a major global health issue, affecting millions of adults worldwide, contributing to significant hospitalizations and mortality. While randomized controlled trials (RCTs) are essential for improving CHF care, their external validity remains uncertain. This study evaluates the external validity of CHF RCTs published between 2014 and 2024 using the criteria developed by van 't Hooft et al.</p><p><strong>Methods: </strong>A systematic appraisal of CHF RCTs was performed using MEDLINE and Embase on April 1, 2025. Included studies were full-text, English-language, human trials focused on CHF interventions. Trials were assessed with a 13-criterion guideline covering pragmatic principles, context, information gain, feasibility, transparency, value, and patient-centeredness. Two reviewers independently screened and extracted data, resolving discrepancies by consensus. Trial characteristics and predictors of usefulness were analyzed via linear regression and descriptive statistics.</p><p><strong>Results: </strong>Among 659 records screened, 44 met inclusion criteria. Of these, 15.9% demonstrated information gain, 36.4% provided context placement, and 4.5% avoided violations of pragmatic principles. Patient-centeredness was fully addressed in 54.5% of trials and 38.6% demonstrated feasibility. A majority of studies disclosed funding at 77.3% and conflict of interest statements at 68.2%. Transparency and usefulness values showed a modest upward trend over time (r = 0.42, P < 0.05).</p><p><strong>Conclusions: </strong>Although CHF RCTs are the gold standard for evaluating new interventions, many fall short in pragmatism, information value, power analysis, and data transparency. Future trials may benefit from prioritizing pragmatic principles, adequate power calculations, cost analysis, and data sharing.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"17 2","pages":"72-81"},"PeriodicalIF":1.4,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13094183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnesium and Cardiac Arrythmias: An Overlooked Guardian of Electrical Stability.","authors":"Kaiyu Jia, Joaquim Anthony Noguer, Elizabeth R Rimsky, Gauri Shailesh Pikale, Aysan Sattarzadeh, Arun Gajan Pradeep, Omar Khayat, Kashif Ahmad, Dov Vachss, Felicia Zhang, Esther Pearce, Shahkar Khan, Suzanne El-Sayegh","doi":"10.14740/cr2198","DOIUrl":"https://doi.org/10.14740/cr2198","url":null,"abstract":"<p><p>Magnesium is one of the inconspicuous cations involved in multiple systems of the human body. Yet, laboratory evaluation of this ion is not routinely conducted. It plays a crucial role in the cardiac system, and abnormal levels can lead to arrhythmias by disrupting the flow of other ions involved in the cardiac membranes. This review aimed to highlight the common etiologies of hypomagnesemia and the fundamental roles of magnesium in the body with particular attention to the mechanism of action of magnesium related to suppression and termination of cardiac arrhythmias, as well as its crucial roles in the treatment of ventricular arrhythmias and reperfusion injuries after myocardial infarction.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"17 2","pages":"55-60"},"PeriodicalIF":1.4,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13094106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimization and Real-World Implementation of Guideline-Directed Medical Therapy in Heart Failure With Reduced Ejection Fraction: A Contemporary Clinical Review.","authors":"Ehsan Shahverdi, Amin Shahverdi, Carsten Schneider, Mathias Lange, Lars Roman Herda","doi":"10.14740/cr2195","DOIUrl":"https://doi.org/10.14740/cr2195","url":null,"abstract":"<p><p>Heart failure with reduced ejection fraction (HFrEF) remains a major global health burden despite the availability of highly effective disease-modifying therapies. Contemporary guidelines consistently endorse four foundational pillars of guideline-directed medical therapy (GDMT); however, real-world implementation remains incomplete, with delayed initiation, suboptimal sequencing, and low rates of target dose achievement. This review aims to provide a clinically oriented, implementation-focused framework for optimizing GDMT in HFrEF, emphasizing early initiation, practical sequencing strategies, structured up-titration, and phenotype-guided prioritization in routine practice. A narrative synthesis of major randomized clinical trials, contemporary guideline recommendations, and real-world registry data was performed. Evidence was integrated to develop pragmatic strategies for rapid initiation (\"four drugs in 4 weeks\"), safe titration, and overcoming common barriers to implementation. Early and comprehensive initiation of renin-angiotensin system inhibition (preferably with angiotensin receptor-neprilysin inhibitors), evidence-based beta-blockers, mineralocorticoid receptor antagonists, and sodium-glucose cotransporter 2 (SGLT2) inhibitors is associated with rapid and sustained reductions in hospitalization and mortality. Clinical benefits of SGLT2 inhibitors emerge within weeks of initiation, reinforcing the importance of early deployment. Nevertheless, substantial residual risk persists even under quadruple therapy, and real-world data demonstrate persistent underutilization of foundational therapies. Structured follow-up, phenotype-guided prioritization, and protocol-driven titration strategies may facilitate safe and comprehensive implementation. Adjunctive device therapy, timely referral for advanced heart failure evaluation, and integration of cardiac rehabilitation further enhance long-term outcomes. The contemporary challenge in HFrEF management lies not only in identifying effective therapies, but in ensuring their timely and coordinated implementation. An implementation-oriented approach that prioritizes rapid initiation, structured up-titration, and individualized clinical decision-making may help bridge the gap between guideline recommendations and real-world practice.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"17 2","pages":"61-71"},"PeriodicalIF":1.4,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13094103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association Between Cholesterol, High-Density Lipoprotein, and Glucose Index and Mortality in Young and Middle-Aged Adults With Diabetes or Prediabetes: NHANES Data (1999-2018).","authors":"Chuan Bo He, Yong Zeng, Liang Zhang","doi":"10.14740/cr2190","DOIUrl":"https://doi.org/10.14740/cr2190","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the association between cholesterol, high-density lipoprotein, and glucose (CHG) index and mortality among patients with diabetes or prediabetes and to determine whether this association changes with age.</p><p><strong>Methods: </strong>From the National Health and Nutrition Examination Survey (1999-2018), 14,369 patients with diabetes or prediabetes were selected and divided into two age groups: 50 years and younger, and older than 50 years. The Cox proportional hazards models, restricted cubic spline (RCS) models and interaction test were employed to analyze the associations between CHG index and mortality.</p><p><strong>Results: </strong>During a median follow-up of 96 months, 2,741 deaths from all causes and 899 deaths related to cardiovascular issues were recorded. Cox proportional hazards regression analysis found a positive correlation between the CHG index and mortality from all causes, as well as cardiovascular causes. According to the RCS model, there is a U-shaped correlation between the baseline CHG index and mortality, and age significantly interacts with this relationship. The study revealed a significant correlation between increased CHG and a heightened risk of death in people aged 50 years and below.</p><p><strong>Conclusions: </strong>We found that the CHG index is associated with mortality in individuals younger than 50 years, underscoring the critical role of the CHG index in identifying and screening for mortality risk among those with early-onset diabetes.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"17 2","pages":"136-148"},"PeriodicalIF":1.4,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13094157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dementia Is Associated With Higher One-Year Mortality and Worse Patient-Centered Outcomes in Patients Undergoing Percutaneous Coronary Intervention for Acute Myocardial Infarction and Cardiogenic Shock.","authors":"Khanjan B Shah, Lingwei Xiang, Samir K Shah, Rachel R Adler, Joel S Weissman","doi":"10.14740/cr2121","DOIUrl":"https://doi.org/10.14740/cr2121","url":null,"abstract":"<p><strong>Background: </strong>Recent trial data demonstrates improved outcomes for the treatment of ST-segment elevation myocardial infarction (STEMI) and cardiogenic shock (CS) with percutaneous coronary intervention (PCI) supported by mechanical circulatory support (MCS). Clinical outcomes in patients with Alzheimer's disease and related dementias (ADRD), however, remain unknown, as these patients were excluded from relevant trials. Physicians and caregivers struggle to navigate time-sensitive decision making for patients with ADRD presenting with STEMI or CS. The aims of this study were to assess the association of ADRD with outcomes of PCI with MCS in the setting of STEMI or CS.</p><p><strong>Methods: </strong>We compared outcomes among Medicare fee-for-service (FFS) beneficiaries aged 66 years or older, with and without ADRD, who underwent PCI with MCS for STEMI or CS from July 1, 2017 to December 31, 2019. The primary clinical outcome was inpatient mortality, and secondary clinical outcomes were 1-year mortality, complications, and readmissions. Patient-centered outcomes were time-at-home ratio and discharge to a higher level of care.</p><p><strong>Results: </strong>A total of 13,110 patients undergoing PCI with MCS for STEMI or CS met study criteria, and 988 (7.5%) patients carried a diagnosis of ADRD. Patients with ADRD were more likely to be older (81.1 vs. 75.5, P < 0.001) and frail (47.0% vs. 22.0%, P < 0.001). Inpatient mortality was similar between groups (odds ratio (OR), 1.05; 95% confidence interval (CI), 0.92-1.21), but 1-year mortality was higher among patients with ADRD (OR, 1.41; 95% CI, 1.21-1.64). Major complications and readmissions were similar between groups. Patients with ADRD were more likely to be discharged to a higher level of care (OR, 1.46; 95% CI, 1.16-1.82) than those without ADRD but demonstrated a similar time-at-home ratio.</p><p><strong>Conclusions: </strong>Patients with ADRD demonstrate similar rates of inpatient mortality and major complications but have higher rates of 1-year mortality and discharge to higher levels of care.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"17 2","pages":"128-135"},"PeriodicalIF":1.4,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13094130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nuclear Respiratory Factor-1 Ameliorates Heart Failure by Suppressing Cardiomyocyte Pyroptosis-Associated Signaling Via the Downregulation of Gasdermin D and Caspase-1.","authors":"Fei Dong, Cai Xia Zhang, Guang Tao Zhang, Yan Yang, Jun Ling Pan, Jian Xiang Lu, Yin Li Luo, Xia Li","doi":"10.14740/cr2153","DOIUrl":"https://doi.org/10.14740/cr2153","url":null,"abstract":"<p><strong>Background: </strong>Cardiac diseases caused by various factors eventually lead to heart failure (HF) as the condition progresses, during which inflammation and pyroptosis are markedly enhanced. Nuclear respiratory factor-1 (NRF-1) is a transcriptional regulator involved in multiple physiological functions; however, its role in pyroptosis during HF remains unclear.</p><p><strong>Methods: </strong>Serum samples from patients with HF were collected to evaluate the levels of NRF-1. An HF rat model was established to assess the expression of NRF-1 in serum and cardiac tissue and to investigate its association with HF and the expression of inflammatory markers gasdermin D (GSDMD), caspase-1, interleukin (IL)-8, and IL-1β. NRF-1-overexpressing and NRF-1-silenced H9C2 cell lines were constructed, and myocardial injury was induced by hypoxia and doxorubicin (DOX) to evaluate the effects of NRF-1 on pyroptosis-related molecules GSDMD and caspase-1, as well as inflammatory cytokines IL-8 and IL-1β. Finally, the expression of NRF-1 in the serum of HF patients was analyzed based on New York Heart Association (NYHA) functional classification to validate the dynamic changes of NRF-1 during pyroptosis in HF.</p><p><strong>Results: </strong>Although previous studies have reported inconsistent findings regarding serum NRF-1 expression levels among different HF patient cohorts, our current results demonstrate that serum NRF-1 expression is significantly reduced in HF patients compared to those with normal cardiac function (NF), while the expression of pyroptosis-related molecules GSDMD and caspase-1, as well as pro-inflammatory cytokines IL-8 and IL-1β, is markedly increased. These findings were further validated in an HF rat model. <i>In vitro</i> experiments revealed that NRF-1 attenuates hypoxia and DOX-induced pyroptosis in H9C2 cardiomyocytes, highlighting its protective role in the pathogenesis of HF. Finally, serum NRF-1 levels assessed according to NYHA functional classification suggest that the differential expression of NRF-1 observed across samples may be attributed to variations in the stages of HF among patients.</p><p><strong>Conclusions: </strong>NRF-1 is a dynamically expressed molecule with cardioprotective properties that ameliorates HF and attenuates pyroptosis by inhibiting the caspase-1/GSDMD signaling pathway.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"17 2","pages":"82-93"},"PeriodicalIF":1.4,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13094104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of a Prognostic Model to Predict Mortality in Patients With Heart Failure With Mildly Reduced Ejection Fraction After Acute Myocardial Infarction.","authors":"Zhi Can Liu, Ling Ling Zhang, Li Peng, Jian Ping Zeng, Ming Yan Jiang","doi":"10.14740/cr2096","DOIUrl":"https://doi.org/10.14740/cr2096","url":null,"abstract":"<p><strong>Background: </strong>Accurately assessing mortality risk in patients with heart failure with mildly reduced ejection fraction (HFmrEF) after acute myocardial infarction (AMI) remains challenging. This study developed and validated a mortality risk predictive model for such patients.</p><p><strong>Methods: </strong>In this single-center retrospective study of 873 hospitalized patients with HFmrEF after AMI, 611 patients were included in the training cohort and 262 in the validation cohort. The primary outcome was all-cause mortality over an average 33-month follow-up. Least absolute shrinkage and selection operator (LASSO) regression identified predictive variables for post-discharge mortality, with model performance assessed via receiver operating characteristic (ROC) analysis and decision curve analysis (DCA).</p><p><strong>Results: </strong>Six mortality risk predictors were identified: age, stroke history, New York Heart Association (NYHA) classification, hemoglobin (Hb) levels, estimated glomerular filtration rate (eGFR), and primary percutaneous coronary intervention (PPCI) implementation. The C-index for training and validation cohorts was 0.795 (95% confidence interval (CI), 0.758-0.832) and 0.741 (95% CI, 0.672-0.81), respectively. Training cohort area under the curve (AUC) metrics for 6-month, 2-year, and 3-year survival were 0.861, 0.805, and 0.815; for the validation cohort, they were 0.722, 0.742, and 0.736.</p><p><strong>Conclusions: </strong>A validated predictive model assessing mortality risk in HFmrEF patients post-AMI was established. External validation in future studies is recommended.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"17 1","pages":"10-22"},"PeriodicalIF":1.4,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12978395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147442887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}