Cardiovascular Therapeutics最新文献

{"title":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":9582,"journal":{"name":"Cardiovascular Therapeutics","volume":"2026 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148085414","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":"Association of Initial Laxative Strategy With Clinical Outcomes in Critically Ill Patients With Acute Myocardial Infarction: A Retrospective Cohort Study","authors":"Bingfu Wang,&nbsp;Yulong Song,&nbsp;Yujian Fan,&nbsp;Zhiqiang Zhao","doi":"10.1155/cdr/1649836","DOIUrl":"10.1155/cdr/1649836","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Although laxatives are commonly used for constipation in critically ill patients with acute myocardial infarction (AMI), the optimal initial choice is unclear. We are aimed at comparing the clinical outcomes of initiating therapy with stimulant, stool softener, and osmotic laxatives.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study analyzed ICU patients with AMI from the MIMIC-IV database, comparing three initial laxative strategies using propensity score matching (PSM). The primary outcome was 28-day mortality. Secondary outcomes included ICU, in-hospital, and 365-day mortality; cardiogenic shock; malignant arrhythmia; delirium; and bowel sound recovery. Findings were validated with inverse probability of treatment weighting (IPTW) and subgroup analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the 1:1:1 PSM cohort of 1887 patients, stool softeners were associated with significantly lower mortality versus stimulants: in-hospital (adjusted OR = 0.39, 95% CI 0.22–0.69, p = 0.001), 28-day (aHR = 0.55, 95% CI 0.40–0.76, p &lt; 0.001), and 365-day (aHR = 0.57, 95% CI 0.45–0.72, p &lt; 0.001). Osmotic laxatives correlated with lower in-hospital (aOR = 0.52, 95% CI 0.30–0.89, p = 0.017) and 28-day (aHR = 0.72, 95% CI 0.55–0.95, p = 0.019) mortality, but not 365-day compared with stimulant laxatives. Both agents were linked to lower delirium risk and better bowel sound recovery. IPTW sensitivity analyses showed consistent results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Among ICU-admitted AMI patients, the initial use of stool softeners or osmotic laxatives was associated with a lower risk of short-term mortality compared with stimulant laxatives. These findings indicate that a more robust and gentle laxative management strategy may have potential clinical value for this high-risk population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9582,"journal":{"name":"Cardiovascular Therapeutics","volume":"2026 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13069469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147653880","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":"The Association Between Sedentary Behavior and Cardiovascular Disease Risk: An Analysis Based on NHANES Data","authors":"Heming Huang,&nbsp;Zhe Zhao,&nbsp;Zemou Yu,&nbsp;Fan Feng,&nbsp;Zaifeng Zhang,&nbsp;Bingge Fan,&nbsp;Ling-bing Meng","doi":"10.1155/cdr/6940329","DOIUrl":"10.1155/cdr/6940329","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Sedentary behavior has become a major global public health challenge and is closely associated with cardiovascular disease (CVD). Sedentary behavior not only increases the risk of various chronic diseases but also poses significant threats to cardiovascular health. Existing studies suggest that sedentary behavior is an independent risk factor for CVD, but the underlying mechanisms across different populations remain inadequately explored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study analyzed data from 31,034 participants in the National Health and Nutrition Examination Survey (NHANES) to investigate the relationship between sedentary behavior and CVD. Standardized questionnaires were used to collect sociodemographic and health information. Statistical analyses, including weighted t-tests, forest plots, logistic regression, and restricted cubic spline regression, were employed to examine the effects of sedentary time on CVD and related influencing factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The findings indicated that prolonged sedentary time was significantly associated with an increased risk of CVD, particularly among individuals aged 60 and older (OR = 17.297, <i>p</i> &lt; 0.001) Factors such as age, gender, and hyperlipidemia played a critical role in the relationship between sedentary behavior and CVD. Restricted cubic spline regression analysis revealed that CVD risk increased markedly after 250 min of sedentary time, with a pronounced rise after 750 min. Multivariate regression analysis also confirmed the negative impact of sedentary behavior on cardiovascular health.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Sedentary behavior is a significant independent risk factor for CVD, and reducing sedentary time is associated with a lower CVD risk. Enhancing public awareness of the hazards of sedentary behavior and implementing effective interventions, especially for the elderly, may contribute to improved cardiovascular health.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9582,"journal":{"name":"Cardiovascular Therapeutics","volume":"2026 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147621799","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":"Effect of Statin Use on Mortality in Individuals With Cardiovascular–Kidney–Metabolic Syndrome: A Retrospective Propensity Score-Matched Cohort Study","authors":"Cheng Yuan,&nbsp;Yuguo Ge,&nbsp;Wenqi Ge,&nbsp;Huaxue Wang,&nbsp;Ximing Deng,&nbsp;Jinmeng Chen,&nbsp;Kaixuan Niu,&nbsp;Jinhui Xiong,&nbsp;Yang Xu,&nbsp;Kun Lu","doi":"10.1155/cdr/7480081","DOIUrl":"10.1155/cdr/7480081","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The present study is aimed at investigating the effects of statins on all-cause and cardiovascular mortalities in individuals with cardiovascular–kidney–metabolic syndrome (CKMS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using data from the National Health and Nutrition Examination Survey (NHANES) 1999–2018, we identified individuals with CKMS and categorized them into statin-treated and untreated groups based on statin exposure. A propensity score matching (PSM) model was applied to balance baseline characteristics between the two groups. All-cause and cardiovascular mortalities were then assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 19087 individuals with CKMS were enrolled, yielding 4762 matched individuals. Compared with the statin-untreated group, statin therapy was associated with significant mortality benefits in CKMS individuals, demonstrating a 27% reduction in all-cause mortality (HR 0.73, 95% CI 0.65–0.82) and a 26% decrease in cardiovascular mortality (HR 0.74, 95% CI 0.61–0.90). Stratified analyses by CKMS stage showed no significant interaction between disease stage and statin use for either all-cause (<i>p</i> for interaction = 0.81) or cardiovascular mortality (<i>p</i> for interaction = 0.13), although statistically significant inverse associations were primarily observed in individuals with advanced CKMS stages. Analyses by statin type indicated that atorvastatin and simvastatin were associated with reduced risks of both all-cause and cardiovascular mortalities, whereas rosuvastatin was associated with a reduced risk of all-cause mortality only. Exploratory subgroup analyses suggested that the associations were more evident among individuals with intermediate levels of total cholesterol (200–240 mg/dL) and LDL cholesterol (130–160 mg/dL).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this nationally representative cohort, statin use was associated with lower risks of all-cause and cardiovascular mortalities among individuals with CKMS. These findings warrant confirmation in prospective studies with larger sample sizes to further clarify potential heterogeneity across statin type, disease stages, and different lipid profiles.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9582,"journal":{"name":"Cardiovascular Therapeutics","volume":"2026 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/cdr/7480081","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147590238","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":"IL6/IL10/TLR4 Govern Immunogenic Cell Death in Aortic Dissection","authors":"Yukui Du,&nbsp;Dongqing Chang,&nbsp;Bofeng Yu,&nbsp;Li Zhang,&nbsp;Liang He,&nbsp;Fengxia Wang,&nbsp;Shaoyan Chang","doi":"10.1155/cdr/4140685","DOIUrl":"10.1155/cdr/4140685","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Aortic dissection (AD), a life-threatening cardiovascular emergency, poses a significant threat to global cardiovascular health. Emerging evidence implicates programmed cell death (PCD) as a critical driver of AD pathogenesis, yet the molecular mechanisms remain poorly defined. This study systematically investigates PCD-related biomarkers in AD to identify novel therapeutic targets.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Multiomics analysis integrated transcriptome sequencing data from eight AD and five control aortic tissues. Differentially expressed genes (DEmRNAs, <i>n</i> = 3094) were intersected with 1574 programmed cell death–related genes (PCD-RGs) to identify candidate biomarkers. Protein–protein interaction (PPI) networks, functional enrichment, immune infiltration profiling, and drug-target prediction were employed to characterize key molecular drivers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three PCD-associated biomarkers were identified: IL6 (11.8-fold upregulated), IL10 (26.1-fold upregulated), and TLR4 (0.38-fold downregulated). These biomarkers exhibited significant enrichment in immunoregulatory pathways including “MYC Targets V1” (FDR &lt; 0.05), with IL10 showing strong immune microenvironment correlations (memory B cells: <i>r</i> = 0.62; endothelial cells: <i>r</i> = −0.58). Regulatory network analysis revealed 58 transcription factors (STAT1/SP1/IRF8) and six key miRNAs (e.g., miR-204-5p) orchestrating biomarker expression. Drug-target mapping identified 91 repurposable agents, including etanercept-szzs (dual IL6/IL10 inhibitor) and TLR4-modulating compounds.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study establishes IL6, IL10, and TLR4 as central regulators of PCD-mediated AD pathogenesis, implicating immune–vascular crosstalk and immunogenic cell death as therapeutic entry points. The identified biomarker network and drug candidates provide a translational framework for developing precision therapies against AD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9582,"journal":{"name":"Cardiovascular Therapeutics","volume":"2026 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/cdr/4140685","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147572270","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":"Comparative Outcomes of Fractional Flow Reserve and Intravascular Ultrasound Guidance for Percutaneous Coronary Intervention in Intermediate Lesions: A Systematic Review and Meta-Analysis","authors":"Eyad Jamileh,&nbsp;Zuha Akhtar,&nbsp;Kanita Farooq,&nbsp;Maria Babu,&nbsp;Mohamed Xamza,&nbsp;Ibrahim Antoun","doi":"10.1155/cdr/6570642","DOIUrl":"10.1155/cdr/6570642","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Advanced techniques beyond angiography increasingly guide percutaneous coronary intervention (PCI). Fractional flow reserve (FFR) and intravascular ultrasound (IVUS) are widely used for physiological and anatomical guidance, respectively. This study compares clinical outcomes of FFR versus IVUS-guided PCI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a systematic review and meta-analysis that identified studies comparing FFR- and IVUS-guided PCI. Primary outcomes included major adverse cardiovascular events (MACE), all-cause mortality, cardiac death, nonfatal myocardial infarction (MI) and target vessel revascularisation (TVR). A secondary outcome was the number of PCI procedures performed. Random effects modelling was used for all outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Six studies comprising 5040 patients (FFR: 2517; IVUS: 2523) were included. There were no significant differences between FFR- and IVUS-guided PCI in the incidence of MACE (RR = 1.13, 95% CI 0.89–1.44), all-cause mortality (RR = 0.82, 95% CI 0.41–1.64), cardiac death (RR = 1.05, 95% CI 0.60–1.85), nonfatal MI (RR = 1.35, 95% CI 0.72–2.52) or TVR (RR = 1.21, 95% CI 0.81–1.81). Subgroup analyses by study design (observational studies and randomised control trials) showed no significant effect modification for any outcome. There was no significant difference in the number of PCI procedures performed (RR = 0.78, 95% CI 0.59–1.02), although heterogeneity was high (<i>I</i>² = 95<i>%</i>).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>FFR and IVUS are both effective for guiding PCI, with similar outcomes in terms of MACE, mortality, MI, TVR and PCI procedures performed. Modality selection should be tailored to lesion complexity, institutional expertise and resource availability.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9582,"journal":{"name":"Cardiovascular Therapeutics","volume":"2026 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/cdr/6570642","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147519856","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":"Ginsenoside Rb1 Mitigates Myocardial Fibrosis Through Inhibiting Exosomal-Derived miRNA-21–Associated Inflammation and Cardiac Signaling","authors":"Shihua Wang,&nbsp;Weifeng Chi,&nbsp;Yinghong Lu,&nbsp;Guangyu Yu,&nbsp;Jie Li,&nbsp;Yingying Nie,&nbsp;Jingxiang Zhou,&nbsp;Yanjie Song,&nbsp;Wenyan Ji","doi":"10.1155/cdr/8873721","DOIUrl":"10.1155/cdr/8873721","url":null,"abstract":"<p>Myocardial fibrosis exemplifies a crucial pathological event in the escalation of heart failure. Natural bioactive agents that can modulate and mitigate myocardial fibrosis hold promising potential as key therapeutic and preventive strategies for managing heart failure. In this study, Ginsenoside Rb1 was found to attenuate myocardial fibrosis and suppress inflammatory responses by downregulating exosomal miRNA-24 expression in the experimental mice models. Primary mouse cardiac fibroblasts (pMCFs) were isolated from neonatal C57BL/6J mice for in vitro assays. For the in vivo investigations, adult C57BL/6J mice were utilized to assess the effects of Rb1 and Ang II on exosome-derived inflammatory pathways. Multiple analytical techniques, including qPCR, Western blotting, nanoparticle tracking analysis (NTA), BrdU staining, and ELISA, were employed to evaluate gene expression, protein levels, exosome characterization, cell proliferation, and cytokine secretion. The obtained results showed that Rb1 prevents Ang II–induced cell death and BrdU-positive cells in the pMCFs. Moreover, we have confirmed that the exosomes derived from pMCF cells have a size range of 80–250 nm, with a peak at 149 nm. RBb-1 prevented the Ang II–exposure-stimulated exosomal mRNA and protein expression of cardiac fibrosis markers (COL1a1, COL3a1, ACTA2, and TGF<i>β</i>1) in both pMCFs and mice models. Moreover, Rb1 inhibited the inflammatory expression which was confirmed by ELISA. In addition to that, Rb1 impedes the exosomal mRNA expression of miRNA-21 in the mouse model. This study will open up a new insight into the relationship between Rb1 and miRNA-21, which mitigates myocardial fibrosis in the Ang II–induced mouse model.</p>","PeriodicalId":9582,"journal":{"name":"Cardiovascular Therapeutics","volume":"2026 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/cdr/8873721","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147509603","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":"Oxidative Stress–Related Genome-Wide Mendelian Randomization Identifies Causal Genes for Coronary Artery Disease","authors":"Hongliang Zhang,&nbsp;Jingsheng Feng,&nbsp;Wence Shi,&nbsp;Guannan Niu,&nbsp;Yanqin Zheng,&nbsp;Zhenyan Zhao,&nbsp;Moyang Wang,&nbsp;Zheng Zhou,&nbsp;Zhe Li,&nbsp;Yongjian Wu","doi":"10.1155/cdr/4594769","DOIUrl":"10.1155/cdr/4594769","url":null,"abstract":"<p>Although oxidative stress (OS) links to the pathogenesis of coronary artery disease (CAD), its underlying genetic mechanisms remain unclear. Through summary data–based Mendelian randomization (SMR) and colocalization, this research seeks to assess the potential causal links between OS-related genes and CAD. Summary-level data on the methylation, expression, and protein abundance levels of OS-related genes were obtained from the corresponding quantitative trait loci (QTL) studies. We obtained genome-wide association study summary statistics for CAD from a previous study (discovery), the FinnGen and UK Biobank (replication). Two-sample MR analysis was conducted to verify the associations between key genes expressions and meta-analysis cohort of CAD risk. Mediation analysis was conducted to evaluate the mediating role of gene expression variation in the causal pathway linking methylation levels of key loci to the risk or progression of the disease. We identified 35 methylation loci, 7 genes, and 12 proteins in the discovery cohort. By integrating multiomic data, we identified <i>SMARCA4</i>, <i>NAGLU, SREBF1</i>, <i>RPTOR,</i> and <i>HLA-B</i> as potential causal targets associated with CAD. The two-sample MR analysis once again confirmed that the expressions of the <i>SMARCA4, SREBF1,</i> and <i>HLA-B</i> genes in the meta-analysis cohort showed a significant association with the risk of CAD, and this association was consistent with the direction of the SMR. Furthermore, both the expression and methylation of <i>SMARCA4</i> were positively associated with CAD, and the direct and indirect effects of SMARCA4 methylation were confirmed. In summary, our results identified potential causal associations between <i>SMARCA4</i>, <i>NAGLU, SREBF1</i>, <i>RPTOR, HLA-B</i>, and CAD. The findings highlight the necessity for further exploration into the underlying etiology of CAD.</p>","PeriodicalId":9582,"journal":{"name":"Cardiovascular Therapeutics","volume":"2026 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/cdr/4594769","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147503311","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":"A Novel Intracardiac Echocardiography–Guided Approach for Vein of Marshall Ethanol Infusion in Persistent Atrial Fibrillation Ablation","authors":"Xiang Huang,&nbsp;Xiao-Lan Li,&nbsp;Jin Feng,&nbsp;Wei Zhang,&nbsp;Xiao-Mei Li","doi":"10.1155/cdr/9390824","DOIUrl":"10.1155/cdr/9390824","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The vein of Marshall (VOM) ethanol infusion is an adjunctive strategy for persistent atrial fibrillation (AF) ablation, traditionally guided by VOM venography. However, venography does not allow real-time evaluation of ethanol distribution and carries procedural risks. Intracardiac echocardiography (ICE) provides high-resolution visualization for precise guidance but remains understudied clinically. This study was aimed at evaluating the feasibility, efficacy, and safety of a novel ICE-guided VOM ethanol infusion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective, matched cohort study was conducted including 126 patients (42 ICE-guided, 84 venography-guided) undergoing de novo radiofrequency (RF) catheter ablation for persistent AF. Propensity score matching (1:2) balanced the groups′ baseline characteristics. Procedural endpoints included ethanol-induced low-voltage area (LVA), procedural efficiency (procedure duration and radiation exposure), complications, and 12-month AF/atrial tachycardia (AT) recurrence. ICE-guided procedures utilized real-time monitoring of ethanol-induced tissue changes, whereas venography relied on contrast extravasation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>ICE guidance produced significantly larger ethanol-induced LVAs, shorter total procedure times, reduced fluoroscopy times, shorter VOM ethanol infusion times, shorter mitral isthmus (MI) ablation times, and lower radiation exposure (all <i>p</i> &lt; 0.05). Major complications were rare and similar between groups (<i>p</i> = 0.719). At 12 months, freedom from AF/AT recurrence was comparable between groups (log-rank test, <i>p</i> = 0.66).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>ICE-guided VOM ethanol infusion enhances procedural precision, reduces radiation exposure, and achieves more extensive substrate modification compared with venography. Although clinical recurrence rates were similar, ICE improves workflow efficiency and improves safety by avoiding distal VOM cannulation. These findings support ICE as a transformative tool for optimizing VOM ethanol ablation. Limitations include the nonrandomized design and small sample size, which warrant further validation in randomized trials.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9582,"journal":{"name":"Cardiovascular Therapeutics","volume":"2026 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/cdr/9390824","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147479918","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":"NHANES-Derived Machine Learning Model for Early Identification of Frailty Risk in CKM: Optimizing Resource Allocation Through Predictive Analytics","authors":"Wenlong Ding,&nbsp;Caoyang Fang,&nbsp;Fachao Shi,&nbsp;Lei Fang,&nbsp;Qin Cui,&nbsp;Zheng Wang","doi":"10.1155/cdr/7296443","DOIUrl":"10.1155/cdr/7296443","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>CKM encompasses a complex group of disease states involving cardiovascular, kidney, and metabolic dysfunction. Frailty is a significant health issue among older adults and is closely associated with adverse outcomes. However, there is currently a lack of predictive tools specifically designed for assessing frailty risk in middle-aged and older patients with CKM Stages 0–3.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study is aimed at developing a machine learning model to predict frailty risk in this population and to identify key predictive factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using data from NHANES 2007–2018, a total of 6749 participants aged 40 years and older were included. Feature selection was conducted using LASSO regression, and the cohort was randomly divided into training and testing sets in a ratio of 7:3. Five machine learning models LR, LightGBM, XGBoost, RF, and DT were compared. Model performance was evaluated via 10-fold cross-validation, and the optimal model was selected based on accuracy, AUC, precision, recall, and F1 score. Feature importance was further explored using SHAP values.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 6749 participants, 1427 (21.14%) were identified as frail. LASSO regression identified 21 important variables, which were used to construct the five machine learning models. The RF model achieved the best performance in predicting frailty risk, as demonstrated by its AUC (0.90), accuracy (0.81), precision (0.54), recall (0.84), and F1 score (0.66). Decision curve analysis and calibration plots further confirmed the clinical utility of this approach. SHAP analysis revealed that the most significant predictors were PIR, antihypertensive medication use, hemoglobin, red blood cell count, albumin, and diabetes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The machine learning model developed in this study can effectively predict the risk of frailty in middle-aged and older adults with CKM Stages 0–3, providing a valuable tool for early identification of high-risk individuals in clinical practice. This model may help optimize healthcare resource allocation, guide-targeted interventions, and improve health management for patients with CKM.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9582,"journal":{"name":"Cardiovascular Therapeutics","volume":"2026 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/cdr/7296443","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147479916","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}