31 reads in the past 30 days
Pulmonary Valve Stenosis: From Diagnosis to Current Management Techniques and Future ProspectsJune 2023
·
357 Reads
·
13 Citations
Published by Taylor & Francis
Online ISSN: 1178-2048
·
Print ISSN: 1176-6344
31 reads in the past 30 days
Pulmonary Valve Stenosis: From Diagnosis to Current Management Techniques and Future ProspectsJune 2023
·
357 Reads
·
13 Citations
27 reads in the past 30 days
Non-Contrast MRI Sequences for Ischemic Stroke: A Concise Overview for Clinical RadiologistsNovember 2024
·
113 Reads
21 reads in the past 30 days
Functional Compression of the Right Internal Carotid Artery by the Hyoid Bone in a Patient with Moyamoya Syndrome and Low Internal Carotid Artery Bifurcation: A Case ReportMay 2025
·
21 Reads
19 reads in the past 30 days
Inclisiran: A New Strategy for LDL-C Lowering and Prevention of Atherosclerotic Cardiovascular DiseaseJuly 2023
·
523 Reads
·
27 Citations
18 reads in the past 30 days
Exploring Myocardial Infarction Knowledge, Attitudes, and Practice Among Mogadishu’s Somali ResidentsJanuary 2024
·
139 Reads
·
6 Citations
Publishes open access research on vascular health and disease, hypertension, vascular biology, arterial evaluation and cardiovascular risk factors.
For a full list of the subject areas this journal covers, please visit the journal website.
June 2025
·
13 Reads
Objective The aim of this study was to investigate the early and late outcomes of Open Surgical Conversion (OSC) following the failure of Endovascular Aneurysm Sealing (EVAS) endografts, regarding surgical technique, morbidity and mortality. Method and Material A single center retrospective observational cohort of 46 patients undergoing OSC after EVAS failure. Primary endpoints were primary technical procedural success and 30-day mortality. Secondary endpoints were complications and primary prosthesis patency. Results Primary technical procedural success was 97.8% (45/46). Elective 30-day mortality for OSC was 10.9% (5/42) and 75% (3/4) for acute OSC procedures. Median survival after OSC was 4.2 years (IQR 1.0, 4.9 years). Four peri-operative and 17 post-operative complications were registered. Major complications included bleeding, myocardial infraction, acute renal failure and splenectomy. Primary prosthesis patency was 82.6% (38/46) at 30-days. At median follow-up of 4.7 years (IQR 3.9, 5.3 years) 69.6% (32/46) of the patients are still alive with patent vascular prostheses. Conclusion Open surgical conversion achieved acceptable technical success rate for failed EVAS, with better outcomes in elective versus emergency procedures. Enhanced surveillance with timely interventions before rupture and careful patient selection through multidisciplinary evaluation are essential for optimizing surgical outcomes.
June 2025
·
1 Read
Background Despite significant advancements in early reperfusion therapy and pharmacological treatment, which have reduced mortality rates after myocardial infarction in recent decades, the in-hospital mortality rate remains high due to factors such as rapid disease progression, comorbid conditions, and potential complications. We aimed to develop and validate a predictive model for in-hospital mortality in myocardial infarction patients. Methods LASSO regression analysis, univariate analysis, and multivariate logistic analysis were used to construct the nomogram in the training set, followed by model comparison, internal validation, and sensitivity analysis. Results The analysis comprised 4688 patients in total. The population of patients was randomly assigned to the training set (n = 3512) and validation set (n = 1176). According to the results of LASSO regression analysis and other results, our nomogram contained a total of 10 independent variables related to patient death, including age, respiratory rate, blood glucose, lactate, PTT, BUN, cerebrovascular disease, chronic lung disease, mild liver disease, and metastatic solid cancer. Moreover, the web calculator and nomogram performed exceptionally well at predicting in-hospital death in myocardial infarction patients. The AUC for the training and validation sets’ respective prediction models was 0.869 (95% CI: 0.849–0.889) and 0.846 (95% CI: 0.807–0.875) (p<0.01). Compared to the Sequential Organ Failure Assessment (SOFA), the nomogram showed greater discrimination in the training and validation sets, and the calibration plots demonstrated an adequate fit for the nomogram in predicting the risk of in-hospital mortality in both groups. The decision curve analysis (DCA) of the nomogram demonstrated a higher net benefit in the training and validation sets and in terms of clinical usefulness than the SOFA. Conclusion We developed a useful nomogram model and developed a nomogram-based web calculator to predict in-hospital mortality in myocardial infarction patients, which will support doctors in patient counseling and logical diagnosis and therapy.
June 2025
·
2 Reads
Background Higher level of carotid-femoral pulse wave velocity (CF-PWV) is indicating higher level of arterial stiffness. China has a population of 1.4 billion, with 1.2 billion population in Han ethnicity, 9.4 million population in Miao ethnicity, 700 thousand population in She ethnicity. We chose these three ethnic groups for analysis, to find some similarities or differences in CF-PWV. Methods We launched early vascular lesion detection technology promotion involving several regions such as the Han (Beijing), Miao (Guizhou Province), and She (Fujian Province) ethnicity. We conducted population testing in different regions and based on the inclusion and exclusion criteria, 1481 individuals were ultimately included. There were 942 han subjects, 186 Miao subjects and 353 She subjects. The CF-PWV was measured using a Complior device. Results The CF-PWV was significantly higher in Han population than in Miao and She population. Levels of systolic blood pressure (SBP) and diastolic blood pressure (DBP) were significantly lower in Han ethnicity than in Miao and She ethnicity. The composition of male, smoking, hypertension and diabetes mellitus were significantly higher in Han ethnicity than in Miao and She ethnicity. Multiple linear regression analysis showed that age, body mass index (BMI), diabetes mellitus, creatinine, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), SBP, and ethnicity were independent associated with the CF-PWV in all subjects. And compared with the Han ethnicity, CF-PWV was significantly lower in Miao and She ethnicity (β= −0.295, β= −0.241, both p<0.001). Conclusion CF-PWV was significantly higher in Han ethnicity than in Miao and She ethnicity. The factors associated with the CF-PWV differed among different ethnicity indicated that different prevention and control strategies needed to be adopted for different ethnic groups and risk factors in different regions to reduce the progression of arteriosclerosis in the local population.
May 2025
·
2 Reads
Background Follistatin-like 1 (FSTL1) is recently becoming a novel cardiokine essential in cardiac angiogenesis. This cardiokine has shown a potential to promote angiogenesis and improve cardiac function, particularly in myocardial injury and ischemia. Despite the increasing relevance, there is no information on the mechanisms of FSTL1 in cardiac angiogenesis. Objective This systematic review aimed to consolidate recent results on the role of FSTL1 in molecular pathways of cardiac angiogenesis. Methods A comprehensive search was conducted using various databases, including PubMed, Scopus, SpringerLink, and ScienceDirect. Inclusion criteria were primary studies that investigated the role of FSTL1 in promoting cardiac angiogenesis with in vivo models. The risk of bias was assessed using SYRCLE risk of bias tool, and data were synthesized to evaluate the impact of FSTL1 on cardiac angiogenesis. Results A total of 5 animal studies were included during the analysis. The results showed the role of FSTL1 as a novel cardiokine in inducing cardiac angiogenesis as assessed by protein examination and histologic analysis. In pathological conditions, the effects of ischemia on the heart increased the expression of FSTL1 as a form of protection for the heart through angiogenesis and as a marker of the disease severity. Furthermore, the molecular mechanisms of FSTL-induced angiogenesis had different signaling pathways, including activation of AMPK, TGFβ-Smad2/3, Akt/mTOR, Erk1/2, and DIP2A-PI3K. Studies showed increased capillary density and improved blood flow in cardiac tissues where FSTL1 was upregulated, suggesting a possible important role in improving cardiac function. Conclusion FSTL1 showed a promising avenue for therapeutic development. Moreover, future studies should explore its role in cardiac angiogenesis in healthy populations.
May 2025
·
1 Read
Objective This study investigates the relationship between serum γKlotho levels and coronary heart disease (CHD) risk and develops a machine learning model for CHD prediction. Methods A total of 1435 subjects were enrolled for analysis and randomized as training (n = 969, 70%) or validation (n = 466, 30%) group. The training group was used for univariate regression. Thereafter, least absolute shrinkage and selection operator (LASSO) regression was conducted for selecting independent risk factors for CHD. Using independent risk factors for CHD, nine machine learning models were developed, the best model was selected by evaluating them, and the model was validated by decision curve analysis (DCA). Results The factors independently associated with CHD risk were age, the serum level of γKlotho, LDL-C, sex, diabetes, hypertension, and smoking status. We used these risk factors to construct nine popular machine-learning models. Among all models, the RF model was better appropriate; thus, we visualized and validated this model, which showed promising clinical application. Conclusion Serum γKlotho levels are novel biomarker which positively related to CHD risk. Additionally, the RF model can better predict the risk of CHD, and RF model is better appropriate to predicting the CHD risk in clinics.
May 2025
·
13 Reads
Background In recent years, vascular aging has emerged as a hot topic in become an important direction of aging research, but a comprehensive bibliometric analysis has not been conducted. Methods The Web of Science database was searched for articles and reviews on vascular aging from January 1, 2014, to August 20, 2024, and the literature was analyzed and knowledge maps were constructed using CiteSpace, VOSviewer, pajek and Scimago Graphica software for econometric analysis and knowledge graph construction of the literature. Results A total of 38,910 authors from 7622 institutions in 111 countries published 7277 papers in 1344 academic journals, with a significant increase in publication volume. The United States is the country with the highest productivity and citation rates, and Mayo Clinic is the most active institution. Tarantini S published the most papers, while Csiszar A received the most citations. Retina-The Journal of Retinal and Vitreous Diseases journal published the most papers, and Circulation journal received the most citations. The main research aspects include age-related macular degeneration, arteriosclerosis, and oxidative stress, which are the main keywords in this field. In the last decade, the term c reactive protein has attracted great attention with its strongest citation explosion. Conclusion In the past decade, the research focus on vascular aging has been increasing year by year. Age-related macular degeneration, arteriosclerosis, oxidative stress and vascular endothelial cells are the emerging research directions in this field.
May 2025
·
4 Reads
Background Endovenous Laser Ablation (EVLA) is the recommended method for treating varicose veins. It is commonly performed in an inpatient or as day surgery setting under either general or spinal anesthesia. The purpose of this study is to assess the technical efficacy and safety performing outpatient EVLA for varicose veins under local tumescent anesthesia for procedure success, complications, recovery time, and patient satisfaction. Methods A retrospective review of 300 consecutive patients who underwent outpatient EVLA under local tumescent anesthesia from October 2014 to June 2019 was undertaken. Patients 25–55 years diagnosed with symptomatic varicose veins and Great Saphenous Vein (GSV) incompetence were enrolled. Patient demographics, clinical characteristics, procedure duration, complications, and follow-up outcomes were recorded. Results A total of 331 limbs were treated. The mean procedure time was 36 minutes. Five procedures were aborted for technical reasons, resulting in an overall technical success rate of 98%. They were minor complications of bruising (13%) and phlebitis (5%), that were resolved and did not require further intervention. There were no significant complications, including deep vein thrombosis (DVT) or pulmonary embolism (PE). Patients were discharged and resumed normal activities within approximately seven days and were well satisfied. Conclusion EVLA for varicose veins can be performed as an outpatient procedure under local tumescent anesthesia safely and with high technical efficiency. It offers the benefits of shorter recovery times, less risk of complications, and lower health care costs.
May 2025
·
8 Reads
Background The Sarcopenia Index (SI) is a recognized predictor of cardiovascular risk in patients with coronary artery disease (CAD), yet its association with aortic valve sclerosis (AVSc) remains insufficiently studied. This study aimed to examine the relationship between SI and AVSc in CAD patients. Methods In this retrospective study, 1056 CAD patients at Shanghai Ruijin Hospital underwent SI assessment and Doppler echocardiography. SI was calculated as [serum creatinine (mg/dL)/cystatin C (mg/L)] × 100. Logistic regression, subgroup analyses, and restricted cubic splines evaluated the SI-AVSc association. ROC curves determined SI’s diagnostic value and its addition to traditional AVSc factors. In parallel with clinical observations, aortic valve changes were analyzed in mice via hematoxylin and eosin, AlizarinRed S, and Masson’s trichrome to assess valve thickness, fibrosis and calcification. Results Patients with the lowest SI levels showed a higher prevalence of AVSc. Multivariate logistic regression revealed that SI was independently associated with AVSc (P<0.001). The C-statistic for SI in identifying AVSc was 0.708 (95% CI: 0.671, 0.744), and it improved risk stratification when SI was added to traditional clinical models (C-statistic increased from 0.840 to 0.866). In the subgroup analysis, the discriminatory power of SI was enhanced among elderly patients. Findings from animal models supported these results, and Spearman correlation analyses revealed negative correlation between SI and peak systolic aortic valve flow velocity (Spearman’s rho=−0.578, P=0.006). Histological analysis demonstrated that aortic valve leaflets in the low SI group were thicker and more fibrotic than those in the high SI group, and this complementary approach provided mechanistic insights into how sarcopenia may promote valve degeneration in elder mice. Conclusion Lower Sarcopenia Index is associated with the presence of AVSc in CAD patients. SI improves risk stratification and acts as a valuable associated marker for AVSc, emphasizing its potential clinical utility in enhancing patient management.
May 2025
·
21 Reads
Background Functional compression of the internal carotid artery by hyoid bone is a rare but potentially serious condition that can lead to vascular complications, particularly when coexisting with intracranial vascular abnormalities. This case report describes a 48-year-old woman with acute cerebral ischemia due to a combination of functional right internal carotid artery compression by the hyoid bone, low carotid bifurcation, and coexisting Moyamoya syndrome. Case Report In this article, we describe the clinical case of a 48-year-old woman who presented with sudden-onset weakness in her left arm. Imaging studies demonstrated acute ischemia in the territory supplied by the right middle cerebral artery. Further evaluation with computed tomography angiography revealed compression of the right internal carotid artery by the hyoid bone. However, additional imaging studies, including digital subtraction angiography and carotid Doppler ultrasound, did not reveal any signs of internal carotid artery stenosis. This suggested that the compression was functional, occurring only in specific positions of the head or arms. The patient was also newly diagnosed with Moyamoya syndrome, characterized by progressive stenosis of the intracranial vessels. Prompt recognition of these findings enabled timely management, including the initiation of antiplatelet therapy. Conclusion In cases of acute brain ischemia, it is crucial to consider both intracranial and extracranial vascular conditions. This case report underscores the significance of identifying anatomical variations in the relationship between the hyoid bone and the internal carotid artery, as it can lead to arterial compression and potentially trigger acute ischemic strokes, especially in combination with Moyamoya syndrome. Understanding these anatomical nuances is essential for early diagnosis and appropriate management.
May 2025
·
3 Reads
Objective Constructing a predictive model to evaluate the risk of coronary heart disease (CHD) for early identification of patients with CHD risk based on new metabolic indicators. Methods A retrospective analysis was conducted based on NHANES databases. Collect general information, cardiovascular comorbidities, new metabolic indicators (BMI, Triglycerides/Glucose, Waist Circumference-to-Height ratio, Cholesterol/HDL, Triglycerides/HDL, Cardiometabolic index, Neutrophil percentage-to-albumin ratio, etc). The least absolute shrinkage and selection operator (LASSO) regression model and multivariate logistic regression were performed to analyze the risk factors of CHD and develop a CHD risk predictive model using R software. Results A total of 3741 individuals were included and 160 (4.3%) individuals had CHD. According to the results of the LASSO regression model and multivariate logistic regression, 9 factors were related to CHD such as Hypertension (Yes), Cardiometabolic index (≥0.672), Mean arterial pressure (<70 mmHg), Gender (male), COPD (Yes), Age (>69), Neutrophil percentage-to-albumin ratio (≥1.465), Thyroid problem (Yes) and Stroke (Yes), which were developed a CHD risk prediction nomogram. The nomogram presented good discrimination with a C-index value of 0.869 (95% confidence interval: 0.82196–0.91604), AUC (0.868) and good calibration. Based on the maximum point of the Youden index, the individuals with a score greater than 136.5 are at high risk for CHD. Conclusion A risk prediction model for CHD has been developed based on new metabolic indicators in this study and boasts a relatively high accuracy in the early identification of patients with CHD risk. It may help clinicians develop strategies to prevent CHD and improve care quality.
May 2025
·
25 Reads
Purpose Sex differences in the clinical course of coronary artery disease (CAD) particularly in Acute Coronary Syndrome (ACS), have been extensively hypothesized. Although coronary bifurcations account for approximately 20% of ACS cases, data concerning potential sex disparities in the outcomes of percutaneous interventions (PCI) remain scarce. Several data suggest the double kiss (DK) Culotte may provide advantages in bifurcation PCI. Therefore, we evaluate potential sex differences in relation to the Culotte technique. Patients and Methods This study retrospectively analyzes sex disparities following PCI interventions in ACS patients using the DK-Culotte or Culotte technique for bifurcation lesions. The primary endpoint was Target Lesion Failure (TLF), a composite of cardiovascular death, target vessel myocardial infarction, or clinically driven target lesion revascularization (TLR). The secondary endpoint included major adverse cardiac events MACE (myocardial infarction, cardiac death, and target lesion revascularization). Results There were no significant differences between sexes regarding TLF (DK-Culotte: Females 10.3% vs Males 5.7%; p=0.401; Culotte: Females 16.2% vs Males 11.8%; p=0.481) or MACE (DK-Culotte: Females 13.8% vs Males 12.5%; p=0.771; Culotte: Females 24.3% vs Males 17.6%; p=0.370) after a 1-year follow-up for both bifurcation techniques. Conclusion The study found no significant differences in clinical outcomes between sexes following PCI for bifurcation lesions in the ACS cohort, regardless of whether the two-stent techniques (DK- Culotte or Culotte) were used.
May 2025
·
5 Reads
Aim The incidence of heart failure (HF) remains high throughout the world, posing a serious threat to human health, with inflammation being a pivotal factor in the entire pathophysiologic process. Systemic inflammatory response index (SIRI) and systemic immune inflammation index (SII) are novel indicators for poor prognosis of HF. This paper aimed to ascertain the connection between SIRI and mortality in critically ill HF patients and to compare the prognostic value with SII. Methods All data on HF patients were sourced from MIMIC-IV. Cox proportional hazards analysis, restricted cubic spline, and Kaplan-Meier survival analysis were utilized to determine the link between SIRI or SII and in-hospital mortality. Receiver operating characteristic curve, area under the curve (AUC), and Youden index were employed to compare the prognostic value of SIRI and SII. Subgroup analysis was conducted to confirm the predictive capability of SIRI on mortality. Propensity score matching was utilized to reveal the connection between SIRI and secondary outcomes. Results 754 patients were included and 45 patients (6.0%) died. There was a positive link between SIRI and in-hospital mortality in both unadjusted (p < 0.001) and adjusted models (p < 0.001 and p = 0.001, respectively), outperforming SII in all models (p > 0.05 in all models). SIRI had a higher AUC and Youden index than SII, indicating better prognostic power. In addition, hospital stay was shorter in the low SIRI group (p = 0.034). Conclusion SIRI predicts in-hospital mortality in critically ill HF patients, and the prognostic power is superior to SII.
April 2025
·
22 Reads
Dyslipidemia is a condition characterized by excessive lipids in the blood plasma, including triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and decreased levels of high-density lipoprotein cholesterol (HDL-C), which is generated mostly due to obesity. This study aims to summarize research conducted on rats and humans regarding the potential of eight fruits in reducing dyslipidemia and their associated health benefits (eg, reduction of free radicals, hypoglycemic effects, weight reduction, lowering of blood pressure, and anti-inflammatory properties). The studied fruits include pomegranate, star fruit, Rosa roxburghii, pineapple, tree tomato, coffee, apple, and passion fruit. Various parts of these fruits, such as the root, leaves, stem, peel, and pulp, were analyzed for their effects. These fruits are edible, widely available, and cost-effective when purchased during the harvest season (Graphical abstract).
April 2025
·
2 Reads
·
1 Citation
Purpose This study aimed to investigate the current practices of VTE prophylaxis in patients undergoing abdominal-pelvic surgery (PAS) and to identify the factors that influence surgeons’ practice of VTE prophylaxis. Patients and Methods This two-phase explanatory sequential mixed-method study used chart audits followed by semi-structured interviews based on the theoretical domain framework (TDF). During Phase I, quantitative data from 240 medical records of patients with PAS in April 2023 were audited to measure adherence rates to the standard thromboprophylaxis guidelines. In Phase II, in-depth interviews with 16 surgeons were conducted and analyzed using thematic content analysis based on the TDF framework to understand the determinants of thromboprophylaxis in patients with PAS. Results Audits of 240 medical records of patients showed the rate of appropriate prophylactic methods was low (11.7%). For patients on anticoagulant prophylaxis, adherence rates regarding drug selection and dosage were high (100% and 89.3%, respectively), whereas adherence rates regarding time of initiation and length of prophylaxis were low (50% and 28.6%, respectively). A qualitative analysis identified 12 theoretical domains relevant to thromboprophylaxis practices among surgeons. The most encountered barriers included concerns about bleeding risk, resource issues, low beliefs about preventive benefits for certain patients with PAS, inadequate knowledge and training, and a lack of protocol and policy. The most encountered enablers included positive beliefs in prophylaxis benefits, mandatory policy and computerized supportive tools, thromboprophylaxis set as patient safety goals, leadership and multidisciplinary working, and training. Conclusion Significant quality gaps were present in VTE prevention practice for abdominal-pelvic surgical patients, and multiple coexisting factors prevented the full adoption of practice standards. The implementation of an anticoagulation stewardship program is essential for addressing practical issues.
April 2025
·
7 Reads
Background Despite a growing evidence from the animal models of the cardioprotective function of the apelinergic system in the setting of myocardial infarction, little is known on the role of apelinergic system in the development of post- infarction adverse left ventricle remodeling in humans. Methods The study group consisted of 49 patients with first-time ST-segment elevation myocardial infarction of anterior wall treated invasively. Echocardiography was performed on index hospitalization and on one-year check-up, with categorizing the study population into group with adverse LV remodeling defined as an increase of LV end diastolic volume by >20% (n = 12) and the group without adverse remodeling (n = 29). ELA, AP-17, AP-13 and APJ receptor levels were measured on one-year follow-up. Results Patients with adverse LV remodeling presented significantly higher plasma level of apelin-13 (85.63 [75.43–96.13] vs 65.43 [57.35–69.35], p = 0.001) and apelin-17 (69.36 [42.61–77.04] vs 30.04 [25.97–41.95], p = 0.004). In a univariable logistic regression analysis, higher LVEDV and LVEDV1, higher LVESV and LVESVi, lower LVEF, higher WMSI score, higher SYNTAX score, higher levels of hs-CRP during index hospitalization and higher levels of AP-13 and AP-17 on the one-year check-up were associated with adverse LV remodeling. In multivariable logistic regression analysis, only AP-17 level was independently associated with adverse LV remodeling (p = 0.050). Conclusion Apelinergic system may be involved in the development of post- infarction adverse left ventricle remodeling.
April 2025
·
5 Reads
Purpose Pemafibrate is a novel selective peroxisome proliferator-activated receptor alpha modulator (SPPARMα) that improves lipid profile, but its effects on cardiovascular events remain unproven. This study examined changes in the cardio-ankle vascular index (CAVI), a marker of arterial stiffness, in high-risk patients with type 2 diabetes mellitus (T2DM) or ischemic heart disease (IHD) treated with pemafibrate. Patients and Methods In this single-center, prospective, observational study, 95 patients with T2DM and/or IHD, who had hypertriglyceridemia (≥150 mg/dL) and started pemafibrate (0.2 mg/day) were analyzed. CAVI was measured at baseline and after 24 weeks of treatment as an indicator of arterial stiffness, along with comprehensive assessment of lipid parameters including triglycerides, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), non-HDL-C, and apolipoproteins. Results No significant change in CAVI was observed after 24 weeks of treatment (median [interquartile range (IQR)]; baseline vs 24 weeks: CAVI 9.4 [8.8–10.6] vs 9.6 [8.9–10.8], p=0.715). However, pemafibrate significantly reduced triglycerides (233 mg/dL [171–329] to 143 mg/dL [111–187], p<0.001), apolipoprotein C-II (8.1 mg/dL [6.1–10.2] to 6.3 mg/dL [5.3–8.3], p<0.001), apolipoprotein C-III (15.3 mg/dL [12.2–18.3] to 11.6 mg/dL [9.3–14.2], p<0.001) and liver enzymes; and increased HDL-C (45 mg/dL [39–52] to 50 mg/dL [40–60], p<0.001), LDL-C (92 mg/dL [70–111] to 103 mg/dL [79–128], p<0.001), apolipoprotein A-I and apolipoprotein A-II (both p<0.05). Calculated small dense low-density lipoprotein cholesterol also decreased significantly (40 mg/dL [31–49] to 36 mg/dL [28–45], p=0.002). Conclusion While pemafibrate improves lipid profile and liver enzymes, its short-term impact on vascular stiffness, as measured by CAVI, appears limited. Extended follow-up studies are needed to clarify its cardiovascular benefits in high-risk patients.
April 2025
·
13 Reads
Objective Hypertension significantly impacts cardiovascular health, leading to arterial stiffness and myocardial dysfunction. Pulse wave velocity (PWV) is a recognized measure of arterial stiffness, while cardiac magnetic resonance imaging (MRI) is the gold standard for assessing myocardial structure and function. The aim of the present study is to investigate the relationship between arterial stiffness, ambulatory blood pressure monitoring (ABPM), and cardiac MRI findings in untreated hypertensive individuals. Methods This cross-sectional study included 22 untreated hypertensive participants referred to the Hypertension ABPM Center of Excellence at Aristotle University of Thessaloniki. Participants underwent carotid-femoral PWV measurement and 24-hour ABPM. Cardiac function and structure were evaluated through cardiac MRI. Statistical analyses included Mann–Whitney and Kruskal–Wallis tests, with logistic regression for associations between c-f PWV and cardiac abnormalities. A significance threshold of p<0.05 was applied. Results The study population had increased office and 24-hour ABPM values. Cardiac MRI revealed systolic LV dysfunction in 31.8% and diastolic LV dysfunction in 63.6% of participants. Myocardial fibrosis was present in 50% of the participants. Elevated PWV was significantly associated with LV systolic dysfunction (p=0.003), LV diastolic dysfunction (p=0.002), myocardial stiffness (p<0.001), and myocardial fibrosis (p = 0.004). Additionally, aortic valve velocity was significantly associated with increased arterial stiffness (p=0.006). Post-hoc analysis of fibrosis showed significant differences (p=0.007 for minimal vs no fibrosis; p=0.011 for severe vs no fibrosis). Conclusion The study confirms a significant correlation between increased arterial stiffness, systolic ABPM-derived systolic blood pressure, and cardiac MRI dysfunction in untreated hypertensive individuals. These findings highlight the importance of arterial stiffness evaluation as a diagnostic tool for early detection of myocardial dysfunction, allowing for timely intervention and targeted treatment strategies to mitigate heart damage.
April 2025
·
6 Reads
Objective There is a significant difference in prognosis among patients with hypertrophic cardiomyopathy (HCM) across different age groups and gender groups. This study aims to explore the risk of sudden cardiac death (SCD) in various age groups and genders. Methods A cohort of 2781 patients with HCM, initially evaluated between 1996 and 2023, were followed for a median of 4.54 years. The patients were divided into three age groups: youth group (aged ≤ 40 years), middle-aged group (aged between 40 and 60 years), and elderly group (aged ≥60 years). The outcome event was (SCD). Kaplan-Meier survival curves and Cox regression analysis were employed to compare outcomes across different age groups for both genders. Additionally, restricted cubic splines (RCS) were utilized to evaluate the potential relationship between age and prognosis within different gender categories. Results A total of 128 patients (4.6%) experienced SCD. In the whole population, significant age differences were observed in the Kaplan-Meier survival curves for SCD (log-rank P<0.0001). Significant age differences in SCD were also noted in both genders (log-rank P<0.0001). In multivariate Cox regression analysis, age was an independent predictor of SCD in the whole population [HR: 0.983; 95% CI: 0.972–0.994; P=0.003] and female patients [HR: 0.963; 95% CI: 0.947–0.98; P<0.001]. However, it was not significant in male patients [HR: 0.995; 95% CI: 0.98–1.01; P=0.538]. Conclusion In patients with HCM, age was an independent predictor of SCD both the whole population and female patients. Compared to young patients, the risk of SCD is reduced by 71.4% in middle-aged patients and by 43.5% in elderly patients across the whole population. Among male patients, the risk of SCD decreases by 68.5% in middle-aged patients and by 10.7% in elderly patients. In female patients, the risk of SCD is reduced by 77.8% in middle-aged patients and by 75.3% in elderly patients.
April 2025
·
13 Reads
Background The clinical performance of drug-coated balloons (DCBs) for the treatment of femoro-popliteal lesions may depend on the specific device used. There is limited evidence on the clinical safety and efficacy of the paclitaxel-coated device Stellarex® for the treatment of long (>180 mm) femoro-popliteal lesions. Methods This is a single arm, prospective, open label, observational study including symptomatic patients with long femoro-popliteal lesions undergoing endovascular revascularization with Stellarex® DCB. The primary endpoints were the safety and efficacy of the DCB over time. Secondary endpoints were represented by functional outcomes. Results Ninety-five patients (median age 72, lesion length 250 mm) were included. At 6 months after the procedure, 61% of patients were asymptomatic as defined by the Rutherford classification, decreasing over time (57% at 12 months, 56% at 24 months, 44% at 36 months). Walking Impairment Questionnaire showed a remarkable improvement at 6 months, with a decreasing trend over time. When single components were analysed, better performances were observed for distance and climbing scores throughout the study period, while speed returned to baseline levels after 24 months. EQ5D Questionnaire showed a statistically significant improvement throughout the study period (with a decreasing trend over time, as seen for Rutherford classification and Walking Impairment Questionnaire). During the 36-months follow-up, 9% of patients died, with previous limb amputation being an independent predictor of mortality (HR = 7.4, p = 0.013). One-year primary patency was 76.5%, with no significant difference compared to the reference rate of 80% (p = 0.810). Primary patency defined as PSVR ≤2.4 (peak systolic velocity ratio) was maintained over time (median survival time free from PSVR >2.4 was not assessable as it exceeded the 36 months of follow-up). Conclusion In our sample, Stellarex showed to be safe and effective and it was associated with an event rate comparable to other devices reported in literature.
April 2025
·
13 Reads
Introduction Acute lower limb ischemia (ALI) is a life and limb threatening event often affecting patients with type 2 diabetes mellitus (T2DM). Little is known about how T2DM affects the risk of adverse events in patients revascularized for ALI. This study aimed to investigate if there were differences in major outcomes between ALI patients with and without T2DM. Methods Between 2010 and 2014, 615 patients underwent revascularization for ALI, according to the Swedish Vascular Registry (SWEDVASC). Using the National Diabetes Registry (NDR), 245 (39.8%) of the patients were identified as having T2DM. Uni- and multivariable Cox or logistic regression analyses were performed to evaluate risk differences for major amputation, mortality, major adverse cardiovascular events (MACE), and fasciotomy between patients with and without T2DM. Results The rates of major amputation and mortality at one year were 32.7% and 21.6% in the T2DM group, compared to 21.9% and 31.9% in the non-DM group, respectively, resulting in a hazard ratio (HR) of 1.52 (95% confidence interval [CI] 1.12–2.07) for major amputation and HR of 0.64 (95% CI 0.46–0.88) for mortality. At one year, the HR for major amputation was 1.45 (95% CI 0.99–2.11), HR for mortality 0.92 (95% CI 0.61–1.39), HR for combined major amputation/mortality 1.27 (95% CI 0.94–1.72), and HR for MACE 1.24 (95% CI 0.92–1.67) for those with T2DM compared to those without in the multivariable Cox-regression analyses. The multivariable logistic regression analysis showed significantly lower odds of fasciotomy, OR 0.1 (95% CI 0.01–0.51) in the T2DM-group. Conclusion T2DM was not significantly associated with higher hazard of major amputation, mortality, combined major amputation/mortality, or MACE after revascularization for ALI, compared to patients without T2DM. Patients with T2DM had significantly lower odds of fasciotomy.
April 2025
·
9 Reads
Objective To analyze the relationship between resistant hypertension (RH) and hypertension, diabetes mellitus, chronic kidney disease, sodium, calcium, magnesium, phosphorus. Methods A total of 475 patients with hypertension admitted to Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 2021 to December 2023 were divided into hypertension group (HT group) and resistant hypertension group (RH group). We compared the differences between these two groups, and analyzed the influencing factors of RH, as well as the correlation between RH and the course of hypertension, diabetes mellitus, chronic kidney disease, and levels of sodium, calcium, magnesium and phosphorus. Results Compared with HT group, RH group had a significantly higher blood pressure (P < 0.05), longer duration of hypertension, diabetes mellitus, and chronic kidney disease (P < 0.01) and a higher proportion of combined chronic kidney disease (P = 0.006). The duration of hypertension, serum sodium ion concentration (≥142.00 mmol/L), calcium ion concentration (2.19 to < 2.30 mmol/L), and 24h urinary phosphorus ion level were independent influencing factors of RH (P < 0.05). Conclusion For hypertension patients with diabetes mellitus or chronic kidney disease, the risk of RH is significantly higher. The risk of RH may be lower in patients with blood sodium <142.00 mmol/L, blood calcium >2.29 mmol/L, 24h urine sodium and magnesium ions of 116.52 and 2.69 mmol, respectively, and higher 24h urine phosphorus ions.
April 2025
·
25 Reads
Purpose To evaluate the performance and outcomes of the 6-minute magnetic resonance imaging (MRI) protocol in diagnosing stroke within Indonesian healthcare setting compared to computed tomography (CT). Patients and methods This retrospective single-center study was conducted at the Universitas Indonesia Hospital in Depok, Indonesia from September 2021 to September 2023. Patients who were diagnosed with acute stroke underwent a clinical evaluation and a 6-minute MRI protocol. The primary objective was to assess the efficiency of the 6-minute MRI protocol in promptly and accurately evaluating acute stroke patients, including determining average MRI time, thrombolysis eligibility, and post-thrombolysis outcomes compared to CT imaging. Exclusions comprised those requiring resuscitation, lack of stroke code activation, or having incomplete documentation. Results This study involved 182 stroke patients, 136 of which underwent MRI and 46 had CT scans. Thrombolysis eligibility was similar between the groups (48.9% for MRI vs 47.8% for CT-Scan), but a higher proportion of eligible MRI patients received thrombolysis (70.1% vs 54.5%, p = 0.037). MRI also achieved shorter door-to-imaging times, especially from February to June 2022. Among those treated for ischemic stroke via MRI, 70.3% showed improvement compared to 55% for CT (p=0.016). Door-to-MRI times varied across periods, averaging 88.2 minutes before national healthcare insurance collaboration, 29.1 minutes during transition, and 47.8 minutes afterward. Conclusion This study emphasizes the crucial role of the 6-minute MRI protocol for accurately diagnosing stroke types, severity, and determining thrombolysis eligibility. Positive outcomes in thrombolysis patients using this protocol highlight its effectiveness. However, prolonged time-to-MRI indicates the need for further improvement. Optimizing time management and workflow efficiency are critical for improving treatment efficacy and safety.
April 2025
·
12 Reads
Purpose To explore the association between angiopoietin-like protein 2 (Angptl2) and cyclophilin A (CyPA) with acute myocardial infarction (AMI) and the occurrence of in-stent restenosis (ISR) after percutaneous coronary intervention (PCI). Patients and Methods A single-center retrospective research was conducted. Clinical data from 146 AMI patients who underwent PCI at our hospital were analyzed and designated as the AMI group. Additionally, 56 healthy individuals who underwent medical check-ups during the same period were enrolled as the Control group. Serum levels of Angptl2 and CyPA were compared between the AMI and control groups. Furthermore, based on the presence or absence of in-stent restenosis (ISR) during the follow-up period, the AMI patients were further divided into ISR and NISR groups. Logistic regression analysis was utilized to ascertain the risk factors influencing ISR after PCI in AMI patients. The diagnostic value of serum Angptl2 and CyPA for ISR after PCI was assessed using the receiver operating characteristic (ROC) curve. Results Compared with the Control group, the AMI group exhibited significantly elevated levels of Angptl2 and CyPA (P<0.05). Logistic regression analysis identified serum Angptl2 and CyPA are risk factors for occurrence of ISR after PCI in AMI patients. Additionally, the ROC curve analysis demonstrated that the combined use of serum Angptl2 and CyPA achieved an area under the curve (AUC) of 0.895 for predicting ISR in AMI patients after PCI. Conclusion Elevated serum levels of Angptl2 and CyPA in AMI patients who developed ISR after PCI suggest that these biomarkers may serve as potential risk indicators for predicting ISR following PCI.
March 2025
·
27 Reads
Background Peripheral artery disease (PAD), a common manifestation of systemic atherosclerosis, is linked to high morbidity and mortality. Risk factors such as age, male gender, and hyperlipidemia significantly contribute to PAD. This study aims to estimate the Predictors and associations of peripheral artery diseases in the Abu Dhabi population. Methods Cross-sectional analysis of diabetic patients who had ankle brachial index tests in 2018–2019. Data collected from electronic medical records include demographics, treatment history, comorbidities (hypertension, smoking), lab results (HbA1c, renal function, lipid profile), and findings from sudoscan test used to assess the function of small nerve fibers and evaluate autonomic dysfunction. A cohort study from the Abu Dhabi Cardiovascular Risk Study (ADRS), to determine the predictors and relationships associated with peripheral artery disease in Abu Dhabi. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 26. Results Among the 359 patients from the cross-sectional study, 65.5% had normal ABI, 14.2% had low abnormal ABI, and 20.3% had high abnormal ABI. The average age was 65.3 years, with 66.3% females and 75.49% United Arab Emirates (UAE) nationals. Most patients (65.2%) were on non-insulin treatments, and 75.8% had hypertension. The mean HbA1c level was 7.3%. Regarding renal function, 51.5% had stage 1 estimated glomerular filtration rate (eGFR), and 9.2% had abnormal eye grading. Ulcers were present in 95.8%, and 9.7% had vascular referrals. Multivariate analysis showed no significant predictors of abnormal ABI (p > 0.05). In the cohort study of 8699 patients, PAD prevalence was highest among those aged 40–59, with significant associations with age, smoking, and diabetes. Conclusion Abnormal ABI was present in 34.5% of patients, with no significant association with various risk factors. However, the cohort study showed that age, smoking, and diabetes are significantly related to PAD development.
March 2025
Introduction Manny evidence indicates that numerous immune cells are linked to the onset and progression of VTE, though the causal relationship remains unclear. To determine the association between immune cells and VTE, we performed a bidirectional two-sample Mendelian randomization (MR) study. Methods A comprehensive MR analysis was conducted to ascertain the causal relationship between immune cell signatures and VTE. Leveraging publicly available genetic data, we examined the causal associations between 731 immune cell signatures and the risk of VTE. The analysis encompassed four types of immune signatures, namely median fluorescence intensities, relative cell counts, absolute cell counts, and morphological parameters. We employed the two-sample MR analysis, used the inverse variance-weighted (IVW) approach as the primary analytical method. Rigorous sensitivity analyses were employed to validate the robustness, heterogeneity, and presence of horizontal pleiotropy in the results. Furthermore, the reverse MR analysis was implemented to confirm the existence of reverse causal relationships. Results Eighteen immune cell signatures were found to have nominally significant associations with VTE according to the IVW method. The level of CD14 expression on CD14+ CD16+ monocytes (OR 0.95) and ten other phenotypes were identified as protective factors against VTE. Conversely, the percentage of HLA DR+ T cells among lymphocytes (OR 1.03) and six other phenotypes were identified as risk factors associated with an increased likelihood of VTE. The expression level of CX3CR1 on CD14- CD16+ monocytes showed a potential bidirectional causal relationship. Conclusion Our study identified 18 types of immune cell signatures that could impact VTE development, offering novel insights for future mechanistic and clinical studies in this field. Further studies to prospectively validate our findings are needed.