Adenosine administration can improve coronary blood flow in patients undergoing primary percutaneous coronary intervention (PCI); however, the therapeutic effects of adenosine on ST resolution and major adverse cardiovascular events (MACEs) after PCI remain unclear. This study aimed to assess the therapeutic effects of adjunctive adenosine administration on patients with acute myocardial infarction (AMI) undergoing PCI using a meta-analytic approach.

We conducted a systematic search across PubMed, Embase, and the Cochrane Library to identify eligible randomized controlled trials (RCTs) published from inception through to March 2024. Primary outcomes included ST resolution and MACEs. The pooled analyses were all conducted using the random-effects model. Additionally, exploratory analyses were carried out through the application of sensitivity and subgroup analyses.

Twenty-one RCTs involving 2467 patients with AMI were selected for the meta-analysis. Adenosine significantly increased the incidence of ST resolution (relative risk [RR]: 1.30; 95% confidence interval [CI]: 1.15–1.46; p < 0.001), while it significantly reduced the risk of MACEs (RR: 0.67; 95% CI: 0.51–0.87; p = 0.003). Moreover, the use of adenosine was associated with reduced incidences of no reflow (RR: 0.35; 95% CI: 0.24–0.52; p < 0.001) and myocardial blush grade (MBG) 0 to 1 (RR: 0.75; 95% CI: 0.58–0.99; p = 0.041). Furthermore, adenosine significantly reduced the risk of heart failure (RR: 0.66; 95% CI: 0.44–0.99; p = 0.044). Finally, adenosine use was associated with a lower creatine kinase-MB (CK-MB) peak value (weighted mean difference: –36.94; 95% CI: –73.76– –0.11; p = 0.049).

This study revealed that adenosine use was associated with an increased incidence of ST resolution, and reduced risk of MACEs.

INPLASY202510051, https://inplasy.com/inplasy-2025-1-0051/.

Tumor characteristics are associated with the risk of cardiovascular death (CVD) in cancer patients. However, the influence of tumor characteristics on CVD risk among prostate cancer (PC) patients who have received radiotherapy (RT) or chemotherapy (CT) is often overlooked. This study explored the association between PC tumor characteristics and CVD risk in PC patients who had received RT or CT.

Fine-gray competitive risk analysis was employed to identify CVD risk factors. Sensitivity analyses were conducted to adjust for confounding factors. The predicted prostate-specific antigen (PSA) and Gleason score values were visualized using a nomogram, which was subsequently validated through calibration curves and concordance indexes (C-indexes).

A total of 120,908 patients were enrolled in the study, with a mean follow-up time of 80 months. PSA values between 10 and 20 ng/mL (adjusted hazard ratio (HR): 1.28, 95% confidence interval (CI): 1.20–1.36, p < 0.001) and >20 ng/mL (adjusted HR: 1.27, 95% CI: 1.21–1.35, p < 0.001), and a Gleason score >7 (adjusted HR: 1.23, 95% CI: 1.07–1.41, p = 0.004) were identified as risk factors of CVD for PC patients after RT or CT. The C-index of the training cohort was 0.66 (95% CI: 0.66–0.67), and the C-index of the validation cohort was 0.67 (95% CI: 0.65–0.68). Consistency was observed between the actual observations and the nomogram. Risk stratification was also significant (p < 0.001).

PSA values ≥10 ng/mL and Gleason scores >7 may be associated with an increased risk of CVD in PC patients after RT or CT. These patients may require more long-term follow-up and monitoring of CVD risk.

Direct comparisons between the drugs are limited, and the dosing remains debatable. Therefore, the study aims to indirectly compare the efficacy and safety of inclisiran, alirocumab, evolocumab, and evinacumab in lipid-lowering through a network meta-analysis.

Databases including PubMed, EMBASE, Web of Science, and the Cochrane Library were utilized to retrieve randomized controlled trials (RCTs). The search was conducted up to July 1, 2023. The Cochrane risk of bias tool was employed to appraise the quality of included studies. R software was used to conduct the Bayesian network meta-analysis.

Twenty-one RCTs with 10,835 patients were included. The network meta-analysis indicated that Evolocumab [mean difference (MD) = –60, 95% credibility interval (CrI) (–72, –49)] was the most effective (87%) in reducing low-density lipoprotein cholesterol (LDL-C), followed by alirocumab (71.4%) and inclisiran (47.2%), with placebo being the least effective (0.01%). In increasing high-density lipoprotein cholesterol (HDL-C), evolocumab [MD = 6.5, 95% CrI (3.2, 10)] ranked first (81.8%), followed by alirocumab (68.2%), with placebo again at the bottom (0.03%). In lowering total cholesterol, evolocumab [MD = –36, 95% CrI (–54, –19)] performed the best (86%), followed by alirocumab (64%), and placebo remained the least effective (0.04%). Regarding adverse events (AEs), evinacumab [odds ratio (OR) = 2, 95% CrI (1.17, 3.44)] ranked the highest (98.9%), followed by inclisiran (59.6%) and evolocumab (15.2%).

Evolocumab appears to be the most effective in increasing HDL-C and reducing LDL-C and total cholesterol. Evinacumab shows the best safety profile with the lowest incidence of AEs.

CRD42024570445, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=570445.

Additional bifurcations at the left main coronary artery (LMCA) could modify the geometry of the left coronary system, disturbing haemodynamic flow patterns and potentially altering endothelial shear stress (ESS). A low ESS has been implicated in atherogenesis. The emergence of the ramus intermedius (RI) from the LMCA creates additional branching, but the specific role of the RI in plaque deposition at the left coronary system remains unclear. This study sought to elucidate the potential effects of the RI on plaque formation at the LMCA and its bifurcation.

A retrospective cross-sectional single-centre study was conducted using data from 139 female patients who were identified to have low risk of cardiovascular disease. These patients underwent cardiac computed tomography angiography between January 2017 and December 2018. Contrasted multiplanar coronary images taken during the best diastolic phase were analysed for the presence (experimental group) or absence (control group) of the RI. Measurements of plaques were done at the LMCA and at a 10 mm distance from the ostia of daughter arteries. Plaque data at the left bifurcation region were analysed using descriptive statistics, chi-square, and binary logistic regression tests. A p-value of <0.05 was considered statistically significant.

Amongst these low-risk patients, 33.8% (n = 47) had an RI. In the presence of RI, there was an eight-fold increased risk of plaque deposition at the LMCA (adjusted odds ratio, aOR = 8.5) and a three-fold increased risk of plaque deposition at the proximal left anterior descending (pLAD), especially on its lateral wall (aOR = 3.5). However, the RI did not influence plaque deposition at the distance of 10 mm from the ostium of the proximal left circumflex artery.

These findings suggest that the RI increases the risk for atherosclerosis plaque deposition by three to eight-fold at the pLAD artery and the LMCA.

The physiological activation of the left atrium (LA) happens through the Bachmann bundle, which is crucial for the heart's proper functioning. Bayes de Luna first described interatrial blocks (IABs) in 1979, noting their disruption of atrioventricular (AV) synchrony. This study aims to evaluate LA mechanics by analyzing LA strain in cases of normal and impaired interatrial conduction, focusing on retrograde flow in the pulmonary veins (PV).

The study included 51 patients who tested positive for SARS-CoV-2 and exhibited related symptoms. Six patients with persistent atrial fibrillation (AF) were excluded from the study (45 patients qualified in total: 23 males, 22 females; mean age 69.0 ± 12.9 years).

IABs were more frequently observed in COVID-19 patients. Thus, they were included despite SARS-CoV-2 being a potential limitation of the study. All participants underwent clinical evaluation, electrocardiography (ECG) (200 mm/s ×256), and echocardiography to assess left ventricular ejection fraction (LVEF), mitral regurgitation (MR), LA volume, global and regional strain, and retrograde flow in the PV. A statistical dependency was found between LA global strain and P-wave morphology, MR, heart failure (HF), and paroxysmal atrial fibrillation (PAF). However, no clear correlation was found between retrograde flow in the PV and LA strain. The mean P-wave duration correlated with its morphology. Additionally, correlations were observed between P-wave morphology and hypertension, being overweight, and PAF.

LA mechanics are negatively influenced by IABs. LA global strain correlates with P-wave duration, ejection fraction (EF), and MR independently. Regional LA strain examination is potentially effective for assessing LA mechanics and complements precise ECG.

Physical activity induces many beneficial adaptive changes to blood vessel microcirculation, ultimately improving both health and exercise performance. This positions it an effective non-pharmacological therapeutic approach for the rehabilitation of patients with various chronic diseases. Understanding the impact of different types of physical activities on microcirculation and elucidating their physiological mechanisms is crucial for optimizing clinical practice.

A comprehensive literature search was performed across multiple databases including PubMed, EBSCO, ProQuest, and Web of Science. Following a rigorous screening process, 48 studies were selected for inclusion into the study.

Existing studies demonstrate that various forms of physical activity facilitate multiple positive adaptive changes at the microcirculation level. These include enhanced microvascular dilation—driven by endothelial cell factors and mechanical stress on blood vessels—as well as increased capillary density. The physiological mechanisms behind these improvements involve the neurohumoral regulation of endothelial cell factors and hormones, which are crucial for these positive effects. Physical activity also ameliorates inflammation markers and oxidative stress levels, upregulates the expression of silent information regulator 2 homolog 3, genes for hypoxia-inducible factors under hypoxic conditions, and induces favorable changes in multiple hemodynamic and hemorheological parameters. These structural and functional adaptations optimize myocardial blood flow regulation during exercise and improve both oxygen transport and utilization capacity, which are beneficial for the rehabilitation of chronic disease patients.

Our provides a reference for using physical activity as a non-pharmacological intervention for patients with chronic conditions. This framework includes recommendations on exercise types, intensity, frequency, and duration. Additionally, we summarize the physiological mechanisms through which physical activity improves microcirculation, which can inform clinical decision-making.

Limited data are available for evaluating the effect of blood glucose on transcatheter aortic valve replacement (TAVR) outcomes in patients with diabetes. We aimed to assess the impact of glucose levels on short-term and long-term adverse outcomes in patients undergoing TAVR.

Data from severe aortic stenosis (AS) patients who underwent TAVR from 2010 to 2022 were collected retrospectively. In total, 615 patients were enrolled in the study: Among the total patient population, 43% had diabetes mellitus (DM), with a mean hemoglobin A1c (HbA1c) level of 7.4 ± 2.5. Within this cohort, 33% were classified as having uncontrolled diabetes, while 17% were considered well-controlled. Diabetic patients were younger (80.7 ± 6.8 vs. 82.0 ± 6.8 years, p = 0.001) and had more cardiovascular risk factors. No significant differences were found in outcomes between the two groups during the twelve-year follow-up. A multivariable logistic regression analysis was conducted on 270 DM patients to examine the impact of blood glucose levels and HbA1c on outcomes such as arrhythmia, stroke, and acute kidney injury (AKI). For arrhythmia, the odds ratio for HbA1c and blood glucose were 1.1039 (p = 0.23), and 0.998 (p = 0.76), indicating no significant associations. In stroke cases, HbA1c had an odds ratio of 1.194 (p = 0.36), while an odds ratio of 1.020 (p = 0.013) for blood glucose indicated a significant association. Notably, for AKI, the odds ratio for HbA1c was 2.304 (p = 0.02), indicating a significant link between higher HbA1c levels and increased AKI risk, with blood glucose levels trending toward significance (odds ratio = 1.0137, p = 0.061).

Diabetic status is a predictor of short-term outcomes following TAVR. Thus, these screening parameters should be included in risk assessment tools for TAVR candidates.

To explore the sex-specific risk factors of associated with arterial stiffness.

A total of 28,291 participants from the Kailuan study cohort were enrolled in this study. A multivariate linear regression analysis and a multivariate logistic regression model were used to analyze the influencing factors of arteriosclerosis (indexed using the brachial–ankle pulse wave velocity, baPWV) between different sexes.

The incidence of arteriosclerosis (baPWV greater than or equal to 1400 cm/s) was 54.70%. The incidence of arteriosclerosis in males (62.13%) was higher than in females (37.41%) (p < 0.01). According to age stratification (5 years difference for each group), the baPWV values of males in all age groups <70 years were higher than in females (p < 0.01). The increase in baPWV values was higher in females over 45 years than in males and correlated with males in the 70–75 age group. The multivariate linear regression model showed that for every 5-year increase in age, the baPWV increased by 62.55 cm/s in males and 71.86 cm/s in females. Furthermore, for every 10 mmHg increase in systolic blood pressure (SBP), the baPWV increased by 61.01 cm/s in males and 51.86 cm/s in females. Regular physical exercise reduced the baPWV in males, but there was no statistical correlation in females. The waist-to-hip ratio (WHR) increased the baPWV in females yet was not statistically significant in males. Multivariate logistic regression analysis showed that after adjusting for confounding factors (age, WHR, SBP, heart rate, triglyceride, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), high-sensitivity C-reactive protein (hs-CRP), estimated glomerular filtration rate (eGFR), diabetes, higher education, higher income, smoking, drinking, and physical exercise), males were 1.89 times more likely than females to develop arteriosclerosis (p < 0.05). A stratified analysis of males and females showed that the risk of arteriosclerosis was higher in females than in males in the 45–60 and over 60 age groups compared with those in the under 44 age group (p < 0.01). Diabetes, LDL-C, and hs-CRP were more likely to be correlated with arteriosclerosis in females than in males (odds ratio (OR): 2.32, 1.26, 1.08 vs. 1.83, 1.17, 1.02, respectively, p < 0.05). Higher education levels reduced the risk of arteriosclerosis in males and females, with OR values of 0.64 and 0.84, respectively (p < 0.05).

The arteriosclerosis detection rate in males was higher than in females. Conversely, the increase in baPWV in females older than 45 years was higher than in males. Meanwhile, WHR, diabetes, LDL-C, and hs-CRP were more likely to be correlated with arteriosclerosis in females.

Chinese Clinical Trail Registry, URL: https://www.chictr.org.cn/showproj.html?proj=8050. Unique identifier: ChiCTR-TNRC-11001489 .

The complex process of cardiac magnetic resonance (CMR) and the uncertainty of each parameter in the diagnosis and prognosis of cardiotoxicity limit its promotion in the cardiac evaluation of patients treated with immune checkpoint inhibitors (ICI).

A comprehensive search was conducted across PubMed, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), and Cochrane databases for relevant articles published up until September 28, 2024.

After screening, 8 articles were included in this study. The analysis revealed that following ICI treatment, the left ventricular global longitudinal strain (GLS) increased significantly [weighted mean difference (WMD) 2.33; 95% confidence interval (CI) 1.26, 3.41; p < 0.01], while the global radial strain (GRS) decreased [WMD –4.73; 95% CI –6.74, –2.71; p < 0.01]. Additionally, T1 and T2 values increased [standardized mean difference (SMD) 1.14; 95% CI 0.59, 1.68; p < 0.01] and [SMD 1.11; 95% CI 0.64, 1.58; p < 0.01], respectively. An elevated T2 was associated with a higher occurrence of major adverse cardiovascular events (MACE), with a hazard ratio of 1.36 (95% CI 1.12, 1.64).

Our findings demonstrate that T1, T2, and GLS increase, while GRS decreases following ICI administration. By consolidating these critical metrics, we propose a streamlined, abbreviated (non-contrast) CMR protocol that can be completed within 15 minutes, thereby facilitating the integration of CMR in cardio-oncology.

CRD42023437238, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023437238.

Elevated homocysteine (Hcy) levels have been linked to poorer outcomes in acute coronary syndrome. This study aimed to assess the predictive value of elevated Hcy levels for major adverse cardiac events (MACE) in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI).

This retrospective cohort study included 183 STEMI patients who underwent primary PCI at a tertiary university hospital in southern China from January 2020 to December 2021. Laboratory values, including Hcy levels, were obtained within 24 hours of admission. Patients were categorized into elevated and normal Hcy groups using a threshold of 12 μmol/L. The study outcome was the occurrence of 6-point MACE, defined as cardiac death, nonfatal myocardial infarction, stroke, ischemia-driven revascularization (PCI or coronary artery bypass grafting), heart failure and all-cause death. Survival analyses were conducted using Kaplan-Meier and Cox proportional hazard methods. Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) approaches were employed to minimize bias.

The mean age of the patients was 64.8 years, with 76.0% being male. After adjusting with PSM or IPTW, covariate imbalances between the two groups were corrected. Over a median follow-up period of 25.8 months, 55 MACE events occurred, resulting in an event rate of 30.1%. Patients with elevated Hcy levels had a higher incidence of MACE in both unadjusted (hazard ratio [HR] = 2.778; 95% confidence interval [CI]: 1.591–4.850; p < 0.001) and adjusted analyses (PSM: HR = 2.995; 95% CI: 1.397–6.423, p = 0.005; IPTW: HR = 3.2; 95% CI: 1.631–6.280, p < 0.001). Multivariate Cox regression further confirmed that elevated Hcy levels were associated with a worse prognosis across the entire cohort (HR = 1.062, 95% CI: 1.029–1.097, p < 0.001), PSM cohort (HR = 1.089, 95% CI: 1.036–1.145, p < 0.001), and IPTW cohort (HR = 1.052, 95% CI: 1.020–1.086, p = 0.001).

Elevated plasma levels of Hcy (≥12 μmol/L) are associated with worse outcomes in STEMI patients undergoing primary PCI, highlighting the potential role of Hcy as a prognostic marker in this population.

Lowering low-density lipoprotein cholesterol (LDL-C) is a well-established strategy for the secondary prevention of coronary heart disease (CHD). However, the effectiveness of specific LDL-C parameters in predicting myocardial infarction (MI) recurrence in real-world settings remains inadequately explored. This study aims to examine the relationship between MI recurrence and various LDL-C parameters in young CHD patients.

This retrospective cohort study involved 1013 patients aged 18–44 at the time of initial CHD diagnosis, collected from the cardiology department clinics at Beijing Anzhen Hospital between October 2022 and October 2023. LDL-C levels were assessed at the time of CHD diagnosis and at the final follow-up. The primary outcome was MI events, analyzed using survival analysis and logistic regression models to determine associations with LDL-C parameters.

The study included 1013 patients (mean age: 38.5 ± 3.9 years; 94.7% men), with a median follow-up time of 1.7 years. Initially, 13.6% had LDL-C levels <1.8 mmol/L, which increased to 37.8% by the study’s end. During follow-up, 96 patients (9.5%) experienced MI. While LDL-C <1.8 mmol/L at baseline showed a slightly lower cumulative incidence of MI than LDL-C ≥1.8 mmol/L, the difference was not statistically significant (log-rank p = 0.335). Reductions in LDL-C levels of ≥50% and the patterns of change did not correlate with decreased MI risk. However, LDL-C <1.4 mmol/L at the final measurement was associated with a reduced MI risk (adjusted odds ratio [OR]: 0.57, 95% confidence interval [CI]: 0.33–0.98) compared with LDL-C ≥2.6 mmol/L.

This study suggests that the most important parameter related to LDL-C for predicting the recurrence of MI in young patients with a history of CHD is the ideal target LDL-C level. Lowering LDL-C to <1.4 mmol/L could potentially reduce MI risk, regardless of baseline LDL-C levels.

This study aimed to develop and validate a predictive model for major adverse cardiovascular events (MACE) following percutaneous coronary intervention (PCI) in patients with new-onset ST-segment elevation myocardial infarction (STEMI) using four machine learning (ML) algorithms.

Data from 250 new-onset STEMI patients were retrospectively collected. Feature selection was performed using the Boruta algorithm. Four ML algorithms—K-nearest neighbors (KNN), support vector machine (SVM), Complement Naive Bayes (CNB), and logistic regression—were applied to predict MACE risk. Model performance was evaluated using area under the curve (AUC), sensitivity, and specificity. Shapley Additive Explanations (SHAP) analysis was used to rank feature importance, and a nomogram was constructed for risk visualization.

Logistic regression showed the best performance (AUC = 0.814 in training, 0.776 in validation) compared to KNN, SVM, and CNB. SHAP analysis identified seven key predictors, including Killip classification, Gensini score, blood urea nitrogen (BUN), heart rate (HR), creatinine (CR), glutamine transferase (GLT), and platelet count (PCT). The nomogram provided accurate risk predictions with strong agreement between predicted and observed outcomes.

The logistic regression model effectively predicts MACE risk after PCI in STEMI patients. The nomogram serves as a practical tool for clinicians, supporting personalized risk assessment and improving clinical decision-making.

This study aimed to identify the risk factors for in-hospital acute kidney injury (AKI) in patients with acute aortic dissection (AAD) and to establish a machine learning model for predicting in-hospital AKI.

We extracted data on patients with AAD from the Medical Information Mart for Intensive Care (MIMIC)-IV database and developed seven machine learning models: support vector machine (SVM), gradient boosting machine (GBM), neural network (NNET), eXtreme gradient boosting (XGBoost), K-nearest neighbors (KNN), light gradient boosting machine (LightGBM), and categorical boosting (CatBoost). Model performance was assessed using the area under the receiver operating characteristic curve (AUC), and the optimal model was interpreted using Shapley Additive explanations (SHAP) visualization analysis.

A total of 325 patients with AAD were identified from the MIMIC-IV database, of which 84 patients (25.85%) developed in-hospital AKI. This study collected 42 features, with nine selected for model building. A total of 70% of the patients were randomly allocated to the training set, while the remaining 30% were allocated to the test set. Machine learning models were built on the training set and validated using the test set. In addition, we collected AAD patient data from the MIMIC-III database for external validation. Among the seven machine learning models, the CatBoost model performed the best, with an AUC of 0.876 in the training set and 0.723 in the test set. CatBoost also performed strongly during the validation, achieving an AUC of 0.712. SHAP visualization analysis identified the most important risk factors for in-hospital AKI in AAD patients as maximum blood urea nitrogen (BUN), body mass index (BMI), urine output, maximum glucose (GLU), minimum BUN, minimum creatinine, maximum creatinine, weight and acute physiology score III (APSIII).

The CatBoost model, constructed using risk factors including maximum and minimum BUN levels, BMI, urine output, and maximum GLU, effectively predicts the risk of in-hospital AKI in AAD patients and shows compelling results in further validations.

The correlation between cardiopulmonary exercise testing (CPET) parameters and the prognosis of patients undergoing percutaneous coronary intervention (PCI) with high pulse pressure (PP) is unclear. The purpose of present study is to investigate the correlation of CPET parameters in patients under PCI with high PP and assess their reference value for prognosis.

Individuals aged 18 years and older who were diagnosed with coronary artery disease (CAD) and underwent PCI along with CPET from November 1, 2015 to September 30, 2021 were enrolled. The patients were categorized into two groups based on PP: high PP group (PP of males ≥50 mmHg; PP of females ≥60 mmHg) and normal PP group (PP of males <50 mmHg; PP of females <60 mmHg). The primary endpoint was major adverse cardiovascular events (MACE). The optimal predictors of MACE were identified through Cox regression analysis. The time-dependent receiver operating characteristic (ROC) curves were generated and the area under the ROC curve (AUC) was measured to evaluate the discriminatory ability in patients with high PP.

A total of 2785 patients were included in present study, with a median follow-up period of 1215 (687–1586) days. Through multifactorial analysis, it was determined that peak oxygen uptake (peak VO₂, hazard ratio (HR): 0.94, 95% confidence interval (95% CI): 0.88 to 1.00, p = 0.038) and ventilatory equivalent for carbon dioxide (VE/VCO₂, HR: 1.08, 95% CI: 1.02 to 1.15, p = 0.007) are important predictive factors in the parameters of CPET. The ROC based on diabetes mellitus (DM), smoking, peak VO₂, and VE/VCO₂ could effectively evaluate the prognosis of patients [1-year AUC: 0.636 (0.515~0.758), 3-year AUC: 0.675 (0.599~0.752), 5-year AUC: 0.718 (0.607~0.830)].

The prognosis of CAD patients with high PP was worse compared to the patients with normal PP. The peak VO₂ and VE/VCO₂ were predictors of MACE in CAD patients with high PP.

Individuals with type 2 diabetes (T2DM) face a significantly increased risk of cardiovascular disease. This study aims to explore the impact of omega-3 polyunsaturated fatty acids (n-3 PUFAs) on cardiovascular indices in this population. Although the benefits of n-3 PUFAs on cardiovascular health and glycemic outcomes are highly regarded, previous research reports have shown inconsistent results. Therefore, a comprehensive meta-analysis is needed to gain a deeper understanding of the specific effects of n-3 PUFAs on patients with T2DM. To examine the effect of n-3 PUFAs on cardiovascular indices in T2DM using a meta-analysis of randomized controlled trials (RCTs).

Online databases including PUBMED, EMBASE and Cochrane libraries were searched up to December 2023. We assessed the overall weighted mean difference in cardiovascular indices between the group supplemented with n-3 PUFAs and the control group. The differences were compared uniformly using pre- and post-treatment differences.

Supplementation with n-3PUFAs in patients diagnosed solely with T2DM significantly reduced low density lipoprotein (LDL) (weighted mean difference (WMD) = –3.92, 95% confidence interval (CI) = –6.52 to –1.32, p = 0.003 < 0.05), triglycerides (WMD = –23.94, 95% CI = –34.95 to –12.93, p = 0.000 < 0.05), cholesterol (WMD = –8.39, 95% CI = –12.06 to –4.72, p = 0.000 < 0.05), glycated hemoglobin (WMD = –0.25, 95% CI = –0.41 to –0.06, p = 0.003 < 0.05) and the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) index (WMD = –0.55, 95% CI = –0.81 to –0.29, p = 0.000 < 0.05). All other differences in lipid indices, glycemic indices, inflammatory parameters and blood pressure were not statistically significant (p > 0.05). Supplementation with n-3 PUFAs decreased high density lipoprotein (HDL) concentration in patients with T2DM and coronary heart disease (CHD) (WMD = –3.92, 95% CI = –6.36 to –1.48, p = 0.002 < 0.05). There were no significant differences in LDL, triglycerides, cholesterol, and C-reactive protein (CRP) in patients with T2DM and CHD (p > 0.05).

N-3 PUFAs improved lipid levels and long-term blood glucose levels in patients diagnosed solely with T2DM, but did not significantly improve blood pressure inflammatory markers. N-3 PUFAs showed no significant improvement in blood lipid and inflammatory indexes in patients with T2DM and CHD.

CRD42024522262, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024522262.

This study investigates the early predictive value of infectious markers for ventilator-associated pneumonia (VAP) after Stanford type A aortic dissection surgery.

A retrospective review of the medical records of all patients with Stanford type A aortic dissection admitted to Shanghai General Hospital from July 2020 to July 2023 who received mechanical ventilation after surgery was performed. Patients were divided into infection and non-infection groups according to the presence of VAP. The clinical data of the two groups were compared. The early predictive values of procalcitonin (PCT), C-reactive protein (CRP), the neutrophil/lymphocyte ratio (NLR) and sputum smears for VAP were evaluated by receiver operating characteristic (ROC) curve analysis.

A total of 139 patients with Stanford type A aortic dissection were included in this study. There were 35 cases of VAP infection, and the VAP incidence rate was 25.18%. The CRP, PCT, and NLR levels in the infection group were more significant than those in the non-infection group (p < 0.05). The percentage of positive sputum smears was 80.00% in the infected group and 77.88% in the non-infected group. The ROC curve analysis revealed that the areas under the curve (AUCs) of PCT, the NLR, CRP and sputum smear were 0.835, 0.763, 0.820 and 0.745, respectively, and the AUC for the combined diagnosis was 0.923. The pathogenic bacteria associated with VAP, after Stanford type A aortic dissection, was mainly gram-negative bacteria.

The combined application of the NLR, CRP, PCT and sputum smear is helpful for the early diagnosis of VAP after Stanford type A aortic dissection surgery to help clinicians make decisions about treating VAP quickly.

The study was aimed at assessing clinical status and outcome of patients affected by aorto-left ventricular tunnel (ALVT).

A systematic search of keywords relating to ALVT was conducted to identify papers published between 1965 and February 2024 present on Pubmed/Medline and Scopus.

A total of 109 studies, which in all consisted of case reports and case series comprising 177 patients (64.2% males, p < 0.02) met the inclusion criteria. The median age of patients was 9.5 ± 8.9 years. Initial diagnosis was based on echocardiographic findings in 86.4% of patients, and confirmed by computed tomography (CT) and/or magnetic resonance imaging (MRI) in 17%. Of the 177 patients identified, 47.1% were diagnosed with a heart murmur and 32.4% with congestive heart failure. Associated cardiac abnormalities were detected in 39.8% (unicuspid/bicuspid aortic valve with or without stenosis/atresia in 14.8%, coronary artery abnormalities in 9.6%). A total of 90.3% of patients underwent surgery, whilst 4.5% were treated by means of transcatheter closure. Outcomes were largely favorable (death was reported in 5.7%). Mild residual aortic regurgitation continued to be present in 22.7% of the sample. In terms of statistics, no risk factors for death were found.

ALVT, an extremely rare congenital cardiac abnormality, may be diagnosed in both newborns and adults. Initial diagnostic observations are usually made using echocardiography, and subsequently refined by means of catheterization, CT or MRI. Surgery should be performed as soon as possible following diagnosis, particularly due to the inefficacy of medical treatment. In selected cases, transcatheter closure may represent a valid option. The condition is associated with a high mortality rate. Moreover, complications, particularly in the form of residual aortic valve regurgitation, may hamper postoperative prognosis. Due to the rarity of the disease, the setting up of an international registry is recommended.

Unexpected cardiovascular events are likely to occur within a short period following an acute myocardial infarction (AMI). The sodium-glucose co-transporter 2 inhibitor (SGLT2-I) is a recently recommended drug for the treatment of AMI. However, its role in the risk of the outcomes following an AMI, including all-cause death and heart failure readmission, remains controversial. Therefore, in this study, we explored the effect of SGLT2-Is on cardiovascular outcomes after an AMI.

PubMed, Web of Science, and Embase were searched without language restrictions to retrieve case-control studies published before April 2024. Citations were independently screened by two authors, and the studies meeting the predefined inclusion criteria were retained. Data on author names, year of publication, location of the study group, gender and age of participants, outcome assessment, adjusted odds ratios (ORs) and 95% confidence intervals (CIs), and the follow-up period were extracted.

Eight studies were eligible for inclusion, and these studies showed that the use of SGLT2-Is after an AMI was significantly associated with a lower risk of hospitalization for heart failure (OR: 0.66, 95% CI 0.57–0.76, p < 0.01) and a lower incidence of major cardiovascular adverse events (OR: 0.79, 95% CI 0.70–0.89, p < 0.01), but was unrelated to a lower incidence of all-cause mortality (OR: 0.84, 95% CI 0.69–1.02, p = 0.07).

Compared with placebo, SGLT2-I therapy following an AMI can reduce the risk of heart failure hospitalization and the incidence of major cardiovascular adverse events, but has no effect on all-cause mortality.

CRD42024542335, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024542335.

To explore the impact of employing the Knowledge, Attitude, and Practice (KAP) model within a unified community physician intervention aimed at managing pulse pressure among elderly individuals with hypertension in Shenyang, along with its associated influencing variables.

2660 hypertensive patients were recruited in the community of Shenyang City in January 2020. After a 1-year KAP intervention by a unified community physician, KAP changes and pulse pressure levels were compared before and after the intervention. Meanwhile, the relevant influences affecting pulse pressure control were explored. Descriptive analysis and multifactorial logistic regression were used.

A significant decrease in pulse pressure by 10.71 mmHg (95% CI: 10.09, 11.33 mmHg) was noted among elderly individuals with hypertension in the community after undergoing a rigorous one-year intervention program (t = 33.79, p < 0.05). Pulse pressure control increased from 32.59% at baseline to 64.92% (χ² = 556.43, p < 0.01). Compared to pre-intervention, knowledge about hypertension, awareness of prevention, medication and behavioural adherence improved significantly. A multifactorial logistic regression analysis revealed that the risk factors for pulse pressure control were female sex, a history of comorbid diabetes mellitus and poor adherence to medication due to forgetfulness.

Unified community physician interventions can change the perceptions of elderly hypertensive patients, improve medication adherence, and improve poor lifestyle habits, thereby improving pulse pressure control in the geriatric population with hypertension residing in local communities.

This study aimed to develop a machine learning-based predictive model for assessing frailty risk among elderly patients with coronary heart disease (CHD).

From November 2020 to May 2023, a cohort of 1170 elderly patients diagnosed with CHD were enrolled from the Department of Cardiology of a tier-3 hospital in Anhui Province, China. Participants were randomly divided into a development group and a validation group, each containing 585 patients in a 1:1 ratio. Least absolute shrinkage and selection operator (LASSO) regression was employed in the development group to identify key variables influencing frailty among patients with CHD. These variables informed the creation of a machine learning prediction model, with the most accurate model selected. Predictive accuracy was subsequently evaluated in the validation group through receiver operating characteristic (ROC) curve analysis.

LASSO regression identified the activities of daily living (ADL) score, hemoglobin, low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), depression, cardiac function classification, cerebrovascular disease, diabetes, solitary living, and age as significant predictors of frailty among elderly patients with CHD in the development group. These variables were incorporated into a logistic regression model and four machine learning models: extreme gradient boosting (XGBoost), random forest (RF), light gradient boosting machine (LightGBM), and adaptive boosting (AdaBoost). AdaBoost demonstrated the highest accuracy in the development group, achieving an area under the ROC curve (AUC) of 0.803 in the validation group, indicating strong predictive capability.

By leveraging key frailty determinants in elderly patients with CHD, the AdaBoost machine learning model developed in this study has shown robust predictive performance through validated indicators and offers a reliable tool for assessing frailty risk in this patient population.

The blood glucose levels in people with prediabetes mellitus (PDM) are regarded as too high to be normal but below the cutoff for diabetes mellitus (DM). Clinical indicators for PDM patients include impaired glucose tolerance (IGT), impaired fasting glucose (IFG), and/or hemoglobin A1c (HbA1c) levels between 5.7 and 6.4% (39–47 mmol/mol). PDM has been shown to raises the risk of cardiovascular disease (CVD) and mortality. Meanwhile, death and morbidity can be predicted by the new ventricular repolarization features of the electrocardiogram (ECG). Several studies have analyzed the connection between DM and the ventricular repolarization characteristics of ECG; however, few studies have examined the connection between PDM and these ventricular repolarization characteristics. This study evaluated the ECG ventricular repolarization parameters in individuals with PDM.

A retrospective case-control design was used. Randomly selected participants included 79 PDM patients (30 men, mean age: 39.7 ± 5.7 years) and 79 controls (30 men, mean age: 39.8 ± 5.2 years). ECG intervals analyzed were the distance from the beginning of the Q wave to the end of the T wave (QT), the distance between Q and S waves (QRS), the distance between the T wave’s termination and point J (JT), and the distance between the peak and endpoint of the T wave (Tp-e), along with corrected and derived measures (corrected QT interval (QTc), the difference between the maximum and smallest QT intervals (QTd), corrected QTd (QTdc), corrected JT interval (JTc), Tp-e/QT, Tp-e/QTc, Tp-e/JT, Tp-e/JTc). Patient records were retrieved from the institution’s database.

Both groups had comparable averages for age, gender, smoking, hyperlipidemia, body mass index (BMI), (p > 0.05 for each). Similarly, both groups had similar QT, QRS, and JT intervals. PDM patients had significantly greater heart rates (bpm), and QTc, QTd, QTdc, JTc, and Tp-e intervals (millisecond, ms) than the control group. The results were deemed significant when HbA1c levels were associated with every employed ECG measurement in our investigation.

In our study, the HbA1c value was shown to be moderately positively correlated with the heart rate and QTc, QTd, QTdc, JTc, and Tp-e intervals, all of which were determined to be significant. Additionally, the HbA1c value showed a weak positive correlation with Tp-e/QT, Tp-e/JT ratios, which were statistically significant. This study showed that patients with PDM are prone to ventricular arrhythmia in the early period of the disorder.

Coronary computed tomography angiography (CTA) can be used to quantitatively and qualitatively evaluate the characteristics of perivascular adipose tissue (PVAT), including PVAT volume and perivascular fat attenuation index (FAI). Moreover, PVAT volume and perivascular FAI on CTA are reportedly high in patients with vasospastic angina (VSA); however, previous investigations have focused on the patient rather than vessel-level analyses. Therefore, this study aimed to assess the relationship between coronary vasospasm and PVAT or FAI by using coronary CTA at the vessel level.

This retrospective study included 51 patients who underwent intracoronary acetylcholine (ACh) provocation testing for the VSA diagnosis and coronary CTA within a 6-month interval. A total of 125 coronary vessels were evaluated. PVAT and FAI on CTA were quantitatively evaluated. The primary interest of the present study was to determine the relationship between PVAT volume and FAI- and ACh-induced coronary vasospasms at the vessel level.

Of the 51 patients, 24 (47.1%) had a positive ACh provocation test (VSA), with 40 of 125 (32.0%) vessels having ACh-induced vasospasm. Obstructive epicardial coronary artery disease was observed in 12 vessels (9.6%). No significant differences in PVAT volume or FAI were identified between vessels with and without ACh-induced vasospasms. Similarly, PVAT volume and FAI did not differ significantly in the individual major coronary arteries between patients with and without positive ACh provocation test results. In contrast, FAI was significantly higher in vessels with obstructive coronary artery disease than in those without.

In patients undergoing intracoronary ACh provocation tests and coronary CTA, no significant association was observed between ACh-induced coronary vasospasm and PVAT volume or FAI at the vessel level. However, FAI significantly increased in vessels with epicardial coronary disease.

Acute type A aortic dissection (TAAD) is a life-threatening cardiovascular emergency with a high mortality rate. The peri-operative factors influencing in-hospital mortality among surgically treated TAAD patients remain unclear. This study aimed to identify key peri-operative risk factors associated with in-hospital mortality.

Peri-operative laboratory data, surgical strategies, and TAAD-related risk factors, associated with mortality, were collected. Machine learning techniques were applied to evaluate the impact of various parameters on in-hospital mortality. Based on the findings, a nomogram model was developed and validated using area under the receiver operating characteristic curve (AUC) analysis, calibration plots, and internal validation methods.

A total of 199 patients with TAAD were included in the study cohort, which was divided into derivation and validation cohorts. Using the least absolute shrinkage and selection operator (LASSO) regression method, 66 features were narrowed down to six key predictors. These included age, lymphocyte count, use of continuous renal replacement therapy (CRRT), cardiopulmonary bypass (CPB) time, duration of mechanical ventilation, and postoperative interleukin-10 (IL-10) levels, all of which were identified as significant risk factors for in-hospital mortality following TAAD surgery.

We developed and validated a predictive model, presented as a nomogram, to estimate in-hospital survival in patients with TAAD. Post-operative IL-10 was identified as an independent prognostic factor for patients with TAAD. The combination of IL-10 with five additional indicators significantly improved the predictive accuracy, demonstrating superiority over the use of any single variable alone.

This study protocol was registered at ClinicalTrials.gov (NCT04711889). https://clinicaltrials.gov/study/NCT04711889.

Fibulin 1 and Fibulin 2 are members of the extracellular matrix (ECM) glycoprotein family. ECMs drive prognosis through remodeling, a key step in the pathogenesis of heart failure (HF). We aimed to compare Fibulin 1 and 2 levels in different stages of HF and to investigate their relationship with other prognostic factors of HF.

Patients with HF were divided into two groups according to left ventricular ejection fraction (LVEF): reduced and non-reduced LVEF. The control and patient groups consisted of individuals with Stages A and B HF, Stages C and D HF, respectively. Fibulin levels were measured at different stages of HF and in the control group. Additionally, Fibulin levels were measured at admission, discharge, and in the first month in patients who were hospitalized due to decompensated HF.

Serum Fibulin 1 and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels were significantly higher in the patient group than in the control group. Serum Fibulin 2 levels were similar between the groups. Although serum Fibulin 2 levels were similar at repeated measurements, serum Fibulin 1 and NT-proBNP levels significantly decreased at discharge and remained similar at 1 month compared with admission. There was a significant positive correlation between Fibulin 1 and NT-proBNP levels and a significant negative correlation between Fibulin 1 levels and LVEF. Fibulin 2 levels were not correlated with LVEF and NT-proBNP.

Our study demonstrated that serum Fibulin 1 levels differ among different HF stages and have a similar temporal change as observed for NT-proBNP levels. A similar association was not observed for Fibulin 2 in our study.

One of the most significant long-term toxicities of breast cancer radiotherapy is major adverse cardiac events (MACE). In current radiotherapy practice, the mean heart dose is the most commonly used parameter. The aim of our study was to reduce the doses of organs at risk (OAR) in the left anterior descending artery (LAD) and left ventricle (LV) by including the LAD and LV in planning radiotherapy while maintaining adequate dose coverage for patients with left-sided breast cancer.

We retrospectively analyzed left-sided breast cancer cases treated at the Kocaeli University Faculty of Medicine. Only patients with local and locally advanced breast cancer were included in the analysis. A total of 77 patients who were treated between 2020 and 2024 were included. The doses to the LAD and LV were added to the optimization algorithms. Two volumetric modulated arc therapy (VMAT) plans were created for each patient. A total of 154 plans were made, including standard and LAD and LV sparing plans.

There was no statistically significant difference in all VMAT plans regarding planning target volume (PTV) D2, D50, and D98 (dose receiving volume of PTV 2%, 50%, and 98%) (p > 0.05). However, a significant decrease was observed in heart V5 (the percentage of the heart receiving at least 5 gray (Gy)) and mean heart dose. A decrease in the mean heart dose was observed in the standard plan compared with the LAD and LV sparing plan (p < 0.001). Similarly, the heart V5 value decreased significantly (p < 0.001). Additionally, significant reductions were measured in all LAD and LV parameters after re-optimization.

We achieved significant reductions in all heart, LAD, and LV parameters without making any changes to the planned treatment volume coverage by adding LAD and LV OARs to the optimization algorithms. The potential risk of MACE can be significantly reduced by implementing this strategy.

The plasma uric acid/albumin ratio (UAR) has emerged as a novel inflammatory biomarker for predicting the development of acute kidney injury (AKI) following percutaneous coronary intervention. However, the potential of the UAR to serve as a predictive marker for AKI in patients undergoing isolated tricuspid valve (TV) surgery remains unknown. This study aimed to explore the association between the UAR and AKI and to assess whether the UAR can predict AKI in these patients.

We conducted a retrospective analysis of patients who underwent isolated TV surgery between January 2018 and June 2019. The patients were divided into three groups based on the tertiles of the UAR. We utilized multivariate logistic regression and restricted cubic spline analysis to examine the association between the UAR and AKI. Additionally, we used the receiver operating characteristic (ROC) curve analysis to assess the predictive accuracy of the UAR for AKI.

A total of 224 patients were enrolled in this study, of whom 41 developed AKI. The incidence of AKI across the three UAR tertiles was 3.8%, 22.2%, and 29.7%, with a significant difference between the group (p < 0.001). In the multivariate analysis, UAR ≥8.5 was associated with a 7-fold increased risk of AKI (odds ratio (OR): 7.73, 95% confidence interval (CI): 1.61–37.14), while a UAR ≥10.8 was a linked to a 9-fold increased risk (OR: 9.34, 95% CI: 1.96–44.60). The restricted cubic spline model showed a linear association between the UAR and AKI development. The area under the curve (AUC) value for the UAR was 0.713 (95% CI: 0.633–0.793; p < 0.001) with a cutoff value of 8.89.

An increased UAR was significantly associated with a higher risk of AKI in patients undergoing isolated TV surgery; however, while the UAR could serve as a marker to predict AKI, it was not superior to uric acid alone.

The association between the platelet to high-density lipoprotein cholesterol ratio (PHR) and the risk of a heart disease event remains unclear. This study aims to determine whether the PHR can identify individuals at high risk for heart disease events, with a particular focus on middle-aged and elderly Chinese individuals.

The retrospective cohort study encompassed 7188 middle-aged and elderly participants (>45 years) sourced from the China Health and Retirement Longitudinal Study (CHARLS) database. This research utilized longitudinal data from 5 follow-up visits spanning 2011 to 2020, which encompassed the collection of demographic profiles and pertinent blood biomarkers. Kaplan-Meier survival analysis was conducted based on PHR quartiles, with differences assessed using the log-rank test. The Cox proportional hazards model evaluated PHR’s hazard ratio (HR) as a predictor of outcome events, with trend tests applied. Restrictive cubic splines (RCS) were employed to explore associations. Subgroup analyses were performed to validate the robustness of the findings.

Baseline comparisons across quartiles of the PHR revealed a progressive increase in PHR values (133.16 vs 202.09 vs 267.04 vs 388.24), which corresponded to ascending incidence rates of heart disease (18.20% vs 18.64% vs 18.86% vs 21.59%) (p < 0.05). The Kaplan-Meier survival analysis of PHR quartile groups revealed a notable elevation in the incidence of cardiovascular events in Q4 compared to Q1, Q2, and Q3 throughout the follow-up period (log-rank p < 0.05). Upon adjustment for age, gender, stroke history, drinking, smoking, body mass index (BMI), white blood cell (WBC) count, fasting plasma glucose (FPG), creatinine (Cr), and triglyceride (TG), the Q4 group continued to exhibit a significantly elevated HR relative to Q1 (HR = 1.203, p = 0.023). Furthermore, RCS affirmed a linear association between PHR and heart disease events (Adjusted: Overall p = 0.014, Nonlinear p = 0.588). When analyzing by gender, high PHR was a risk factor for males (Q4: HR = 1.352, p = 0.019), but not for females (Q4: HR = 1.158, p = 0.166). Subgroup analysis indicates a significant association between higher PHR levels and increased risk of cardiac events compared to lower levels.

Our study reveals a positive correlation between PHR levels and the incidence of heart disease events in middle-aged and elderly men in China. However, no such correlation was observed in female patients.

Statin therapy is associated with an increased risk of new-onset diabetes (NOD), possibly due to a reduction in coenzyme Q10 (CoQ10) levels as a result of statin use. This study aimed to investigate the relationship between exogenous CoQ10 supplementation and the development of NOD.

This study included 4394 participants from the National Health and Nutrition Examination Survey (NHANES). Baseline characteristics were compared between those with and without NOD and between those with and without CoQ10. Univariate logistic regression was performed to identify factors associated with NOD. Two models were used for confounding factors, including demographics and various covariates. Multifactor logistic regression further assessed the association between CoQ10 supplementation and NOD. Additionally, restricted cubic spline (RCS) analysis was conducted to evaluate the potential nonlinear relationship between daily CoQ10 dose and NOD.

Univariate logistic regression showed an association between CoQ10 supplementation and a reduced risk of NOD (odds ratio [OR] = 0.323, 95% confidence interval [CI] 0.157–0.668, p = 0.003), which remained significant after adjustments in model 1 (OR = 0.344, 95% CI 0.160–0.737, p = 0.006) and model 2 (OR = 0.232, 95% CI 0.057–0.942, p = 0.041). There was no evidence of a linear association between daily CoQ10 dose and NOD in logistic regression analysis (OR = 0.999, 95% CI 0.994–1.004, p = 0.720), and no evidence of a nonlinear correlation in the RCS analysis (p > 0.05).

CoQ10 supplementation in individuals taking statins was associated with a reduced risk of NOD, and this association was independent of the CoQ10 dose.

Atrial fibrillation (AF) is a complication that occurs following a spasm provocation test (SPT) with acetylcholine (ACh). However, the characteristics of patients with AF remain unclear. Furthermore, the association of AF with the outcome of the coronary microvascular function test (CMFT) is unknown. This study aimed to evaluate whether patients with angina with non-obstructive coronary artery disease (ANOCA) who developed AF during SPT with ACh had any clinical characteristics. Additionally, we assessed the association of AF with the CMFT results.

We included 123 patients with ANOCA who underwent SPT and CMFT. We defined AF as AF during ACh provocation. The coronary arteries that demonstrated AF before CMFT were defined as AF vessels (n = 21) and those in sinus rhythm (SR) were defined as SR-1 vessels (n = 165). Vessels that were restored to sinus rhythm immediately following AF were defined as AF-SR vessels (n = 29) and those that remained in sinus rhythm for some time were defined as SR-2 vessels (n = 136). Coronary flow reserve (CFR) and index of microcirculatory resistance (IMR) were obtained, and CFR of <2.0 and/or IMR of ≥25 were diagnosed as coronary microvascular dysfunction (CMD).

Of the 123 patients, 31 (25%) had AF but with no characteristic patient background. CFR was significantly lower in AF vessels than in SR-1 vessels (p = 0.035) and IMR did not differ between the two groups (p = 0.918). A study of the three groups that included AF-SR vessels revealed that IMR tended to be lower in AF-SR vessels than in the SR-2 and AF vessels (p = 0.089), and that the frequency of IMR of ≥25 was significantly lower than in the other two groups (p = 0.016).

AF occurred in 25% of SPTs with ACh, but the predictive clinical context remains unclear. Our results indicated that AF may affect the outcome of the CMFT. Thus, decisions for CMD management should be made with caution in the presence of AF.

Data regarding racial differences in patients with hypertrophic cardiomyopathy (HCM) is sparse. We hypothesized that Hispanic-Latino (HL), Non-Hispanic (NH), and African-American (AA) race impacts the clinical presentation of HCM.

A total of 641 HCM patients (HL = 294, NH = 274, AA = 73) were identified retrospectively from our institutional registry between 2005–2021. Clinical characteristics, echocardiographic indices, and outcomes were assessed using analysis of variance, Kruskal-Wallis, and multivariate linear regression statistical analyses, with Dunn-Bonferroni and Tukey test applied in post-hoc pairwise assessments.

The HL and NH patients were older compared with AA (69.2 ± 14.7 vs 67.9 ± 15.3 vs 59.4 ± 15.8 years; p < 0.001). The HL group had higher prevalence of females compared with NH (62 vs 47%; p = 0.002), and more moderate-severe mitral regurgitation (35 vs 23 vs 12% p < 0.001) and a higher E/e’ ratio (16.4 ± 8.1 vs 14.9 ± 6.6 vs 13.3 ± 4.5; p = 0.002) when compared with NH and AA. Multivariate linear regression analysis revealed HL ethnicity (β = 0.1) was associated with worse New York Heart Association (NYHA) class independent from moderate-severe mitral regurgitation (β = 0.2), chronic obstructive pulmonary disease (β = 0.17), female gender (β = 0.13), coronary artery disease (β = 0.12), atrial fibrillation (β = 0.11), peak trans-mitral E-wave velocity (β = 0.11), left ventricular mass index (β = 0.1), and reverse septal curve morphology (β = 0.1) (model, r = 0.5, p < 0.001). At 2.5-year median follow-up, all-cause mortality (8%) and composite complications (33%) were similar across the cohort.

HCM patients of HL race have worse heart failure symptoms when compared with NH and AA, with severity independent of cardiovascular co-morbidities.