Liu HY, Hong ZX, Jiang ZH
… +2 more, Shen Y, Hong K
Zhonghua Xin Xue Guan Bing Za Zhi
· 2026 Jan · PMID 41529851
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Investigate the distribution characteristics of plakophilin 2 (PKP2) variants in the protein structural domains and the relationship between genotypes and phenotypes in patients with arrhythmogenic right ventricular card...Investigate the distribution characteristics of plakophilin 2 (PKP2) variants in the protein structural domains and the relationship between genotypes and phenotypes in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC). By searching the Human Gene Mutation Database, ClinVar, PubMed and Embase databases, all reported PKP2 variants were collected. These variants were classified based on mutation types, ultimately including non-synonymous single nucleotide variations (nsSNVs) associated with ARVC. Simultaneously, topology information of the PKP2 protein was retrieved from the Uniprot database, and PKP2 nsSNVs were categorized according to the protein's structural domains. The pathogenicity of PKP2 nsSNVs was assessed using the InterVar software, and the distribution of pathogenic classifications in different structural domains was explored. Hotspot variants were selected from PKP2 nsSNVs, and their distribution characteristics in structural domains were analyzed. Finally, R software was employed to analyze the overall distribution patterns of PKP2 total variants, pathogenic or likely pathogenic variants and hotspot variants in protein structural domains, and the correlation between PKP2 variants and ARVC clinical phenotypes. This study collected a total of 1 358 reported PKP2 variants, which included 497 nsSNVs associated with ARVC. The PKP2 nsSNVs associated with ARVC were significantly enriched in the Arm1, Arm2, Arm3, and Arm7 regions of the protein structure. Additionally, 55 pathogenic or likely pathogenic variants were enriched in the Arm3 and Arm5. There were a total of 179 hotspot variants, and their pathogenic risks did not show significant differences compared to other nsSN Vs. Variants located in the Arm1 domain were more prone to ventricular premature contractions, while patients with variants in the Arm4 were more likely to exhibit myocardial fibrofatty changes. Patients with variants in the Region1 were more susceptible to ventricular tachycardia (all <0.05). The PKP2 nsSNVs associated with ARVC are enriched in the Arm1, Arm2, Arm3, and Arm7 structural domains, with a higher proportion of pathogenic or likely pathogenic variants in the Arm3 and Arm5 domains. Moreover, Region 1 significantly increases the risk of ventricular arrhythmia among ARVC patients.
Zhonghua Xin Xue Guan Bing Za Zhi
· 2026 Jan · PMID 41529850
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Evaluate the short-term safety and effectiveness of a novel helical scoring balloon catheter in the treatment of coronary lesions during percutaneous coronary intervention (PCI). This study employed a multicenter, prosp...Evaluate the short-term safety and effectiveness of a novel helical scoring balloon catheter in the treatment of coronary lesions during percutaneous coronary intervention (PCI). This study employed a multicenter, prospective, randomized controlled non-inferiority trial design. Led by the General Hospital of Northern Theater Command, it enrolled 207 patients scheduled for PCI across three centers between October 2021 and March 2022. Patients were randomized 1∶1 to the spiral-scored balloon group (=104) or the ScoreFlex balloon group (=103) with 30-day follow-up. The primary endpoint was device success rate, defined as successful delivery to the target lesion, normal inflation and deflation, successful withdrawal, and residual stenosis ≤50.0% after pre-ballooning. The non-inferiority margin was set at -9.0%. Secondary endpoints included procedure success rate, 30-day target lesion failure, and patient-oriented cardiovascular clinical composite endpoint. The incidence of non-device-related adverse events and device-related complications was also assessed in both groups. The spiral-scored balloon group had an average age of (60.1±9.3) years, with 69 males (66.3%). The ScoreFlex balloon group had an age of (61.2±9.0) years, with 74 males (71.8%). For the primary endpoint, the device success rate was 98.1% (102/104) in the spiral-scored balloon group and 100.0% (103/103) in the ScoreFlex balloon group. The lower limit of the 95% for the rate difference was -4.6%, exceeding the non-inferiority margin of -9.0%, confirming non-inferiority (<0.001). For secondary endpoints, the procedure success rates were 100.0% in both groups. Neither group experienced the 30-day target lesion failure or patient-reported cardiovascular clinical composite endpoint. Safety analysis showed the incidence of non-device-related adverse events was 1.9% (2/104) in the spiral-scored balloon group and 2.9% (3/103) in the ScoreFlex balloon group, with no statistically significant difference (=0.683). No device-related complications occurred in either group. The novel spiral scoring balloon catheter was noninferior to the ScoreFlex scoring balloon for device success and demonstrated favorable 30-day safety and effectiveness, supporting its use as an option for coronary lesion preparation during PCI.
Zhonghua Xin Xue Guan Bing Za Zhi
· 2026 Jan · PMID 41529849
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To evaluate the prognostic value of F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT gated myocardial metabolic imaging combined with Tc-methoxyisobutylisonitrile (MIBI) single-photon emission computed to...To evaluate the prognostic value of F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT gated myocardial metabolic imaging combined with Tc-methoxyisobutylisonitrile (MIBI) single-photon emission computed tomography (SPECT) gated myocardial perfusion imaging in patients with ischemic heart failure complicated by multi-vessel coronary disease and diabetes. This was a retrospective study. Patients with ischemic heart failure complicated by multi-vessel coronary disease and diabetes who underwent Tc-MIBI SPECT gated myocardial perfusion imaging and F-FDG PET/CT gated myocardial metabolic imaging between April 2016 and January 2021 at Beijing Anzhen Hospital, Capital Medical University were enrolled. All patients were followed up, with all-cause death as the endpoint. Patients were divided into the death group and the survival group based on whether the endpoint event occurred during the follow-up period. Cox regression model was used to identify the independent influencing factors of all-cause death in these patients. Subgroup analyses were performed according to hibernating myocardium (≤10% or >10%) and therapy strategy (revascularization or medical therapy). Kaplan-Meier survival curves were plotted, and the log-rank test was used to compare the differences in cumulative survival rates between groups with different hibernating myocardium ranges and treatment methods. A total of 156 patients were enrolled, with an age of 60.0 (52.0, 66.0) years, including 131 males (84.0%). During a follow-up of 5.0 (3.3, 5.9) years, 38 all-cause deaths were observed, and 118 patients survived. Multivariate Cox regression analysis showed that revascularization was a protective factor against all-cause death in patients with ischemic heart failure complicated by multivessel coronary artery disease and diabetes mellitus (=0.298, 95% 0.144-0.617, =0.001). Kaplan-Meier survival analysis revealed that among patients with hibernating myocardium range >10%, the cumulative survival rate was significantly higher in those who underwent revascularization than in those receiving medical therapy ((86.7±4.0)% vs. (38.0±10.7)%, log-rank <0.001). In contrast, there was no statistically significant difference in cumulative survival rate between revascularization and medical therapy groups among patients with hibernating myocardium range ≤10% ((83.3±10.8)% vs. (75.0±10.8)%, log-rank >0.05). In patients with ischemic heart failure complicated by multivessel coronary artery disease and diabetes mellitus, revascularization is a protective factor for prognosis. Assessment of hibernating myocardium facilitates risk stratification and guides treatment decision-making in such patients, helping identify high-risk individuals who may benefit from revascularization.
Song WH, Wang Q, Shangguan WF
… +5 more, Zhao ZQ, Liu EZ, Xu G, Li GP, Liu T
Zhonghua Xin Xue Guan Bing Za Zhi
· 2026 Jan · PMID 41529848
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To investigate the efficacy of cryoballoon ablation in the treatment of patients with atrial fibrillation (AF) complicated by heart failure with preserved ejection fraction (HFpEF), and to analyze the relevant influencin...To investigate the efficacy of cryoballoon ablation in the treatment of patients with atrial fibrillation (AF) complicated by heart failure with preserved ejection fraction (HFpEF), and to analyze the relevant influencing factors of AF recurrence after cryoballoon ablation. This prospective cohort study consecutively enrolled patients with AF who underwent cryoballoon ablation in the Department of Cardiology, Second Hospital of Tianjin Medical University between May 2020 and December 2023. According to the presence or absence of HFpEF, the enrolled patients were divided into non-HFpEF group and HFpEF group, and their baseline data were collected. Propensity score matching was used to match the baseline data of the two groups at a ratio of 1∶2. In the matched cohort, patients were followed up, and further divided into recurrence group and non-recurrence group based on whether AF recurrence occurred during the follow-up period. Cox regression model was used to analyze the influencing factors of AF recurrence after cryoballoon ablation. A total of 444 patients were enrolled, aged (67±9) years, including 221 (49.8%) males; among them, 371 were in the non-HFpEF group and 73 in the HFpEF group. After propensity score matching, 207 patients were included in the subsequent analysis, aged (68±10) years, consisting of 101(48.8%) males. 138 patients were in the non-HFpEF group and 69 in the HFpEF group. During a follow-up period of 292 (135, 574) days, 40 patients had AF recurrence, while 167 had no recurrence. Compared with the non-recurrence group, the recurrence group had a higher incidence of early atrial arrhythmia (40.0% vs. 10.2%, <0.001) and a lower maximum emptying velocity of the left atrial appendage (47.00 (25.00, 65.00) cm/s vs. 54.00 (38.00, 70.74) cm/s, =0.030). Univariate Cox regression analysis showed that HFpEF (=0.845, 95% 0.429-1.662, =0.625) was not an influencing factor for AF recurrence after cryoballoon ablation. Multivariate Cox regression analysis revealed that early atrial arrhythmia (=3.586, 95% 1.680-7.651, =0.001) and free triiodothyronine level (=0.661, 95% 0.479-0.911, =0.011) were influencing factors for AF recurrence after cryoballoon ablation. Cryoballoon ablation can be used as an effective treatment option for patients with AF complicated by HFpEF. Early atrial arrhythmia and free triiodothyronine levels were influencing factors of AF recurrence after cryoballoon ablation.
Zhonghua Xin Xue Guan Bing Za Zhi
· 2026 Jan · PMID 41529847
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To compare the differences in cardiac magnetic resonance (CMR) characteristics between dilated cardiomyopathy (DCM) patients accompanied by left ventricular hypertrabeculation and those with isolated DCM, and to investig...To compare the differences in cardiac magnetic resonance (CMR) characteristics between dilated cardiomyopathy (DCM) patients accompanied by left ventricular hypertrabeculation and those with isolated DCM, and to investigate the impact of left ventricular hypertrabeculation on the prognosis of DCM patients. This single-center retrospective cohort study enrolled DCM patients who were admitted to Peking Union Medical College Hospital from November 2016 to March 2025. Basic clinical data and CMR parameters of the patients were collected. According to the results of echocardiography, the patients were divided into the isolated DCM group and the DCM with left ventricular hypertrabeculation group. Patients were followed up through outpatient visits or telephone calls. The composite endpoint consisting of cardiovascular death, heart failure hospitalization, and malignant arrhythmia events (ventricular fibrillation, sustained ventricular tachycardia) was used as the outcome event. Univariate and multivariate Cox proportional hazards regression models were used to analyze the risk factors affecting the prognosis of DCM patients. Survival analysis was performed using Kaplan-Meier curves, and the log-rank test was used to compare the differences in the incidence of outcome events between groups. Subgroup analysis was conducted according to the range of left ventricular late gadolinium enhancement (LGE) (≥7.5% and <7.5%). A total of 114 DCM patients were enrolled, including 65 in the isolated DCM group and 49 in the DCM with left ventricular hypertrabeculation group. In the isolated DCM group, the patients had an age of (44±16) years, with 44 males (68%); in the DCM with left ventricular hypertrabeculation group, the patients had an age of (40±17) years, with 32 males (65%). Regarding echocardiographic parameters, there were no statistically significant differences in left ventricular ejection fraction ((34±8)% vs. (32±11)%) and left ventricular end-diastolic diameter ((65±8) mm vs. (66±8) mm) between the isolated DCM group and the DCM with left ventricular hypertrabeculation group (both >0.05). In terms of CMR characteristics, the left ventricular end-diastolic volume (126 (105, 158) ml vs. 146 (114, 185) ml), left ventricular global longitudinal strain ((-8.15±3.17)% vs. (-8.56±3.76)%), and left ventricular LGE extent (11.4 (4.3, 26.6)% vs. 12.3 (5.4, 20.2)%) in the isolated DCM group were lower than those in the DCM with left ventricular hypertrabeculation group, while the left ventricular ejection fraction was higher than that in the DCM with left ventricular hypertrabeculation group (29 (23, 35)% vs. 27 (20, 39)%). However, there were no statistically significant differences in the above CMR parameters between the two groups (all >0.05). For prognosis, during a follow-up of 368 (146, 652) days, 25 patients (22%) experienced outcome events, including 4 cases (4%) of cardiovascular death, 22 cases (19%) of heart failure hospitalization, and 1 case (1%) of malignant arrhythmia. Cox regression analysis showed that left ventricular hypertrabeculation was not associated with the occurrence of outcome events in DCM patients (=0.682, 95% 0.301-1.540, =0.358), while left ventricular LGE extent was associated with the prognosis of DCM patients (=6.589, 95% 1.064-40.794, =0.043). Kaplan-Meier curves showed that there was no statistically significant difference in the cumulative incidence of outcome events between the isolated DCM group and the DCM with left ventricular hypertrabeculation group (log-rank =0.355); however, DCM patients with left ventricular LGE extent ≥7.5% had a higher risk of adverse prognosis than those with left ventricular LGE extent <7.5% (log-rank =0.032). There are no significant differences in CMR characteristics between DCM patients with left ventricular hypertrabeculation and those with isolated DCM, and left ventricular hypertrabeculation had no impact on the prognosis of DCM patients. In contrast, left ventricular LGE extent was a risk factor affecting the prognosis of DCM patients.
Chinese Society of Cardiology, Chinese Medical Association, Chinese College of Cardiovascular Physicians, Editorial Board of Chinese Journal of Cardiology
Zhonghua Xin Xue Guan Bing Za Zhi
· 2026 Jan · PMID 41448576
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