BMC Cardiovascular Disorders[JOURNAL]
Sun
200 papers
Sex disparities in pre-hospital delay in patients with acute myocardial infarction: a systematic review and meta-analysis.
Hu D, Duan Y, Song J … +1 more , Wei L
BMC Cardiovasc Disord · 2026 Jun · PMID 42265637 · Full text
BACKGROUND: Pre-hospital delay is a critical determinant of outcomes in acute myocardial infarction (AMI). While sex-based differences in time to presentation have been documented, evidence regarding the association betw...
BACKGROUND: Pre-hospital delay is a critical determinant of outcomes in acute myocardial infarction (AMI). While sex-based differences in time to presentation have been documented, evidence regarding the association between sex and pre-hospital delay remains inconsistent. This study aimed to determine whether female sex is associated with prolonged pre-hospital delay among patients with AMI. METHODS: We conducted a systematic review and meta-analysis of studies published between 2000 and 2025, retrieved from PubMed and Web of Science. Included studies reported multivariable-adjusted odds ratios (ORs) for the association between sex (female vs. male) and pre-hospital or patient delay in AMI. Risk of bias was assessed using the Agency for Healthcare Research and Quality checklist. Summary ORs were calculated using inverse variance-weighted random-effects models. Heterogeneity was evaluated using I²and Cochran's Q statistics. Publication bias was assessed via funnel plots and Egger's test. RESULTS: Twenty-nine studies involving 127,409 AMI patients were analysed (21 evaluated pre-hospital delay, 8 focused on patient delay). Female sex was significantly associated with prolonged pre-hospital delay (OR = 1.17, 95% CI = 1.11 to 1.23, I=46.3%) and demonstrated an even stronger association with patient delay (OR = 1.23, 95% CI = 1.10 to 1.38, I=11.9%). These associations persisted across AMI subtypes and after adjustment for confounding factors. CONCLUSION: Significant sex disparities exist in pre-hospital delay among AMI patients, with women experiencing longer delays than men. Addressing these gender disparities is crucial for improving timely recognition and management of AMI, ultimately leading to better clinical outcomes and reduced gender-based healthcare inequalities. TRIAL REGISTRATION: PROSPERO (ID: CRD420251022182).
Association between PM components and electrocardiogram abnormalities among elderly individuals: a longitudinal study in Guangzhou, China.
Zhang C, Zhou Q, Chen J … +9 more , Qian ZM, Kavuri M, Burroughs T, Ai Z, Wei S, Lin W, Zhang Z, Liu H, Lin H
BMC Cardiovasc Disord · 2026 Jun · PMID 42265622 · Full text
BACKGROUND: Fine particulate matter (PM) is linked with cardiovascular diseases (CVD), however, its association with electrocardiogram (ECG) abnormality, a prognostic indicator of CVD, remains largely unknown, especially...
BACKGROUND: Fine particulate matter (PM) is linked with cardiovascular diseases (CVD), however, its association with electrocardiogram (ECG) abnormality, a prognostic indicator of CVD, remains largely unknown, especially different chemical components of PM. This study aimed to investigate the longitudinal associations of long-term exposure to PM and its chemical constituents with electrocardiogram abnormalities among elderly individuals in Guangzhou, China. METHODS: The study was based on a survey of elderly people in the communities of Guangzhou from 2018 to 2022. Bilinear interpolation and residential addresses were used to ascertain annual averages of PM and its components prior to ECG abnormalities. The generalized estimation equations (GEE) models were used to evaluate the association with ECG abnormalities. RESULTS: 215,073 participants were included in this study. Each participant received at least one electrocardiogram examination, with a total of 691,990 recordings. PM and its five components (sulfate, nitrate, ammonium, organic matter, and black carbon) were significantly associated with elevated risks of ECG abnormalities. For PM, odds ratio (OR) of ECG abnormalities per interquartile range (IQR) increase was 1.029 (95% confidence interval [CI]: 1.020-1.037), among its components was the highest for ammonium (OR:1.070, 95% CI: 1.062-1.078), followed by nitrate (OR:1.058, 95% CI: 1.050-1.065), sulfate (OR:1.047, 95% CI: 1.040-1.054), black carbon (OR:1.034, 95% CI: 1.027-1.042) and organic matter (OR:1.030, 95% CI: 1.022-1.037). CONCLUSION: Our study provides evidence that PM and its components might lead to a greater risk of ECG abnormalities, underscoring the clinical value of ECG as an early indicator of potential reversible risks in the cardiovascular system. Strategies that target reducing PM pollution might improve the health outcomes of elderly people with ECG abnormalities.
Serum Human epididymal protein 4 as a predictor of adverse events in acute ischemic stroke patients receiving antiplatelet therapy.
Liu N, Bao N, Liu G … +1 more , Luo X
BMC Cardiovasc Disord · 2026 Jun · PMID 42265618 · Full text
BACKGROUND: Acute kidney injury (AKI) frequently develops in certain patients with acute ischemic stroke (AIS) and often indicates a poor prognosis. However, the relationship between serum human epididymal protein 4 (HE4...
BACKGROUND: Acute kidney injury (AKI) frequently develops in certain patients with acute ischemic stroke (AIS) and often indicates a poor prognosis. However, the relationship between serum human epididymal protein 4 (HE4), a newly recognized biomarker of renal injury, and adverse outcomes in AIS patients remains unclear. AIM: This study aimed to investigate the prognostic value of admission serum HE4 levels for predicting unfavorable outcomes in AIS patients undergoing antiplatelet therapy. METHODS: We conducted a cohort study involving 144 consecutive adult patients admitted for AIS who received antiplatelet treatment. Blood samples were collected after admission to measure serum HE4 concentrations. RESULTS: Serum HE4 levels were markedly elevated in AIS patients on antiplatelet therapy compared with healthy controls (116.4 ± 24.8 pmol/L vs. 25.3 ± 9.8 pmol/L). Kaplan-Meier analysis revealed that higher HE4 levels were associated with an increased incidence of cardiovascular events and/or recurrent stroke. Multivariate Cox regression analysis indicated that elevated HE4 concentrations independently predicted a higher risk of cardiovascular events (HR = 3.02; 95% CI: 1.51-6.29; P = 0.01) and stroke recurrence (HR = 3.81; 95% CI: 1.64-6.63; P < 0.01). CONCLUSIONS: Elevated serum HE4 levels are significantly associated with a heightened risk of cardiovascular events and recurrent stroke in AIS patients receiving antiplatelet therapy, suggesting that HE4 may serve as a potential biomarker for predicting adverse outcomes in this population.
Radiofrequency ablation of long-standing persistent atrial fibrillation in a patient with dextrocardia, interrupted inferior vena cava and mirrored persistent left superior vena cava.
Ma YL, Wang LZ, Ma XM
BMC Cardiovasc Disord · 2026 Jun · PMID 42265614 · Full text
INTRODUCTION: Catheter ablation is an established treatment for atrial fibrillation (AF). However, AF ablation in patients with complex congenital anatomical variants, including mirror dextrocardia, interrupted inferior...
INTRODUCTION: Catheter ablation is an established treatment for atrial fibrillation (AF). However, AF ablation in patients with complex congenital anatomical variants, including mirror dextrocardia, interrupted inferior vena cava (IVC), and persistent left superior vena cava (PLSVC), remains technically challenging, with limited published clinical experience. CASE PRESENTATION: We report a 60-year-old female patient with long-standing persistent AF and heart failure with reduced ejection fraction, who had mirror dextrocardia, interrupted IVC, and PLSVC. The procedure was performed via a left internal jugular vein approach for transseptal puncture and ablation. The strategy included bilateral pulmonary vein isolation, linear ablation of the left atrial roof, mitral isthmus, and hepatic venous - tricuspid isthmus, plus electrical isolation of the PLSVC, all guided by intracardiac echocardiography and electroanatomic mapping. OUTCOMES: At 17 months of follow-up, the patient remained asymptomatic with no documented atrial arrhythmia recurrence. Left ventricular ejection fraction improved from 36% to 46%. CONCLUSIONS: This single case demonstrates that in patients with complex anatomical variants and long-standing persistent AF, AF ablation incorporating targeted PLSVC electrical isolation via a left internal jugular vein approach under intracardiac echocardiography guidance is feasible, safe, and clinically effective. Further experience is needed to confirm the generalizability of this strategy.
ECG-guided culprit-first vs. angiography-based revascularization in STEMI: a real-world retrospective study.
Yan C, Zhang L, Sha S … +3 more , Chen X, Li H, Xu X
BMC Cardiovasc Disord · 2026 Jun · PMID 42260411 · Full text
BACKGROUND: The single transradial guiding catheter (STGC) technique has emerged as a promising approach to minimize catheter exchanges and optimize reperfusion timelines in ST-elevation myocardial infarction (STEMI) pat...
BACKGROUND: The single transradial guiding catheter (STGC) technique has emerged as a promising approach to minimize catheter exchanges and optimize reperfusion timelines in ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI). This study aimed to compare the procedural efficiency and clinical outcomes of two STGC-based strategies: electrocardiogram (ECG)-guided culprit-first intervention and angiography-based group. METHODS: A retrospective cohort study was conducted on 494 STEMI patients who underwent transradial PCI using a 6Fr IL3.5 (Terumo) STGC at Jiading District Central Hospital between January 2022 and December 2024. Patients were stratified into two groups based on procedural workflow: the ECG-guided group (n = 128) underwent immediate culprit vessel PCI guided by preoperative ECG followed by contralateral angiography, while the angiography-based group (n = 366) received bilateral diagnostic angiography prior to culprit vessel intervention. Primary endpoints included door-to-balloon (D2B), catheterization lab-to-balloon (C2B), and puncture-to-balloon (P2B) times. Secondary endpoints encompassed procedural success rate, 30-day major adverse cardiac events (MACE), and operator preference. RESULTS: The ECG-guided group demonstrated significantly shorter median C2B (20.96 vs. 23.55 min, p = 0.01) and P2B times (13.89 vs. 16.06 min, p < 0.01) compared to the angiography-based group. However, there was no statistically significant difference in D2B time between the two groups (50.46 vs. 56.44 min, p = 0.36). Both groups achieved high procedural success rates (98.43% vs. 99.18%, p = 0.68) and comparable post-PCI Thrombolysis In Myocardial Infarction flow grade(TIMI)-3 flow rates (98.44% vs. 99.18%). Culprit vessel distribution differed significantly (p < 0.001), with left anterior descending artery (LAD) predominance in the ECG-guided group (71.88%) and a more balanced distribution between right coronary artery (RCA) and LAD in the angiography-based group. Operator preference strongly influenced strategy selection (p = 0.002), with four operators showing varying inclinations towards angiography-based group (66.67∽87.18%). No significant differences were observed in 30-day MACE (cardiac death, reinfarction, target vessel revascularization) or stroke rates (all p > 0.05). CONCLUSIONS: In STEMI patients undergoing transradial PCI with an IL3.5 single transradial guiding catheter, the ECG-guided culprit-first strategy was associated with significantly shorter C2B and P2B times compared with the angiography-based approach. However, no significant difference was observed in total D2B time between the two strategies.
Left atrium incisure curvature: an indicator for predicting atrial fibrillation-related cardioembolism.
He J, Wang Y, Hou J … +8 more , Chen P, Wei W, Hu D, Fu Z, Zheng D, Xia L, Deng D, Dong R
BMC Cardiovasc Disord · 2026 Jun · PMID 42260400 · Full text
BACKGROUND: The use of supplementary parameters, such as clinical criteria, biomarkers, and imaging data, may enhance the risk prediction of stroke and systemic embolic events. Current stroke risk scores are clinically p...
BACKGROUND: The use of supplementary parameters, such as clinical criteria, biomarkers, and imaging data, may enhance the risk prediction of stroke and systemic embolic events. Current stroke risk scores are clinically practical but limited in their ability to predict stroke risk accurately in individual patients. It is difficult for doctors to distinguish patients with truly high-thrombotic risk. In this study, we propose a simple and effective method for predicting stroke and systemic embolic events in patients with atrial fibrillation (AF). METHODS: In this retrospective study, 169 patients with AF were divided into three groups: Group A (those with paroxysmal AF with no cardioembolic events), Group B (those with persistent AF with no cardioembolic events), and Group C (those with persistent AF with cardioembolic events). By examining the chest CT images of all the included patients, we discovered that the left atrium (LA) incisure disappearing with the progression of AF, particularly in those with cardioembolic events (Group C). For the convenience of quantitative analysis, a border detection algorithm along with an LA incisure curvature computation algorithm was developed to predict cardioembolic events in patients with AF. RESULTS: The results indicated that the average curve rates of LA incisure were - 2.6 (-3.55, -1.95) ×10, -1.40 (-2.13, -0.43) ×10, and 0.51 (0.02, 1.40) ×10 for Groups A, B, and C, respectively. The accuracy, sensitivity, and specificity of the LA incisure curvature for predicting cardioembolic events were 85.21%, 96%, and 80.7%, respectively. CONCLUSIONS: LA incisure curvature is an effective indicator for predicting AF-related strokes and systemic embolic events, which should be confirmed through multicentre retrospective and prospective research in the future.
Position-wise comparison of handheld 6-lead ECG versus the standard 12-lead ECG in patients with arrhythmia: comparative study.
Park YJ, Eom S, Lee SJ … +7 more , Na Y, Lim J, Park M, Ahn HJ, Chang M, Joo S, Ahn MS
BMC Cardiovasc Disord · 2026 Jun · PMID 42260399 · Full text
BACKGROUND: As 12‑lead electrocardiographs (ECGs) require a clinical infrastructure that limits timely access, portable 6‑lead devices may extend diagnostics to community and remote settings. We evaluated the signal equi...
BACKGROUND: As 12‑lead electrocardiographs (ECGs) require a clinical infrastructure that limits timely access, portable 6‑lead devices may extend diagnostics to community and remote settings. We evaluated the signal equivalence of a handheld 6‑lead ECG (HATIV P30) versus the standard 12‑lead in an arrhythmia cohort, considering posture and synchrony. METHODS: In this prospective single-center study, simultaneous 10-s 12-lead ECGs and time-aligned 10-s segments from 30-s 6-lead recordings were obtained from arrhythmia patients in both supine and sitting positions. A blinded electrophysiologist performed rhythm classification and ECG measurements. Diagnostic accuracy and numerical agreement of key parameters (PR interval, QRS duration, QT/QTc intervals, and amplitudes) were evaluated. RESULTS: A total of 229 paired recordings were analyzed after excluding 6 pairs. The overall diagnostic accuracy of the 6‑lead versus 12‑lead was 99.1% in the supine position (n = 113) and 99.1% in the sitting position (n = 116); one atrial flutter was misclassified as atrial fibrillation in each position. Bland-Altman analyses showed small mean differences (12‑lead minus 6‑lead): PR + 12.1/ + 7.4 ms (supine/sitting), QRS - 6.4/ - 6.0 ms, QT - 10.3/ - 5.3 ms, QTc - 11.5/ - 6.4 ms; heart‑rate difference ≈0.03 bpm. The absolute differences were < 20 ms in approximately ~ 70% for PR and ~ 55-62% for QT/QTc. In an exploratory asynchronous pairing (supine 12‑lead vs sitting 6‑lead; n = 103), accuracy decreased to 97.1% and parameter differences widened, consistent with postural/temporal effects. CONCLUSIONS: In patients with arrhythmia, the handheld 6‑lead showed near‑perfect rhythm agreement and small numerical differences versus the 12‑lead under synchronized acquisition in both positions. Asynchronous or posture-mismatched comparisons reduce the agreement, and acquisition conditions should be considered. The 6‑lead may be a practical alternative when the 12‑lead is unavailable in patients with arrhythmia.
Protein C deficiency in a uremic patient: a rare case of multivessel thromboembolism and type 5 cardiorenal syndrome.
Ying Q, Shen J, Yang X … +8 more , Wu Y, Wu H, Shi X, Wu S, Zhao N, Wang M, Li X, Mao Y
BMC Cardiovasc Disord · 2026 Jun · PMID 42260396 · Full text
Protein C deficiency is a rare inherited disorder characterized by low levels or impaired function of protein C, a natural anticoagulant protein. Deficiency in protein C activity leads to a hypercoagulable state, predomi...
Protein C deficiency is a rare inherited disorder characterized by low levels or impaired function of protein C, a natural anticoagulant protein. Deficiency in protein C activity leads to a hypercoagulable state, predominantly resulting in venous thromboembolism. We report a case of a 69-year-old female with uremia who presented with recurrent heart failure, myocardial infarction, and extensive thromboembolism involving both arterial (coronary, abdominal aorta, renal, iliac, splenic, and femoral arteries) and venous systems (femoral, popliteal, and calf muscle veins). Progressive renal dysfunction led to a diagnosis of uremia, and genetic testing confirmed protein C deficiency. The patient ultimately succumbed to multiple organ failure, intractable ascites, and spontaneous bacterial peritonitis. This case underscores the importance of considering protein C deficiency in patients presenting with unexplained multivessel thromboembolism. For patients presenting with unexplained myocardial infarction, renal/hepatic dysfunction, extensive vascular thrombosis or calcification, acral gangrene, or persistently elevated D-dimer levels, we recommend implementing key diagnostic interventions, including protein C activity assay and genetic screening. This case suggests that protein C deficiency may be a rare potential etiology of type 5 cardiorenal syndrome, an association that requires further validation in larger cohort studies.
Prevalence of hyperhomocysteinemia in South Asian patients with heart disease: a systematic review and meta-analysis.
Alabbi MN, Nanziba R, Malek NM … +5 more , Ahmed N, Hoque H, Siddiqee MH, Bhattacharjee B, Deen NS
BMC Cardiovasc Disord · 2026 Jun · PMID 42260385 · Full text
BACKGROUND: Hyperhomocysteinemia, characterized by an elevated concentration of serum homocysteine, is a well-recognized risk factor for cardiovascular pathophysiology. South Asians are known to have a high burden of car...
BACKGROUND: Hyperhomocysteinemia, characterized by an elevated concentration of serum homocysteine, is a well-recognized risk factor for cardiovascular pathophysiology. South Asians are known to have a high burden of cardiovascular disease, and hyperhomocysteinemia is commonly observed in this population. The present systematic review and meta-analysis aimed to assess the pooled prevalence of hyperhomocysteinemia and estimate the serum homocysteine concentrations among South Asians with heart disease. METHODS: Following PRISMA 2020 reporting guidelines, systematic searches were conducted to identify studies focusing on the South Asians, heart disease and homocysteine. Random-effects meta-analyses were performed using MetaXL to determine the pooled prevalence of hyperhomocysteinemia among patients with heart disease, and standardized mean difference in serum homocysteine concentration between patients with and without heart disease. Meta-regression analyses were performed to identify the source of data heterogeneity. Additionally, GRADE tool was used to assess the certainty of evidence for the study outcomes. RESULTS: A total of 47 articles comprising 6094 heart disease patients from India, Pakistan, Bangladesh and Afghanistan met the inclusion criteria. The overall pooled prevalence of hyperhomocysteinemia was 61% (95% CI: 49-72%) with a significant heterogeneity (I = 98%; p < 0.01). The weighted mean serum homocysteine concentration was 20.98 µmol/L (SD: 4.57). Additionally, the standardized mean difference in serum homocysteine concentration between patients with and without heart disease was 2.22 (95% CI: 1.63-2.82). Subgroup analyses of pooled prevalence and standardized mean difference based on different covariates demonstrated high degree of heterogeneity (I = 85-98%; p < 0.01) and the subsequent meta-regression analyses indicated that study precision, as indicated by the standard error and the number of patients, substantially contributed to the observed heterogeneity. Finally, GRADE assessment rated certainty of evidence for prevalence as low and for SMD as moderate. CONCLUSION: Despite variability and limited country representation, this first meta-analysis of South Asian population shows that the prevalence of hyperhomocysteinemia is high among heart disease patients in this region, with homocysteine concentrations significantly exceeding the diagnostic threshold of ≥ 15 µmol/L. These findings stress the need for homocysteine-lowering interventional studies to confirm hyperhomocysteinemia as a potential risk factor of heart disease in this region. TRIAL REGISTRATION: Prospero registration number: CRD42023424762.
Risk factors and outcomes of HPH in high-altitude residents via echocardiographic evaluation.
Wang S, Yu L, Huang L … +4 more , Liu X, Luo F, Wang W, Wang L
BMC Cardiovasc Disord · 2026 Jun · PMID 42260366 · Full text
BACKGROUND: Over 80 million people live above 2,500 m, where hypobaric hypoxia increases hypoxic pulmonary hypertension (HPH) risk. In Qinghai, China (> 3,000 m), over 5 million face a high HPH burden with limited medica...
BACKGROUND: Over 80 million people live above 2,500 m, where hypobaric hypoxia increases hypoxic pulmonary hypertension (HPH) risk. In Qinghai, China (> 3,000 m), over 5 million face a high HPH burden with limited medical resources. OBJECTIVE: To evaluate risk factors and outcomes of HPH in high-altitude residents using echocardiography. METHODS: This retrospective study analyzed 627 HPH patients (PASP > 50 mmHg) in Qinghai (2018-2022), categorized as moderate (50 < PASP < 70 mmHg) or severe (PASP ≥ 70 mmHg). Clinical, biochemical, and echocardiographic data were assessed, with mortality tracked via telephone follow-up after ≥ 1 year. Logistic and Cox regression identified severity and mortality predictors. RESULTS: Among 627 high-altitude residents with HPH, 360 (57.4%) had moderate HPH (50 < PASP < 70 mmHg) and 267 (42.6%) had severe HPH (PASP ≥ 70 mmHg). Severe HPH was associated with higher APTT (p = 0.004), LPa (p = 0.004), cyanosis (p = 0.003), and right ventricular hypertrophy (p = 0.001) via multivariate logistic regression. Mortality predictors, identified by multivariate Cox regression, included LPa (p = 0.001), atrial fibrillation (p = 0.003), heart failure (p = 0.021), and alcohol consumption (p = 0.013). CONCLUSION: In Qinghai's high-altitude residents, APTT, LPa, cyanosis, and right ventricular hypertrophy drive severe HPH, while LPa, atrial fibrillation, heart failure, and alcohol consumption predict mortality. Monitoring APTT and LPa may aid early detection, and managing modifiable factors like alcohol and atrial fibrillation could reduce mortality in resource-limited settings.
Sex-specific non-linear association between post-procedural high-sensitivity troponin t and 12-month mortality after PCI: insights from a prospective large-scale registry.
Yang X, Na K, Qiu M … +4 more , Li J, Li Y, Yan C, Han Y
BMC Cardiovasc Disord · 2026 Jun · PMID 42260356 · Full text
BACKGROUND: Post-procedural high-sensitivity cardiac troponin T (hs-TnT) is an established prognostic marker in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). Current pra...
BACKGROUND: Post-procedural high-sensitivity cardiac troponin T (hs-TnT) is an established prognostic marker in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). Current practice applies uniform troponin thresholds regardless of sex, potentially overlooking biological differences in cardiac mass and injury patterns. This study aimed to investigate whether the association between elevated hs-TnT and clinical outcomes differs by sex, and to characterize sex-specific dose-response relationships. METHODS: This retrospective analysis utilized data from a prospective PCI registry enrolling consecutive ACS patients between March 2016 and March 2019. Patients were stratified by post-procedural hs-TnT concentrations measured within 48 h after PCI (< 0.5 vs. ≥ 0.5 ng/mL). The primary outcome was all-cause mortality at 12 months after PCI. The main secondary outcomes included ischemic events (composite of cardiac death, myocardial infarction, or stroke) at 12 months. Multivariable Cox regression models with sex-by-hs-TnT interaction terms and restricted cubic spline (RCS) analyses were performed. RESULTS: Among 14,214 patients (10,416 males, 3,798 females), elevated hs-TnT (≥ 0.5 ng/mL) was associated with increased 12-month mortality in both sexes, with a stronger association in females (aHR 2.83; 95% CI 1.56-5.13) than in males (aHR 1.63; 95% CI 1.03-2.58; P for interaction = 0.019). For cardiac death, similar differences were observed (P for interaction = 0.023). RCS analysis revealed a nonlinear relationship between hs-TnT and mortality in females (P for nonlinearity = 0.01), whereas the relationship was linear in males (P for nonlinearity = 0.12). The formal test of interaction between continuous hs-TnT and sex confirmed this divergence (P = 0.0042). CONCLUSIONS: The prognostic impact of elevated post-procedural hs-TnT on mortality was substantially greater in female than in male ACS patients. These hypothesis-generating findings suggest that sex-specific approaches to troponin-based risk stratification after PCI warrant further investigation.
Smartwatch-derived exercise metrics as predictors of early hypertension: a prospective observational study.
Ceyhun ESA, Ceyhun G
BMC Cardiovasc Disord · 2026 Jun · PMID 42252402 · Full text
BACKGROUND: Early identification of individuals at risk for hypertension is essential for effective cardiovascular disease. Physiological and activity metrics derived from consumer smartwatches may offer a practical, non...
BACKGROUND: Early identification of individuals at risk for hypertension is essential for effective cardiovascular disease. Physiological and activity metrics derived from consumer smartwatches may offer a practical, noninvasive approach to identify individuals at increased risk before the clinical onset of hypertension. METHODS: In this 12-month prospective observational study, 230 normotensive adults aged 30-60 years were followed using consumer smartwatches. Baseline wearable predictors were calculated as the mean of the first 30 days of valid data after enrollment and included heart rate variability, resting heart rate, and time spent in moderate-to-vigorous physical activity. Incident hypertension was defined according to current European guidelines using standardized office blood pressure measurements obtained at follow-up. RESULTS: During follow-up, 28 participants (12.2%) developed hypertension. Individuals who developed hypertension exhibited lower baseline heart rate variability and spent less time in moderate-to-vigorous physical activity compared with those who remained normotensive. In multivariable logistic regression analysis, lower heart rate variability, lower levels of physical activity, and higher body mass index were independently associated with incident hypertension. An interaction between autonomic variability and physical activity was observed, indicating that individuals with both reduced autonomic regulation and low physical activity had the highest predicted risk. Machine-learning models showed improved statistical discrimination compared with clinical variables alone and were used as complementary exploratory analyses. CONCLUSIONS: Smartwatch-derived autonomic and physical activity metrics were independently associated with the development of hypertension over a 12-month period. These findings from an observational study suggest a potential role for wearable-derived physiological parameters as digital biomarkers for early hypertension risk stratification, although further validation in larger and externally replicated cohorts is required.
Identifying high-risk and actionable profiles for prevention in hypertensive patients with concurrent dyslipidemia: a population-based retrospective study.
Xu Y, Huang H, Wang J … +2 more , Wu Y, Zhang J
BMC Cardiovasc Disord · 2026 Jun · PMID 42251330 · Full text
BACKGROUND: Hypertension and dyslipidemia are major global risk factors for cardiovascular diseases, with their prevalence increasing annually. In China, hypertension and dyslipidemia exhibit a "dual high" epidemic chara...
BACKGROUND: Hypertension and dyslipidemia are major global risk factors for cardiovascular diseases, with their prevalence increasing annually. In China, hypertension and dyslipidemia exhibit a "dual high" epidemic characteristic. To contribute to the reduction of their prevalence, this study analyzes factors related to dyslipidemia in hypertensive patients from a clinical perspective. METHODS: This study analyzed data from 5,018 hypertensive patients recruited from 110 hospitals across China. Participants were categorized into a dyslipidemia group and a non-dyslipidemia group based on diagnostic criteria. Variables selected based on clinical relevance and univariate associations were included in a multivariate logistic regression model to determine independent factors associated with the co-occurrence of hypertension and dyslipidemia. RESULTS: Analysis of the dyslipidemia group and non-dyslipidemia group revealed that the dyslipidemia group exhibited significantly higher proportions (p < 0.05) in multiple disease conditions (stroke, angina pectoris, atrial fibrillation), medication use (beta-blockers, antiplatelet agents, etc.), and family histories of certain diseases (hypertension, coronary heart disease, diabetes) compared to the non-dyslipidemia group. Regression analysis further identified BMI, family history of hypertension, stroke, angina pectoris, atrial fibrillation, obstructive sleep apnea, and family history of coronary heart disease as significant correlates of hypertension combined with dyslipidemia. CONCLUSIONS: Hypertension comorbid with dyslipidemia demonstrates significant correlations with body mass index (BMI) and familial predisposition (family histories of hypertension and coronary heart disease). Furthermore, individual medical histories and pharmacological regimens exhibit substantial associations with disease progression. These findings suggest potential targets for a three-tier prevention approach. With appropriate validation in prospective studies, prioritized screening and early intervention for high-risk individuals may contribute to halting or delaying disease progression.
Pesticide exposure and the risk of arterial hypertension and obesity in farm workers: a systematic review of literature.
Ulrich J, Jäggi L, Rüfli D … +1 more , Fuhrimann S
BMC Cardiovasc Disord · 2026 Jun · PMID 42249321 · Full text
BACKGROUND: Farm workers experience some of the highest chronic pesticide exposures worldwide, yet potential links with key cardiovascular risk factors remain underexplored. This systematic review focuses specifically on...
BACKGROUND: Farm workers experience some of the highest chronic pesticide exposures worldwide, yet potential links with key cardiovascular risk factors remain underexplored. This systematic review focuses specifically on associations between occupational pesticide exposure and hypertension or obesity in farm-exposed adult populations, highlighting two major, modifiable cardiovascular risk factors in a high-risk group. METHODS: MEDLINE was systematically searched for observational studies of hypertension and/or obesity among adults with farm-related pesticide exposure. Using the PECOS framework, two reviewers independently screened records and extracted data on study design, population, exposure assessment, outcomes, and main findings. RESULTS: Of 355 records, 14 studies met inclusion criteria (10 cross-sectional, 2 case-control, 2 cohort). Most assessed general pesticide use (n = 9), with fewer examining specific pesticide groups, chemical classes, or active ingredients (each n = 4). Obesity was positively associated with organophosphates (n = 3), atrazine (n = 1), and general pesticide exposure (n = 5), while two studies reported inverse associations; no other active ingredient showed consistent effects. General pesticide exposure was associated with hypertension in three studies, but overall evidence for blood pressure was heterogeneous. CONCLUSIONS: Occupational exposure to organophosphates, atrazine, and general pesticide use may increase obesity risk among farm workers, suggesting a potential contribution to cardiovascular disease, whereas associations with hypertension remain uncertain. Interpretation is constrained by limited, heterogeneous data and by a predominant focus on compounds now restricted or banned in many high-income settings. Future longitudinal studies should apply standardized, quantitative exposure assessment and evaluate currently used pesticides and mixtures in diverse agricultural contexts.
Triple-vessel coronary involvement and giant aneurysm in a 6-year-old boy with kawasaki disease: a case report.
Majnoon MT, Rajabi MM, Hemati S … +3 more , Ziaee V, Rafati Navaei M, Gharib B
BMC Cardiovasc Disord · 2026 Jun · PMID 42243716 · Full text
BACKGROUND: Kawasaki disease (KD) is an acute systemic vasculitis of unknown origin. It represents one of the most important causes of acquired heart disease in the pediatric population. Coronary artery involvement is th...
BACKGROUND: Kawasaki disease (KD) is an acute systemic vasculitis of unknown origin. It represents one of the most important causes of acquired heart disease in the pediatric population. Coronary artery involvement is the most serious complication and may result in aneurysm formation and thrombosis. However, simultaneous involvement of all three major coronary arteries and giant aneurysm is rare and usually indicates severe disease. CASE PRESENTATION: This case report describes a 6-year-old boy with KD who developed progressive involvement of all three major coronary arteries despite standard treatment. The patient received intravenous immunoglobulin (IVIG) on the eighth day of illness, after which the fever resolved. However, follow-up imaging revealed a giant aneurysm of the left anterior descending (LAD) artery along with progressive dilation of the left circumflex (LCX) and right coronary arteries (RCA). During the clinical course, mural thrombosis developed within the LAD aneurysm, and the patient was readmitted for further management. Intensive medical therapy was initiated, including corticosteroids, cyclosporine, infliximab, anticoagulation, and antiplatelet agents. Coronary angiography demonstrated partial patency of the LAD with preserved distal run-off; therefore, surgical intervention was deferred. During follow-up, improvement of the aneurysms in the RCA and LCX was observed, whereas the LAD aneurysm and associated thrombosis persisted. Despite these findings, the patient remained clinically stable with preserved cardiac function and normal daily activities. CONCLUSION: This case report documented a rare occurrence of triple-vessel coronary involvement with a giant LAD aneurysm and thrombosis in KD. This study highlighted that, despite severe coronary abnormalities and resistance to standard treatment, favorable clinical outcomes may still be achieved with medical therapy and close long-term follow-up.
Incidence and predictors of stroke among hypertension patients in Awi Zone public hospitals, Northwest Ethiopia: Retrospective follow-up study.
Telayneh AT, Eneyew NG, Temesgen H … +1 more , Teshome M
BMC Cardiovasc Disord · 2026 Jun · PMID 42243715 · Full text
BACKGROUND: Stroke is a medical emergency neurologic dysfunction that occurs when blood flow to the brain is interrupted, due to a blockage or bleeding lasting ≥ 24 h, resulting in brain cell death and severe complicatio...
BACKGROUND: Stroke is a medical emergency neurologic dysfunction that occurs when blood flow to the brain is interrupted, due to a blockage or bleeding lasting ≥ 24 h, resulting in brain cell death and severe complications. It is the second most common cause of death, next to coronary heart disease. There are limited findings on the incidence of stroke among hypertension patients in Ethiopia. OBJECTIVES: To assess the incidence and predictors of stroke among hypertensive patients at Awi Zone public hospitals, Northwest Ethiopia. METHODS: A hospital-based retrospective follow-up study was conducted among adult hypertensive patients in Awi public hospitals between April 1, 2016 and March 30, 2023. A computer-generated simple random sampling method was used to select 510 study participants. Data were entered using EpiData version 4.6 and Stata version 17 for coding, cleaning, and analysis. In bi-variable analysis, variables with a p-value < 0.25 were selected for multivariable Cox proportional regression analysis. Finally, in multivariable analysis, variables with a p-value < 0.05, and 95% CI with their AHR were used to declare them as predictors. RESULTS: The incidence rate of stroke was 5.53 per 100 person-years [95% CI: 4.60, 6.65]. Rural residence [AHR: 1.88 (95% CI: 1.13, 3.12)], family history of stroke [AHR: 2.52 (95% CI: 1.33, 4.77)], Atrial fibrillation [AHR: 3.10 (95% CI: 1.62, 5.90)], total cholesterol ≥ 200 mg/dl [AHR: 4.42 (95% CI: 2.71, 7.23)], overweight [AHR: 1.82 (95% CI: 1.16, 2.87)], and low-density lipoprotein-cholesterol ≥ 100 mg/dl [AHR: 1.77 (95% CI: 1.11, 2.83)] were statistically significant. CONCLUSIONS: In this study, the incidence rate of stroke was 5.5 per 100 person-years. Rural residence, overweight, atrial fibrillation, high levels of cholesterol and low-density lipoprotein-cholesterol, and a positive family history of stroke were identified as predictors of stroke. To lower the incidence of stroke among hypertension patients, patients should adopt healthy lifestyles such as weight loss and healthy eating, and healthcare professionals should pay special attention to patients presenting with known risk factors.
Prevalence and factors associated with uncontrolled systolic blood pressure among treated older adults in Sri Lanka: a nationwide multicenter cross-sectional study.
De Zoysa P, Weerarathna TP, Darshana I … +9 more , Egodage UK, Rathnayake R, Jayasekara M, Sujanitha V, Matthias AT, Ratnayake B, Mayurathan P, Premawardana N, Pathirage L
BMC Cardiovasc Disord · 2026 Jun · PMID 42243704 · Full text
BACKGROUND: Uncontrolled systolic blood pressure (SBP) is a major modifiable determinant of cardiovascular morbidity and mortality in older adults. This study aimed to evaluate the prevalence, associated factors, and car...
BACKGROUND: Uncontrolled systolic blood pressure (SBP) is a major modifiable determinant of cardiovascular morbidity and mortality in older adults. This study aimed to evaluate the prevalence, associated factors, and cardiovascular implications of uncontrolled SBP among treated older adults in Sri Lanka. METHODS: A nationwide multicenter cross-sectional study was conducted in medical outpatient clinics of ten tertiary care hospitals representing all nine provinces of Sri Lanka. A total of 1,339 adults aged ≥ 65 years receiving antihypertensive therapy for at least six months were recruited using systematic sampling. Blood pressure (BP) was measured using a standardized three-reading protocol. Uncontrolled SBP was defined as SBP ≥ 130 mmHg irrespective of diastolic BP, in accordance with contemporary guideline recommendations. Data was collected using interviewer-administered questionnaires and medical record review. Associations between patient characteristics and uncontrolled SBP were assessed using chi-square tests, independent samples t-tests, and multivariable logistic regression analysis. RESULTS: The mean age of participants was 69.4 ± 6.6 years, and 56.8% were female. The mean duration of hypertension was 9.8 ± 8.3 years. Uncontrolled SBP was present in 71.2% of treated older adults. Only 34.4% were receiving dual antihypertensive therapy, while 42.2% remained on monotherapy. Major adverse cardiovascular events (MACE) were reported in 38.2% of participants, and other vascular comorbidities were present in 81.6%. In multivariable analysis, satisfactory income (OR 1.96, 95% CI 1.20-3.20, p = 0.007), low physical activity (OR 1.41, 95% CI 1.07-1.86, p = 0.015), and higher neck circumference (OR 1.01, 95% CI 1.01-1.02, p = 0.014) were independently associated with uncontrolled SBP. Importantly, uncontrolled SBP was significantly associated with MACE (OR 1.31, 95% CI 1.01-1.69, p = 0.044). Medication adherence, dietary salt intake, BMI, and vascular comorbidities were not independently associated with uncontrolled SBP. CONCLUSIONS: Over two-thirds of treated older adults in Sri Lanka had uncontrolled SBP, which was more common among participants with MACE. Higher income, low physical activity, and increased neck circumference were associated with uncontrolled SBP among treated older adults. These findings highlight the importance of targeted strategies, including lifestyle modification and improved risk-based management, to optimize BP control in this population.
Preliminary exploration of dynamic changes in circulating mitochondrial DNA (ΔmtDNA) as a prognostic biomarker for acute ST-segment elevation myocardial infarction patients: a prospective observational study.
Tian S, Wang L, Wang D … +2 more , Bai S, Wang X
BMC Cardiovasc Disord · 2026 Jun · PMID 42243686 · Full text
BACKGROUND: Mitochondrial DNA (mtDNA) likely contributes to myocardial ischemia-reperfusion injury, yet the prognostic value of its dynamic changes (ΔmtDNA) for major adverse cardiovascular events (MACE) after percutaneo...
BACKGROUND: Mitochondrial DNA (mtDNA) likely contributes to myocardial ischemia-reperfusion injury, yet the prognostic value of its dynamic changes (ΔmtDNA) for major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI) in acute ST-segment elevation myocardial infarction (STEMI) patients remains unclear. METHODS: This prospective study enrolled 236 STEMI patients undergoing emergency PCI. We measured serum mtDNA levels both before and after the procedure to calculate ΔmtDNA. Based on their ΔmtDNA values, patients were stratified into three groups: a Low ΔmtDNA group (T1, ΔmtDNA < 1.46), an Intermediate ΔmtDNA group (T2, 1.46 ≤ ΔmtDNA ≤ 3.62), and a High ΔmtDNA group (T3, ΔmtDNA > 3.62). RESULTS: During a 1-year follow-up, 58 MACE cases occurred (incidence 24.5%). The Cox proportional hazards model indicated that each standard deviation increase in ΔmtDNA was associated with a 23.9% higher MACE risk (HR 1.239, 95% CI 1.161-1.321, P < 0.001). When ΔmtDNA was analyzed by tertiles, the risk displayed a dose-response relationship (P for trend < 0.001). Restricted cubic spline analysis supported a linear positive association (P for nonlinear = 0.263). Survival curves showed significantly different cumulative MACE risks among the ΔmtDNA groups (Log-rank P < 0.001). Subgroup analysis revealed a significantly stronger association between ΔmtDNA and MACE risk in patients treated with β-blockers or PCSK9 inhibitors (P for interaction < 0.05). CONCLUSIONS: This study demonstrates that ΔmtDNA is significantly associated with post-PCI MACE risk in STEMI patients, an association primarily driven by recurrent angina rather than hard endpoints such as mortality or myocardial infarction. These findings suggest that ΔmtDNA could serve as an exploratory biomarker to identify patients at elevated risk for ischemia-driven symptomatic events, but its clinical utility requires further validation through formal discrimination analyses and comparisons with established risk scores.
The exploration to identify key molecules in the interaction between endothelial cells and mono-macrophages in atherosclerosis based on the single cell transcriptome.
Li B, Zhu R, Gao N … +7 more , Li S, Yang N, Wang H, Yu H, Lu Z, Sègbo AGJ, Zheng F
BMC Cardiovasc Disord · 2026 Jun · PMID 42243679 · Full text
Coronary artery disease (CAD) is the leading cause of global cardiovascular deaths, and atherosclerosis (AS) is the characteristic pathological change in CAD. The interactions between monocytes/macrophages and endothelia...
Coronary artery disease (CAD) is the leading cause of global cardiovascular deaths, and atherosclerosis (AS) is the characteristic pathological change in CAD. The interactions between monocytes/macrophages and endothelial cells play an essential role in the formation and progression of atherosclerotic plaques. In this study, we used published single-cell RNA sequencing datasets of calcified atherosclerotic core (AC) plaques and patient-matched proximal adjacent (PA) carotid artery tissue to characterize the single-cell profiles of carotid artery cells. We specifically analyzed endothelial cells (ECs) and monocyte-macrophage (MM) populations to identify cell subpopulations and signaling pathways associated with AS. By comparing cell-cell communication (CCC) between AC and PA, we identified signaling pathways and corresponding ligand-receptor pairs significantly altered in AS. For preliminary validation, Transwell co-culture experiments were conducted for 24 h with human umbilical vein endothelial cells (HUVECs) and human aortic endothelial cells (HAECs) co-cultured with M0, M1, or M2 macrophages. Through integrative analyses, we identified 15 cell clusters and 6 cell subpopulations closely related to AS. Among the altered pathways, MK (Midkine), GALECTIN (Galactose lectin), and SPP1 (Secreted phosphoprotein 1) showed significant changes in AC, with the MK pathway being the most prominent. Notably, the MDK-NCL pair was upregulated in the AS-associated EC and MM subpopulations. In vitro assays confirmed that MDK and NCL expression levels were significantly higher in the ECs and M1 macrophage co-culture group than in the M0 or M2 control groups. In conclusion, this work characterizes AS-related cell heterogeneity and identifies potential key signaling pathways and interactions, providing candidate targets for the prevention and treatment of CAD.
Association of epicardial fat volume with early outcomes in patients undergoing cryoablation for atrial fibrillation.
Uçar M, Çetin N, Soylu MÖ … +2 more , Şaşmaz Mİ, Can F
BMC Cardiovasc Disord · 2026 Jun · PMID 42237242 · Full text
BACKGROUND: Epicardial fat is a metabolically active visceral adipose tissue that has been implicated in atrial remodeling and atrial fibrillation (AF) pathophysiology. Although increased epicardial fat volume has been a...
BACKGROUND: Epicardial fat is a metabolically active visceral adipose tissue that has been implicated in atrial remodeling and atrial fibrillation (AF) pathophysiology. Although increased epicardial fat volume has been associated with AF presence and recurrence after radiofrequency ablation, its role in predicting early outcomes after cryoballoon ablation (CBA) remains incompletely defined. This study aimed to evaluate the association between computed tomography (CT)-derived epicardial fat volume and early arrhythmia recurrence following CBA for paroxysmal AF. METHODS: We retrospectively analyzed 61 consecutive patients who underwent CBA for paroxysmal AF. Epicardial fat volume was quantified on pre-procedural non-contrast cardiac CT using automated segmentation with predefined attenuation thresholds (- 30 to - 190 HU). Patients were followed for 6 months after a 3-month blanking period. AF recurrence was defined as any documented atrial fibrillation, atrial flutter, or atrial tachycardia lasting ≥ 30 s. Clinical, echocardiographic, laboratory, and procedural variables were compared between patients with and without recurrence. Univariate logistic regression and receiver operating characteristic (ROC) curve analyses were performed to identify predictors of recurrence. Multivariable logistic regression analysis was performed including age, body mass index, and epicardial fat volume. RESULTS: During follow-up, arrhythmia recurrence occurred in 14 patients (23.0%). Patients with recurrence were older and had higher rates of hypertension and coronary artery disease. Epicardial fat volume was significantly higher in patients with recurrence compared with those without recurrence (333.5 ± 82.1 vs. 201.2 ± 66.8 cm³, p < 0.001). In univariate logistic regression analysis, epicardial fat volume was a strong predictor of recurrence (OR 1.02 per cm³, 95% CI 1.01-1.04, p < 0.001), along with age, body mass index, left atrial diameter, coronary artery disease, and lower hemoglobin levels. ROC analysis demonstrated excellent discriminatory ability of epicardial fat volume for predicting recurrence (AUC = 0.891), outperforming body mass index (AUC = 0.836). No major procedural complications were observed. CONCLUSION: Increased CT-derived epicardial fat volume is strongly associated with early atrial arrhythmia recurrence following cryoballoon ablation for paroxysmal AF. Epicardial fat volume demonstrated excellent predictive performance and may provide incremental value beyond conventional clinical and echocardiographic parameters. Pre-procedural assessment of epicardial fat volume may help identify patients at higher risk for recurrence and guide individualized ablation strategies and follow-up.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe