Cardiology Research And Practice[JOURNAL]
Sun
200 papers
A randomized crossover clinical trial comparing 24-h blood pressure measurements from two different cuffless wrist ambulatory monitors with cuffed ambulatory monitoring for translation to clinical practice: Rationale and Design of Continuum BP study.
Gupta AK, Ahmed A, Bowles R … +7 more , Learoyd A, Kirkpatrick E, Gurung N, Rathod K, Ahluwalia A, Mathur A, Continuum BP Investigators
Am Heart J Plus · 2026 May · PMID 42007007 · Full text
STUDY OBJECTIVE: Cuffless blood pressure (BP) measuring devices have potential to improve screening, diagnosis and management of hypertension. However, translation of BP estimates from such devices to cuffed BP readings,...
STUDY OBJECTIVE: Cuffless blood pressure (BP) measuring devices have potential to improve screening, diagnosis and management of hypertension. However, translation of BP estimates from such devices to cuffed BP readings, which currently inform hypertension and cardiovascular risk management guidelines, remains uncertain. We designed Continuum BP to understand how BP measurements from two independent CE-marked wrist worn devices can be contextualized for clinical use. DESIGN: Prospective observational randomized crossover study. SETTING: William Harvey Heart Centre, Queen Mary, University of London. PARTICIPANTS: 48 adult volunteers. INTERVENTIONS: Aktiia Bracelet (utilizing photoplethysmography) and the Healthstats BPro Evo (utilizing applanation tonometry) worn independently, each alongside cuffed OnTrak ambulatory BP monitor (ABPM), across two 24 h non-overlapping periods of monitoring by the same individuals. MAIN OUTCOME MEASURES: Difference between average daytime, 24 h and night-time systolic and diastolic BP estimated by each cuffless device and ABPM; and acceptability of wearing each device type compared to ABPM. Data will be used to estimate a numerical calibration of readings from each of Aktiia/Healthstats BPro Evo to ambulatory BP. CONCLUSION: Continuum BP received ethical approval from West of Scotland National Health Service research ethics committee (24/WS/0131) and was advertised across Queen Mary University of London campuses and affiliated hospitals. Recruitment is complete. Collected data is being analysed. Findings will enable physicians to interpret and use cuffless BP from two commonly available wrist devices in routine practice, and disseminated through study website, scientific meetings and publications. Trial registration https://clinicaltrials.gov/ (NCT06573801).
Elevated blood viscosity is associated with dysautonomia in long COVID symptoms.
Tamariz L, Milanes I, Bast E … +3 more , Shehadeh LA, Klimas N, Palacio A
Am Heart J Plus · 2026 May · PMID 42007006 · Full text
BACKGROUND: Long COVID is associated with elevated inflammatory and antibody levels. Elevated plasma proteins can increase blood viscosity and decrease blood flow. Our aim is to evaluate if blood viscosity is associated...
BACKGROUND: Long COVID is associated with elevated inflammatory and antibody levels. Elevated plasma proteins can increase blood viscosity and decrease blood flow. Our aim is to evaluate if blood viscosity is associated with long COVID outcomes. METHODS: We conducted a cross-sectional study and included a sample of patients enrolled in our long COVID clinic. We estimated whole blood viscosity (WBV) using two previously validated formulas and compared it with the NASA lean test, COMPASS-31 scale as measures of dysautonomia and the symptom burden as measured by the modified COVID-19 Yorkshire scale. We obtained WBV at three different shear stress. We divided WBV and evaluated the distribution of symptom scores using univariate and multivariate models. RESULTS: We included 185 patients for this study. Our sample had a mean age of 56 ± 11 years, included 53% minorities and 32% were women. The mean C19-YRSm did not change with increasing tertile of WBV ( > 0.05) while the mean COMPASS-31 score increased with increasing tertile of WBV in all levels of shear stress. In adjusted models the beta-coefficient of the C19-YRSm was (B -0.19p = 0.90) and for COMPASS-31 was (B 7.0 = 0.01) for 208 s and for all other levels of shear stress Twenty-three percent of patients in tertile 1 had either POTS or orthostatic hypotension compared to 32% on tertile 3 ( = 0.04). CONCLUSION: Whole blood viscosity was associated with dysautonomia and not with long COVID symptoms.
Cardiopulmonary exercise testing is safe in hypertrophic cardiomyopathy - Incidence and outcomes of sustained ventricular arrhythmias in a large referral cohort.
Csecs I, Mamillo K, Geske JB … +4 more , Garzona-Navas A, Klarich KW, Ommen SR, Allison TG
Am Heart J Plus · 2026 May · PMID 42007005 · Full text
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Letter to the editor regarding "social determinants of health and hospitalization risk in heart failure: A retrospective analysis".
Jaiswal A, Arya M, Sharma DB
Am Heart J Plus · 2026 May · PMID 42007004 · Full text
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Beyond the Biopsy: Imaging Frontiers in Cardiac Sarcoidosis.
Antoun I, Assadi J, Zakkar M … +2 more , Ng GA, Bhandari SS
Cardiol Res Pract · 2026 · PMID 42004244 · Full text
Cardiac sarcoidosis (CS) represents an inflammatory infiltrative disease, which creates difficulties during diagnosis and prognosis. The identification and management of CS heavily depend on advanced cardiac imaging tech...
Cardiac sarcoidosis (CS) represents an inflammatory infiltrative disease, which creates difficulties during diagnosis and prognosis. The identification and management of CS heavily depend on advanced cardiac imaging techniques. The article examines multimodality imaging in CS by evaluating cardiac magnetic resonance (CMR) imaging, positron emission tomography (PET) with computed tomography (CT), single-photon emission computed tomography (SPECT), echocardiography, CT and hybrid imaging approaches. This review examines each imaging modality with respect to its fundamental principles, diagnostic capabilities, benefits and drawbacks and references key research from the past decade. CMR stands as the primary diagnostic method for detecting myocardial scar and fibrosis in CS patients, providing essential prognostic information. The PET/CT system with 18-fluorodeoxyglucose (FDG) provides an effective method for detecting active inflammation and tracking treatment response. Echocardiography is a readily accessible screening tool that reveals the structural and functional effects of CS, while strain imaging techniques enable the detection of early disease involvement. The use of delayed-enhanced cardiac CT provides an alternative method for detecting myocardial scar. It helps identify patients who are ineligible for CMR and excludes coronary artery disease. Diagnostic confidence and disease activity assessment improve with hybrid imaging, particularly when PET/MR is used. The Discussion section integrates these findings with an evaluation of emerging quantitative imaging markers and novel tracers that show promise for enhancing CS evaluation. The implementation of multimodality imaging techniques has transformed the management of CS by enabling earlier diagnosis, risk assessment and treatment guidance. A personalised imaging approach that combines multiple diagnostic methods yields the best results for diagnosing CS and enhances patient-care outcomes.
Radiotherapy Reprograms Intermediate Monocytes Into Proinflammatory Drivers of Systemic Inflammation in Radiation-Induced Heart Disease.
He J, Kong D, Zhang C … +5 more , Chen Q, Yang H, Wang Y, Wu T, Wu Q
Cardiol Res Pract · 2026 · PMID 42004243 · Full text
Radiation-induced heart disease (RIHD) is a serious complication of thoracic radiotherapy, and its pathogenesis involves systemic immune alterations. To elucidate these mechanisms, we profiled peripheral blood mononuclea...
Radiation-induced heart disease (RIHD) is a serious complication of thoracic radiotherapy, and its pathogenesis involves systemic immune alterations. To elucidate these mechanisms, we profiled peripheral blood mononuclear cells (PBMCs) from patients before and after thoracic radiotherapy using single-cell RNA sequencing (scRNA-seq), with key findings validated via multiparameter flow cytometry and ELISA assays. Our analysis revealed that radiotherapy markedly reshaped the immune composition, expanding innate myeloid cells (monocytes and neutrophils) and reducing lymphocytes (T and NK cells); these compositional shifts were independently confirmed by flow cytometric analysis. Cell-cell communication networks showed that postradiotherapy monocytes evolved into central signaling hubs, exhibiting heightened proinflammatory ligand-receptor interactions. Consistent with this, monocytes showed broad transcriptional reprogramming with upregulation of canonical inflammatory pathways (IL-6/STAT3, TNF/NF-κB) and metabolic regulators (mTORC1, glycolysis). ELISA assays corroborated these transcriptomic signatures, demonstrating significantly elevated plasma levels of IL-6 and TNF-α post-treatment. Notably, scRNA-seq identified a selective expansion of the highly plastic intermediate (CD14++CD16+) monocyte subset, a specific population shift further verified by flow cytometry. These intermediate monocytes exhibited an immature, progenitor-like profile and were enriched at the origin of a Monocle3 pseudotime trajectory. Trajectory analysis indicated they differentiate into mature classical monocytes that upregulate proinflammatory effector genes such as S100A8, S100A9, and S100A12. Furthermore, pseudotime gene clustering revealed a functional bifurcation in monocyte behavior: one module drove inflammatory activation, while a second module simultaneously engaged oxidative stress responses and antioxidant defenses (e.g., glutathione metabolism). In summary, by integrating single-cell transcriptomics with experimental validation, we demonstrate that radiotherapy drives a systemic immune shift characterized by intermediate monocyte expansion and bifurcated programs of inflammation and stress adaptation. Intermediate monocytes emerge as key drivers of postradiotherapy inflammation, offering a potential cellular biomarker of RIHD risk and a target for immunomodulatory interventions to mitigate cardiovascular injury in cancer survivors.
Research Progress of Nerve Injury-Induced Protein 1 in Cardiovascular Diseases.
Xu X, Mu Y
Cardiol Res Pract · 2026 · PMID 42004242 · Full text
Nerve injury-induced protein 1 (Ninjurin 1) is a cell surface adhesion molecule that contains one extracellular adhesion domain and two transmembrane domains. Originally discovered in nerve injury, it has been extensivel...
Nerve injury-induced protein 1 (Ninjurin 1) is a cell surface adhesion molecule that contains one extracellular adhesion domain and two transmembrane domains. Originally discovered in nerve injury, it has been extensively studied for its role in nerve regeneration. Ninj1 mediates the transendothelial migration of myeloid cells mainly through the extracellular adhesion domain, thereby aggravating the inflammation of the central nervous system. In addition to regulating the inflammatory phenotype of cells, Ninj1 actively mediates the rupture of the plasma membrane and regulates the programmed death of inflammatory cells, thereby participating in the host defense against exogenous infection. In recent years, Ninj1, an important protein associated with inflammasome activation, has garnered increasing attention from researchers regarding its mechanistic role and pathophysiological significance in cardiovascular diseases. Accumulating evidence suggests that Ninj1 not only participates in the regulation of inflammatory responses and cell death processes but also plays a critical role in the onset and progression of various cardiovascular conditions, including atherosclerosis, myocardial ischemia-reperfusion injury, and heart failure. Therefore, an in-depth exploration of the specific functions of Ninj1 in the cardiovascular system holds significant scientific and clinical value for elucidating the molecular mechanisms underlying these diseases and for developing novel therapeutic strategies. This review aims to summarize the research progress on Ninj1 in cardiovascular diseases and to outline its mechanisms in pathological processes.
Association Between Socioeconomic Status and Mortality Risk in CKM Stage 0-3 Patients: Analysis of Inflammatory Mediation.
Ding W, Shi F, Fang L … +3 more , Cui Q, Wang Z, Fang C
Cardiol Res Pract · 2026 · PMID 41982502 · Full text
OBJECTIVE: This study aimed to investigate whether socioeconomic status (SES) influences the risk of all-cause and cardiovascular mortality among patients with cardiovascular-kidney-metabolic (CKM) syndrome stages 0-3 th...
OBJECTIVE: This study aimed to investigate whether socioeconomic status (SES) influences the risk of all-cause and cardiovascular mortality among patients with cardiovascular-kidney-metabolic (CKM) syndrome stages 0-3 through the systemic inflammation response index (SIRI). The investigation utilized a nationally representative sample from the U.S. National Health and Nutrition Examination Survey (NHANES) database and employed mediation analysis for systematic assessment. METHODS: Data were derived from NHANES surveys conducted between 1999 and 2018, enrolling adults who met the classification criteria for CKM stages 0-3. SES was defined by the stratified family income-to-poverty ratio (PIR), with SIRI serving as the mediator. The primary outcomes were all-cause and cardiovascular mortality. Methodological approaches included weighted multivariable Cox regression, subgroup analyses, sensitivity analyses, and bootstrap-based mediation analysis. RESULTS: The study included 15,623 participants who were followed for a mean duration of 115 months, during which 1788 all-cause deaths and 405 cardiovascular deaths were recorded. After comprehensive adjustment for potential confounders, each unit increase in PIR was associated with a significantly reduced risk of all-cause mortality (HR = 0.88, 95% CI: 0.84-0.92) and cardiovascular mortality (HR = 0.85, 95% CI: 0.77-0.95). Participants in the high SES group demonstrated substantially lower risks for both all-cause mortality (HR = 0.57, 95% CI: 0.47-0.69) and cardiovascular mortality (HR = 0.50, 95% CI: 0.34-0.73) compared to their low SES counterparts. Notably, mediation analysis revealed that SIRI accounted for 63.67% of the association between SES and all-cause mortality, and 60.45% of the association between SES and cardiovascular mortality after full adjustment for confounding variables. CONCLUSION: SES significantly impacts the risk of all-cause and cardiovascular mortality among patients with CKM stages 0-3, with a substantial portion of this effect mediated through systemic inflammation as measured by SIRI. These findings suggest that comprehensive interventions targeting both socioeconomic conditions and chronic inflammation may effectively enhance long-term health outcomes in this vulnerable population.
Evaluating the Efficacy and Outcomes of Transcatheter Aortic Valve Replacement Versus Surgical Aortic Valve Replacement in Low- to Intermediate-Risk Aortic Regurgitation Patients: A Comprehensive Clinical Comparison.
Zhang X, Yan C, Li S … +1 more , Cheng C
Cardiol Res Pract · 2026 · PMID 41982501 · Full text
BACKGROUND: Transcatheter aortic valve replacement (TAVR) has been established as an alternative to surgery for high-risk aortic regurgitation (AR) patients. However, its applicability to low- and intermediate-risk popul...
BACKGROUND: Transcatheter aortic valve replacement (TAVR) has been established as an alternative to surgery for high-risk aortic regurgitation (AR) patients. However, its applicability to low- and intermediate-risk populations remains under investigation. This study evaluates the clinical outcomes, quality of care, and patient-centered implications of TAVR versus surgical aortic valve replacement (SAVR) in this population. METHODS: Between 2021 and 2024, clinical data were retrospectively analyzed from 70 AR patients at our center, including 37 who underwent TAVR and 33 who received SAVR with bioprosthetic valves. Baseline characteristics, perioperative metrics, and major clinical outcomes were assessed. International registry data (FRANCE-TAVI and ALIGN-AR) were utilized for external validity comparisons. RESULTS: Baseline characteristics were comparable between groups. TAVR was associated with shorter operation time ( = 0.001), reduced blood use ( < 0.001), and shorter hospital stays ( = 0.021). No 30-day mortality was observed in TAVR, whereas four deaths occurred in the SAVR group ( = 0.029). Conduction abnormalities differed, with complete left bundle branch block (CLBBB) more frequent in TAVR ( = 0.025) and complete right bundle branch block (CRBBB) in SAVR ( = 0.029). Despite its minimally invasive nature, ICU observation time remained similar ( = 0.339) due to perioperative complications. Economic analysis suggests potential cost savings with TAVR in specific scenarios. CONCLUSION: TAVR offers favorable short-term outcomes for low- to intermediate-risk AR patients, yet challenges in perioperative care require optimization. Long-term studies and multicenter trials are needed to refine patient selection and postprocedural management strategies.
Clinically Relevant Doses of Remimazolam Modulate Cardiac Electrophysiology: Late Repolarization Prolongation and Increased Conduction Dispersion With Preserved QTc.
Wang Z, Cao Y, Su G … +4 more , Feng Y, Yang R, Bai X, Gao H
Cardiol Res Pract · 2026 · PMID 41982500 · Full text
BACKGROUND: Remimazolam, an ultra-short-acting benzodiazepine with rapid metabolism and cardiovascular stability, is increasingly used for anesthesia, yet its cardiac electrophysiologic effects are incompletely character...
BACKGROUND: Remimazolam, an ultra-short-acting benzodiazepine with rapid metabolism and cardiovascular stability, is increasingly used for anesthesia, yet its cardiac electrophysiologic effects are incompletely characterized. METHODS: We conducted a multimodal evaluation in Langendorff-perfused guinea pig hearts and human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs), using surface electrocardiogram (ECG), multielectrode mapping, optical mapping, and whole-cell patch-clamp across remimazolam doses (0, 1, 2, 3 mg/kg/h). RESULTS: High-dose remimazolam (3 mg/kg/h) prolonged the PR interval ( = 0.027), and T-wave duration was prolonged at 2 and 3 mg/kg/h ( = 0.017 and < 0.001), while QT interval and corrected QT interval (QTc) remained unchanged ( > 0.1). Multielectrode mapping showed prolonged activation time at 2 and 3 mg/kg/h versus NC ( = 0.02 and 0.003) and increased conduction dispersion at 2 and 3 mg/kg/h ( = 0.0193 and 0.0101). Conduction velocity (CV) was reduced at 3 mg/kg/h compared with NC and 1 mg/kg/h ( = 0.01 and 0.02). Optical mapping demonstrated prolonged action potential duration at 90% repolarization (APD) (NC: 107.93 ± 0.63 ms vs 3 mg/kg/h: 118.94 ± 1.83 ms, < 0.001) and calcium transient duration at 90% recovery (CTD) (NC: 116.20 ± 1.04 ms vs 3 mg/kg/h: 125.63 ± 1.15 ms, < 0.001), accompanied by increased APD interquartile range (APD-IQR; ≤ 0.02 vs NC) and increased CTD interquartile range (CTD-IQR; = 0.005). In hiPSC-CMs, 1500 ng/mL remimazolam selectively prolonged APD ( = 0.04) without significant effects on action potential amplitude, upstroke velocity, or early repolarization indices (all > 0.05). CONCLUSION: These findings indicate that at higher clinically relevant exposures, remimazolam selectively lengthens late repolarization and increases conduction heterogeneity-features consistent with an arrhythmogenic substrate-while QT and QTc remains stable, supporting cautious use and ECG monitoring in at-risk populations.
Primary Cardiac Synovial Sarcoma (PCSS): Clinicopathologic Features of 6 Cases and Literature Comparison.
Cai YX, Liu SJ, Sun Q … +2 more , Li H, Meng XL
Cardiol Res Pract · 2026 · PMID 41982499 · Full text
Primary cardiac synovial sarcoma (PCSS) is an exceedingly rare tumor. This study presents a comprehensive analysis of six novel PCSS cases identified within our institutional cohort, compared with published literature co...
Primary cardiac synovial sarcoma (PCSS) is an exceedingly rare tumor. This study presents a comprehensive analysis of six novel PCSS cases identified within our institutional cohort, compared with published literature cohorts, focusing on their clinical presentations, histopathological features, immunohistochemical and molecular characteristics, therapeutic interventions, and prognosis. Our institutional cohort included five male and one female patients, with a median age of 44 years. Presenting symptoms included dyspnea, chest tightness, back pain, and syncope. Tumors were located in the pericardium (four cases) and the cardiac wall (two cases). The tumor size ranged from 2.0 to 14.5 cm. Histopathologically, four cases were monophasic and two were biphasic. Immunohistochemical analysis revealed consistent expression of TLE1, vimentin, and BCL-2. Molecular analysis confirmed the presence of the gene fusion through fluorescence in situ hybridization (FISH) in five cases, whereas one FISH-negative case was positive for the gene fusion through next-generation sequencing (NGS). All patients underwent surgical intervention (tumor excision) followed by adjuvant chemotherapy with doxorubicin and ifosfamide. At follow-up, four patients were alive without disease and two had died. This case series highlights the clinicopathologic and molecular features of PCSS. Overall, gene rearrangement and TLE1 expression are crucial diagnostic markers for differentiating PCSS from other neoplasms.
Knowledge, risk perception, and associated factors of cardiovascular disease among adult with type 2 diabetic mellitus attending public hospitals in Addis Ababa, Ethiopia: A multicenter cross-sectional study.
Tolla AT, Mengistu D, Gela D … +1 more , Tolera BD
Am Heart J Plus · 2026 May · PMID 41970454 · Full text
BACKGROUND: Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality in patients with type 2 diabetes mellitus. Understanding diabetes patients' knowledge and perception of CVD risk factors is es...
BACKGROUND: Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality in patients with type 2 diabetes mellitus. Understanding diabetes patients' knowledge and perception of CVD risk factors is essential for enhancing the quality of patient outcomes. This study aimed to assess the knowledge, risk perception, and factors associated with cardiovascular disease among adult patients with type 2 diabetes mellitus attending public hospitals in Addis Ababa, Ethiopia. METHODS: This cross-sectional study enrolled 389 participants via systematic random sampling from public hospitals in Addis Ababa, Ethiopia. Data were collected via a pre-tested structured questionnaire and analyzed using SPSS (version 27.0). Predictors of CVD knowledge and risk perception were identified through multivariable logistic regression. Statistical significance was defined as ( < 0.05) with 95% confidence intervals. RESULTS: Of 389 participants, 61.4% (95% CI: 56.6-66.2%) had good CVD knowledge and 43.4% (95% CI: 38.5-48.3%) demonstrated good risk perception. Factors significantly associated with good knowledge included secondary education (AOR = 6.15, = 0.037), being married (AOR = 2.56, = 0.018), and regular exercise (AOR = 2.63, < 0.001), while history of smoking (AOR = 0.25, < 0.001) and high-fat diet consumption (AOR = 0.23, < 0.001) were inversely associated. Higher risk perception was independently predicted by age 41-64 years (AOR = 1.90, = 0.032) and regular exercise (AOR = 2.35, < 0.001). CONCLUSION: This study highlights the need for targeted educational interventions to improve low CVD knowledge and risk perception among patients with type 2 diabetes mellitus, particularly addressing disparities by educational levels, marital status, age, and modifiable behavioral factors.
Associations of probiotics, prebiotics, synbiotics, and yogurt supplements with oxidative balance scores and all-cause and cardiovascular mortalities in neuropsychiatric disorders.
Liu Y, Liu Y, Wang G … +3 more , Zhang H, Li Z, Zhang J
Am Heart J Plus · 2026 May · PMID 41970453 · Full text
BACKGROUND: Neuropsychiatric disorders are highly prevalent, significantly impacting patients' Quality of Life. Probiotics can modulate the balance of gut flora, ameliorating neuropsychiatric disorders and ultimately red...
BACKGROUND: Neuropsychiatric disorders are highly prevalent, significantly impacting patients' Quality of Life. Probiotics can modulate the balance of gut flora, ameliorating neuropsychiatric disorders and ultimately reducing Oxidative Stress (OS) and inflammatory responses. Herein, we aimed to determine the associations of probiotics, prebiotics, synbiotics, and yogurt supplements with Oxidative Balance Scores (OBS) and all-cause and cardiovascular mortalities in neuropsychiatric disorders. METHODS: This study utilized the National Health and Nutrition Examination Survey (NHANES) 2007-2018 data, with 13,857 participants included in the final analysis. Probiotics supplements intakes, OBS values, depression, sleep disturbances, and cognitive function were assessed based on questionnaires and laboratory data. Logistic regression, mediation effects analysis, and COX regression modeling were employed to explore these supplements' associations with OBS values in relation to mortality linked to depression, sleep disorders, and cognitive dysfunction. RESULTS: The intake of probiotics was positively correlated with OBS, indicating that the subjects who took probiotic supplements had healthier dietary habits and lifestyles. Mediation analysis revealed that probiotics could improve depressive symptoms (mediation effect = 28.03%, = 0.024) and cognitive function (mediation effects = 9.26%, 14.64%, and 18.63%, respectively; < 0.05) by reducing inflammatory responses. Furthermore, probiotic intake correlated negatively with all-cause mortality at the levels of depression, sleep disorders, and cognitive functioning [Hazard Ratio (HR) = 0.874, 0.906, and 0.810, respectively] and cardiovascular mortality related to depression and cognitive dysfunction (HR = 0.963 and 0.403, respectively). CONCLUSION: Probiotics, prebiotics, synbiotics, and yogurt supplements may reduce inflammatory responses and OS, potentially alleviating neuropsychiatric disorders and improving patients' Survival Rates.
Prevalence and characteristics of adults with atherosclerotic cardiovascular disease, chronic kidney disease, and systemic inflammation in the USA.
Nanna MG, Sloan LA, Navar AM … +5 more , Faurby MD, Husemoen LLN, Paul R, Tombak G, Sattar N
Am Heart J Plus · 2026 May · PMID 41970452 · Full text
STUDY OBJECTIVE: Systemic inflammation increases the risk of cardiovascular events and is often present in patients with atherosclerotic cardiovascular disease (ASCVD), particularly in those who also have chronic kidney...
STUDY OBJECTIVE: Systemic inflammation increases the risk of cardiovascular events and is often present in patients with atherosclerotic cardiovascular disease (ASCVD), particularly in those who also have chronic kidney disease (CKD). However, the prevalence of systemic inflammation in patients with ASCVD and CKD is not well characterized. Here, we estimate the prevalence of ASCVD with CKD and systemic inflammation in the US population and describe the characteristics of people with ASCVD, CKD stages 3-4, and systemic inflammation, who are at high risk for cardiorenal events. DESIGN AND SETTING: Cross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES) 2015-2020 continuous cycles. PARTICIPANTS: Adults aged ≥ 20 years with ASCVD who had high-sensitivity C-reactive protein (hsCRP) measurements. MAIN OUTCOME MEASURES: Prevalence and characteristics of adults with systemic inflammation in groups with ASCVD, with ASCVD and CKD, and with ASCVD and CKD stages 3-4. Systemic inflammation was defined as hsCRP levels ≥ 2 mg/L. RESULTS: Our study sample included 238,164,067 adults. In total, 8.5% had ASCVD, of whom 55.5% had systemic inflammation. The prevalence of systemic inflammation in individuals with ASCVD and CKD stages 3-4 (1.6% of the US population) was 59.1%, equating to 0.9% or > 2 million individuals in the general US adult population. CONCLUSIONS: In summary, over half of US adults with ASCVD and CKD stages 3-4 were estimated to have systemic inflammation. This group could benefit from weight loss strategies, lifestyle changes, and other approaches to improve cardiovascular outcomes.
Endothelial stress as reflected by EASIX predicts cardiovascular morbidity and mortality: Insights from a nationally representative cohort.
Xia Y, Wang M
Am Heart J Plus · 2026 May · PMID 41953586 · Full text
BACKGROUND: Endothelial dysfunction (ED) is a key pathophysiological mechanism in cardiovascular diseases (CVD). The Endothelial Activation and Stress Index (EASIX), derived from routine laboratory markers, has been prop...
BACKGROUND: Endothelial dysfunction (ED) is a key pathophysiological mechanism in cardiovascular diseases (CVD). The Endothelial Activation and Stress Index (EASIX), derived from routine laboratory markers, has been proposed as a surrogate indicator of endothelial stress. However, its relevance to CVD burden and long-term outcomes in the general population remains uncertain. METHODS: We analyzed data from 38,713 adults aged ≥20 years enrolled in the U.S. National Health and Nutrition Examination Survey (NHANES, 1999-2018), representing approximately 1.7 billion individuals after weighting. EASIX was calculated as [LDH (U/L) × creatinine (mg/dL)] / platelet count (10/L) and log₂-transformed. Weighted logistic regression assessed the association between EASIX and CVD prevalence, while weighted Cox models examined its relationship with all-cause (ACM) and cardiovascular mortality (CVM). Restricted cubic spline analyses evaluated potential nonlinear trends, and subgroup analyses tested effect modification. RESULTS: Among 38,713 participants, 4131 had CVD. Higher EASIX values were independently associated with greater CVD prevalence (adjusted OR = 1.43, 95% CI: 1.34-1.53). Each log₂ increase in EASIX corresponded to higher risks of ACM (HR = 1.39, 95% CI: 1.28-1.51) and CVM (HR = 1.54, 95% CI: 1.38-1.72). Individuals in the top EASIX quartile exhibited more than double the mortality risks compared with those in the lowest quartile. Associations were nonlinear and consistent across most subgroups. CONCLUSIONS: EASIX demonstrated independent, nonlinear associations with both CVD prevalence and long-term mortality. These findings highlight EASIX as a practical, cost-efficient biomarker for cardiovascular risk stratification in population settings.
Increased cardiovascular disease risk in patients with periodontal disease: Insights from studies of periodontal treatment.
Kesavalu LN, Lucas AR, Reddy SSP
Am Heart J Plus · 2026 May · PMID 41953585 · Full text
Oropharyngeal infection has long been associated with cardiovascular disease (CVD), specifically valvular disease and endocarditis. However, the relationship between periodontal disease (PD), with associated infection an...
Oropharyngeal infection has long been associated with cardiovascular disease (CVD), specifically valvular disease and endocarditis. However, the relationship between periodontal disease (PD), with associated infection and inflammation, and CVD is often overlooked. The aim of this review was to synthesize and critically appraise interventional clinical evidence of nonsurgical periodontal therapy (NSPT) effects on systemic inflammatory mediators, cardiovascular biomarkers, and clinical cardiovascular outcomes. Across interventional studies, NSPT was associated with reductions in systemic inflammatory biomarkers (e.g., C-reactive protein, interleukin 6), as well as modest improvements in blood pressure and select lipid parameters, particularly among patients with coexisting cardiometabolic disease. In contrast, most studies evaluating clinical cardiovascular endpoints did not demonstrate superiority of NSPT over less intensive periodontal care, reflecting small sample sizes, short follow-up durations, and heterogeneous study designs. A prospective study in patients undergoing atrial fibrillation ablation reported significantly fewer arrhythmia recurrences among those receiving periodontal therapy. Although NSPT reduced inflammatory biomarkers, 4 of 5 studies that evaluated clinical atherosclerotic vascular disease outcomes did not show superiority of NSPT versus less intensive treatment. In contrast, a nonrandomized study of patients with atrial fibrillation demonstrated significantly reduced arrhythmia after radiofrequency catheter ablation when PD therapy was given during postablation recovery. Existing evidence supports a consistent association and biological plausibility for a contributory role of PD in increased cardiovascular risk, while definitive causal relationships remain to be established. Adequately powered, properly randomized clinical trials with longer follow-up are warranted to evaluate the potential for NSPT to reduce CVD outcomes.
The Correlation Between Triglyceride-Glucose Index (TyG Index) With the Severity of Acute New-Onset Heart Failure (NOHF) Complications in Acute Myocardial Infarction Based on Killip Classification.
Felicia L, Suraya N, Purwanti R
Cardiol Res Pract · 2026 · PMID 41948142 · Full text
BACKGROUND: Cardiovascular disease is the leading cause of morbidity and mortality in Indonesia, in which acute myocardial infarction (AMI) has an estimated mortality rate of 9.2%. Heart failure is the most common compli...
BACKGROUND: Cardiovascular disease is the leading cause of morbidity and mortality in Indonesia, in which acute myocardial infarction (AMI) has an estimated mortality rate of 9.2%. Heart failure is the most common complication of AMI and increases the risk of death by 3-4 times. The Killip classification assesses the severity and prognosis of acute new-onset heart failure (NOHF) in AMI patients: Class I (6% mortality), Class II (17%), Class III (38%), and Class IV (81%). The triglyceride-glucose (TyG) index, a reliable marker for insulin resistance, is linked to cardiovascular disease pathogenesis. Several studies showed that the TyG index can predict the development of cardiovascular events. AIM: This study aims to determine the correlation between TyG index levels and the severity of acute NOHF complications in patients with acute myocardial infarction based on the Killip classification. METHODS: This cross-sectional analytical observational study involved adult patients with AMI diagnoses in the ER of Dr. Hasan Sadikin Hospital, Bandung, in January-December 2023, who had fasting blood glucose and triglyceride examinations within 72 h of admission and had been assessed with Killip classification. Data analysis was performed using the Spearman test using SPSS software version 25.0. RESULTS: This study included 100 AMI patients who met the inclusion and exclusion criteria. Significant relationships were found between comorbidities (diabetes mellitus, hypertension, and smoking) and patient outcomes against Killip classification. Killip Class I had the most improved outcomes (54 patients). Killip Class IV (10 patients) had the most deaths and highest triglycerides and glucose levels. The TyG index showed a strong positive correlation with acute NOHF severity in patients with AMI based on the Killip classification ( = 0.746, < 0.001). CONCLUSION: The TyG index has a strong positive correlation with the severity of acute NOHF in patients with acute myocardial infarction based on the Killip classification.
Correlation Between Early Arterial Lactate Levels, Arterial Bicarbonate Ion Levels, and the Lactate/Albumin Ratio and In-Hospital Mortality in Patients With Acute Myocardial Infarction Complicated With Cardiac Shock.
Wang J, Zheng M, Yang Y … +2 more , Bao Z, Wulasihan M
Cardiol Res Pract · 2026 · PMID 41948141 · Full text
BACKGROUND: To investigate the connection between early arterial lactate, arterial bicarbonate ion, lactate/albumin ratio (L/A) and in-hospital mortality in patients with acute myocardial infarction complicated with card...
BACKGROUND: To investigate the connection between early arterial lactate, arterial bicarbonate ion, lactate/albumin ratio (L/A) and in-hospital mortality in patients with acute myocardial infarction complicated with cardiac shock (AMICS). METHODS: A receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of these indicators for in-hospital mortality in 395 patients with AMICS. A Kaplan‒Meier survival curve was drawn to analyze the median survival time of each subgroup. A Cox fitted proportional risk model was used to verify the association between these indicators and all-cause mortality during hospitalization. RESULTS: ROC curve analysis revealed that the areas under the curve for arterial bicarbonate ion level, arterial lactate level, and L/A were 0.707, 0.679, and 0.670, respectively, indicating that these parameters have certain value for predicting in-hospital mortality in patients with AMICS. The Kaplan‒Meier survival curve revealed that the median survival time of the low bicarbonate ion group was shorter than that of the high bicarbonate ion group, and the median survival time of the low lactic acid group and low L/A group was longer than that of the high lactic acid group and the high L/A group. The Cox proportional risk model indicated that higher arterial bicarbonate ion levels were a protective factor for in-hospital death in AMICS patients and that higher arterial lactate levels and a higher L/A were independent risk factors. CONCLUSION: Early arterial bicarbonate ion levels, arterial lactate levels, and the L/A were predictive of all-cause death in AMICS patients.
The incidence and associated factors of pulmonary embolism after cardiac surgery: A retrospective nationwide inpatient sample database study.
Zheng L, Xie H, Cao X … +8 more , Wang Z, Li J, Wang X, Li X, Tu B, Ren Y, Wang J, Liu W
Am Heart J Plus · 2026 May · PMID 41939692 · Full text
BACKGROUND: Cardiac surgery is associated with a significant risk of postoperative pulmonary embolism (PE), a life-threatening complication. This study sought to evaluate the epidemiology, associated factors, and clinica...
BACKGROUND: Cardiac surgery is associated with a significant risk of postoperative pulmonary embolism (PE), a life-threatening complication. This study sought to evaluate the epidemiology, associated factors, and clinical outcomes of PE following cardiac surgery in the United States. METHODS: Using the National Inpatient Sample (NIS) database, we conducted a retrospective analysis of patients who underwent cardiac surgery between 2010 and 2022. Univariate and multivariate analyses were performed to identify patient- and hospital-level factors associated with PE. Clinical outcomes, including in-hospital mortality, length of stay, and total charges, were also assessed, stratified by pre-COVID (2010-2019) and COVID-era (2020-2022) periods. RESULTS: The incidence of PE following cardiac surgery significantly increased from 0.6% in 2010 to 3.2% in 2022, and remained elevated during the 2020-2022 period. Independent associated factors included female sex, Black race, a higher comorbidity burden (≥3 comorbidities), Medicaid insurance coverage, admission to large or teaching hospitals, and prolonged hospitalization (> 9 days). High-risk comorbidities included metastatic cancer, drug abuse, and pulmonary circulation disorders. PE development was associated with increased in-hospital mortality, prolonged hospitalization, and increased total charges. CONCLUSIONS: This large-scale analysis reveals a rise in the incidence of PE following cardiac surgery over the past decade. Identifying high-risk patient profiles and associated factors can guide targeted prevention strategies and optimize perioperative management to mitigate the substantial clinical and economic burden of this severe complication.
Colchicine in addition to usual care for acute pericarditis with classical ECG changes after catheter ablation for cardiac arrhythmias.
Toniolo M, Rebellato L, Imazio M
Am Heart J Plus · 2026 Apr · PMID 41938985 · Full text
BACKGROUND: Acute pericarditis is a complication associated with radiofrequency or cryo-energy catheter ablation (CA) for arrhythmias and may be accompany pericardial effusion. A frequent complication of acute pericardit...
BACKGROUND: Acute pericarditis is a complication associated with radiofrequency or cryo-energy catheter ablation (CA) for arrhythmias and may be accompany pericardial effusion. A frequent complication of acute pericarditis is the onset of arrhythmias. While colchicine has demonstrated both anti-inflammatory and anti-arrhythmic effects in acute pericarditis, its efficacy in cases specifically developing post-CA remains unknown.The purpose of this study is to determine whether colchicine administration after the diagnosis of acute pericarditis due to CA is associated with a reduction in the recurrence rate of arrhythmias. METHODS: Patients who developed acute pericarditis after CA for arrhythmias were retrospectively included in this study. Following the CA procedure, a group of patients was prescribed 0.5 mg of colchicine twice daily for 14 days at the operator's discretion, in addition to usual care. The primary outcome was freedom from arrhythmias within 12 months. Secondary outcomes included signs of pericarditis, recurrence of pericardial effusion, and the incidence of constrictive pericarditis. RESULTS: Among the 75 consecutively enrolled patients, acute pericarditis occurred after: pulmonary vein isolation ( = 50), endocardial ventricular tachycardia ablation ( = 18), right outflow premature ventricular contraction ablation ( = 5), and atrioventricular nodal re-entrant tachycardia ablation ( = 2). During a median follow-up of 365.0 days (IQR 333.0-420.0 days), freedom from any arrhythmia (regardless of anti-arrhythmic drug use) was similar between groups (76.2% in the colchicine group vs. 74.1% in the usual care group; log-rank = 0.93). Univariate analysis showed that colchicine use was not associated with a lower risk of arrhythmia recurrence. No cases of recurrent pericarditis or constrictive pericarditis were observed in either group during the follow-up period. CONCLUSION: Colchicine, when added to usual care, doesn't appear associated with improved clinical outcomes in patients who developed acute pericarditis following CA for arrhythmias.Clinical trial number: UD5684993756.
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