. This study investigated the role and underlying regulatory mechanisms of circular RNA fibronectin type III domain containing 3B (circFNDC3B) in abdominal aortic aneurysm (AAA). The expression of circFNDC3B in AAA and normal tissues was assessed by quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR). To evaluate the biological functions of circFNDC3B, assays were employed including 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide (MTT), flow cytometry, and Caspase-3 activity assays. Additionally, RNA immunoprecipitation (RIP), dual-luciferase reporter assay, Western blotting, and rescue experiments were utilized to elucidate the molecular mechanism of circFNDC3B. Our findings revealed a significant upregulation of circFNDC3B expression in AAA clinical specimens compared to normal tissues. Functionally, overexpression of circFNDC3B inhibited vascular smooth muscle cells (VSMCs) proliferation and induced apoptosis, contributing to AAA formation in the Ang II-induced AAA model. Mechanistically, circFNDC3B acted as a molecular sponge for miR-1270, leading to the upregulation of programmed cell death 10 (PDCD10). Decreased expression of PDCD10 abrogated the -promoting effects of circFNDC3B overexpression on AAA development. This study demonstrates that circFNDC3B promotes the progression of AAA by targeting the miR-1270/PDCD10 pathway. Our findings suggest that circFNDC3B as well as miR-1270/PDCD10 pathway may serve as a potential therapeutic target for AAA treatment.

Colchicine is an anti-inflammatory drug with promising efficacy for preventing cardiovascular events. We aimed to assess the pooled effect of colchicine on ischemic stroke among patients with established atherosclerotic cardiovascular diseases. . PubMed, Scopus, Web of Science, and the Cochrane Library were systematically searched from the inception to August 5, 2024. A random-effects (DerSimonian-Laird) model was used to conduct this meta-analysis. The inclusion criteria were as follows: (I) being a randomized controlled trial; and (II) measuring the efficacy of colchicine compared to placebo for preventing ischemic stroke among those with established atherosclerotic cardiovascular diseases. . We identified 13 eligible clinical trials with 24900 participants. Colchicine significantly decreased the risk of ischemic stroke (relative risk (RR) 0.85, 95% confidence interval (CI) (0.72, 0.99), I=2.92%) among those with established atherosclerotic cardiovascular diseases. Colchicine was more effective when used at 0.5 mg/day (RR 0.86, 95% CI (0.75, 0.99)), prescribed for more than 30 days (RR 0.86, 95% CI (0.75, 1.00)) or for more than 90 days (RR 0.65, 95% CI (0.46, 0.92)), or administered for patients with acute coronary syndrome (RR 0.46, 95% CI (0.23, 0.92)). In addition, colchicine was more effective in studies with a sample size of more than 500 patients, consistent with sensitivity analysis, which indicated that the results relied on large-sized clinical trials. . Colchicine may decrease the risk of ischemic stroke among patients with established atherosclerotic cardiovascular diseases, particularly after long-term use; however, future studies are needed due to inconsistencies between existing trials.

Antibiotic therapy is the primary treatment for infective endocarditis (IE), yet up to 50% of patients still require surgical intervention. However, surgical intervention carries significant risks of mortality and complications for IE patients, and there remains a lack of consensus on which preoperative characteristics of infective endocarditis have a substantial impact on patient prognosis. Particularly, some IE patients develop periannular abscesses, leading to more severe complications. The objective of our study is to identify predictors of poor outcomes in infective endocarditis and to further evaluate the impact of surgical intervention on patient prognosis, with the aim of adding value to the existing factors known to affect IE prognosis. In this retrospective cohort study, we evaluated 210 patients treated for infective endocarditis (IE) at our hospital between December 2016 and June 2023. To analyze short-term outcomes, the patients were divided into two groups based on whether they experienced poor outcomes. We compared demographic characteristics, echocardiographic findings, laboratory test results, surgical details, and postoperative outcomes between the two groups. Patients' long-term outcomes, including survival status and time of death, were assessed through follow-up, which involved telephone contact with the patient or their family. The follow-up period concluded on June 30, 2024. The median age of the patients was 55 years, with most patients ranging from 42 to 64 years. Male patients accounted for 67.1%, and 21.4% had underlying cardiac conditions. During hospitalization, 125 out of 210 patients (59.5%) underwent surgery, with an emergency surgery rate of 6.2% and an in-hospital mortality rate of 13.8%.Regarding short-term outcomes, multivariate logistic regression analysis indicated that surgical treatment (OR 0.211, 95% CI 0.073-0.621) was associated with better patient prognosis. Periannular abscess (OR 4.948, 95% CI 1.005-24.349) and poorer cardiac function (NYHA II [OR 0.041, 95% CI 0.008-0.224], NYHA III [HR 0.207, 95% CI 0.057-0.757], with NYHA IV as the reference group) were significantly associated with poor prognosis in IE patients. For long-term outcomes, multivariate Cox survival analysis showed that surgical treatment (HR 0.200, 95% CI 0.091-0.437) was associated with improved long-term survival. Cerebral infarction (HR 1.939, 95% CI 1.050-3.582) and poorer cardiac function (NYHA II [HR 0.108, 95% CI 0.037-0.313], NYHA III [HR 0.308, 95% CI 0.118-0.805], with NYHA IV as the reference group) were significant factors associated with long-term mortality in IE patients. Surgical treatment was associated with improved short-term prognosis and long-term survival rates in patients with infective endocarditis. In terms of short-term outcomes, the presence of periannular abscesses and poor cardiac function were significant factors associated with poor prognosis. For long-term outcomes, cerebral infarction and poor cardiac function were significant factors associated with increased long-term mortality in these patients.

After cardiac surgery, there may be barriers to being physically active. Patients are encouraged to gradually increase physical activity, but limited knowledge exists regarding postoperative physical activity levels. This study aimed to assess patient-reported physical activity six months after cardiac surgery, determine adherence to WHO's physical activity recommendations, and explore potential relationships between pain, dyspnea, fear of movement, and activity levels.

To elucidate physical activity in the first year after myocardial infarction (MI), and to explore differences in various subgroups, delineated by age, participation in exercise-based cardiac rehabilitation (exCR), or restrictions due to the covid-19 pandemic. Secondly, to explore associations between changes in physical activity variables with blood pressure and lipid levels.

. To evaluate patient characteristics and 5-year outcomes after surgical mitral valve (MV) repair for leaflet prolapse at a medium-sized cardiothoracic center. . Contemporary reports on the outcome of MV repair at medium-sized cardiothoracic centers are sparse. . Patients receiving open-heart surgery with MV repair due to primary mitral regurgitation caused by leaflet prolapse between 2015 and 2021, without active endocarditis, were included. Clinical data, complications, re-interventions, mortality, and echocardiographic data were retrospectively registered from electronical patient charts, both pre-operatively and from post-operative follow-ups. . One hundred and three patients were included, 83% male, with a mean age of 62 years. All-cause mortality was 9% during a median follow-up time of 4.9 years. Re-intervention rate on the MV was 4%. Post-operative complications before last available follow-up visit at median 3.0 years were infrequent, with new-onset atrial fibrillation/flutter in 16%, post-operative MV regurgitation grade II or above in 17% and post-operative tricuspid regurgitation grade II or above in 14%. . These data demonstrate that surgical MV repair for leaflet prolapse at a medium-sized cardiothoracic center was associated with low re-intervention rate and few severe complications. The presented results are comparable to data from surgical high-volume centers, indicating that surgical MV repair can be safely performed at selected medium-sized cardiothoracic centers.

This study aims to identify the risk factors contributing to in-hospital mortality in patients with acute ST-elevation myocardial infarction (STEMI) who develop acute heart failure (AHF) post-percutaneous coronary intervention (PCI). Based on these factors, we constructed a nomogram to effectively identify high-risk patients.

The risk of sudden cardiac death (SCD) is increased during endurance competitive sports. Coronary artery disease (CAD) is the most common cause of SCD in master athletes ≥ 35 years old (MAs). To reduce the risk of SCD self-assessment of symptoms by questionnaire, and evaluation of cardiovascular risk-score, are recommended as pre-participation cardiovascular evaluation (PCVE). We aimed to examine whether PCVE predicts CVD in MAs with or without increased risk as measured by validated score instruments. We performed a single-site observational cohort study of healthy MAs based on findings at PCVE. They were allocated in two different groups: those MAs with reported symptoms on the questionnaire and/or with elevated cardiovascular risk score were allocated to a symptom group (SG), while MAs with no symptoms, nor raised risk score were defined as control group (CG). Thereafter, all were examined with extended examinations: resting-ECG, cardiorespiratory exercise testing and echocardiography. Total, 81 (18 women) MAs participated in the study. There were no differences at baseline between SG ( = 39) and CG ( = 42); sex ( = 0.11), age (55.0 ± 9.8 vs. 51.9 ± 11.1 years;  = 0.18), maximal oxygen uptake (49.8 ± 7.6 vs. 51.6 ± 7.0 ml/kg/min;  = 0.26), resting heart rate (61.4 ± 12.8 vs. 60.2 ± 11.0/min;  = 0.66), training hours/week (7.0 ± 3.2 vs. 7.1 ± 3.1;  = 0.88). After further examination, sixteen (20%) MAs were found with CVD: 12 in SG, 4 in CG ( = 0.024). The negative predictive value and specificity of the PCVE were 90% and 58%, respectively. Negative findings on PCVE by questionnaire and cardiovascular risk-score may be a strategy to exclude subjects from preparticipation screening, thus saving resources.

Children with repaired tetralogy of Fallot (rToF) often have pulmonary regurgitation with right ventricular (RV) dilatation and dysfunction, whereas less is known about the effect on the left ventricle (LV). The aim was to investigate LV haemodynamic variables derived from non-invasive pressure-volume loops in children with rToF and how they compare to controls and previous research on adults.

. The aim was to demonstrate a reliable method to test the function of the whole heart. . Pigs of varying sizes (44-80 kg) were exposed to dose response of adrenaline. Blood pressures and cardiac output were measured. The explanted hearts were tested in a novel system to see if we could replicate the values at maximal adrenaline stimulation. The perfusion solution was STEEN Solution™ with erythrocytes and continuous infusion of essential drugs. In contrast to normal body circulation which is sequential, the heart evaluation system is divided into left and right heart circuits which are operating in parallel, making it possible to test the right and left heart individually or as a whole. The system provides coronary flow measurements. The nonlinear dynamic resistances are constructed to stabilize systolic and diastolic pressures in a broad range and independently from cardiac output. It is important for the functional evaluation to avoid pumping help for the heart; therefore, atrial vortexes are constructed to minimize pump flow directionality and energy from entering atria. evaluation was able to match the maximal effect of adrenaline on cardiac output and blood pressures. After 2 h of evaluation, the blood gases and lactate were normal and free haemoglobin was zero. Autopsy of the hearts showed no macroscopic pathology. The system is able to give a reliable functional evaluation of the heart .

Current guidelines recommend that surveillance imaging should be performed at least every third year for patients with ascending thoracic aortic aneurysm (ATAA) even though such aneurysms' growth rate is mostly minimal. The purpose of this study was to clarify the pattern of the growth of ATAAs in a real-life patient population to adjust the optimal timing of aortic surveillance for each patient. This study includes patients ( = 209) who had been followed due to ATAA in the central hospital of North Karelia in Eastern Finland between years 2007 and 2023. Aortic imaging was performed using either computed tomography (CT) or transthoracic echocardiography (TTE). In the CT images, the aortic dimensions were measured according to guidelines in four levels of the ascending aorta. TTE measurements were collected from medical records. Measurements were used to explore the pattern of the ATAA growth. During the mean surveillance time 5.0 ± 3.5 years, the median growth rate of ATAAs was 0.37 mm/year. One fifth (21.5%) of the aneurysms showed no expansion during the follow-up. Despite the minimal growth rate during surveillance, some patients ended up exceeding the cut-off for preventive surgery. Among the patients, who showed expansion during the follow-up, the linear model seemed to best describe the growth of ATAA. The majority of the patients had a very low ATAA growth rate. Based on this study, the growth of ATAAs could be described using a linear model, which could, in turn, be used to predict the growth of an aneurysm.

. Aortic stiffness is a marker of vascular ageing. Non-conventional risk markers reflecting vascular ageing are largely unexplored. We aimed to investigate the relationship between self-perceived age (SPA) and self-rated health (SRH) with aortic stiffness in the general population. . Cross-sectional assessment of 3760 participants from two Swedish population-based cohorts (mean age 43.5 ± 14.5 years, 53.4% women). Participants completed two self-administered questions about SPA (SPA- referring to SPA perceived by oneself, and SPA- referring to SPA perceived by others) graded as: younger, no difference, or older than same-aged/sex peers. SRH was graded as poor versus good. Aortic stiffness (vascular ageing) was assessed by carotid-femoral pulse wave velocity (PWV). Linear regression was performed stratified by the median age of 45 years. . Chronologically younger men and women ≤45 years with older SPA- had unexpectedly lower PWV ( - 0.39,  < .001 and  - 0.40,  < .001, respectively), independently of cardiovascular risk factors and social health determinants, compared with subjects with younger SPA-. Lower PWV was also observed in women ≤45 years with older SPA- ( - 0.24 m/s,  = .005) compared with younger SPA-, but not in men. A similar pattern between SPA-, SPA- and PWV was found in chronologically younger subjects ≤45 years reporting good SRH. On the contrary, chronologically older subjects >45 years reporting poor SRH, with older SPA- had increased vascular ageing (PWV 2.57,  = .03). . Self-perceived age is a subjective cognitive variable inversely associated with vascular ageing particularly among chronologically younger adults ≤45 years.

The clinical impact of heart rate (HR) in heart failure with preserved ejection fraction (HFpEF) is a matter of debate. Among those with HFpEF, chronotropic incompetence (CI) has emerged as a pathophysiological mechanism linked to the severity of the disease. In this study, we sought to evaluate whether admission heart rate in acute heart failure differs along left ventricular ejection fraction (LVEF).

To investigate whether normal body mass index (BMI) shortly after percutaneous coronary intervention (PCI) for myocardial infarction is associated with increased risk of long-term major cardiovascular events (MACE), and to explore potential clinical determinants of long-term weight loss (WL) after PCI. Single-center cohort study with 5-year follow-up of patients treated with PCI for myocardial infarction between 2016 and 2018. Categorical WL was defined as > 0 kg body weight reduction from baseline to end of follow-up. Of 236 patients (24% women), mean age was 64.9 ± 10.2 years and mean BMI within 4 days after PCI was 27.1 ± 4.3 kg/m. Seventy-five patients (32%) had at least one MACE, equally distributed between those with normal weight (31%), overweight (32%), and obesity (31%). Patients with overweight or obesity had a lower crude mortality rate than their normal weight counterparts (7.4% vs 16.4%,  = 0.049), but the relative hazard of death did not differ from those with normal weight, HR 0.50, 95% CI 0.22-1.15. Patients with either a long-term WL ( = 112) or no WL ( = 95) had a comparable incidence of non-fatal MACE (27% vs 22%,  = 0.518). The proportion of patients reporting unintentional weight loss was significantly higher in the normal weight group (82%) compared with those with overweight (41%) or obesity (28%),  < 0.001. Our results did not confirm any association between normal BMI after PCI and long-term MACE. However, patients with normal BMI at baseline had a higher incidence of unintentional WL than those with elevated BMI. Trial registration: Current research information system in Norway (CRISTIN): ID 542528.

Using a systematic meta-analysis, we investigated if patients with type 2 diabetes (T2D) and with varying baseline blood pressure (BP) differ in the cardiorenal benefits received from sodium-glucose co-transporter 2 inhibitors (SGLT-2is) and glucagon-like peptide 1 receptor agonists (GLP-1RAs). Randomized, placebo-controlled, cardiovascular outcome trials (CVOTs) of SGLT-2is and GLP-1RAs were identified from MEDLINE, Embase, and the Cochrane Library up to April 2024. Hazard ratios (HRs) with 95% CIs were pooled. The differential treatment effect by baseline BP category within each trial was estimated as the ratio of the HR (RHR) and pooled. Seventeen publications based on 9 unique CVOTs (4 SGLT-2is and 5 GLP-1RAs) were eligible. In participants with normal baseline BP, comparing SGLT-2is with placebo, the HRs (95% CIs) were 0.88 (0.79-0.97) for major adverse cardiovascular events (MACE), 0.73 (0.59-0.91) for heart failure (HF) hospitalization, 0.78 (0.65-0.94) for composite CVD death/HF hospitalization, and 0.55 (0.41-0.73) for composite renal outcome. The corresponding estimates for participants with higher baseline BP were 0.88 (0.81-0.96), 0.67 (0.57-0.79), 0.73 (0.65-0.82), and 0.61 (0.48-0.77), respectively. In participants with normal baseline BP, GLP-RAs had no strong effect on MACE, stroke and nephropathy, but reduced stroke and nephropathy risk in those with higher baseline BP. Estimated RHRs showed no statistical evidence that baseline BP modified the cardiorenal benefits of SGLT-2is and GLP-1RAs. In patients with T2D, the cardiorenal benefits of treatment with SGLT2-Is and GLP1-RAs were similar in patients with normal baseline BP compared to those with a higher baseline BP.

. Surgery for acute type A aortic dissection confers a risk for significant bleeding. We analyzed the impact of massive bleeding on complications after surgery for acute type A aortic dissection. . Patients undergoing surgery for acute type A aortic dissection from the retrospective multicenter Nordic Consortium for Acute Type A Aortic Dissection (NORCAAD) database 2005-2014 were eligible. Massive bleeding was defined according to the Universal Definition of Perioperative Bleeding. The primary outcome measure was early mortality and secondary outcome measures were perioperative stroke, mechanical ventilation more than 48 h, new-onset dialysis, and intensive care unit stay. Propensity score matching was performed to adjust for differences in covariates. . Nine hundred ninety-seven patients were included, of whom 403 (40.4%) had massive bleeding. In the propensity score-matched cohort (344 pairs), patients with massive bleeding had higher 30-day mortality (17.2 versus 7.6%,  < .001), mechanical ventilation more than 48 h (52.8 versus 22.6%,  < .001), perioperative stroke (24.3 versus 14.8%,  = .002), new-onset dialysis (22.5 versus 4.9%,  < .001), and longer intensive care unit stay (6 versus 3 days,  < .001), compared with patients without massive bleeding. Risk factors for massive bleeding were previous cardiac surgery, preoperative clopidogrel or ticagrelor therapy, DeBakey type I dissection, and localized or generalized malperfusion. . Massive bleeding in surgery for acute type A aortic dissection is associated with a markedly increased risk for severe complications as well as early death. Further improvement of surgical technique and pharmacological optimization of coagulation is paramount to possibly improve outcomes in acute type A aortic dissection repair.

This study describes aortic growth, survival and events in patients with aortic arch pathology.

This study aimed to assess the practicality of using a stepwise pedigree-based approach to differentiate between familial and sporadic Dilated Cardiomyopathy (DCM), while also considering timing of the genetic analysis. The analysis includes an examination of the extent to which complete family investigations were conducted in real-world scenarios as well as the length of the investigation.

. Chronic kidney disease (CKD) and diabetes mellitus (DM) contribute significantly to cardiovascular disease (CVD) and mortality, with prevalence increasing. The evolving demographic of myocardial infarction (MI) patients, influenced by sedentary lifestyles and advanced medical care, lacks understanding regarding the interplay of CKD, DM, age, and post-MI mortality. This study aims to address this gap by evaluating the long-term impact of CKD and DM on post-MI mortality across age groups. . A retrospective cohort study utilized data from the Estonian Myocardial Infarction Registry (EMIR), Estonian Population Register (EPR), and six major hospitals in Estonia, covering AMI hospitalizations from 2012 to 2019. Statistical analyses included Cox proportional hazards regression models and Kaplan-Meier's curves. . Analysis of 17,085 MI patients revealed age-dependent associations between renal function and mortality. In patients <65 years, even minor decreases in renal function increased both short-term (HR 2.79, 95% CI 1.71-4.55) and long-term (HR 1.24, 95% CI 1.05-1.47) mortality. Mortality significantly increased in patients >80 years only below an estimated glomerular filtration rate (eGFR) of 44 ml/min/1.73 m. Newly diagnosed DM patients exhibited higher mortality rates (average HR 1.53, 95% CI 1.45-1.62), while pre-DM did not significantly differ from non-DM patients across all age groups. The DM-renal failure interaction did not significantly influence mortality. . An age-dependent association between eGFR and post-MI outcomes emphasizes the need for personalized therapeutic approaches considering age-specific eGFR thresholds and comorbidities to optimize patient management.