bluuebunny/crossref_metadata_2025 huggingface dataset:
The use of myocardial global longitudinal strain to evaluate the effectiveness of reperfusion in acute myocardial infarction
Authors: Doniyorov D , Atamuratov B R , Fozilov K H G , Bekmetova F M , Abdullaeva S Y A , Tursunova N B
Published: January 2025

Introduction

Global longitudinal deformation is a good predictor of LV ejection fraction independence and shows areas of myocardial damage

Purpose

The purpose of this study was to evaluate global longitudinal strain (GLS) in groups of patients with acute myocardial infarction who received primary thrombolysis, primary percutaneous coronary intervention (PCI) and life-saving PCI.

Methods

The study included 200 patients with acute myocardial infarction. The patients were divided into 3 groups, depending on the method of reperfusion: primary thrombolysis (62 patients), primary PCI (106 patients) and life-saving PCI performed after unsuccessful thrombolysis (32 patients). All patients received standard therapy, which included acetylsalicylic acid, ticagrelor, enoxaparin, beta blockers and ACE inhibitors. The assessment of GLS was performed before reperfusion, on the 14th day after reperfusion and 6 months later. The modular values of GLS were compared.

Results

Baseline values did not differ significantly between the groups. On day 14 after reperfusion, a significant increase in GLS was observed in the first and second groups (primary thrombolysis and PCI, respectively) (10.9 ± 2.95 vs 12.7 ± 1.98, p = 0.00001; 11.8 ± 2.41 vs 13.1 ± 1.92, p = 0.00001), while in the third group (rescue PCI) the values increased slightly but not significantly (11.3 ± 1.63 vs 11.6 ± 1.95, p = 0.17). At 6 months after reperfusion, the values of GLS significantly increased in all three groups, with the best results in the primary PCI group: 15.9 ± 2.08 vs 14.8 ± 1.81 in the first group and 13.6 ± 2.07 in the third group (p = 0.01). Regarding clinical outcomes, no cases of early post-infarction angina or left ventricular aneurysm were observed in the primary PCI group, but this group had a higher incidence of mild to moderate chronic heart failure (10.38% vs 0% and 29.25% vs 6.45% and 34.8%, respectively, p = 0.01).

Conclusion

The conducted study in patients with acute myocardial infarction who underwent various methods of reperfusion therapy revealed significant differences in the dynamics of recovery of longitudinal deformation of the left ventricular myocardium. It has been established that the assessment of this parameter can serve as an additional diagnostic and prognostic criterion in this category of patients. The data obtained indicate the advantages of primary PCI over thrombolytic therapy and life-saving PCI in terms of restoring myocardial contractile function. Thus, early primary PCI should be considered as the preferred method of reperfusion therapy in acute myocardial infarction.
Is dyspnea the new angina?
Authors: Rodriguez D , Cano R , Casanova C , Velez A , Martin Penato A , De La Cruz E , Martinez V , Iglesias D , Lareo A , Cadenas R , Paredes B , Aguilera M C , Garcia A
Published: January 2025

Introduction

The exercise stress echocardiogram is a highly valuable tool for evaluating patients with dyspnea as the main symptom (without angina) and suspected coronary artery disease (CAD). This involves a large volume of patients in daily practice, and etiological orientation is often difficult, especially in patients with high cardiovascular risk.

Objective

This study aims to define the likelihood of inducible ischemia in this population concerning their pretest probability described in the literature, as well as to compare the exercise workload achieved during the test with the predicted workload.

Methods

We performed a retrospective analysis of 116 consecutive diagnostic exercise stress echocardiograms (2021-2023) conducted on patients with dyspnea as the main symptom (14.55% of the total exercise stress echocardiograms).

Results

The average age was 67.93 years (standard deviation [SD] 9.99), and the average body mass index (BMI) was 28.87 (SD 4.37). Baseline characteristics included hypertension (79 patients, 68.1%), diabetes (39 patients, 33.6%), dyslipidemia (76 patients, 65.5%), smoking (46 patients, 39.7%), and known pulmonary disease (21 patients, 18.1%). Among the patients, 104 (89.7%) had an intermediate pretest probability of CAD. The main reason for test termination was dyspnea in 78 patients (67.2%). The average maximum workload achieved was 7.28 METs (SD 2.34), compared to a predicted maximum workload of 6.58 METs (SD 1.78), resulting in an actual/predicted METs ratio of 1.14. The stress echocardiogram was positive for inducible ischemia in 8 cases (6.9%), with no significant differences between diabetic and non-diabetic patients (6.49% positive in non-diabetics, 7.89% positive in diabetics, p = 0.781).

Conclusions

Patients referred for dyspnea as the main symptom demonstrated greater functional capacity than predicted, suggesting both a challenging assessment of functional class in clinical consultations and a possible underestimation of age-predicted functional capacity formulas in the current population. Additionally, the positivity rate for ischemia was lower than described in the literature for a population with predominantly intermediate pretest probability of CAD.

Salgo le characteristics
Pressure-volume analysis by three-dimensional echocardiography: a novel and superior method to predict response following cardiac resynchronization therapy
Authors: Hammersboen L E R , Remme E W , Aalen J M , Larsen C K , Donal E , Duchenne J , Penicka M , Kongsgaard E , Galli E , Voigt J U , Stugaard M , Smiseth O A , Boe E A
Published: January 2025

Introduction

Long-term response to cardiac resynchronization therapy (CRT) is primarily assessed by 2D echocardiography. The combination of 3D echocardiography and left ventricular (LV) pressure curve estimation allows for pressure-volume (PV) analysis and LV work efficiency (LVWE) estimation which may be superior to today’s methods.

Aim

To investigate if PV-analysis by 3D echocardiography is superior to 2D volumes at predicting long-term survival in CRT.

Methods

In a recent prospective multicenter study, non-invasive PV-analysis (n=106) and 2D volume analysis by biplane Simpson’s method (n=195) were performed, before and 6 months after CRT. The LV pressure curve was estimated by aligning a reference pressure curve with mitral and aortic valve events obtained from echocardiography. The amplitude of the curve was adjusted to brachial systolic cuff pressure and combined with 3D volumes for PV-analysis. As shown in figure 1, LVWE was calculated as the ratio of estimated stroke work (red area) to total mechanical energy (red + blue areas). The cutoff value for change in LV end-systolic volume (ESV) was set at 15% and at >35% for LVWE using Receiver Operator Curve analysis. Volumetric non-responders were subdivided into response based on LVWE.

Results

After 6±2 years follow-up, 47 (23%) patients had died. Relative change in 3D and 2D LV ESV showed similar ability to predict long-term all-cause mortality (log rank p<0.001 for both) (Figure 2). However, LVWE identified patients with a positive effect of CRT who were volumetric non-responders. These patients had similar outcomes as volumetric responders (HR 1.91, 95% CI: 0.54-6.81) (Figure 3). LVWE also identified non-responders with particularly adverse outcomes (HR 3.46, 95% CI: 1.32-9.10 vs volumetric non-response and LVWE >35%).

Conclusions

PV-analysis by 3D-echoardiography identifies a new group of patients who respond to CRT without a 15% reduction in ESV who have similar outcomes to volumetric responders. In our data, 3D echocardiography was superior to 2D volumes at predicting long-term all-cause mortality after CRT.

LV work efficiency before and after CRT

LV work efficiency and survival
Prognostic implications of secondary tricuspid regurgitation dynamic trends in acute heart failure
Authors: Anastasiou V , Peteinidou E P , Daios S D , Fardoulis E F , Gogos C G , Moysidis D V M , Papazoglou A S P , Didagelos M D , Giannakoulas G G , Karamitsos T K , Ziakas A Z , Kamperidis V K
Published: January 2025

Background

The response of secondary tricuspid regurgitation (STR) to therapeutic management in acute heart failure (HF) is variable. STR improvement may indicate reverse right ventricular remodeling and response to treatment. The dynamic trends of STR during HF hospitalization and their prognostic relevance remain unexplored.

Methods

All consecutive patients hospitalized for acute HF underwent echocardiographic assessment within 24 hours from admission and 24 hours prior to discharge. Patients were divided into 3 groups; No/mild STR on admission, significant STR on admission that improved on discharge (Improved TR), and significant STR on admission without improvement on discharge (Non-improved TR). All-cause death and HF hospitalization was the composite primary end-point.

Results

Out of 401 patients, 285 (71.1%) presented with significant STR on admission; of these 136 (33.9%) demonstrated TR improvement on discharge (Figure 1A). Chronic HF, RV free wall longitudinal strain (LS) and effective regurgitant orifice area (EROA) on admission were independent predictors for TR improvement (Figure 1B). Spline curve analyses indicated that the STR subgroup with RV free wall LS <-14.2 % and EROA <0.34 cm2 on admission were most likely to achieve TR improvement on discharge. After a median follow up of 6 months (interquartile range, 2.3-9.8), 141 (35.2%) patients reached the primary endpoint. Patients with Non-improved TR showed higher cumulative event rates compared to the other 2 groups (No/mild TR: 20.7%, Improved TR: 28.7%, Non-improved TR: 52.3%, Log-rank p <0.001) (Figure 1C). Non-improved TR was independently associated with the composite outcome (hazard ratio 2.15 [95% CI, 1.37–3.38]; p <0.001).

Conclusion

The dynamic trends of STR carry a clinically relevant value in acute HF. Absence of STR improvement during hospitalization indicates worst long-term survival.

Figure 1: Graphical Abstract
Association with outcomes of the planimetry of vena contracta area by 3-dimensional color Doppler echocardiography in patients with secondary tricuspid regurgitation
Authors: Gavazzoni M , Benzoni G , Penso M , Tomaselli M , Gagliardi M F , Fisicaro S , Clement A , Radu N , Buta A , Rella V , Kawada Y , Parati G , Badano L P , Muraru D
Published: January 2025

Background

The cut-off value for defining severe secondary tricuspid regurgitation (STR) using the planimetry of color Doppler three-dimensional echocardiography (3DE) vena contracta area (VCA) has been determined in previous studies based on its correlation with the values of the effective regurgitant orifice area (EROA), obtained using the proximal isovolumic surface area (PISA) method, in patients with severe STR. However, the association of VCA with outcomes has not been examined in these studies.

Purpose

We sought to 1) identify the cut-off value of 3DE VCA associated with an increased risk of death for any cause or heart failure hospitalizations (HF) in patients with STR; 2) test if the planimetry of 3DE VCA may improve the risk stratification over the quantitative parameters of STR severity.

Methods

Retrospective analysis of patients with STR consecutively enrolled in the FUTURE 3DECHO study who had good quality 3DE dataset for VCA planimetry.

Results

We selected 184 patients (76±13 years, 43% women). According to the guideline-recommended multiparametric approach, 15% of the patients had mild, 51% moderate, 22% severe, and 12% massive STR. The mean 3DE VCA was 0.72±0.41 cm2 and it increased significantly with the severity of STR. Among all the quantitative parameters of STR severity, the strongest correlation of 3DE VCA was found with EROA by PISA (Spearman: 0.63, p < 0.001). Using spline curve analysis, a 3DE VCA of 0.65 cm2 was identified as the threshold value associated with increased risk of experiencing the composite endpoint in the whole population (Figure 1A). At univariate analysis, a 3DE VCA > 0.65 cm2 carried a 4-fold increased risk of combined events and it also stratified the risk in patients with EROA < 0.4 cm2 (Figure 1B). When added to a multivariable model including right atrial volume, right ventricular ejection fraction, pulmonary arterial systolic pressure, STR EROA and regurgitant volume, VCA increased significantly the predictive power of the model and mainteined its independent correlation with outcomes (HR: 1.011, CI 95%: 1.003-1.019, P=0.007; X2 of models: 44 vs 39, p value <0.001) (Figure 2).

Conclusion

3DE VCA has independent and incremental value over the other parameters of severity for predicting the risk of events in patients with STR. 3DE VCA> 0.65 cm2 identified STR patients with EROA< 0.4 cm2 at higher risk of experiencing the composite endpoint of death and HF.

Figure 1 A and B

Figure 2. Cox Regression multivariate
Relationship between position, shape and deformation of papillary muscles and mitral regurgitation after transcatheter aortic valve replacement
Authors: Li X , Wei X , Chen F , Zhou W X , Liang Y J , Zhao Z G , Li Q , Wei J F , Tang H , Feng Y , Chen M
Published: January 2025

Background

Previous studies have shown that preoperative co-existing moderate/severe mitral regurgitation (MR) and postoperative persistent MR can affect the prognosis of patients with transcatheter aortic valve replacement (TAVR). However, most studies only focus on mitral valve leaflets and annulus, and few touches on papillary muscle.

Purpose

To explore the relationship between the shape, position and deformation of papillary muscles and MR outcome after TAVR.

Methods

This retrospective cohort study included 1159 consecutive patients who underwent TAVR between April 2012 and September 2021. The 141 patients who met the inclusion and exclusion criteria and have MR≥3+ grade were divided into improved MR (IMR) group and non-improved (NMR) group according to the grading of MR at 1 month after operation. MSCT and 18-segments method were used to analyze the shape and locate the attachment of papillary muscle. The deformation and synchrony of the papillary muscle attachment were analyzed using two-dimensional speckle tracking. Associations with MR improvement after TAVR were explored.

Results

A total of 141 patients (mean age, 73 years ± 8; 94 men) were included. IMR was observed in 104 patients, and NMR was seen in the remaining 37. There was no significant difference in the deformation and synchrony of myocardium at attachment and in the papillary muscle morphology between groups. However, the range of papillary muscle attachment was increased in the NMR group compared to the IMR group (2.08±0.92 vs. 1.36±0.61, p<0.001; 2.32±0.88 vs. 1.76±0.77, p<0.001). Inferior displacement of papillary muscle (OR: 14.151; 95% CI: 2.90, 69.045; P = .001) was found to be an independent predictor of less MR improvement after TAVR.

Conclusion

The papillary muscles in the NMR group had no significant morphological tendency, but their attachment range was significantly increased and more towards apical. Inferior displacement of papillary muscles was an independent risk factors for unalleviated MR.
Prognostic value of dynamic changes in right ventricular-pulmonary arterial coupling in acute heart failure
Authors: Anastasiou V , Daios S D , Peteinidou E P , Fardoulis E F , Gogos C G , Didagelos M D , Giannakoulas G G , Karamitsos T K , Ziakas A Z , Kamperidis V K
Published: January 2025

Background

Right ventricular-pulmonary arterial (RV-PA) coupling is a powerful prognosticator in heart failure (HF). However, acute HF treatment may improve the connection of RV to the PA circulation for some patients. Whether the dynamic changes of RV-PA coupling during hospitalization for acute HF carry a prognostic value remains unexplored.

Methods

TAPSE/PASP was measured in all consecutive patients hospitalized for acute HF using echocardiography within 24 hours from admission and within 24 hours before discharge. TAPSE/PASP ≥0.36 mm/Hg was considered RV-PA coupling and TAPSE/PASP <0.36 mm/Hg RV-PA uncoupling. Patients were divided into 3 groups; RV-PA coupling on admission, RV-PA uncoupling on admission that improved to RV-PA coupling on discharge (Improved RV-PA uncoupling), and RV-PA uncoupling on admission without improvement on discharge (Non-improved RV-PA uncoupling). All-cause death and HF hospitalization was the composite primary endpoint.

Results

Of the 401 patients 185 (46.1%) had RV-PA coupling on admission, 93 (23.2%) had Improved RV-PA uncoupling, and 123 (30.7%) had Non-improved RV-PA uncoupling. After a median follow up of 6 months (interquartile range, 2.3-9.8), 141 (35.2%) patients reached the primary endpoint. Patients with Non-improved RV-PA uncoupling showed higher cumulative event rates compared to the other 2 groups (RV-PA coupling: 24.3%, Improved RV-PA uncoupling: 24.7%, Non-improved RV-PA uncoupling: 59.3%, Log-rank p< 0.001) (Figure 1). In multivariate cox-regression analysis Non-improved RV-PA uncoupling was independently associated with the composite outcome (hazard ratio 2.54 [95% CI, 1.45–4.46]; p =0.001), and provided incremental prognostic information over a baseline clinical and echocardiographic model and RV-PA uncoupling on admission (Figure 2).

Conclusion

Absence of improvement in RV-PA uncoupling in response to acute HF treatment is associated with worst event-free survival and may indicate advanced RV failure and PA remodeling not amenable to medical management.

Figure 1: Event-free survival

Figure 2: Incremental prognostic value
Inodilators in acute heart failure: what about the right ventricle?
Authors: Carvalho M , Cabral M , Goncalves C , Vazao A , Martins A , Ruivo C
Published: January 2025

Objectives

This research examines the impact of levosimendan on right ventricular (RV) function in patients with cardiovascular conditions, aiming to evaluate enhancements in crucial echocardiographic indicators of RV systolic performance.

Methods

A total of 54 patients hospitalized for acute heart failure were enrolled in the study and divided into two groups: 25 patients received 12.5 mg of levosimendan over 24 hours, while the remaining 29 patients served as the control group. Echocardiographic parameters were measured at baseline and after treatment for both groups.

Results

In the levosimendan group, the post-treatment S' tissue velocity increased significantly from 9.48 ± 1.06 cm/s to 10.43 ± 1.28 cm/s (p=0.025), whereas the control group exhibited a change from 9.31 ± 0.93 cm/s to 9.53 ± 1.11 cm/s. The fractional area change (FAC) showed a notable improvement in the levosimendan group from 20 ± 3% to 27 ± 2% (p < 0.0001), compared to a minor change in the control group. Tricuspid annular plane systolic excursion (TAPSE) significantly increased in the levosimendan group from 13.8 ± 0.4 mm to 15.6 ± 0.36 mm (p < 0.0001), while the control group displayed minimal change. Systolic pulmonary artery pressure (SPAP) reduction was more significant in the levosimendan group (from 58.67 ± 7.28 mmHg to 47.22 ± 5.6 mmHg) compared to the control group (from 60.5 ± 9.34 mmHg to 55.85 ± 7.41 mmHg) (p=0.012). Additionally, RV strain improved considerably in the levosimendan group from -20 ± 3% to -23 ± 3% (p=0.03), while the control group changed from -19 ± 3% to -20 ± 3%.

Conclusion

Levosimendan markedly enhances right ventricular function, as demonstrated by significant increases in S' velocity, FAC, RV strain, and TAPSE, along with a notable reduction in SPAP. These results indicate that levosimendan is a promising therapeutic agent for improving RV function.
Propensity score-matched analysis in isolated left ventricular dilation and non-ischaemic dilated cardiomyopathy
Authors: Goncalves T , Pezel T , Garot P , Toupin S , Duhamel S , Sanguineti F , Unterseeh T , Hovasse T , Gall E , Hamzi L , Unger A , Dillinger J G , Henry P , Bousson V , Garot J
Published: January 2025

Introduction

The presence and extent of late gadolinium enhancement (LGE) assessed by cardiac magnetic resonance imaging (CMR) are strong prognosticators of death in patients with non-ischaemic dilated cardiomyopathy (DCM), defined as left ventricular (LV) dilation and left ventricular ejection fraction (LVEF)<50%. Although the current guidelines defined the concept of "isolated LV dilation" (ILVD) as LV dilation with preserved LVEF≥ 50%, the prognostic value of the "LGE granularity" is not established in this population.

Purpose

To assess the prognostic value of the concept of "LGE granularity" including its extent, location, and pattern for predicting all-cause death above traditional prognosticators in patients with DCM or ILVD, separately.

Methods

Between 2008 and 2021, all consecutive patients with DCM and ILVD without implantable cardioverter-defibrillator or history of sustained ventricular arrhythmia referred for CMR were included in two centres. The primary outcome was all-cause death using the French National Registry of Death. A propensity score matching was performed to balance characteristics in patients with DCM vs. those with ILVD. Cox regressions were performed to determine the prognostic value of each LGE findings.

Results

Of 2,752 patients analysed (age 52±8 years, 56% male), 15% patients died after a median (interquartile range) follow-up of 9 (7-12) years. A total of 737 (27%) patients had LGE. In the propensity-score matched population (N=1,084 in DCM subgroup and N=1,084 in isolated LV dilation), the LGE presence was associated with death (HR=2.98, 95%CI: 1.97-4.50, p<0.001). In ILVD patients with LGE (N=265), the LGE extent (HR=1.41, 95%CI:1.09-1.83, p=0.009), the presence of LGE in multiple areas (HR=3.86, 95%CI: 1.73-8.61, p<0.001) and the septal location (HR=2.97, 95%CI:1.37-6.46, p=0.006) were strong prognosticators of death after adjustment for traditional prognosticators. Similarly, in DCM patients with LGE (N=268), the LGE extent (HR=1.42, 95% CI:1.07-1.89, p=0.014), the presence of LGE in multiple areas (HR=8.41, 95%CI: 3.32-21.3, p<0.001) and the septal location (HR=6.65, 95% CI: 3.02-14.6, p<0.001) were strongly associated with death.

Conclusion

The concept of "LGE granularity" was independently associated with all-cause death after adjustment for all traditional prognosticators in both DCM and ILVD. These results suggest that CMR assessment could improve the risk stratification in this population.

Survival curves Multivariable analysis
Coronary septic embolism presenting as acute myocardial infarction. A case report of a singular manifestation of infective endocarditis
Authors: Ferreira Carvalho Mariana , Gonçalves Carolina , Saldanha Santos Beatriz , Morais João
Published: January 2025

Background

Acute ST-elevation myocardial infarction (STEMI) complicated by infective endocarditis (IE) presents a unique challenge in clinical management, especially when associated with septic embolism leading to coronary artery occlusion.

Case summary

The current clinical report describes the case of a 72-year-old male with a history of arterial hypertension, dyslipidaemia, and severe obstructive sleep apnea. The patient presented with anterior STEMI due to an embolic occlusion in the left anterior descending (LAD) artery, secondary to IE. Coronary angiography revealed embolic occlusion at the LAD origin, and balloon angioplasty without stent placement was performed, considering the embolic and infectious nature of the occlusion. Despite targeted interventions, including broad-spectrum antibiotics and support for cardiogenic shock, the patient's condition deteriorated, leading to cardiac arrest and subsequent death on the fourth day of hospitalization.

Conclusion

This case emphasizes the critical need for adapting STEMI management in the presence of IE. It highlights the importance of considering IE in STEMI differential diagnosis and adjusting intervention strategies accordingly.
Management of coexisting patent foramen ovale and pulmonary arteriovenous malformation: a case report of sequential closure
Authors: Yagasaki Hiroto , Suzuki Takeki , Watanabe Keitaro , Watanabe Ryota , Noda Toshiyuki
Published: January 2025

Background

Concurrent patent foramen ovale (PFO) and pulmonary arteriovenous malformation (PAVM) are rare but can cause paradoxical embolism and platypnoea–orthodeoxia syndrome (POS).

Case summary

A 72-year-old female with embolic stroke history developed positional dyspnoea. Evaluation revealed right-to-left shunting through PFO and PAVM in the right middle lobe. Orthodeoxia was confirmed by 6% SpO2 decrease upon position change. A staged approach was adopted: PFO closure with Amplatzer™ Occluder, followed by PAVM embolization 1 month later. Symptoms improved significantly post-procedure. No residual shunting or symptoms have been observed during the 2-year follow-up.

Discussion

This case emphasizes thorough evaluation in patients with cryptogenic stroke and POS, especially when symptoms persist. It demonstrates the effectiveness of staged treatment for concurrent PFO and PAVM, highlighting the importance of individualized strategies and long-term follow-up.
Sex and age-specific 10-year mortality after coronary stenting: an analysis of two randomized trials
Authors: Pinxterhuis Tineke H , Ploumen Eline H , Doggen Carine J M , van Vliet Daphne , Kok Marlies M , Zocca Paolo , Hartmann Marc , van Houwelingen K Gert , Stoel Martin G , de Man Frits H A F , Linssen Gerard C M , von Birgelen Clemens
Published: January 2025

Aims

Over time, clinical outcome after percutaneous coronary intervention (PCI) with contemporary drug-eluting stents (DES) has improved. While most patients survive for many years after PCI, data on potential sex differences in age-specific 10-year mortality risk in all-comer patients are scarce. This study aimed to examine the sex- and age-specific 10-year mortality risk after PCI with new-generation DES.

Methods and results

This investigator-driven study assessed women and men, enrolled in our centre in two large-scale all-comer PCI trials (TWENTE and DUTCH PEERS; ClinicalTrials.gov NCT01066650 and NCT01331707, respectively), and compared their long-term mortality risk with that of the general population. The life status was checked in a national database of personal records. Information about the causes of death was obtained from medical records. Of all 2743 patients, 220/748 women and 461/1995 men died (29.4 vs. 23.1%, respectively, P < 0.001). Deceased patients had higher cardiovascular risk profiles and were older than patients who survived. Compared to the general population of a similar age, women and men who underwent PCI showed significantly increased 10-year all-cause mortality risks with a standardized mortality ratio of 2.13 [95% confidence interval (CI): 1.85–2.41] and 1.63 (95% CI: 1.48–1.78), respectively. No sex difference in causes of death was observed (cardiac, 28.2% women vs. 30.8% men, P = 0.46; vascular, 4.1 vs. 5.4%, P = 0.45; non-cardiovascular, 38.2 vs. 44.5%, P = 0.11).

Conclusion

PCI patients of both sexes showed higher 10-year age-specific mortality risks than the general population with a more pronounced difference observed in women. There was no sex difference in underlying causes of death. Furthermore, both women and men who died had higher cardiovascular risk profiles than those who survived.
Integration of apolipoprotein B into the SCORE2 framework: implications for cardiovascular risk prediction
Authors: Wong Wen Kai , Takeuchi Fumihiko , Thao Le Thi Phuong , Nicholls Stephen J , Chew Derek P , Peter Karlheinz
Published: January 2025

Aims

To evaluate whether integrating Apolipoprotein B (ApoB) into the Systematic Coronary Risk Evaluation 2 (SCORE2) cardiovascular risk prediction framework improves its predictive accuracy and clinical applicability within the UK Biobank population.

Methods and results

A 10-year prospective cohort study was conducted with 448 303 UK Biobank participants eligible for SCORE2 calculation. Three approaches were employed: (i) threshold analysis to determine the optimal ApoB cutoff for cardiovascular disease (CVD) risk prediction using Youden’s Index, (ii) assessment of the synergistic effect of SCORE2 and ApoB through concordant and discordant classifications, and (iii) recalibration of the SCORE2 model by incorporating ApoB as an additional predictor. Each 0.2 g/L increase in ApoB was associated with an increased subdistribution hazard for CVD events [subdistribution hazard ratio (SHR): 1.13; 95% CI: 1.11–1.14, P < 0.001], accounting for non-cardiovascular death as a competing risk. Threshold analysis identified an optimal ApoB cutoff at 1.18 g/L; however, it demonstrated limited discriminatory performance (area under the curve 0.54), with low sensitivity (32.4%), and moderate specificity (74.4%). Individuals with both low ApoB (<1.18 g/L) and low SCORE2 risk (<5%) had a lower CVD incidence rate (232.51 per 100 000 person-years) compared with those identified as low risk by SCORE2 alone (253.69 per 100 000 person-years). Integration of ApoB into the SCORE2 model did not significantly improve the model discrimination, calibration, and net reclassification improvement.

Conclusion

Apolipoprotein B exhibited a dose–response relationship with cardiovascular risk but had limited standalone predictive utility within the UK Biobank population. However, combining ApoB with SCORE2 thresholds improved the identification of low-risk individuals, suggesting a complementary role for ApoB in refining cardiovascular risk stratification.
Comparative functional analyses of the prostate-specific KLK3 enzyme in primates reveal the impact of sexual selection
Authors: Kahveci Emine F , Colvin Zielen Amanda M , Gibbs William J , McIntyre Clancy A , Modi Raahi , Johnstonbaugh Hannah Z , Washington Thomas H , Brown David R , Hockman Megan R , Rossman Neil R , Jensen-Seaman Michael I
Published: January 2025

Male reproductive proteins frequently evolve rapidly in animals, potentially due to adaptive evolution driven by sperm competition, polyspermy avoidance, or pathogen defense. Alternatively, elevated rates of protein change may be due to relaxed constraint. The prostate-specific protease KLK3 has experienced dynamic evolution since its origin stemming from a gene duplication in the ancestor of all Old World primates, with instances of rapid evolution, stasis, and pseudogenization. As we demonstrate with functional assays using recombinant proteins, these changes have resulted in a chimpanzee KLK3 ortholog with greater enzyme velocity and higher efficiency than other apes, including humans. Reduced enzyme efficiency was observed in gorillas and gibbons who both possess a chimeric KLK2/KLK3 enzyme resulting from independent genomic deletions. The relative efficiency of KLK3 homologs among these species correlates well with their presumed levels of sperm competition. Furthermore, the reconstructed protein of the human-chimpanzee last common ancestor has enzyme kinetics identical to modern humans, suggesting that the observed functional differences between humans and chimpanzees are derived in the latter and allowing us to tentatively speculate that their common ancestor did not possess a polygynandrous mating system similar to modern chimpanzees.
Craniofacial modularity and the evolution of cranial kinesis in the adaptive radiation of Furnariidae (Aves: Passeriformes)
Authors: Stefanini Manuel I , Milla Carmona Pablo S , Gómez-Bahamón Valentina , Mongiardino Koch Nicolás , Soto Ignacio M , Gómez Raúl O , Zyskowski Kristof , Tambussi Claudia P
Published: January 2025

The role of phenotypic modularity in the evolution of skull morphology in birds has been a subject of debate in recent years. Furnariids (ovenbirds and woodcreepers), a spectacular avian adaptive radiation, are distinguished in their cranial morphology as the only passerines with two types of cranial kinesis, constituting a great model to test whether the evolution of novelties linked to kinesis was associated with shifts in patterns of evolutionary modularity and allometry in the avian skull. Our analyses by means of geometric morphometric tools and phylogenetic comparative methods show that the beak and neurocranium of furnariids evolved in a modular fashion and shaped by the cranial kinesis evolution. Besides, species with prokinesis show a higher degree of modularity and morphological disparity, lower phenotypic rates, as well as higher contribution of allometry in the evolution of the beak morphology than species with proximal rhynchokinesis, suggesting, as observed in several vertebrates, that the functional demands associated with higher degrees of cranial kinesis promoted rapid integration throughout the skull. Prokinetic—robust morphotypes and proximal rhynchokinetic—gracile morphotypes, have repeatedly evolved by evolutionary convergence in both modules, which suggests the existence of functional trade-offs and long-standing adaptive optima related to cranial kinesis.
The protist community of the oligotrophic waters of the Gulf of Mexico is distinctly shaped by depth-specific physicochemical conditions during the warm season
Authors: Sidón-Ceseña Karla , Martínez-Mercado Miguel Angel , Chong-Robles Jennyfers , Ortega-Saad Yamne , Camacho-Ibar Victor Froylán , Linacre Lorena , Lago-Lestón Asunción
Published: January 2025

Marine protists are key components of biogeochemical cycles and microbial food webs, which respond quickly to environmental factors. In the Gulf of Mexico (GoM), the Loop Current intensifies in summer and supplies the gulf with warm and oligotrophic waters. However, the cyclonic eddies within the GoM create favorable conditions for biological productivity by bringing nutrient-rich water to the subsurface layer. In this study, we investigated the response of the protist community to the regional physicochemical conditions, its spatial and temporal variability, the influence of mesoscale structures, and its ecological roles in the mixed layer (ML) and deep chlorophyll maximum (DCM). This is the first study to conduct a V9-18S rRNA gene survey for this community in the Mexican Exclusive Economic Zone of the GoM. The regional distribution, temporal changes, and mesoscale structures significantly affected the structure of the protist community in the ML. In contrast, only mesoscale structures significantly affected the protist community in the DCM. Different protist assemblages were also present between the ML and DCM, with the Alveolata representing ∼60% of the community in both layers, followed by haptophytes and MAST (Marine Stramenopiles) in the ML; pelagophytes and radiolarians were the more prevalent taxa in the DCM. Finally, co-occurrence analyses revealed that competition, parasitism, and predation were the potential interactions shaping these communities at both depths.
Isolation and identification of Lactobacillus species from gut microbiota of Aegiale hesperiaris (Lepidoptera: Hesperiidae) larvae
Authors: Herrera-Cardoso Ericka Denice , Tapia-Cervantes Karen Alejandra , Cepeda-Negrete Jonathan , Gutiérrez-Vargas Santiago , León-Galván Ma Fabiola
Published: January 2025

Entomophagy, the practice of consuming insects, is a global tradition. In Mexico, one of the most notable and widely consumed insects is the larva of Aegiale hesperiaris. This insect feeds on the leaves of various Agave species with high polysaccharide content, suggesting their potential role as prebiotics for the intestinal microbiota, particularly lactic acid bacteria (LAB). LAB are recognized for their use as probiotics in foods due to their health-promoting capabilities. In this study, LAB from the intestinal microbiota of A. hesperiaris larvae were isolated and characterized, utilizing 16S rRNA gene identification. The analysis revealed three bacterial species from the Lactobacillaceae family, indicating a close symbiotic relationship with the insect. This suggests a significant impact on carbohydrate and protein metabolism, vitamin synthesis, and amino acid production, contributing to the high nutritional value of this edible insect. The study provides insights into the bacteria within the digestive tract of A. hesperiaris larvae and their role in enhancing the nutritional value of this edible insect. Additionally, it establishes a foundation for future research on the ecological roles and potential biotechnological benefits of these bacteria in the food industry and the development of therapies for various conditions and diseases.
The B Chromosome of Pseudococcus viburni: A Selfish Chromosome that Exploits Whole-Genome Meiotic Drive
Authors: Vea Isabelle M , de la Filia Andrés G , Jaron Kamil S , Barlow Scott E J , Herbette Marion , Mongue Andrew J , Nelson Ross , Ruiz-Ruano Francisco J , Ross Laura
Published: January 2025

Meiosis is generally a fair process: each chromosome has a 50% chance of being included into each gamete. However, meiosis can become aberrant with some chromosomes having a higher chance of making it into gametes than others. Yet, why and how such systems evolve remains unclear. Here, we study the unusual reproductive genetics of mealybugs, where only maternal-origin chromosomes are included in gametes during male meiosis, while paternal chromosomes are eliminated. One species—Pseudococcus viburni—has a segregating B chromosome that drives by escaping paternal genome elimination. We present whole genome and gene expression data from lines with and without B chromosomes. We identify B-linked sequences including 204 protein-coding genes and a satellite repeat that makes up a significant proportion of the chromosome. The few paralogs between the B and the core genome are distributed throughout the genome, arguing against a simple, or at least recent, chromosomal duplication of one of the autosomes to create the B. We do, however, find one 373 kb region containing 146 genes that appears to be a recent translocation. Finally, we show that while many B-linked genes are expressed during meiosis, most of these are encoded on the recently translocated region. Only a small number of B-exclusive genes are expressed during meiosis. Of these, only one was overexpressed during male meiosis, which is when the drive occurs: an acetyltransferase involved in H3K56Ac, which has a putative role in meiosis and is, therefore, a promising candidate for further studies.
A chromosome-level, haplotype-resolved genome assembly and annotation for the Eurasian minnow (Leuciscidae: Phoxinus phoxinus) provide evidence of haplotype diversity
Authors: Oriowo Temitope Opeyemi , Chrysostomakis Ioannis , Martin Sebastian , Kukowka Sandra , Brown Thomas , Winkler Sylke , Myers Eugene W , Böhne Astrid , Stange Madlen
Published: January 2025

Background

In this study, we present an in-depth analysis of the Eurasian minnow (Phoxinus phoxinus) genome, highlighting its genetic diversity, structural variations, and evolutionary adaptations. We generated an annotated haplotype-phased, chromosome-level genome assembly (2n = 50) by integrating high-fidelity (HiFi) long reads and chromosome conformation capture data (Hi-C).

Results

We achieved a haploid size of 940 megabase pairs (Mbp) for haplome 1 and 929 Mbp for haplome 2 with high scaffold N50 values of 36.4 Mb and 36.6 Mb and BUSCO scores of 96.9% and 97.2%, respectively, indicating a highly complete genome assembly. We detected notable heterozygosity (1.43%) and a high repeat content (approximately 54%), primarily consisting of DNA transposons, which contribute to genome rearrangements and variations. We found substantial structural variations within the genome, including insertions, deletions, inversions, and translocations. These variations affect genes enriched in functions such as dephosphorylation, developmental pigmentation, phagocytosis, immunity, and stress response. In the annotation of protein-coding genes, 30,980 messenger RNAs and 23,497 protein-coding genes were identified with a high completeness score, which further underpins the high contiguity of our genome assemblies. We performed a gene family evolution analysis by comparing our proteome to 10 other teleost species, which identified immune system gene families that prioritize histone-based disease prevention over NB-LRR-related-based immune responses. Additionally, demographic analysis indicates historical fluctuations in the effective population size of P. phoxinus, likely correlating with past climatic changes.

Conclusions

This annotated, phased reference genome provides a crucial resource for resolving the taxonomic complexity within the genus Phoxinus and highlights the importance of haplotype-phased assemblies in understanding haplotype diversity in species characterized by high heterozygosity.
Absolute palaeointensity estimates from Precambrian India and the long-term thermal evolution of the Earth
Authors: Bristol K E , Sprain C J , Meert J G , Yasar I D , Pandit M K , Sinha A K , Dann A B
Published: January 2025

Despite significant progress in palaeomagnetic research over the last century, the origin, evolution and long-term behaviour of the geomagnetic field remains poorly understood. One significant open question is when and how the inner core nucleated. Since geomagnetic field behaviour is intrinsically linked to the thermal evolution of the core, scientists have turned to the global palaeointensity record to search for proxies for inner core nucleation. From this record, two signals have been identified as possible indicators of inner core nucleation: (1) a spike in magnetic field strength between 1.5–1.0 Ga, and (2) an initially strong, but gradually decreasing field strength that resulted in a weak dynamo in the Ediacaran. Although both these hypotheses are vastly different, they do have one common challenge hindering rigorous testing: a paucity of palaeointensity data. This is especially true for the Precambrian time period for which well-preserved outcrops are scarce and weathering/alteration is nearly inescapable. Despite making up almost 90 per cent of Earth's history, data from this super eon comprise < 10 per cent of the global palaeointensity database. This lack of data for most of Earth's history represents a considerable gap in our knowledge and greatly impedes our ability to understand the origin and evolution of our planet and its magnetic field. In an effort to fill in this gap, we performed palaeointensity experiments on Precambrian-aged mafic dykes from India (Malani Igneous Suite and Bastar, Dharwar and Bundelkhand Cratons) with ages ranging from ∼740 Ma to ∼2.36 Ga. To monitor thermal alteration and minimize the effects of non-ideal grain sizes, the Thellier method following the IZZI protocol was used. Successful results were obtained for samples from the Bundelkhand (∼740 Ma) and Bastar (∼1.89 Ga) cratons. The Bastar results fall in a ∼40 Myr gap in the database and corroborate field trends predicted by the Monte Carlo axial dipole moment model, which suggests that intensity values were moderately low (2–4 × 1022 A m2) in the middle Palaeoproterozoic. The Bundelkhand result suggests that the field may have been rapidly decaying in the late Tonian to early Cryogenian.
La judicialización de la política y el control constitucional en modelos híbridos restringidos: el activismo judicial por “defecto” de ParaguayThe judicialization of politics and judicial review in restricted hybrid models: judicial activism by “default” in Paraguay
Authors: Castagnola Andrea , Pérez-Liñán Aníbal
Published: January 2025

Does the institutional design of constitutional review affect the judicialization of politics and judicial behavior? Traditionally, political factors and the personal characteristics of judges are considered the main explanations for judicial behavior, often overlooking the role of institutional design. This article examines the “restricted hybrid” model of constitutional review in Paraguay, a country with low political polarization due to party hegemony, yet marked by judicial activism. The analysis of the Constitutional Chamber between 1995 and 2015 reveals that the restricted hybrid design influences judges voting behavior, suggesting that judicial activism is not necessarily a deliberate strategy but an unintended consequence of the institutional design. In contexts of low polarization and restricted constitutional review, like in Paraguay, judges have shown deference to strong presidents but not to strong congresses.
Population-Level Impact of Human Papillomavirus Vaccination on the Incidence of Genital Warts in Sweden
Authors: Astorga Alsina Ana Martina , Herweijer Eva , Lei Jiayao
Published: January 2025

Background

Sweden introduced human papillomavirus (HPV) vaccination in 2006 via opportunistic, subsidized, catch-up, and school-based programs. Notably, genital warts (GW) are the first observable clinical outcome following HPV-6/11 infection, the strains targeted by vaccination. We aim to assess the incidence of GW in Sweden and its change throughout vaccination programs.

Methods

This ecological study used Swedish registers to obtain national population data and cases of GW from 2006 to 2018 in 15- to 44-year-old men and women. We used Poisson models to estimate GW incidence change after vaccination compared to a prevaccination period, stratified by age and sex, and incidence change of GW in birth cohorts eligible for vaccination compared to a prevaccination cohort. Finally, we estimated GW cases averted in each vaccinated cohort.

Results

The incidence of GW decreased during periods following HPV vaccination. In 2016–2018, over a decade after vaccination availability, incidence decreased by 89% (95% confidence interval [CI], 83%–93%), 73% (95% CI, 71%–75%), 50% (95% CI, 43%–56%), and 20% (95% CI, 10%–28%) in women aged 15–19, 20–24, 25–29, and 30–34 years, respectively. A similar reduction was observable in men, although of lower magnitude. We estimated 18 890 and 12 343 GW cases averted among vaccinated cohorts of women and men, respectively.

Conclusions

We report on population-level decreases of GW incidence in women and men following increased vaccination coverage. Cohorts eligible for school-based vaccination recorded the largest decrease in GW incidence in Sweden to date. For the period under study, decreases among men could be attributed to herd effects.