Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: The characteristics of acute heart failure (AHF) vary according to ischemic and non-ischemic etiology. Risk stratification of these characteristics by etiology is a pressing issue. METHODS AND RESULTS: A total of 1655 AHF patients were analyzed. Patients were divided into two groups by their etiology [ischemia (n = 693) and non-ischemia (n = 962) groups], and the ischemia group was further divided into three groups according to their British Cardiovascular Intervention Society (BCIS)-complex high risk indicated percutaneous coronary intervention (CHIP) score [low-score (Q1, BCIS-CHIP ≤2, n = 203), middle-score (Q2, 3 ≤ BCIS-CHIP≤4, n = 229), and high-score (Q3, BCIS-CHIP ≥5, n = 261)]. A multivariate logistic regression model showed that male sex [odds ratio (OR): 2.286, 95% confidence interval (CI): 1.785-2.926] and presence of chronic kidney disease (OR: 1.506, 95%CI: 1.197-1.895) were independently associated with ischemic etiology. Kaplan-Meier curve analysis showed that HF events within 1000 days were significantly less frequent in the ischemia group than in the non-ischemia group, and that the survival and event-free rates were significantly lower in the high-BCIS-CHIP score group than in the other two groups. A Cox regression model indicated that a high-BCIS-CHIP score was an independent predictor of 1000-day mortality [hazard ratio (HR): 2.282, 95%CI: 1.454-3.583] and HF events (HR: 1.968, 95%CI: 1.429-2.710). CONCLUSION: Ischemic AHF was associated with male sex and chronic kidney disease, and the BCIS-CHIP score is valuable for risk stratification of ischemic AHF patients.

DOI： 10.1016/j.jjcc.2026.03.007

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Transient focal mid-ventricular Takotsubo syndrome (TTS) complicated by cardiogenic shock due to cardiac rupture has not been documented to our knowledge. CASE SUMMARY: A 76-year-old man was airlifted by helicopter emergency medical services. On admission, cardiogenic shock secondary to cardiac tamponade was diagnosed. Emergency pericardial fenestration was performed. Left ventricular angiography revealed severe dyskinesis in the mid-ventricular segment and hyperkinesis in both the basal and the apical regions. These findings initially raised suspicion for cardiac rupture secondary to a ventricular aneurysm. Repeat left ventricular angiography on day 4 showed complete resolution of wall motion abnormalities. A diagnosis of transient mid-ventricular stress cardiomyopathy complicated by cardiac rupture was made at that time. Surgical repair was performed. The patient was discharged home 56 days after admission. DISCUSSION: Partial or focal forms of TTS can mimic ventricular aneurysm, complicating diagnosis. TAKE-HOME MESSAGE: TTS should be considered a potential cause of cardiac rupture and included in the differential diagnosis by cardiologists.

DOI： 10.1016/j.jaccas.2025.106606

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Mitochondrial dynamics-related RNAs during hospitalization for acute heart failure (AHF) were rarely evaluated in various points. In total, 234 patients who visited the emergency room for AHF were retrospectively evaluated. Blood samples were collected within 15 min of admission (day 1), after 48-72 h, and between days 7 and 21. Low miR-140-3p during hospitalization was defined as the level being categorized as Q1 more than once (on days 1, 3 and/or 14), and normal-140-3p during hospitalization as the level never being categorized as Q1. The median miR-140-3p levels were significantly decreased on days 3 and 14 (2.53 [1.06-6.42] and 3.65 [1.41-9.05], respectively) in comparison to the value on day 1 (6.71 [2.66-14.0]). Kaplan-Meier curves indicated that all-cause mortality within 1000 days was significantly higher in the low-miR-140-3p group than in the other-miR-140-3p group on days 1 and 14. Moreover, the survival rate was significantly lower and the rate of HF events was significantly higher in the low-miR-140-3p group than in the normal-miR-140-3p group. The miRNA levels of patients further decreased during treatment for AHF. Low levels of mitochondrial fission-related miRNAs during AHF treatment were independently associated with an increased risk of long-term adverse outcomes.

DOI： 10.1038/s41598-025-23792-4

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Mitochondria are dynamic organelles that can change their morphology. The role of these mitochondrial dynamics in cardiomyocytes remains obscure in patients with heart failure (HF). Endomyocardial biopsies were performed consecutively in 127 HF patients, and mitochondrial morphology data were obtained from 111 patients by electron microscopy. The patients were divided into three groups according to mitochondrial area quartiles (fission [Q1, area ≤ 0.119 μm2, n = 27], normal [Q2/Q3, 0.120 μm2 ≤ area ≤ 0.178 μm2, n = 55], and fusion [Q4, area ≥ 0.179 μm2, n = 28]). In the fission group, the serum N-terminal pro-brain natriuretic peptide and B-type natriuretic peptide (BNP) levels were significantly higher, and patients with HF and a reduced left ventricular ejection fraction were more common, than in the other groups. A multivariate logistic regression model showed that diabetes mellitus was independently associated with placement in the fission group (odds ratio: 2.835, 95%confidence interval [CI]: 1.037-7.752). A Kaplan-Meier curve analysis showed that the prognosis was significantly poorer in the fission group than in the other groups, and a multivariate Cox regression model revealed fission to be an independent predictor of 1500-day mortality (hazard ratio: 4.365, 95%CI: 1.198-15.909). The circulating levels of miR-140-5p (≥2500) were independently associated with the presence of mitochondrial fission (OR: 3.622, 95%CI: 1.260-10.413). Excessive mitochondrial fission was observed in patients with severe HF status, and was independently associated with adverse outcomes in HF patients. Circulating mitochondrial dynamics-related miRNA levels might be of use in detecting mitochondrial fission in the cardiomyocytes of HF patients.

DOI： 10.1038/s41440-025-02338-1

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BACKGROUND: This study aimed to elucidate the age trends among non-surgical patients requiring intensive care over a 10-year period and the prognostic impact of aging in relation to their underlying etiologies. METHODS AND RESULTS: In all, 4,279 non-surgical patients requiring intensive care from 2012 to 2021 were enrolled in the study. Patient backgrounds and prognoses were compared among age 4 groups: Group A, age <60 years (n=910); Group B, age 60-69 years (n=1,062); Group C, age 70-79 years (n=1,355); and Group D, age ≥80 years (n=952). During the study period, the number of patients aged 60-69 years decreased significantly with time, whereas the number aged over 80 years increased significantly. A multivariate Cox regression model identified Group D as an independent predictor of 365-day all-cause mortality (hazard ratio [HR] 2.070; 95% confidence interval [CI] 1.619-2.646) relative to Group A. Multivariate logistic regression analysis indicated that the presence of sepsis was independently associated with 365-day mortality, especially in the cohort aged ≥80 years (HR 1.878; 95% CI 1.270-2.777; P=0.002). CONCLUSIONS: The mean age of patients requiring non-surgical intensive care is increasing annually, and greater age was identified as a significant factor associated with a higher 365-day mortality rate. The presence of sepsis was linked to increased 365-day mortality among older individuals.

DOI： 10.1253/circj.CJ-24-1030

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Language：Japanese   Publisher：日本内科学会-関東地方会  

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Language：Japanese   Publisher：(一社)日本集中治療医学会  

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Language：Japanese   Publisher：(一社)日本集中治療医学会  

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Language：English   Publisher：(一社)日本循環器学会  

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Language：English   Publisher：(一社)日本循環器学会  

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