BackgroundEarly identification of new-onset atrial fibrillation (NOAF) is crucial for preventing related complications. Left atrial strain parameters (LASPs), evaluated by speckle tracking echocardiography, are considered promising markers reflecting atrial cardiomyopathy and functional abnormalities. Therefore, this study aimed to quantitatively evaluate the predictive value of LASPs for NOAF through a systematic review and meta-analysis.MethodsThe Cochrane Library, Embase, PubMed, and Web of Science were retrieved up to July 30, 2025, for cohort, case-control, and cross-sectional investigations evaluating the correlation of peak atrial longitudinal strain (PALS), left atrial reservoir strain (LASr), left atrial conduit strain (LAScd), left atrial systolic strain (LASct), and peak atrial contraction strain (PACS) with the risk of NOAF. Random-effects models were employed to pool risk ratios (RR) and diagnostic performance metrics. Sensitivity analyses and Egger's test were applied to verify the stability of prognostic outcomes and publication bias, respectively. Subgroup and meta-regression analyses were conducted for multiple confounders. A summary receiver operating characteristic (SROC) curve was plotted, and the area under the curve (AUC) was computed.ResultsThirty-nine studies involving 20,681 subjects were incorporated. Meta-analyses revealed that low levels of PALS [RR (95% CI): 3.95 (1.57–9.92)], LASr [3.73 (2.34–5.96)], LAScd [2.26 (1.22–4.19)], and LASct [6.54 (2.25–19.0)] as dichotomous variables were associated with a higher risk of NOAF. As continuous variables, a one-unit decrease in PALS, PACS, LASr, LAScd, and LASct was independently associated with an elevated risk of NOAF (all P < 0.05). SROC analysis indicated that the pooled AUCs for PALS, LASr, and LASct were 0.84, 0.84, and 0.78, respectively, suggesting good diagnostic performance for these parameters.ConclusionLASPs exhibit significant diagnostic value for NOAF. They can be utilized in clinical practice to evaluate and predict the risk of NOAF.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251044556.

OBJECTIVE:To evaluate the clinical validity of ultrasound localization microscopy (ULM)-based microvasculomics for quantitatively detecting microcirculatory dysfunction in transplant renal artery stenosis (TRAS). METHODS:In this study, 54 renal transplant recipients underwent digital subtraction angiography (DSA) and ultrasound examination. They were divided into TRAS (n = 15) and control (n = 39) groups. Using ULM imaging derived from contrast-enhanced ultrasound (CEUS) videos, the study compared microvascular morphological, velocity, and comprehensive parameters between the groups. RESULTS:Baseline characteristics and most Doppler and CEUS parameters were comparable between the groups, with the exception of the segmental artery resistance index (RI). ULM analysis revealed that, compared to controls, TRAS patients exhibited significantly lower vessel ratio, mean velocity, vessel count, perfusion index, and location velocity. These parameters were significantly correlated with serum levels of renal allograft function markers. Multivariate LASSO regression identified four discriminative parameters: vessel count, perfusion index, velocity entropy, and segmental artery RI. ROC analysis demonstrated that combining these parameters achieved an AUC of 0.84 (95% CI = 0.72-0.97) for TRAS prediction, with a sensitivity of 93.3%. CONCLUSION:Ultrasound microvasculomics provides detailed insights into the microvascular structure and hemodynamics of TRAS, presenting a promising novel tool for monitoring and early intervention in renal allograft microstructural pathology.

Early identification of subclinical left ventricular (LV) systolic dysfunction (LVSD) in patients with isolated left bundle branch block (LBBB) and preserved LV ejection fraction (LVEF), termed LBBBpEF, is clinically important. Electrocardiography (ECG) has been proposed as a potential screening tool for detecting subclinical LVSD in LBBBpEF patients, but its effectiveness has not been fully validated. This study investigated the relationships between specific ECG characteristics and subclinical LVSD in LBBBpEF patients. The study included 111 patients with LBBBpEF. Two-dimensional speckle-tracking echocardiography was used to derive the LV global longitudinal strain (LV GLS), with LV GLS>-20

Tuberculous pericarditis is often difficult to diagnose because of atypical symptoms and insufficient etiology examination. We present a case wherein the patient initially presented with a high fever accompanied by recurrent pericardial effusion. Notably, the etiology and genetic diagnosis of tuberculosis were negative. With the combined application of multimodal imaging techniques such as transthoracic echocardiography, transesophageal echocardiography, contrast-enhanced ultrasound and enhanced CT, clinical diagnosis and treatment can provide sufficient evidence to support tuberculous pericarditis. Following the definitive diagnosis, the patient received an adequate course of antituberculosis treatment, and the condition improved significantly, with no recurrence of symptoms.

Autophagy related gene 4B (ATG4B) plays a central role in autophagy machinery, but its clinical relevance to AAA remains unknown. In this study, 205 AAA patients and 205 age- and sex-matched controls were included to detect the serum ATG4B levels. Meanwhile, abdominal aortic specimens from 24 AAA patients and 6 human organ donors were collected to evaluate the mRNA and in situ protein expression of ATG4B. We observed significantly higher ATG4B mRNA and protein expression levels in AAA group compared to those in control group, with a positive correlation between mRNA levels and serum/in situ protein levels (serum, r = 0.518, P = 0.010; in situ, r = 0.453, P = 0.026). Serum ATG4B exhibited the diagnostic potential for AAA (AUC = 0.702, sensitivity = 75.6

BackgroundLEOPARD syndrome (LS) is a rare genetic disorder presenting various clinical manifestations from childhood, complicating its diagnosis. In this study, we aim to refine the imaging presentation of LS and emphasize the importance of multimodality imaging in enhancing diagnostic accuracy and preventing serious cardiovascular events.CaseA 41-year-old woman was admitted to hospital with a suspected apical tumor detected by a transthoracic echocardiogram (TTE), which was later identified as apical myocardial hypertrophy through cardiac magnetic resonance imaging (CMR). She had abnormal electrocardiograms from the age of 2 years and freckles around the age of 4 years. In recent years, she has been experiencing exertional dyspnea. Supplemental coronary computer tomography angiography (CCTA) revealed diffuse coronary dilatation. Both multimodality imaging and clinical manifestations led to a suspicion of LS, which was confirmed by subsequent genetic testing. The patient declined further treatment. A 3-month follow-up CMR showed no significant change in the lesion.ConclusionThis report elucidates the diagnostic transition from an initial suspicion of an apical tumor by TTE to a definitive diagnosis of left ventricular apical hypertrophy by CMR in a 41-year-old woman with LS. It underscores the value of multimodality imaging (TTE, CCTA, CMR) in unraveling unusual cardiac manifestations in rare genetic disorders such as LS.

Although N6-methyladenosine (m6A) modification has been implicated in the pathogenesis of abdominal aortic aneurysm (AAA), the relationship between m6A-associated single nucleotide polymorphisms (m6A-SNPs) and AAA remains unknown. This study used integrative multi-omics analysis and clinical validation approaches to systematically identify potential m6A-SNPs connected with AAA risk. We found that rs6859 and rs10198139 could modulate the expression of local genes, NECTIN2 and HPCAL1, respectively, which exhibited upregulation in AAA tissues, and their risk variants were significantly correlated with an increased susceptibility to AAA. Incorporating rs6859 and rs10198139 improved the efficiency of AAA risk prediction compared to the model considering only conventional risk factors. Additionally, these two SNPs were predicted to be located within the regulatory sequences, and rs6859 showed a substantial impact on m6A modification levels. Our findings suggest that m6A-SNPs rs6859 and rs10198139 confer an elevated risk of AAA, possibly by promoting local gene expression through an m6A-mediated manner.

BACKGROUND:The relationship between plant-based diets and gallstone disease has been debated. This study aimed to shed light on the association between plant-based dietary index and the risk of developing gallstone disease. METHODS:Eligible participants were selected from National Health and Nutrition Examination Survey (NHANES) 2017-2020. Three plant-based diet indexes (PDI, healthy PDI, unhealthy PDI) were calculated using data from two NHANES 24-h dietary recall interviews. Restricted Cubic Spline and multivariate logistic regression were used to analyze the associations. Subgroup analysis was adopted to make the results more robust. RESULTS:A total of 5673 eligible participants were analyzed. After adjusting for various confounding variables, uPDI was positively associated with gallstone disease (OR = 1.53, 95%CI: 1.02-2.29). No association was found between PDI/hPDI and gallstone disease (p > 0.05). The results of subgroup analysis did not show any positive association between uPDI and gallstones in specific groups. CONCLUSION:Our study shows that the elevated uPDI are linked to a higher risk of gallstone disease.

Cardiovascular diseases are closely associated with a high-cholesterol or high-fat diet. The aim of the present study was to investigate the cadioprotective effect of epigallocatechin-3-gallate (EGCG) in high-fat diet-fed rats, with special emphasis on myocardial infarction. A high-fat diet was administered to male Wistar rats for 45 days and the rats of the treatment group were administered EGCG via intraperitoneal injection for the last 15 days. The serum lipid profile, antioxidant enzyme activity, lipid peroxidation, lipid metabolic proteins and cardiac tissue markers were assessed. The myocardium and aorta were also histopathologically examined. The high-fat diet-fed rats were found to be hypercholesterolemic or exhibited abnormal values in the selected parameters. However, these abnormalities were reversed to near-normal values in the rats administered EGCG. Similarly, the enzymatic antioxidant activity and non-enzymatic antioxidant levels were improved with EGCG treatment in high-fat diet-fed rats. In addition, EGCG activated sirtuin 1, endothelial nitric oxide synthase and AMP-activated protein kinase α, which suggests that its protective effect is mediated through the stimulation of lipid metabolism. The histopathological examination further revealed that EGCG significantly prevented the development of tissue abnormalities and improved the morphology of myocardial tissue. Taken together, our results suggested that EGCG plays a significant role in the protection of the cardiovascular system against the high-fat diet. This is a preliminary study, emphasizing on the cardioprotective properties of EGCG. We are currently analyzing the molecular mechanism underlying the protective effects of EGCG.

Current guidelines encourage large studies in a diverse population to establish normal reference ranges for three-dimensional (3D) echocardiography for different ethnic groups. This study was designed to establish the normal values of 3D-left ventricular (LV) and left atrial (LA) volume and function in a nationwide, population-based cohort of healthy Han Chinese adults. A total of 1117 healthy volunteers aged 18–89 years were enrolled from 28 collaborating laboratories in China. Two sets of 3D echocardiographic instruments were used, and full-volume echocardiographic images were recorded and transmitted to a core laboratory for image analysis with a vendor-independent off-line workstation. Finally, 866 volunteers (mean age of 48.4 years, 402 men) were qualified for final analysis. Most parameters exhibited substantial differences between different sex and age groups, even after indexation by body surface area. The normal ranges of 3D-LV and 3D-LA volume and function differed from those recommended by the American Society of Echocardiography and the European Association of Cardiovascular Imaging guidelines, presented by the World Alliance Societies of Echocardiography (WASE) study, and from the 2D values in the EMINCA study. The normal reference values of 3D echocardiography-derived LV and LA volume and function were established for the first time in healthy Han Chinese adults. Normal ranges of 3D-LV and 3D-LA echocardiographic measurements stratified with sex, age, and race should be recommended for clinical applications.

Three-dimensional (3D) echocardiography is an emerging technique for assessing right ventricular (RV) volume and function, but 3D-RV normal values from a large Chinese population are still lacking. The aim of the present study was to establish normal values of 3D-RV volume and function in healthy Chinese volunteers. A total of 1117 Han Chinese volunteers from 28 laboratories in 20 provinces of China were enrolled, and 3D-RV images of 747 volunteers with optimal image quality were ultimately analyzed by a core laboratory. Both vendor-dependent and vendor-independent software platforms were used to analyze the 3D-RV images. We found that men had larger RV volumes than women did in the whole population, even after indexing to body surface area, and older individuals had smaller RV volumes. The normal RV volume was significantly smaller than that recommended by the American Society of Echocardiography/European Association of Cardiovascular Imaging guidelines in both sexes. There were significant differences in 3D-RV measurements between the two vendor ultrasound systems and the different software platforms. The echocardiographic measurements in normal Chinese adults II study revealed normal 3D-RV volume and function in a large Chinese population, and there were significant differences between the sexes, ages, races, and vendor groups. Thus, normal 3D-RV values should be stratified by sex, age, race, and vendor.

AbstractEvidence of the triglyceride‐glucose (TyG) index as an independent predictor of arterial stiffness in stage 1 hypertension patients is scarce. This study aimed to explore the association between TyG index and arterial stiffness in this population. A total of 1041 individuals from 32 centers with normal/elevated blood pressure (BP, <130/80 mmHg; 345 men (33%); median age, 37 years) and 585 stage 1 hypertension patients (BP ≥130/80 and <140/90 mmHg; 305 men (52%); median age, 47 years) were prospectively enrolled. Arterial stiffness was determined by measuring carotid ultrafast pulse‐wave velocity (ufPWV). TyG index was calculated as ln (fasting triglyceride (TG) × fasting blood glucose/2). Patients with a higher TyG index tended to have higher ufPWV. The TyG index was positively associated with ufPWV at the end of systole in stage 1 hypertension patients after adjusting for confounding factors (β for per unit .48), and restricted cubic spline analysis confirmed a linear association. Subgroup analyses in terms of age, sex, and body mass index yielded similar results. However, no significant relationship was observed between the TyG index and ufPWV in the population with normal/elevated BP. The fully adjusted β between ufPWV and the TyG index was higher than the TG/high‐density lipoprotein cholesterol ratio, TG, and pulse pressure. In conclusion, patients with a higher TyG index had greater arterial stiffness, and the TyG index independently and positively correlated with arterial stiffness in stage 1 hypertension patients. The TyG index may provide a simple and reliable marker to monitor arterial stiffness in hypertensive patients.

Coronary artery disease (CAD), caused by coronary artery occlusion, is a common cardiovascular disease worldwide. Long non-coding RNAs (lncRNAs) are implicated in the regulation of endothelial cell injury, angiogenesis, plaque formation, and other pathological mechanisms in CAD by acting on different cell types. Some lncRNAs are significantly upregulated in CAD patients; however, other lncRNAs are significantly downregulated. Differential expression of lncRNAs in CAD patients enables them to be exploited as potential biomarkers to evaluate disease progression and diagnosis/prognosis in CAD patients. In this study, we reviewed the role of lncRNAs in the development of different clinical subtypes of CAD.

Background: Several miRNAs have been implicated in the clinical outcomes of cardiovascular disorders, but the role of miR-1-3p in abdominal aortic aneurysm (AAA) prognosis remains unclear. This study aimed to investigate the correlation of single nucleotide polymorphisms (SNPs) in pri-miR-1-3p and mature miR-1-3p expression with postoperative mortality of AAA patients. Methods: A total of 230 AAA patients who received AAA repair were recruited and followed up for 5 years. SNP genotyping was carried out using KASP method and relative expression of serum miR-1-3p was measured with qRT-PCR. Results: Multivariate Cox regression analyses showed that both rs2155975 and rs4591246 variant genotypes were associated with increased all-cause mortality of postoperative AAA patients after adjusting possible confounders. Patients who died tended to have lower baseline miR-1-3p expression (overall and for age < 65 years, aneurysm-related death or cardiac death subgroup) when compared to alive patients; further Cox regression yielded an independent relationship of preoperative low serum miR-1-3p levels with incidents of all-cause death. Patients carrying rs2155975 AG + GG or rs4591246 AG + AA genotype had a higher ratio of low miR-1-3p levels in contrast to those with AA or GG genotype, respectively. The Kaplan–Meier survival curves suggested that the combined genotype in rs2155975 or rs4591246 and low miR-1-3p levels could decrease the overall survival of AAA patients during 5-year follow-up. Conclusions: This pilot study demonstrated the importance of rs2155975 and rs4591246 polymorphisms and baseline serum miR-1-3p levels as promising markers to predict mortality among patients following AAA repair.

Background: Coronary slow flow (CSF) is an angiographic entity characterized by delayed coronary opacification with no evident obstructive lesion in the epicardial coronary artery. Several studies have shown that the occurrence and development of CSF may be closely related to inflammation. Soluble vascular cell adhesion molecule-1 (sVCAM-1) is a biomarker related to inflammation. The aim of this study was to evaluate the correlation between plasma soluble VCAM-1 level and CSF occurrence and thus the predictive value of VCAM-1 for CSF. Methods: Forty-six CSF patients and thirty control subjects were enrolled. Corrected thrombolysis in myocardial infarction frame count (cTFC) was used to diagnose CSF. Functional status and quality of life were determined by the Seattle Angina Questionnaire (SAQ). Echocardiography was used to evaluate the systolic and diastolic function of the left ventricle (LV) and right ventricle (RV). The plasma levels of sVCAM-1, IL-6, and TNF-α were quantified by enzyme-linked immunosorbent assay. Results: Compared with the control group, the physical limitation score by the SAQ, the LV global longitudinal strain (GLS), mitral E, and mitral E/A decreased in patients with CSF, while the plasma IL-6 and TNF-α levels increased. The plasma sVCAM-1 level in the CSF group was significantly higher than that in the control group (186.03 ± 83.21 vs. 82.43 ± 42.12 ng/mL, p < 0.001), positively correlated with mean cTFC (r = 0.57, p < 0.001), and negatively correlated with the physical limitation score (r = −0.32, p = 0.004). Logistic regression analyses confirmed that plasma sVCAM-1 level (OR = 1.07, 95%CI: 1.03–1.11) is an independent predictor of CSF, and the receiver operating characteristic curve analysis showed that plasma sVCAM-1 levels had statistical significance in predicting CSF (area under curve = 0.88, p < 0.001). When the sVCAM-1 level was higher than 111.57 ng/mL, the sensitivity for predicting CSF was 87% and the specificity was 73%. Conclusions: Plasma sVCAM-1 level can be used to predict CSF and was associated with the clinical symptoms of patients. It may serve as a potential biomarker for CSF in the future.