Clinical Research in Cardiology

<p><em>Clinical Research in Cardiology</em> is an international journal for clinical cardiovascular research. It provides a forum for original and review articles as well as critical perspective articles. Articles are only accepted if they meet stringent scientific standards and have undergone peer review. The journal regularly receives articles from the field of clinical cardiology, angiology, as well as heart and vascular surgery.</p> <p>As the official journal of the German Cardiac Society, it gives a current and competent survey on the diagnosis and therapy of heart and vascular diseases.</p> <p>Supplemental issues are published in Clinical Research of Cardiology Supplements.</p>

List of Papers (Total 1,086)

Even mild elevations of C-reactive protein levels predict long-term prognosis in heart failure with mildly reduced ejection fraction

Objective C-reactive protein (CRP) levels reflect systemic inflammation which may mediate adverse outcomes in heart failure (HF). The present study sought to investigate the prognostic impact of baseline CRP levels in patients hospitalized with HF with mildly reduced ejection fraction (HFmrEF). Background While inflammation is recognized as a key pathophysiological component of...

Timing of IABP initiation and its impact on outcomes in acute myocardial infarction with cardiogenic shock: insights from a bi-center retrospective study

Background The optimal timing of intra-aortic balloon pump (IABP) initiation in cardiogenic shock (CS) complicating acute myocardial infarction (AMI) remains uncertain. Contemporary ESC guidance and the recent EACTS/STS/AATS MCS guideline highlight gaps regarding timing, patient selection, and ischemic burden. In this study, the association between IABP timing, myocardial area at...

Differential effects of transcatheter edge-to-edge repair on forward stroke volume in atrial and ventricular secondary mitral regurgitation

Introduction Transcatheter edge-to-edge mitral valve repair (M-TEER) is an established treatment for secondary mitral regurgitation (MR). Forward stroke volume (FSV), reflecting left ventricular forward flow, is a prognostic marker in heart failure and valvular disease. However, its clinical relevance in secondary MR has not been clearly defined. Objective To assess the impact of...

Conformity with guideline-directed medical therapy and clinical outcomes in secondary cardiovascular prevention—results of a German claims data analysis

Aims Clinical guidelines for secondary cardiovascular (CV) prevention provide recommendations for medical treatment to improve patient prognosis. This retrospective German study aimed to identify the level of guideline implementation in patients suffering from myocardial infarction (MI), stroke or transient ischemic attack (TIA), and the impact of guideline-directed medical...

Covert macrovascular disease and early outcome after ischemic cerebrovascular events

Background Covert cerebrovascular disease is traditionally defined as microvascular brain injury. Whether non-culprit macrovascular abnormalities below conventional stenosis thresholds represent a clinically relevant form of vascular vulnerability remains unclear. We investigated the prevalence and prognostic significance of covert macrovascular disease (CMVD) in acute ischemic...

Time to return of spontaneous circulation and associations with early neurological outcome at hospital discharge after out-of-hospital cardiac arrest

Aim To assess the impact of time to return of spontaneous circulation (ROSC) on early in-hospital neurological function and long-term survival in survivors after out-of-hospital cardiac arrest (OHCA). Methods This retrospective cohort study included survivors of OHCA admitted to the cardiology ward at Aarhus University Hospital. Patients were included from June 2020 to February...

Inpatient cardiac computed tomography angiography in Germany between 2005 and 2023: a nationwide registry study

Background Cardiac computed tomography angiography (CCTA) is a non-invasive imaging method, which enables detailed evaluation of the cardiac anatomy and the assessment of coronary artery disease (CAD). The diagnostic quality and availability improved, while data on the actual use of CCTA is sparse. We aimed to evaluate in-hospital CCTA utilization, the related diagnoses, and...

Ultrasound common hepatic artery denervation (CHA-D) as a novel neuromodulatory strategy for cardiovascular-kidney-metabolic syndrome: first-in-human experience

Background Hypertension may remain uncontrolled despite lifestyle measures, guideline-directed multidrug therapy, and renal denervation (RDN). Sympathetic overactivity contributes to persistent blood pressure (BP) elevation and cardiometabolic dysfunction. Given its central role in metabolic regulation and dense sympathetic innervation, the liver represents an attractive target...

Ultrasound-guided femoral vascular access in adult congenital heart disease patients undergoing catheter ablation on uninterrupted oral anticoagulation

Background Data on ultrasound-guided vascular access (UGVA) to reduce vascular access complications in adult congenital heart disease (ACHD) patients undergoing catheter ablation (CA) on uninterrupted oral anticoagulation (OAC) are limited. Objective Comparison of UGVA to a standard approach with regard to vascular access complications in ACHD patients. Methods We retrospectively...

Greater amounts of visceral adipose and lean body mass increase heart failure risk in older women

Objective Clinical body composition measures have not been well-studied in relation to heart failure (HF) risk among older women, which was the objective of this investigation. Methods Participants were 10,521 postmenopausal women without known HF who had whole-body dual energy x-ray absorptiometry scans at baseline (mean age 63), 3- and 6-years later. Total fat and lean mass (kg...

Atrial and ventricular longitudinal strain in elite cyclists

Aims In elite athletes, differentiation between physiological and pathological cardiac remodelling can be challenging. Left ventricular (LV) strain has become part of the standard in echocardiography. Data on right ventricular (RV), left atrial (LA) and right atrial (RA) strain are sparse in elite athletes. Methods Transthoracic echocardiography including longitudinal strain...

Impact of serum potassium levels on success of electrical cardioversion in atrial fibrillation

Background Electrical cardioversion (ECV) is an effective treatment for restoring sinus rhythm in supraventricular tachycardias such as atrial fibrillation (AFib) and atrial flutter (AFlu). In clinical practice, serum potassium is often adjusted towards the upper normal range prior to ECV, although evidence supporting a beneficial effect on acute cardioversion success is limited...

The inflammatory fingerprint reveals immune cell populations associated with disease activity in cardiac sarcoidosis

Objective Sarcoidosis is a systemic granulomatous inflammatory disease and patients with cardiac involvement are at increased risk of adverse events. Pathophysiologic processes leading to myocardial inflammation and fibrosis are yet to be determined. Therefore, characterization of the immune response leading to enhanced disease activity and portending poor prognosis of patients...

Association of DAPT duration with bleeding and ischemic outcomes after percutaneous coronary intervention with drug-coated balloons: a meta-analysis

Introduction Drug-coated balloons (DCB) represent a promising tool in percutaneous coronary intervention (PCI), enabling a “leave nothing behind” strategy. Evidence guiding the optimal duration of dual antiplatelet therapy (DAPT) after DCB angioplasty remains limited. Methods A systematic review and meta-analysis was conducted according to PRISMA guidelines. Pooled DAPT duration...

Impact of lipoprotein(a) on the durability of aortic bioprosthetic valves

Background The expanding use of bioprosthetic aortic valve replacements has raised concerns regarding the long-term durability of bioprosthetic valve prostheses. While lipoprotein(a) [Lp(a)] is implicated in the pathogenesis of native aortic valve stenosis, its impact on bioprosthetic valve degeneration leading to reintervention remains unclear. Objective To evaluate the...

Impact of Previous Cardiac Surgery on Outcomes After Tricuspid Valve Transcatheter Edge-to-Edge Repair: Insights from EuroTR

Background Data on the association of previous cardiac surgery (PCS) with outcomes following tricuspid valve transcatheter edge-to-edge repair (T-TEER) are limited. Objectives This study aimed to evaluate the impact of PCS on outcomes after T-TEER. Methods This analysis included patients from the EuroTR registry (European Registry of Transcatheter Repair for Tricuspid...

Development of a guideline-based clinical decision support system for emergency department assessment of suspected non-ST-elevation acute coronary syndromes

Background Chest pain is the leading cause of presentations to the emergency department (ED), and the number of patients presenting with this symptom may cause overcrowding. To accelerate triage in the ED, clinical decision pathways using fast diagnostic protocols and high sensitivity cTn (hs-cTn) assays are being recommended by guidelines. However, their implementation is...

Shock index and modified shock index at discharge as predictors of long-term mortality after myocardial infarction: results from the Augsburg Myocardial Infarction Registry

Background Shock index (SI) and modified shock index (mSI), measured at hospital admission, have been shown to be predictive for mid- and long-term outcomes after acute myocardial infarction (AMI). Whether these associations also hold when indices are measured at discharge is unclear, so this study’s aim was to analyze the association between SI and mSI at discharge and long-term...

Impact of angiographic valve expansion on the hemodynamic outcome in valve-in-valve transcatheter aortic valve replacement

Background The durability of surgical aortic valve replacement prostheses can be limited due to structural valve deterioration over the years. Because of increased patient age and surgical risk, many of these patients are treated with valve-in-valve transcatheter aortic valve replacement (TAVR). Full expansion of the valve is often difficult to achieve in these patients, which...

Catheter-directed thrombectomy in acute pulmonary embolism and angiographic signs of chronic thromboembolic pulmonary disease

Background Angiographic signs of chronic thromboembolic pulmonary hypertension or disease (CTEPH/D) are frequently found during large-bore thrombectomy (LBT) in acute pulmonary embolism (PE). Data on the incidence of CTEPH/D signs and outcome after LBT are lacking. These angiographic signs are not equivalent to a confirmed diagnosis of CTEPH/D. Aims To investigate the efficacy...

Duration of dual antiplatelet therapy and risk of stent thrombosis in patients undergoing complex PCI: a meta-analysis

Background Patients undergoing complex percutaneous coronary intervention (PCI) have a higher risk of ischemic events and often receive extended dual antiplatelet therapy (DAPT), particularly to protect against stent thrombosis (ST). The selection of an optimal DAPT strategy in this setting remains challenging given the intrinsic ischemic and bleeding risk. Previous observations...

ADA-HF: acetazolamide as a chloride sparing diuretic in patients admitted to hospital with heart failure

Background We assessed whether oral acetazolamide (ACZ) increases diuresis and reduces chloride loss when given alongside high-dose intravenous (IV) furosemide in patients admitted to hospital with HF. Methods and Results ADA-HF was a single-centre, open-label, randomised controlled trial. Patients were randomised to ACZ 250 mg twice daily plus high-dose (240 mg per day) IV...

Real-time three-dimensional systolic dyssynchrony index predicts pacing-induced left ventricular dysfunction and cardiomyopathy

Background Right ventricular pacing leads to left ventricular (LV) dyssynchrony, which is a critical factor in the pathophysiology of pacing-induced LV dysfunction (PIVD) and cardiomyopathy (PICM). Objectives This study aimed to determine the incidence of PIVD and PICM and evaluate the prognostic value of the real-time three-dimensional echocardiography (RT3DE)-derived systolic...