2026-04-02
Ting Zhang, Li Liang, Sulan Huang
BackgroundAdvanced maternal age is associated with an increased risk of preeclampsia;however, reliable and easily accessible biomarkers for early risk stratification remain limited. The serum uric acid–to–creatinine ratio (SUA/sCr) has been proposed as an indicator of systemic oxidative stress, yet evidence regarding its association with preeclampsia remains limited. This study aimed to examine the association between SUA/sCr levels and the risk of preeclampsia among women of advanced maternal age.Methodsa total of 2,296 pregnant women aged ≥35 years were included in this retrospective cohort study. Multivariable logistic regression models were applied to evaluate the association between SUA/sCr and preeclampsia, with odds ratios (ORs) and 95% confidence intervals (CIs) reported. Restricted cubic spline regression was used to assess potential dose-response and non-linear relationships, and subgroup analyses were conducted to explore potential effect modification.ResultsPreeclampsia occurred in 14.29% of the participants. After multivariable adjustment,each standard deviation increase in SUA/sCr was associated with a higher risk of preeclampsia(OR = 1.29; 95% CI: 1.13–1.47; P = 0.0001). Restricted cubic splines suggested no strong evidence of nonlinearity (P = 0.354), while a two-piecewise model indicated a suggestive change-point, with a suggested inflection point at an SUA/sCr value of approximately 8.18 (95% CI: 7.60–8.55);However, the threshold effect did not reach conventional statistical significance. Below this value, SUA/sCr was positively associated with preeclampsia risk, whereas no significant association was observed above it. The calculated E-value (1.73) indicated moderate robustness to unmeasured confounding. In subgroup analyses, the association differed by proteinuria status (P for interaction = 0.0146), which should be interpreted cautiously and warrants external validation.ConclusionHigher SUA/sCr levels in early pregnancy were associated with an increased risk of preeclampsia among women of advanced maternal age. These findings suggest that SUA/sCr may serve as a potential risk indicator in this population; however, the observed non-linear relationship should be interpreted cautiously and warrants further prospective validation.
DOI: 10.3389/fcvm.2026.17499152026-04-01
Guan-Ying Yang, Shi-Kun Chen, Si-Qi Luo, Jin-Zi Su, Wen-Qin Cai
BackgroundHypertension is often associated with elevated nighttime blood pressure and is a significant risk factor for cardiovascular and cerebrovascular diseases. This study explored the effects of renal denervation (RDN) on circadian blood pressure rhythms and clock gene expression in spontaneously hypertensive rats (SHRs).MethodsTen-week-old SHRs were randomized into RDN and sham surgery (Sham) groups, with Wistar-Kyoto (WKY) rats as controls. Blood pressure was measured at rest (14:00) and during activity (02:00) biweekly, and blood pressure variability was analyzed.ResultsRDN significantly reduced BP and enhanced circadian BP variation, particularly during the resting phase. The Sham group displayed minimal circadian variations in plasma and renal norepinephrine levels, whereas the RDN group exhibited an overall reduction in norepinephrine levels, with lower levels at rest than during activity. Furthermore, the Sham group showed no significant circadian variation in the renin-angiotensin-aldosterone system (RAS), whereas RDN restored circadian rhythms in ACE1, Ang II, ACE2, and Ang1-7. Additionally, the Sham group demonstrated consistently high renal BMAL1 protein expression throughout the day, whereas RDN reduced BMAL1 expression during the resting phase, indicating restored circadian variation.ConclusionsThese findings suggest that RDN not only lowers blood pressure but also improves circadian rhythm, likely through the modulation of sympathetic nervous activity, the RAS system, and the circadian clock gene BMAL1.
DOI: 10.3389/fcvm.2026.17391532026-04-01
Xiaoyan Kang, Jiping Xue, Min Zhao, Yanxia Zhang, Junwang Miao, Shuai Li, Chunsong Kang
ObjectiveObesity and obstructive sleep apnea-hypopnea syndrome (OSAHS) often coexist. Chronic intermittent hypoxia in OSAHS can compound cardiac remodeling, but the comprehensive impact of OSAHS severity on obese patients remains unclear.MethodsA total of 83 obese patients were included in this study and divided into the obesity-only group (27 cases) and the obesity-OSAHS group (56 cases) based on the presence of OSAHS. An additional 30 healthy individuals served as the control group. According to the apnea-hypopnea index (AHI), the obesity-OSAHS group was further classified into a mild group (30 cases), moderate group (16 cases), and severe group (10 cases). Echocardiographic and strain parameters were compared across these groups, and factors influencing global longitudinal strain (GLS) were analyzed.ResultsLeft ventricular GLS progressively declined across the control group (−21.28%), obesity-only group (−18.85%), and obesity-OSAHS group (−17.03%) (all P<0.05). Within the OSAHS group, GLS decreased with increasing severity: mild (−18.00%), moderate (−16.69%), and severe (−14.69%) (all P < 0.05). Structural cardiac remodeling was more pronounced in the severe group, with a left ventricular mass index (LVMI) value of 101.64 g/m2, compared with 87.11 g/m2 in the moderate group and 83.94 g/m2 in the mild group (P = 0.016). The AHI and LVMI were identified as independent predictors of reduced GLS.ConclusionObese patients exhibit impaired myocardial mechanics, which is further aggravated by OSAHS. With increasing OSAHS severity, GLS declines and myocardial dysfunction worsens. AHI and LVMI are independent risk factors for this dysfunction in obese patients with OSAHS.
DOI: 10.3389/fcvm.2026.16725852026-04-01
Qingsong Li, Haobiao Liu, Xuefeng Yu, Jing Tang, Licheng Yang, Yingjie Cai, Zhihao Yang, Lianxu Jia, Ziwei Guo, Jing Han
ObjectiveTo assess the combined effects of dyslipidemia, lipid parameters, non-traditional lipid markers, and body mass index (BMI) on hypertension incidence among petrochemical workers.MethodsThis retrospective cohort study analyzed associations between lipid markers, BMI, and incident hypertension using multivariable logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Dose–response relationships were examined with restricted cubic spline models.ResultsDyslipidemia was associated with increased hypertension risk, with stronger associations in men. Elevated TC, TG, and LDL-C were significantly associated with hypertension in men, whereas only TG was significant in women. High LDL-C independently increased hypertension risk in the total population and in men. Increasing quartiles of TC and TG showed clear linear dose–response relationships. In men, hypertension risk rose with the number of coexisting lipid abnormalities. Non-traditional lipid markers (non-HDL-C, TG/HDL-C ratio, and TyG index) were positively associated with hypertension and exhibited linear dose–response patterns. Overweight and obesity further increased risk, particularly when combined with dyslipidemia.ConclusionAdverse lipid profiles, non-traditional lipid markers, and excess body weight are important determinants of hypertension risk in this occupational cohort.
DOI: 10.3389/fcvm.2026.17885522026-04-01
Hua Xu, Jin-Yan Yang
Acute type A aortic dissection (ATAAD) is a life-threatening cardiovascular emergency where delays in diagnosis worsen outcomes. While computed tomography angiography remains the diagnostic gold standard, its requirement for patient transport, contrast administration, and radiation exposure limits its utility in urgent scenarios. Multimodal point-of-care ultrasound (PoCUS) presents a viable bedside alternative by combining transthoracic echocardiography, vascular ultrasound, and, when available, transesophageal echocardiography. This integrated approach facilitates a rapid, comprehensive assessment, allowing for the detection of key findings—such as pericardial effusion, aortic root dilation, and an intimal flap—within minutes. PoCUS can shorten the time from clinical suspicion to treatment decision, avoid the risks associated with transporting unstable patients, and assist in differentiating other causes of acute chest pain. This perspective article scrutinizes the role of multimodal PoCUS in screening for ATAAD, addresses its technical and training limitations, and explores future directions, including integration with artificial intelligence, standardized training protocols, and optimized clinical workflows. The goal is to inform the development of more efficient, timely diagnostic strategies for this critical condition.
DOI: 10.3389/fcvm.2026.17800672026-04-01
Ji-Fang Ma, Qi-Fan Hua, You Zhou, Juan Hu, Wei-Feng Song, Ke Chen, Xiao-Biao Zang, Er-Peng Liang, Yong-Hui Zhao, Zhi-Ping Guo, Hai-Xia Fu
BackgroundEpicardial adipose tissue (EAT) is involved in atrial fibrillation (AF) pathogenesis. Its specific role in stratifying AF subtypes among patients who also have reduced ejection fraction heart failure is not well defined.ObjectiveWe aimed to compare EAT volume between AF patients with and without reduced ejection fraction heart failure, and to assess its link with AF subtypes.MethodsIn this retrospective study, 224 AF patients (2018–2023) were classified into CAH group (combined AF and heart failure, LVEF < 50%, n = 90) and AF group (AF without heart failure, LVEF ≥50%, n = 134). Cardiac computed tomography (CT) was used to quantify EAT volume.ResultsOverall EAT volume was similar between the CAH and AF groups (152.3 ± 61.6 vs. 166.8 ± 73.2 mL, P = 0.12). However, patients with persistent AF (PsAF) had significantly larger EAT volumes than those with paroxysmal AF (PaAF) in the entire cohort (166.9 ± 71.0 vs. 145.1 ± 61.0 mL, P = 0.04). This difference was driven entirely by the CAH subgroup, where PsAF patients had greater EAT than PaAF patients (160.2 ± 59.5 vs. 127.8 ± 13.4 mL, P = 0.03); no such difference existed in the AF subgroup. EAT volume correlated with left atrial (LA) diameter overall (r = 0.35, P < 0.05). While EAT volume predicted PsAF with high sensitivity but very low specificity in all patients (AUC = 0.60, sensitivity = 97.8%, specificity = 1.6%), its performance was more balanced within the CAH subgroup (AUC = 0.66, sensitivity = 86.8%, specificity = 45.5%). Notably, in this CAH group, LA diameter lost its predictive value for PsAF (AUC = 0.58, P = 0.28).ConclusionIn patients with heart failure, increased epicardial adipose tissue (EAT) volume is linked to the progression from paroxysmal to persistent atrial fibrillation (AF). Measuring EAT volume may therefore serve as a useful imaging biomarker to identify those at higher risk of AF progression, which could help guide more personalized management.
DOI: 10.3389/fcvm.2026.17804142026-04-01
Stefanie Marek-Iannucci, Marco Tigano, Caitlyn Cardetti, Shey-Shing Sheu, Maria Gamero Huaman, Rene J. Alvarez, Eduardo Rame, Rupsa C. Boelig, Indranee N. Rajapreyar
BackgroundBiomarkers for predicting preeclampsia are not routinely available. Currently, preeclampsia is diagnosed with the development of clinical manifestations and proteinuria when widespread endothelial dysfunction and end-organ dysfunction have occurred.ObjectivesThis study aimed to (1) compare the serial changes in circulating mitochondrial cell-free DNA (ccf-mtDNA) levels between pregnant women who developed preeclampsia and healthy pregnant controls and (2) to determine if circulating microRNAs (miRNAs) previously linked to placenta development and/or preeclampsia could be detected.MethodsThis single-center, nested case–control study involved singleton pregnancies less than 16 weeks of gestation at increased risk for preeclampsia, with at least one high-risk factor or two moderate-risk factors, and healthy pregnant controls. Patients were followed throughout their pregnancy, with blood collected at three time points to quantify plasma levels of ccf-mtDNA and five microRNAs (miRNAs). All patients received 81 mg aspirin daily initiated before 16 weeks of gestation.ResultsThe mean and standard deviation (SD) of age in years was 31.1 ± 7.5 for the preeclampsia group and 31.9 ± 5.7 for the control group. Gestational age at delivery in weeks was 36.3 ± 3.2 for the preeclampsia group and 36.9 ± 4.3 for the healthy control group. The gestational age at diagnosis of preeclampsia was 34.8 ± 3.4 weeks. Participants who developed preeclampsia had a significantly reduced amount of ccf-mtDNA in the maternal circulation compared to that in healthy pregnant controls. The reduction in ccf-mtDNA reached significance at Visit 1 (1.688 ± 1.254 copies for the preeclampsia group versus 4.014 ± 2.381 copies for 1 µL of plasma for the healthy control group), corresponding to the second trimester. ccf-mtDNA levels in the exosomal fraction remained unchanged throughout pregnancy. The plasma levels of miRNA-137 were significantly decreased in patients with preeclampsia compared to healthy pregnant controls at all time points.ConclusionsPlasma levels of miRNA-137 and ccf-mtDNA are decreased as early as the first and second trimester, respectively before the clinical diagnosis of preeclampsia in the third trimester. Early detection of changes in plasma levels of miRNAs and ccf-mtDNA could be used for early prediction of preeclampsia.
DOI: 10.3389/fcvm.2026.17782212026-04-01
Mengmeng Ren, Yiming Wang, Lin Zhong, Chunxiao Wang
BackgroundIschemic stroke is a leading cause of death and disability worldwide. Identifying patients with carotid atherosclerosis who are at high risk is clinically important. Acute coronary syndrome (ACS) is a manifestation of systemic atherosclerosis, in which inflammation plays a key role in plaque progression and destabilization. However, the relationship between blood cell-derived systemic inflammation indices and carotid plaque burden in patients with ACS remains unclear.MethodsThis retrospective study included 7,178 patients with ACS. Carotid ultrasound was used to classify patients into carotid plaque and non-plaque groups. Systemic inflammation indices—including neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), neutrophil-to-monocyte-plus-lymphocyte ratio (NMLR), systemic inflammatory response index (SIRI), systemic immune-inflammatory index (SII), aggregate index of systemic inflammation (AISI), and platelet-to-lymphocyte ratio (PLR)—were calculated from routine blood tests. Multivariable logistic regression, restricted cubic spline models, and subgroup analyses were used to evaluate their associations with carotid plaques.ResultsPatients with carotid plaques had significantly higher NLR, MLR, NMLR, SIRI, SII, AISI, and PLR. After full adjustment, MLR, SIRI, and AISI showed significant non-linear associations with carotid plaques, with inflection points of 0.26, 0.9, and 205, respectively. Compared with the lowest quartile, the highest quartile was associated with increased odds of carotid plaques for MLR (OR 1.453), SIRI (OR 1.409), and AISI (OR 1.379). Subgroup analyses showed that these associations were mainly observed in women and in non-diabetic patients. In patients with hypertension, MLR, SIRI, and AISI remained positively associated with carotid plaques.ConclusionMLR, SIRI, and AISI are independently associated with carotid plaques in patients with ACS, particularly among women and non-diabetic individuals, and may serve as potential markers for ischemic stroke risk stratification in this population.
DOI: 10.3389/fcvm.2026.17629262026-03-31
Tao Zhou, Ming Liu, Ting Wu, Min Zhang, Jianjun Dong, Zhuangfei Ma, Ying Li, Xinru Ba
ObjectiveTo investigate the effects of deep learning reconstruction (DLR) on the image quality and quantification of coronary artery calcium (CAC).Materials and methodsPatients who underwent calcium scoring and coronary CT angiography examinations were retrospectively collected. The images of calcium scoring were reconstructed using filtered back projection (FBP), hybrid iterative reconstruction (HIR) and DLR algorithms. The CT value, image noise, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of aortic root and left ventricle were compared in three algorithms. Two radiologists scored the subjective image quality using a four-point scale. The quantification of CAC (Agatson score, calcium volume and mass) in FBP, HIR and DLR were calculated by automatic software. The risk classification of CAC were evaluated according to the Agatston score.ResultsIn objective image quality, compared with FBP and HIR, DLR significantly reduced image noise and improved SNR (all p 0.05). DLR received significantly higher subjective scores (3.80 ± 0.40) than HIR (3.48 ± 0.50) and FBP (2.36 ± 0.48) (both p 0.05). In risk classification analysis, DLR reduced the number of reclassification compared with HIR.ConclusionDLR enhances the image quality and consistency of CAC quantification compared with FBP and HIR. Besides, DLR reduced risk reclassification relative to HIR.
DOI: 10.3389/fcvm.2026.1639920