WCN26-7273 Features of Cardiorenal Interactions in Patients with Сoronary Artery Disease and Renal Artery Stenosis

Cardiovascular genomics: the advanced frontier of CVD management Prof. Dr. Prabir Kumar Das FCPS, MD, FACC,FCSI Former HOD, Dept. of Cardiology, Ctg. Medical College & Secretary General, Chattogram Heart Foundation Abstract Cardiovascular genomics are specialized field that explore the role of genetics in the development and progression of cardiovascular diseases. About 10-15% of all non communicable diseases are familial and inherited conditions following Mandolin or monogenic inheritance pattern. These includes congenital heart disease, aortic and arterial disease, inherited cardiomyopathies, inherited arrhythmias and cardiac conduction defects, atrial fibrillation, familial hypercholesterolemia, systemic hypertension, pulmonary hypertension and some rare CV diseases. Understanding the genetic basis of rare and common CVDs has advanced substantially over the last 25 years. With the advent of sequencing of human genome by next generation sequencing(NGS) technique in 2000,it emerged as a preferred method of complete elucidation of genetic cause of single gene disorders .CV genomic medicine offers opportunity to review and organize management and prevention of wide ranging inherited and familial CV conditions..It encompasses personalized medicine targeting specific individuals; precision medicine targeting specific molecular disease and evidence-based medicine with most upto date top validated evidences. Several NGS based diagnostic multi-gene panels now available for confirmation of disease causing specific gene mutation or pathogenic variants in major inherited CV conditions. Genomic laboratories offer this service and developed specific genotype-phenotype databases. High risk screening allows earlier diagnosis, risk stratification, aggressive treatment and improved outcome. DNA-editing technology through application of CRISPR-Cas9 can be used to edit genes within living organisms enabling correction of monogenic conditions. For polygenic CVD whole genome sequencing at birth may allow primordial prevention with assessment of genetic determinants of lifetime risk for CVD. At present use of genomics has gone beyond screening, diagnosis and risk prediction into therapeutics. Evaluating genomic information now forms part of routine clinical workflow for inherited cardiac conditions in improving diagnostic decision-making, screening of relatives, and guiding decisions on therapy.

Objective: To analyze the epidemiological characteristics of adult inpatients with diabetes-related chronic non-healing wounds in Hainan province. Methods: This study was a retrospective cohort study. From July 2019 to July 2024, 1 372 adult inpatients with diabetes-related chronic non-healing wounds and conformed to the inclusion criteria were admitted to three hospitals in Hainan province, including 951 cases in the First Affiliated Hospital of Hainan Medical University, 287 cases in the Second Affiliated Hospital of Hainan Medical University, and 134 cases in Hainan Sino-German Orthopedic Hospital. The clinical data of patients were collected, including age, gender, occupation, disease duration and type of diabetes mellitus, underlying comorbidity, formation cause, type, location, and number of wounds, pathogenic microorganism culture result of wound secretion specimens on admission, treatment modality and outcome at discharge, and hospitalization duration and hospitalization costs of patients with different types of wounds. Results: The patients were 18-96 years in age, with 892 patients aged ≥60 years. There were 889 males and 483 females, with 838 agricultural workers. The duration of diabetes mellitus was 10 (5,18) years, and 98.91% (1 357/1 372) of the patients had type 2 diabetes mellitus. Patients with diabetes mellitus were often combined with hypertension (678 cases), arterial disease (300 cases), and stroke (220 cases). The primary cause of wound formation was infection (930 cases). The predominant type of wounds was diabetic foot ulcer (809 cases), followed by other wounds (232 cases), pressure ulcers (187 cases), and traumatic ulcers (144 cases). The wounds were primarily located on feet (809 wounds) and lower legs (474 wounds) with single wound (997 cases). The pathogenic microorganism culture results of wound secretion specimens from 540 patients were positive, with a total of 606 strains of pathogenic microorganism detected, predominantly Gram-negative bacteria (324 strains). The main pathogenic microorganisms were Staphylococcus aureus (125 strains), Pseudomonas aeruginosa (71 strains), and Escherichia coli (71 strains). Fungal detection rate was high of 6.11% (37/606). The primarily wound treatment modalities included simple debridement (396 cases) and debridement combined with vacuum sealing drainage (444 cases). At discharge, the wounds in 84.62% (1 161/1 372) of the patients showed improvement, 11.30% (155/1 372) of the patients achieved wound healing, and 3.28% (45/1 372) of the patients experienced wound exacerbation; the other 0.80% (11/1 372) of the patients died. Patients with diabetic foot ulcer exhibited significantly longer hospitalization duration (18 (10, 29) d) and higher hospitalization costs (3.9 (2.1, 6.0) ten thousand yuan) compared with patients with pressure ulcer (14 (7, 21) d and 2.8 (1.5, 4.2) ten thousand yuan), traumatic ulcer (12 (6, 18) d and 2.3 (1.2, 3.5) ten thousand yuan), and other wounds (16 (8, 25) d and 3.1 (1.8, 5.0) ten thousand yuan), P<0.05. Conclusions: The adult inpatients with diabetes-related chronic non-healing wounds in Hainan province are predominantly elderly male agricultural workers with underlying comorbidities. The detected predominant pathogenic microorganisms in wounds are Gram-negative bacteria, and fungal detection rate is high. Diabetic foot ulcer poses greater treatment burden, and patients with diabetic foot ulcers had significantly longer hospitalization duration and higher hospitalization costs compared with those of other wounds.

A Novel Technique for Recanalizing Below-the-Ankle Lesion in Chronic Limb-Threatening Ischemia: Wire Exteriorization via the Wound.

ObjectiveTo descriptively compare the clinical outcomes of drug-coated balloons (DCB) and plain balloon angioplasty (POBA) in hemodialysis patients with Below-The-Knee (BTK) peripheral artery disease.MethodsThis retrospective study included 96 hemodialysis patients (DCB:55 POBA:41). Outcomes included changes in Rutherford grade, wound healing, freedom from target lesion revascularization (CD-TLR), survival, and amputation-free survival.ResultsBoth groups demonstrated improvement in Rutherford grade at 12 months. Wound healing occurred in 60.6% (95% CI 42.1-76.8) of the DCB group and 50.0% (95% CI 32.0-67.9) of the POBA group. Amputation-free survival was 72.7% (95% CI 59.0-83.0) with DCB and 67.7% (95% CI 52.5-80.0) with POBA. Freedom from CD-TLR was 78.9% (95% CI 65.0-88.5) for DCB and 91.6% (95% CI 79.0-97.0) for POBA. No clear between-group differences were observed.ConclusionNo significant differences were observed between DCB and POBA in this small retrospective cohort.

BackgroundClinical and preclinical evidence suggests that inflammation is closely associated with various arterial diseases. Multiple studies have reported the effects of statins on different cell types, yet the effects of atorvastatin (ATV) and its mechanisms on inflamed HUVECs’ cellular responses are still under investigation. This study investigates how different doses of ATV affect inflammatory responses, extracellular matrix (ECM) regulators, and cell migration capacity assessed by an in vitro scratch wound closure assay in lipopolysaccharide (LPS) stimulated endothelial cells.MethodsATV was applied to cells at different doses (5-10-50 µM) with or without LPS (20 ng/mL). Cell proliferation and toxicity were investigated in the indicated groups. Then, the possible effects of ATV on MMP-2, MMP-9, TIMP-1,TIMP-2 expression levels, scratch-closure (cell migration) time were examined. Gene expression of MMP-2, MMP-9, TIMP-1, and TIMP-2 was quantified by qPCR, while protein levels were determined by Western blotting. Cell migration was evaluated using a scratch assay and real-time imaging system.ResultsHigh-dose ATV was more cytotoxic, while wound closure times showed a numerical increase that did not reach statistical significance under LPS stimulation. While low-dose ATV increased MMP and TIMP expressions, high-dose treatment reduced TIMP-1 and disturbed the MMP/TIMP balance. This imbalance was accompanied by reduced cellular recovery capacity under inflammatory stress.ConclusionsThis study highlights the complex cellular effects of ATV under inflammatory conditions, supporting its context- and dose-dependent role in endothelial cell behavior and matrix regulation. These findings highlight the importance of dosage optimization in therapeutic contexts targeting vascular inflammation and provide novel insight into how statin dosing influences endothelial recovery mechanisms, beyond cholesterol regulation.Graphical Supplementary InformationThe online version contains supplementary material available at 10.1186/s12860-026-00573-z.

Numerous studies have emphasized the health benefits of dietary habits, particularly concerning arterial diseases. Nevertheless, the relationship between dietary habits and the risk of aortic dissection and aortic aneurysm remains unclear globally. This study aims to explore potential causal relationships between dietary habits and these 2 types of aortic disease. We analyzed data from genome-wide association studies, which included 34 dietary habits from the Nicola Pirastu study and summary statistics from the FinnGen R11 database regarding aortic dissection and aortic aneurysm, to evaluate the association between dietary habits and these conditions. We primarily employed inverse variance weighting as the analytical method, supplemented by other analyses including weighted median, Mendelian randomization-Egger, simple model, and weighted model, and assessed the robustness of the results by sensitivity analysis. Inverse variance weighting analysis showed that fish consumption (odds ratio [OR] = 0.17, 95% confidence interval [CI] = 0.06–0.53, P = .002) and oily fish consumption (OR = 0.13, 95% CI = 0.03–0.56, P = .006) were associated with a reduced risk of aortic dissection. Dry fruit consumption (OR = 0.43, 95% CI = 0.22–0.82, P = .011) and oily fish consumption (OR = 0.56, 95% CI = 0.35–0.96, P = .033) were associated with a reduced risk of aortic aneurysm. The Cochran heterogeneity test indicated no significant heterogeneity among single-nucleotide polymorphisms (P > .05) and no substantial pleiotropy was detected (Mendelian randomization-Egger intercept P > .05, global test P > .05). However, no causal relationship between other dietary habits and aortic dissection and aortic aneurysm was observed (P > .05). This study provides evidence to support a causal relationship between dietary habits and reduced risk of aortic dissection and aortic aneurysm, providing valuable insights for future aortic disease prevention strategies.

Functional Limb Preservation after Surgical Distal Venous Arterialization with Free Flap in Chronic Limb-Threatening Ischemia with Severe Foot Arterial Disease

Cardiovascular disease (CVD) is a major cause of death worldwide. Congenital heart disease, arterial disease, heart failure, rheumatic heart condition, and cerebral disease are some of its most prevalent types. Early disease detection can help us avoid potentially fatal diseases and provide patients with better care than we could in later stages because prevention is always preferable than therapy. Those who are diagnosed may have a very high death rate because they are not accessible at an early stage. A variety of research techniques in the machine learning domains can assist in anticipating CVDs and identifying their behavioral patterns in enormous amount of data in order to solve these issues. The results of these estimates will help doctors make judgments and identify patients early, reducing the likelihood of death. This research covers the creation of an innovative, reliable, effective, and intelligent predictive system for early CVD detection using Deep Neural Network (DNN) model in order to optimize prevention and treatment for CVDs. Its goal is to automatically select significant features and detect heart disease in its earlier stages. The presented model's average accuracy, precision, recall, sensitivity, and F1-score are 99.98%, 98.78%, 97.86%, and 98.56%, respectively. Compared to other existing models, the presented method successfully achieved and maximized classification effectiveness with greater amounts of precision and pinpointing.

BackgroundType 2 diabetes mellitus (T2DM) is associated with arterial diseases; particularly, the incidence of atherosclerotic conditions is increased among patients with diabetes. Basement membrane (BM) protein levels are increased in the artery wall of T2DM patients, but the underlying mechanisms and potential consequences remain elusive. This study aimed to identify putative connections between the level of arterial BM components, clinical characteristics, all-cause mortality and major adverse events (MACE) in groups of patients with and without T2DM.MethodsInternal thoracic artery samples from 668 patients undergoing coronary artery bypass graft surgery at Odense University Hospital, Denmark, from 2008 to 2018 were included, of which 27% were diagnosed with T2DM. Seventeen vascular proteins were quantified using liquid chromatography tandem mass spectrometry.ResultsLevels of BM components—collagen IV, laminin, and perlecan—were significantly elevated in T2DM patients compared to non-diabetic controls. In the diabetic group, we found strong correlations between collagen IV and laminin levels and hemoglobin A1c, whereas correlations with plasma lipids, blood pressure, and body mass index (BMI) were weak or absent. Moreover, collagen IV and laminin were associated with both all-cause mortality and major adverse cardiovascular events (MACE) up to 14 years after surgery after adjustment for age, sex, and comorbidities.ConclusionsWe demonstrate that arterial basement membrane protein accumulation is related to glycemic status in T2DM. Furthermore, the observed associations between collagen IV and laminin levels and clinical outcomes support the notion that generalized alterations in arterial basement membranes may contribute to the development of cardiovascular disease.Graphical abstractSupplementary InformationThe online version contains supplementary material available at 10.1186/s12933-025-03026-7.

ABSTRACTAimLower‐extremity arterial disease (LEAD) is a manifestation of atherosclerotic cardiovascular disease, affecting 230 million people worldwide with increasing prevalence. Medial arterial calcification (MAC) is common in LEAD patients and contributes to disease‐related mortality. However, therapeutic strategies targeting femoral MAC are lacking, and its underlying mechanisms remain unclear. This study aimed to identify molecular drivers of femoral MAC in LEAD.Methods & ResultsCalcium deposits and pro‐calcifying markers were analyzed in human patient samples using von Kossa staining, immunofluorescence, and gene expression analysis. Femorals showed significantly more calcification and pro‐calcifying gene expression than carotids. Given MAC abundance in LEAD, we assessed medial calcification in Apoe−/− mice fed a WD for 4/21 weeks. Digital PCR revealed upregulation of Ddr1 and Bmp2 in femoral versus carotid arteries after 21 weeks of WD. DDR1 expression positively correlated with calcification in human femoral samples. In vitro experiments with mouse femoral vs. carotid vascular smooth muscle cells (VSMCs) confirmed a significantly higher prevalence of calcifying proteins (DDR1, BMP2, and RUNX2) in femoral VSMCs. Additionally, calcification analyses in murine and human VSMCs showed that DDR1 inhibition reduced, while DDR1 activation increased, calcium deposition. Transcriptomic analysis revealed elevated NF‐κB expression in human femoral arteries, matching data in femoral VSMCs. DDR1 stimulation activated NF‐κB, and its inhibition blocked DDR1‐induced calcification.ConclusionThis study identifies DDR1 as a key driver of calcification in LEAD, operating through NF‐κB activation and the expression of calcifying proteins. Targeting DDR1 may offer a novel therapeutic approach to prevent MAC in LEAD.

The Atherosclerosis Risk in Communities (ARIC) study started in 1987‐1989 (visit 1), when participants from four U.S. communities were 45‐64yo. Participants have been seen at up to 10 additional in‐person visits with annual/semi‐annual telephone calls to ascertain clinical events, hospitalizations, and other health outcomes. In 2011‐2013, at ARIC visit 5, the ARIC Neurocognitive Study (ARIC‐NCS) was initiated for surviving participants, incorporating neuropsychological assessments at multiple in‐person visits and informant interviews to support cognitive adjudication. A subset of participants have undergone brain MRI with measurement of brain volumes, cortical thickness, arterial disease and vascular lesions, with a smaller subset having brain florbetapir PET. Blood‐based Alzheimer's disease (AD) biomarkers are available at multiple visits along with extensive measurement of vascular risk factors, vascular markers, and ‐omic (e.g.genomic and proteomic) data. This presentation will focus on the available data in ARIC, the methods underlying its collection and subsequent analysis, and some of the primary contributions of this study to the field. With 37 years of follow‐up, a great strength of ARIC is the ability to evaluate risk factors in midlife; ARIC studies have supported an association of midlife hypertension, diabetes, physical inactivity, and other vascular risk factors with reduced dementia risk, even among those with increased genetic risk for dementia. ARIC studies have demonstrated associations between stroke and dementia, and have linked vascular risk factors with blood‐based and imaging biomarkers of AD‐related dementias. ARIC has demonstrated the importance of hearing loss in dementia risk, and a subset of ARIC participants were recruited into (and were those who most benefited from the intervention of) the ACHIEVE study of hearing aid use for reduction of dementia. Proteomic studies have identified markers of dementia risk when evaluated in midlife. Recently, ARIC data informed updated estimates on lifetime risk of dementia, where it was estimated that among individuals surviving beyond age 55, 42% would develop dementia over their lifetime through age 95. ARIC studies continue to focus on risk factors for dementia, particularly now in the oldest old, and on contributors to cognitive reserve and resilience. ARIC follows a model of data sharing and broad collaboration.

Artificial Intelligence-based phonocardiogram signal classification using segment-specific multi-domain features for cardiovascular and arterial disease

The number of master athletes (MAs) is steadily increasing, reflecting broader societal trends in healthy aging and competitive sports participation beyond the age of 35. This work presents an up-to-date, evidence-based framework for evaluating the cardiovascular and general health of master athletes, integrating current guidelines with sport-specific considerations, and focusing primarily on cardiovascular prevention and risk management. It also acknowledges conditions that are more prevalent in this population-accelerated coronary calcification/coronary artery disease, endurance-related atrial fibrillation, and mild aortic enlargement-within the preventive assessment framework. While regular exercise confers significant cardiovascular and metabolic benefits, aging athletes present unique clinical challenges requiring tailored assessment and management strategies. Current evidence highlights the importance of recognizing both traditional and sport-specific risk factors, employing appropriate diagnostic modalities (including advanced imaging when indicated), and implementing an integrated approach combining lifestyle, pharmacological, and procedural interventions. MAs require individualized, multidisciplinary care to ensure safe and sustained participation in sports. Early detection and targeted management of cardiovascular and metabolic risk factors, along with ongoing surveillance, are essential for preserving health, performance, and quality of life in this growing population.

THE primary objective of the MOTIV BTK PILOT STUDY WAs to evaluate the immediate and long-term safety and efficacy of the MOTIV® sirolimus-eluting bioresorbable scaffold (Reva Medical, San Diego, California, USA) in below-the-knee (BTK) arteries for the treatment of patients with rest pain or minor tissue loss (critical limb-threatening ischemia (CLTI)). This is a prospective, single-arm, multi-center trial of a novel drug-eluting bioresorbable scaffold with a new scaffold material (Tyrocore®), which includes an iodinated, polycarbonate copolymer of tyrosine analogs and has a surface coating of the same Tyrocore material and the antiproliferative drug sirolimus. Fifty-eight patients were included between August 2019 and July 2021. The primary efficacy outcome measure was primary patency at 12months. The primary safety outcome measure was freedom from serious device-related adverse events at 30days. Secondary outcome measures were immediate technical success, primary patency at 24 and 36months, clinically driven target lesion revascularization rate (CD-TLR) and limb salvage at 12, 24, and 36months. Follow-up was performed at 1, 6, 24, and 36months, including clinical assessment and core laboratory adjudicated color duplex ultrasound. Seventy-six MOTIV scaffolds were implanted in 60 study limbs with an average lesion length of 29.5mm. Primary patency at 12, 24, and 36months was 88.3%, 81.7%, and 80% (with numbers of limbs at risk being 43, 38 & 30) respectively. The 30-day adverse event rate was 1.7%. Technical success was achieved in 99%. At 3years, freedom from CD-TLR was 93% and limb salvage rate was 95%. The 36-month results of this pilot MOTIV BTK study demonstrated favorable safety and effectiveness performance in CLTI patients with BTK atherosclerotic disease. Level 3: non-randomized controlled cohort study.

Cardiovascular disease remains the leading cause of death and disability in Croatia and worldwide, accounting for nearly one in every three deaths in Croatia and a significant share of healthcare expenditures.Coronary artery disease (CAD), the most common form, is frequently underdiagnosed or diagnosed only after acute events, leading to costly hospitalizations and avoidable mortality.MSCT Coronarography has emerged as a proven, non-invasive diagnostic tool with superior accuracy in detecting CAD compared to traditional stress testing.As a first of its kind in Croatia, the establishment of specialized MSCT Coronarography Unit in Dubrava University Hospital, made of nurses, X-ray technicians, cardiologists and radiologists represents a transformative step in modernizing cardiac diagnostics 1,2 .A dedicated specialized unit for CT coronarography can streamline care pathways, reduce invasive procedures, and lower system-wide costs by early, precise diagnosis, patient-centered care, cost efficiency and resource optimization, integration with preventive cardiology.With targeted government investment, robust implementation strategy, and Ministry of health collaboration, this initiative will reduce healthcare costs, save lives, and align Croatian cardiac care with global best practices.

Background/Objectives: Minimally invasive direct coronary artery bypass (MIDCAB) surgery, performed through a left minithoracotomy, has emerged as an alternative to conventional coronary artery bypass grafting (CABG), which requires a full sternotomy. This procedure is ideal for patients with isolated proximal left anterior descending (LAD) artery disease or high surgical risk. The aim of this study was to assess the long-term clinical outcomes of MIDCAB performed at a single center with stratification by revascularization strategy. Methods: A total of 480 patients who underwent off-pump MIDCAB between 2012 and 2024 at a single center were retrospectively analyzed and categorized into three distinct groups: complete revascularization (MIDCAB-CR), hybrid coronary revascularization (MIDCAB-HCR) and incomplete revascularization (MIDCAB-IR). Short- and long-term outcomes, including mortality, major adverse cardiac and cerebral events (MACCE) and LITA–LAD graft patency were evaluated. Median follow-up was 3.39 years. Results: In-hospital mortality was 1.4%. At a median follow-up duration of 3.39 years, the overall LITA–LAD graft patency was 94.4% with 5- and 10-year survival rates of 78% and 60%, respectively. MIDCAB-CR and MIDCAB-HCR groups showed comparable long-term survival and freedom from MACCE, both significantly better than those observed in the MIDCAB-IR groups. Conclusions: These findings support the safety and durability of MIDCAB as an effective revascularization strategy, especially when performed as complete or hybrid revascularization. Incomplete revascularization may be considered in selected high-risk patients but is associated with worse outcomes.

A mathematical model on stenosed artery with its application in arterial diseases

Long-term antithrombotic therapy practices in adult patients with short bowel syndrome following acute mesenteric ischemia: An international case-based survey.

Mineralocorticoid receptor (MR) overactivation plays a crucial role in the pathogenesis of chronic kidney disease, as well as several cardiovascular and arterial diseases. Current studies determined the mechanisms of the beneficial kidney effects of the nonsteroidal MR antagonist finerenone (FN) in a mouse model of Western diet-induced obesity and insulin resistance. Ten-week-old male C57BL/6J mice were fed a low-fat (LF) or a Western diet (WD) for 12 weeks followed by treatment with either vehicle or FN for another 14 weeks (intervention studies) until they were 36 weeks old. Finerenone treatment prevented 1) the increased albuminuria and kidney injury molecule 1 (KIM1); 2) the expanded extracellular mesangial matrix and synaptopodin coverage; 3) fibronectin, collagen IV, CD45, and CD68 immunostaining; 4) glomerular basement membrane disruption, podocyte foot processes effacement, and mitochondrial structural abnormalities; 5) the proinflammatory cytokines [monocyte chemoattractant protein-1 (MCP-1)], innate immunity pathways [Toll-like receptor-2 (TLR2), stimulator of interferon genes (STING), signal transducer and activator of transcription 3 (STAT3)], and fibrosis markers fibronectin, transforming growth factor-β (TGFβ), and plasminogen activator inhibitor-1 (Pail); and 6) the increased kidney cholesterol levels. There was also reduced expression of nuclear receptor estrogen-related receptor-γ (ERRγ) without changes in ERRα in WD-fed mice, whereas both ERRα and ERRγ expression levels increased after finerenone treatment. NADH lifetime analysis showed decreased bound NADH, compatible with decreased mitochondrial oxidative phosphorylation (OXPHOS) in the kidneys of WD-fed mice compared to controls, which was prevented by finerenone treatment. In conclusion, finerenone treatment exhibits a renal protective role and prevents the progression of kidney disease by regulating mitochondrial function, most likely via ERRγ, and reducing lipid accumulation and inflammation. NEW & NOTEWORTHY Finerenone, a nonsteroidal mineralocorticoid receptor (MR) antagonist, has shown promise in protecting against kidney damage in obese, insulin-resistant mice. It effectively prevents albuminuria, inflammation, fibrosis, and mitochondrial dysfunction, while also restoring estrogen-related receptor-γ (ERRγ) expression. These results suggest that finerenone could play a key role in halting the progression of kidney disease by enhancing mitochondrial function and reducing harmful lipid accumulation, offering a potential therapeutic strategy for managing kidney complications in metabolic disorders.