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Front Cardiovasc Med. 2025 Sep 22;12:1670164. doi: 10.3389/fcvm.2025.1670164. eCollection 2025.

ABSTRACT

Located sinus of Valsalva (SOV) dissection is a rare but critical condition that presents as inferior ST-segment elevation myocardial infarction (STEMI). We present two cases in which computed tomography angiography (CTA) was essential in identifying SOV dissection. In the first case, CTA confirmed a localized dissection of the right SOV. Surgical revascularization was delayed owing to initial diagnostic challenges and the family's hesitation, which ultimately led to a fatal outcome. In the second, intravascular ultrasound (IVUS) confirmed extrinsic compression of the right coronary artery (RCA), and following emergency stent implantation, coronary blood flow was restored, conservative treatment achieved a favorable clinical outcome. These cases highlight the pivotal role of early CTA when angiographic findings are incongruent with the clinical presentation, the utility of IVUS in determining the etiology of coronary artery occlusion, and the critical importance of timely revascularization.

PMID:41059440 | PMC:PMC12497843 | DOI:10.3389/fcvm.2025.1670164

PeerJ. 2025 Oct 3;13:e20145. doi: 10.7717/peerj.20145. eCollection 2025.

ABSTRACT

BACKGROUND: Type 2 diabetes mellitus (T2DM) significantly increases the risk of acute myocardial infarction (AMI). Polymorphisms in the ADIPOQ gene, which encodes the adiponectin hormone, are believed to influence cardiovascular disease risk. This study aims to evaluate the association between three ADIPOQ gene variants-rs266729, rs2241766, and rs1501299-and the risk of AMI in Vietnamese patients with T2DM.

METHODS: A case-control study was conducted from January 2023 to June 2024 at the University Medical Center, Ho Chi Minh City. The study included 275 T2DM patients with a history of AMI (case group) and 275 T2DM patients without AMI (control group). Participants were matched by age, gender, smoking status, and duration of T2DM to control for potential confounding factors. DNA was extracted from peripheral blood samples, and the three polymorphisms were genotyped using Sanger sequencing.

RESULTS: Significant associations were found between ADIPOQ gene polymorphisms and AMI risk. The G/G genotype of rs266729 and the T/T genotype of rs1501299 were associated with a reduced risk of AMI (OR = 0.45, 95% CI [0.23-0.89], p = 0.021; OR = 0.45, 95% CI [0.22-0.90], p = 0.025, respectively). In contrast, the T/G genotype of rs2241766 was significantly associated with an increased risk of AMI (OR = 2.07, 95% CI [1.44-2.97], p < 0.001).

CONCLUSION: This study suggests that rs266729 and rs1501299 may have protective effects, while rs2241766 may increase the risk of AMI in Vietnamese patients with T2DM. These findings highlight the importance of further research into adiponectin levels and long-term monitoring, and support the potential use of genetic variants in personalized cardiovascular risk management for patients with T2DM.

PMID:41059404 | PMC:PMC12499558 | DOI:10.7717/peerj.20145

Front Pharmacol. 2025 Sep 22;16:1625232. doi: 10.3389/fphar.2025.1625232. eCollection 2025.

ABSTRACT

Mitsugumin 53 (MG53), a member of the tripartite motif family proteins, is predominantly expressed in skeletal and cardiac muscles. Endogenous MG53 was first identified as a crucial component of the sarcolemmal membrane repair machinery. In cardiac muscles, MG53 prevented against ischemia/reperfusion-induced myocardial injury. Recent research has demonstrated that native MG53 is present in and performs significant functions within various non-striated muscle tissues, including lung epithelial cells, the inner cortex of the kidney, macrophages, aortic valves, corneal epithelial cells, as well as in the tear film and aqueous humor. These studies indicate a potential application of recombinant human MG53 (rhMG53) in various disease models. To date, an increasing number of studies have confirmed that rhMG53 exhibits broad protective effects in skeletal muscle injury, cardiovascular diseases, and other multiple-organ injuries. In this review, we clarify the therapeutic functions of rhMG53 and the molecular mechanisms involved in multiple organ injuries, emphasizing the development of rhMG53 protein as a potential therapeutic agent for treating a range of diseases.

PMID:41059189 | PMC:PMC12497760 | DOI:10.3389/fphar.2025.1625232

J Neuroendovasc Ther. 2025;19(1):2025-0092. doi: 10.5797/jnet.oa.2025-0092. Epub 2025 Oct 4.

ABSTRACT

OBJECTIVE: Carotid artery stenting (CAS) has been reported to be a safe and effective option for treating carotid atherosclerotic disease. However, reports and studies from resource-limited countries are scarce. The published data support the use of embolic protection devices (EPDs) to reduce periprocedural stroke. This study aimed to evaluate the outcomes of CAS procedures without EPDs in Yemen, one of the lowest-income countries.

METHODS: This is a retrospective cohort study regarding CAS for symptomatic carotid artery stenosis that was conducted at the stroke center of Borg Al-Atiba and American Modern Hospital during the period from March 2023 to March 2025. All patients with symptomatic carotid artery stenosis were included in the study. CAS procedures were performed by a single interventional neurologist. The primary outcomes included a 30-day periprocedural mortality, stroke, myocardial infarction, or arrhythmia. Any other complications were considered secondary outcomes.

RESULTS: A total of 62 patients (53 males) were included in this study, with a mean age of 60.2 ± 9.7 years. All patients had symptomatic carotid artery stenosis. The technical success rate was 100%. No perioperative cerebral infarctions were observed. One patient developed transient dysarthria, but diffusion-weighted-MRI was negative. Significant bradycardia occurred in 2 patients and responded immediately to atropine. Three patients developed mild local hematoma, and 1 patient had a femoral pseudoaneurysm. Closed-cell Carotid WALLSTENT (Boston Scientific, Marlborough, MA, USA) was used as a single stent in all patients.

CONCLUSION: CAS conducted by a trained interventional neurologist without EPDs demonstrates a low complication rate, and it is an effective and safe option in countries with limited resources.

PMID:41059090 | PMC:PMC12500383 | DOI:10.5797/jnet.oa.2025-0092

Nurs Res Pract. 2025 Sep 28;2025:7096059. doi: 10.1155/nrp/7096059. eCollection 2025.

ABSTRACT

Objective: This study aims to comprehend the current status of prehospital delay among patients with acute myocardial infarction. It analyzes the correlation between various factors and prehospital delay and explores the influencing factors. Methods: A cross-sectional survey was conducted. From February to June 2023, 260 AMI patients were selected by consecutive sampling from the study hospital in Yanji City, Jilin Province. General Data Questionnaire, Pain level Scale, Family Support Scale, Psychological distress scale, and Chinese version of the perceived impairment of medical decision-making scale were used. SPSS 28.0 and AMOS 28.0 were employed for t-test, chi-square test, Pearson correlation analysis, binary logistic regression analysis, and model construction. Results: The median prehospital delay time was 4.67 h. There were 174 patients with prehospital delay, accounting for 66.92%. The structural equation model indicated that the total effect values of prehospital delay influencing factors from strong to weak were pain level (-0.294), a perceptual disorder of medical decision-making (0.209), psychological distress (0.084), and family support (-0.068). Conclusions: Approximately two-thirds of patients experience a prehospital delay. Risk factors for prehospital delay include being female, lower family monthly income, lower education level, complications, symptom relief after taking medicine, lack of health care awareness, seeing a doctor alone, psychological distress, and perceptual disorder of medical decision-making. Protective factors are the pain level and family support. Patient or Public Contribution: No patient or public contribution. Reporting Method: The authors adhered to the EQUATOR network guidelines STROBE to report observational cross-sectional studies.

PMID:41058922 | PMC:PMC12497531 | DOI:10.1155/nrp/7096059

EJHaem. 2025 Oct 6;6(5):e70161. doi: 10.1002/jha2.70161. eCollection 2025 Oct.

ABSTRACT

A Sickle Cell Anemia patient with severe ventricular arrhythmia and left ventricular dysfunction achieved rapid, complete cardiac recovery after haplo-identical stem cell transplantation, raising questions about SCA cardiac pathophysiology and highlighting the potential for reversible cardiac complications following curative treatment. Trial Registration: The authors have confirmed clinical trial registration is not needed for this submission.

PMID:41058956 | PMC:PMC12498570 | DOI:10.1002/jha2.70161

Transplant Direct. 2025 Oct 3;11(11):e1858. doi: 10.1097/TXD.0000000000001858. eCollection 2025 Nov.

ABSTRACT

BACKGROUND: Donation after circulatory death (DCD) is the major contributor to the growth in deceased organ donation in the United States. Normothermic regional perfusion (NRP) and ex situ machine perfusion (es-MP) have been vital for improving organ assessment and preservation in DCD donor organs. The procurement procedure and storage strategy for noncardiac donors were determined by liver transplant centers in the early era of machine perfusion in the United States. In this study, we analyzed the landscape of liver utilization from noncardiac DCD donors in the United States during the early era of machine perfusion.

METHODS: All adult (18 y and older) DCD donors in the United States for which the heart was not used for transplantation from October 1, 2020, to December 31, 2023, were compared using procurement technique (NRP versus super rapid recovery [SRR]) and storage strategy (ex situ machine perfusion [es-MP] versus static cold storage).

RESULTS: One hundred fifty-six livers were transplanted from 284 NRP donors (55% utilization) versus 2497 liver transplants from 9132 SRR donors (27% utilization). Es-MP was used in 19% (n = 30) of liver NRP cases versus 28% (n = 695) of liver SRR cases. Eight hundred fifty-one liver grafts (32%) were exposed to NRP, es-MP, or both.

CONCLUSIONS: Given the variation in liver graft management, further research needs to be conducted on the optimal strategies for using technologies such as NRP and es-MP in liver transplantation in the United States; better data collection is necessary to support this research and additional strategies are required to increase access to machine perfusion on a national level are needed.

PMID:41058935 | PMC:PMC12499658 | DOI:10.1097/TXD.0000000000001858

Innovations (Phila). 2025 Oct 7:15569845251375442. doi: 10.1177/15569845251375442. Online ahead of print.

ABSTRACT

Despite efforts to improve donor heart allocation policies, geographic disparities, logistical challenges and patient criteria limit organ availability. However, recent surgical innovations offer potential solutions. These include partial heart transplantation and xenotransplantation. Partial heart transplantation is a new procedure with the potential to address several clinical challenges in treating congenital heart defects. Cardiac xenotransplantation involves the transplantation of genetically modified porcine hearts into humans, offering a potential solution to the shortage of donor organs. Although immunologic barriers and ethical concerns remain, ongoing research aims to mitigate the risks and optimize outcomes, providing hope for patients in need. These innovative surgical approaches offer promising avenues for addressing the critical shortage of donor hearts and with ongoing research, may hold the potential to revolutionize heart transplantation, and improve outcomes for patients facing terminal heart failure.

PMID:41058154 | DOI:10.1177/15569845251375442

Pediatr Transplant. 2025 Nov;29(7):e70204. doi: 10.1111/petr.70204.

ABSTRACT

BACKGROUND: In 2020, the Organ Procurement and Transplantation Network authorized the creation of a National Heart Review Board for Pediatrics along with a guidance document. The purpose of this study was to evaluate the utilization of exception requests and approval rates after the implementation of the new review board.

METHODS: This was a retrospective review of 1A and 1B exception requests between June 2021 and January 2023. Exception request narratives were reviewed to determine if the request followed guidance and then analyzed the frequency of those approved by diagnosis.

RESULTS: There were 591 exception requests submitted for 419 candidates with an overall approval rate of 91%. Only 55% of the exceptions followed the guidance, but of those, 97% were approved. Exceptions submitted that did not follow the guidance had a lower approval rate of 85%. 1A exception requests that followed the guidance were significantly more likely to be approved than those that did not (97% vs. 62%, respectively, p < 0.05). For 1B requests, approval rates did not differ between requests that followed the guidance and those that did not (98% vs. 95%, respectively, p = 0.15). Candidates with single ventricle congenital heart disease made up 59% of 1B exception requests. There is no 1B exception guidance for candidates with dilated or hypertrophic cardiomyopathy; however, requests were still submitted and 95% were approved.

CONCLUSION: Most status 1A exceptions being granted followed the guidance document from OPTN. While the greatest number of requests for 1B exceptions were for single ventricle physiology candidates, many exceptions outside the guidance are being sought and granted.

PMID:41058036 | DOI:10.1111/petr.70204

Pediatr Transplant. 2025 Nov;29(7):e70203. doi: 10.1111/petr.70203.

ABSTRACT

BACKGROUND: Screening for social needs has become increasingly common across healthcare settings. While pediatric programs across the United States have successfully implemented social needs in a clinic setting, the ability to connect families with a positive screen to needed resources is not entirely clear. Through this quality improvement initiative, we sought to universally screen for social needs and refer all families with a positive screen to community resources.

METHODS: Social needs screening was conducted within a pediatric heart transplant clinic in the Western USA. The clinic team devised two separate resource referral pathways: high-risk needs (addressed by social worker) and low-risk needs (referred to Unite Us). Referral outcomes of interest were resource identification and resource connection, with the social worker pathway demonstrating higher effectiveness.

RESULTS: Social needs screening identified 66 active needs among 28 of the 86 families screened. Team members were unable to identify a community resource for almost half of the identified needs (n = 30, 44.8%), most often because a resource was not found (n = 23). Of the 59 needs addressed, the clinic team was able to connect families to resources for 24 needs. Overall, families were connected to resources for 36.4% of all identified needs.

CONCLUSIONS: Screening for social needs revealed a high degree of social need. However, referral to resources was hampered by two key barriers-lack of available resources and lack of local program follow-up. When resources were identified, the in-person support and referral pathway was more effective than remote support.

PMID:41058021 | DOI:10.1111/petr.70203

Acta Paediatr. 2025 Oct 8. doi: 10.1111/apa.70332. Online ahead of print.

ABSTRACT

AIMS: To evaluate growth and body composition at NICU discharge in term-born neonates with structural congenital anomalies and identify predictors of body fat percentage.

METHODS: This prospective observational study included 61 term neonates (≥ 37 weeks' gestation) with cardiac or non-cardiac congenital anomalies requiring surgery. Anthropometric measures at birth and discharge and body composition at discharge were measured.

RESULTS: Mean z-scores declined significantly between birth and discharge for weight (-0.38 to -1.53), length (-0.02 to -0.64), and head circumference (-0.04 to -0.79) (all p < 0.001). Infants with congenital heart disease demonstrated a more pronounced weight z-score decline. At discharge, mean body fat was 9% (SD 4.9), with no significant differences between cardiac and non-cardiac anomalies or sexes. Fat-free mass was relatively preserved (91%, 910 g/kg). Multivariate analysis identified time of full enteral feeds (p = 0.02) and maternal ethnicity (p = 0.03) as independent predictors of body fat.

CONCLUSION: Term neonates with congenital anomalies experience significant postnatal growth restriction and reduced fat mass by NICU discharge. Maternal ethnicity and time to full enteral feeds independently influence body fat percentage. These findings support the need for individualised nutrition and routine body composition monitoring to optimise outcomes in this high-risk group.

PMID:41059561 | DOI:10.1111/apa.70332

J Rural Med. 2025 Oct;20(4):311-313. doi: 10.2185/jrm.2025-006. Epub 2025 Oct 1.

ABSTRACT

OBJECTIVE: Venous malformations (VMs) are low-flow blood reservoir mass lesions with spongy or cystic venous lumens caused by dilation of the venous system vasculature. A VM is a congenital lesion that presents at birth and enlarges during childhood as the host grows. Subcutaneous lesions due to VMs are rarely diagnosed at an advanced age. We report a case of axillary VM in an older patient.

PATIENT: A 92-year-old man was suspected of having left axillary lymphadenopathy (single nodule, 23 mm long) on chest computed tomography (CT) scan. Seven years earlier, a chest CT scan showed a small, 13 mm nodule in the same area.

RESULTS: On ultrasound elastography, the lesion did not appear hard, however, color Doppler imaging revealed abundant blood flow, suggesting a malignant lesion. Histologically, the lesions were consistent with VM.

CONCLUSION: VMs should be considered a differential diagnosis for superficial lymphadenopathy, even in older patients.

PMID:41059371 | PMC:PMC12497984 | DOI:10.2185/jrm.2025-006

Crit Care Explor. 2025 Oct 3;7(10):e1327. doi: 10.1097/CCE.0000000000001327. eCollection 2025 Oct.

ABSTRACT

OBJECTIVE: To train and test supervised machine learning (ML) models to predict low cardiac output syndrome (LCOS) within the first 48 postoperative hours in neonates undergoing cardiothoracic surgery.

DESIGN: Retrospective observational study. An efficient tree-based gradient-boosting algorithm (LightGBM) ML models were developed to predict LCOS occurrence at 2-, 4-, 6-, and 12-hour forecasting horizons, incorporating data from the prediction time and the two preceding hours. SHapley Additive exPlanations (SHAP) analyses were used for feature importance analyses.

SETTING: Single center, January 2012 to April 2023.

PATIENTS: Neonates 28 days old or younger who underwent cardiothoracic surgery.

INTERVENTIONS: None.

MEASUREMENTS AND MAIN RESULTS: A total of 181 neonates were included, with 14.9% experiencing LCOS. A multivariate time-series dataset was constructed using hourly clinical and laboratory variables recorded during the first 48 postoperative hours. The LightGBM ML models achieved area under the receiver operating characteristic curve values ranging from 0.91 to 0.98 and area under the precision-recall curve values ranging from 0.60 to 0.80 for LCOS prediction across 2-, 4-, 6-, and 12-hour forecasting horizons. SHAP analyses identified higher vasoactive inotrope score, lower urine output, and higher serum lactate as the most influential predictors.

CONCLUSIONS: This study demonstrates that the supervised machine learning models can accurately predict LCOS in neonates, offering high interpretability. The findings support further validation in multicenter settings and integration into clinical workflows to enhance postoperative critical cardiac care neonates.

PMID:41058756 | PMC:PMC12499747 | DOI:10.1097/CCE.0000000000001327

Cardiol Young. 2025 Oct 8:1-4. doi: 10.1017/S1047951125109761. Online ahead of print.

ABSTRACT

BACKGROUND: Clinical outcomes of a standardised enhanced recovery after surgery protocol, including thoracic epidural analgesia, were studied in children undergoing trans-atrial cardiac surgery via the right mid-axillary thoracotomy approach.

METHODS: This single-centre retrospective study examined 42 paediatric patients who underwent trans-atrial cardiac surgeries via the mid-axillary approach (2018 to 2020), of whom 30 received epidural catheters. The standardised enhanced recovery after surgery protocol included transesophageal echo-guided thoracic epidural catheter placement, multimodal analgesia, reduced opioid use, and planned early extubation and discharge. Clinical outcomes assessed included extubation times, postoperative analgesic requirements, ICU pain scores, hospital length of stay, and any complications related to regional anaesthesia or surgery.

RESULTS: Thirty patients received an epidural placed between the third and sixth thoracic interspace levels under transesophageal ultrasonography guidance. The median age was 42 months (range 3-156), and the median weight was 15.7 kg (range 4.9-61 kg). Epidural infusions were continued for a median of 52 hours postoperatively. The intraoperative fentanyl usage was a median of 4.5 mcg/kg (interquartile range (IQR) 2-9). Intraoperative extubation was achieved in 28 of the 30 patients. Median post-extubation pain scores in the first 6 and 12 hours were 0 (IQR 0), and postoperative rescue opioid requirements were low in epidural patients. There were no instances of tracheal reintubation, neuraxial blockade-related complications, or other anaesthesia-related adverse events.

CONCLUSION: Through our standardised and reproducible anaesthetic protocol, we achieved excellent and nearly pain-free recovery in paediatric patients undergoing trans-atrial cardiac surgeries via the mid-axillary approach.

PMID:41058510 | DOI:10.1017/S1047951125109761

Semin Pediatr Surg. 2025 Sep 11:151539. doi: 10.1016/j.sempedsurg.2025.151539. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the risk factors of postoperative poor incision healing in children with congenital pectus excavatum who underwent thoracoscopic-assisted Nuss procedure.

METHODS: In this study, a retrospective cohort study method was adopted to statistically analyze the clinical data of children with congenital pectus excavatum who underwent thoracoscopic-assisted Nuss procedure from 2017 to 2024. The children were categorized into groups with good incision healing and groups with poor healing according to the criteria, and the risk factors that might affect the incision healing were collected, including gender, age, height, weight, BMI, HI, type of pectus excavatum, and previous allergy history, number of the Nuss bars, whether fixation piece was applied, fixation method, suture method, surgical time and bleeding amount.

RESULTS: Based on the inclusion and exclusion criteria, a total of 272 children with Nuss procedure were collected, and during the follow-up period, 25 children experienced poor incision healing. Univariate and multivariate logistic regression analyses were performed in both groups, and the results showed that low BMI, asymmetric pectus excavatum, previous allergy history, wire-fixed bars, and intradermal sutures were independent risk factors for poor incisional healing after the Nuss procedure for pectus excavatum (all P < 0.05).

CONCLUSION: Poor postoperative incision healing is more likely to occur in children with low BMI, asymmetric pectus excavatum, previous allergy history, and children with intraoperative wire fixation of bars and intradermal sutures.

PMID:41058358 | DOI:10.1016/j.sempedsurg.2025.151539

Innovations (Phila). 2025 Oct 7:15569845251375442. doi: 10.1177/15569845251375442. Online ahead of print.

ABSTRACT

Despite efforts to improve donor heart allocation policies, geographic disparities, logistical challenges and patient criteria limit organ availability. However, recent surgical innovations offer potential solutions. These include partial heart transplantation and xenotransplantation. Partial heart transplantation is a new procedure with the potential to address several clinical challenges in treating congenital heart defects. Cardiac xenotransplantation involves the transplantation of genetically modified porcine hearts into humans, offering a potential solution to the shortage of donor organs. Although immunologic barriers and ethical concerns remain, ongoing research aims to mitigate the risks and optimize outcomes, providing hope for patients in need. These innovative surgical approaches offer promising avenues for addressing the critical shortage of donor hearts and with ongoing research, may hold the potential to revolutionize heart transplantation, and improve outcomes for patients facing terminal heart failure.

PMID:41058154 | DOI:10.1177/15569845251375442

Eur Heart J Imaging Methods Pract. 2025 Aug 6;3(4):qyaf098. doi: 10.1093/ehjimp/qyaf098. eCollection 2025 Oct.

ABSTRACT

AIMS: Over the past decade, transcatheter valve replacement has emerged as a therapy for selected patients with valvular heart. Clinical experience with transcatheter mitral valve replacement (TMVR) has been limited to date and provides little insight into its potential as a viable therapy for MR. The present study aims to analyze the current longest follow-up real-life outcomes of TMVR procedures with a specific focus on the patient population left untreated due to the unfeasibility of the procedure.

RESULTS: Out of 3400 patients referred for mitral pathology, 88 were screened for TMVR procedure, being unfeasible for surgical and TEER procedure (Transcatheter Edge-to-Edge Repair). 37 pts (45%) were screened positive and treated with TMVR; 30 (81%) with Tendyne system (Abbott) and 7 (19%) with Tiara. For cardiac death, in TMVR the survival was 97.2%, 90.7%, and 90.7% at 1, 2, and 4 years, respectively. Concerning MT, instead, it was 86.4%, 77%, and 42% at 1, 2, and 4 years, respectively. A difference is seen between the two groups, P-value 0.024.

CONCLUSION: TMVR is a valid option in selected patients and give valid longer follow-up results. The TMVR-ineligible patients showed a progressive detrimental worse survival across the follow-up.

PMID:41058678 | PMC:PMC12499754 | DOI:10.1093/ehjimp/qyaf098

Cell Death Discov. 2025 Oct 7;11(1):453. doi: 10.1038/s41420-025-02725-0.

ABSTRACT

Recent studies found that treatment with an anti-T-cell immunoglobulin mucin-1 (TIM1) monoclonal antibody (RMT1-10) regulated immune responses by inducing regulatory B cells (Bregs). However, the role of these cells in myocardial ischemia-reperfusion injury (IRI) is unknown. This study aimed to investigate the protective effect of RMT1-10 on myocardial IRI and its potential mechanism. We established a myocardial IRI model, and Triphenyl tetrazolium chloride staining, Terminal deoxynucleotidyl transferase nick-end-labeling, hematoxylin and eosin, and transmission electron microscopy were performed to examine the myocardial infarction size, myocardial cell apoptosis, and cardiomyocyte morphology and structure. The data showed that RMT1-10 could alleviate myocardial IRI, increase the number of TIM1+Bregs and interleukin 10 (IL-10) secretion, and regulate the expression of inflammatory factors after myocardial IRI. However, treatment with RMT1-10 and Anti-CD20 abrogated the protective effect of RMT-10. In addition, RMT1-10 treatment inhibited T cells but significantly activated Tregs after IRI, while RMT1-10 combined with Anti-CD20 abolished this effect on Tregs. Furthermore, sequencing analysis showed marked expression changes among genes related to several classical signaling pathways in response to RMT1-10. Taken together, these findings indicated that RMT1-10 could increase the number of TIM1+ Bregs and regulate IL-10-mediated inflammatory reactions, activate Tregs to inhibit inflammation, and might regulate the above-mentioned signaling pathways to protect against myocardial IRI.

PMID:41057354 | DOI:10.1038/s41420-025-02725-0

Phytomedicine. 2025 Sep 25;148:157302. doi: 10.1016/j.phymed.2025.157302. Online ahead of print.

ABSTRACT

BACKGROUND: Xin-Ji-Er-Kang (XJEK), a traditional Chinese medicine formulation, has shown protective effects in various murine models of cardiovascular disease. However, its potential mechanisms in mitigating drug-induced cardiotoxicity, particularly its role in regulating ferroptosis, remain unclear.

AIM OF THE STUDY: This study aimed to evaluate the cardioprotective effects of XJEK against doxorubicin (DOX)-induced myocardial injury and to elucidate its potential mechanisms.

MATERIALS AND METHODS: The protective effects of XJEK were assessed using in vivo and in vitro models of DOX-induced cardiotoxicity (DIC). Cardiac function, related biomarkers, mitochondrial function, and indicators of ferroptosis were evaluated. To clarify the mechanism, NRF2 expression was silenced using small interfering RNA (siRNA).

RESULTS: XJEK significantly alleviated DIC both in vivo and in vitro by restoring mitochondrial function, reducing lipid peroxidation, lowering reactive oxygen species (ROS) production, and decreasing iron accumulation and ferroptosis-related protein expression. Mechanistically, XJEK exerted these protective effects by inhibiting ferroptosis through activation of the NRF2 pathway.

CONCLUSION: XJEK effectively attenuates DOX-induced cardiotoxicity by suppressing ferroptosis via NRF2 activation. These findings suggest that NRF2-mediated anti-ferroptosis signalling contributes to the cardioprotective effects of XJEK, highlighting its therapeutic potential for managing drug-induced myocardial injury.

PMID:41056858 | DOI:10.1016/j.phymed.2025.157302

Ecotoxicol Environ Saf. 2025 Oct 6;304:119156. doi: 10.1016/j.ecoenv.2025.119156. Online ahead of print.

ABSTRACT

Among adults without a history of cardiovascular diseases (CVD), we estimated the effects of urinary bisphenol A (BPA) and plasma nitric oxide metabolites (NOx) on risks of 24-h ST-segment depression events (STDE) and T-wave inversion events (TIE), two indicators of myocardial ischemia, recorded in five types of leads (i.e., anterior, anterolateral, lateral, inferior and all leads) by 12-lead Holter monitors. Target genes for BPA exposure and myocardial ischemia were identified by network toxicology analyses. Furthermore, we explored whether L-arginine (L-Arg, a substrate for NO synthesis) supplementation (9 g/day) could mitigate the potential adverse effects of BPA exposure on STDE and TIE. Among the 105 participants included in the final analyses, urinary BPA concentrations were associated with significant increases in the numbers of 24-h STDE in anterior, anterolateral and all leads, and in the numbers of 24-h TIE in all five types of leads. The inverse associations between NOx and the numbers of 24-h STDE and TIE were weakened along with the increasing BPA concentrations. A total of 1287 potential target genes were found to be associated with the influence of BPA on myocardial ischemia. Biological processes such as "response to nitric oxide" and pathways such as "vascular smooth muscle contraction" were significantly enriched. L-Arg supplementation significantly attenuated the BPA-STDE and BPA-TIE associations in most types of leads. This cross-sectional analysis, conducted in adults without a history of CVD, revealed that exposure to BPA is associated with increases in indicators of myocardial ischemia. Moreover, the adverse cardiac effects of BPA can be effectively mitigated by supplementation with L-Arg.

PMID:41056681 | DOI:10.1016/j.ecoenv.2025.119156