This retrospective, multi-center study evaluates the relationships between novel liver function scoring systems - Albumin-Bilirubin (ALBI) score, EZ-ALBI, PALBI, and MELD-XI - and outcomes in patients undergoing transcatheter aortic valve implantation (TAVI). Feature importance was assessed with SHAP-values via the XGBoost-algorithm. The ALBI score exhibited the strongest association with 30-day mortality after TAVI (AUC = 0.723, p < 0.001), outperforming other scores in this regard and consistently demonstrating predictive power across various subgroup populations. Higher 30-day mortality rates were observed in the higher tertiles of the ALBI score compared to the lower tertiles (log-rank p-value = 0.004). The ALBI-based nomogram (C-index = 0.81, 95% CI:0.73-0.86, p = 0 < 001) demonstrated superior predictive power for 30-day mortality post-TAVI compared to the STS (C-index = 0.71, 95% CI :0.64-0.77, p = 0 < 001). In addition, the nomogram showed a significant improvement in reclassification (69.3%, p < 0.001) and a stronger discrimination 15.2%, p < 0.001) compared to the STS. It integrates nine variables, first ALBI score (SHAP:1.165), including NYHA class (0.594), body mass index (0.510), glomerular filtration rate, creatinine, hemoglobin, gender, predilatation requirement, presence of chronic kidney disease, and providing a comprehensive risk assessment tool. This study exhibits the significance of liver dysfunction with AS patients and suggests incorporating liver function parameters in pre-operative risk assessments for better clinical outcomes in TAVI procedures.

Background: There is insufficient data in the literature regarding the relationship between bidirectional conduction block (BCB) parameters and right atrial dimension (RAd). In our study, we aimed to evaluate the relationship between RAd and BCB parameters in typical atrial flutter (AFL) patients. Methods: This prospective study included 197 patients who underwent successful RFA with a diagnosis of typical AFL between 2020 and 2025. We performed RAd and BCB measurements in addition to routine assessments in all patients. The presence of BCB was confirmed by measurement of the CTI double-potential peak-to-peak interval (DPPPI) during CSp pacing, as well as by the difference between the conduction times from isthmus lateral-to-medial pacing to the CSp stimulus (ΔI-CS = LI-to-CSp − MI-to-CSp) and the difference between the conduction times from CSp pacing to the lateral and medial isthmus sites (ΔCS-I = CSp-to-LI − CSp-to-MI). Patients were divided into 3 groups according to RAd: Group-I: 2.4 cm/m2. Results: The number of patients in Groups I, II, and III was determined to be 99, 55, and 43, respectively. RA-volume, LVEF, RAd, and LAd values, as well as LI-to-CSp, ΔI-CS, CSp-to-LI, ΔCS-I, and DPPPI durations, significantly increased from Group I to Group III. MI-to-CSp and CSp-to-MI durations also increased from Group I to Group III; being Group I was significantly lower than Groups II and III. When DPPPI durations were categorized as ≤110 ms, 110–119 ms, 120–129 ms, and ≥130 ms, a significant difference was observed among the groups, and all Group II–III cases were found to have a DPPPI duration of ≥120 ms. In Groups II and III, the proportions of patients with DPPPI ≥ 130 ms were 46% and 84%, respectively. Conclusions: Our study showed that cavotricuspid-isthmus BCB parameters, which are indicators of successful AFL ablation, are closely and significantly related to RAd.

Background: Right atrial pressure (RAP) is an important prognostic criterion in pulmonary hypertension. Elevated mean RAP measured by cardiac catheterization is an independent risk factor for mortality. Accurate bedside assessment of congestion in the management of patients with PH remains challenging. As a continuous conduit of circulating fluid, systemic congestion represented by high RAP may be reflected by peripheral venous pressure (PVP). We evaluated the reliability of PVP measurements for assessing congestion beyond conventional clinical assessments. Methods: We performed conventional congestion assessments and PVP measurements in 138 patients undergoing right heart catheterization. PVP was measured via the 16-gauge peripheral venous access placed in the upper extremity. Results: The mean RAP and PVP were 8.7 ± 4.2 mm Hg and 10.7 ± 4.3 mm Hg, respectively. PVP exhibited a strong linear correlation with RAP (Pearson R = 0.839; P < .001). PVP demonstrated significant discriminatory power for both RAP < 8 mm Hg (area under the curve: 0.91 [95% confidence interval: 0.86 to 0.96]; sensitivity: 72%; specificity: 94% cutoff: 8.5 mm Hg) and RAP ≥ 12 mm Hg (area under the curve: 0.92 [0.87 to 0.97]; sensitivity: 82%; specificity: 89% cutoff: 12.5 mm Hg). Conclusion: PVP measured via peripheral venous access strongly correlates with invasively obtained RAP. PVP measurements may improve current bedside assessments of congestion.

Aims: Chronic total occlusion (CTO) represents a clinically important form of coronary artery disease in which collateral circulation plays a critical role in maintaining myocardial perfusion. Although testosterone has been suggested to influence vascular function and angiogenesis, the relationship between androgenic parameters and coronary collateral development remains uncertain. Methods: This cross-sectional case-control study included 230 male patients diagnosed with CTO by coronary angiography. Coronary collateral circulation was graded using the Rentrop classified categorized as good CCF (score 2–3) or bad CCF (score 0–1). Serum levels of total testosterone, free testosterone, SHBG, dehydroepiandrosterone sulfate (DHEAS), and dihydrotestosterone (DHT) were measured, and bioavailable testosterone (BioT) and free testosterone index (FTI) were calculated. Associations between androgenic parameters and collateral circulation were analyzed using correlation analysis, logistic regression, and ROC curve analysis. Results: Of the study cohort, 142 patients had good CCF and 88 had bad CCF. Patients with good CCF had higher levels of total testosterone (p

Background and Objectives: Inflammation and nutritional status are closely associated with prognosis in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS). This study compared the prognostic performance of the conventional Naples score and CRP-modified Naples score for predicting in-hospital mortality. Materials and Methods: This retrospective, single-center study included 921 patients with NSTE-ACS undergoing percutaneous coronary intervention. Multivariable logistic regression, ROC analysis, reclassification indices, restricted cubic spline analysis, and decision curve analysis were performed. Results: In-hospital mortality occurred in 79 patients (8.6%). Patients who died had higher Naples score and modified Naples score values than survivors. In multivariable models adjusted for baseline clinical variables and GRACE score, both the modified Naples score and conventional Naples score remained independently associated with in-hospital mortality. The modified Naples score showed an adjusted-OR of 3.85 (95% CI: 2.71–5.48; p < 0.001), whereas the conventional Naples score showed an adjusted-OR of 4.52 (95% CI: 3.05–6.70; p < 0.001). The addition of the modified Naples score improved model performance, with a C-index of 0.819, NRI of 0.741, and IDI of 0.127. Similarly, the conventional Naples score model showed a C-index of 0.827, NRI of 0.843, and IDI of 0.125. In ROC analysis, the AUC was 0.701 for the modified Naples score and 0.683 for the conventional Naples score, without a statistically significant difference between them (ΔAUC = 0.017; p = 0.300). Decision curve analysis showed positive net clinical benefit for both scores, with no consistent superiority of either score. Conclusions: Both Naples-based scores were independently associated with in-hospital mortality and provided comparable prognostic performance in patients with NSTE-ACS undergoing PCI.