Cancer treatment might cause heart failure and deteriorate the patients’ quality of life. Despite the wide use of conventional echocardiography, it often fails to detect cardiotoxicity until advanced cardiac dysfunction at potentially irreversible stages. Advanced techniques, such as three-dimensional imaging and strain analysis in stress echocardiography, have shown promise in identifying cardiotoxicity at subclinical stages, even when traditional measures remain within normal ranges. These novel techniques have been shown to identify cardiac impairment in 30%–50% of the patients undergoing potentially cardiotoxic chemotherapy, which allows for early intervention and enhanced patient management. Although professional societies are advocating for the inclusion of these techniques into routine monitoring protocols, more research is needed to optimize and standardize their use across various centers and chemotherapeutic agents. This review explores the role of stress echocardiography in the early detection and monitoring of chemotherapy-induced cardiotoxicity. It delves into current knowledge and emerging research, aiming to provide a comprehensive understanding and to highlight areas worthy of further investigation.

Background and aim: Clinical data on the prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction and etiology-associated steatohepatitis (MetALD) in a multi-ethnic U.S. population are limited. Additionally, the impact of physical activity (PA) and diet quality (DQ) on the risk of MASLD, MetALD, and compensated advanced chronic liver disease (cACLD) remains unclear. This study aimed to investigate the associations of PA and diet quality with the risks of MASLD, MetALD, and cACLD.Methods and results: This cross-sectional study analyzed data from 7,125 participants in the National Health and Nutrition Examination Survey (NHANES) 2017–2020. Diet quality was assessed using the Healthy Eating Index-2015 (HEI-2015). PA was assessed based on the 2020 WHO Physical Activity Guidelines, with participants reporting the intensity, frequency, and duration of their activities over the past 7 days. MASLD and MetALD were diagnosed based on clinical criteria, and cACLD was defined by advanced liver fibrosis. Bivariate and multivariable logistic regression models were used to assess associations between PA, diet quality, and liver disease outcomes. The prevalence of MASLD and MetALD was 35.07 and 21.46%, respectively. HQD was associated with significantly lower risks of MASLD (OR: 0.49, 95% CI: 0.38–0.62) and MetALD (OR: 0.45, 95% CI: 0.36–0.56). High PA levels were linked to reduced risks of MASLD (OR: 0.47, 95% CI: 0.38–0.58) and MetALD (OR: 0.53, 95% CI: 0.39–0.72). The lowest risks for both MASLD and MetALD were observed in highly active participants with an HQD (MASLD OR: 0.41, 95% CI: 0.32–0.53; MetALD OR: 0.54, 95% CI: 0.41–0.71). Significant interactions were observed between PA, HQD, and age, BMI, and SES, which further reduced the risks of MASLD and MetALD. For cACLD, both increased PA and HQD were associated with reduced risk. Compared to non-high-activity participants with a non-HQD, physically active participants with an HQD had the lowest risk of cACLD (OR: 0.44, 95% CI: 0.24–0.82).Conclusion: High proportions of the US population have MASLD or MetALD. HQD and high PA levels were associated with lower risks of MASLD, MetALD, and cACLD.

Stroke is a leading cause of morbidity and mortality worldwide, with modifiable risk factors being crucial for prevention efforts. Magnesium, an essential mineral involved in numerous physiological processes, is linked to cardiovascular health. However, the relationship between magnesium status, assessed through the Magnesium Depletion Score (MDS), and stroke risk remains underexplored. This study aims to investigate the association between MDS and stroke incidence, as well as the potential correlation between MDS and all-cause and cardiovascular disease (CVD) mortality among US adults. Furthermore, we explore the mediation role of Life’s Essential 8 (LE8) in the relationship between MDS and stroke. Utilizing data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018, we conducted a cross-sectional analysis of 44,588 participants. Participants were divided into three groups based on their MDS levels: none to low (MDS = 0–1), middle (MDS = 2), and high (MDS = 3–5). Multivariable logistic regression models were employed to assess the relationship between MDS and stroke risk, adjusting for multiple confounders. Additionally, Cox regression models and Kaplan-Meier survival curves were used to evaluate the association between MDS and mortality outcomes. Subgroup and mediation analyses were performed to explore the role of LE8 in MDS associations with the risk of stroke. Higher MDS was significantly associated with increased stroke risk in a dose-dependent manner. Participants with high MDS scores (3–5) had an odds ratio (OR) of 1.96 (95% CI 1.55–2.49) for stroke compared to those with low MDS scores (0–1). For all-cause mortality, high MDS was associated with a hazard ratio (HR) of 1.73 (95% CI 1.41–2.09), and for CVD mortality, the HR was 2.01 (95% CI 1.49–2.71). Kaplan-Meier analyses revealed lower survival probabilities with increasing MDS levels. Subgroup analyses revealed that higher MDS was associated with increased stroke risk across age and gender groups, with stronger effects observed in older individuals, males, and those with higher cardiovascular risk factors, while LE8 mediated 26.5% of this relationship. Our findings provide strong evidence that higher MDS is significantly associated with increased stroke risk and higher all-cause and CVD mortality among stroke patients. LE8 plays a significant mediating role in this association.

Liver fibrosis and cirrhosis are characterized by the excessive accumulation of extracellular matrix (ECM) in the liver, and they represent significant glo

Cardiovascular disease (CVD) is influenced by metabolic dysfunction, chronic inflammation, and adiposity. The C-reactive protein-triglyceride-glucose index (CTI) integrates inflammatory and metabolic information, but the associations of CTI-derived adiposity indices with incident CVD remain insufficiently characterized. We aimed to examine the associations of several CTI-derived adiposity indices with incident CVD and compare their relative performance in a nationwide cohort of middle-aged and older adults. We analyzed data from 6,161 participants aged ≥ 45 years without baseline CVD from the China Health and Retirement Longitudinal Study (CHARLS). Four CTI-derived adiposity indices were evaluated: CTI-WHtR, CTI-BMI, CTI-BRI, and CTI-WWI. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for incident CVD. Dose-response relationships were assessed using restricted cubic splines (RCS). Kaplan-Meier, discrimination and reclassification, cumulative exposure, trajectory, subgroup, component-outcome, mediation, and sensitivity analyses were also performed. During a median follow-up of 9 years, 1,503 participants (24.39%) developed CVD. Higher levels of CTI-derived adiposity indices were associated with increased CVD risk. In fully adjusted models, participants in the highest quartile had higher CVD risk than those in the lowest quartile for CTI-WHtR (HR = 1.57, 95% CI 1.24-2.00), CTI-BMI (HR = 1.55, 95% CI 1.23-1.97), CTI-BRI (HR = 1.40, 95% CI 1.11-1.78), and CTI-WWI (HR = 1.37, 95% CI 1.08-1.74), with significant trends across quartiles. RCS analyses showed predominantly linear dose-response relationships. Discrimination was modest, with AUCs ranging from 0.558 for CTI-WWI to 0.573 for CTI-WHtR, compared with 0.522 for CTI. All CTI-derived indices improved continuous net reclassification improvement and integrated discrimination improvement beyond the conventional risk factor model. Higher cumulative exposure and higher trajectory clusters of CTI-derived indices were also associated with increased CVD risk. Mediation analyses suggested interrelationships between metabolic-inflammatory dysregulation and adiposity in relation to CVD. CTI-derived adiposity indices were associated with incident CVD in middle-aged and older adults, with CTI-WHtR showing the most consistent overall performance among the evaluated indices. These findings support the epidemiological relevance of integrating metabolic-inflammatory burden with adiposity-related phenotypes in cardiovascular risk assessment.