Low-grade systemic inflammation and left ventricular dysfunction in hypertensive compared to non-hypertensive hypertrophic cardiomyopathy

Effect of CBC-Derived Inflammatory Indicators in Predicting Chronic Kidney Disease Risk in Hypertrophic Cardiomyopathy Patients

Background: Hypertrophic cardiomyopathy (HCM) is a prevalent condition that often coexists with chronic kidney disease (CKD), significantly impacting patient prognosis. This study aimed to investigate the predictive value of complete blood cell counts derived inflammatory indicators in assessing CKD risk in HCM patients. Methods: This study enrolled HCM patients and categorized them into CKD and non-CKD group based on discharge diagnoses. Analyzed indicators included systemic inflammation response index (SIRI), systemic immune inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR). Least absolute shrinkage and selection operator (LASSO) logistic and multivariable logistic regression were employed to identified independent risk factors for CKD, which were subsequently utilized to develop a nomogram. Results: A total of 1795 HCM patients were included, including 112 (6.24%) individuals assigned to the CKD group. In univariate analyses, NLR (AUC: 0.755; 95%CI: 0.711-0.800) demonstrated superior accuracy compared to others. Eighteen baseline characteristics exhibiting statistical difference were incorporated into LASSO-logistic regression. Six factors were further selected by multivariable logistic regression. The results identified male gender (OR: 2.622; 95% CI: 1.565-4.393, p < 0.001), Hb (OR: 0.972; 95% CI: 0.962-0.981, p < 0.001), Pro-BNP (OR: 1.000; 95% CI: 1.000-1.000, p < 0.001), SIRI (OR: 1.037; 95% CI: 1.026-1.049, p < 0.001), and SII (OR: 1.000; 95% CI: 1.000-1.001, p = 0.003) as risk factors. These five factors were used to construct a nomogram, which exhibited good accuracy and consistency. Conclusions: Male gender, Hb, Pro-BNP, SIRI, and SII were identified as risk factors for CKD risk in HCM patients. A nomogram was developed using these factors, which may facilitate early identification and management of high-risk individuals.

Features of Idiopathic Halitosis and Its Association With Low-Grade Systemic Inflammation

OBJECTIVES

Idiopathic halitosis is occasionally encountered in clinical practice, yet with scarce reports. This work aimed to investigate its features and potential association with low-grade systemic inflammation (LGSI).

METHODS

This retrospective study reviewed idiopathic halitosis from 2469 halitosis patients and compared them with 63 healthy controls (HCs). Organoleptic score (OLS), exhaled volatile sulfur compounds (VSCs), serum inflammatory cytokines, and fractional exhaled nitric oxide (FeNO200) to indicate LGSI were determined.

RESULTS

Totally, 54 (2.19%) idiopathic halitosis patients were identified and they were extraoral. Dimethyl sulfide (DMS) was found to be the primary exhaled VSC. Inflammatory cytokines were slightly elevated in 5.56% (3/54) of idiopathic halitosis compared to none of HCs (p = 0.095). FeNO200 was elevated in 79.63% (43/54) of idiopathic halitosis compared to none of HCs (p < 0.001), with a sensitivity of 79.63% and specificity of 100% for the diagnosis of idiopathic halitosis. The FeNO200 level had positive correlations with OLS (r = 0.871) and DMS level (r = 0.485).

CONCLUSION

Idiopathic halitosis is a rare condition which is closely associated with LGSI and possibly caused by unexplored extraoral pathologies. FeNO200 is recommended for its diagnosis with a high diagnostic power.

The Prognostic Value of Right Ventricular Function in Patients with Chronic Heart Failure-A Prospective Study

Background: In patients with stable chronic heart failure with a reduced ejection fraction (HFrEF), left ventricular ejection fraction (LVEF) provides limited prognostic value, especially in patients with moderately to severely reduced LVEF. Echocardiographic parameters of right ventricular function may be associated with adverse clinical events in these patients. Therefore, we analyzed 164 patients with HFrEF in a prospective single-center cohort study to evaluate whether the parameters of right ventricular function are associated with worsening heart failure (WHF) hospitalizations, cardiovascular and all-cause deaths and combined endpoints. Methods: Echocardiographic cine loops were analyzed using vendor-independent post-processing software. Multivariate Cox regression analyses were performed, which were then adjusted for clinical characteristics and left ventricular functional parameters. Results: In these models, higher tricuspid annular plane systolic excursion (TAPSE) was significantly associated with lower rates of WHF hospitalizations (HR 0.880, 95%CI 0.800-0.968, p = 0.008), a composite endpoint of WHF hospitalizations and cardiovascular death (HR 0.878, 95%CI 0.800-0.964, p = 0.006), and a composite endpoint of WHF hospitalization and all-cause death (HR 0.918, 95%CI 0.853-0.988, p = 0.023). These associations were more pronounced in patients with LVEF ≤ 35%. Conclusions: In conclusion, in patients with HFrEF, TAPSE is an independent prognosticator for adverse clinical outcomes, warranting further studies to elucidate whether incorporating TAPSE into established risk scores improves their diagnostic accuracy.