Review
Medicine, General & Internal
Annette Wacker-Gussmann, Gretchen K. Eckstein, Janette F. Strasburger
Summary: The number of women diagnosed with ion channelopathy in childhood and effectively treated using beta blockers, sympathectomy, and cardiac pacemakers/defibrillators is increasing. Offspring of these women have a 50% risk of inheriting the disease, necessitating complex delivery room preparation in pregnancies with inherited arrhythmia syndromes. Fetal magnetocardiography now allows for the detection of various arrhythmias in susceptible fetuses, requiring specialists to have optimal knowledge and equipment for the care of these specialized pregnancies.
JOURNAL OF CLINICAL MEDICINE
(2023)
Review
Pharmacology & Pharmacy
Michael Cristian Garcia, Kai La Tsang, Simran Lohit, Jiawen Deng, Tyler Schneider, Jessyca Matos Silva, Lawrence Mbuagbaw, Anne Holbrook
Summary: This study evaluated the association between hydroxychloroquine (HCQ) or chloroquine (CQ) and major adverse cardiac events (MACE). The analysis of randomized controlled trials showed that both HCQ and CQ did not increase the risk of MACE. These findings have important implications for patient safety and prescribing practices.
ANNALS OF PHARMACOTHERAPY
(2023)
Article
Cardiac & Cardiovascular Systems
Sami Viskin, Ehud Chorin, Arie Lorin Schwartz, Piotr Kukla, Raphael Rosso
Summary: Cardiac memory is an interesting electrocardiographic phenomenon where T waves become abnormal in the opposite direction of wide QRS complex, and normalize at a later stage. Reduction of repolarizing potassium currents during cardiac memory may lead to prolonged QT syndrome and ventricular arrhythmias.
Article
Medicine, General & Internal
Sok-Sithikun Bun, Nathan Heme, Florian Asarisi, Fabien Squara, Didier Scarlatti, Pamela Moceri, Emile Ferrari
Summary: This study analyzed the clinical characteristics of patients with high-grade atrioventricular block (AVB) presenting with torsades de pointes (TdP), and found that the QTc(FR), JT, and Tpeak-to-end intervals were significantly prolonged in these patients.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Cardiac & Cardiovascular Systems
Mathilde R. Rivaud, Jason D. Bayer, Matthijs Cluitmans, Jeanne van der Waal, Laura R. Bear, Bastiaan J. Boukens, Charly Belterman, Lisa Gottlieb, Fanny Vaillant, Emma Abell, Remi Dubois, Veronique M. F. Meijborg, Ruben Coronel
Summary: The study found that torsades de pointes arrhythmia can be induced within a critical range of repolarization time and repolarization time heterogeneities, maintained by reentry wandering along the repolarization gradient. Local restitution curves from the long and short repolarization time regions crossed, associated with T wave inversion at coupling intervals at either side of the crossing point.
Editorial Material
Pharmacology & Pharmacy
Zachary R. Noel, Vincent Y. See, Alexander H. Flannery
Summary: Acute care pharmacists play a crucial role in identifying drug-drug interactions that may lead to QT prolongation, but there is a risk of overemphasis on the QTc interval in some cases.
ANNALS OF PHARMACOTHERAPY
(2021)
Article
Cardiac & Cardiovascular Systems
William Lee, Ben Ng, Melissa M. Mangala, Matthew D. Perry, Rajesh N. Subbiah, Jamie I. Vandenberg, Adam P. Hill
Summary: A new method of quantifying action potential morphology has been developed to predict the risk of drug-induced cardiac abnormalities. This method, which focuses on the shape changes of the repolarization phase, outperforms conventional metrics and has the potential to improve the assessment of proarrhythmia in preclinical drug development.
CIRCULATION-ARRHYTHMIA AND ELECTROPHYSIOLOGY
(2023)
Article
Cardiac & Cardiovascular Systems
Edi Prifti, Ahmad Fall, Giovanni Davogustto, Alfredo Pulini, Isabelle Denjoy, Christian Funck-Brentano, Yasmin Khan, Alexandre Durand-Salmon, Fabio Badilini, Quinn S. Wells, Antoine Leenhardt, Jean-Daniel Zucker, Dan M. Roden, Fabrice Extramiana, Joe-Elie Salem
Summary: The study aimed to enhance the prediction of drug-induced TdP and diagnosis of cLQTS using convolutional neural network models analyzing ECG alterations induced by sotalol. The CNN models outperformed QTc measurements and were particularly effective shortly after a diTdP episode.
EUROPEAN HEART JOURNAL
(2021)
Article
Rheumatology
H. Michael Belmont, Mayce Haj-Ali
Summary: This study demonstrates that HCQ treatment does not cause a clinically significant increase in QTc levels in SLE patients.
Article
Cardiac & Cardiovascular Systems
Ali Danish Khan Yousafzai, Ali Haider Bangash, Saleha Yurf Asghar, Syed Mohammad Mehmood Abbas, Hashir Fahim Khawaja, Saiqa Zehra, Asjad Ullah Khan, Musa Kamil, Noor Ayesha, Ayesha Khalid Khan, Rabia Mohsin, Osama Ahmed, Arshiya Fatima, Aliya Ali, Ain ul Badar, Maryum Naveed Abbasi, Mohammad Ashraf, Ali Haider Shah, Tahir Iqbal
Summary: This study conducted a meta-analysis of meta-analyses to evaluate the clinical efficacy of azithromycin in COVID-19 management. The results showed that azithromycin did not have superior efficacy compared to other treatments and there is a risk of antimicrobial resistance. Therefore, it is recommended to remove azithromycin from COVID-19 management protocols.
Article
Public, Environmental & Occupational Health
Richard L. Morrow, Barbara Mintzes, Patrick C. Souverein, Christine E. Hallgreen, Bilal Ahmed, Elizabeth E. Roughead, Marie L. De Bruin, Sarah Brogger Kristiansen, Joel Lexchin, Anna Kemp-Casey, Ingrid Sketris, Dee Mangin, Sallie-Anne Pearson, Lorri Puil, Ruth Lopert, Lisa Bero, Danijela Gnjidic, Ameet Sarpatwari, Colin R. Dormuth
Summary: A longitudinal study showed that hydroxyzine initiation decreased in the UK after the safety advisories, but remained unchanged in British Columbia, Canada.
Review
Biochemistry & Molecular Biology
Daniela Baracaldo-Santamaria, Kevin Llinas-Caballero, Julian Miguel Corso-Ramirez, Carlos Martin Restrepo, Camilo Alberto Dominguez-Dominguez, Dora Janeth Fonseca-Mendoza, Carlos Alberto Calderon-Ospina
Summary: Long QT syndromes can be acquired or congenital, and drugs are a known risk factor for inducing acquired long QT syndrome. Despite common molecular mechanisms involved in QT interval prolongation, there is considerable inter-individual variability in drug response, emphasizing the importance of personalized medicine in evaluating the risk of each individual.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2021)
Article
Medicine, Legal
H. Ahmed, M. K. Larsen, M. R. Hansen, C. U. Andersen
Summary: The study found 22.5% of forensic autopsy cases with a high risk of medication-induced prolongation of the QT-interval (miQTP), with 0.9% suspected of fatal cardiac arrhythmia related to treatment with QT-PMs. A genetic pro-arrhythmic background could not be excluded in some cases.
FORENSIC SCIENCE INTERNATIONAL
(2021)
Article
Cardiac & Cardiovascular Systems
Tyler Gallo, C. William Heise, Raymond L. Woosley, James E. Tisdale, Malinda S. Tan, Sheila M. Gephart, Corneliu C. Antonescu, Daniel C. Malone
Summary: This study evaluated the actions taken by clinicians in response to a CDS advisory that used a modified Tisdale QT risk score and offered easily selected management options. The results showed that the system was effective in guiding clinicians to take appropriate measures for medications with potential TdP risk, with ordering an ECG being the most frequent action taken.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2022)
Article
Cardiac & Cardiovascular Systems
Thomas F. O'Connell, Christopher J. Bradley, Amr E. Abbas, Brian D. Williamson, Akash Rusia, Adam M. Tawney, Rick Gaines, Jason Schott, Alex Dmitrienko, David E. Haines
Summary: This study characterized QTc prolongation in hospitalized COVID-19 patients treated with HCQ/AZM. Several clinical factors were associated with greater QTc prolongation, but changes in QTc were not linked to increased risk of death.
JACC-CLINICAL ELECTROPHYSIOLOGY
(2021)
Editorial Material
Physiology
Sadis Matalon, Carol Ann Remme, Willis K. Samson
PHYSIOLOGICAL REVIEWS
(2021)
Article
Cardiac & Cardiovascular Systems
Babken Asatryan, Lauren Yee, Yael Ben-Haim, Stephan Dobner, Helge Servatius, Laurent Roten, Hildegard Tanner, Lia Crotti, Jonathan R. Skinner, Carol Ann Remme, Philippe Chevalier, Argelia Medeiros-Domingo, Elijah R. Behr, Tobias Reichlin, Katja E. Odening, Andrew D. Krahn
Summary: Sex-related differences in cardiac channelopathies are increasingly recognized, with varying risks and clinical features between men and women in different conditions, mainly influenced by age and sex hormones. While sex-specific predictors have been identified, gaps in the mechanistic understanding of these differences remain, highlighting the need for further research to address these disparities and improve patient outcomes.
Article
Cardiac & Cardiovascular Systems
R. W. Roudijk, K. Taha, M. Bourfiss, P. Loh, L. van den Heuvel, M. J. Boonstra, F. van Lint, S. M. van der Voorn, A. S. J. M. te Riele, L. P. Bosman, I. Christiaans, T. A. B. van Veen, C. A. Remme, M. P. van den Berg, J. P. van Tintelen, F. W. Asselbergs
Summary: In relatives of patients with dilated cardiomyopathy and arrhythmogenic cardiomyopathy, non-invasive diagnostic techniques such as biomarkers, electrocardiography, and imaging are promising for early detection of subclinical disease; however, further optimization and integration into clinical practice are needed. Personalized approaches may be required for determining the optimal screening interval and intensity of cascade screening.
NETHERLANDS HEART JOURNAL
(2021)
Article
Cardiac & Cardiovascular Systems
Vincent Portero, Thomas Nicol, Svitlana Podliesna, Gerard A. Marchal, Antonius Baartscheer, Simona Casini, Rafik Tadros, Jorien L. Treur, Michael W. T. Tanck, I. Jane Cox, Fay Probert, Tertius A. Hough, Sara Falcone, Leander Beekman, Martina Muller-Nurasyid, Gabi Kastenmuller, Christian Gieger, Annette Peters, Stefan Kaab, Moritz F. Sinner, Andrew Blease, Arie O. Verkerk, Connie R. Bezzina, Paul K. Potter, Carol Ann Remme
Summary: This study identified a mouse line with a high incidence of sudden death at a young age due to a nonsense mutation in the Bcat2 gene, leading to elevated levels of branch chain amino acids. The elevated BCAA levels were found to be positively correlated with arrhythmia-related indices and calcium dysregulation in both mouse models and human cardiomyocytes. The involvement of the mTOR pathway activation was demonstrated in preventing pro-arrhythmic events induced by high BCAA concentrations, suggesting a potential link between elevated BCAAs and arrhythmia in conditions like diabetes and heart failure.
CARDIOVASCULAR RESEARCH
(2022)
Article
Cardiac & Cardiovascular Systems
Elijah R. Behr, Chiara Scrocco, Arthur A. M. Wilde, Eloi Marijon, Lia Crotti, Konstantinos E. Iliodromitis, Carol A. Remme, Jedrzej Kosiuk, Irina Rudaka, Georgia Sarquella Brugada, Katie Frampton, Eric Schulze-Bahr, Kristine Jubele, Carlo de Asmundis, Nynke Hofman, Jacob Tfelt-Hansen, Serge Boveda, Giulio Conte
Summary: This survey aimed to investigate the current practice for the investigation of Sudden Unexplained Death in the Young (SUDY) among European countries. The survey found significant heterogeneity of service provision and variable adherence to current recommendations, partly attributable to the availability of dedicated units and specialist tests, genetic evaluation, and post-mortem examination.
Editorial Material
Physiology
Willis K. Samson, Gina L. C. Yosten, Carol Ann Remme
PHYSIOLOGICAL REVIEWS
(2022)
Review
Cardiac & Cardiovascular Systems
Carol Ann Remme
Summary: Ventricular arrhythmias and sudden cardiac death are most commonly observed in the presence of coronary artery disease, cardiomyopathy, and heart failure, but are also increasingly seen in patients with diabetes mellitus and obesity. However, our understanding of the underlying disease mechanisms is incomplete, which limits the prevention and treatment options for arrhythmias and sudden cardiac death in these patients.
CANADIAN JOURNAL OF CARDIOLOGY
(2022)
Editorial Material
Cardiac & Cardiovascular Systems
John L. Sapp, Andrew Krahn, William G. Stevenson, Carol Ann Remme, Francois Philippon, Stanley Nattel
CANADIAN JOURNAL OF CARDIOLOGY
(2022)
Review
Cardiac & Cardiovascular Systems
Jolanda van der Velden, Folkert W. Asselbergs, Jeroen Bakkers, Sandor Batkai, Luc Bertrand, Connie R. Bezzina, Ilze Bot, Bianca J. J. M. Brundel, Lucie Carrier, Steven Chamuleau, Michele Ciccarelli Dana Dawson, Sean M. Davidson, Andreas Dendorfer, Dirk J. Duncker, Thomas Eschenhagen, Larissa Fabritz, Ines Falcao-Pires, Peter Ferdinandy, Mauro Giacca, Henrique Girao, Can Gollmann-Tepekoeylue, Mariann Gyongyosi, Tomasz J. Guzik, Nazha Hamdani, Stephane Heymans, Andres Hilfiker, Denise Hilfiker-Kleiner, Alfons G. Hoekstra, Jean-Sebastien Hulot, Diederik W. D. Kuster, Linda W. van Laake, Sandrine Lecour, Tim Leiner, Wolfgang A. Linke, Joost Lumens, Esther Lutgens, Rosalinda Madonna, Lars Maegdefessel, Manuel Mayr, Peter van der Meer, Robert Passier, Filippo Perbellini, Cinzia Perrino, Maurizio Pesce, Silvia Priori, Carol Ann Remme, Bodo Rosenhahn, Ulrich Schotten, Rainer Schulz, Karin R. Sipido, Joost P. G. Sluijter, Frank van Steenbeek, Sabine Steffens, Cesare M. Terracciano, Carlo Gabriele Tocchetti, Patricia Vlasman, Kak Khee Yeung, Serena Zacchigna, Dayenne Zwaagman, Thomas Thum, Michele Ciccarelli
Summary: Cardiovascular diseases are a major cause of illness and death, and research is needed to improve diagnostics and discover new preventive and curative therapies. Translating basic science to clinical practice is challenging for complex conditions like cardiovascular diseases, which are often caused by multiple risk factors and comorbidities. Animal models play a vital role in providing important pathophysiological insights into disease mechanisms, particularly on an organ and systemic level.
CARDIOVASCULAR RESEARCH
(2022)
Article
Cell Biology
Pablo Montanes-Agudo, Simona Casini, Simona Aufiero, Auriane C. Ernault, Ingeborg van der Made, Yigal M. Pinto, Carol Ann Remme, Esther E. Creemers
Summary: The study reveals that the minor spliceosome regulates the electrophysiological properties of cardiomyocytes by modulating the expression and function of voltage-dependent ion channels. This finding has important implications for genetic diseases and acquired diseases such as heart failure, in which there are changes in minor spliceosome activity.
JOURNAL OF CELL SCIENCE
(2022)
Article
Cardiac & Cardiovascular Systems
Stephanie M. van der Voorn, Mimount Bourfiss, Anneline S. J. M. te Riele, Karim Taha, Marc A. Vos, Remco de Brouwer, Tom E. Verstraelen, Rudolf A. de Boer, Carol Ann Remme, Toon A. B. van Veen
Summary: This study investigated the correlation between PICP/ICTP levels in the blood of PLN p.Arg14del variant carriers and disease severity and outcome. The results showed that high PICP/ICTP ratios were associated with clinical parameters such as TWI and PVCs.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Editorial Material
Cardiac & Cardiovascular Systems
Hanno L. Tan, Carol Ann Remme
Correction
Genetics & Heredity
Julien Barc, Rafik Tadros, Charlotte Glinge, David Y. Chiang, Mariam Jouni, Floriane Simonet, Sean J. Jurgens, Manon Baudic, Michele Nicastro, Franck Potet, Joost A. Offerhaus, Roddy Walsh, Seung Hoan Choi, Arie O. Verkerk, Yuka Mizusawa, Soraya Anys, Damien Minois, Marine Arnaud, Josselin Duchateau, Yanushi D. Wijeyeratne, Alison Muir, Michael Papadakis, Silvia Castelletti, Margherita Torchio, Cristina Gil Ortuno, Javier Lacunza, Daniela F. Giachino, Natascia Cerrato, Raphael P. Martins, Oscar Campuzano, Sonia Van Dooren, Aurelie Thollet, Florence Kyndt, Andrea Mazzanti, Nicolas Clementy, Arnaud Bisson, Anniek Corveleyn, Birgit Stallmeyer, Sven Dittmann, Johan Saenen, Antoine Noel, Shohreh Honarbakhsh, Boris Rudic, Halim Marzak, Matthew K. Rowe, Claire Federspiel, Sophie Le Page, Leslie Placide, Antoine Milhem, Hector Barajas-Martinez, Britt-Maria Beckmann, Ingrid P. Krapels, Johannes Steinfurt, Bo Gregers Winkel, Reza Jabbari, Moore B. Shoemaker, Bas J. Boukens, Doris Skoric-Milosavljevic, Hennie Bikker, Federico Manevy, Peter Lichtner, Marta Ribases, Thomas Meitinger, Martina Muller-Nurasyid, Konstantin Strauch, Konstantin Strauch, Annette Peters, Holger Schulz, Lars Schwettmann, Reiner Leidl, Margit Heier, Jan H. Veldink, Leonard H. van den Berg, Philip Van Damme, Daniele Cusi, Chiara Lanzani, Sidwell Rigade, Eric Charpentier, Estelle Baron, Stephanie Bonnaud, Simon Lecointe, Audrey Donnart, Herve Le Marec, Stephanie Chatel, Matilde Karakachoff, Stephane Bezieau, Barry London, Jacob Tfelt-Hansen, Dan Roden, Katja E. Odening, Marina Cerrone, Larry A. Chinitz, Paul G. Volders, Maarten P. van de Berg, Gabriel Laurent, Laurence Faivre, Charles Antzelevitch, Stefan Kaab, Alain Al Arnaout, Jean-Marc Dupuis, Jean-Luc Pasquie, Olivier Billon, Jason D. Roberts, Laurence Jesel, Martin Borggrefe, Pier D. Lambiase, Jacques Mansourati, Bart Loeys, Antoine Leenhardt, Pascale Guicheney, Philippe Maury, Eric Schulze-Bahr, Tomas Robyns, Jeroen Breckpot, Dominique Babuty, Silvia G. Priori, Carlo Napolitano, Pascal Defaye, Pascal Defaye, Frederic Anselme, Jean Philippe Darmon, Francois Wiart, Carlo de Asmundis, Pedro Brugada, Ramon Brugada, Elena Arbelo, Josep Brugada, Philippe Mabo, Nathalie Behar, Carla Giustetto, Maria Sabater Molina, Juan R. Gimeno, Can Hasdemir, Peter J. Schwartz, Lia Crotti, Pascal P. McKeown, Sanjay Sharma, Elijah R. Behr, Michel Haissaguerre, Frederic Sacher, Caroline Rooryck, Hanno L. Tan, Carol A. Remme, Pieter G. Postema, Mario Delmar, Patrick T. Ellinor, Steven A. Lubitz, Jean-Baptiste Gourraud, Michael W. Tanck, Alfred L. George, Calum A. MacRae, Paul W. Burridge, Christian Dina, Vincent Probst, Arthur A. Wilde, Jean-Jacques Schott, Richard Redon, Connie R. Bezzina
Article
Genetics & Heredity
Julien Barc, Rafik Tadros, Charlotte Glinge, David Y. Chiang, Mariam Jouni, Floriane Simonet, Sean J. Jurgens, Manon Baudic, Michele Nicastro, Franck Potet, Joost A. Offerhaus, Roddy Walsh, Seung Hoan Choi, Arie O. Verkerk, Yuka Mizusawa, Soraya Anys, Damien Minois, Marine Arnaud, Josselin Duchateau, Yanushi D. Wijeyeratne, Alison Muir, Michael Papadakis, Silvia Castelletti, Margherita Torchio, Cristina Gil Ortuno, Javier Lacunza, Daniela F. Giachino, Natascia Cerrato, Raphael P. Martins, Oscar Campuzano, Sonia Van Dooren, Aurelie Thollet, Florence Kyndt, Andrea Mazzanti, Nicolas Clementy, Arnaud Bisson, Anniek Corveleyn, Birgit Stallmeyer, Sven Dittmann, Johan Saenen, Antoine Noel, Shohreh Honarbakhsh, Boris Rudic, Halim Marzak, Matthew K. Rowe, Claire Federspiel, Sophie Le Page, Leslie Placide, Antoine Milhem, Hector Barajas-Martinez, Britt-Maria Beckmann, Ingrid P. Krapels, Johannes Steinfurt, Bo Gregers Winkel, Reza Jabbari, Moore B. Shoemaker, Bas J. Boukens, Doris Skoric-Milosavljevic, Hennie Bikker, Federico C. Manevy, Peter Lichtner, Marta Ribases, Thomas Meitinger, Martina Muller-Nurasyid, Jan H. Veldink, Leonard H. van den Berg, Philip Van Damme, Daniele Cusi, Chiara Lanzani, Sidwell Rigade, Eric Charpentier, Estelle Baron, Stephanie Bonnaud, Simon Lecointe, Audrey Donnart, Herve Le Marec, Stephanie Chatel, Matilde Karakachoff, Stephane Bezieau, Barry London, Jacob Tfelt-Hansen, Dan Roden, Katja E. Odening, Marina Cerrone, Larry A. Chinitz, Paul G. Volders, Maarten P. van de Berg, Gabriel Laurent, Laurence Faivre, Charles Antzelevitch, Stefan Kaab, Alain Al Arnaout, Jean-Marc Dupuis, Jean-Luc Pasquie, Olivier Billon, Jason D. Roberts, Laurence Jesel, Martin Borggrefe, Pier D. Lambiase, Jacques Mansourati, Bart Loeys, Antoine Leenhardt, Pascale Guicheney, Philippe Maury, Eric Schulze-Bahr, Tomas Robyns, Jeroen Breckpot, Dominique Babuty, Silvia G. Priori, Carlo Napolitano, Carlo de Asmundis, Pedro Brugada, Ramon Brugada, Elena Arbelo, Josep Brugada, Philippe Mabo, Nathalie Behar, Carla Giustetto, Maria Sabater Molina, Juan R. Gimeno, Can Hasdemir, Peter J. Schwartz, Lia Crotti, Pascal P. McKeown, Sanjay Sharma, Elijah R. Behr, Michel Haissaguerre, Frederic Sacher, Caroline Rooryck, Hanno L. Tan, Carol A. Remme, Pieter G. Postema, Mario Delmar, Patrick T. Ellinor, Steven A. Lubitz, Jean-Baptiste Gourraud, Michael W. Tanck, Alfred L. George, Calum A. MacRae, Paul W. Burridge, Christian Dina, Vincent Probst, Arthur A. Wilde, Jean-Jacques Schott, Richard Redon, Connie R. Bezzina
Summary: This study identifies new susceptibility loci for Brugada syndrome through a genome-wide association meta-analysis. Functional studies suggest that microtubule-related trafficking effects on sodium channel expression may be an underlying molecular mechanism. These findings provide new insights into the genetic architecture and molecular underpinnings of Brugada syndrome.
Article
Biochemistry & Molecular Biology
Stephanie M. van der Voorn, Mimount Bourfiss, Steven A. Muller, Tolga Cimen, Ardan M. Saguner, Firat Duru, Anneline S. J. M. te Riele, Carol Ann Remme, Toon A. B. van Veen
Summary: Arrhythmogenic cardiomyopathy (ACM) is characterized by a fibro-(fatty) replacement of the myocardium. However, current cardiac imaging modalities have limitations in detecting fibrosis patterns. In this study, serum samples were collected from 45 ACM patients and the levels of PICP and ICTP were measured. The results showed that diagnosed patients had higher levels of PICP and PICP/ICTP compared to preclinical variant carriers, indicating an increased collagen deposition. Furthermore, negative correlations were found between PICP/ICTP ratio and right ventricular ejection fractions, as well as significant correlations with left ventricular function. These findings suggest that PICP/ICTP levels may serve as potential biomarkers for ACM.