{ "abstract": "Background: Cardiovascular hemodynamic stress may be associated with alterations in the circulating ionome. We investigated whether a hypothesis-driven multielement composite, the congestion-associated ionomic dysregulation score (CIDS; higher copper and strontium and lower rubidium and iron), was associated with N-terminal pro-B-type natriuretic peptide (NT-proBNP) and cardiorenal–hematologic burden. Methods: This retrospective, single-center, cross-sectional study included 192 patients undergoing cardiovascular evaluation or treatment. Serum trace elements were quantified by inductively coupled plasma mass spectrometry, and CIDS was calculated from standardized element concentrations. Results: Higher CIDS was associated with higher NT-proBNP (ρ = 0.416, FDR-adjusted p < 0.001), worse New York Heart Association (NYHA) functional status (ρ = 0.370, p < 0.001), lower hemoglobin (ρ = −0.287, p < 0.001), lower eGFR (ρ = −0.191, p = 0.012), and higher uric acid (ρ = 0.241, p = 0.002). In the common complete-case sample, each 1-SD increase in CIDS was associated with higher log-transformed NT-proBNP after multivariable adjustment (β = 0.276, 95% CI 0.077–0.475; HC3-robust p = 0.007), and model R2 increased from 0.368 to 0.407. The observed ΔR2 exceeded the median from randomly weighted composites but did not clearly exceed the permutation null distribution (empirical p = 0.063). The referral-stratified estimates differed in magnitude (β = 0.179 versus 0.569), without a significant interaction (p = 0.171). Conclusions: CIDS was associated with myocardial stress and cardiorenal–hematologic burden in this cohort, but the single-center, cross-sectional findings do not establish causality, unique superiority over alternative composites, or external biomarker validity. Because CIDS was standardized internally within this cohort, no externally applicable reference values or clinical cutoffs can currently be defined.", "abstract_shown": true, "affiliations": [ "College of Medicine, Korea University, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Republic of Korea", "College of Medicine, Inje University, 75 Bokji-ro, Busanjin-gu, Busan 47392, Republic of Korea", "Department of Precision Medicine in Medical, Surgical and Critical Area (Me.Pre.C.C.), University of Palermo, 90134 Palermo, Italy", "Department of Research, IRCCS ISMETT, 90127 Palermo, Italy", "Thoracic Research Center, Collegium Medicum, Nicolaus Copernicus University, 85-067 Bydgoszcz, Poland", "Department of Cardiac Surgery, Center of Postgraduate Medical Education, Central Clinical Hospital of the Ministry of Interior, 02-507 Warszawa, Poland", "Department of Hypertensiology, Angiology, and Internal Medicine, Poznan University of Medical Sciences, ½ Dluga Street, 61-848 Poznan, Poland", "Department of Vascular, Endovascular Surgery, Angiology and Phlebology, Poznan University of Medical Sciences, ½ Dluga Street, 61-848 Poznan, Poland", "Department of Trace Analysis, Faculty of Chemistry, Adam Mickiewicz University, 61-614 Poznan, Poland", "Cardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, ½ Długa, 61-848 Poznan, Poland" ], "article_type": "research article", "arxiv": null, "author_total": 17, "authors": [ { "affs": [ 0 ], "name": "Minseung Kang", "orcid": "0009-0001-6144-5543" }, { "affs": [ 1 ], "name": "Siwon Baek", "orcid": "0009-0004-9239-7822" }, { "affs": [ 2, 3 ], "name": "Giuseppe Maria Raffa", "orcid": "0000-0001-7141-2561" }, { "affs": [ 2, 3 ], "name": "Calogera Pisano", "orcid": "0000-0002-6488-1965" }, { "affs": [ 3 ], "name": "Vincenzo Nuzzi" }, { "affs": [ 2, 4, 5 ], "name": "Mariusz Kowalewski", "orcid": "0000-0002-5478-3245" }, { "affs": [ 6 ], "name": "Beata Krasińska", "orcid": "0000-0002-3464-1645" }, { "affs": [ 5 ], "name": "Piotr Suwalski" }, { "affs": [ 6 ], "name": "Yvgen Spasenenko" }, { "affs": [ 2 ], "name": "Antonio Segreto" }, { "affs": [ 6 ], "name": "Katarzyna Gabriel" }, { "affs": [ 6 ], "name": "Andrzej Tykarski" }, { "affs": [ 7 ], "name": "Zbigniew Krasiński", "orcid": "0000-0002-2798-1959" }, { "affs": [ 8 ], "name": "Julia Frąckowiak", "orcid": "0009-0001-8858-3188" }, { "affs": [ 9 ], "name": "Marek Jemielity", "orcid": "0000-0003-2442-4644" }, { "affs": [ 2, 4, 9 ], "name": "Tomasz Urbanowicz", "orcid": "0000-0001-8080-2764" }, { "affs": [ 8 ], "name": "Anetta Hanć", "orcid": "0000-0001-7524-2897" } ], "bibtex": "https://research.draconitic.com/paper/cqdt4yst3sxn7.bib", "cited_by": 0, "doi": "10.3390/molecules31203588", "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13707558/?tool=EBI", "id": "cqdt4yst3sxn7", "issns": [ "1420-3049" ], "landing_url": "https://www.mdpi.com/1420-3049/31/20/3588", "language": "eng", "licence": "CC-BY-4.0", "licence_label": "CC BY 4.0", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "openalex", "2916|Trace Elements in Health" ] ], "openalex": "W7221105433", "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13707558/pdf/?tool=EBI", "pmcid": "PMC13707558", "pmid": null, "published": "2026-10-01", "publisher": "MDPI AG", "ris": "https://research.draconitic.com/paper/cqdt4yst3sxn7.ris", "sources": [ { "first_seen": "2026-10-30T12:18:42Z", "native_id": "10.3390/molecules31203588", "source": "crossref", "url": "https://www.mdpi.com/1420-3049/31/20/3588" }, { "first_seen": "2026-10-30T12:21:46Z", "native_id": "PMC:PMC13707558", "source": "europepmc", "url": "https://europepmc.org/article/PMC/PMC13707558" } ], "subjects": [ { "field": "chemistry", "origin": "issn:1420-3049", "subfield": "general" } ], "title": "A Multielement Ionomic Dysregulation Pattern Is Associated with NT-proBNP and Cardiorenal Burden in Patients with Cardiovascular Disease", "title_text": "A Multielement Ionomic Dysregulation Pattern Is Associated with NT-proBNP and Cardiorenal Burden in Patients with Cardiovascular Disease", "type": "peer-reviewed", "updated_at": "2026-10-30T12:21:46Z", "url": "https://research.draconitic.com/paper/cqdt4yst3sxn7", "venue": "Molecules", "versions": [] }