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Research Article | DOI: https://doi.org/10.31579/2692-9759/183
1Department of Cardiology, China Aerospace Science and Industry Corporation 731 Hospital, Beijing, 100074, China.
2Department of Cardiology, Shenzhen Bao'an Disteict Songgang People's Hospital, Shenzhen 518105, China.
*Corresponding Author: Visfatin and 25-Hydroxy Vitamin D3 Levels Affect Coronary Collateral Circulation Development in Patients with Chronic Coronary Total Occlusion
Citation: Xiaoling Ji, Shuqi Jin, Yuxia Wang, Yumiao Chen, Jing Zhang, (2026), Visfatin and 25-Hydroxy Vitamin D3 Levels Affect Coronary Collateral Circulation Development in Patients with Chronic Coronary Total Occlusion, Cardiology Research and Reports, 8(1); DOI:10.31579/2692-9759/183
Copyright: © 2026, Xiaoling Ji. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 19 December 2025 | Accepted: 31 December 2025 | Published: 05 January 2026
Keywords: 25-hydroxyvitamin D3; coronary collateral circulation; chronic total occlusion
Background:
CCC plays a vital role in the myocardial blood supply, especially for ischaemic myocardium. Evidence suggests that the visfatin and 25-(OH)D3 levels are related to the degree and incidence of vascular stenosis associated with coronary artery disease. However, few studies have evaluated the effect of visfatin and 25-(OH)D3 on CCC development in CTO patients. This study aimed to evaluate the relationship between the serum visfatin level and 25-hydroxy vitamin D3 [25-(OH)D3] and coronary collateral circulation (CCC) in patients with chronic total occlusion (CTO).
Methods:
A total of 189 patients with CTO confirmed by coronary angiography were included. CCC was graded from 0 to 3 according to the Rentrop-Cohen classification. Patients with grade 0 or 1 collateral development were included in the poor CCC group (n=82), whereas patients with grade 2 or 3 collateral development were included in the good CCC group (n=107). The serum visfatin and 25-(OH)D3 levels were measured by ELISA.
Results:
The visfatin level was significantly higher in the poor CCC group than in the good CCC group, and the 25-(OH)D3 level was significantly lower in the poor CCC group than in the good CCC group (P≤0.001).
Correlation analysis showed that the Rentrop grade was negatively correlated with the visfatin level (r=-0.692, P≤0.001) but positively correlated with the 25-(OH)D3 level (r=0.635, P≤0.001). Logistic regression analysis showed that the visfatin and 25-(OH)D3 levels were independent risk factors for CCC (OR=1.597, 95% CI: 1.3-1.961, P≤0.001 and OR=0.566, 95% CI: 0.444-0.722, P≤0.001, respectively). The visfatin and 25-(OH)D3 levels can effectively predict the CCC status.
Conclusion: The serum visfatin and 25-(OH)D3 levels are related to CCC development and are independent predictors of poor CCC.
Coronary collateral circulation (CCC) is crucial and is related to the prognosis of patients with coronary artery disease (CAD). Well-developed coronary collaterals can restore blood flow to ischaemic areas of the myocardium and protect myocardial tissue at risk [1]. Studies have shown that well-developed collateral circulation can limit the area of myocardial infarction, reduce arrhythmia, protect cardiac function, reduce mortality, and ultimately improve the cardiovascular prognosis [2-4]. Currently, there is no noninvasive technology to evaluate collateral function [2,5]. Therefore, the identification of circulating biomarkers to assess the advantages and disadvantages of CCC and exploration of its internal mechanism have important clinical significance.
Visfatin is an adipocyte factor that is produced in large quantities in visceral adipose tissue [6] and is additionally expressed within the heart, liver, muscle, placenta, lung，kidney and bone marrow[7].It has also been reported that visfatin plays a direct role in arterial remodeling[8].Therefore, the connection between visfatin and CCC has become an area of interest, but research in this area is still lacking.
Vitamin D is a steroid hormone produced by irradiating the skin with ultraviolet rays of the sun.It performs biological functions by binding to vitamin D receptors (VDRs) that are widely present in human tissues. VDRs have been confirmed on the surface of cardiomyocytes,smooth muscle cell, and sendothelial cells,and control the proliferation and differentiation of these cells[9,10].
Current studies have shown that vitamin D in an independent manner to promote human umbilical vein endothelial cells (HUVECs) proliferation and migration [11].Additionally, increases in the number of myeloid cells (MCs) [12] and regulation of the VEGF [13] signal transduction pathway affect arteriogenesis and angiogenesis. Although evidence exists to support a positive regulatory role of vitamin D in both arteriogenesis and angiogenesis, few reports have examined its relationship with CCC in patients with chronic total occlusion (CTO).
In this study, we explored the relationship among the serum visfatin level, serum 25-(OH)D3 level and CCC status in CTO patients.
2.1 Patient population
189 cases of coronary angiography confirmed that at least one coronary artery with 100% diameter stenosis was collected in the Department of Cardiology from November 2018 to February 2019[100 men and 89 women; mean age: 62±8 years].Patients were divided into a good CCC group (n= 107, Rentrop grade 2 or 3) and a poor CCC group (n=82, Rentrop grade 0 or 1) according to the Rentrop-Cohen classification of CCC on coronary angiography.
The exclusion criteria included recent acute coronary syndrome (<3 months), coronary artery bypass operation, heart failure, cardiomyopathy, valvular heart disease, previous revascularization history, peripheral vascular disease, chronic obstructive pulmonary disease, chronic kidney or liver disease, previous diagnosis of malignancy, concomitant inflammatory disease, metabolic disease related to vitamin D, and the use of medications containing vitamin D preparations within the previous 3 months. Coronary heart disease risk factors such as hypertension, diabetes, hyperlipidaemia, body mass index (BMI) and smoking history were recorded for all patients.
The study was approved by the hospital ethics committee, and informed consent of each patient was obtained.
2.2 Coronary angiography
Coronary angiography was performed using the Judkins method through radial artery puncture. CCC was graded according to the Rentrop-Cohen classification, as follows [14]: grade 0, no obvious collateral vessels (opaque area, no contrast medium filling in the distal infarction); grade 1, collateral perfusion of the coronary artery that did not reach the coronary artery of the pericardium; grade 2, partial perfusion of the subepithelial segment by CCC; and grade 3, perfusion of the coronary epicardial segment by CCC.
2.3 Biochemical measurements
Fasting venous blood was drawn from the enrolled patients on the day of coronary angiography. Routine laboratory parameters, including the troponin I (TnI), creatinine, total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and calcium levels, were immediately determined. The blood samples collected for 25-(OH)D3 and visfatin measurements were snap frozen and stored at -70°C until analysis. The serum concentrations of 25-(OH)D3 and visfatin were measured by the ELISA method with a Roche 601 (BISL kit, UK).
2.4 Statistical analysis
Statistical analysis was performed using the SPSS 23.0 statistical package (IBM Corporation, New York, NY, USA).
Continuous variables are expressed as the mean ± SD or median and 25th and 75th percentiles [(M (P25, P75)], categorical variables are expressed as percentages, and the chi-square test was used to assess the rational distribution hypothesis of continuous variables. Differences between two groups of normally distributed continuous variables were compared with a T-test, and differences between non-normally distributed continuous variables were assessed using the Mann-Whitney U test. Categorical data were compared with the chi-square test, and Spearman’s correlation coefficient was used to assess the correlations between the serum 25-(OH)D3 and visfatin levels and the Rentrop grade. Binary logistic regression analysis was used to determine independent predictors of poor CCC development. A P value of 0.05 or less was considered to indicate statistical significance.
3.1 Baseline patient characteristics
The 189 patients included in the study were included in the good CCC group (good collaterals, 107 patients, Rentrop grade 2 or 3) or poor CCC group (poor collaterals, 82 patients, Rentrop grade 0 or 1).
The baseline characteristics of patients with good CCC group and poor CCC group are shown in Table 1. Both groups were similar in age, gender, BMI, smoking history, hypertension, cholesterol and calcium levels (P>0.05). However, the proportion of patients with diabetes was higher in the poor CCC group than in the good CCC group (52.4% vs. 33.6%, P≤0.001). Furthermore, the LDL-C, TnI, and creatinine levels were obviously higher in the poor CCC group than in the good CCC group, as shown in Table 1
| Variable | good(n=107) | Poor(n=82) | P |
| age （years） | 63（56，68） | 64（58，69） | 0.078 |
| Gender male n(%) | 55（51.4） | 45（54.9） | 0.064 |
| Hypertension n( %) | 57（53.3） | 54（65.9） | 0.082 |
| Diabetes n（%） | 36（33.6） | 43（52.4） | 0.009 |
| Smoking n（%） | 55（51.4） | 45（54.9） | 0.635 |
| BMI（kg/m2） | 26（25，29） | 26（26，29） | 0.204 |
| LDL-C (mmol/l) | 1.5(0.65,3.02 ) | 2.6(2.03,3.02) | ≤0.001 |
| TG(mmol/l) | 2.2（1.7，2.6） | 2.03（1.58，2.08） | 0.15 |
| TC(mmol/l) | 4.2（3.8，5.01） | 4.3（3.9，4.8） | 0.32 |
| TNI(ng/ml ) | 0.08(0.05,0.16) | 0.16(0.12,0.25) | ≤0.001 |
| Creatinine(mg/l) | 66（50，90） | 75（59，90） | 0.034 |
| 25（OH）D3 (ng/ml) | 32(29,35) | 25(21,28) | ≦0.001 |
| Calcium(mmol/l) | 2.06（2.02，2.1） | 2.06（2.03，2.1） | 0.182 |
| Visfatin(ng/ml) | 10.3(9.2,12.8) | 17.4(14.2,21.13) | ≤0.001 |
| Rentrop score (n) | |||
| 0 | 18 | ||
| 1 | 64 | ||
| 2 | 64 | ||
| 3 | 43 |
Table 1: Demographic properties and biochemical parameters of the good CCC group and the poor CCC group.
CCC, coronary collateral circulation; BMI, Body mass index；TnI:Troponin I;TC , Total cholesterol; TG, triglycerides; LDL-c, low-density lipoprotein cholesterol.
3.2 Serum visfatin and 25-(OH)D3 levels in each patient group
The serum visfatin level was significantly higher in the poor CCC group than in the good CCC group (P≤0.001). The serum 25-(OH)D3 level was significantly lower in the poor CCC group than in the good CCC group (P≤0.001), as shown in Figure 1-2.
3.3 Relationship among the serum visfatin and 25-(OH)D3 levels and the Rentrop grade
Spearman correlation analysis showed a significant negative correlation between the visfatin level and the Rentrop grade (r=-0.692, P≤0.001) (Figure 3). A significant positive correlation was observed between the 25-(OH)D3 level and the Rentrop grade (r=0.689, P≤0.001) (Figure 4). Furthermore, an L-shaped relationship was observed between the 25-(OH)D3 and visfatin levels (Figure 5).
3.4 Binary logistic regression analysis:
Binary logistic regression was performed between CCC development and 25-(OH) D3, visfatin, LDL-C and other factors. CCC development was used as the dependent variable, and all univariate analyses with P values less than
0.1 were included in the logistic regression equation as independent variables. Stepwise regression was used for multivariate analysis. The serum 25-(OH)D3, visfatin, and LDL-C levels and diabetes were independent risk factors for poor CCC development (Figure 6).
The present study revealed the following findings. (1) The visfatin level was significantly higher in CTO patients in the poor CCC group than in those in the good CCC group, and a positive correlation was observed between a high visfatin level and poorly developed CCC. A high visfatin level was an independent predictor of poor CCC in patients with CTO. (2) The 25-(OH)D3 level was significantly lower in CTO patients in the poor CCC group than in patients in the good CCC group. A low serum 25-(OH)D3 level was positively correlated with poorly developed CCC in CTO patients. It is worth noting that a low serum 25-(OH)D3 level was an independent predictor of poorly developed CCC in CTO patients. (3) An L-shaped relationship was observed between the serum 25-(OH)D3 and visfatin levels. (4) A high LDL-C level and a history of diabetes also contributed to poor CCC development in CTO patients.
Coronary collateral growth is thought to develop by the expansion of a pre-existing collateral network and the formation of new blood vessels [15,16]. Recent studies have found that the main factor affecting the development of coronary collateral vessels is the pressure gradient between segments located at the proximal and distal ends of the occlusion [17,18]. VEGF, EPCs, FGF, transforming growth factors (TGF-β), and nitric oxide (NO)-activated biological substances also play significant roles in both angiogenesis and arteriogenesis [19].
Visfatin is a known proinflammatory cytokine that plays an important role in many chronic inflammatory diseases, including atherosclerosis and cardiovascular diseases.As a cytokine, visfatin can regulate the expression of key regulators of vascular remodelling, such as vascular endothelial growth factor (VEGF) [20], fibroblast growth factor 2 (FGF-2) [21] and matrix metalloproteinases (MMPs) [22].Recent studies shows that visfatin promotes angiogenesis through a VEGF-dependent mechanism in endothelial progenitor cells (EPCs) [23].Auguet et al. found that visfatin was highly expressed in unstable carotid plaques and coronary atherosclerotic plaques of lipomacrophages[24].In addition, it has recently been reported that extracellular visfatin is directly involved in vascular remodeling[8].However,the relationship between visfatin and coronary collateral circulation is still unclear.
This study reports, for the first time, the relationship between visfatin and CCC in CTO patents. The visfatin level was significantly higher in CTO patients in the poor CCC group than in patients in the good CCC group, which may be related to the following mechanisms: (1) Visfatin induces LOX-1 expression in vascular endothelial cells, which causes inflammation, leads to endothelial cell damage and dysfunction, and promotes the vicious cycle of atherosclerosis [25]. (2) Visfatin activates ERK 1/2 and NF-κB, resulting in increased inducible nitric oxide synthase (iNOS) production [26]. iNOS is a proinflammatory enzyme that can cause an imbalance in NO production, induce endothelial dysfunction, and ultimately lead to impaired angiogenesis. Therefore, the inflammatory effect of visfatin promotes endothelial dysfunction, which may result in poor CCC development. Visfatin also has a two-way regulatory effect in metabolic diseases. Further research is needed to understand the impact of visfatin in different situations and clinical conditions related to cardiovascular disease.
Recent studies have shown that vitamin D can regulate the growth of endothelial cells and smooth muscle[27].Even vitamin D deficiency is positively correlated with the degree of coronary vascular stenosis [28]. Vitamin D is also closely related to the degree of vascular endothelial dysfunction in patients with coronary heart disease [29]. However, the relationship between vitamin D and collateral circulation and the underlying mechanism are largely unclear.
In our study, the 25-(OH)D3 level was significantly higher in the good CCC group than in the poor CCC group. This is consistent with the research results reported by Dogan Y [30]. The following points may provide a reasonable explanation for the poor CCC development caused by vitamin D deficiency: (1) vitamin D promotes the adhesion of white blood cells, increases VEGF-A expression, and promotes the growth and migration of vascular smooth muscle cells [31,32]; therefore, vitamin D deficiency can lead to impaired CCC development; (2) vitamin D activates and induces NO production, mediates the VEGF signalling pathway, and stimulates the growth of coronary collaterals [33,34], leading to poor CCC development. Cianciolo et al. [35] confirmed that VDRs are also present on circulating EPCs. Vitamin D deficiency can not only reduce the number of circulating EPCs but also decrease their ability to proliferate and form blood vessels, leading to impaired CCC development.
Our study is also the first to show an L-shaped relationship between 25(OH)D3 and visfatin. In the absence of 25(OH)D3, when the visfatin level was less than 30 nmol/L, a negative correlation was observed between 25(OH)D3 and visfatin. However, when the 25(OH)D3 level was greater than 30 nmol/L, the visfatin level did not continue to decrease with increasing 25(OH)D3; in contrast, the level remained constant. This phenomenon may suggest that supplementation with vitamin D to the normal range will not lead to further declines in endolipids in patients with vitamin D deficiency. This may also provide another possible explanation for the recent results reported by Heike et al. [36], indicating an absence of cardiovascular benefits from vitamin supplementation (it is worth noting that in the intervention and control groups, the plasma 25(OH)D3 levels at baseline and 12 months after the intervention were higher than 50 nmol/L).
Our study found that the serum LDL-C level was significantly higher in the poor CCC group than in the good CCC group. Moreover, the 25-(OH)D3 level was negatively correlated with the LDL-C level, which is similar to the results reported by Song et al. [37].
High levels of LDL-C are a definite risk factor for coronary arteries, which can induce endothelial cell dysfunction and impair the growth of coronary collateral vessels[38,39].
In our study, the frequency of diabetes was significantly higher in the poor CCC group (52.4%) than in the good CCC group (33.6%), and diabetic patients had lower vitamin D levels than nondiabetic patients. Nisanci et al. [40] also found insufficient opening of the collateral circulation in diabetic patients by measuring the coronary wedge pressure. Studies have found that due to the severely impaired function of vascular endothelial cells in diabetic patients, the abilities of these cells for proliferation, adhesion, integration and eventually angiogenesis are significantly reduced [41].
In conclusion, visfatin and vitamin D seem to play important roles in the regulation of key mechanisms involved in CCC development.
Seasonal changes in vitamin D levels and sun exposure may affect the results of the study, so we recruited patients from November to February to minimize inter-individual variability. In addition, physical exercise is also one of the factors that affect the level of vitamin D and the development of collateral circulation. Although the patients we selected indicated that they did not participate in regular physical exercise, this could not completely eliminate the impact on the results of the study. This is the shortcoming of this study.
Our study shows that CTO patients with poor CCC development have lower serum 25-(OH)D3 and higher serum visfatin levels than CTO patients with good CCC development. Low serum 25-(OH)D3 and high serum visfatin levels are independent predictors of poor collateral circulation in CTO patients.
The analyzed data sets generated during the study are available from the corresponding author on reasonable request.
Ethics approval and consent to participate
The ethics committee of China Aerospace Science and Industry Corporation 731 Hospital approved the present study, and all participants provided their written, informed consent.
Conflicts of interest
The authors declare that there is no conflict of interest regarding the publication of this paper.
Acknowledgements
Part of the data was presented as a peer exchange, at the 29th Great Wall International Congress of Cardiology.
Funding
This study was supported by the Science Foundation of AMHT (2018-LCYL-009) and the Medical and health research project of China aerospace science and industry corporation LTD (KYLX-56).
Authors' contributions
X.-L. Ji wrote the manuscript. X.-L. Ji designs and performs experiments, analyzes data, interprets data. X.-L. Ji and S.-Q. Jin drafts experiments. Y.-X. Wang,Y.-M. Chen and J.-Zhang were responsible for ELISA and recorded date. All authors approved the manuscript.
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Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.
Dear Agrippa Hilda- Editorial Coordinator of Journal of Neuroscience and Neurological Surgery, "The peer review process was very quick and of high quality, which can also be seen in the articles in the journal. The collaboration with the editorial office was very good."
I would like to express my sincere gratitude for the support and efficiency provided by the editorial office throughout the publication process of my article, “Delayed Vulvar Metastases from Rectal Carcinoma: A Case Report.” I greatly appreciate the assistance and guidance I received from your team, which made the entire process smooth and efficient. The peer review process was thorough and constructive, contributing to the overall quality of the final article. I am very grateful for the high level of professionalism and commitment shown by the editorial staff, and I look forward to maintaining a long-term collaboration with the International Journal of Clinical Case Reports and Reviews.
To Dear Erin Aust, I would like to express my heartfelt appreciation for the opportunity to have my work published in this esteemed journal. The entire publication process was smooth and well-organized, and I am extremely satisfied with the final result. The Editorial Team demonstrated the utmost professionalism, providing prompt and insightful feedback throughout the review process. Their clear communication and constructive suggestions were invaluable in enhancing my manuscript, and their meticulous attention to detail and dedication to quality are truly commendable. Additionally, the support from the Editorial Office was exceptional. From the initial submission to the final publication, I was guided through every step of the process with great care and professionalism. The team's responsiveness and assistance made the entire experience both easy and stress-free. I am also deeply impressed by the quality and reputation of the journal. It is an honor to have my research featured in such a respected publication, and I am confident that it will make a meaningful contribution to the field.
"I am grateful for the opportunity of contributing to [International Journal of Clinical Case Reports and Reviews] and for the rigorous review process that enhances the quality of research published in your esteemed journal. I sincerely appreciate the time and effort of your team who have dedicatedly helped me in improvising changes and modifying my manuscript. The insightful comments and constructive feedback provided have been invaluable in refining and strengthening my work".
I thank the ‘Journal of Clinical Research and Reports’ for accepting this article for publication. This is a rigorously peer reviewed journal which is on all major global scientific data bases. I note the review process was prompt, thorough and professionally critical. It gave us an insight into a number of important scientific/statistical issues. The review prompted us to review the relevant literature again and look at the limitations of the study. The peer reviewers were open, clear in the instructions and the editorial team was very prompt in their communication. This journal certainly publishes quality research articles. I would recommend the journal for any future publications.
Dear Jessica Magne, with gratitude for the joint work. Fast process of receiving and processing the submitted scientific materials in “Clinical Cardiology and Cardiovascular Interventions”. High level of competence of the editors with clear and correct recommendations and ideas for enriching the article.
We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.
My article, titled 'No Way Out of the Smartphone Epidemic Without Considering the Insights of Brain Research,' has been republished in the International Journal of Clinical Case Reports and Reviews. The review process was seamless and professional, with the editors being both friendly and supportive. I am deeply grateful for their efforts.
To Dear Erin Aust – Editorial Coordinator of Journal of General Medicine and Clinical Practice! I declare that I am absolutely satisfied with your work carried out with great competence in following the manuscript during the various stages from its receipt, during the revision process to the final acceptance for publication. Thank Prof. Elvira Farina
Dear Jessica, and the super professional team of the ‘Clinical Cardiology and Cardiovascular Interventions’ I am sincerely grateful to the coordinated work of the journal team for the no problem with the submission of my manuscript: “Cardiometabolic Disorders in A Pregnant Woman with Severe Preeclampsia on the Background of Morbid Obesity (Case Report).” The review process by 5 experts was fast, and the comments were professional, which made it more specific and academic, and the process of publication and presentation of the article was excellent. I recommend that my colleagues publish articles in this journal, and I am interested in further scientific cooperation. Sincerely and best wishes, Dr. Oleg Golyanovskiy.
Dear Ashley Rosa, Editorial Coordinator of the journal - Psychology and Mental Health Care. " The process of obtaining publication of my article in the Psychology and Mental Health Journal was positive in all areas. The peer review process resulted in a number of valuable comments, the editorial process was collaborative and timely, and the quality of this journal has been quickly noticed, resulting in alternative journals contacting me to publish with them." Warm regards, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. I appreciate the journal (JCCI) editorial office support, the entire team leads were always ready to help, not only on technical front but also on thorough process. Also, I should thank dear reviewers’ attention to detail and creative approach to teach me and bring new insights by their comments. Surely, more discussions and introduction of other hemodynamic devices would provide better prevention and management of shock states. Your efforts and dedication in presenting educational materials in this journal are commendable. Best wishes from, Farahnaz Fallahian.
Dear Maria Emerson, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. I am delighted to have published our manuscript, "Acute Colonic Pseudo-Obstruction (ACPO): A rare but serious complication following caesarean section." I want to thank the editorial team, especially Maria Emerson, for their prompt review of the manuscript, quick responses to queries, and overall support. Yours sincerely Dr. Victor Olagundoye.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. Many thanks for publishing this manuscript after I lost confidence the editors were most helpful, more than other journals Best wishes from, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Agrippa Hilda, Editorial Coordinator, Journal of Neuroscience and Neurological Surgery. The entire process including article submission, review, revision, and publication was extremely easy. The journal editor was prompt and helpful, and the reviewers contributed to the quality of the paper. Thank you so much! Eric Nussbaum, MD
Dr Hala Al Shaikh This is to acknowledge that the peer review process for the article ’ A Novel Gnrh1 Gene Mutation in Four Omani Male Siblings, Presentation and Management ’ sent to the International Journal of Clinical Case Reports and Reviews was quick and smooth. The editorial office was prompt with easy communication.
Dear Erin Aust, Editorial Coordinator, Journal of General Medicine and Clinical Practice. We are pleased to share our experience with the “Journal of General Medicine and Clinical Practice”, following the successful publication of our article. The peer review process was thorough and constructive, helping to improve the clarity and quality of the manuscript. We are especially thankful to Ms. Erin Aust, the Editorial Coordinator, for her prompt communication and continuous support throughout the process. Her professionalism ensured a smooth and efficient publication experience. The journal upholds high editorial standards, and we highly recommend it to fellow researchers seeking a credible platform for their work. Best wishes By, Dr. Rakhi Mishra.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. The peer review process of the journal of Clinical Cardiology and Cardiovascular Interventions was excellent and fast, as was the support of the editorial office and the quality of the journal. Kind regards Walter F. Riesen Prof. Dr. Dr. h.c. Walter F. Riesen.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. Thank you for publishing our article, Exploring Clozapine's Efficacy in Managing Aggression: A Multiple Single-Case Study in Forensic Psychiatry in the international journal of clinical case reports and reviews. We found the peer review process very professional and efficient. The comments were constructive, and the whole process was efficient. On behalf of the co-authors, I would like to thank you for publishing this article. With regards, Dr. Jelle R. Lettinga.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, I would like to express my deep admiration for the exceptional professionalism demonstrated by your journal. I am thoroughly impressed by the speed of the editorial process, the substantive and insightful reviews, and the meticulous preparation of the manuscript for publication. Additionally, I greatly appreciate the courteous and immediate responses from your editorial office to all my inquiries. Best Regards, Dariusz Ziora
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation, Auctores Publishing LLC, We would like to thank the editorial team for the smooth and high-quality communication leading up to the publication of our article in the Journal of Neurodegeneration and Neurorehabilitation. The reviewers have extensive knowledge in the field, and their relevant questions helped to add value to our publication. Kind regards, Dr. Ravi Shrivastava.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, Auctores Publishing LLC, USA Office: +1-(302)-520-2644. I would like to express my sincere appreciation for the efficient and professional handling of my case report by the ‘Journal of Clinical Case Reports and Studies’. The peer review process was not only fast but also highly constructive—the reviewers’ comments were clear, relevant, and greatly helped me improve the quality and clarity of my manuscript. I also received excellent support from the editorial office throughout the process. Communication was smooth and timely, and I felt well guided at every stage, from submission to publication. The overall quality and rigor of the journal are truly commendable. I am pleased to have published my work with Journal of Clinical Case Reports and Studies, and I look forward to future opportunities for collaboration. Sincerely, Aline Tollet, UCLouvain.
Dear Ms. Mayra Duenas, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. “The International Journal of Clinical Case Reports and Reviews represented the “ideal house” to share with the research community a first experience with the use of the Simeox device for speech rehabilitation. High scientific reputation and attractive website communication were first determinants for the selection of this Journal, and the following submission process exceeded expectations: fast but highly professional peer review, great support by the editorial office, elegant graphic layout. Exactly what a dynamic research team - also composed by allied professionals - needs!" From, Chiara Beccaluva, PT - Italy.
Dear Maria Emerson, Editorial Coordinator, we have deeply appreciated the professionalism demonstrated by the International Journal of Clinical Case Reports and Reviews. The reviewers have extensive knowledge of our field and have been very efficient and fast in supporting the process. I am really looking forward to further collaboration. Thanks. Best regards, Dr. Claudio Ligresti
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation. “The peer review process was efficient and constructive, and the editorial office provided excellent communication and support throughout. The journal ensures scientific rigor and high editorial standards, while also offering a smooth and timely publication process. We sincerely appreciate the work of the editorial team in facilitating the dissemination of innovative approaches such as the Bonori Method.” Best regards, Dr. Matteo Bonori.
I recommend without hesitation submitting relevant papers on medical decision making to the International Journal of Clinical Case Reports and Reviews. I am very grateful to the editorial staff. Maria Emerson was a pleasure to communicate with. The time from submission to publication was an extremely short 3 weeks. The editorial staff submitted the paper to three reviewers. Two of the reviewers commented positively on the value of publishing the paper. The editorial staff quickly recognized the third reviewer’s comments as an unjust attempt to reject the paper. I revised the paper as recommended by the first two reviewers.
Dear Maria Emerson, Editorial Coordinator, Journal of Clinical Research and Reports. Thank you for publishing our case report: "Clinical Case of Effective Fetal Stem Cells Treatment in a Patient with Autism Spectrum Disorder" within the "Journal of Clinical Research and Reports" being submitted by the team of EmCell doctors from Kyiv, Ukraine. We much appreciate a professional and transparent peer-review process from Auctores. All research Doctors are so grateful to your Editorial Office and Auctores Publishing support! I amiably wish our article publication maintained a top quality of your International Scientific Journal. My best wishes for a prosperity of the Journal of Clinical Research and Reports. Hope our scientific relationship and cooperation will remain long lasting. Thank you very much indeed. Kind regards, Dr. Andriy Sinelnyk Cell Therapy Center EmCell
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. It was truly a rewarding experience to work with the journal “Clinical Cardiology and Cardiovascular Interventions”. The peer review process was insightful and encouraging, helping us refine our work to a higher standard. The editorial office offered exceptional support with prompt and thoughtful communication. I highly value the journal’s role in promoting scientific advancement and am honored to be part of it. Best regards, Meng-Jou Lee, MD, Department of Anesthesiology, National Taiwan University Hospital.
Dear Editorial Team, Journal-Clinical Cardiology and Cardiovascular Interventions, “Publishing my article with Clinical Cardiology and Cardiovascular Interventions has been a highly positive experience. The peer-review process was rigorous yet supportive, offering valuable feedback that strengthened my work. The editorial team demonstrated exceptional professionalism, prompt communication, and a genuine commitment to maintaining the highest scientific standards. I am very pleased with the publication quality and proud to be associated with such a reputable journal.” Warm regards, Dr. Mahmoud Kamal Moustafa Ahmed
Dear Maria Emerson, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews’, I appreciate the opportunity to publish my article with your journal. The editorial office provided clear communication during the submission and review process, and I found the overall experience professional and constructive. Best regards, Elena Salvatore.
Dear Mayra Duenas, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews Herewith I confirm an optimal peer review process and a great support of the editorial office of the present journal
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. I am really grateful for the peers review; their feedback gave me the opportunity to reflect on the message and impact of my work and to ameliorate the article. The editors did a great job in addition by encouraging me to continue with the process of publishing.
Dear Cecilia Lilly, Editorial Coordinator, Endocrinology and Disorders, Thank you so much for your quick response regarding reviewing and all process till publishing our manuscript entitled: Prevalence of Pre-Diabetes and its Associated Risk Factors Among Nile College Students, Sudan. Best regards, Dr Mamoun Magzoub.
International Journal of Clinical Case Reports and Reviews is a high quality journal that has a clear and concise submission process. The peer review process was comprehensive and constructive. Support from the editorial office was excellent, since the administrative staff were responsive. The journal provides a fast and timely publication timeline.
Dear Maria Emerson, Editorial Coordinator of International Journal of Clinical Case Reports and Reviews, What distinguishes International Journal of Clinical Case Report and Review is not only the scientific rigor of its publications, but the intellectual climate in which research is evaluated. The submission process is refreshingly free of unnecessary formal barriers and bureaucratic rituals that often complicate academic publishing without adding real value. The peer-review system is demanding yet constructive, guided by genuine scientific dialogue rather than hierarchical or authoritarian attitudes. Reviewers act as collaborators in improving the manuscript, not as gatekeepers imposing arbitrary standards. This journal offers a rare balance: high methodological standards combined with a respectful, transparent, and supportive editorial approach. In an era where publishing can feel more burdensome than research itself, this platform restores the original purpose of peer review — to refine ideas, not to obstruct them Prof. Perlat Kapisyzi, FCCP PULMONOLOGIST AND THORACIC IMAGING.
Dear Grace Pierce, International Journal of Clinical Case Reports and Reviews I appreciate the opportunity to review for Auctore Journal, as the overall editorial process was smooth, transparent and professionally managed. This journal maintains high scientific standards and ensures timely communications with authors, which is truly commendable. I would like to express my special thanks to editor Grace Pierce for his constant guidance, promt responses, and supportive coordination throughout the review process. I am also greatful to Eleanor Bailey from the finance department for her clear communication and efficient handling of all administrative matters. Overall, my experience with Auctore Journal has been highly positive and rewarding. Best regards, Sabita sinha
Dear Mayra Duenas, Editorial Coordinator of the journal IJCCR, I write here a little on my experience as an author submitting to the International Journal of Clinical Case Reports and Reviews (IJCCR). This was my first submission to IJCCR and my manuscript was inherently an outsider’s effort. It attempted to broadly identify and then make some sense of life’s under-appreciated mysteries. I initially had responded to a request for possible submissions. I then contacted IJCCR with a tentative topic for a manuscript. They quickly got back with an approval for the submission, but with a particular requirement that it be medically relevant. I then put together a manuscript and submitted it. After the usual back-and-forth over forms and formality, the manuscript was sent off for reviews. Within 2 weeks I got back 4 reviews which were both helpful and also surprising. Surprising in that the topic was somewhat foreign to medical literature. My subsequent updates in response to the reviewer comments went smoothly and in short order I had a series of proofs to evaluate. All in all, the whole publication process seemed outstanding. It was both helpful in terms of the paper’s content and also in terms of its efficient and friendly communications. Thank you all very much. Sincerely, Ted Christopher, Rochester, NY.
