Frontiers in Cardiovascular Medicine最新文献

{"title":"Inflammation and lipid-related determinants in coronary atherosclerosis: mechanisms, biomarkers, and therapeutic implications.","authors":"Fubo Zhang, Qingchi Liao","doi":"10.3389/fcvm.2026.1790509","DOIUrl":"https://doi.org/10.3389/fcvm.2026.1790509","url":null,"abstract":"<p><p>Coronary atherosclerosis is increasingly recognized as a chronic, maladaptive inflammatory disease initiated by arterial retention of apolipoprotein B (apoB)-containing lipoproteins and amplified by innate and adaptive immune responses. Although low-density lipoprotein cholesterol (LDL-C) remains a central causal factor, substantial residual risk persists despite intensive LDL-C lowering, emphasizing the clinical relevance of residual inflammatory risk and additional atherogenic lipid metrics such as apolipoprotein B (apoB), remnant cholesterol, small dense LDL, and lipoprotein(a) [Lp(a)]. Landmark outcome trials validate both paradigms: potent lipid-lowering therapies reduce major adverse cardiovascular events, and targeted anti-inflammatory therapies such as IL-1β inhibition and low-dose colchicine reduce recurrent events without altering LDL-C, establishing inflammation as a modifiable driver of coronary risk. This review integrates mechanistic evidence linking lipids and inflammation across the atherosclerotic continuum-from endothelial activation and leukocyte recruitment to plaque destabilization and thrombosis-while critically appraising biomarkers, imaging approaches, and therapeutic strategies. We propose a practical dual-axis framework integrating residual cholesterol and inflammatory risks to guide combined therapy and highlight future directions including genetics-informed lipid management [notably Lp(a)], inflammation-resolution biology, and precision targeting of upstream inflammatory pathways such as IL-6 signaling.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"13 ","pages":"1790509"},"PeriodicalIF":2.8,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intracoronary nicorandil improves coronary microcirculatory function after primary PCI in first-episode STEMI: an angiography-derived evaluation using AMR and QFR.","authors":"Qing Yu, Jie Lin, Jiashi Ding, Feifei Ye, Peng Li, Shikun Chen, Yiling Zhan, Wenqin Cai, Jiaqi Ou","doi":"10.3389/fcvm.2026.1786130","DOIUrl":"https://doi.org/10.3389/fcvm.2026.1786130","url":null,"abstract":"<p><strong>Background: </strong>Microvascular dysfunction remains a major driver of adverse outcomes after ST-segment elevation myocardial infarction (STEMI) despite successful restoration of epicardial patency by primary percutaneous coronary intervention (PCI). Nicorandil has nitrate-like vasodilatory properties and ATP-dependent potassium channel (KATP)-opening properties, effects that may improve reperfusion physiology. However, its effects on wire-free, angiography-derived measures of microvascular function are not well defined. We evaluated whether intracoronary nicorandil administered during primary PCI improves angiography-derived microvascular function assessed by angiographic microcirculatory resistance (AMR) and quantitative flow ratio (QFR).</p><p><strong>Methods: </strong>In this prospective, single-center randomized trial, 63 patients with first-episode STEMI undergoing primary PCI were allocated 1:1 to intracoronary nicorandil (2 mg after guidewire crossing; <i>n</i> = 32) or control (standard PCI; <i>n</i> = 31). The prespecified primary endpoint was final post-PCI AMR. QFR-derived indices, reperfusion measures [Thrombolysis in Myocardial Infarction (TIMI) flow grade, no-reflow, ST-segment resolution], hemodynamics, biomarkers, and clinical events were analyzed as secondary/exploratory outcomes, with multiplicity controlled using the Benjamini-Hochberg false discovery rate (FDR) where applicable.</p><p><strong>Results: </strong>Baseline characteristics were balanced between groups. Compared with control, intracoronary nicorandil was associated with a higher rate of post-PCI TIMI grade 3 flow (96.9% vs. 74.2%; overall <i>P</i> = 0.013). Final AMR was significantly lower in the nicorandil group (1.4 ± 0.5 vs. 2.7 ± 0.5; <i>P</i> < 0.001). Vessel QFR and change in QFR (<i>Δ</i>QFR) also favored nicorandil (both <i>P</i> < 0.001), whereas residual QFR showed only a borderline/non-significant difference after FDR correction (raw <i>P</i> = 0.027; q = 0.051). Peak creatine kinase-MB (CK-MB) and cardiac troponin I (cTnI) were numerically lower with nicorandil but not statistically different; left ventricular ejection fraction (LVEF) at 1 week was similar between groups. Rates of intra-procedural hypotension, in-hospital major adverse cardiovascular events (MACE), and MACE at 3-month follow-up did not differ.</p><p><strong>Conclusions: </strong>In this pilot randomized study, intracoronary nicorandil administered during primary PCI was associated with improved angiography-derived surrogate indices of microvascular resistance and epicardial physiology without an observed increase in peri-procedural hemodynamic instability or short-term adverse events. These findings should be interpreted as exploratory and warrant confirmation in larger multicenter studies with longer follow-up and outcome-linked validation.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"13 ","pages":"1786130"},"PeriodicalIF":2.8,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally invasive treatment strategy for severe congenital pulmonary valve insufficiency and pulmonary artery aneurysmal dilatation: a case report.","authors":"Daokuo Zheng, Jingjing Chen, Yanfei He, Bangtian Peng, Zhenwei Ge","doi":"10.3389/fcvm.2026.1778125","DOIUrl":"https://doi.org/10.3389/fcvm.2026.1778125","url":null,"abstract":"<p><p>Pulmonary valve insufficiency most commonly occurs following various precordial interventions, including repair of tetralogy of Fallot, balloon dilatation for pulmonary stenosis, and surgical or percutaneous treatment for pulmonary atresia with intact ventricular septum. Isolated congenital pulmonary valve insufficiency is rare, and insufficiency secondary to myxomatous degeneration of the pulmonary valve is even rarer. We report the case of a 16-year-old female with severe pulmonary valve insufficiency and aneurysmal dilatation of the pulmonary artery caused by myxomatous degeneration of the pulmonary valve. The patient underwent minimally invasive surgical treatment, and no regurgitation was observed at one-year follow-up.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"13 ","pages":"1778125"},"PeriodicalIF":2.8,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraprocedural atrial tachycardia during ablation of paroxysmal atrial fibrillation: incidence, mechanisms, and clinical outcomes.","authors":"Qiushi Chen, Youfu Huang, Yan Dong, Xuesheng Fan, Nishant Yadav, Li Jiang, Yuan He, Zhongda Chen, Wei Zhao, Fengxiang Zhang","doi":"10.3389/fcvm.2026.1822766","DOIUrl":"https://doi.org/10.3389/fcvm.2026.1822766","url":null,"abstract":"<p><strong>Background: </strong>Radiofrequency catheter ablation (RFCA) is the mainstay treatment for paroxysmal atrial fibrillation (PAF). However, the incidence, risk factors, and impact of intra-procedural atrial tachycardia (IAT) during PAF ablation remain insufficiently characterized. The purpose of this study was to explore the incidence, risk factors, electrophysiological features, and clinical outcomes of IAT.</p><p><strong>Methods: </strong>In this single-center, prospective study, 255 patients undergoing RFCA for PAF were analyzed. IAT was defined as stable tachycardia lasting more than 2 min, either induced or spontaneous. Logistic regression identified risk factors for AT, and Kaplan-Meier analysis was used to examine its impact on long-term success.</p><p><strong>Results: </strong>IAT occurred in 13.33% of patients. Right atrial enlargement was identified as an independent risk factor [odds ratio (OR) = 1.14, <i>P</i> = 0.015], and AT involving the peri-tricuspid (45%), peri-mitral (45%), roof-dependent (2.5%) and focal (7.5%) types were found. The overall 12-month sinus rhythm maintenance rate was 78.0%, with no significant difference between the AT and non-AT groups (79.4% vs. 77.8%, <i>P</i> = 0.84).</p><p><strong>Conclusions: </strong>IAT was observed in 13.3% of patients undergoing PAF ablation, with macro-reentrant circuits around the tricuspid and mitral annuli being the primary mechanisms. Right atrial diameter served as a key predictor. Our data demonstrate that with successful intra-procedural identification and targeted ablation, IAT patients can achieve a 12-month prognosis similar to non-IAT patients.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"13 ","pages":"1822766"},"PeriodicalIF":2.8,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Antenatal diagnosis of double-chambered right ventricle in two cases: follow-up and literature review.","authors":"Kazim Oztarhan, Aysin Kale, Idil Kacur, Aylin Oztarhan, Selda Atar, Ali Gedikbasi","doi":"10.3389/fcvm.2026.1760854","DOIUrl":"https://doi.org/10.3389/fcvm.2026.1760854","url":null,"abstract":"<p><p>Double-chambered right ventricle (DCRV) is defined as the progressive division of the right ventricle into two chambers: a high-pressure inlet chamber and a low-pressure outlet chamber. To date, only three cases diagnosed prenatally have been reported in the literature, all of which were associated with unfavorable pregnancy outcomes. In this study, we discuss DCRV in general, along with two cases of type 1 DCRV that did not cause hemodynamically significant obstruction and resulted in successful pregnancy outcomes. From a hemodynamic perspective, the following echocardiographic criteria may affect the prenatal fetal process: (1) detection of tricuspid regurgitation on echocardiography; and (2) pulmonary blood flow velocity and the difference in pressure between the proximal and distal right ventricle.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"13 ","pages":"1760854"},"PeriodicalIF":2.8,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13144018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Echocardiographic strain as an ally in the evaluation of congenital heart disease: a narrative review.","authors":"Yesika Lucero Alvarez Alarcón, Lina Paola Montaña-Jimenez","doi":"10.3389/fcvm.2026.1662430","DOIUrl":"https://doi.org/10.3389/fcvm.2026.1662430","url":null,"abstract":"<p><strong>Introduction: </strong>Congenital heart diseases (CHDs) are the most common congenital malformations in newborns and are associated with significant long-term cardiac morbidity. Conventional echocardiographic parameters such as ejection fraction often fail to detect subclinical myocardial dysfunction. Myocardial strain analysis, primarily through speckle-tracking echocardiography (STE), has emerged as a sensitive, non-invasive technique to assess myocardial deformation and guide clinical decision-making in pediatric patients with CHDs.</p><p><strong>Methods: </strong>This narrative review was conducted through a comprehensive search of PubMed, Embase, and Scopus databases, covering literature from 2009 to 2025. Search terms included \"global longitudinal strain,\" \"congenital heart disease,\" and pediatric age-related keywords. A total of 119 records were screened, and 40 studies were selected based on relevance and methodological quality. Articles were included regardless of language but ultimately analyzed in English or Spanish.</p><p><strong>Results: </strong>The reviewed studies confirm the clinical utility of strain imaging in detecting early myocardial dysfunction, monitoring surgical outcomes, and predicting prognosis across various CHDs, including atrial and ventricular septal defects, Tetralogy of Fallot, single-ventricle physiology, and transposition of the great arteries. RV longitudinal strain and atrial strain have shown prognostic value in early dysfunction and adverse outcomes. Additionally, fetal myocardial strain imaging has demonstrated utility in prenatal diagnosis and individualized care planning.</p><p><strong>Conclusion: </strong>Myocardial strain imaging is a powerful adjunct to conventional echocardiography, offering enhanced sensitivity for identifying subclinical myocardial dysfunction. Its integration into routine practice enhances risk stratification, informs therapeutic decisions, and contributes to personalized care in CHD across all stages of life, including the fetal period. Its systematic use is strongly recommended in pediatric cardiology centers specializing in CHD.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"13 ","pages":"1662430"},"PeriodicalIF":2.8,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"miR-181a post-transcriptionally targets GRK2 to limit maladaptive signaling in cardiomyocytes.","authors":"Heidi Cho, Melissa Lieu, Erhe Gao, Stephanie M Kereliuk, Samuel Slone, Thiele Osvaldt Rosales, Christina Liu, Maya Hoteit, Eric Barr, J Kurt Chuprun, Walter J Koch","doi":"10.3389/fcvm.2026.1821660","DOIUrl":"https://doi.org/10.3389/fcvm.2026.1821660","url":null,"abstract":"<p><strong>Background: </strong>Pathological upregulation of G protein-coupled receptor kinase 2 (GRK2) is a hallmark of heart failure and contributes to maladaptive signaling, hypertrophic remodeling, and cardiomyocyte death. MicroRNAs (miRNAs) are key post-transcriptional regulators of cardiac stress responses, however whether GRK2 is subject to miRNA targeting has not yet been fully established.</p><p><strong>Methods: </strong>miRNA microarray profiling was performed on mouse hearts two weeks after myocardial infarction. Bioinformatic target prediction analysis identified candidate miRNAs that are predicted to bind GRK2 in the 3' untranslated region (UTR). Direct binding was assessed using luciferase reporter assays, and miR-181a was selected as the miRNA of interest to further pursue mechanistic and functional validation. miR-181a was overexpressed or inhibited in neonatal rat ventricular myocytes (NRVMs) and exposed to several modes of cellular stress to induce hypertrophy, hypoxia, and accumulation of reactive oxygen species. GRK2 expression, hypertrophic remodeling, oxidative stress, cell viability, and cyclic AMP (cAMP) signaling were assessed using quantitative PCR, immunoblotting, fluorescence imaging, and biochemical assays.</p><p><strong>Results: </strong>miR-181a directly targeted the GRK2 3'UTR and suppressed GRK2 expression at both mRNA and protein levels. miR-181a overexpression attenuated stress-induced hypertrophic gene expression, reduced cardiomyocyte cell size, decreased oxidative stress, improved survival under hypoxia, and enhanced cAMP production under <i>β</i>-AR stimulation. Conversely, inhibition of miR-181a resulted in sustained GRK2 expression, exacerbated hypertrophic signaling, and decreased cAMP production.</p><p><strong>Conclusion: </strong>These findings identify miR-181a as a functional post-transcriptional regulator of GRK2 that limits maladaptive signaling, hypertrophic remodeling, and cardiomyocyte injury. miR-181a-mediated GRK2 inhibition represents a potential therapeutic strategy for mitigating pathological signaling in heart failure.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"13 ","pages":"1821660"},"PeriodicalIF":2.8,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13144137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neutrophil-to-albumin ratio predicts 30-day mortality in acute aortic dissection: a retrospective cohort study.","authors":"Yunxian Chen, Cheng Ling, Yang Song, Jiefan Xiao, Baofeng Chen, Liangqiu Tang, Shebing Zhang","doi":"10.3389/fcvm.2026.1791503","DOIUrl":"https://doi.org/10.3389/fcvm.2026.1791503","url":null,"abstract":"<p><strong>Background: </strong>Acute aortic dissection (AAD) carries high early mortality, necessitating reliable prognostic tools. The neutrophil-to-albumin ratio (NPAR) synergistically encapsulates inflammatory activity and nutritional status, yet its prognostic utility in AAD remains underexplored.</p><p><strong>Methods: </strong>We retrospectively enrolled 415 patients with AAD diagnosed at Yuebei People's Hospital between January 2020 and December 2024. NPAR was calculated from admission laboratory values and analyzed as both a continuous and categorical variable (tertiles). Logistic regression models were used to assess the association between NPAR and 30-day mortality. Restricted cubic spline (RCS) analysis examined the dose-response relationship. Receiver operating characteristic analysis compared NPAR with NLR, SII, and PLR. Prespecified subgroup analyses examined effect consistency.</p><p><strong>Results: </strong>Higher NPAR values were independently associated with increased 30-day mortality (adjusted OR: 1.48; 95% CI: 1.05-2.09; <i>P</i> = 0.027). Patients in the highest NPAR tertile (≥22.37) had significantly greater mortality risk than those in the lowest tertile (<19.95) (adjusted OR: 20.28; 95% CI: 1.45-283.0; <i>P</i> = 0.025). RCS analysis revealed a linear positive association between NPAR and mortality. NPAR demonstrated superior discrimination for 30-day mortality (AUC: 0.741) compared with NLR, SII, and PLR. Subgroup analyses yielded consistent associations across prespecified strata with no significant interactions.</p><p><strong>Conclusions: </strong>Elevated admission NPAR is an independent predictor of short-term mortality in AAD. As an easily available and inexpensive biomarker, NPAR may improve early risk stratification and guide clinical decision-making in this high-risk population.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"13 ","pages":"1791503"},"PeriodicalIF":2.8,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exercise benefits in metabolism on cardiovascular disease.","authors":"Yuxuan Guo, Qiang Zheng, Xianyue Wang, Ben Zhang, Tao Yan","doi":"10.3389/fcvm.2026.1781202","DOIUrl":"https://doi.org/10.3389/fcvm.2026.1781202","url":null,"abstract":"<p><p>Low physical activity (PA) is an independent predictor of cardiovascular disease. Exercise, as a non-pharmacological intervention for prevention and treatment, has been widely proven to have direct cardiovascular protective effects, including improving cardiopulmonary function and regulating cardiac energy metabolism through key molecular pathways such as the PI3 K/Akt, AMPK, mTOR, PPAR, and SIRT3 signaling, which optimize mitochondrial function and reduce oxidative stress. Simultaneously, it can indirectly promote cardiovascular health by reshaping a healthy gut microbiota and enhancing the body's overall metabolic environment. Therefore, examining the interactions between the cardiovascular system and various metabolic systems from a holistic perspective is both important and necessary to fully understand the multiple mechanisms by which exercise benefits cardiovascular health. This review will systematically describe the direct regulatory effects of exercise on cardiopulmonary function and cardiac energy metabolism. Building on this, it will explore how exercise influences the diversity and abundance of gut microbiota, the function of the gut barrier, and the mediation of key gut microbiota metabolites such as short-chain fatty acids. It will also examine the links between gut microbiota dysbiosis and major adverse cardiovascular events, along with the potential intervention mechanisms of exercise. From an integrated metabolism perspective, the review will comprehensively detail the pathways through which exercise provides cardiovascular protection by regulating the cardiovascular system, gut microbiota, and interactions among multiple metabolic systems. Finally, it adopts an analytical framework based on multi-omics integration and systems biology network analysis, thereby overcoming the limitations of traditional single-dimensional research and facilitating a more comprehensive, holistic understanding of the complex, multi-scale metabolic changes induced by exercise and the underlying cardiovascular-protective regulatory networks.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"13 ","pages":"1781202"},"PeriodicalIF":2.8,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethanol infusion of the vein of Marshall reduces localized voltage but preserves mitral isthmus conduction velocity.","authors":"Yi Lu, Li Shu, Chunhui Liu, Shenghui Ma, Zhejun Cai","doi":"10.3389/fcvm.2026.1807237","DOIUrl":"https://doi.org/10.3389/fcvm.2026.1807237","url":null,"abstract":"<p><strong>Background: </strong>Ethanol infusion of the vein of Marshall (EIVOM) has emerged as a promising adjunct to pulmonary vein isolation (PVI) for atrial fibrillation (AF).</p><p><strong>Methods: </strong>Patients undergoing catheter ablation for persistent AF (>3 months) were enrolled in this study. After PVI, high-density mapping (HD-Grid, Abbott, St Paul, MN) was performed during coronary sinus pacing (100 bpm) to assess left atrial conduction velocity (CV) and voltage. EIVOM was then performed (1-3 mL ethanol × 3 doses), followed by repeat mapping. The CV and voltage were analyzed in the left lateral wall (mitral isthmus/appendage base), with ≥300 points collected per region. A post-EIVOM electrophysiological study with isoprenaline was conducted to induce arrhythmias.</p><p><strong>Results: </strong>Twenty patients with AF (mean age, 64.30 [SD, 7.97] years, five women [25.0%]) with 24 (interquartile range: 6-60) months of AF duration underwent EIVOM (7.8 ± 2.1 mL). Voltage dropped from 1.92 (1.12-2.61) to 1.24 (0.91-2.05) mV postprocedure (<i>p</i> < 0.05), particularly in the atrial ridge regions. CV remained unchanged (1.00 [0.92-1.10] vs. 1.02 [0.95-1.14] m/s, <i>p</i> = 0.15). Atrial flutter was induced in three patients (one mitral isthmus-dependent, one tricuspid isthmus-dependent, and one roof-dependent). All patients maintained sinus rhythm at discharge without complications.</p><p><strong>Conclusions: </strong>In the acute setting, EIVOM induces localized voltage reduction in the atrial ridge regions without markedly affecting conduction velocity in the mitral isthmus areas.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"13 ","pages":"1807237"},"PeriodicalIF":2.8,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13139011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}