Frontiers in Cardiovascular Medicine最新文献

{"title":"Predictive value of IBI for acute kidney injury with contrast after PCI in patients with ST-segment elevation myocardial infarction.","authors":"Wenjun Ge, Ying Zhang, Song Ge, Mei Chen, Yang Xu","doi":"10.3389/fcvm.2025.1562731","DOIUrl":"10.3389/fcvm.2025.1562731","url":null,"abstract":"<p><strong>Background: </strong>Contrast-induced acute kidney injury (CI-AKI) is a common complication in patients with ST-segment elevation myocardial infarction (STEMI) and is associated with an inflammatory response. Inflammatory burden index (IBI) is a novel inflammatory marker, and the relationship between IBI and CI-AKI in STEMI patients is currently unknown. The aim of this study was to investigate the effect of IBI on CI-AKI after percutaneous coronary intervention (PCI) in STEMI patients.</p><p><strong>Methods: </strong>This was a single-center retrospective observational study consecutively enrolling patients diagnosed with STEMI and successful PCI between August 2022 and December 2024. Logistic regression analysis was used to identify risk factors associated with CI-AKI. Restricted cubic spline (RCS) was used to explore the dose-response relationship between IBI and CI-AKI. The predictive effectiveness of the models was assessed by the net reclassification index (NRI) and the integrated discriminant improvement index (IDI).</p><p><strong>Results: </strong>A total of 647 patients were included in this study and the incidence of CI-AKI during hospitalization was 78 (12.1%). After adjusting for possible confounding factors, the result showed that IBI > 18.89 (OR = 2.418, 95% CI: 1.331-4.392) was an independent factor for CI-AKI in STEMI patients. RCS results suggested that there was a non-linear dose-response relationship between IBI and CI-AKI. After integrating IBI, the ability of the new model to predict CI-AKI in STEMI patients was significantly improved (NRI = 0.315, IDI = 0.019, <i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>Elevated IBI is an independent risk factor for CI-AKI after PCI in STEMI patients, and there is a non-linear dose-response relationship between IBI and CI-AKI. Integrating IBI can improve the risk stratification of STEMI patients regarding CI-AKI.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1562731"},"PeriodicalIF":2.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779403","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":"Two-dimensional speckle tracking of the ascending aorta: a novel approach to evaluate arterial stiffness in pediatric patients with repaired conotruncal anomalies using echocardiography.","authors":"Anmol Goyal, Anitha Parthiban, David A White, Daniel Forsha, Doaa Aly","doi":"10.3389/fcvm.2025.1555568","DOIUrl":"10.3389/fcvm.2025.1555568","url":null,"abstract":"<p><strong>Background: </strong>Children with repaired conotruncal abnormalities (CTA) are at risk of progressive aortic dilation and deteriorating aortic elasticity even after surgical correction. Strain imaging, using a 2-dimensional speckle tracking echocardiography (2D-STE), has been used for arterial stiffness assessment, but pediatric data are still lacking. We investigated the feasibility, reproducibility, and clinical value of 2D-STE derived ascending aorta (AAo) stiffness in children with repaired CTA.</p><p><strong>Methods: </strong>22 pediatric patients with repaired CTA were included along with 25 age- and sex- matched healthy controls (mean age 10.2 ± 4.5 years). Conventional 2D echocardiographic and 2D-STE assessment of AAo mechanics was performed. M-mode AAo strain, aortic distensibility and aortic stiffness index as well as 2D-STE derived AAo global circumferential strain (GCS) were calculated and compared between groups.</p><p><strong>Results: </strong>2D-STE was successfully performed and analyzed in the entire, prospectively enrolled cohort. Patients with repaired CTA had significantly lower 2D-STE derived AAo GCS compared to controls (9.4 ± 1.3 vs. 15.2 ± 1.7, <i>P</i>-value <0.001). AAo GCS in repaired CTA patients had strong negative correlation with age (<i>r</i> = -0.76, CI -0.9 to -0.51) and a moderate negative correlation with the absolute aortic valve annulus (<i>r</i> = -0.55), absolute aortic root (<i>r</i> = -0.67), absolute sino-tubular junction (<i>r</i> = -0.67) and absolute AAo dimension (<i>r</i> = -0.71). On multivariate analysis, absolute aortic root and ascending aorta dimension were significantly associated with AAo GCS independent of other variables. Intra-observer reproducibility was good to excellent for the CTA and entire cohort (ICC = 0.87 and 0.96 respectively), while inter-observer reproducibility was moderate for the CTA cohort 0.71 vs. 0.92 for the entire cohort.</p><p><strong>Conclusion: </strong>AAo GCS using 2D STE is highly feasible and reproducible as well as provides novel insights into the aortic deformation mechanics in pediatric patients with repaired CTA, thus holds promise in longitudinal assessment and risk stratification of aortopathy-associated congenital heart disease patients.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1555568"},"PeriodicalIF":2.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779471","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":"Emerging horizons: clinical applications and multifaceted benefits of SGLT-2 inhibitors beyond diabetes.","authors":"Qing Feng, Miaoqiong Wu, Zizhao Mai","doi":"10.3389/fcvm.2025.1482918","DOIUrl":"10.3389/fcvm.2025.1482918","url":null,"abstract":"<p><p>SGLT-2 inhibitors, initially developed for type 2 diabetes, demonstrate profound cardiorenal and metabolic benefits. This review synthesizes evidence from clinical trials and mechanistic studies to elucidate their roles in cardiovascular diseases, chronic kidney disease, and non-alcoholic fatty liver disease. Key findings include a notable reduction in cardiovascular death/heart failure hospitalization, a marked decrease in heart failure hospitalization risk, and significant improvements in renal and hepatic outcomes. Emerging mechanisms, such as autophagy induction, ketone utilization, and anti-inflammatory effects, underpin these benefits. Ongoing trials explore their potential in non-diabetic populations, positioning SGLT-2 inhibitors as transformative agents in multisystem disease management.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1482918"},"PeriodicalIF":2.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779447","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":"Global, regional, and national burdens of ischemic heart disease in the older adults aged 60-89 years: a systematic analysis for the Global Burden of Disease Study 2019.","authors":"Hao Zhi, Yuedong Yang, Juan Zhao, Chenhan Mao, Jianping Shen, Xindong Wang","doi":"10.3389/fcvm.2025.1443881","DOIUrl":"10.3389/fcvm.2025.1443881","url":null,"abstract":"<p><strong>Background: </strong>Ischemic heart disease (IHD) places a heavy burden on individual and public health. Nevertheless, comprehensive assessments of the burden of IHD in the elderly are absent. It is imperative to update the burden of IHD in older adults and predict the trends.</p><p><strong>Methods: </strong>The absolute numbers and age-standardized rates (ASRs) of prevalence, mortality, and disability-adjusted life-years (DALYs) for IHD among people aged 60-89 years from 1990 to 2019 were analyzed based on the Global Burden of Disease Study 2019 (GBD 2019). Joinpoint regression analysis was utilized to evaluate the epidemiologic trend of IHD in the elderly from 1990 to 2019. Bayesian age-period-cohort model was used to predict the burden of IHD among the elderly from 2020 to 2034.</p><p><strong>Results: </strong>Age-standardized prevalence rate (ASPR), age-standardized incidence rate (ASIR), age-standardized DALY rate (ASDR), and age-standardized mortality rate (ASMR) of IHD in older adults have declined slightly over the past 30 years. In 2019, the ASPR, ASIR, ASDR, and ASMR among the elderly with IHD were 14,280.53 (95% UI, 12,301.34-16,610.6), 1,445.21 (1,142-1,793.58), 11,225.74 (10,342.09-11,960.64), and 675.24 (614.21-721.75) per 100,000<b>.</b> The burden of IHD was significantly higher in older men than in women during the study period. In terms of socio-demographic index (SDI), countries and territories with lower SDI bore a more severe burden of IHD. The burden of IHD in the elderly varied considerably across countries. Uzbekistan had the largest increase in rates of prevalence, incidence, DALY, and mortality. The projections show a downward trend in DALY and mortality rates for IHD in older adults from 2020 to 2034, but incidence and prevalence will increase.</p><p><strong>Conclusion: </strong>From 1990 to 2019, the worldwide burden of IHD among the elderly witnessed a decline. The IHD burden varied significantly across countries and territories. Policymakers should rationalize the allocation of health resources and implement effective prevention and treatment strategies to reduce the burden of IHD among the elderly in economically less developed countries and regions.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1443881"},"PeriodicalIF":2.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779458","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":"Exploring associations between estrogen and gene candidates identified by coronary artery disease genome-wide association studies.","authors":"Ava P Aminbakhsh, Emilie T Théberge, Elizabeth Burden, Cindy Kalenga Adejumo, Annabel K Gravely, Anna Lehman, Tara L Sedlak","doi":"10.3389/fcvm.2025.1502985","DOIUrl":"10.3389/fcvm.2025.1502985","url":null,"abstract":"<p><strong>Introduction: </strong>Coronary artery disease (CAD) is the leading cause of death around the world, with epidemiological sex and gender differences in prevalence, pathophysiology and outcomes. It has been hypothesized that sex steroids, like estrogen, may contribute to these sex differences. There is a relatively large genetic component to developing CAD, with heritability estimates ranging between 40%-60%. In the last two decades, genome-wide association studies (GWAS) have contributed substantially to advancing the understanding of genetic candidates contributing to CAD. The aim of this study was to determine if genes discovered in CAD GWASs are affected by estrogen via direct modulation or indirect down-stream targets.</p><p><strong>Methods: </strong>A scoping review was conducted using MEDLINE and EMBASE for studies of atherosclerotic coronary artery disease and a genome-wide association study (GWAS) design. Analysis was limited to candidate genes with corresponding single nucleotide polymorphisms (SNPs) surpassing genome-wide significance and had been mapped to genes by study authors. The number of studies that conducted sex-stratified analyses with significant genes were quantified. A literature search of the final gene lists was done to examine any evidence suggesting estrogen may modulate the genes and/or gene products.</p><p><strong>Results: </strong>There were 60 eligible CAD GWASs meeting inclusion criteria for data extraction. Of these 60, only 36 had genome-wide significant SNPs reported, and only 3 of these had significant SNPs from sex-stratified analyses mapped to genes. From these 36 studies, a total of 61 genes were curated, of which 26 genes (43%) were found to have modulation by estrogen. All 26 were discovered in studies that adjusted for sex. 12/26 genes were also discovered in studies that conducted sex-stratified analyses. 12/26 genes were classified as having a role in lipid synthesis, metabolism and/or lipoprotein mechanisms, while 11/26 were classified as having a role in vascular integrity, and 3/26 were classified as having a role in thrombosis.</p><p><strong>Discussion: </strong>This study provides further evidence of the relationship between estrogen, genetic risk and the development of CAD. More sex-stratified research will need to be conducted to further characterize estrogen's relation to sex differences in the pathology and progression of CAD.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1502985"},"PeriodicalIF":2.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779452","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":"The roles of neutrophils in cardiovascular diseases.","authors":"Yanjie Lian, Xiaolei Lai, Cong Wu, Li Wang, JuJu Shang, Heyi Zhang, Sihan Jia, Wenlong Xing, Hongxu Liu","doi":"10.3389/fcvm.2025.1526170","DOIUrl":"10.3389/fcvm.2025.1526170","url":null,"abstract":"<p><p>The immune response plays a vital role in the development of cardiovascular diseases (CVDs). As a crucial component of the innate immune system, neutrophils are involved in the initial inflammatory response following cardiovascular injury, thereby inducing subsequent damage and promoting recovery. Neutrophils exert their functional effects in tissues through various mechanisms, including activation and the formation of neutrophil extracellular traps (NETs). Once activated, neutrophils are recruited to the site of injury, where they release inflammatory mediators and cytokines. This study discusses the main mechanisms associated with neutrophil activity and proposes potential new therapeutic targets. In this review, we systematically summarize the diverse phenotypes of neutrophils in disease regulatory mechanisms, different modes of cell death, and focus on the relevance of neutrophils to various CVDs, including atherosclerosis, acute coronary syndrome, myocardial ischemia/reperfusion injury, hypertension, atrial fibrillation, heart failure, and viral myocarditis. Finally, we also emphasize the preclinical/clinical translational significance of neutrophil-targeted strategies.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1526170"},"PeriodicalIF":2.8,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771919","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":"Efficacy and safety of distal transradial access for coronary angiography and percutaneous coronary intervention: a meta-analysis.","authors":"Qinyan Yang, Xianli Wei, Jianyu Wu, Chunlan Li, Yuechen Qin, Haijian Zeng, Mengtian Qin, Yue Zou, Shiming Zhang, Weiming Liang, Jie Li","doi":"10.3389/fcvm.2025.1530995","DOIUrl":"10.3389/fcvm.2025.1530995","url":null,"abstract":"<p><strong>Introduction: </strong>This meta-analysis aims to evaluate the efficacy and safety of dTRA for coronary angiography (CAG) and percutaneous coronary intervention (PCI) in comparison to cTRA.</p><p><strong>Materials and methods: </strong>Four databases (PubMed, Embase, Web of Science, and Cochrane Library) were searched from their inception to 13 April 2024 for studies comparing dTRA and cTRA in coronary diagnostic or interventional catheterization. The meta-analysis evaluated radial artery occlusion (RAO), procedure success, the success rate of catheter puncture, the success rate of a single attempt, hematoma occurrence, radial artery spasms, puncture site bleeding, puncture time, procedural time, the dosage of contrast medium, and hemostasis time.</p><p><strong>Results: </strong>A total of 31 studies were included in the meta-analysis. Compared with cTRA, dTRA significantly reduced the incidence of RAO [odds ratio (OR) = 0.41, 95% CI: 0.34-0.50, <i>P</i> < 0.05], hematoma (OR = 0.67, 95% CI:0.56-0.80, <i>P</i> < 0.05), and shorter hemostasis time [weighted mean difference (WMD) = -0.43, 95% CI:-0.65 to -0.20, <i>P</i> < 0.05] but had a significantly lower procedure success rate (OR = 0.41, 95% CI: 0.30-0.56, <i>P</i> < 0.05), a lower catheter puncture success rate (OR = 0.44, 95% CI: 0.27-0.71, <i>P</i> < 0.05), and a longer puncture time (WMD = 0.60, 95% CI: 0.44-0.75, <i>P</i> < 0.05). No significant differences were observed between dTRA and cTRA in terms of the success rate of a single attempt, radial artery spasms, puncture site bleeding, procedural time, and dosage of contrast medium.</p><p><strong>Conclusions: </strong>Our results revealed that dTRA is a workable and safe method for cardiovascular interventional diagnostics and treatment. It significantly reduces the incidence of RAO and hematoma, as well as shortens hemostasis time following surgery.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024596238, PROSPERO (CRD42024596238).</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1530995"},"PeriodicalIF":2.8,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11959052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763435","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":"Association of myocardial and liver T2* iron measurements with systolic and diastolic function by CMR feature tracking strain analysis.","authors":"Hugo G Quezada-Pinedo, Benedikt Bernhard, Jan C Zurkirchen, Anselm W Stark, Noushin Sadat Ahanchi, Catherine Gebhard, Daniel Ott, Alan A Peters, Hendrik von Tengg-Kobligk, Jonathan Schütze, Adam Bakula, Andreas Wahl, Kim N Cajachagua-Torres, Taulant Muka, Christoph Gräni","doi":"10.3389/fcvm.2025.1547161","DOIUrl":"10.3389/fcvm.2025.1547161","url":null,"abstract":"<p><strong>Background/objectives: </strong>Myocardial and liver iron overload can be assessed through T2* in magnetic resonance imaging (MRI). It is unclear, how T2* measurements are associated with systolic and diastolic left ventricular function assessed by novel feature tracking (FT) strain.</p><p><strong>Methods: </strong>Consecutive patients with suspected iron overload undergoing MRI T2* were retrospectively included. T2* was studied continuously and in categories: normal myocardial iron status (T2* ≥ 20 ms), myocardial iron overload (T2* < 20 ms), normal liver iron status (T2* ≥ 15.4 ms) and liver iron overload (T2* < 15.4 ms). Multivariable regression models were used to assess associations between T2* and FT strain.</p><p><strong>Results: </strong>Among 172 participants, longitudinal e/a ratio [-0.17 (-0.27, -0.08), <i>p</i> = 0.001], longitudinal early diastolic strain rate [-0.13 (-0.23, -0.03), <i>p</i> = 0.014], circumferential late diastolic strain rate [0.18 (0.03, 0.32), <i>p</i> = 0.016], longitudinal late diastolic strain rate [0.20 (0.03, 0.36), <i>p</i> = 0.019] were associated with higher T2*. Liver iron overload was associated with circumferential systolic strain rate [-0.42 (-0.74, -0.09), <i>p</i> = 0.014] and longitudinal early diastolic strain rate [0.27 (0.04, 0.49), <i>p</i> = 0.023]. Combined liver and myocardial iron overload were associated with longitudinal e/a ratio [0.72 (0.19, 1.24), <i>p</i> = 0.008]. No associations of T2* values with systolic function were found.</p><p><strong>Conclusion: </strong>Liver and a combination of myocardial and liver iron overload were associated with increased early diastolic filling and increased e/a ratio respectively, which may serve as markers of diastolic dysfunction. Impaired diastolic function, even in the absence of myocardial iron overload was associated with liver iron metabolism and may indicate early cardiac involvement, while left ventricular systolic function is still preserved.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1547161"},"PeriodicalIF":2.8,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11958997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763429","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":"Cardiac preservation using <i>ex vivo</i> organ perfusion: new therapies for the treatment of heart failure by harnessing the power of growth factors using BMP mimetics like THR-184.","authors":"William D Carlson, Dattatreyamurty Bosukonda, Peter C Keck, Philippe Bey, Shannon N Tessier, Frederic R Carlson","doi":"10.3389/fcvm.2025.1535778","DOIUrl":"10.3389/fcvm.2025.1535778","url":null,"abstract":"<p><p>As heart transplantation continues to be the gold standard therapy for end-stage heart failure, the imbalance between the supply of hearts, and the demand for them, continues to get worse. In the US alone, with less than 4,000 hearts suitable for transplant and over 100,000 potential recipients, this therapy is only available to a very few. The use of hearts Donated after Circulatory Death (DCD) and Donation after Brain Death (DBD) using <i>ex vivo</i> machine perfusion (EVMP) is a promising approach that has already increased the availability of suitable organs for heart transplantation. EVMP offers the promise of enabling the expansion of the overall number of heart transplants and lower rates of early graft dysfunction. These are realized through (1) safe extension of the time between procurement and transplantation and (2) <i>ex vivo</i> assessment of preserved hearts. Notably, <i>ex vivo</i> perfusion has facilitated the donation of DCD hearts and improved the success of transplantation. Nevertheless, DCD hearts suffer from serious preharvest ischemia/reperfusion injury (IRI). Despite these developments, only 40% of hearts offered for transplantation can be utilized. These devices do offer an opportunity to evaluate donor hearts for transplantation, resuscitate organs previously deemed unsuitable for transplantation, and provide a platform for the development of novel therapeutics to limit cardiac injury. Bone Morphogenetic Protein (BMP) signaling is a new target which holds the potential for ameliorating myocardial IRI. Recent studies have demonstrated that BMP signaling has a significant role in blocking the deleterious effects of injury to the heart. We have designed novel small peptide BMP mimetics that act via activin receptor-like kinase (ALK3), a type I BMP receptor. They are capable of (1) inhibiting inflammation and apoptosis, (2) blocking/reversing the epithelial-mesenchymal transition (EMT) and fibrosis, and (3) promoting tissue regeneration. In this review, we explore the promise that novel therapeutics, including these BMP mimetics, offer for the protection of hearts against myocardial injury during <i>ex vivo</i> transportation for cardiac transplantation. This protection represents a significant advance and a promising <i>ex vivo</i> therapeutic approach to expanding the donor pool by increasing the number of transplantable hearts.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1535778"},"PeriodicalIF":2.8,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11960666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763432","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":"Successful pharmaco-mechanical treatment of a subtotally occluded venous bypass graft in a patient presenting with acute coronary syndrome: a case report and review of the current literature on the role of local thrombolysis.","authors":"Matthias Renker, Samuel Sossalla, Christoph Schoefthaler, Grigorios Korosoglou","doi":"10.3389/fcvm.2025.1471462","DOIUrl":"10.3389/fcvm.2025.1471462","url":null,"abstract":"<p><p>Coronary artery bypass grafting (CABG) is a common and effective treatment for patients with complex coronary artery disease. This case report discusses a 75-year-old male patient who presented with angina and shortness of breath due to thrombus formation in a venous graft 20 years after CABG. Initial diagnostics indicated non-ST-elevation myocardial infarction, leading to immediate intervention. Cardiac catheterization revealed thrombus in the vein graft to the large first diagonal branch, necessitating percutaneous coronary intervention. Despite initial efforts, thrombus aspiration and further catheter advancement were unsuccessful. A combination of balloon angioplasty, stent implantation, and intra-arterial thrombolysis with recombinant tissue plasminogen activator (rt-PA) was employed, resulting in significant thrombus reduction and improved coronary flow. Follow-up coronary CT angiography (CCTA) confirmed complete thrombus resolution and patent graft. The patient was discharged with dual antiplatelet therapy and showed favorable outcomes. This case emphasizes the challenges of managing thrombotic complications in venous bypass grafts and highlights the effectiveness of a multifaceted interventional approach combined with CCTA for non-invasive patient follow-up and assessment of treatment success. Furthermore, a review of the current literature on the role of local thrombolysis for occluded coronary artery bypass grafts is provided.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1471462"},"PeriodicalIF":2.8,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751871","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}