Frontiers in Cardiovascular Medicine最新文献

{"title":"Impact of left ventricular ejection fraction on unplanned readmission after aortic regurgitation surgery: a single-center retrospective cohort study.","authors":"Pan Li, Yong-Jian Zhang, Feng-Wei Guo, Hong Chen, Ya-Ling Dong, Jia-Nan Shang, Hui-Rong Wu, Fei Wang, Meng Chen, Li-Tao Ruan, Yang Yan, Yan Song","doi":"10.3389/fcvm.2026.1714384","DOIUrl":"https://doi.org/10.3389/fcvm.2026.1714384","url":null,"abstract":"<p><strong>Background and objective: </strong>Aortic regurgitation (AR) is a common valvular heart disease. Despite advances in surgical techniques, unplanned readmission rates after surgery remain high. This study aimed to investigate the risk of postoperative unplanned readmission in patients with only mildly impaired left ventricular ejection fraction (LVEF 55%-60%) but concomitant left ventricular enlargement.</p><p><strong>Methods: </strong>This single-center retrospective cohort study enrolled 841 adult patients diagnosed with aortic regurgitation who underwent surgical treatment at our hospital between January 2020 and December 2024. All patients underwent transthoracic echocardiography (TTE) within 3 days before surgery. The primary endpoint event was unplanned readmission during postoperative follow-up.</p><p><strong>Results: </strong>During follow-up, 46 patients experienced unplanned readmission. Risk factor analysis for readmission indicated that patients in the LVEF 55%-60% group had significantly higher risk of postoperative readmission [HR (95% CI): 4.118 (1.488-11.397), <i>P</i> = 0.006]. Further Cox proportional hazards regression analysis revealed that LVEDD > 65 mm and LVEF <60% were significant risk factors for unplanned readmission during postoperative follow-up (<i>P</i> < 0.05). Among all patients with unplanned readmissions, 21 cases had both LVEDD > 65 mm and LVEF < 60%, of whom 12 patients (57.14%) had an LVEF of 55%-60%. Cox regression analysis showed that patients meeting both risk factors had a significantly higher risk of unplanned readmission compared to those with neither risk factor [HR (95% CI): 2.548 (1.174-5.534), <i>P</i> = 0.018].</p><p><strong>Conclusion: </strong>Patients with mildly impaired left ventricular ejection fraction (LVEF 55%-60%) combined with significant left ventricular dilation (LVEDD >65 mm) constitute a high-risk cohort for unplanned readmission postoperatively. For patients with aortic regurgitation, even those exhibiting only mildly impaired LVEF, coexisting significant left ventricular dilation warrants heightened vigilance regarding readmission risk.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"13 ","pages":"1714384"},"PeriodicalIF":2.8,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13139105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835544","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":"Clinical and procedural outcomes of very high-power short-duration vs. standard power ablation for pulmonary vein isolation.","authors":"Inês Rodrigues, João Almeida, Rafael Teixeira, Tiago Martins, Mafalda Carrington, Helena Gonçalves, João Primo, Marco Oliveira, Paulo Fonseca, Ricardo Fontes-Carvalho","doi":"10.3389/fcvm.2026.1806509","DOIUrl":"https://doi.org/10.3389/fcvm.2026.1806509","url":null,"abstract":"<p><strong>Introduction: </strong>Pulmonary vein isolation (PVI) using shorter but higher-power radiofrequency (RF) applications can improve lesion quality and reduce procedural time compared to the standard approach, while ensuring similar clinical and safety outcomes. The aim of this study was to compare very high-power short-duration (vHPSD) with standard-power atrial fibrillation (AF) ablation regarding clinical outcomes, procedural efficiency and safety.</p><p><strong>Methods: </strong>All patients who underwent first PVI using RF energy between January 2021 and June 2024 were included. The two groups (standard-power vs. vHPSD AF ablation) were matched using a propensity score analysis and compared at 12 months regarding freedom from AF recurrence, quality of life improvement and safety.</p><p><strong>Results: </strong>333 patients were submitted to PVI, and after the propensity score analysis, 226 patients were analysed (65.0% male, median age 62.8 years, comparable baseline characteristics). The median follow-up time was 554 days (IQR 351, 729) for the vHPSD group and 728 days (IQR 555, 730) for the standard group (<i>p</i> < 0.01). Freedom from AF recurrence at 12 months was similar between groups (83.7% vs. 86.1%, <i>p</i> = 0.85) and both groups exhibited significant and similar improvements in QoL measurements, following the procedure (mean adjusted difference of +13.9, 95% CI 10.4-17.5, <i>p</i> < 0.001). Total procedural time was significantly shorter in the vHPSD arm (86.5 min vs. 100.0 min, <i>p</i> < 0.01) and PV first-pass isolation (FPI) was significantly lower in the vHPSD group (52.3% vs. 72.3%, <i>p</i> < 0.01). AF catheter ablation had a favourable safety profile, with a low prevalence of adverse effects, irrespective of the type of RF energy used.</p><p><strong>Conclusion: </strong>VHPSD AF ablation was a more efficient technique with a shorter procedural time, achieving similar clinical outcomes despite having a lower FPI rate. Both techniques appeared to be safe with low prevalence of adverse effects.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"13 ","pages":"1806509"},"PeriodicalIF":2.8,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13139015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835915","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 outcomes of valve-in-valve TMVR for patients with mitral bioprosthetic valve dysfunction: a single-center retrospective study.","authors":"Tao Zhang, Yahua Li, Bin Lin, Li Li, Bowen Lian, Pengju Guo, Xiaoyan Zhao","doi":"10.3389/fcvm.2026.1747077","DOIUrl":"https://doi.org/10.3389/fcvm.2026.1747077","url":null,"abstract":"<p><strong>Objective: </strong>To explore the clinical efficacy and follow-up results of the valve-in-valve transcatheter mitral valve replacement (TMVR) technique in patients with mitral bioprosthetic valve dysfunction.</p><p><strong>Methods: </strong>The medical data of patients with biological valve dysfunction after mitral valve replacement who underwent TMVR in our hospital from January 2019 to January 2024 were retrospectively collected. The echocardiography data, New York Heart Association (NYHA) grade, EuroQol visual analogue scale (EQ-VAS) score, and 6-minute walking distance before and after the operation were compared.</p><p><strong>Results: </strong>A total of 33 patients, 8 males and 25 females, with an average age of 70.70 ± 9.04 years, were included in this study. All 33 patients underwent TMVR surgery successfully. Seven patients underwent surgery via the atrial septal approach, and 26 patients underwent surgery via the apical approach. The success rate of the TMVR was 100.0%. One patient had a complication of cerebral infarction and eventually died 7 days after the operation. Compared with those prior to the operation, the NYHA grade, EQ-VAS score and the 6-minute walking distance were improved significantly at follow-up (all <i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>Valve-in-valve TMVR is a feasible option for patients with degenerated bioprosthetic mitral valves. However, follow-up studies are still needed to determine the long-term effects.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"13 ","pages":"1747077"},"PeriodicalIF":2.8,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13139149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835848","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":"Correction: Mechanisms modulating foam cell formation in the arterial intima: exploring new therapeutic opportunities in atherosclerosis.","authors":"M T La Chica Lhoëst, A Martinez, L Claudi, E Garcia, A Benitez-Amaro, A Polishchuk, J Piñero, D Vilades, J M Guerra, F Sanz, N Rotllan, J C Escolà-Gil, V Llorente-Cortés","doi":"10.3389/fcvm.2026.1808883","DOIUrl":"https://doi.org/10.3389/fcvm.2026.1808883","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/fcvm.2024.1381520.].</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"13 ","pages":"1808883"},"PeriodicalIF":2.8,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835859","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":"Early nurse-assessed intrinsic capacity stratifies rehospitalization risk after percutaneous coronary intervention in coronary artery disease patients.","authors":"Yuning Zhao, Wenwen Zhang, Jing Yang, Yuqi Fang, Yizhu Yan, Guangyao Zhai","doi":"10.3389/fcvm.2026.1763248","DOIUrl":"https://doi.org/10.3389/fcvm.2026.1763248","url":null,"abstract":"<p><strong>Background: </strong>Intrinsic capacity (IC) has shown potential in predicting health outcomes in older adults. However, its prognostic value in patients with coronary artery disease (CAD) following percutaneous coronary intervention (PCI) has not been established.</p><p><strong>Methods: </strong>In this retrospective cohort study, patients with CAD undergoing PCI were included. IC score was assessed within 48 h of admission using a structured nurse-administered questionnaire. The primary outcome was all-cause rehospitalization. Secondary outcomes included cardiovascular rehospitalization and non-cardiovascular rehospitalization. Kaplan-Meier analysis, Cox proportional hazards models, and restricted cubic spline (RCS) were used to estimate the relation between IC score and rehospitalization. Subgroup analysis and receiver operating characteristic (ROC) curves were used to assess predictive performance.</p><p><strong>Results: </strong>A higher IC score, indicating poorer IC, was independently associated with increased all-cause rehospitalization risk (HR = 3.07 for IC = 4 compared with IC = 0, 95% CI 1.89-5.00) and cardiovascular rehospitalization risk (HR = 5.23 for IC = 4 compared with IC = 0, 95% CI 2.30-11.89). Subgroup analyses showed that this relationship remained consistent across lesion morphologies and revascularization strategies. In contrast, IC score was not a significant predictor of non-cardiovascular rehospitalization. RCS curves showed the linear positive relationship between IC score and HR of cardiac rehospitalization with the cutoff of 2.5. ROC curve for all-cause rehospitalization showed IC score with the AUC of 0.692 (95% CI: 0.664-0.729).</p><p><strong>Conclusion: </strong>IC score is an accessible, independent, and robust predictor of cardiovascular rehospitalization after PCI in CAD patients.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"13 ","pages":"1763248"},"PeriodicalIF":2.8,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835407","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":"Long-term follow-up results of percutaneous closure of atrial septal defect with a novel biodegradable poly-L-lactic acid device in pediatrics: data from a prospective, single-center trial.","authors":"Yi-Fan Li, Zhao-Feng Xie, Bo-Ning Li, Jun-Jun Shen, Shu-Shui Wang, Yu-Mei Xie, Zhi-Wei Zhang","doi":"10.3389/fcvm.2026.1804642","DOIUrl":"https://doi.org/10.3389/fcvm.2026.1804642","url":null,"abstract":"<p><strong>Background: </strong>The poly-L-lactic acid (PLLA) occluder is a novel, fully biodegradable device designed for percutaneous atrial septal defect (ASD) closure. First-in-human studies have demonstrated its preliminary safety and efficacy.</p><p><strong>Objective: </strong>This study aimed to evaluate the 5-year safety and efficacy of the PLLA device for percutaneous ASD closure in a single-center pediatric cohort.</p><p><strong>Methods: </strong>From May 2018 to August 2019, 36 patients with clinically significant ASD were enrolled and underwent percutaneous closure using the PLLA device. Follow-up assessments were conducted at discharge and at 1, 3, 6, 12, 24, 36, 48, and 60 months post-implantation. The primary endpoint was a composite of clinical success, defined as successful closure and absence of major complications at the 60-month follow-up.</p><p><strong>Results: </strong>Successful device implantation was achieved in 35 of 36 patients (97.2%). All of the 35 patients completed the 5-year follow-up. The closure success rate and complete closure rate at 5 years were 85.7% (30/35) and 77.1% (27/35), respectively. Clinically significant residual leaks at 5- year visit were observed in 5 patients (14.3%). A total of 5 complications (14.3%) occurred, consisting of cardiac arrhythmia (<i>n</i> = 3), moderate mitral regurgitation (<i>n</i> = 1), and migraine (<i>n</i> = 1). Patients with a larger baseline ASD indexed diameter (>15.18 mm/m²) and a smaller device-to-defect ratio (<1.47) showed an increased risk of residual leaks after PLLA device implantation.</p><p><strong>Conclusion: </strong>Long-term follow-up confirms a favorable safety profile for percutaneous ASD closure using the PLLA device, with a cumulative complication rate of 14.2% and no major adverse events reported over 5 years. However, the incidence of residual leaks remains noteworthy, suggesting suboptimal long-term efficacy in pediatric patients and in cases involving large defects.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"13 ","pages":"1804642"},"PeriodicalIF":2.8,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13147298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835680","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":"Results from a prospective international real-world registry of sutureless aortic bioprosthesis by a minimally invasive approach.","authors":"Giovanni Concistrè, Max Baghai, Giuseppe Santarpino, Alistair Royse, Mattia Glauber, Marco Solinas","doi":"10.3389/fcvm.2026.1812903","DOIUrl":"https://doi.org/10.3389/fcvm.2026.1812903","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to report clinical and hemodynamic results from a real-world registry of aortic valve replacement (AVR) with the Perceval sutureless bioprosthesis, comparing mini-sternotomy (MS) versus mini-thoracotomy (MT) approach.</p><p><strong>Methods: </strong>This prospective international registry enrolled 1,652 patients across 55 institutions between 2011 and 2021. Patients undergoing isolated AVR by minimally invasive cardiac surgery approaches were analyzed. Preoperative covariates were adjusted using 1:1 propensity score matching, reaching a final cohort of 261 patients for each approach.</p><p><strong>Results: </strong>Isolated AVR via minimally invasive approaches was performed in 710 patients-406 in MS and 304 in MT. After matching, the baseline characteristics were similar between the two groups, except for the preoperative NYHA class distribution. MT was associated with shorter intensive care unit and hospital stays (<i>p</i> = <0.001 and <i>p</i> = 0.050, respectively), but with higher cross-clamp and cardiopulmonary bypass times compared to MS (<0.001). Within 30 days, one cardiovascular death occurred in the MS group, while 4 (1.5%) reinterventions were reported in the MT group. Pacemaker implantation was required in 5 (1.9%) patients in the MS group and 14 (5.4%) patients in the MT group, with no statistically significant difference. In the matched cohort, survival probability for late events showed no difference between surgical approaches. Mean pressure gradients remained stable during follow-up, with no difference between the groups.</p><p><strong>Discussion: </strong>Our propensity-matched analysis demonstrates that the use of Perceval in minimally invasive approaches is associated with low perioperative complication rates. Sutureless implanted in MT has lower intensive care and in-hospital stay without significant differences in long-term clinical and echocardiographic outcomes.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"13 ","pages":"1812903"},"PeriodicalIF":2.8,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835867","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":"Can indwelling pleural catheters provide additional benefits in elderly heart failure patients with pleural effusion? A real-world retrospective multicenter analysis.","authors":"Yinghua Wang, Yan Jin, Hui Li, Qi Guo, Qingqi Ji, Yan Pan, Min Zhang","doi":"10.3389/fcvm.2026.1680099","DOIUrl":"https://doi.org/10.3389/fcvm.2026.1680099","url":null,"abstract":"<p><strong>Background: </strong>Pleural effusion (PE) is a common presentation in patients with congestive heart failure. Evidence on the necessity of therapeutic pleural drainage (PD) remains conflicting, highlighting a gap in optimal care for patients. This study aimed to compare standard diuretic therapy (SDT) within guideline-directed medical therapy (GDMT) versus PD in elderly acute heart failure (AHF) patients with moderate PE.</p><p><strong>Methods and results: </strong>We conducted a real-world multicenter, retrospective observational cohort study in China. We screened patients within the age range of 60-100 years who were admitted to hospital with AHF and moderate pleural effusions between January 2014 and January 2024. Patients were divided into two groups: the PD group and the GDMT group. The primary and secondary endpoints were time to spontaneous pleurodesis and readmission rate, respectively. Of the 936 elderly AHF patients with moderate pleural effusion who were screened, 514 of them were included in final analysis. Time to spontaneous pleurodesis and time to discharge were shorter in the GDMT group than in the PD group (<i>P</i> = 0.001, <i>P</i> = 0.001). There were no differences in 90- and 180-day readmission rates between the two groups (hazard ratio (HR) 1.450, <i>P</i> = 0.063 and HR 1.383,<i>P</i> = 0.068).</p><p><strong>Conclusion: </strong>SDT within GDMT yielded comparable outcomes to pleural drainage in elderly AHF patients with moderate PE, with respect to effusion resolution and hospital length of stay, without increased risk of worsening renal function or electrolyte imbalance.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"13 ","pages":"1680099"},"PeriodicalIF":2.8,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835917","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: Endothelialized but unstable: late migration of a ventricular septal defect closure device.","authors":"Min-Jung Jan, Chung-Chi Wang, Sheng-Ling Jan, Wei-Li Liu","doi":"10.3389/fcvm.2026.1807603","DOIUrl":"https://doi.org/10.3389/fcvm.2026.1807603","url":null,"abstract":"<p><p>Late device migration following transcatheter perimembranous ventricular septal defect (VSD) closure is exceedingly uncommon, as most cases of embolization occur within the first hours to weeks after implantation. In the present case, migration was observed 18 months post-procedure, representing an unusually late presentation. Notably, surgical retrieval demonstrated complete circumferential endothelialization of the device, confirming true long-term tissue incorporation before subsequent erosion and detachment. Furthermore, serial early and mid-term imaging consistently showed a stable device position, making early malposition or technical error an unlikely cause. This constellation of findings underscores the rarity of very late mechanical destabilization after an initially successful device closure.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"13 ","pages":"1807603"},"PeriodicalIF":2.8,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835893","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":"Transesophageal vs. transthoracic echocardiography for infective endocarditis: a systematic review and meta-analysis.","authors":"Yuan Yang, Wenming Zhang","doi":"10.3389/fcvm.2026.1808304","DOIUrl":"https://doi.org/10.3389/fcvm.2026.1808304","url":null,"abstract":"<p><strong>Objective: </strong>This meta-analysis aims to systematically evaluate the diagnostic accuracy of transesophageal echocardiography (TEE) vs. transthoracic echocardiography (TTE) in detecting infective endocarditis (IE).</p><p><strong>Methods: </strong>A comprehensive computerized search was performed in PubMed, Embase, Web of Science, and Cochrane Library databases to identify relevant English-language diagnostic trials or cohort studies published from inception to September 2025. Two independent researchers conducted literature screening, data extraction, and quality assessment using the Newcastle-Ottawa Scale. Diagnostic accuracy data were extracted or calculated, and pooled sensitivity, specificity, and their 95% confidence intervals (CIs) were determined. A summary receiver operating characteristic (SROC) curve was constructed. Statistical analyses were performed using RevMan 5.3 and Stata 18.0 and related software. Heterogeneity was assessed using the <i>I²</i> statistic, and publication bias was evaluated using Deeks' funnel plot asymmetry test.</p><p><strong>Results: </strong>A total of 13 studies involving 2,765 suspected patients with IE were finally included. A meta-analysis demonstrated that, using TEE as the reference, the pooled sensitivity of TTE was 0.72 (95% CI: 0.55-0.84), and the pooled specificity was 0.72 (95% CI: 0.55-0.85), with significant heterogeneity (sensitivity <i>I²</i>  = 95.96%, specificity <i>I²</i>  = 98.73%). The area under the SROC curve was 0.78 (95% CI: 0.74-0.82), indicating moderate diagnostic performance. Publication bias was detected (<i>P</i> = 0.04). Sensitivity analyses confirmed the overall stability of the results, although heterogeneity sources were identified. Subgroup analyses revealed statistically significant heterogeneity in sensitivity among different TTE subgroups (<i>P</i> = 0.001), while no significant heterogeneity was observed in specificity subgroups.</p><p><strong>Conclusion: </strong>TEE remains superior in IE diagnosis. For patients with high clinical suspicion but negative or inconclusive TTE findings, additional TEE examination is recommended to improve diagnostic accuracy and support clinical decision-making.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"13 ","pages":"1808304"},"PeriodicalIF":2.8,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835881","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}