Frontiers in Cardiovascular Medicine最新文献

{"title":"Levosimendan versus dobutamine in septic cardiomyopathy: a randomized clinical trial on cardiac function and safety.","authors":"Feng Zhao, Haolei Wei, Leqing Lin, Hui Wang, Zhuxian Zhang, Liang Guo","doi":"10.3389/fcvm.2025.1641604","DOIUrl":"10.3389/fcvm.2025.1641604","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the clinical efficacy, safety, and impact on outcomes of levosimendan compared with dobutamine in patients with septic cardiomyopathy.</p><p><strong>Methods: </strong>A randomized clinical trial was conducted in patients with septic cardiomyopathy between December 2022 and March 2024. Eligible patients received either levosimendan or dobutamine in addition to standard sepsis treatments. Baseline characteristics, laboratory parameters, pulse index continuous cardiac output, clinical outcomes, and adverse reactions were recorded and compared between the two groups.</p><p><strong>Results: </strong>A total of 50 patients were analyzed, with 25 patients in each group. The mean age was 76.4 (±12.3) years, and 28 patients (56%) were male. Baseline characteristics were comparable between groups. Following treatment, improvements were observed in both groups in left ventricular ejection fracture and levels of cardiac troponin I, B-type natriuretic peptide, cardiac index (CI), lactate, and norepinephrine infusion rate(all <i>P</i> < 0.05), with significantly greater improvements in the levosimendan group (<i>P</i> < 0.05). Additionally, the CI was higher in the levosimendan group compared to the dobutamine group (<i>P</i> < 0.05). No statistically significant differences were observed between groups in other pulse index continuous cardiac output variables, laboratory tests, clinical outcomes, or adverse reactions.</p><p><strong>Conclusions: </strong>In patients with septic cardiomyopathy, levosimendan treatment resulted in greater improvements in cardiac function, hemodynamic stability, and tissue perfusion compared with dobutamine, without an increase in adverse reactions. Further studies are needed to evaluate the long-term effects of levosimendan on clinical outcomes in this patient population.</p><p><strong>Registration number: </strong>ChiCTR2500101261.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1641604"},"PeriodicalIF":2.8,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12491170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231628","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 and predictability of major perioperative cardiovascular adverse events and elevated neutrophil percentage-to-albumin ratio in patients with stable coronary artery disease undergoing non-cardiac surgery.","authors":"Haodong Jiang, Jia Zhu, Congying Wang, Xiaojun Xia, Runzhe Wu, Feiyu Chen, Yongquan Niu, Yunpeng Jin","doi":"10.3389/fcvm.2025.1623731","DOIUrl":"10.3389/fcvm.2025.1623731","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate the utility of the preoperative neutrophil percentage-to-albumin ratio (&lt;i&gt;N&lt;/i&gt;PAR) for predicting perioperative major adverse cardiovascular events (MACE) in patients with stable coronary artery disease (SCAD) undergoing non-cardiac surgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this retrospective cohort study, we included all adult SCAD patients who underwent non-cardiac surgery at the Fourth Affiliated Hospital of Zhejiang University School of Medicine between October 2020 and October 2024. The primary endpoint was the occurrence of MACE during the perioperative period, defined as a composite of all-cause mortality, cardiac arrest, myocardial infarction, heart failure, or stroke occurring intraoperatively or during the postoperative hospital stay. We used multivariable logistic regression to assess the independent association between NPAR and MACE risk. To explore potential nonlinearity, we fitted smooth curves and performed threshold-effect analysis. Mediation analysis quantified the proportion of the NPAR-MACE relationship explained by estimated glomerular filtration rate (eGFR). Incremental predictive value was evaluated by comparing the area under the receiver operating characteristic curve (AUC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI) before and after adding NPAR to established risk models. Feature selection was conducted using the Boruta algorithm, and predictive performance was further validated with an XGBoost model interpreted via Shapley Additive Explanations (SHAP).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 1,771 patients, 90 (5.1%) experienced MACE. The MACE subgroup had a higher mean NPAR than those without events (19.4 ± 5.3 vs. 15.9 ± 3.5; &lt;i&gt;P&lt;/i&gt; &lt; 0.001). Each 1-unit increase in NPAR was associated with a 20% higher risk of MACE (OR 1.20; 95% CI 1.10-1.30). A J-shaped relationship emerged, with an inflection point at NPAR 13.7 (P_threshold = 0.005). eGFR mediated 8.4% of the NPAR-MACE association. NPAR alone yielded an AUC of 0.721. Adding NPAR to the Revised Cardiac Risk Index raised the AUC from 0.679-0.755 (NRI 0.599; IDI 0.035; all &lt;i&gt;P&lt;/i&gt; &lt; 0.01). The XGBoost model achieved an AUC of 0.773, and SHAP analysis identified NPAR as the most influential predictor.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Preoperative NPAR is an independent, readily available predictor of perioperative MACE in SCAD patients. Incorporation of NPAR into existing risk models significantly enhances predictive accuracy and may inform targeted perioperative management strategies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 1,771 patients, 90 (5.1%) experienced MACE. The MACE subgroup had a higher mean NPAR than those without events (19.4 ± 5.3 vs. 15.9 ± 3.5; &lt;i&gt;P&lt;/i&gt; &lt; 0.001). Each 1-unit increase in NPAR was associated with a 20% higher risk of MACE (OR 1.20; 95% CI 1.10-1.30). A J-shaped relationship emerged, with an inflection point at NPAR 13.7 (P_threshold = 0.005). eGFR medi","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1623731"},"PeriodicalIF":2.8,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12491289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231848","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 effect of guideline-directed medicine on patients with new-onset heart failure following acute myocardial infarction.","authors":"Mengjie Lei, Jingyao Wang, Xiao Wang, Xue Sue, Cairong Li, Yanli Yang, Yachao Li, Zhigang Zhao, Zengming Xue","doi":"10.3389/fcvm.2025.1639213","DOIUrl":"10.3389/fcvm.2025.1639213","url":null,"abstract":"<p><strong>Aims: </strong>To investigate the impact of guideline-directed medical therapy (GDMT) during hospitalization on the prognosis of patients with heart failure (HF) episode complicating post-acute myocardial infarction (AMI).</p><p><strong>Methods: </strong>From 01/05/2017 to 30/09/2022, 527 patients with HF episode complicating post-AMI at a single medical center who were retrospectively analyzed. Based on whether GDMT during hospitalization was used in patients undergoing percutaneous coronary intervention (PCI), the patients were divided into the GDMT group (<i>n</i> = 379) and the non-GDMT group (<i>n</i> = 148), with a follow-up period of 12 months after PCI. The primary endpoint was the composite endpoint of all-cause death and all-cause readmission.</p><p><strong>Results: </strong>The incidence of the primary endpoints (7.9% vs. 18.9%, <i>P</i> < 0.001), cardiac death and cardiac readmission composite events (5.5% vs. 15.5%, <i>P</i> = 0.002), all-cause readmission events (7.1% vs. 18.9%, <i>P</i> < 0.001), and cardiac readmission events (5.0% vs. 13.5%, <i>P</i> = 0.001) in the GDMT group were lower. Cox regression analysis revealed that the incidence of primary endpoints, cardiac death and cardiac readmission composite events, all-cause readmission events, and cardiac readmission events in patients treated with GDMT during hospitalization were 0.266 times (<i>HR</i> 0.266; <i>95% CI</i> 0.146-0.487; <i>P</i> < 0.001), 0.282 times (<i>HR</i> 0.282; <i>95% CI</i> 0.137-0.581; <i>P</i> = 0.001), 0.251 times (<i>HR</i> 0.251; <i>95% CI</i> 0.136-0.464; <i>P</i> < 0.001) and 0.262 times (<i>HR</i> 0.262; <i>95% CI</i> 0.125-0.551; <i>P</i> < 0.001), respectively, compared to patients treated without GDMT.</p><p><strong>Conclusion: </strong>For patients with HF episode complicating post-AMI who undergo PCI, the use of GDMT during hospitalization reduces the incidence of primary endpoints, cardiac death and cardiac readmission composite endpoints, and all-cause readmission and cardiac readmission.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1639213"},"PeriodicalIF":2.8,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12491194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231706","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":"Thromboelastography in ruptured abdominal aortic aneurysm management: lessons from vascular, cardiac, and trauma surgery.","authors":"Michał Gniedziejko, Joanna Halman, Nina Kimilu, Marcin Folwarski, Mariusz Siemiński","doi":"10.3389/fcvm.2025.1668165","DOIUrl":"10.3389/fcvm.2025.1668165","url":null,"abstract":"<p><p>Ruptured abdominal aortic aneurysm (rAAA) is a critical surgical emergency. Thromboelastography (TEG) is a viscoelastic, point-of-care test that provides a comprehensive real-time assessment of coagulation and fibrinolysis. Although TEG has been successfully adopted in trauma and cardiac surgery for individualised transfusion guidance, its role in rAAA has not been sufficiently explored. We conducted a review of studies published between 2009 and 2024 to assess the utility of TEG or rotational thromboelastometry (ROTEM) in rAAA management. Evidence from vascular surgery suggests reduced blood-product transfusions and postoperative bleeding. Additional data from cardiac surgery and emergency/trauma demonstrated improved survival, fewer reoperations and cost efficiency. Although there are few direct studies on the utility of TEG in rAAA and these are mostly descriptive, the results presented in this review suggest its potential role in vascular emergencies. To confirm this, well-designed prospective studies are essential to determine when and how TEG should guide decision-making in this critical setting.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1668165"},"PeriodicalIF":2.8,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12491231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231708","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":"Associations of vitamin D with coronary revascularization and heart rate variability in hypertensive patients.","authors":"Zongbin Li, Yuting Zou, Ruizhe Li, Minglei Zhang","doi":"10.3389/fcvm.2025.1590701","DOIUrl":"10.3389/fcvm.2025.1590701","url":null,"abstract":"<p><strong>Background: </strong>Even though substantial evidence has found that vitamin D deficiency correlates to risk factors for cardiovascular disease (CVD), few studies have shown how vitamin D affects coronary revascularization and heart rate variability (HRV). We aimed to explore the connection between vitamin D levels with coronary revascularization and HRV in hypertensive patients.</p><p><strong>Methods: </strong>A total of the 250 eligible participants with hypertension hospitalized at the Department of Cardiology, Sixth Medical Center of Chinese PLA General Hospital was consecutively recruited. The status of vitamin D is measured utilizing serum 25-hydroxyvitamin D₃ [25(OH)D₃] concentrations. The primary endpoints were defined as patients undergoing coronary revascularization treatment. The secondary endpoints were defined as the variation in HRV. HRV indices were recorded in participants using a 24-h Holter electrocardiogram (ECG). In addition, direct renin concentrations and plasma aldosterone concentrations were measured in the supine and standing positions.</p><p><strong>Results: </strong>In the study, 165 eligible patients assigned to the vitamin D deficiency [25(OH)D₃ < 20 ng/ml] group and 85 to the vitamin D non-deficiency[25(OH)D₃ ≥ 20 ng/ml] group. In both univariate logistic regression analysis (OR: 2.46, 95% CI: 1.06-5.68; <i>P</i> = 0.036) and multivariate logistic regression analysis (OR: 2.54, 95% CI: 1.02-6.33; <i>P</i> = 0.046), the 25(OH)D₃ < 20 ng/ml demonstrated to be a significant risk factor of primary endpoints for those hypertensive patients. Receiver operating characteristic curve (ROC) analysis showed the multivariable-adjusted model for predicting primary endpoints in patients with hypertension, with an area under the curve (AUC) of 0.73 (95% CI: 0.64-0.82, <i>p</i> < 0.001). Regarding secondary endpoints, the HRV indexes such as standard deviation of normal-to-normal (NN) intervals (SDNN) (<i>P</i> = 0.04), standard deviation of the averages of NN intervals in all 5-min segments (SDANN) (<i>P</i> = 0.03), and Triangle indexes values (<i>P</i> = 0.02) were significantly different in the two groups. Finally, we observed that hypertensive patients with vitamin D deficiency had significantly greater aldosterone and aldosterone-to-renin ratio (ARR) values than those having vitamin D non-deficiency.</p><p><strong>Conclusion: </strong>Vitamin D deficiency was prevalent in hypertensive patients and was independently associated with the risk of coronary revascularization. Vitamin D deficiency also affects HRV and ARR values in hypertensive patients.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1590701"},"PeriodicalIF":2.8,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12491254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231861","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":"Conditional 1-year outcomes after emergent conversion to open heart surgery during transcatheter aortic valve implantation: a propensity-matched landmark analysis.","authors":"Giuseppe Nasso, Walter Vignaroli, Gaetano Contegiacomo, Alfredo Marchese, Ernesto Greco, Khalil Fattouch, Raffaele Bonifazi, Flavio Fiore, Giacomo Schinco, Antongiulio Valenzano, Carlo Solimando, Vito Margari, Fabrizio Resta, Tommaso Loizzo, Dritan Hila, Domenico Paparella, Giuseppe Speziale","doi":"10.3389/fcvm.2025.1660381","DOIUrl":"10.3389/fcvm.2025.1660381","url":null,"abstract":"<p><strong>Background: </strong>Emergent conversion to open heart surgery (E-OHS) during transcatheter aortic valve implantation (TAVI) is rare (0.5%-2%) but carries high perioperative mortality. Long-term outcomes in survivors beyond 30 days are not well defined.</p><p><strong>Objectives: </strong>To assess 1-year conditional outcomes in patients who survived ≥30 days post-TAVI, comparing E-OHS survivors with propensity-matched uncomplicated TAVI recipients.</p><p><strong>Methods: </strong>Between January 2020 and August 2023, 825 consecutive TAVI procedures were performed at three Italian centers; 11 patients (1.3%) required E-OHS for catastrophic intraprocedural complications. A 30-day landmark analysis excluded early deaths (E-OHS: <i>n</i> = 3; controls: <i>n</i> = 25). Propensity matching (1:10) was performed on nine variables, yielding 8 E-OHS survivors and 80 well-matched controls.</p><p><strong>Primary endpoint: </strong>All-cause mortality from day 31 to 1 year.</p><p><strong>Secondary endpoints: </strong>Composite of death, moderate-or-greater paravalvular regurgitation, or valve reintervention; heart failure rehospitalization; permanent pacemaker; stroke/transient ischemic attack (TIA); and acute kidney injury (AKI).</p><p><strong>Results: </strong>Baseline characteristics were comparable. The mean age was 77 ± 5 years; EuroSCORE II was 6.8 ± 2.1%. One-year conditional mortality was 0% in E-OHS survivors vs. 2.9% in controls (<i>p</i> = 0.64). The composite endpoint occurred in 12.5% vs. 13.6% (<i>p</i> = 0.88). Other outcomes were similar: heart failure rehospitalization (12.5% vs. 11.2%), pacemaker implantation (12.5% vs. 9.6%), stroke/TIA (0% vs. 1.2%), and AKI (0% vs. 7.2%). No structural valve deterioration or thrombosis was observed.</p><p><strong>Conclusions: </strong>E-OHS survivors who overcome the initial high-risk phase achieve 1-year outcomes comparable to standard TAVI patients. These findings support immediate surgical backup within TAVI programs and provide reassurance for high-risk patient counseling.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1660381"},"PeriodicalIF":2.8,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231909","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":"Arrhythmia prevention protocol during papaverine administration for invasive coronary functional assessment.","authors":"Dobrin Vassilev, Niya Mileva, Gavril Stoev, Ilter Pazardzhykly, Panayot Panayotov, Gianluca Rigatelli, Valery Gelev","doi":"10.3389/fcvm.2025.1621053","DOIUrl":"10.3389/fcvm.2025.1621053","url":null,"abstract":"<p><strong>Background: </strong>Accurate assessment of coronary physiology through invasive functional testing is critical for the effective management of chronic coronary syndromes. The induction of maximal and sustained coronary hyperemia is essential for obtaining reliable measurements of fractional flow reserve (FFR), coronary flow reserve (CFR), and the index of microcirculatory resistance (IMR). Intracoronary papaverine is a potent vasodilator for inducing hyperemia but has been associated with ventricular arrhythmias, limiting its clinical use.</p><p><strong>Methods: </strong>This single-center prospective study investigates the feasibility and safety of a novel hyperemic protocol involving intravenous (i.v.) lidocaine administration followed by intracoronary papaverine in patients undergoing invasive coronary functional assessment. All patients underwent FFR, CFR, and IMR measurements after receiving an initial dose of 100 mg of i.v. lidocaine followed by papaverine (20 mg for the left coronary artery and 5-10 mg for the right coronary artery).</p><p><strong>Results: </strong>A total of 389 patients were enrolled. Functionally significant stenosis (FFR ≤ 0.80) was identified in 36% of patients and microvascular dysfunction in 48%. Ventricular arrhythmias occurred in 1.5% of patients, including four episodes of ventricular fibrillation and two of ventricular tachycardia; all resolved with prompt defibrillation and without hemodynamic compromise.</p><p><strong>Conclusion: </strong>These findings suggest that pre-treatment with lidocaine may enhance the safety of papaverine-induced hyperemia during invasive coronary testing.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1621053"},"PeriodicalIF":2.8,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231823","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":"A case report of hepatocarcinoma-originated pericardial malignancy.","authors":"Bin Wu, Zhixiao Wang, Weizhe Lin, Jian Xiong, Chaoyong He","doi":"10.3389/fcvm.2025.1643805","DOIUrl":"10.3389/fcvm.2025.1643805","url":null,"abstract":"<p><p>Cardiac tumors constitute an exceptionally rare neoplastic entity posing significant diagnostic challenges. We report a 55-year-old female patient without prior oncologic history who presented with acute-onset bilateral lower extremity edema progressing over 72 h. Transthoracic echocardiography demonstrated a pericardial mass with concomitant hemorrhagic pericardial effusion. Subsequent magnetic resonance imaging and systemic positron emission tomography localized the lesion to the right bottom of the heart. Surgical exploration suggested a cardiac occupancy as an irregular, fish-flesh-like soft tissue mass, pathology biopsy was performed suggesting a malignant tumour of epithelial origin, and immunohistochemistry was suggestive of hepatic origin. The patient received combination therapy comprising programmed death-1 inhibitor camrelizumab (200 mg via intravenous infusion every 21 days) and oral lenvatinib (8 mg once daily). Serial contrast-enhanced computed tomography of the thorax and abdomen demonstrated progressive metastatic dissemination with malignant pleural and peritoneal effusion formation. Despite therapeutic intervention, the patient ultimately experienced disease progression culminating in mortality.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1643805"},"PeriodicalIF":2.8,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231870","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":"Editorial: Reviews in transcatheter aortic valve implantation.","authors":"Mi Chen, Albert Markus Kasel","doi":"10.3389/fcvm.2025.1678985","DOIUrl":"10.3389/fcvm.2025.1678985","url":null,"abstract":"","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1678985"},"PeriodicalIF":2.8,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231668","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":"Imaging myocardial scar in hypertrophic cardiomyopathy: advances in CMR and CT.","authors":"Matteo Sclafani, Chiara Perrotti, Luigi Salerno, Melwyn Luis Muthukkattil, Camilla Lustri, Gabriele Cristofari, Giulio Falasconi, Maria Beatrice Musumeci, Diego Penela, Andrea Saglietto, Agnese Iannaccone, Emanuele Barbato, Antonio Berruezo, Pietro Francia","doi":"10.3389/fcvm.2025.1649728","DOIUrl":"10.3389/fcvm.2025.1649728","url":null,"abstract":"<p><p>Myocardial scarring is a hallmark of hypertrophic cardiomyopathy (HCM) and a major driver of adverse outcomes, including sudden cardiac death and heart failure progression. The fibrotic substrate in HCM is complex, encompassing both replacement and interstitial fibrosis, often accompanied by myocardial disarray. Advanced cardiovascular imaging enables detailed scar characterization, which is crucial for risk stratification and personalized management. Cardiovascular magnetic resonance (CMR) is the gold standard for non-invasive fibrosis assessment. Techniques such as late gadolinium enhancement, myocardial mapping of T1 and T2 relaxation properties, and diffusion tensor imaging provide complementary insights into scar burden and architecture. Cardiac computed tomography (CT) is an emerging modality with increasing clinical relevance. Delayed iodine enhancement and CT-derived extracellular volume mapping offer a valuable alternative for scar assessment, particularly when CMR is contraindicated. This review highlights the role of multimodality imaging in assessing myocardial scar in HCM, with a focus on CMR and CT, and explores their clinical implications.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1649728"},"PeriodicalIF":2.8,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231689","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}