Future cardiology最新文献

{"title":"Safety and efficacy of percutaneous patent foramen ovale closure compared with anti-thrombotic therapy for people with cryptogenic stroke: a systematic review and meta-analysis.","authors":"Jay Tewari, Harsh Agrawal, Pooja Dubey, Alok Dwivedi, Shubhechha Neupane, Vanshika Singh, Indika Mallawaarachchi, Debabrata Mukherjee","doi":"10.1080/14796678.2026.2665753","DOIUrl":"https://doi.org/10.1080/14796678.2026.2665753","url":null,"abstract":"<p><strong>Background: </strong>Stroke is a leading cause of death and disability. Patent foramen ovale (PFO) is more common in cryptogenic stroke, but the benefit of closure over antithrombotic therapy remains debated. We updated randomized evidence comparing PFO closure with antithrombotic therapy.</p><p><strong>Methods: </strong>MEDLINE, Embase, and Cochrane Central were searched through September 2025. Primary outcomes were stroke, transient ischemic attack (TIA), and a composite of stroke, TIA, death, or systemic embolism. Serious adverse events and atrial fibrillation were assessed.</p><p><strong>Results: </strong>Six trials (<i>n</i> = 3,560; closure 1,889; therapy 1,671) were included. Composite events occurred in 84 (4.4%) vs 152 (9.1%). Closure reduced the composite endpoint (HR 0.46, 95% CI 0.28-0.75; <i>p</i> = 0.002) and recurrent stroke (37 [2.0%] vs 77 [4.6%]; HR 0.27, 95% CI 0.12-0.62; <i>p</i> = 0.002). Benefit was greatest in men, age <45 years, and those with large shunts. Serious adverse events and mortality were similar, but atrial fibrillation increased (HR 4.46, 95% CI 2.00-9.92; <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>In selected patients, PFO closure lowers recurrent stroke and composite events versus antithrombotic therapy, at the cost of higher atrial fibrillation.</p><p><strong>Protocol registration: </strong>www.crd.york.ac.uk/prospero identifier is CRD420251167260.</p>","PeriodicalId":12589,"journal":{"name":"Future cardiology","volume":" ","pages":"1-10"},"PeriodicalIF":1.0,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rheumatic heart disease and mitral stenosis.","authors":"David Ho, Tony Li, Ryan Leow, Ching Hui Sia","doi":"10.1080/14796678.2026.2647664","DOIUrl":"https://doi.org/10.1080/14796678.2026.2647664","url":null,"abstract":"<p><p>Rheumatic heart disease (RHD) remains a leading cause of mitral stenosis (MS), particularly in developing countries like India, China or countries within Africa. Characterized by a long latent phase after acute rheumatic fever, rheumatic MS often leads to significant morbidity and mortality. This paper explores its epidemiology, natural history, and clinical consequences, including associations with atrial fibrillation, pulmonary hypertension, heart failure, systemic embolism, and infective endocarditis. We review diagnostic tools, particularly echocardiography, and management strategies such as balloon mitral commissurotomy and surgical interventions. Emerging therapies, including lithotripsy-facilitated procedures and trans-catheter valve replacement, offer promise for high-risk patients. Early detection and comprehensive care are essential to reduce the global burden of rheumatic MS.</p>","PeriodicalId":12589,"journal":{"name":"Future cardiology","volume":" ","pages":"1-15"},"PeriodicalIF":1.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147813795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decoding Kounis syndrome with artificial intelligence: from diagnosis to precision medicine.","authors":"George Kipourgos, Anastasios Tzenalis, Efthymia Andrikopoulou-Gkila, Nicholas G Kounis","doi":"10.1080/14796678.2026.2659086","DOIUrl":"https://doi.org/10.1080/14796678.2026.2659086","url":null,"abstract":"<p><p>Kounis syndrome-acute coronary events triggered by allergic or hypersensitivity reactions-remains underrecognized across emergency and cardiology settings. Its heterogeneous presentation and overlapping mechanisms (vasospasm, plaque erosion/rupture, stent thrombosis) challenge timely diagnosis and tailored therapy.This review synthesizes contemporary evidence on pathophysiology, clinical spectrum, and management of Kounis syndrome (Types I-III), and map how artificial intelligence (AI) could enhance care pathways. We outline data streams relevant to AI (ECG, biomarkers, imaging, clinical narratives), modeling approaches (machine learning, sequence models), and decision-support scenarios (early detection, risk stratification, treatment selection, and monitoring). We also address implementation barriers, including dataset shift, bias, transparency, and governance.Kounis syndrome is a prime candidate for AI-enabled diagnostic support given its pattern-based signatures at the interface of allergy and acute coronary syndromes. Near-term priorities include curated multicenter datasets with harmonized phenotyping, prospective validation of models embedded in clinical workflows, and hybrid rules-plus-learning systems aligned with guideline-based care. Integrating allergy severity, hemodynamics, and ischemic burden into dynamic risk tools may reduce missed diagnoses and optimize anti-allergic and antithrombotic strategies while safeguarding patient safety.</p>","PeriodicalId":12589,"journal":{"name":"Future cardiology","volume":" ","pages":"1-11"},"PeriodicalIF":1.0,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147768543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment with finerenone in people with heart failure and mildly reduced or preserved ejection fraction: a plain language review.","authors":"Marc Bains, Jawad H Butt, John W Ostrominski, Maria A Pabon Porras, Laurence Humphreys-Davies","doi":"10.1080/14796678.2026.2650667","DOIUrl":"https://doi.org/10.1080/14796678.2026.2650667","url":null,"abstract":"","PeriodicalId":12589,"journal":{"name":"Future cardiology","volume":" ","pages":"1-29"},"PeriodicalIF":1.0,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147768903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In-hospital mortality after pericardiocentesis: role of effusion etiology and hemodynamic physiology.","authors":"Nabeel Sami, Laura Bradel, Gioia Turitto","doi":"10.1080/14796678.2026.2664532","DOIUrl":"https://doi.org/10.1080/14796678.2026.2664532","url":null,"abstract":"<p><strong>Aims: </strong>This study evaluated the impact of effusion etiology, hemodynamic presentation, and comorbidity burden on in-hospital outcomes following pericardiocentesis.</p><p><strong>Patients and methods: </strong>A retrospective analysis of 62 adults who underwent pericardiocentesis at a tertiary academic hospital (2021-2024) was performed. The primary outcome was in-hospital mortality. The Charlson Comorbidity Index (CCI) and a post hoc Pericardial Risk Score (PRS) were evaluated as predictors.</p><p><strong>Results: </strong>Median age was 72 years (55% male; median CCI 2). Complications occurred in 13% and recurrence in 10%. In-hospital mortality was 8.1% (5/62), limited to malignant, ischemic, infectious, or anticoagulation-related effusions. The PRS showed a stepwise increase in mortality from 0% (PRS 0) to 25% (PRS 2) (<i>p</i> = 0.037), while the CCI did not predict mortality (<i>p</i> = 0.27).</p><p><strong>Conclusions: </strong>Pericardiocentesis remains safe and effective with low recurrence. Mortality is driven by effusion etiology and hemodynamic severity rather than comorbidity burden. A simple etiology-physiology risk score outperformed the CCI and may help guide post-procedural management.</p>","PeriodicalId":12589,"journal":{"name":"Future cardiology","volume":" ","pages":"1-8"},"PeriodicalIF":1.0,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147768945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of chronic total occlusion on outcomes following transcatheter aortic valve implantation: a systematic review and meta-analysis.","authors":"Kyriakos Dimitriadis, Nikolaos Pyrpyris, Eirini Beneki, David Meier, Angelos Papanikolaou, Eirini Dris, Panagiotis Theofilis, Panagiotis Antiochos, Stephane Fournier, Georgios Tzimas, Konstantinos Aznaouridis, Konstantinos Tsioufis","doi":"10.1080/14796678.2026.2664534","DOIUrl":"https://doi.org/10.1080/14796678.2026.2664534","url":null,"abstract":"<p><strong>Aim: </strong>The pre-procedural presence of chronic total occlusions (CTO) in patients undergoing transcatheter aortic valve implantation (TAVI) could be a significant predictor of outcomes. This meta-analysis aims to investigate whether CTO presence significantly alters outcomes in TAVI patients.</p><p><strong>Methods: </strong>A systematic search was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. After study selection, a random effect meta-analysis was performed.</p><p><strong>Results: </strong>Seven studies with a total of 15,162 patients undergoing TAVI were included. There was no significant difference regarding in-hospital [Relative Risk (RR): 1.13; 95% Confidence Interval (95% CI): 0.82-1.55] and 1-year all-cause mortality (RR: 1.58; 95% CI: 0.71-3.50). Patients with CTO exhibited significantly increased rates of myocardial infarction (RR: 1.27, 95% CI: 1.07-1.51) and reduced rates of new pacemaker implantation (RR: 0.88, 95% CI: 0.79-0.98). No differences were found in cardiogenic shock (RR: 1.18, 95% CI: 0.97-1.44), acute kidney injury (RR: 1.06, 95% CI: 0.88-1.28), vascular complications (RR: 1.10, 95% CI: 0.91-1.33), or bleeding (RR: 1.01, 95% CI: 0.89-1.14).</p><p><strong>Conclusion: </strong>In TAVI patients, pre-procedural unrevascularized CTO presence is not related to short- or mid-term increased mortality. Further studies are needed to identify predictors of adverse events and phenotypes benefiting from revascularization.</p>","PeriodicalId":12589,"journal":{"name":"Future cardiology","volume":" ","pages":"1-10"},"PeriodicalIF":1.0,"publicationDate":"2026-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147768868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of fatal neonatal dilated cardiomyopathy in an infant of a diabetic mother.","authors":"Zakaria Yusuf Hassan, Abdullahi Abdulkadir Hashi Elmi, Abdihafid Mohamed Abdullahi","doi":"10.1080/14796678.2026.2662011","DOIUrl":"https://doi.org/10.1080/14796678.2026.2662011","url":null,"abstract":"<p><p>Dilated cardiomyopathy (DCM) is the most common pediatric cardiomyopathy and a leading cause of heart failure and cardiac transplantation in children. While a rare complication of maternal diabetes, the dilated phenotype of Infant of a Diabetic Mother (IDM) cardiomyopathy carries a high risk of morbidity and mortality. We report a term female neonate born to a mother with poorly controlled gestational diabetes (HbA1c 8.0%) who developed severe cardiogenic shock within 24 hours of life. Echocardiography confirmed DCM with profound biventricular dysfunction (initial left ventricular ejection fraction [LVEF] 28%, deteriorating to <17% within 5 days) and associated left ventricular non-compaction (LVNC) morphology. Despite maximal medical therapy, the infant's condition deteriorated, and she died on day 11 of life. Comprehensive diagnostic workup for alternative etiologies was limited by the rapid clinical course. This fatal case highlights the potential severity of the dilated form of IDM cardiomyopathy, which can be rapidly progressive and refractory to treatment. It underscores the critical importance of optimal glycemic control in pregnancy while acknowledging that alternative genetic or metabolic etiologies cannot be definitively excluded. This presentation should be recognized as a high-risk clinical entity distinct from the more common and often transient hypertrophic form.</p>","PeriodicalId":12589,"journal":{"name":"Future cardiology","volume":" ","pages":"1-5"},"PeriodicalIF":1.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147768507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of multi-marker stress echocardiography.","authors":"Eugenio Picano, Angela Zagatina, Lauro Cortigiani, Ratnasari Padang, Garvan C Kane, Hector R Villarraga, Adelaide M Arruda-Olson, Jorge Lowenstein, Rosina Arbucci, Hugo Rodriguez-Zanella, Ayten Safarova, Tatiana Timofeeva, Francesca Bursi, Alla Boshchenko, Olga Zhuravleva, Yi Wang, Lixue Yin, Jesus Peteiro Vazquez, Fiore Manganelli, Elisa Merli, Dimitrios Soulis, Ariel Saad, Jelena Celutkiene, Laura Balkeviciene, Sergio Kobal, Ana Djordjevic-Dikic, Nicola Gaibazzi, Clarissa Borguesan-Daros, Aleksandra Nikolic, Miodrag Ostojic, Tamara Kovacevic-Preradovic, Karina Wierzbowska-Drabik, Jaroslaw D Kasprzak, Luigi Gerra, Scipione Carerj, Quirino Ciampi, Patricia A Pellikka","doi":"10.1080/14796678.2026.2659089","DOIUrl":"https://doi.org/10.1080/14796678.2026.2659089","url":null,"abstract":"<p><p>Stress echocardiography (SE) has evolved beyond its traditional role of detecting coronary artery disease (CAD) through a single marker-regional wall motion abnormality (RWMA). This conventional approach, while guideline-embedded, faces a declining positivity rate and reduced prognostic power in today's diverse patient population. In response, SE has undergone a conceptual transformation into a multi-marker, comprehensive functional assessment of patient vulnerability. The modern multi-marker protocol, known as the ABCDE-SE, integrates five steps during a single stress test: Step A assesses RWMA for ischemia; Step B quantifies pulmonary congestion via B-lines and E/e'; Step C evaluates left ventricular volume response; Step D measures coronary flow velocity reserve for microvascular function; and Step E determines heart rate reserve for autonomic function. Each step identifies distinct pathophysiological mechanisms and actionable therapeutic targets, significantly refining risk stratification.Developed and validated over the past decade with the SE 2030 study (2016-2030), the flagship project of SIECVI, Italian Society of Echocardiography and Cardiovascular Imaging, and adopted by 50 laboratories from 20 countries, the ABCDE protocol represents a universal and widely accessible platform, applicable to all patients with suspected cardiac disease. It paves the way for personalized medicine by enabling tailored therapies targeted to the specific vulnerabilities.</p>","PeriodicalId":12589,"journal":{"name":"Future cardiology","volume":" ","pages":"1-11"},"PeriodicalIF":1.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147768887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating sotatercept in the treatment of pulmonary arterial hypertension.","authors":"William Salibe-Filho, Nathalia Zorze Rossetto, Luiza Sarmento Tatagiba, Yuri de Deus MontAlverne Parente, Carlos Viana Poyares Jardim, Caio Julio Cesar Fernandes, José Leonidas Alves-Junior, Rogerio Souza","doi":"10.1080/14796678.2026.2659085","DOIUrl":"https://doi.org/10.1080/14796678.2026.2659085","url":null,"abstract":"<p><p>Pulmonary arterial hypertension (PAH) is a progressive disease characterized by pulmonary vascular remodeling, right ventricular overload, and premature death. Despite advances achieved through endothelin receptor antagonists, phosphodiesterase type 5 inhibitors, and prostacyclin analogs, these agents primarily act as vasodilators and do not reverse underlying vascular pathology. Sotatercept, a first-in-class activin signaling modulator, restores the balance between pro- and antiproliferative signaling within the pulmonary vasculature via the TGF-β/activin-BMPR2 pathway, offering a novel disease-modifying mechanism. Following encouraging preclinical data, a series of clinical trials, PULSAR, SPECTRA, STELLAR, ZENITH, and HYPERION, demonstrated consistent efficacy across diverse PAH populations. Sotatercept significantly reduced pulmonary vascular resistance, improved exercise capacity, and decreased morbidity and mortality, including in patients receiving maximal background therapy. Across studies, adverse events were generally mild to moderate, with epistaxis, telangiectasia, and increased hemoglobin being the most common treatment-related events. Collectively, these findings establish sotatercept as a major advance in PAH therapy, marking a transition from purely vasodilatory approaches toward targeted modulation of vascular remodeling. By improving pulmonary hemodynamics and right ventricular function, sotatercept represents a new therapeutic option for improving clinical outcomes across different stages of PAH.</p>","PeriodicalId":12589,"journal":{"name":"Future cardiology","volume":" ","pages":"1-10"},"PeriodicalIF":1.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Granulocyte colony stimulating factor for acute myocardial infarction: an updated systematic review and meta-analysis of randomized controlled trials.","authors":"Luiz Guilherme Silva Almeida, Lucca Tamara Alves Carretta, Luciano Falcão, Adolfo Moraes de Souza, Yasmin Picanço Silva, Mariana Pulrolnik Parrillo de Oliveira, Ricardo F O Suruagy-Motta, Karlos Daniell Araújo Dos Santos, Rafael Torres Fonseca Dos Santos, Gustavo Surgik, Fernanda Almeida Andrade","doi":"10.1080/14796678.2026.2655394","DOIUrl":"https://doi.org/10.1080/14796678.2026.2655394","url":null,"abstract":"<p><strong>Introduction: </strong>Granulocyte Colony-Stimulating Factor (G-CSF) has been explored as a therapy to enhance myocardial repair after acute myocardial infarction (AMI). Earlier meta-analyses of randomized controlled trials (RCTs) reported no significant improvement but recently published studies warranted an updated synthesis.</p><p><strong>Methods: </strong>We searched PubMed, Embase, Cochrane Library, and Web of Science for RCTs comparing G-CSF with placebo or standard care in AMI. Primary outcomes were left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), and left ventricular ejection fraction (LVEF). Secondary outcomes were mortality, reinfarction, restenosis, and revascularization.</p><p><strong>Results: </strong>Eleven RCTs encompassing 1,073 participants were included. G-CSF significantly reduced LVEDV in echocardiography studies (MD: -4.39 mL; 95% CI -6.80, -1.98; <i>p</i> < 0.001), whereas no effect was observed in MRI studies (MD: -0.19 mL; 95% CI -7.22, 6.84; <i>p</i> = 0.958). LVEF improved in the echocardiography subgroup (MD: 6.76%; 95% CI 1.62, 11.90; <i>p</i> = 0.010) but not in the MRI subgroup (MD: -0.08%; 95% CI -2.38, 2.22; <i>p</i> = 0.947). LVESV showed no significant differences. No effects were seen for mortality, reinfarction, restenosis, or revascularization.</p><p><strong>Conclusion: </strong>G-CSF may confer structural benefits detectable by echocardiography, yet clinical outcomes remain unchanged. Larger, high-quality trials are needed to define its therapeutic role.</p>","PeriodicalId":12589,"journal":{"name":"Future cardiology","volume":" ","pages":"1-14"},"PeriodicalIF":1.0,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147698470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}