International journal of cardiology最新文献

{"title":"Prognostic value of left atrial strain analysis in patients with chronic myocarditis","authors":"Yuting Zou ,&nbsp;Zhongwei Yuan ,&nbsp;Xinyi Wang ,&nbsp;Zhiyan Li ,&nbsp;Cuiyan Wang","doi":"10.1016/j.ijcard.2026.134170","DOIUrl":"10.1016/j.ijcard.2026.134170","url":null,"abstract":"<div><h3>Background</h3><div>Left atrial (LA) strain and left atrioventricular coupling index (LACI) independently predict prognosis in multiple cardiovascular diseases, but their prognostic value in chronic myocarditis remains unclear. This study aimed to evaluate the prognostic value of CMR-derived LA strain and LACI in patients with chronic myocarditis.</div></div><div><h3>Methods</h3><div>This single-center retrospective study included patients suspected of chronic myocarditis who underwent CMR from June 2019 to October 2024. CMR-derived LA functional parameters, LACI, as well as clinical characteristics and outcomes were collected. Composite endpoints included major adverse cardiovascular events and arrhythmia (including ventricular premature beats and intraventricular conduction block). Multivariable Cox regression identified predictive parameters.</div></div><div><h3>Results</h3><div>A total of 113 patients (mean age 50 ± 12 years; 62 males) were enrolled. After a median follow-up of 24 months, 17 (15.0%) patients experienced composite events. Multivariable Cox regression showed that LA reservoir strain (adjusted HR = 0.770, 95%CI: 0.631–0.894, <em>P</em> = 0.003) and LA conduit strain (adjusted HR = 0.770, 95%CI: 0.615–0.911, <em>P</em> = 0.007) were independent predictors of composite events. LA reservoir strain and LA conduit strain had high negative predictive values (98.6% and 97.5%, respectively) and sensitivities (94.1% and 88.2%, respectively) for ruling out composite events, with statistical significance. The integrated model incorporating traditional CMR parameters, LARS, and LACS exhibited the best predictive performance (AUC=0.906, 95% CI: 0.788–0.973).</div></div><div><h3>Conclusion</h3><div>CMR-derived LA reservoir and conduit strains are independent predictors of adverse clinical outcomes in patients with chronic myocarditis, serving as reliable “rule-out” tools for composite events. Additionally, the combined model of these two strains exhibits excellent predictive performance for composite events.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"448 ","pages":"Article 134170"},"PeriodicalIF":3.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Air pollution and the cardiometabolic pathway to stroke","authors":"Kasper Rosenbech ,&nbsp;Stephan Peronard Mayntz","doi":"10.1016/j.ijcard.2026.134168","DOIUrl":"10.1016/j.ijcard.2026.134168","url":null,"abstract":"","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"448 ","pages":"Article 134168"},"PeriodicalIF":3.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145975020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-invasive evaluation of left ventricular hemodynamic force abnormalities in hypertrophic cardiomyopathy: Implications for myosin inhibition","authors":"Chiara Zocchi ,&nbsp;Alessandra Milazzo ,&nbsp;Giorgia Panichella ,&nbsp;Manuel Garofalo ,&nbsp;Angela I. Fanizzi ,&nbsp;Maddalena Ragagnin ,&nbsp;Raffaele Coppini ,&nbsp;Raymond H. Chan ,&nbsp;Mattia Zampieri ,&nbsp;Francesco Cappelli ,&nbsp;Maurizio Pieroni ,&nbsp;Gianni Pedrizzetti ,&nbsp;Iacopo Olivotto ,&nbsp;Annamaria Del Franco","doi":"10.1016/j.ijcard.2026.134175","DOIUrl":"10.1016/j.ijcard.2026.134175","url":null,"abstract":"<div><h3>Background</h3><div>Hypertrophic cardiomyopathy (HCM) is characterized by abnormal myocardial mechanics, with or without left ventricular outflow tract obstruction (LVOTO). Myosin inhibitors such as mavacamten have shown clinical efficacy in reducing obstruction, but their effects on left ventricular hemodynamic forces (HDF)—a novel marker of myocardial function—are not yet defined. This study aimed to characterize left ventricular HDF patterns in patients with obstructive (oHCM) and non-obstructive (noHCM) HCM compared to healthy controls, and to evaluate the impact of long-term mavacamten therapy on HDF parameters in oHCM.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 40 HCM patients (20 oHCM, 20 noHCM) and 20 age- and sex-matched healthy controls. HDF parameters were quantified using echocardiographic strain imaging software (<em>Qstrain</em>, <em>Medis Medical Imaging Systems</em>). Parameters included systolic and diastolic force amplitudes and time indices. Six oHCM patients receiving mavacamten were assessed at baseline and after three years of therapy.</div></div><div><h3>Results</h3><div>Compared to controls, HCM patients had significantly reduced systolic time to peak (<em>p</em> &lt; 0.001) and diastolic-systolic transition time (p &lt; 0.001), indicating premature systolic thrust and impaired relaxation. Diastolic force amplitude was significantly lower in oHCM than noHCM (p &lt; 0.001). Mavacamten treatment in oHCM patients significantly prolonged diastolic-systolic transition (<em>p</em> = 0.030) and restored longitudinal force dynamics (<em>p</em> = 0.031), suggesting improved mechanical coordination and reduced LVOTO.</div></div><div><h3>Conclusions</h3><div>HDF analysis identifies distinct mechanical impairments in HCM regardless of obstruction status. Mavacamten favorably modulates HDF, delaying systolic thrust initiation and normalizing force distribution, offering new mechanistic insights into its therapeutic action in HCM.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"448 ","pages":"Article 134175"},"PeriodicalIF":3.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145975008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary access after TAVR with the 4th and 5th -generation self-expanding Evolut valves: The EPROMPT-CA study","authors":"Lior Lupu,&nbsp;Toby Rogers,&nbsp;Waiel Abusnina,&nbsp;Dan Haberman,&nbsp;Matteo Cellamare,&nbsp;Cheng Zhang,&nbsp;Vaishnavi Sawant,&nbsp;Syed W. Ali,&nbsp;Sevket T. Ozturk,&nbsp;Kalyan R. Chitturi,&nbsp;Abhishek Chaturvedi,&nbsp;Itsik Ben-Dor,&nbsp;Lowell F. Satler,&nbsp;Ron Waksman","doi":"10.1016/j.ijcard.2025.134073","DOIUrl":"10.1016/j.ijcard.2025.134073","url":null,"abstract":"<div><h3>Background</h3><div>As transcatheter aortic valve replacement (TAVR) expands to lower-risk patients, optimizing post-TAVR coronary access and identifying its determinants have become increasingly important.</div></div><div><h3>Objectives</h3><div>To evaluate coronary access and assess CT predictors of selective access post-TAVR with the Evolut FX/FX+ valves.</div></div><div><h3>Methods</h3><div>This single-center, prospective study enrolled patients undergoing transfemoral TAVR with Evolut FX/FX+ valves. Coronary access was attempted immediately post-deployment, with CT performed at 30–60 days. The primary endpoint was coronary access success. CTs were analyzed for predictors of access success.</div></div><div><h3>Results</h3><div>A total of 143 patients (103 FX, 40 FX+) were enrolled; post-TAVR CT was completed in 76 (55 FX, 21 FX+). Coronary access was successful in 95.1 % of left coronary artery (LCA) and 83 % of right coronary artery (RCA) attempts. Success rates were similar between FX and FX+, but FX+ required less contrast (5.45 vs. 8.92 mL; <em>p</em> &lt; 0.001) and fewer catheters (1.13 vs. 1.32; <em>p</em> = 0.014) for LCA. Access determinants differed by artery: LCA access was primarily associated with ostial position relative to the aortic cusp and transcatheter heart valve frame, while RCA access was mainly influenced by larger aortic root and valve dimensions. Commissural and coronary alignment were not associated with selective access. None of the identified associations reliably predicted selective coronary access, and subjective predictions by CT readers were also inaccurate.</div></div><div><h3>Conclusions</h3><div>Post-TAVR coronary access using Evolut FX/FX+ valves was more frequently successful for the LCA than the RCA. The FX+ valve facilitated coronary access with reduced procedural effort. CT identified distinct anatomical determinants for LCA versus RCA access. However, CT-derived analyses did not reliably predict coronary access success.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"448 ","pages":"Article 134073"},"PeriodicalIF":3.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145900174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From assumed rarity to measured reality: Inherited cardiac diseases and sudden cardiac death","authors":"Marco Zuin ,&nbsp;Cristina Balla ,&nbsp;Matteo Bertini","doi":"10.1016/j.ijcard.2026.134159","DOIUrl":"10.1016/j.ijcard.2026.134159","url":null,"abstract":"","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"448 ","pages":"Article 134159"},"PeriodicalIF":3.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145989064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of 18F-fluorodeoxyglucose positron emission tomography one month after initiation of prednisolone therapy in patients with cardiac sarcoidosis","authors":"Toshifumi Tamura ,&nbsp;Sakae Takenaka ,&nbsp;Toshiyuki Nagai ,&nbsp;Satonori Tsuneta ,&nbsp;Takeshi Hamaya ,&nbsp;Kenji Hirata ,&nbsp;Yoshiya Kato ,&nbsp;Hirokazu Komoriyama ,&nbsp;Yuta Kobayashi ,&nbsp;Atsushi Tada ,&nbsp;Sho Kazui ,&nbsp;Yutaro Yasui ,&nbsp;Akinori Takahashi ,&nbsp;Kiwamu Kamiya ,&nbsp;Taro Temma ,&nbsp;Takahiro Sato ,&nbsp;Ichizo Tsujino ,&nbsp;Kohsuke Kudo ,&nbsp;Satoshi Konno ,&nbsp;Toshihisa Anzai","doi":"10.1016/j.ijcard.2026.134181","DOIUrl":"10.1016/j.ijcard.2026.134181","url":null,"abstract":"<div><h3>Background</h3><div>Current guidelines for cardiac sarcoidosis (CS) recommend maintaining the initial maximal dose of prednisolone (PSL) for one month after initiation; however, the prognostic significance of ¹⁸F-fluorodeoxyglucose positron emission tomography (FDG-PET) performed at this time point remains unclear. We sought to investigate whether FDG-PET performed at one month after the initiation of PSL is associated with adverse events in patients with CS.</div></div><div><h3>Methods</h3><div>We examined 109 consecutive CS patients who underwent FDG-PET at diagnosis and one month after initiating PSL between January 2010 and January 2025 in a university hospital. The change in maximum standardized uptake value (SUV_max) from baseline to one month was calculated. Responder was defined as those with an SUV_max reduction ≥25%, while non-responder had a reduction &lt;25% or any increase. The primary outcome was a composite of aborted sudden cardiac death, sustained ventricular tachycardia, hospitalization of worsening heart failure, and all-cause death.</div></div><div><h3>Results</h3><div>Of the 109 patients, 83 were classified as responder and 26 as non-responder. Over a median follow-up of 4.9 years (interquartile range, 2.3–8.2), the primary outcome occurred in 37 patients. Non-responder had a significantly higher risk of the primary outcome, and this association persisted after sequential adjustment for established prognostic covariates.</div></div><div><h3>Conclusions</h3><div>An inadequate reduction in SUV_max on FDG-PET performed one month after PSL initiation was independently associated with adverse clinical events in patients with CS. These findings suggest that non-responder represents a clinical challenge and even very early follow-up FDG-PET may provide prognostic insights.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"448 ","pages":"Article 134181"},"PeriodicalIF":3.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular responses to a 3-minute Harvard step test in Paediatric competitive athletes","authors":"Gian Luca Ragazzoni ,&nbsp;Luna Cavigli ,&nbsp;Alex Boncompagni ,&nbsp;Guglielmo Leonardo Manfredi ,&nbsp;Silvia Giangrandi ,&nbsp;Riccardo Mei ,&nbsp;Elisa Pucci ,&nbsp;Sofia Capparuccia ,&nbsp;Marta Focardi ,&nbsp;Giulia Elena Mandoli ,&nbsp;Maria Concetta Pastore ,&nbsp;Cosetta Meniconi ,&nbsp;Andrea Franchini ,&nbsp;Massimo Capitani ,&nbsp;Matteo Cameli ,&nbsp;Serafina Valente ,&nbsp;Marco Bonifazi ,&nbsp;Flavio D'Ascenzi","doi":"10.1016/j.ijcard.2025.134097","DOIUrl":"10.1016/j.ijcard.2025.134097","url":null,"abstract":"<div><h3>Background</h3><div>The Italian pre-participation screening (PPS) program includes a simplified 3-min step test to assess cardiovascular responses in paediatric athletes, yet limited data exist on the cardiovascular response to this test in the paediatric population.</div></div><div><h3>Objectives</h3><div>To evaluate heart rate (HR), blood pressure (BP), and arrhythmic responses to a step test in healthy children undergoing PPS.</div></div><div><h3>Methods</h3><div>We prospectively enrolled 647 athletes (mean age 13 ± 2 years, 51 % male) undergoing PPS from September 2023 to May 2024. All participants performed a 3-min step test with continuous ECG monitoring and BP measurements at rest, peak, and recovery. Subgroup analyses were performed by sex and age group. Regression analyses were used to assess predictors of HR_peak, % of predicted HR_peak and systolic BP.</div></div><div><h3>Results</h3><div>The mean resting HR was 81 ± 17 bpm, with HR_peak of 169 ± 14 bpm (85 % of predicted). The most significant HR increase occurred in the first minute. BP_peak remained modest (128/60 mmHg). Female athletes had higher HRs but lower BP than males (<em>p</em> &lt; 0.001). Resting HR declined with age, while HR_peak remained constant across groups. BP increased with age, though only systolic BP differed at peak. Regression analysis identified resting HR, sex, and BMI as predictors of HR_peak, while weight alone predicted systolic BP_peak. Exercise-induced premature ventricular beats (PVBs) occurred in 0.46 % of athletes, all with benign morphology and no underlying structural heart disease.</div></div><div><h3>Conclusions</h3><div>The step test elicits a strong HR response in paediatric athletes and has a low arrhythmic yield. However, it is not suitable for assessing hypertensive responses during exercise.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"448 ","pages":"Article 134097"},"PeriodicalIF":3.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145756649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional ability index predicts cardiovascular disease and comorbid health outcomes in older Chinese adults: A national longitudinal cohort study","authors":"Zhenyu Liu ,&nbsp;Ran Zhao ,&nbsp;Siyan Huo ,&nbsp;Zihao Yin ,&nbsp;Fangjun Xu ,&nbsp;Jiaxin Bao","doi":"10.1016/j.ijcard.2026.134173","DOIUrl":"10.1016/j.ijcard.2026.134173","url":null,"abstract":"<div><h3>Background</h3><div>Aging populations face increasing cardiovascular disease (CVD) risks worldwide. However, existing tools often neglect critical functional and environmental determinants that are essential in health assessments. This study evaluated the functional ability index (FAI), which integrates physical, cognitive, and social domains, as a comprehensive predictor of CVD and comorbid outcomes in older Chinese adults.</div></div><div><h3>Methods</h3><div>Analysing 4298 participants from the China Health and Retirement Longitudinal Study (2011–2018), we employed Cox proportional hazards models to assess associations between FAI and CVD, self-rated health, falls, and hospitalization. Additionally, time-dependent analysis and population-attributable fraction (PAF) estimation were utilized to evaluate predictive accuracy and quantify modifiable risk contributions.</div></div><div><h3>Results</h3><div>High functional ability (FAI ≥ 12) was independently associated with substantially reduced risks of CVD (HR: 0.64, 95% CI: 0.56–0.72), self-rated health (HR: 0.62), falls (HR: 0.75), and hospitalization (HR: 0.73) in fully adjusted models. Time-dependent analysis identified 4 years as the optimal predictive window. Crucially, PAF analysis revealed that non-CVD multimorbidity (−70.2%) and weight loss (−54.9%) were the strongest modifiable contributors to CVD risk. These two factors also consistently remained the dominant determinants for both hospitalization and self-rated health. In contrast, affect (−22.0%) and gait level (−21.0%) emerged as the leading contributors to falls, highlighting distinct functional targets.</div></div><div><h3>Conclusion</h3><div>As a robust, non-invasive aging tool, the FAI facilitates risk stratification by identifying modifiable indicators—managing chronic conditions, preventing malnutrition, and improving psychological health. This framework provides a practical approach for guiding targeted interventions to reduce cardiovascular burden and promote healthy aging.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"448 ","pages":"Article 134173"},"PeriodicalIF":3.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145975030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When “more statin” adds little: Rethinking intensification in the era of early combination therapy","authors":"Francesco Giallauria ,&nbsp;Giuseppe Vallefuoco ,&nbsp;Gianluigi Cuomo","doi":"10.1016/j.ijcard.2026.134166","DOIUrl":"10.1016/j.ijcard.2026.134166","url":null,"abstract":"","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"448 ","pages":"Article 134166"},"PeriodicalIF":3.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Right ventricle in HFpEF: Illuminating the complex interplay between exercise and RV-PA coupling","authors":"Shantanu Sengupta ,&nbsp;Shubhan Sengupta","doi":"10.1016/j.ijcard.2026.134153","DOIUrl":"10.1016/j.ijcard.2026.134153","url":null,"abstract":"","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"448 ","pages":"Article 134153"},"PeriodicalIF":3.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145911474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}