Journal of Cardiovascular Development and Disease最新文献

{"title":"Cardiovascular Effects of Long-Term Treatment with Enhanced External Counterpulsation in Patients with Ischemic Heart Failure: Randomized, Placebo-Controlled, Open-Label Clinical Trial.","authors":"Alexey S Lishuta, Olga A Slepova, Nadezhda A Nikolaeva, Yuri N Belenkov","doi":"10.3390/jcdd12090352","DOIUrl":"10.3390/jcdd12090352","url":null,"abstract":"<p><p>(1) Background. Although treatment with enhanced external counterpulsation (EECP) in patients with ischemic chronic heart failure (CHF) is pathophysiologically justified, its long-term vascular effects remain insufficiently defined. We aimed to study the vascular effects of long-term complex treatment (36 months) including EECP in patients with ischemic CHF, and to examine the relationship between these effects and clinical outcomes. (2) Methods. A total amount of 120 patients with ischemic CHF were randomized to receive one course of EECP per year (35 h; Group 1), two courses of EECP per year (70 h; Group 2), or one course of placebo-counterpulsation per year (35 h; Group 0;). For a period of 36 months, all patients underwent annual assessments including transthoracic echocardiography, nailfold videocapillaroscopy, finger photoplethysmography, applanation tonometry, exercise tolerance testing, and clinical outcome monitoring. (3) Results. Compared to the placebo group, long-term EECP treatment in patients with ischemic CHF, was accompanied by a significantly greater increase in exercise tolerance (∆23.5-45.0% vs. 7.0%; <i>p</i> < 0.001) and improvements in left ventricular ejection fraction (∆9.9-19.6% vs. 5.6%; <i>p</i> < 0.001) and myocardial stress (decrease in NT-proBNP level ∆-80.4--82.4% vs. -75.8%; <i>p</i> < 0.001), as well as both functional and structural vascular parameters (<i>p</i> < 0.001). The effect size depended on the annual number of EECP courses. The highest event-free survival was found in Group 2. At 36 months, improvement of vascular parameters emerged as stronger predictors of reduced cardiovascular event risk compared to the 12-month. (4) Conclusions. Long-term EECP treatment of patients with ischemic CHF improves both functional and structural vascular parameters, with an increasing role of their improvement in reducing the risk of cardiovascular events after 36 months.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 9","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cine MRI-Derived Radiomics for the Detection of Functional Tricuspid Regurgitation in Pulmonary Hypertension: A Proof-of-Concept Study.","authors":"Kai Lin, Roberto Sarnari, Daniel Z Gordon, Michael Markl, James C Carr","doi":"10.3390/jcdd12090353","DOIUrl":"10.3390/jcdd12090353","url":null,"abstract":"<p><p>(1) Objective: The objective was to test the hypothesis that cine MRI-derived radiomic features can detect functional tricuspid regurgitation (FTR) in the context of pulmonary hypertension (PH). (2) Materials and methods: In total, 53 PH patients were retrospectively enrolled. Thirty-three patients had echocardiography-defined mild-to-severe FTR, while the other twenty patients had no or trivial regurgitation. For all participants, 93 radiomic features were extracted from four-chamber cine MRI using a fixed-size region of interest (ROI) located in the right atrium (RA), 0.5-1 cm above the tricuspid valve. The levels of radiomic features were averaged over the ventricular systole and compared between patients with and without FTR using t tests. In patients with FTR, radiomic features were related to hemodynamic parameters in the right heart using the Pearson correlation coefficient (r). (3) Results: There were no significant differences in demographic information, right heart catheterization (RHC) results, and most cine MRI-derived cardiac function indices between the two subject groups. Eight of ninety-three radiomic features were significantly different between PH patients with and without FTR. Radiomic features can be used to discriminate two subject groups (AUC = 0.77). In patients with FTR, multiple radiomic features are related to the pressure in the RA, right ventricle (RV), and pressure difference between RA and RV (r: 0.4 to 0.55), <i>p</i> values < 0.05. (4) Conclusion: Cine MRI-derived radiomic features of the cardiac blood pool differ between PH patients with and without FTR. Cine MRI shows promise as a method for assessing FTR in the context of complex cardiovascular diseases (CVDs).</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 9","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global Longitudinal Strain as a Sensitive Marker of Left Ventricular Dysfunction in Pediatric Dilated Cardiomyopathy: A Case-Control Study.","authors":"Iolanda Muntean, Beatrix-Jullia Hack, Asmaa Carla Hagau","doi":"10.3390/jcdd12090351","DOIUrl":"10.3390/jcdd12090351","url":null,"abstract":"<p><p>Pediatric dilated cardiomyopathy (DCM) is a rare but important cause of heart failure (HF) and a major indication for cardiac transplantation. Early detection of subclinical myocardial dysfunction is essential for risk stratification and management. This study aimed to evaluate left ventricular (LV) systolic function in children with DCM using conventional echocardiographic parameters and speckle-tracking echocardiography (STE) and to explore the relationship between deformation indices, clinical severity and biomarkers. <b>Methods:</b> We conducted a case-control study including 29 children diagnosed with DCM and 27 healthy controls matched by age and sex. All participants underwent clinical evaluation, NT-proBNP measurement, and transthoracic echocardiography. LV systolic function was assessed using conventional echocardiographic parameters, while STE was used to measure LV global longitudinal strain (GLS) and strain rate (SR) from all apical views. <b>Results:</b> GLS and SR were significantly reduced in the DCM group across all apical views (Global GLS: -11.13 ± 6.79% vs. -19.98 ± 3.25%, Global SR: -0.74 ± 0.39 s^-1 vs. -1.12 ± 0.16 s^-1; <i>p</i> < 0.01). GLS strongly correlated with functional indices (LV ejection fraction, shortening fraction, S' lateral wave), LV end-diastolic diameter Z-score and NT-proBNP (<i>p</i> < 0.05), but not with MAPSE. In the primary model, GLS was associated with NYHA/Ross III-IV (OR 1.54 per 1% increase; 95% CI 1.14-2.07; <i>p</i> = 0.005); adding systolic blood pressure (<i>p</i> = 0.798) or heart rate (<i>p</i> = 0.973) did not materially change the GLS estimate (Δ ≤ 2%). In separate collinearity-avoiding models, LVEF (OR 1.12 per 1% decrease; 95% CI 1.03-1.22; <i>p</i> = 0.009), LVSF (OR 1.19 per 1% decrease; 95% CI 1.04-1.36; <i>p</i> = 0.011), and NT-proBNP (≈OR 1.11 per 100 units; <i>p</i> = 0.013) were also associated with advanced class. ROC analysis showed excellent discrimination for NT-proBNP (AUC 0.948) and GLS (AUC 0.906), and good-excellent performance for LVEF (AUC 0.869) and LVSF (AUC 0.875). <b>Conclusions:</b> Speckle-tracking derived parameters such as GLS and SR are sensitive and clinically relevant markers of LV dysfunction in pediatric DCM. Global longitudinal strain demonstrated a strong association with both clinical and biochemical markers of disease severity, after accounting for heart rate and blood pressure, supporting its integration into routine evaluation and risk stratification in pediatric DCM.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 9","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12471063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac Computed Tomography for the Assessment of Myocardial Bridging: A Scoping Review of the Emerging Role of Artificial Intelligence and Machine Learning.","authors":"Amro Abu Suleiman, Federico Russo, Luigi Della Valle, Davide Ausiello, Ewelina Bukowska-Olech, Vincenzo Iannibelli, M Omar Al Droubi, Gabriella Sannino, Marco Bernardi, Luigi Spadafora","doi":"10.3390/jcdd12090350","DOIUrl":"10.3390/jcdd12090350","url":null,"abstract":"<p><p>(1) Background: Myocardial bridging (MB) is a congenital coronary anomaly with potential clinical significance. Artificial intelligence (AI) applied to cardiac computed tomography angiography (CCTA), particularly through CT-derived fractional flow reserve (CT-FFR), offers a novel, non-invasive approach for assessing MB. (2) Methods: We conducted a systematic review of the literature focusing on studies investigating AI-enhanced CCTA in the evaluation of MB. (3) Results: Ten studies were included. AI-based models, including radiomics, demonstrated moderate to high accuracy in predicting proximal plaque formation, and motion correction algorithms improved image quality and diagnostic confidence. Other findings were limited by the types of studies included and conflicting findings across studies. (4) Conclusions: AI-enhanced CCTA shows promise for the non-invasive functional assessment of MB and its risk stratification. Further prospective studies and validation are required to establish standardized protocols and confirm clinical utility.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 9","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Utility of HEFESTOS Score and Complementary Lung Ultrasound for Heart Failure Decompensation in Primary Care Outpatients: A Prospective Cohort Study.","authors":"Marcos Haro-Montoya, Rosa Caballol-Angelats, José Fernández-Sáez, Maylin Montelongo-Sol, Laura Conangla-Ferrin, Victoria Cendrós-Cámara, Jose María Verdú-Rotellar, Josep Lluís Clua-Espuny","doi":"10.3390/jcdd12090347","DOIUrl":"10.3390/jcdd12090347","url":null,"abstract":"<p><p>Heart failure (HF) is a major contributor to morbidity, mortality, and healthcare costs, particularly among older adults. Effective outpatient risk stratification remains a clinical challenge, especially following hospital discharge or episodes of acute decompensation. Although both lung ultrasound (LUS) and the HEFESTOS score have shown individual prognostic value, their combined use in primary care settings has not been extensively explored. This prospective cohort study included 107 patients with confirmed HF followed at a primary care center in southern Catalonia. At baseline, all patients underwent LUS and HEFESTOS assessment. The primary outcome was HF decompensation, defined as worsening symptoms requiring medical attention, emergency care, hospitalization, or death. Over a mean follow-up of 72 days, 25 patients (23.3%) experienced decompensation. In multivariate analysis, only the HEFESTOS score was independently associated with decompensation. LUS and HEFESTOS showed moderate agreement (Kappa = 0.456), and LUS demonstrated moderate discriminative capacity (AUC = 0.677) with high sensitivity (81.7%) and positive predictive value (81.7%). These findings support the routine use of the HEFESTOS score in primary care and suggest that LUS may serve as a complementary tool, particularly for identifying subclinical pulmonary congestion. Their combined use could enhance outpatient risk stratification and guide individualized follow-up strategies in HF management.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 9","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Topography of the Papillary Muscles in the Mitral Valve Complex and Their Relevance for Mitral Valve Function.","authors":"Alina-Jutta Van Laethem, Jens Figiel, Andreas H Mahnken, Rabia Ramzan, Marc Irqsusi, Sebastian Vogt, Ardawan J Rastan","doi":"10.3390/jcdd12090348","DOIUrl":"10.3390/jcdd12090348","url":null,"abstract":"<p><p><b>Background:</b> The mitral valve apparatus is a complex system that requires sufficient function of all involved structures. Previous studies have demonstrated that ventricular remodeling can cause displacement of subannular structures, including the papillary muscles, which in turn promotes the development of mitral regurgitation. Furthermore, in such cases, annuloplasty alone is often insufficient to restore optimal valve function. Instead, additional reconstruction of the subannular apparatus is associated with improved clinical outcomes. Our study aimed to analyze the topography of the papillary muscles in the mitral valve complex and their relevance for mitral valve function. <b>Methods:</b> In 148 patients who underwent both cardiac computed tomography (CT) and echocardiography, the position of the papillary muscles within the left ventricle was assessed. CT scans were evaluated in end-diastolic four-chamber view, two-chamber view, and short-axis view. CT analysis involved determining the position of the papillary muscles based on a modified left ventricular segmentation scheme, which subdivided the original segments into \"a\" and \"b\" subsegments in a counterclockwise manner. Furthermore, the midventricular diameter, ventricular length, as well as the angle between the papillary muscle (PM) and the left ventricular wall, were measured. Comorbidities were assessed. The presence of mitral regurgitation (MR) and ejection fraction was determined based on echocardiographic data. Echocardiography was conducted either as part of initial cardiological assessments or during follow-up examinations. For detailed statistical analysis, the patients were divided into the following groups: control group, MR-only group, coronary heart disease (CHD)-only group, and combined CHD and MR subgroup. <b>Results:</b> Mitral regurgitation was significantly correlated with age (<i>p</i> < 0.001) and hypertension (<i>r</i> = 0.1900, <i>p</i> = 0.0208), and in the MR-only subgroup, additionally with atrial fibrillation (<i>r</i> = 0.2426, <i>p</i> = 0.0462). The length (<i>p</i> < 0.001) and internal diameter (<i>p</i> < 0.001) of the left ventricle were significantly larger in men than in women. Different positions of the papillary muscles were identified. Segment 7a was significantly correlated with MR in the combined CHD and MR subgroup. In normal-sized ventricles, patients with MR and papillary muscle in 12a (<i>p =</i> 0.0095) or 10a (<i>p =</i> 0.0460) showed a significantly larger angle than patients without MR (overall dataset). <b>Conclusions:</b> Assessment of papillary muscle position is essential in diagnosing mitral regurgitation and should guide the consideration of subannular repair during surgical treatment.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 9","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12471129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimodal Imaging from Fetal to Adult Life: A Comprehensive Approach to Hypoplastic Left Heart Syndrome (HLHS).","authors":"Sara Moscatelli, Jolanda Sabatino, Isabella Leo, Nunzia Borrelli, Martina Avesani, Giovanni Di Salvo, Claudia Montanaro, Valeria Pergola, Raffaella Motta, Jessica Ielapi, Assunta Di Costanzo, Rosalba De Sarro, Giulia Guglielmi, Irene Cattapan, Gabriella Gaudieri, Leonie Luedke, Marco Alfonso Perrone","doi":"10.3390/jcdd12090349","DOIUrl":"10.3390/jcdd12090349","url":null,"abstract":"<p><p>Hypoplastic Left Heart Syndrome (HLHS) accounts for 2-3% of congenital heart diseases (CHDs). HLHS is characterized by reduced systemic blood flow due to hypoplastic left ventricle (LV) and underdeveloped left-sided cardiac structures. Without a series of staged interventional treatments, HLHS is often fatal, typically within the first hours or days of life. This manuscript aims to provide a comprehensive overview of the role of echocardiography, cardiovascular magnetic resonance (CMR), and cardiac computed tomography angiography (CCTA) in the optimal management of patients with HLHS. Specifically, it explores the contributions of various non-invasive imaging modalities to the diagnosis, planning of staged palliative interventions, interstage monitoring, and long-term follow-up of HLHS. Furthermore, the advantages and limitations of each imaging technique will be highlighted to aid in clinical decision-making; however, it is important to note that, at present, no universal guidelines exist, and imaging strategies remain largely dependent on individual centre expertise and protocols.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 9","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Flow Diverting Stents for the Treatment of Complex Visceral and Renal Aneurysms-A Systematic Review.","authors":"Marcello Andrea Tipaldi, Elisa Zaccaria, Nicolò Ubaldi, Edoardo Massaro, Gianluigi Orgera, Tommaso Rossi, Aleksejs Zolovkins, Miltiadis Krokidis, Pasqualino Sirignano, Michele Rossi","doi":"10.3390/jcdd12090346","DOIUrl":"10.3390/jcdd12090346","url":null,"abstract":"<p><p>Flow-diverting stents (FDS) are sophisticated endovascular devices that aim to modulate blood flow and promote aneurysm thrombosis while maintaining branch vessel patency. Initially designed and developed for the treatment of intracranial aneurysms, these devices have since been applied to the peripheral circulation. However, they are still used sporadically, largely due to a lack of the scientific evidence supporting its use in visceral aneurysms. This review article aims to provide an overview of the current data on the clinical outcomes from the use of FDS in the treatment of complex visceral and renal aneurysms or pseudoaneurysms and to assess the added value of these devices.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 9","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI Applied to Cardiac Magnetic Resonance for Precision Medicine in Coronary Artery Disease: A Systematic Review.","authors":"Cristina Jiménez-Jara, Rodrigo Salas, Rienzi Díaz-Navarro, Steren Chabert, Marcelo E Andia, Julián Vega, Jesús Urbina, Sergio Uribe, Tetsuro Sekine, Francesca Raimondi, Julio Sotelo","doi":"10.3390/jcdd12090345","DOIUrl":"10.3390/jcdd12090345","url":null,"abstract":"<p><p>Cardiac magnetic resonance (CMR) imaging has become a key tool in evaluating myocardial injury secondary to coronary artery disease (CAD), providing detailed assessments of cardiac morphology, function, and tissue composition. The integration of artificial intelligence (AI), including machine learning and deep learning techniques, has enhanced the diagnostic capabilities of CMR by automating segmentation, improving image interpretation, and accelerating clinical workflows. Radiomics, through the extraction of quantitative imaging features, complements AI by revealing sub-visual patterns relevant to disease characterization. This systematic review analyzed AI applications in CMR for CAD. A structured search was conducted in MEDLINE, Web of Science, and Scopus up to 17 March 2025, following PRISMA guidelines and quality-assessed with the CLAIM checklist. A total of 106 studies were included: 46 on classification, 19 using radiomics, and 41 on segmentation. AI models were used to classify CAD vs. controls, predict major adverse cardiovascular events (MACE), arrhythmias, and post-infarction remodeling. Radiomics enabled differentiation of acute vs. chronic infarction and prediction of microvascular obstruction, sometimes from non-contrast CMR. Segmentation achieved high performance for myocardium (DSC up to 0.95), but scar and edema delineation were more challenging. Reported performance was moderate-to-high across tasks (classification AUC = 0.66-1.00; segmentation DSC = 0.43-0.97; radiomics AUC = 0.57-0.99). Despite promising results, limitations included small or overlapping datasets. In conclusion, AI and radiomics offer substantial potential to support diagnosis and prognosis of CAD through advanced CMR image analysis.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 9","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Personalized Treatment of Patients with Coronary Artery Disease: The Value and Limitations of Predictive Models.","authors":"Antonio Greco, Davide Capodanno","doi":"10.3390/jcdd12090344","DOIUrl":"10.3390/jcdd12090344","url":null,"abstract":"<p><p>Risk prediction models are increasingly used in the management of coronary artery disease (CAD), with applications ranging from diagnostic stratification to prognostic assessment and therapeutic guidance. In the context of CAD and percutaneous coronary intervention, clinical decision-making often relies on risk scores to estimate the likelihood of ischemic and bleeding events and to tailor antithrombotic strategies accordingly. Traditional scores are derived from clinical, anatomical, procedural, and laboratory variables, and their performance is evaluated based on discrimination and calibration metrics. While many established models are simple, interpretable, and externally validated, their predictive ability is often moderate and may be limited by outdated derivation cohorts, overfitting, or lack of generalizability. Recent advances have introduced artificial intelligence and machine learning models that can process large, high-dimensional datasets and identify patterns not apparent through conventional methods, with the aim to incorporate complex data; however, they are not exempt from limitations and struggle with integration into clinical practice. Notably, ethical issues, such as equity in model application, over-stratification, and real-world implementation, are of critical importance. The ideal predictive model should be accurate, generalizable, and clinically actionable. This review aims at providing an overview of the main predictive models used in the field of CAD and to discuss methodological challenges, with a focus on strengths, limitations and areas of applicability of predictive models.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 9","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}