Reviews in cardiovascular medicine最新文献

{"title":"Application of Telemedicine in the Management of Cardiovascular Diseases: A Focus on Heart Failure.","authors":"Pornthira Mutirangura, Dil Patel, Hassan Akram, Andrew Hughes, Jose Arriola-Montenegro, Despoina Koukousaki, Joel Money, Marinos Kosmopoulos, Mikhail Meyer, Mikako Harata, Andras Toth, Tamas Alexy","doi":"10.31083/RCM37835","DOIUrl":"10.31083/RCM37835","url":null,"abstract":"<p><p>Heart failure (HF) is a complex clinical syndrome that represents one of the leading causes of morbidity and mortality in developed nations. It is well established that every HF-related hospital admission leads to worsened quality of life for the patient and their caregiver and also imposes a significant financial burden on society. Therefore, reducing hospital admissions for this population has emerged as a critical tactic over the past decades. Initial attempts at remote monitoring focused on self-reported vital signs and symptoms, yet these proved ineffective. Meanwhile, subsequent technological advancements have enabled the development of miniature sensors capable of detecting and monitoring a wide range of physiologically relevant parameters; some of these advancements have been integrated into implantable devices, such as pacemakers and defibrillators. However, noninvasive monitoring has recently emerged as an alternative option for patients with HF, offering early congestion detection without requiring an invasive procedure. This review aims to summarize implanted and noninvasive devices, their characteristics, monitored parameters, and potential limitations and challenges around their integration into routine clinical practices.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 6","pages":"37835"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592042","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":"Construction and Clinical Relevance of a Predictive Model of Coronary Microcirculatory Dysfunction in Patients With Acute Myocardial Infarction Following Percutaneous Coronary Intervention.","authors":"Shuai Wang, Yuanyuan Zhao, Yanlong Zhao, Yanling Wang, Zhenxing Fan, Zhi Liu","doi":"10.31083/RCM38533","DOIUrl":"10.31083/RCM38533","url":null,"abstract":"<p><strong>Background: </strong>Coronary microcirculatory dysfunction (CMD) after percutaneous coronary intervention (PCI) in patients suffering from acute myocardial infarction (AMI) may adversely affect prognosis. The objective of this study was to assess the postoperative microcirculatory status and to construct a predictive model for CMD.</p><p><strong>Methods: </strong>This study is a retrospective analysis of 187 AMI patients who underwent PCI at Xuanwu Hospital. Patients were divided into two cohorts based on postoperative angiography-derived microcirculatory resistance (AMR) values: a non-CMD group (AMR <250 mmHg*s/m, n = 93) and a CMD group (AMR ≥250 mmHg*s/m, n = 76). Clinical and laboratory data were extracted, predictive models were constructed and risk factors associated with CMD were identified through the implementation of LASSO regression analyses.</p><p><strong>Results: </strong>The non-CMD group (n = 93) had a significantly lower body mass index (BMI) (25.40 ± 2.84) and a higher proportion of males (91.4%) compared to the non-CMD group (n = 76) (BMI: 26.64 ± 3.74, <i>p</i> < 0.05; males: 78.9%, <i>p</i> < 0.05). The non-CMD group also exhibited lower Creatine Kinase (CK) levels, glucose levels (GLU), mean platelet volume (MPV), and platelet distribution width (PDW). LASSO regression identified significant predictors of CMD after PCI in AMI patients. A nomogram showed excellent predictive performance (area under curve (AUC): 0.737) and higher net benefit compared to individual models.</p><p><strong>Conclusion: </strong>The predictive model developed in this study effectively identifies the risk of microcirculatory dysfunction in AMI patients after PCI, providing important insights for clinical decision-making. Future research should further validate the external applicability of this model and explore its potential in clinical practice.</p><p><strong>Clinical trial registration: </strong>NCT06062316, https://clinicaltrials.gov/study/NCT06062316?term=NCT06062316&rank=1, registration time: December 21, 2023.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 6","pages":"38533"},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592063","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":"Feasibility Study of Triple-low CCTA for Coronary Artery Disease Screening Combining Contrast Enhancement Boost and Deep Learning Reconstruction.","authors":"Zhihua Wu, Min Chen, Yingwen Wei, Chen Shen, Wen Han, Rulin Xu, Zhenyuan Zhou, Jiexiong Xu","doi":"10.31083/RCM31334","DOIUrl":"10.31083/RCM31334","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The aim of this study was to compare the image quality of coronary computed tomography angiography (CCTA) images obtained using contrast enhancement boost (CE-boost) technology combined with deep learning reconstruction technology at a low dose and low contrast agent flow rate/dosage with traditional CCTA images, while exploring the potential application of this technology in early screening of coronary artery disease.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;From March 2024 to September 2024, 60 patients suspected of having coronary artery stenosis were enrolled in this study. Ultimately, 46 patients were included for analysis. Based on different acquisition protocols, divided into Group A and Group B. Group A underwent conventional computed tomography (CT) angiography with a tube voltage of 120 kV, a contrast agent injection rate of 6 mL/s, and a dosage of 0.9 mL/kg. Group B received a triple-low CCTA protocol with a tube voltage of 100 kV, a contrast agent injection rate of 2 mL/s, and a dosage of 0.3 mL/kg. Additionally, Group C was created by applying CE-Boost combined with a deep learning reconstruction technique to Group B images. The radiation dose and contrast agent dosage were compared between Group A and Group B. The image quality of the three groups, including CT values, background noise, signal-to-noise ratio (SNR), and contrast signal-to-noise ratio (CNR), was also compared, with &lt;i&gt;p&lt;/i&gt; &lt; 0.05 indicating significant statistical differences.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Our results indicate that Group A required 67.8% more contrast agent and a 52.0% higher radiation dose than Group B (64.68 ± 3.30 mL vs. 20.19 ± 2.22 mL, 6.21 (4.60, 7.78) mSv vs. 2.05 (1.42, 4.33) mSv, all &lt;i&gt;p&lt;/i&gt; &lt; 0.05). Image analysis revealed superior subjective scores in Groups A (4.68 ± 0.72) and C (4.38 ± 0.95) versus Group B (4.25 ± 0.10) (both &lt;i&gt;p&lt;/i&gt; &lt; 0.05), with no statistical difference between Groups A and C. CT values were significantly elevated in Group A across all vessels compared to both Groups B and C (&lt;i&gt;p&lt;/i&gt; &lt; 0.05), while Group C exceeded Group B post CE-Boost. SNR comparisons showed Group A dominance over B in the proximal right coronary artery (RCA-1)/left main coronary artery (LM)/left anterior descending coronary artery (LAD)/left circumflex coronary artery (LCX) and over C in the RCA-1/LM (&lt;i&gt;p&lt;/i&gt; &lt; 0.05), contrasting with the superiority of SNR in Group C versus B in the middle right coronary artery/distal right coronary artery (RCA-2/3)/LM/LAD/LCX. CNR analysis demonstrated an equivalent performance between A and C, though both groups significantly surpassed Group B (A vs. B: &lt;i&gt;p&lt;/i&gt; &lt; 0.05; C vs. B: &lt;i&gt;p&lt;/i&gt; &lt; 0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The triple-low CCTA protocol using CE-Boost technology combined with deep learning reconstruction, achieved a 52% reduction in radiation exposure and a 67.8% reduction in contrast agent usage, while preserving diagnostic image quality (with CNR and noise le","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 6","pages":"31334"},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592068","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":"Early and Very Early Post-Transcatheter Aortic Valve Implantation Infective Endocarditis: Imaging Challenges.","authors":"Nikoleta Hadjigeorgiou, Despo Melanarkiti, Theodora Eleni Plakomyti, Vasileios Demou, Vasileios Giannakopoulos, Chariton Sapouridis, Angeliki Mouzarou","doi":"10.31083/RCM36771","DOIUrl":"10.31083/RCM36771","url":null,"abstract":"<p><p>Transcatheter aortic valve implantation (TAVI) is a minimally invasive procedure to treat severe aortic stenosis in select patients. Patients who have undergone TAVI are at high risk of infective endocarditis (IE), especially during the first year post-operation. Early diagnosis of IE is essential to initiate targeted antibiotic therapy and/or surgical intervention. However, the early detection of IE following TAVI poses significant diagnostic challenges. Current imaging techniques, including echocardiography, nuclear imaging, and magnetic resonance imaging, have varying degrees of sensitivity and specificity, each with inherent limitations. Nuclear imaging modalities, such as positron emission tomography/computed tomography using ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG PET/CT) and white blood cell single photon emission computed tomography/computed tomography (WBC SPECT/CT), have shown promise in early IE detection, particularly due to the ability of these methods to identify metabolic and anatomical abnormalities. However, false-positive results related to post-operative inflammation complicate data interpretation, and limited data exist for using these methods in very early IE detection post-TAVI. Intracardiac echocardiography (ICE) offers enhanced visualization of prosthetic valve leaflets, but the invasive nature of ICE restricts its widespread use. Whole-body imaging, such as ¹⁸F-FDG PET/CT, facilitates the identification of distant lesions and systemic complications, aiding diagnosis and treatment decisions. Diagnosing IE after TAVI is especially challenging within the first 60 days post-procedure, a critical period when imaging findings may be inconclusive due to false negatives or limited availability of advanced modalities. This review underscores the diagnostic complexity of very early and early (0-60 days) IE post-TAVI, emphasizing the need for a multimodal imaging approach to overcome the limitations of individual modalities. Nonetheless, early antimicrobial therapy should be considered even without definitive imaging findings, highlighting the importance of clinical vigilance in managing this challenging condition.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 6","pages":"36771"},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592065","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":"Evaluation of the Atherogenic Index of Plasma in the Prognostic Value of Ischemic Heart Failure Post-Percutaneous Coronary Intervention.","authors":"Yinxiao Xu, Biyang Zhang, Meishi Ma, Yi Kan, Tienan Sun, Xin Huang, Yujie Zhou","doi":"10.31083/RCM33470","DOIUrl":"10.31083/RCM33470","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The atherogenic index of plasma (AIP) is calculated as the logarithm of the triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) ratio. While previous studies suggested that TG and HDL-C levels were linked to the prognosis in various cardiovascular conditions, including ischemic heart failure (IHF), there is limited research specifically examining AIP in the context of IHF. Therefore, our study sought to explore the association between AIP and the prognosis of IHF and to compare the predictive value of AIP, HDL-C, and TG levels for identifying patients with poor outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective cohort study was conducted at a single institution involving 2036 IHF patients with post-percutaneous coronary intervention (PCI) who were followed for 36 months. Patients were divided into four groups categorized according to AIP quartiles. The primary outcome of interest was major adverse cardiovascular events (MACEs), while secondary outcomes included all-cause mortality, non-fatal myocardial infarction (MI), and any revascularization. Kaplan-Meier survival curves were used to evaluate the occurrence of endpoints across the four groups. Multivariate Cox regression analysis reinforced that AIP independently predicted primary and secondary outcomes. Restricted cubic spline (RCS) method was employed to examine the non-linear association between AIP and endpoints. Receiver operating characteristic (ROC) curves, combined with the Delong test, were used to assess and compare the predictive accuracy of AIP, TG, and HDL-C.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Result: &lt;/strong&gt;The incidence of MACEs (Q4:Q1 = 50.6:23.0, &lt;i&gt;p&lt;/i&gt; &lt; 0.001), all-cause death (Q4:Q1 = 25.0:11.6, &lt;i&gt;p&lt;/i&gt; &lt; 0.001), and any revascularization (Q4:Q1 = 21.6:9.6, &lt;i&gt;p&lt;/i&gt; &lt; 0.001) were significantly higher in patients with elevated AIP. The Kaplan- Meier curve analysis further supported a positive association between AIP and MACEs (&lt;i&gt;p&lt;/i&gt; &lt;sub&gt;log-rank&lt;/sub&gt; &lt; 0.001). Multivariate Cox analysis showed that AIP was independently associated with the increased risk of MACEs (Q4:Q1 (HR (95% CI)): 2.84 (2.25-3.59), &lt;i&gt;p&lt;/i&gt; &lt;sub&gt;trend&lt;/sub&gt; &lt; 0.001), all-cause death (Q4:Q1 (HR (95% CI)): 2.76 (1.98-3.84), &lt;i&gt;p&lt;/i&gt; &lt;sub&gt;trend&lt;/sub&gt; &lt; 0.001), non-fatal MI (Q4:Q1 (HR (95% CI)): 3.01 (1.32-6.90), &lt;i&gt;p&lt;/i&gt; &lt;sub&gt;trend&lt;/sub&gt; &lt; 0.001), and any revascularization (Q4:Q1 (HR (95% CI)): 2.92 (2.04-4.19), &lt;i&gt;p&lt;/i&gt; &lt;sub&gt;trend&lt;/sub&gt; &lt; 0.001). In RCS, higher AIP was non-linearly relevant to an increased risk of MACEs (&lt;i&gt;p&lt;/i&gt; &lt;sub&gt;non-linear&lt;/sub&gt; = 0.0112). In subgroup analysis, the predictive value of AIP for MACEs was more pronounced in the younger patient subgroup (&lt;i&gt;p&lt;/i&gt; &lt;sub&gt;interaction&lt;/sub&gt; = 0.003). The ROC curves showed the predictive value of AIP (area under curve [AUC] = 0.641), HDL-C (AUC = 0.600), and TG (AUC = 0.629), and AIP had the best predictive value among TG (AIP:TG: difference in AUC (95% CI), 0.012 (0.001-0.024), &lt;i&gt;p&lt;/i&gt; for Delong t","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 6","pages":"33470"},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592067","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":"Cardiovascular Disease Mortality Risk among Long-term Survivors of Different Hodgkin Lymphoma Types.","authors":"Zhenxing Lu, Liyu Guo, Huijuan He, Linglong Liu, Manting Feng, Xueqi Xiao, Xin Lin, Yingyu Deng, Tianwang Guan, Xiaoping Peng","doi":"10.31083/RCM24981","DOIUrl":"10.31083/RCM24981","url":null,"abstract":"<p><strong>Background: </strong>The temporal trend and disparities in cardiovascular disease (CVD) mortality risk among long-term survivors of different Hodgkin lymphoma (HL) types are unclear. Therefore, we aimed to examine the temporal trend and disparities in CVD mortality risk among survivors of various HL subtypes.</p><p><strong>Methods: </strong>This multicenter cohort included 20,423 patients with HL diagnosed between 1975 and 2018, with an average follow-up time of 18.5 years. Proportional mortality ratio, cumulative cause-specific mortality accounting for competing risks, standardized mortality ratio, and absolute excess risk were calculated.</p><p><strong>Results: </strong>Patients with nodular lymphocyte-predominant HL (NLPHL) and classical HL exhibited higher CVD-related deaths than HL-related deaths after approximately 12 and 120 months of follow-up, respectively. From the initial diagnosis to >500 months of follow-up, the cumulative CVD mortality increased continuously without a plateau and exceeded that of HL at different times in most patients with various HL types. However, CVD mortality risk exceeded that of HL earlier in NLPHL than in other types. Black or male patients with nodular sclerosing classical HL exhibited a higher CVD mortality risk, while a contrary trend was noted among those with lymphocyte-rich classical HL or lymphocyte-depleted classical HL. Over the past decades, CVD mortality risk has decreased slowly or remained unchanged. Patients with HL exhibited higher risks of CVD mortality than the general population.</p><p><strong>Conclusions: </strong>CVD mortality risk exceeded that of HL over time among many survivors. This temporal trend was significantly different among various HL subtypes. Thus, more effective strategies are required to reduce the risk of CVD mortality, depending on subtypes.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 6","pages":"24981"},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592046","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":"The Effect of Impaired Cerebral Autoregulation on Postoperative Delirium in Neonates and Infants After Corrective Cardiac Surgery: A Study on Modifiable Risk Factors for Delirium.","authors":"Yordan H Georgiev, Marcel Methner, Maximilian Iller, Juliane Engel, Jörg Michel, Johannes Nordmeyer, Felix Neunhoeffer","doi":"10.31083/RCM37292","DOIUrl":"10.31083/RCM37292","url":null,"abstract":"<p><strong>Background: </strong>The risk factors for developing postoperative pediatric delirium (PD) are multifactorial and include underlying conditions, cyanosis, surgery, intensive care stay, analgesia used for sedation, and withdrawal symptoms. Disturbed cerebral autoregulation in children with congenital heart disease (CHD) can lead to hyper- and hypoperfusion states of the central nervous system and is potentially associated with poor neurological outcomes. Our study aimed to investigate whether disturbed cerebral autoregulation postoperatively is associated with the onset of PD in children with CHD.</p><p><strong>Methods: </strong>We conducted a prospective observational study in neonates and infants undergoing corrective surgery for CHD via cardiopulmonary bypass (CPB). Cerebral regional oxygen saturation (rSO2) and mean arterial pressure (MAP) were measured within the first 24 hours after surgery in the pediatric intensive care unit (PICU). The cerebral oximetry index (COx) was calculated from these parameters using ICM+ software. A COx ≥0.4 was considered indicative of impaired autoregulation. Delirium symptoms were assessed using the Sophia Observation of Withdrawal-Pediatric Delirium (SOS-PD) score.</p><p><strong>Results: </strong>Cerebral autoregulation was evaluated postoperatively at the bedside of 49 neonates and infants (22 males, 44.9%, vs. 27 females, 55.1%) between January 2019 and April 2023. The median age of the patients was 134 days (interquartile range (IQR): 49.5-184 days), the median weight was 5.1 kg (IQR: 4.0-6.3 kg), and the monitoring duration was 23.0 hours (IQR: 20-24.5 hours). In total, 27/49 (55%) patients developed postoperative PD during their stay in the PICU. There was no statistically significant difference in the duration of globally impaired autoregulation between the delirious and non-delirious groups (14.5% vs. 13.9%, <i>p</i> = 0.416). No evidence was found supporting the effect of MAP outside the lower and upper limits of autoregulation for the onset of postoperative delirium (<i>p</i> = 0.145 and <i>p</i> = 0.904, respectively). Prolonged mechanical ventilation, longer PICU stay, and higher use of opioids and benzodiazepines were observed in the delirious group.</p><p><strong>Conclusion: </strong>Our findings suggest that impairment of cerebral autoregulation cannot solely explain the higher rate of PD in children undergoing congenital cardiac surgery. Rigorous hemodynamic management may potentially minimize the impact of cerebral hypo- or hyperperfusion states during the postoperative period, preventing their harmful effects. Additional studies with a larger sample size are needed to confirm the hypothesis and current findings.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 6","pages":"37292"},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592085","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":"Classification, Diagnosis, and Prognosis of Cardiomyopathy: A Comprehensive Narrative Review.","authors":"Yubin Jin, Wenjing Che, Jiuyue Yang, Shumin Chang, Wenqi Bao, Xinyue Ren, Pengyu Yu, Aijie Hou","doi":"10.31083/RCM36280","DOIUrl":"10.31083/RCM36280","url":null,"abstract":"<p><p>Cardiomyopathy denotes a group of heart diseases caused by structural or functional heart muscle disorders, with various genetic and non-genetic etiologies. Based on the current literature, this narrative review synthesizes key findings from available information on the classification, diagnosis, and prognosis of inherited or acquired cardiomyopathies. Following a different approach to prior systematic reviews, this study does not implement any formal inclusion or exclusion criteria or structured search strategy. However, this review does consider the evidence of influential studies, prominent cardiology guidelines, and expert consensuses to provide a comprehensive overview of recent advancements in the field. Further, explication is performed for the latest advances in genetic mutations, diagnostic imaging techniques, and therapeutic techniques. All diagnoses involve clinical presentations, imaging, and laboratory tests. Future research directions include personalized therapy, quantitative imaging techniques, and new drug treatments. This review highlights cardiomyopathy research by emphasizing the integration of precision medicine, advanced imaging, and molecular diagnostics. Future research on cardiomyopathy should include precision medicine and personalized therapies with an exhaustive integration of techniques and resources to catalyze further innovations in diagnostics and therapeutic approaches. Thus, this narrative review will provide clinicians and researchers with insight into the future of cardiomyopathy management by summarizing key developments and trends.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 6","pages":"36280"},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592060","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":"Impact of Uncontrolled Diabetes on Myocardial Global Longitudinal Strain: A Case-Control Study.","authors":"Khaled Elenizi, Rasha Alharthi, Abdullah Alanazi, Nasser Alotaibi, Mubarak Alajmi, Abdulrahman Alsubaie, Sahar Gamil, Mohammed Alqahtani","doi":"10.31083/RCM38967","DOIUrl":"10.31083/RCM38967","url":null,"abstract":"<p><strong>Background: </strong>Subclinical systolic dysfunction due to diabetic microangiopathy and its impact on left ventricular (LV) function remains unclear. Myocardial deformation (strain) imaging can detect LV systolic dysfunction earlier than conventional ejection fraction evaluations. Thus, this study aimed to examine the relationship between uncontrolled diabetes and impaired LV global longitudinal strain (GLS) in patients with diabetes mellitus (DM) compared to non-diabetic individuals.</p><p><strong>Methods: </strong>A total of 76 asymptomatic patients with uncontrolled type 2 DM and 76 age- and gender-matched healthy controls underwent transthoracic echocardiography imaging. Patients with coronary artery disease, an LV ejection fraction <55%, atrial fibrillation, or inadequate echocardiographic quality were excluded. The presence of proliferative retinopathy, microalbuminuria, nephropathy, or peripheral neuropathy defines diabetic microvascular complications.</p><p><strong>Results: </strong>The absolute GLS% was significantly lower in the uncontrolled diabetic group (-18.4 ± 1.7) compared to controls (-22 ± 1.9, <i>p</i> < 0.001). Diabetic patients with complications had lower absolute GLS% values of -18.9 ± 1.7 for no complications, -17.5 ± 1.3 for one complication, and -16.8 ± 1.3 for two or more complications (<i>p</i>-value = 0.001). Regression analysis showed a positive association between complications and lower absolute GLS% (β = 0.41, <i>p</i> < 0.001). No significant difference was found in LV mass between hypertensive (155.1 ± 40.4) and non-hypertensive individuals (139.8 ± 44.3; <i>p</i>-value = 0.19).</p><p><strong>Conclusion: </strong>Uncontrolled diabetes and the presence of complications were associated with lower absolute GLS% values, suggesting impaired myocardial deformation. These findings highlight the importance of monitoring GLS% as a potential marker for cardiac involvement in diabetic patients.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 6","pages":"38967"},"PeriodicalIF":1.9,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592081","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":"Chronic Total Occlusion Revascularization Strategies: A Comparative Study of Percutaneous Coronary Intervention and Coronary Artery Bypass Grafting.","authors":"Yanci Liu, Shaoping Wang, Hongyu Peng, Qian Fan, Jinghua Liu","doi":"10.31083/RCM27226","DOIUrl":"10.31083/RCM27226","url":null,"abstract":"<p><strong>Objective: </strong>Currently, there are limited data on the clinical outcomes of percutaneous coronary intervention (PCI) compared to coronary artery bypass grafting (CABG) for the treatment of chronic total occlusion (CTO). We compared the clinical outcomes of patients with CTO lesions treated by PCI versus CABG.</p><p><strong>Methods: </strong>This study included 2587 patients with coronary artery disease (CAD) with CTO from January 1, 2019 to December 31, 2021. Both short- and long-term clinical outcomes were compared in patients with CTO who received successful revascularization. The primary endpoint, defined as major adverse cardiac and cerebrovascular events (MACCE), was a composite of all-cause mortality, cerebrovascular events, and myocardial infarction. Unplanned revascularization and heart failure hospitalization were defined as secondary endpoints separately. Propensity score matching was applied to balance baseline characteristics between the two groups.</p><p><strong>Results: </strong>The PCI group had lower MACCE (0.47% vs. 2.11%) within 30 days of the index operation, but the difference did not reach statistical significance (<i>p</i> = 0.06). After an average follow-up of 37.2 months, no significant differences were observed between PCI and CABG in all-cause mortality (hazard ratio [HR] = 2.29, 95% CI: 0.79-6.61; <i>p</i> = 0.13), MACCE (HR = 2.03, 95% CI: 0.86-4.76; <i>p</i> = 0.10), or heart failure hospitalization rate (sub distribution HR [SHR] = 0.98, 95% CI: 0.26-3.74; <i>p</i> = 0.98). However, patients who underwent PCI had a higher risk of unplanned revascularization (SHR = 10.32, 95% CI: 2.42-43.95; <i>p</i> = 0.002).</p><p><strong>Conclusion: </strong>In patients with CAD with CTO, PCI was associated with a trend of lower short-term MACCE compared to CABG, but with a higher risk of long-term unplanned revascularization. There were no significant differences in long-term all-cause mortality, MACCE, or heart failure hospitalization rates between PCI and CABG.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 6","pages":"27226"},"PeriodicalIF":1.9,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592047","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}