Reviews in cardiovascular medicine最新文献

{"title":"Biomarker-Guided Versus Clinically Guided Management Strategies for Heart Failure: A Systematic Review and Meta-Analysis.","authors":"Hao Zhou, Ting Liu, Fuxia Lan, Kai Liu, Xin Wei, Ying Xu","doi":"10.31083/RCM46184","DOIUrl":"https://doi.org/10.31083/RCM46184","url":null,"abstract":"<p><strong>Background: </strong>The clinical value of B-type natriuretic peptide (BNP) or N-terminal pro-B-type natriuretic peptide (NT-proBNP)-guided therapy for improving outcomes in patients with heart failure (HF) remains controversial. Thus, this meta-analysis synthesizes the available evidence from randomized controlled trials (RCTs) to determine whether a biomarker-guided strategy reduces all-cause mortality and HF-related hospitalizations compared with clinically guided management.</p><p><strong>Methods: </strong>This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We conducted a systematic search of PubMed, Embase, the Cochrane Library, and Web of Science databases from inception to May 2025 for RCTs comparing biomarker-guided versus clinically guided management in patients with HF. Pooled risk ratios (RRs) were calculated using a random-effects model. We performed extensive supplementary analyses, including a subgroup analysis, sensitivity analysis, and trial sequential analysis (TSA).</p><p><strong>Results: </strong>We included 17 articles (reporting on 17 distinct RCTs) comprising 5069 patients. The primary meta-analysis showed that biomarker-guided therapy was associated with a significant reduction in all-cause mortality (RR 0.84, 95% confidence interval (CI) 0.73-0.96; I² = 12.2%) and HF-related hospitalizations (RR 0.79, 95% CI 0.65-0.96; I² = 53.7%). However, the robustness of these findings was undermined by subsequent analyses. Meanwhile, a sensitivity analysis restricted to studies with a low risk of bias rendered the mortality benefit non-significant (RR 0.90, 95% CI 0.79-1.03). Egger's test indicated potential publication bias (<i>p</i> = 0.0285), and TSA suggested the cumulative evidence was insufficient to draw a definitive conclusion.</p><p><strong>Conclusions: </strong>Although there is a trend toward benefit, the existing evidence for biomarker-guided HF therapy is deemed \"very low\" quality based on the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) assessment. The results were compromised by methodological deficiencies in primary studies and potential publication bias. Therefore, the evidence is inadequate to support the routine use of this strategy in clinical practice. Further large-scale, high-quality RCTs are warranted.</p><p><strong>The prospero registration: </strong>CRD420250652134, https://www.crd.york.ac.uk/PROSPERO/view/CRD420250652134.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 3","pages":"46184"},"PeriodicalIF":1.3,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13036551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594283","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":"Evolution of Clinical Indications for Mitral Valve Transcatheter Edge-to-Edge Repair.","authors":"Carla Iglesias-Otero, Julio Echarte-Morales, David González-Fernández, Andrés Íñiguez-Romo, Rodrigo Estévez-Loureiro","doi":"10.31083/RCM47139","DOIUrl":"https://doi.org/10.31083/RCM47139","url":null,"abstract":"<p><p>Mitral valve transcatheter edge-to-edge repair (M-TEER) has evolved from a highly specialized intervention to an essential treatment option for patients with severe mitral regurgitation (MR) who are unsuitable candidates for surgery. Moreover, current guidelines support the use of M-TEER in both secondary MR and selected cases of primary MR. In addition to these established indications, data from clinical trials and registries indicate that M-TEER is associated with improved short-term outcomes compared with conservative therapy in acute MR after myocardial infarction, and is beneficial in more complex scenarios, such as advanced heart failure, hypertrophic obstructive cardiomyopathy, and mitral annulus calcification. Meanwhile, combined strategies, such as repairing the mitral and tricuspid valves simultaneously, adding M-TEER to transcatheter aortic valve replacement, or performing this procedure alongside left atrial appendage closure, are gaining ground as practical ways to address the broader needs of these high-risk patients. More recently, M-TEER has been used in patients with moderate MR, as this stage is now recognized to be associated with adverse outcomes. Overall, current evidence supports M-TEER as a safe and versatile therapy across an expanding range of clinical scenarios. Nonetheless, ongoing studies will help further clarify long-term outcomes and refine patient selection.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 3","pages":"47139"},"PeriodicalIF":1.3,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13036549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594374","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":"Hemolysis in Pulsed Field Ablation for Atrial Fibrillation: A Narrative Review.","authors":"Angelica Cersosimo, Nicola Pierucci, Marco Valerio Mariani, Andrea Matteucci, Andrea Giovanni Parato, Vincenzo Mirco La Fazia, Andrea Natale","doi":"10.31083/RCM46485","DOIUrl":"https://doi.org/10.31083/RCM46485","url":null,"abstract":"<p><p>Pulsed field ablation (PFA) has emerged as a promising non-thermal energy source for treating atrial fibrillation (AF), demonstrating comparable efficacy to traditional thermal ablation techniques while offering an improved safety profile. However, recent evidence suggests that PFA may be associated with intravascular hemolysis, a complication that can potentially lead to acute kidney injury (AKI). This review aims to provide a comprehensive overview of the mechanisms of hemolysis associated with PFA and to summarize current strategies to mitigate the risk of AKI. The delivery of high-voltage electrical pulses during PFA can induce red blood cell lysis, resulting in elevated circulating free hemoglobin. The extent of hemolysis has been shown to correlate with several procedural variables, including peak output voltage, catheter-tissue contact quality, and, particularly, the number of energy applications delivered. Recent studies have highlighted that adequate preprocedural hydration may effectively reduce the incidence of AKI by promoting renal clearance of hemolytic products. Although hemolysis appears to be an unavoidable effect of pulsed field ablation, the clinical consequences associated with hemolysis, particularly AKI, can be significantly reduced with preventive measures.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 3","pages":"46485"},"PeriodicalIF":1.3,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13036529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594377","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":"Myocardial Revascularization in 2025: A Clinical Perspective on the Evolution of Technologies, Strategic Decision-Making, and Future Horizons.","authors":"Vaibhav Sharma, Kriti Ahuja","doi":"10.31083/RCM45516","DOIUrl":"https://doi.org/10.31083/RCM45516","url":null,"abstract":"<p><p>Coronary artery disease remains the leading cause of death worldwide, causing the field of myocardial revascularization to evolve rapidly. This review synthesizes current evidence and emerging trends, providing clinicians with practical guidelines to support decision-making in practice. Current drug-eluting stents have attained excellent safety profiles, with restenosis rates below 3%. Percutaneous treatment of complex lesions is now routinely feasible, with success rates of 90-95% in experienced institutions. Surgical revascularization remains the standard of care for complex multivessel disease, and total arterial grafting provides a strong long-term survival advantage. Nonetheless, emerging technologies, such as artificial intelligence (AI)-guided interventions, robotic interventions, and precision medicine strategies, have the potential to overcome current limitations and extend advanced therapies to high-risk patients. The optimal revascularization plan increasingly depends on integrating anatomical complexity, physiological significance, patient-specific features, and institution-specific expertise. Heart team-based decision-making is now a necessity, particularly in difficult cases where hybrid strategies might offer particular advantages. Over the coming decade, the extensive use of AI-assisted procedural planning, the broader adoption of minimally invasive treatments, and the establishment of prescription-based personalized medicine protocols are likely to be observed. Success will depend on addressing current challenges, including health disparities, delayed complications, and increasing heterogeneity in the patient population.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 3","pages":"45516"},"PeriodicalIF":1.3,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13036553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594311","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 Efficacy of Traditional Chinese Exercises in Patients With Chronic Heart Failure: An Umbrella Review and Meta-Analysis.","authors":"Xiaoyu Zhao, Rongjun Zou, Haoran Miao, Xing Chang, Kroekkiat Chinda, Fang Chen, Miao Zhang, Jin Zhuo, Xuejing Sun, Yijun Chen, Chao Li, Qingyong He, Cheng Luo, Timothy Kwok, Dachun Xu, Yiqian Zhang, Hao Zhou, Xiaoping Fan, Sang-Bing Ong","doi":"10.31083/RCM46055","DOIUrl":"https://doi.org/10.31083/RCM46055","url":null,"abstract":"<p><strong>Background: </strong>Chronic heart failure (CHF) is a common clinical syndrome characterized by reduced exercise capacity, diminished quality of life (QoL), and unfavorable cardiovascular outcomes. Conventional cardiac rehabilitation often requires moderate-to-high-intensity exercise, which may be tolerated poorly by many CHF patients. Low-intensity mind-body interventions, such as traditional Chinese exercises (TCEs), are potentially more suitable; however, the evidence from existing studies is fragmented and sometimes inconsistent. Thus, this study aimed to conduct an umbrella review of systematic reviews (SRs) and meta-analyses (MAs) to evaluate the effectiveness of TCEs in improving exercise capacity, QoL, and cardiovascular function in patients with CHF.</p><p><strong>Methods: </strong>An umbrella review of SRs/MAs was conducted by searching English and Chinese databases without language limits and focusing on randomized controlled trials (RCTs) that assessed the additional benefit of TCEs in individuals with CHF. Methodological quality was appraised using the A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) checklist and the Risk of Bias in Systematic Reviews (ROBIS) instrument. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was utilized to quantify the certainty of evidence. Individual trial data were retrieved, and re-meta-analyses were performed using standard statistical procedures, with publication bias assessed via Egger's test.</p><p><strong>Results: </strong>A total of 15 SRs/MAs were included, encompassing 65 original trials. Our re-meta-analysis indicated that TCEs were associated with substantially longer 6-minute walk test (6-MWT) values, improved QoL measured by the Minnesota Living with Heart Failure Questionnaire (MLHFQ), higher left ventricular ejection fraction (LVEF), reduced B-type natriuretic peptide (BNP) levels, and enhanced maximal oxygen consumption (VO₂max). Baduanjin exhibited a particularly robust effect on lowering N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations, while Yijinjing yielded comparatively greater improvements in VO₂max. Nonetheless, limitations such as suboptimal methodological quality and overlapping study samples require cautious interpretation.</p><p><strong>Conclusions: </strong>TCEs may serve as a beneficial adjunct to standard care for CHF, improving exercise capacity, QoL, and key cardiac markers. Large, rigorous RCTs with extended follow-up are needed to confirm the durability of TCEs and further define the role of these exercises in comprehensive CHF rehabilitation.</p><p><strong>The prospero registration: </strong>CRD420251003129 (https://www.crd.york.ac.uk/PROSPERO/view/CRD420251003129).</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 3","pages":"46055"},"PeriodicalIF":1.3,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13036533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594196","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 Impact of Early In-Hospital Use of SGLT2 Inhibitors on Outcomes in Patients With Acute Heart Failure: An Updated Systematic Review and Meta-Analysis.","authors":"Yifan Deng, Yue Ma, Hao Li, Li Zhu","doi":"10.31083/RCM45590","DOIUrl":"https://doi.org/10.31083/RCM45590","url":null,"abstract":"<p><strong>Background: </strong>Sodium-glucose cotransporter 2 (SGLT2) inhibitors, employed as antidiabetic agents, have been shown to effectively improve the prognosis of patients with chronic and stable heart failure, chronic kidney disease, and diabetes in the context of cardiovascular-renal-endocrine integrated management. However, the safety and clinical benefits of the early application of SGLT2 inhibitors in hospitalized patients with acute heart failure remain controversial. This study aimed to evaluate the safety and prognostic impact of early SGLT2 inhibitor therapy in patients with acute heart failure.</p><p><strong>Methods: </strong>A systematic literature search of the PubMed, Web of Science, and Cochrane Library databases was conducted to identify studies on the use of SGLT2 inhibitors in acute heart failure. Two researchers independently screened studies, extracted data, and assessed the risk of bias in the included studies. The meta-analysis was performed using STATA 16.0 software (StataCorp, College Station, TX, USA).</p><p><strong>Results: </strong>A total of 23 studies involving 47,291 patients with acute heart failure were included in this analysis (10 randomized controlled trials and 13 observational studies). Early use of SGLT2 inhibitors in hospitalized patients with acute heart failure was associated with a reduction in the incidence of composite events in the short term (relative risk (RR) = 0.64, 95% confidence interval (CI) (0.56, 0.74)), all-cause mortality (RR = 0.72, 95% CI (0.60, 0.86)), and heart failure rehospitalization rates (RR= 0.77, 95% CI (0.63, 0.87)); however, the early use of SGLT2i did not improve the incidence of cardiogenic death (RR = 0.74, 95% CI (0.51, 1.08)). Additionally, the early administration of SGLT2 inhibitors significantly reduced the incidence of cardiogenic mortality (RR = 0.77, 95% CI (0.60, 1.0); <i>p</i> = 0.045), as well as decreasing heart failure rehospitalization rates (RR = 0.77, 95% CI (0.70, 0.86)) and all-cause mortality (RR = 0.49, 95% CI (0.41, 0.60)), without increasing the incidence of adverse drug reactions such as acute kidney injury, urinary tract infections, diabetic ketoacidosis, hypoglycemia, or hypotension.</p><p><strong>Conclusion: </strong>Early in-hospital use of SGLT2 inhibitors can safely and effectively reduce the incidence of all-cause mortality, cardiogenic rehospitalization, and composite events in acute heart failure patients in both the short term and over one year.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 3","pages":"45590"},"PeriodicalIF":1.3,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13036538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594239","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":"Lipoprotein(a) as a Risk Factor for Recurrent Acute Coronary Syndrome and Unplanned Revascularization in Fractional Flow Reserve-Negative Lesions.","authors":"Yingying Zhao, Jiayi Luo, Kai Xu, Yang Li, Yaling Han","doi":"10.31083/RCM47169","DOIUrl":"https://doi.org/10.31083/RCM47169","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to explore the association between serum lipoprotein(a) [Lp(a)] levels and recurrent acute coronary syndrome (ACS) and revascularization of target lesions in patients with ACS who showed no functional ischemia on fractional flow reserve (FFR) testing during coronary angiography (CAG).</p><p><strong>Methods: </strong>The retrospective observational study was conducted at the General Hospital of Northern Theater Command and included 513 patients with new ACS recruited from 23 February 2016 to 6 November 2023 and followed up. These patients underwent CAG examination and were found to have at least one coronary artery with moderate or greater stenosis, and also underwent FFR measurement with FFR value >0.80. Patients experienced recurrent ACS and underwent unplanned revascularization were defined as the revascularization group, while patients did not experience recurrent ACS and undergo unplanned revascularization were assigned to the no revascularization group. The study employed propensity score matching (PSM) and receiver operating characteristic (ROC) curve analysis to evaluate the correlation between serum Lp(a) and recurrent ACS and unplanned revascularization in target lesion with FFR value >0.80.</p><p><strong>Results: </strong>Serum Lp(a) levels were higher in female patients. There were no statistically significant differences in the basic clinical characteristics, medication use, laboratory test results or ejection fraction values between the two groups. During a average follow-up of 6.5 years, 119 patients (23.2%) experienced recurrent ACS and unplanned revascularization in the target lesion. The level of serum Lp(a) in the patients that underwent unplanned revascularization was significantly higher than in the group that did not undergo repeated revascularization (65.80 mmol/L vs. 60.57 mmol/L, <i>p</i> = 0.034).</p><p><strong>Conclusion: </strong>Serum Lp(a) is an independent risk factor for recurrent ACS and unplanned revascularization in patients with ACS and FFR negative plaque.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 3","pages":"47169"},"PeriodicalIF":1.3,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13036542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594360","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":"Congenital Heart Disease and Pulmonary Arterial Hypertension: Current Perspectives.","authors":"Enrique Blanca-Jover, Francisco Contreras-Chova, Antonio Jerez-Calero, Jose Uberos-Fernandez, Laura Pérez-Lara","doi":"10.31083/RCM48337","DOIUrl":"https://doi.org/10.31083/RCM48337","url":null,"abstract":"<p><p>Pulmonary arterial hypertension (PAH) is the most serious complication of congenital heart disease (CHD), constituting a heterogeneous clinical entity classified within Group 1 of the Clinical Classification of Pulmonary Hypertension (PH). PAH associated with congenital heart disease (PAH-CHD) affects approximately 3-10% of patients with CHD and accounts for up to one-third of all PAH cases in the adult population. This review provides an educational and up-to-date perspective on the epidemiology, pathophysiology, diagnosis, and management of PAH-CHD. The updated haemodynamic definitions of the 2022 European Society of Cardiology (ESC)/European Respiratory Society (ERS) guidelines (mean pulmonary artery pressure (PAP) ≥20 mmHg) and the importance of contemporary registries (COMPERA-CHD, HOPE) in defining prognosis are discussed. The pathophysiology is explored in depth, from initial shear stress to the imbalance in the three canonical pathways that regulate pulmonary vascular functions (endothelin, nitric oxide, prostacyclin), the role of inflammation and metabolism, and the central importance of the TGF-β/BMPR2 genetic pathway, which has led to new disease-modifying therapies. Moreover, this review addresses the crucial clinical distinction between paediatric management, constrained by limited evidence, and adult management (ACHD), with a focus on the multisystem disorder of Eisenmenger syndrome (ES) and the challenges of care transition. The gold-standard diagnostic (right heart catheterisation), the 'treat and repair' strategy in the haemodynamic 'grey zone', and the complex risk stratification in this population are also analysed. Additionally, the evidence from key trials (BREATHE-5, MAESTRO, REPLACE) and the paradigm shift towards initial combination therapy (AMBITION) are reviewed from a therapeutic perspective. Finally, the most significant advance is highlighted: Sotatercept, a vascular remodelling reversal agent (STELLAR study), concluding with a review of chronic complications and prospects in the field.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 3","pages":"48337"},"PeriodicalIF":1.3,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13036531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594273","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":"Intelligent Decision Support for Transcatheter Aortic Valve Replacement: Machine Learning Spans From Anatomical Assessment to Dynamic Risk Modeling.","authors":"Xinjie Hu, Peiling Xie, Ying Li","doi":"10.31083/RCM44364","DOIUrl":"https://doi.org/10.31083/RCM44364","url":null,"abstract":"<p><p>This study aimed to investigate the application of machine learning (ML) in transcatheter aortic valve replacement (TAVR) and to demonstrate that, owing to the unique strengths of ML, this field outperforms conventional approaches in both preoperative assessment and postoperative prediction of TAVR. Nonetheless, TAVR is the preferred treatment option for medium- and high-risk patients with aortic stenosis, a common valvular disease, because of the associated minimally invasive nature and rapid recovery. However, challenges remain in preoperative evaluation and in predicting postoperative complications. Thus, ML technology offers innovative solutions for these challenges. This study provides an overview of current ML applications in TAVR and evaluates the associated benefits in measuring preoperative anatomical parameters and predicting postoperative complications. Indeed, the superiority of ML models for preoperative planning can be assessed by comparing ML model-derived data with measurements from senior and junior observers across various aortic root anatomical parameters. Additionally, this review discusses the challenges of applying ML in TAVR, including data acquisition, privacy protection, and model generalizability. The ongoing advancement of artificial intelligence (AI) technologies, particularly the integration of explainable AI and federated learning, is expected to enhance the accuracy and personalization of preoperative planning and postoperative prediction for TAVR. This progress will facilitate broader application of these technologies, ultimately benefiting a wider patient population.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 3","pages":"44364"},"PeriodicalIF":1.3,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13036514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594331","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":"Representation of Women in Atrial Fibrillation Clinical Trials: A Systematic Review.","authors":"Ramzi Ibrahim, Hoang Nhat Pham, Christopher Kanaan, Buthainah Alhwarat, Enkhtsogt Sainbayar, Sabrina Soin, Chadi Ayoub, Alaide Chieffo, Garima Sharma, Jo Protheroe, Justin Z Lee, Reza Arsanjani, Kwan Lee, Mamas A Mamas","doi":"10.31083/RCM47907","DOIUrl":"https://doi.org/10.31083/RCM47907","url":null,"abstract":"<p><strong>Background: </strong>Disparities exist in the representation of genders in cardiovascular clinical trials. Atrial fibrillation (AF) is associated with significant morbidity and mortality; however, understanding regarding the representation of women in AF-related clinical trials remains limited. Therefore, this systematic review sought to evaluate the representation of women in AF-related clinical trials.</p><p><strong>Methods: </strong>We conducted a systematic review of clinical trials using the PubMed, Scopus, and EMBASE databases from 1996 to January 1st, 2024, focusing on AF-related lifestyle interventions, pharmacological treatments, catheter ablation, and device therapies for AF. Data extraction and analysis encompassed trial characteristics, participant demographics, and funding sources. The primary outcome was the prevalence of female enrollees, quantified through participation-to-prevalence ratios (PPRs). This was estimated overall and stratified by funding source, intervention type, and enrollment region.</p><p><strong>Results: </strong>Of the 103 clinical trials involving 218,322 participants (39.5% female), the PPR ranged from 0.00 to 1.73, with an average PPR of 1.03. Meanwhile, 43% of the trials exhibited female under-representation (PPR, <0.8). University-funded trials showed higher female enrollment (mean PPR, 0.951) compared to industry/government-funded trials (mean PPR, 0.800). No differences were observed in the representation of women when comparing enrollment regions or intervention types.</p><p><strong>Conclusions: </strong>Despite advancements in AF management, gender disparities persist in AF-related clinical trial representation, particularly in industry/government-funded studies compared to university-funded trials. Thus, addressing implicit biases and enforcing sex equality guidelines are critical steps toward more inclusive cardiovascular research.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 3","pages":"47907"},"PeriodicalIF":1.3,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13036515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594127","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}