Reviews in cardiovascular medicine最新文献

{"title":"Takotsubo Syndrome in Patients With Acute Coronary Syndrome or Myocarditis.","authors":"Manuel Martínez-Sellés","doi":"10.31083/RCM39562","DOIUrl":"10.31083/RCM39562","url":null,"abstract":"<p><p>Stress cardiomyopathy/Takotsubo syndrome (TTS) is a transient cardiac condition characterized by sudden and reversible left ventricular dysfunction, typically triggered by emotional or physical stress. The international TTS (InterTAK) score predicts the probability of suffering from TTS. However, the diagnostic algorithm includes three mutually exclusive diagnoses: acute coronary syndrome (ACS), TTS, and acute infectious myocarditis. Thus, we propose to include the conditions in which TTS is associated with ACS or myocarditis. While TTS is commonly associated with non-ischemic stressors, recent evidence has indicated that TTS can be found in patients with ACS. Nonetheless, in some cases, ACS may trigger rather than exclude TTS. Additionally, TTS could also prompt plaque ruptures in coronary arteries. Meanwhile, infections and conditions that cause myocarditis can also produce physical stress that may trigger TTS. Furthermore, TTS has been reported after confirmed viral myocarditis. This opinion article explores the intricate relationships between (i) TTS and ACS, and (ii) TTS and myocarditis, delving into the related pathophysiologies and diagnostic challenges. However, further research is required to elucidate the mechanisms that link TTS with these conditions.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 8","pages":"39562"},"PeriodicalIF":1.3,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030377","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":"Preoperative Risk Factors for Acute Postoperative Atrial Fibrillation in Patients Undergoing Mitral Valve Repair for Degenerative Mitral Regurgitation: Insights Into Cardiac Geometry.","authors":"Hang Xu, Xinhe Xu, Jiexu Ma, Shanshan Zheng, Wu Song, Zhaoji Zhong, Sheng Liu","doi":"10.31083/RCM38938","DOIUrl":"10.31083/RCM38938","url":null,"abstract":"<p><strong>Background: </strong>Postoperative atrial fibrillation (POAF) commonly occurs following surgical repair of degenerative mitral regurgitation (DMR) and is associated with unfavorable outcomes. This study aimed to identify preoperative risk factors for acute POAF in patients undergoing mitral valve repair for DMR, with a specific focus on the role of preoperative echocardiography.</p><p><strong>Methods: </strong>A retrospective study was conducted involving 1127 DMR patients who underwent mitral valve repair between 2017 and 2022. The primary endpoint was the occurrence of acute POAF within 30 days after surgery. Univariate and multivariate logistic regression analyses were performed to identify risk factors for POAF. Additionally, subgroup analyses were conducted to evaluate the predictive value of preoperative parameters for the development of acute POAF.</p><p><strong>Results: </strong>Acute POAF was observed in 152 patients (13.5%). After adjusting for covariates, multivariate analysis revealed that age (odds ratio (OR) 1.05; 95% confidence interval (CI) 1.03-1.07, <i>p</i> < 0.001), hypertension (OR 1.50; 95% CI 1.03-2.21, <i>p</i> = 0.037), left ventricular ejection fraction (OR 0.95; 95% CI 0.92-0.98, <i>p</i> = 0.004), and left atrial enlargement (OR 1.03; 95% CI 1.00-1.06, <i>p</i> = 0.019) were independent predictors of acute POAF. The interventricular septum (IVS) thickness demonstrated a strong association with acute POAF (OR 1.21; 95% CI 1.06-1.38, <i>p</i> = 0.005). The optimal cut-off value for the IVS thickness in predicting acute POAF was 11.0 mm. The adjusted OR of association between an IVS thickness >11 mm and acute POAF was 1.73 (95% CI 1.03-2.89, <i>p</i> = 0.037). The IVS thickness was consistently identified as a significant predictor of POAF in the subgroup analyses.</p><p><strong>Conclusions: </strong>Preoperative assessment of clinical morbidity and echocardiographic parameters, particularly IVS thickness, can be valuable in identifying high-risk patients for acute POAF and informing targeted strategies for prevention and management.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 8","pages":"38938"},"PeriodicalIF":1.3,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030523","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 Role of Vericiguat in Heart Failure Therapy: From Clinical Trials to Clinical Practice.","authors":"Lucia Tricarico, Michele Correale, Ester Maria Lucia Bevere, Natale Daniele Brunetti, Massimo Iacoviello","doi":"10.31083/RCM39886","DOIUrl":"10.31083/RCM39886","url":null,"abstract":"<p><p>Heart failure with reduced ejection fraction (HFrEF) is a progressive condition that is associated with high rates of morbidity, frequent hospitalizations, and significant mortality. Despite advancements in guideline-directed medical therapy (GDMT), many patients continue to be at risk for worsening heart failure (WHF). Vericiguat is a novel soluble guanylate cyclase (sGC) stimulator that targets the impaired nitric oxide (NO)-sGC-cyclic guanosine monophosphate (cGMP) pathway. Thus, by improving vascular and myocardial function, vericiguat offers a promising therapeutic option for patients with HFrEF who remain symptomatic despite receiving optimal medical treatment. This review explores the pathophysiological rationale, mechanism of action, and clinical evidence supporting the use of vericiguat. We analyze data from key randomized controlled trials (RCTs), such as SOCRATES-REDUCED and VICTORIA, as well as meta-analyses, to assess the efficacy and safety of using vericiguat in HFrEF. Additionally, we review real-world studies to evaluate the applicability of vericiguat in clinical practice.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 8","pages":"39886"},"PeriodicalIF":1.3,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030537","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":"Sex Differences in Reverse Left Ventricular Remodeling in Patients Who Underwent Transcatheter Aortic Valve Replacement in a Chinese Population.","authors":"Jiaqi Zhang, Chengwei Chi, Li Cha, Yuwei Wang, Yuxin Shao, Qingtao Meng, Shulong Zhang, Jihong Liu, Enze Jin","doi":"10.31083/RCM39581","DOIUrl":"10.31083/RCM39581","url":null,"abstract":"<p><strong>Background: </strong>Differences between female and male patients may influence the outcomes of transcatheter aortic valve replacement (TAVR). However, knowledge regarding known sex differences in TAVR procedures among Chinese people remains limited. Therefore, this study aimed to investigate the impact of sex-related differences on reverse left ventricular (LV) remodeling following TAVR in the Chinese population.</p><p><strong>Methods: </strong>Patients with severe symptomatic aortic stenosis (AS) who underwent TAVR at the Heart Center of the Affiliated Zhongshan Hospital of Dalian University were enrolled. A total of 136 patients who underwent implantation of a self-expandable Venus A valve between 2019 and 2024 were evaluated. We retrospectively compared the clinical outcomes and characteristics of all patients by sex.</p><p><strong>Results: </strong>In our study, females presented with a smaller body surface area (BSA) (1.68 ± 0.15 m² vs. 1.90 ± 0.14 m², <i>p</i> < 0.001), aortic valve area (AVA) (0.64 ± 0.22 cm² vs. 0.77 ± 0.20 cm², <i>p</i> = 0.003), left ventricular end-diastole diameter (LVEDD) (49.72 ± 7.37 mm vs. 53.33 ± 8.36 mm, <i>p</i> = 0.023), as well as interventricular septum in diastole (IVSD) (12.85 ± 2.19 mm vs. 13.88 ± 2.61 mm, <i>p</i> = 0.034) at baseline. Comparatively, males had larger aortic root structures at baseline and a larger size of valve implantation during the procedure (<i>p</i> < 0.05). However, the indexed AVA was not significantly different between the two groups at baseline. Sex-specific outcomes, particularly AVA, LVEDD, aortic root diameter (AO), and IVSD, were significantly different during each follow-up within the first six months (<i>p</i> < 0.05), indicating that females experienced greater improvements in these echocardiographic characteristics after TAVR. Left ventricular ejection fraction (LVEF) only improved significantly at 1-month follow-up in females compared to males (57.77 ± 7.87% vs. 54.40 ± 8.21%, <i>p</i> = 0.037). Multivariable linear-regression analysis showed that being a female patient (Beta: 10.200; 95% CI: 0.075-20.326; <i>p</i> = 0.048), as well as having a higher IVSD (Beta: 2.939; 95% CI: 1.110-4.769; <i>p</i> = 0.002), and higher baseline left ventricular mass index (LVMi) (Beta: 0.409; 95% CI: 0.298-0.521; <i>p</i> < 0.001) were independently associated with greater mid-term LVMi regression post-TAVR.</p><p><strong>Conclusions: </strong>Female patients with AS exhibited more favorable mid-term LV reverse remodeling post-TAVR compared to male patients in a Chinese population.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 8","pages":"39581"},"PeriodicalIF":1.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030365","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":"Pathophysiology, Diagnosis, and Management of Coronary Artery Aneurysms: A Review.","authors":"Rengin Çetin Güvenç, Abdullah Ayar Al Arfaj, Hola Razouk, Tolga Sinan Güvenç","doi":"10.31083/RCM39702","DOIUrl":"10.31083/RCM39702","url":null,"abstract":"<p><p>Coronary artery aneurysms (CAAs) are frequent entities that are encountered in up to 8% of patients undergoing coronary imaging. The most frequent cause of CAAs is atherosclerotic \"positive remodeling\" of coronary arteries, while congenital, inflammatory, and traumatic etiologies could also be seen. Aneurysms serve as foci for thrombus formation, which may occlude the aneurysmatic segment or embolize distally. Rupture of an aneurysm is a rare yet potentially catastrophic complication of a CAA. Most aneurysms can be managed medically, while percutaneous exclusion of an aneurysm from coronary circulation is appropriate for CAAs that are prone to rupture or thrombosis. Surgical correction remains the ultimate option for patients who are not amenable to percutaneous management or those with a compelling indication for surgery. This review summarizes the available knowledge on the nomenclature, classification, pathophysiology, diagnosis, and management of CAAs, with a particular emphasis on treatment strategies to mitigate the risks associated with CAAs.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 8","pages":"39702"},"PeriodicalIF":1.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030530","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 Intrinsic Capacity on 5-year Mortality of Older Patients With Cardiovascular Disease.","authors":"Yuhao Wan, Wenzheng Li, Junpeng Liu, Ke Chai, Hua Wang, Jiefu Yang","doi":"10.31083/RCM37477","DOIUrl":"10.31083/RCM37477","url":null,"abstract":"<p><strong>Background: </strong>Intrinsic capacity (IC) is defined as the combination of all physical and mental (including psychosocial) capacities that an individual can rely on at any given time. Previous studies have shown that a decline in IC is linked to an increased mortality rate. Thus, this study aimed to evaluate the impact of IC on the 5-year mortality of older people with cardiovascular disease.</p><p><strong>Methods: </strong>This was a prospective cohort study conducted at a tertiary-level A hospital in China between September 2018 and April 2019, with a follow-up period of 5 years. We applied a proposed IC score to assess the baseline IC of each participant. The primary clinical outcome was 5-year all-cause mortality.</p><p><strong>Results: </strong>A total of 524 older patients (mean age, 75.2 ± 6.5 years; 51.7% men) were enrolled from the cardiology ward. A total of 86 patients (16.5%) experienced all-cause mortality over the 5-year follow-up period. Compared with the survival group, patients in the mortality group were older (81.1 ± 5.7 vs. 74.0 ± 6.0; <i>p</i> < 0.01), showed a higher male proportion (61.6% vs. 49.8%; <i>p</i> = 0.04), had a lower intrinsic score [7.0 (6.0, 8.0) vs. 8.0 (7.0, 9.0); <i>p</i> < 0.01], and a higher prevalence rates of atrial fibrillation or atrial flutter (34.9% vs. 20.1%; <i>p</i> < 0.01), heart failure (44.2% vs.11.2%; <i>p</i> < 0.01), diabetes (48.8% vs. 33.1%; <i>p</i> < 0.01), and chronic kidney disease (19.8% vs. 4.3%; <i>p</i> < 0.01). After adjusting for covariates, multivariate Cox regression showed that the IC score was associated with a lower hazard ratio of 5-year all-cause mortality (hazard ratio (HR) = 0.79, 95% confidence interval (CI): 0.69-0.92, <i>p</i> < 0.01).</p><p><strong>Conclusions: </strong>Among these older aged patients with cardiovascular disease, the IC score is independently associated with 5-year all-cause mortality, with a lower IC score indicating a poorer prognosis.</p><p><strong>Clinical trial registration: </strong>ChiCTR1800017204; date of registration: 07/18/2018. URL: https://www.chictr.org.cn/showproj.html?proj=28931.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 8","pages":"37477"},"PeriodicalIF":1.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030512","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":"Epicardial Adipose Tissue and Liver Fibrosis in Patients With Type 2 Diabetes Mellitus and Metabolic Dysfunction-Associated Liver Disease.","authors":"Simona Cernea, Andrada Larisa Roiban, Danusia Onișor, Nora Rat","doi":"10.31083/RCM39534","DOIUrl":"10.31083/RCM39534","url":null,"abstract":"<p><strong>Background: </strong>Epicardial adipose tissue (EAT) is an indicator of high cardiovascular and metabolic risk. This study aimed to investigate the association between EAT thickness (EATT) and liver fibrosis and steatosis in patients with type 2 diabetes mellitus (T2DM) and metabolic dysfunction-associated steatotic liver disease (MASLD).</p><p><strong>Methods: </strong>Patients with T2DM and MASLD underwent a complex evaluation, which included clinical, laboratory, and liver and transthoracic cardiac ultrasound assessments. The EATT was measured using the standard method. Liver fibrosis and steatosis were evaluated by several non-invasive indexes, through which patients with severe steatosis and advanced fibrosis were identified. Correlations between the EATT and markers of liver fibrosis and steatosis were evaluated by bivariate and multiple regression analyses.</p><p><strong>Results: </strong>In this study population of 267 T2DM patients with MASLD, the median EATT value was 7 mm. 43.8% of study patients had an EATT >7 mm. The EATT was higher in patients with advanced liver fibrosis (8.97 ± 2.88 mm vs. 7.09 ± 2.38 mm; <i>p</i> < 0.0001) and in those with more severe hepatic steatosis (7.69 ± 2.70 mm vs. 6.61 ± 1.88 mm; <i>p</i> = 0.0310). A higher percentage of patients with advanced liver fibrosis had an EATT of >7 mm (68.3% vs. 36.7%; odds ratio (OR) = 3.72 [95% confidence interval (CI): 2.02; 6.87]; <i>p</i> < 0.0001). In the bivariate analyses, the EATT significantly correlated with the markers of body adiposity, non-invasive indexes of liver steatosis and fibrosis, aspartate aminotransferase (ASAT), gamma glutamyl transpeptidase (GGT), diabetes duration, and pO2. The multiple regression analyses indicated that the EATT was independently associated with fibrosis-4 (FIB-4) score and body fat mass, and with serum ferritin (in fully adjusted models), while the correlation with the markers of hepatic steatosis became non-significant after adjustments for body adiposity.</p><p><strong>Conclusion: </strong>T2DM patients with MASLD and markers of advanced liver fibrosis have higher EATT, which was independently associated with liver fibrosis.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 8","pages":"39534"},"PeriodicalIF":1.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030454","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":"Artificial Intelligence in Adult Congenital Heart Disease: Diagnostic and Therapeutic Applications and Future Directions.","authors":"Ibrahim Antoun, Ali Nizam, Armia Ebeid, Mariya Rajesh, Ahmed Abdelrazik, Mahmoud Eldesouky, Kaung Myat Thu, Joseph Barker, Georgia R Layton, Mustafa Zakkar, Mokhtar Ibrahim, Kassem Safwan, Radek M Dibek, Riyaz Somani, G André Ng, Aiden Bolger","doi":"10.31083/RCM41523","DOIUrl":"10.31083/RCM41523","url":null,"abstract":"<p><p>Adult congenital heart disease (ACHD) constitutes a heterogeneous and expanding patient cohort with distinctive diagnostic and management challenges. Conventional detection methods are ineffective at reflecting lesion heterogeneity and the variability in risk profiles. Artificial intelligence (AI), including machine learning (ML) and deep learning (DL) models, has revolutionized the potential for improving diagnosis, risk stratification, and personalized care across the ACHD spectrum. This narrative review discusses the current and future applications of AI in ACHD, including imaging interpretation, electrocardiographic analysis, risk stratification, procedural planning, and long-term care management. AI has been demonstrated as being highly accurate in congenital anomaly detection by various imaging modalities, automating measurement, and improving diagnostic consistency. Moreover, AI has been utilized in electrocardiography to detect previously undetected defects and estimate arrhythmia risk. Risk-prediction models based on clinical and imaging information can estimate stroke, heart failure, and sudden cardiac death as outcomes, thereby informing personalized therapy choices. AI also contributes to surgery and interventional planning through three-dimensional (3D) modelling and image fusion, while AI-powered remote monitoring tools enable the detection of early signals of clinical deterioration. While these insights are encouraging, limitations in data availability, algorithmic bias, a lack of prospective validation, and integration issues remain to be addressed. Ethical considerations of transparency, privacy, and responsibility should also be highlighted. Thus, future initiatives should prioritize data sharing, explainability, and clinician training to facilitate the secure and effective use of AI. The appropriate integration of AI can enhance decision-making, improve efficiency, and deliver individualized, high-quality care to ACHD patients.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 8","pages":"41523"},"PeriodicalIF":1.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030310","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":"Point-of-Care Ultrasound Optimizes the Preoperative Use of Prostaglandin E1 in Infants With Transposition of the Great Arteries.","authors":"Wei Zhang, Yu-Yu Tan, You-Qun Zou, Shu-Sheng Wen, Min Yang, Yu-Mei Liu","doi":"10.31083/RCM39250","DOIUrl":"10.31083/RCM39250","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to determine the optimal dosages of prostaglandin E1 required to maintain a patent ductus arteriosus (PDA) in infants with transposition of the great arteries (TGA) based on point-of-care ultrasound (POCUS) findings.</p><p><strong>Methods: </strong>Infants with TGA were recruited from two groups (the historical control group and the POCUS group that received POCUS in combination with pulse oximetry saturation (SpO₂) to titrate the dose of prostaglandin E1 (PGE1)).</p><p><strong>Results: </strong>A total of 150 patients were included in this study. The mean gestational ages were 38.6 weeks and 38.9 weeks, respectively, and the mean birth weights were 3.09 kg and 3.23 kg, respectively, in the control and POCUS groups. The rate of PGE1 prescriptions in the control group (93.3%) was higher than in the POCUS group (71.1%; <i>p</i> < 0.001). The time at which PGE1 was initiated (prenatally diagnosed) was earlier than in the control group (0.05 ± 0.01 vs. 1.66 ± 3.72 d; <i>p</i> < 0.001). The proportion of patients using a low dose (less than 5 ng/kg⋅min) of PGE1 was higher in the POCUS group (40.6% vs. 8.9%; <i>p</i> < 0.001). The multivariate logistic regression analysis indicated that implementing POCUS significantly reduces the dosage of PGE1.</p><p><strong>Conclusion: </strong>POCUS can optimize the use of PGE1, reduce unnecessary usage, postpone the initiation of PGE1, minimize the maintenance dose, and reduce the impact dose. POCUS guidance enhances the safety and effectiveness of PGE1 in infants with TGA.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 8","pages":"39250"},"PeriodicalIF":1.3,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030510","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":"Current Advancements in the Diagnosis and Management of Mild-to-moderate Coronary Stenosis.","authors":"Cuimei Guo, Haizhu Gao, Xinxin Bian, Nan Lin, Lijun Gan, Xueying Chen","doi":"10.31083/RCM38822","DOIUrl":"10.31083/RCM38822","url":null,"abstract":"<p><p>Coronary heart disease (CHD) is associated with increased morbidity and mortality. Acute cardiovascular events frequently occur in patients with coronary artery stenoses exceeding 70%. Although coronary revascularization can significantly improve ischemic symptoms, the inflection point for reducing mortality from CHD has yet to be reached. Therefore, the prevention and treatment of mild-to-moderate coronary artery stenosis should be given significant attention to more effectively reduce the incidence and mortality of acute events from CHD. Subsequently, a stenosis of less than 70% is used to characterize the incidence of mild to moderate coronary artery stenosis. While acute cardiovascular events caused by soft plaque and plaque rupture may not have a significant impact on hemodynamics, these events are detrimental and result in increased mortality. This review summarizes the methods available for detecting mild-to-moderate coronary artery stenoses, assessing risk, and understanding the mechanisms underlying adverse events. Moreover, this review proposes intervention strategies for preventing and treating mild to moderate coronary stenosis.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 8","pages":"38822"},"PeriodicalIF":1.3,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030408","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}