Reviews in cardiovascular medicine最新文献

{"title":"Deep Learning Optimizes the Diagnostic Performance of Coronary Computed Tomography Angiography in Heavily Calcified Coronary Plaques: A Chinese Multicenter Study.","authors":"Chunyan Shi, Chengjin Yu, Bin Zhang, Benjamin Ellison, Zhifan Gao, Zhe Fang, Bin Hu, Jiayin Zhang, Ximing Wang, Longjiang Zhang, Heye Zhang, Lei Xu, Rui Wang","doi":"10.31083/RCM49404","DOIUrl":"https://doi.org/10.31083/RCM49404","url":null,"abstract":"<p><strong>Background: </strong>Accurate evaluation of coronary luminal stenosis using coronary computed tomography angiography (CCTA) remains significantly impaired in the presence of severe coronary artery calcification. Calcification-related blooming artifacts frequently lead to overestimation of stenosis severity and reduced diagnostic specificity, representing a persistent and unresolved challenge in clinical practice. Thus, this study aimed to develop and validate a self-supervised deep learning (DL) algorithm to improve the diagnostic performance of CCTA for assessing luminal stenosis in patients with heavily calcified coronary plaques (Agatston score >300), using quantitative coronary angiography (QCA) as the reference standard.</p><p><strong>Methods: </strong>This multicenter retrospective study enrolled 786 patients with agatston score (AS) >300 who underwent both CCTA and QCA from four Chinese hospitals. The dataset was randomly divided into a training group (80%, n = 628) for algorithm development and a validation group (20%, n = 158). The diagnostic performance of the DL model and radiologists was compared using sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for detecting ≥50% diameter stenosis at the lesion, vessel, and patient levels. Reporting time was also evaluated.</p><p><strong>Results: </strong>In the validation cohort, 476 calcified lesions in 213 vessels from 93 patients were confirmed by QCA to have ≥50% diameter stenosis. The DL model demonstrated significantly higher specificity than radiologists at both the vessel level (52% vs. 30%) and patient level (74% vs. 57%) (all <i>p</i> < 0.05). In lesions with severe calcification (cross-sectional calcium arc 270°-360°), DL further improved lesion-level specificity and NPV by 27% and 36%, respectively (all <i>p</i> < 0.05). In addition, DL markedly reduced reporting time compared with radiologists (61.9 ± 2.56 s vs. 376.6 ± 127.2 s; <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>The proposed self-supervised DL model enables rapid and more accurate assessment of luminal stenosis in the presence of heavily calcified plaques, with improved diagnostic specificity and greater workflow efficiency.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 9","pages":"49404"},"PeriodicalIF":2.2,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171165","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":"Nonlinear and Vessel-Specific Association Between Coronary Artery Calcium Burden and Coronary Computed Tomography Angiography Underestimation of Coronary Stenosis.","authors":"Xuzhe Wang, Chengzhuo Wang, Yu Xie, Wenyu Wang, Ruifeng Liu","doi":"10.31083/RCM52230","DOIUrl":"10.31083/RCM52230","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery calcium (CAC) introduces substantial artifacts in coronary computed tomography angiography (CCTA). Although calcification is classically associated with overestimation of stenosis severity, underestimation may be even more clinically hazardous because underestimation can lead to inappropriate deferral of revascularization. Thus, this study aimed to investigate the association between CAC burden and CCTA underestimation, with emphasis on vessel-specific anatomical heterogeneity.</p><p><strong>Methods: </strong>We retrospectively evaluated 673 patients without known coronary artery disease who underwent both CCTA and invasive coronary angiography (ICA) within 90 days, yielding 2692 vessel observations. Underestimation was defined strictly at the vessel level as a CCTA stenosis grade lower than the corresponding ICA grade. Restricted cubic splines (RCS) were used to characterize the nonlinear association between CAC burden and the risk of underestimation. Within-patient clustering across the left main (LM), left anterior descending (LAD), left circumflex (LCX), and right coronary artery (RCA) was accounted for using generalized estimating equations (GEEs).</p><p><strong>Results: </strong>Any-vessel underestimation occurred in 389 patients (57.8%). Vessel-specific susceptibility varied markedly: LM, 3.0%; LAD, 27.9%; LCX, 29.3%; and RCA, 22.4%. RCS analysis demonstrated a significant nonlinear association between total CAC score and patient-level underestimation in the fully adjusted model (<i>p</i>-overall = 0.014; <i>p</i>-nonlinear = 0.004), with an upward risk trajectory observed as calcification increased relative to the median reference of 301. GEE modeling confirmed that patient-level CAC burden independently predicted vessel-level underestimation (CAC ≥400 vs. 0: odds ratio, 2.01; 95% confidence interval, 1.20-3.36; <i>p</i> = 0.008), with a significant interaction between CAC and vessel territory (<i>p</i> < 0.001). A sensitivity analysis restricted to patients without any CCTA overestimation (n = 155) confirmed a robust nonlinear association between total CAC score and pure underestimation risk (<i>p</i>-overall = 0.012; <i>p</i>-nonlinear = 0.005), suggesting that concurrent overestimation noise partially obscures this dynamic risk trajectory in the full cohort.</p><p><strong>Conclusions: </strong>The association between calcification burden and CCTA underestimation is nonlinear and strongly dependent on coronary territory. Since the RCS-derived odds ratio (OR) = 1, crossings depend on the median reference value (CAC = 301) and should be interpreted as markers of risk trajectory rather than absolute diagnostic cutoffs. Integrating total calcium burden with vessel-specific susceptibility may help mitigate the risk of missed severe stenosis on CCTA.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 9","pages":"52230"},"PeriodicalIF":2.2,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171599","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":"Risk of Atrial Fibrillation Recurrence After Modified Cox-Maze IV Surgery: Comparing Atrial Functional Mitral Regurgitation and Rheumatic Mitral Regurgitation.","authors":"Ke Xu, Jingcheng Wu, Yi Li, Lailong Sun, Ming Yan, Fuwei Zhang, Chaobing Liu, SongLin Zhang","doi":"10.31083/RCM49184","DOIUrl":"https://doi.org/10.31083/RCM49184","url":null,"abstract":"<p><strong>Background: </strong>The comparative efficacy of the modified Cox-Maze IV procedure (CMP IV) in treating atrial fibrillation (AF) in patients with atrial functional mitral regurgitation (AFMR) and those with rheumatic mitral regurgitation (RMR) remains inadequately characterized. Therefore, this study aimed to evaluate and compare postoperative AF recurrence rates and clinical outcomes between these two etiologically distinct groups.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 221 patients (AFMR group: n = 53; RMR group: n = 168) with concomitant long-standing persistent AF who underwent mitral valve surgery combined with modified CMP IV or other concomitant procedures at our institution between January 2019 and September 2024. To address baseline imbalances, propensity score matching was performed at a 1:1 ratio, resulting in well-matched cohorts of 32 patients with AFMR and 32 with RMR patients for the final analysis. The primary endpoint was AF recurrence. Statistical comparisons utilized chi-square tests, <i>t</i>-tests, exact McNemar tests, and paired <i>t</i>-tests.</p><p><strong>Results: </strong>After PSM, 32 patients remained in each group with balanced baselines. The AFMR group showed a higher trend toward postoperative AF recurrence. Pre‑discharge AF recurrence rates did not differ significantly between groups (37.5% vs. 12.5%; <i>p</i> = 0.057), however, the risk of AF recurrence before discharge was significantly higher in the AFMR group (OR = 3.67, 95% CI: 1.02-13.14, <i>p</i> = 0.046). At the 1-year follow-up, a statistically significant difference in AF recurrence was observed between the two groups (31.2% vs 6.2%, <i>p</i> = 0.021), and the risk difference persisted (OR = 9.00, 95% CI: 1.14-71.04, <i>p</i> = 0.037). Kaplan-Meier analysis showed a significant difference in freedom from AF recurrence (log‑rank χ² = 6.33; <i>p</i> = 0.012), supported by sensitivity analyses (log‑rank χ² = 6.01; <i>p</i> = 0.014). Mortality did not differ at 30 days (3.1% vs. 0%; <i>p</i> = 1.000) or 1 year (3.1% vs. 3.1%; <i>p</i> = 1.000), with comparable overall survival (log‑rank <i>p</i> = 0.99).</p><p><strong>Conclusions: </strong>In patients undergoing mitral valve surgery with modified CMP IV, those with AFMR exhibit a significantly higher risk of postoperative AF recurrence compared with patients with RMR, despite similar early-term survival outcomes. Postoperative AF monitoring should be intensified in patients with AFMR to improve long-term outcomes.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 9","pages":"49184"},"PeriodicalIF":2.2,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167669","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 Long QT Syndrome: From Conventional Management to Emerging Biological Therapies.","authors":"Qing Liu, Yifei Wang, Ping Zhang, Tingting Lv","doi":"10.31083/RCM51843","DOIUrl":"https://doi.org/10.31083/RCM51843","url":null,"abstract":"<p><p>Congenital long QT syndrome (LQTS), the first identified cardiac ion channelopathy, is characterized by delayed ventricular repolarization and a prolonged heart rate-corrected QT interval (QTc), conferring an increased risk of malignant ventricular arrhythmias and sudden cardiac death. Current standard-of-care management for LQTS, including beta-blockers, sodium channel blockers, left cardiac sympathetic denervation (LCSD), and implantable cardioverter-defibrillators (ICDs), reduces adverse events and improves survival but primarily mitigates downstream electrophysiological consequences rather than correcting the underlying genetic defects. Rapid advances in molecular biology have driven the development of mechanism-directed strategies such as gene editing, RNA interference (RNAi), and experimental antibody-based interventions, which aim to restore channel function or modulate channel regulation at the source. This review synthesizes current knowledge on LQTS classification and pathogenesis and evaluates both guideline-directed therapies and emerging molecular interventions. We emphasize subtype-specific approaches, highlight the rationale and preclinical progress for gene- and RNA-based therapies, and outline practical considerations for translation, including delivery, durability, and safety. Therefore, this review provides a comprehensive, mechanism-based framework to inform future precision medicine approaches for LQTS.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 9","pages":"51843"},"PeriodicalIF":2.2,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169684","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":"A Single-Center Retrospective Analysis of the Diagnostic Efficacy of Transthoracic Echocardiography in the Classification of Patent Ductus Arteriosus.","authors":"Minxin Zhang, Chen Qian, Shuang Wang, Tianxing Fang, Bin Wang, Jinping Liu","doi":"10.31083/RCM51081","DOIUrl":"https://doi.org/10.31083/RCM51081","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the diagnostic efficacy of transthoracic echocardiography (TTE) in classifying patent ductus arteriosus (PDA).</p><p><strong>Methods: </strong>A total of 616 patients diagnosed with PDA underwent TTE. TTE measurements were obtained using the parasternal short-axis view of the great arteries and the suprasternal fossa aortic long-axis view. Using digital subtraction angiography (DSA) as the gold standard, the diagnostic efficacy of TTE for PDA classification was evaluated.</p><p><strong>Results: </strong>Among true-positive cases correctly diagnosed by both TTE and DSA, the sensitivity for tubular PDA was 100.00%, and the specificity was 50.74%. For funnel-type PDA, the sensitivity was 50.57%, and the specificity was 100.00%. For a window-type PDA, the sensitivity was 60.00%, and the specificity was 100.00%. The internal diameters of the tubular PDA and the pulmonary artery side of the funnel-type PDA measured by TTE showed good agreement with those measured by DSA. In addition, in the suprasternal long-axis view of the ascending aorta (SSLAX-AA) of TTE among true-positive cases, the sensitivity for diagnosing tubular PDA was 100.00%, and the specificity was 75.25%; the sensitivity for funnel-type PDA was 75.51%, and the specificity was 100.00%; the sensitivity for window-type PDA was 66.67%, and the specificity was 100.00%. The diagnostic efficacy of this view was improved compared with the overall TTE, which may be due to the similarity between this view and the DSA view.</p><p><strong>Conclusions: </strong>Among true-positive cases, TTE has high sensitivity for diagnosing tubular PDA and high specificity for diagnosing funnel-type PDA. Meanwhile, TTE shows good agreement with DSA in measuring key parameters. Furthermore, TTE demonstrates stability in the diagnostic classification of PDA, with no significant influence from operator variability. TTE could serve as a reliable basis for clinical decision-making to aid in the diagnostic classification of PDA.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 9","pages":"51081"},"PeriodicalIF":2.2,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166618","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":"Mechanisms and Advances in the Treatment of Arrhythmias Associated With Pulmonary Hypertension.","authors":"Caijuan Huan, Zhaoming Fu, Rong Jiang, Shuo Liu, Xuan Zhang, Jian Yang","doi":"10.31083/RCM52744","DOIUrl":"https://doi.org/10.31083/RCM52744","url":null,"abstract":"<p><p>Arrhythmias related to pulmonary hypertension (PH) are major complications of disease progression and are associated with a significantly increased risk of death. The pathophysiology of these arrhythmias involves complex, multifaceted mechanisms. Arrhythmic substrates include electrical remodeling (ion channel imbalance, gap junction protein connexin 43 (Cx43) dysfunction, and autonomic neuropathy), structural remodeling (right ventricular hypertrophy/fibrosis), metabolic disorders (mitochondrial dysfunction and the Warburg effect), and chronic inflammation. Clinically, PH-related atrial arrhythmias, particularly atrial fibrillation (AF)/flutter (AFL), are the most common. Diagnosis often requires combining ambulatory electrocardiography and implantable cardiac monitoring to detect subclinical events. Current treatment methods include optimizing PH-targeted therapy (e.g., dual- or triple-targeted drug therapy, soluble guanylate cyclase (sGC) stimulators), antiarrhythmic drugs, and catheter ablation, as well as emerging therapies such as Cx43 modulators, gene therapy (targeting bone morphogenetic protein receptor type 2 (<i>BMPR2</i>)/<i>switch-independent 3A</i> (<i>SIN3A</i>)), and microRNA (miRNA)-based regulation. Future work should focus on elucidating underlying mechanisms, developing precise risk stratification models, and formulating targeted individualized intervention strategies.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 9","pages":"52744"},"PeriodicalIF":2.2,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166846","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 Autoimmune Diseases in the Development of Aortic Aneurysms.","authors":"Jaroslav Michalek, Martin Petrek, Jana Petrkova","doi":"10.31083/RCM50176","DOIUrl":"https://doi.org/10.31083/RCM50176","url":null,"abstract":"<p><p>Aortic aneurysms are abnormal dilations of the aortic wall and represent a significant cause of morbidity and mortality worldwide. In many cases, especially when the thoracic aorta is involved, the first and only symptom is sudden death. While aortic aneurysms are traditionally associated with factors such as advanced age, hypertension, and atherosclerosis, growing evidence points to a critical role for autoimmune diseases in their pathogenesis. The hallmarks of autoimmune disorders, such as chronic systemic inflammation, immune dysregulation, and vascular tissue remodeling, can create a pro-aneurysmal environment within the vasculature. This review explores the complex interplay between autoimmune diseases and aortic aneurysm formation, focusing on pathogenic mechanisms, specific disease associations, and implications for diagnosis and management. A better understanding of these relationships is vital for advancing therapeutic strategies aimed at mitigating vascular complications in affected patients.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 9","pages":"50176"},"PeriodicalIF":2.2,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167691","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 \"Floating Lotus\" Sign on Intracardiac Echocardiography: Characterization and Predictors of a Novel Left Atrial Appendage Pseudo-Thrombus.","authors":"Liang Zhang, Yanyan Bai, Yanhua Zhu, Jianhua Sun, Liuliu Feng, Jingyu Zhang, Songqun Huang","doi":"10.31083/RCM50367","DOIUrl":"https://doi.org/10.31083/RCM50367","url":null,"abstract":"<p><strong>Background: </strong>Intracardiac echocardiography (ICE) is increasingly used for left atrial appendage (LAA) assessment during atrial fibrillation (AF) procedures. We describe a novel, thrombus-mimicking artifact on ICE, termed the \"Floating Lotus\" sign.</p><p><strong>Methods: </strong>In this retrospective multicenter study, we analyzed data from 172 patients undergoing ICE-guided AF ablation and/or LAA occlusion. The incidence, imaging features, and clinical correlates of the \"Floating Lotus\" sign were assessed.</p><p><strong>Results: </strong>The \"Floating Lotus\" sign was observed in 48 patients (27.9%). It manifested as a mobile, echogenic mass within an anechoic space, revealing an underlying pericardial effusion. Patients exhibiting the sign had a higher prevalence of recent stroke (35.4% vs. 15.3%, <i>p</i> = 0.004), heart failure (64.6% vs. 8.1%, <i>p</i> < 0.001), and larger left atrial diameter (44.3 ± 6.8 vs. 39.7 ± 5.4 mm, <i>p</i> < 0.001). In multivariable analysis, only heart failure (left ventricular ejection fraction (LVEF) <55%) remained an independent predictor (odds ratio [OR] 14.39, 95% confidence interval [CI] 5.51-37.58, <i>p</i> < 0.001). Lower LAA emptying velocity was independently associated with persistent AF, higher CHA₂DS₂-VASc score, and recent stroke (all <i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>The \"Floating Lotus\" sign is a common ICE pseudo-thrombus, often associated with heart failure. Accurate recognition of this sign, based on its dynamic imaging features, is therefore critical to prevent misdiagnosis and avoid unnecessary procedural cancellation or anticoagulation changes.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 9","pages":"50367"},"PeriodicalIF":2.2,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171120","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":"Development and Clinical Evaluation of a Vascular Access-Optimized Perioperative Care Pathway for Temporary Pacemaker Implantation.","authors":"Huiqing Huang, Junhuan Mao, Ziguan Zhang, Zhengrong Huang, Yadan Chen, Dehua He","doi":"10.31083/RCM50024","DOIUrl":"https://doi.org/10.31083/RCM50024","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the safety and feasibility of a perioperative care pathway for temporary pacemaker implantation using a median cubital vein approach.</p><p><strong>Methods: </strong>A total of 238 patients who underwent non-emergency temporary pacemaker implantation between September 2020 and October 2024 were enrolled and randomly assigned to either the femoral vein group (F group) or the median cubital vein group (M group). The M group received a standardized perioperative nursing care pathway tailored to median cubital vein access. Electrode dislodgement and procedure-related complications were compared between the groups. Patient comfort and emotional status were assessed using the General Comfort Questionnaire (GCQ), the Self-Rating Anxiety Scale (SAS), and the Self-Rating Depression Scale (SDS). The quality of nursing care was evaluated using predefined quality control standards.</p><p><strong>Results: </strong>The M group demonstrated significantly lower rates of electrode dislodgement and complications than the F group (<i>p</i> < 0.05). Postoperatively, GCQ scores were significantly higher in the M group, whereas SAS and SDS scores were significantly lower (all <i>p</i> < 0.05). Compliance with nursing care quality standards was also higher in the M group (<i>p</i> < 0.01). Within-group analysis showed significant reductions in SAS and SDS scores in both groups before pacemaker removal, with greater improvements observed in the M group (<i>p</i> < 0.05). No significant improvement in GCQ scores was observed in the F group. The M group showed also higher adherence to the standardized perioperative nursing care pathway than the F group (<i>p</i> < 0.01).</p><p><strong>Conclusion: </strong>Compared with femoral vein access, temporary pacemaker implantation via the median cubital vein was associated with improved safety, greater patient comfort, and better emotional outcomes. The vascular access-optimized perioperative care pathway provided meaningful clinical benefits and warrants broader implementation.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 9","pages":"50024"},"PeriodicalIF":2.2,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169850","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, Valvular, and Vascular Abnormalities in Lipedema.","authors":"Attila Nemes","doi":"10.31083/RCM50869","DOIUrl":"https://doi.org/10.31083/RCM50869","url":null,"abstract":"<p><p>Lipedema is a chronic, progressive, and often underdiagnosed disease characterized by the pathological, bilateral, and symmetrical accumulation of adipose tissue. This distribution results in disproportionate and painful swelling of the limbs. Typically extending distally from the hips, this predominantly female condition is frequently misidentified as lifestyle-induced obesity or bilateral lymphedema. This review aims to provide a comprehensive overview of the current understanding of structural and functional abnormalities in myocardial dimensions, mechanics, valves, and major arteries in patients with lipedema. According to the existing literature, left atrial enlargement, left ventricular rotational abnormalities, mitral annular dilation, and increased aortic stiffness have been identified in patients with lipedema. These findings suggest latent but significant alterations in left heart physiology. Although current data remain limited and are primarily focused on the left heart and the aorta, the rapid evolution of cardiac imaging technologies suggests that both clinical knowledge and the body of research in this field are poised for significant expansion.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 9","pages":"50869"},"PeriodicalIF":2.2,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169758","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}