Reviews in cardiovascular medicine最新文献

{"title":"Three-Dimensional Echocardiographic Evaluation of Rheumatic Tricuspid Valve Disease: A Prospective Single-Center Cohort Study.","authors":"Mahmoud Abdelnabi, Abdallah Almaghraby, Moustafa Gamal, Mohamed Ayman Abdel-Hay, Hoda Abdelgawad","doi":"10.31083/RCM48678","DOIUrl":"https://doi.org/10.31083/RCM48678","url":null,"abstract":"<p><strong>Background: </strong>Rheumatic heart disease (RHD) remains a prevalent cause of valvular heart pathology worldwide, especially in younger populations of low- and middle-income countries. Tricuspid valve (TV) involvement in RHD is usually secondary to left-sided valvular lesions and is often underdiagnosed, since two-dimensional echocardiography (2DE) has limited ability to visualize the complex tricuspid anatomy. Compared with 2DE, three-dimensional echocardiography (3DE) provides an en face visualization of the tricuspid valve, enabling direct planimetric measurements and detailed commissural assessment, and offers advantages for evaluating complex valvular heart disease (VHD). Thus, this study aimed to assess baseline characteristics and valvular morphology in patients with rheumatic tricuspid valve disease using 3DE.</p><p><strong>Methods: </strong>A prospective cohort single-center study conducted between April 2022 and April 2023 included 34 patients with rheumatic TV involvement. Baseline demographics, morphological features, and hemodynamic parameters were assessed using transthoracic 3DE.</p><p><strong>Results: </strong>The mean age of included patients was 45.5 ± 9.1 years, and 88.2% were female. Most patients had associated left-sided valvular involvement (mitral or combined mitral and aortic). Commissural fusion (50%), leaflet thickening (82.4%), restricted mobility (85.3%), and coaptation loss (58.8%) were predominantly noted. The mean diastolic TV gradient was 3.9 ± 3.4 mmHg, planimetry area 3.3 ± 1.7 cm², and estimated pulmonary artery systolic pressure 43.3 ± 19.5 mmHg. Mean right ventricular (RV) global longitudinal strain was -23.6 ± 6.1%.</p><p><strong>Conclusion: </strong>Rheumatic TV involvement is characterized by commissural fusion, leaflet thickening, and coaptation loss, highlighting the diagnostic value of 3DE in identifying morphological patterns that may guide intervention planning.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 3","pages":"48678"},"PeriodicalIF":1.3,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13036517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594237","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":"Coronary Microvascular Dysfunction in Cardiomyopathies: Insights on Clinical and Prognostic Roles.","authors":"Federico Giacobbe, Pierre Meynet, Marco Balducci, Sergio Capoccia, Rino Andrea Cimino, Arianna Morena, Antonio Dalu, Fabrizio D'Ascenzo, Ovidio De Filippo, Filippo Novarese, Francesco Bruno, Claudia Raineri, Federico Conrotto, Athanasios Sakalidis, Pierluigi Omedé, Giuseppe Giannino, Filippo Angelini, Pier Paolo Bocchino, Veronica Dusi, Italo Porto, Gaetano Maria De Ferrari","doi":"10.31083/RCM46829","DOIUrl":"https://doi.org/10.31083/RCM46829","url":null,"abstract":"<p><p>Coronary microvascular dysfunction (CMD) is a key driver of ischemia and prognosis across several non-ischemic cardiomyopathies. This review summarizes the main tools for diagnosing microvascular dysfunction and available evidence on CMD incidence and the prognostic role in patients with cardiomyopathies. In dilated cardiomyopathy, CMD is associated with reduced myocardial blood flow, greater fibrosis, adverse remodeling, and worse outcomes. In hypertrophic cardiomyopathy, CMD is highly prevalent and multifactorial (arteriolar remodeling, reduced capillary density, extravascular compression, diastolic dysfunction, and/or left ventricular (LV) outflow obstruction), correlating with fibrosis, heart failure, and arrhythmias/sudden death. In Takotsubo syndrome, CMD appears acute and reversible, with microvascular spasms as a predominant mechanism and plausible pathophysiologic basis of the event. In arrhythmogenic right ventricular cardiomyopathy, preliminary data show a blunted hyperemic response and autonomic abnormalities that may impair microvascular vasodilation. In infiltrative and storage diseases (amyloidosis and Anderson-Fabry disease), CMD is often early, preceding hypertrophy/fibrosis, and contributes to symptoms, contractile dysfunction, and adverse outcomes; in sarcoidosis, microvascular inflammation reduces coronary flow reserve (CFR) and is associated with events. Targeted therapies remain limited; optimization of risk factors and drugs that modulate endothelial/metabolic function (statins, angiotensin converting enzyme (ACE) inhibitors, vasodilating β-blockers, calcium channel blockers, sodium glucose cotransporter 2 (SGLT2) inhibitors) yielded variable signals; device-based and nonpharmacologic strategies are under investigation. In conclusion, integrating microcirculatory assessment improves risk stratification and may furnish future therapeutic targets across cardiomyopathies.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 2","pages":"46829"},"PeriodicalIF":1.3,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12959992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366507","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":"Right Ventricular Function in Patients With Significant Tricuspid Regurgitation.","authors":"Xavier Galloo, Philippe Unger","doi":"10.31083/RCM47857","DOIUrl":"https://doi.org/10.31083/RCM47857","url":null,"abstract":"<p><p>Significant tricuspid regurgitation (TR) is increasingly recognized as a major determinant of morbidity and mortality, yet the clinical impact of significant TR has long been underestimated. Assessment of right ventricular (RV) systolic function is central to understanding and managing TR and represents the principal determinant of symptoms, therapeutic response, and long-term outcomes. The unique sensitivity of the RV to alterations in preload and afterload leads to maladaptive remodeling, making accurate functional assessment essential for risk stratification and for optimizing the timing and type of intervention, especially given the expanding range of available surgical and transcatheter treatment options. Echocardiography remains the primary imaging modality, providing qualitative and quantitative evaluations of RV function through parameters such as tricuspid annular plane systolic excursion (TAPSE), RV fractional area change (RVFAC), and tissue Doppler systolic velocity (S'). Advances in speckle-tracking echocardiography for RV free-wall longitudinal strain and in three-dimensional imaging have improved accuracy; however, all echocardiographic measures remain limited by the complex geometry of the RV. When feasible and available, cardiac magnetic resonance (CMR) imaging serves as the reference standard for precise assessment of RV volumetric and functional parameters. Impaired RV systolic function, both before and after intervention, irrespective of the imaging parameter used for the assessment, consistently predicts adverse outcomes in patients with severe TR, including heart failure progression, reduced exercise tolerance, and decreased survival. Therefore, early recognition and quantification of RV dysfunction are crucial to enable timely therapy, as interventions before the development of advanced RV impairment provide symptomatic and survival benefits. This review summarizes the pathophysiology, quantitative thresholds, and prognostic significance of RV function assessment, emphasizing the pivotal role this evaluation plays in the contemporary management of significant TR.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 2","pages":"47857"},"PeriodicalIF":1.3,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12960001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366280","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":"Catheter Ablation vs. Medical Therapy for Ventricular Tachycardia in Ischemic Cardiomyopathy: A Meta-Analysis and Trial Sequential Analysis of Randomized Controlled Trials.","authors":"Su-Ping Wang, Yuan Yuan, Peng-Yu Zhong, Zhen-Yu Zhou","doi":"10.31083/RCM46164","DOIUrl":"https://doi.org/10.31083/RCM46164","url":null,"abstract":"<p><strong>Background: </strong>Managing ischemic cardiomyopathy-related ventricular tachycardia (VT) remains clinically challenging since no definitive consensus exists regarding the optimal therapeutic approach. Therefore, this study aimed to assess the safety and efficacy of catheter ablation for VT in patients with ischemic cardiomyopathy.</p><p><strong>Methods: </strong>We systematically searched the PubMed, EMBASE, and Cochrane Library databases to identify pertinent clinical trials. We selected the relative risk (RR) and mean difference (MD) as the effect measures, which were calculated using Review Manager software. Additionally, we used trial sequential analysis to assess each outcome.</p><p><strong>Results: </strong>Our study included six randomized controlled trials with 1064 patients. Catheter ablation was found to reduce the risk of the composite endpoint (RR 0.83, 95% confidence interval (CI) 0.74-0.94; <i>p</i> = 0.002), cardiac hospitalizations (RR 0.82, 95% CI 0.71-0.95; <i>p</i> = 0.007), and adverse events (RR 0.75, 95% CI 0.62-0.91; <i>p</i> = 0.003). Additionally, no significant differences were observed between the two groups regarding VT recurrence (RR 0.94, 95% CI 0.83-1.06; <i>p</i> = 0.33), appropriate implantable cardioverter-defibrillator (ICD) shocks (RR 0.85, 95% CI 0.72-1.01; <i>p</i> = 0.06), or all-cause mortality (RR 0.93, 95% CI 0.73-1.18; <i>p</i> = 0.53).</p><p><strong>Conclusions: </strong>Catheter ablation reduced the incidence of composite endpoints, cardiac hospitalizations, and adverse events related to VT in patients with ischemic cardiomyopathy. However, no statistically significant differences were found between the two groups for VT recurrence, appropriate ICD shocks, and all-cause mortality.</p><p><strong>The prospero registration: </strong>https://www.crd.york.ac.uk/PROSPERO/view/CRD420251011744.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 2","pages":"46164"},"PeriodicalIF":1.3,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12960011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366547","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":"Optimization of Distal Radial Access Into Clinical Routine Practice Through Ultrasound Guidance: A Review and Technical Guide.","authors":"Claudiu Ungureanu, Giuseppe Colletti, Steven Haine, Gregory Angelo Sgueglia","doi":"10.31083/RCM46471","DOIUrl":"https://doi.org/10.31083/RCM46471","url":null,"abstract":"<p><p>Distal radial access (DRA) has emerged as a preferred approach in cardiac and peripheral vascular catheterization, offering distinct advantages over traditional access methods. However, DRA is inherently more challenging due to the smaller diameter, sharper angulation, and greater anatomical variability of the vessels, which collectively increase the risk of puncture failure and the need for crossover to alternative vascular access. Thus, ultrasound guidance has become increasingly important. Unlike the conventional transradial approach, where ultrasound guidance remains optional, the use of ultrasound guidance in DRA could offer additional benefits, including potentially improved success rates and a reduced risk of damage to surrounding anatomical structures. This review highlights the essential role of vascular ultrasound in DRA and presents a detailed, step-by-step guide that integrates sonographic and anatomical techniques. Therefore, by promoting technical precision and ensuring safer vascular access, this approach aims to optimize the success and safety of catheterization procedures and foster the widespread adoption of DRA in clinical practice.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 2","pages":"46471"},"PeriodicalIF":1.3,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12960003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366282","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":"Critical Reappraisal of Takotsubo Syndrome (TS) and Myocarditis Association: \"The Myocarditis-Like Features\" Seen in TS Are Secondary Changes and not True Myocarditis.","authors":"Shams Y-Hassan","doi":"10.31083/RCM46256","DOIUrl":"https://doi.org/10.31083/RCM46256","url":null,"abstract":"<p><p>Takotsubo syndrome (TS) is an acute cardiac disease entity characterized by a reversible regional, usually circumferential, left ventricular wall motion abnormality in patients presenting with a clinical picture resembling that of acute coronary syndrome with non-obstructive coronary arteries. Overwhelming evidence supports the involvement of sympathetic nervous system hyperactivation in the pathogenesis of TS. Therefore, the diagnostic pathogenic term of autonomic neurocardiogenic (ANCA) syndrome has also been introduced. An association between TS or ANCA syndrome and \"myocarditis\" has been reported. The definitive histopathological diagnosis of acute \"myocarditis\" is based on myocardial infiltration with mainly mononuclear cells and signs of non-ischemic myocyte necrosis with or without fibrosis. The radiological diagnosis of myocarditis is based on the cardiac magnetic resonance (CMR) imaging findings of hyperemia, myocardial oedema, and non-ischemic myocardial necrosis/fibrosis. These endomyocardial biopsy and CMR imaging findings may also be seen in TS or ANCA syndrome and have been interpreted as true \"myocarditis\". However, histopathological changes in TS or ANCA syndrome begin with hypercontraction of sarcomeres, and myocardial cells may die in a tonic state if hypercontraction is severe and persistent. This myocardial cell necrosis elicits mononuclear cell infiltration, followed by fibrosis and scarring. Mononuclear cell infiltration occurs as a response or secondary process following the development of myocardial cell necrosis. Regrettably, these histopathological \"secondary myocarditis-like changes\" and the consequent CMR imaging findings have been, and at times remain, misdiagnosed as true \"myocarditis\" for many decades. These misinterpretations have been critically reviewed, analyzed, and illustrated with revealing images and with a novel conclusion.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 2","pages":"46256"},"PeriodicalIF":1.3,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12959990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147365598","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":"Potential Similarity of Serum Cholesterol Multivariate Coefficients in the Prediction of Coronary Heart Disease Across Populations: A Review From the Seven Countries Study.","authors":"Alessandro Menotti, Paolo Emilio Puddu","doi":"10.31083/RCM46488","DOIUrl":"https://doi.org/10.31083/RCM46488","url":null,"abstract":"<p><p>This study aimed to review the unique contribution of the Seven Countries Study (SCS) of cardiovascular diseases to the possible non-heterogeneity in multivariate coefficients of serum cholesterol in predicting coronary heart disease (CHD) mortality across different populations. This study reviewed five published analyses from the SCS, which together encompassed 16 cohorts of middle-aged men from eight nations across seven countries in the USA, northern and southern Europe, and Japan. In total, these analyses included 12,763 participants and follow-up periods ranging from 25 to 60 years after the baseline examination. Serum cholesterol was measured using uniform, standardized procedures that differed from those reported in the literature. Marked differences in mortality rates were observed, with higher rates in the USA and northern Europe and lower rates in the other regions. A systematic comparison of serum cholesterol coefficients did not reveal significant heterogeneity across cohort combinations or follow-up durations of 25, 40, 50, and 60 years for CHD mortality. In all cases, coefficients were adjusted for three additional risk factors: age, cigarette smoking, and systolic blood pressure. Variations in CHD mortality rates across populations were explained by differences in serum cholesterol levels. In contrast, the magnitudes of serum cholesterol coefficients were relatively similar across groups, although not necessarily homogeneous. These findings support the idea that predictive models of CHD mortality developed for a specific population can also be applied to other populations, since the expectation, at least for serum cholesterol, is to obtain similar relative risk estimates, not absolute risk, which aligns with the limited evidence that is available in the current literature.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 2","pages":"46488"},"PeriodicalIF":1.3,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12960010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366196","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":"Functional Substrate Mapping in Ablation for Scar-Related Ventricular Tachycardia.","authors":"Shiro Nakahara, Hirotsugu Sato, Jason S Bradfield","doi":"10.31083/RCM45479","DOIUrl":"https://doi.org/10.31083/RCM45479","url":null,"abstract":"<p><p>Notably, most ventricular tachycardia (VT) episodes in patients with VT attributable to structural heart disease are not hemodynamically tolerated. Therefore, techniques for substrate mapping during stable intrinsic or paced rhythm have been developed that eliminate the need to induce VT. Moreover, advances in catheter technology, enabling high-density multi-electrode mapping of abnormal electrograms, have improved the ability of electrophysiologists to identify the substrate responsible for scar-related VT. In addition to the conventional identification of late potentials and local abnormal ventricular activity (LAVA), several substrate imaging approaches have been developed, including the identification of sites of conduction slowing via isochronal late activation mapping and the modification of wavefronts by changing the pacing site. Further, a new near-field algorithm provides a degree of objectivity to the previously subjective annotations of local potential timing. Additionally, changes in the substrate within the scar, specifically the induction of a line of block and subsequent alteration of a LAVA by decremental conduction, can identify functional abnormal ventricular activity that contributes to the development and maintenance of VT and can further improve the accuracy of substrate mapping. Novel cardiac magnetic resonance imaging and computed tomography analyses, facilitated by specialized software, also provide information for non-invasive estimation of the VT isthmus location. Therefore, continued clinical implementation of these techniques and technologies has the potential to improve safety, reduce the complexity, and expand the number of patients who can safely undergo VT ablation.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 2","pages":"45479"},"PeriodicalIF":1.3,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12959984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147365950","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 Lipoprotein(a) Implementation Gap: Bridging Evidence and Clinical Practice.","authors":"Hyun Suk Yang, Seokhwan Yoon, Mina Hur","doi":"10.31083/RCM47152","DOIUrl":"https://doi.org/10.31083/RCM47152","url":null,"abstract":"<p><p>Lipoprotein(a) [Lp(a)] represents one of cardiovascular medicine's most profound implementation gaps: a genetically determined risk factor affecting 1.5 billion people worldwide, yet historically underutilized in clinical practice despite overwhelming evidence of its importance. This review examines the transformation of Lp(a) from an untreatable genetic burden to a promising therapeutic target through four interconnected perspectives. First, we document the implementation gap, where, despite affecting 20% of the global population, screening remains below 1%. The evolution from selective screening (2018 American College of Cardiology/American Heart Association (ACC/AHA)) to universal measurement (2024 National Lipid Association (NLA) Class I recommendation) reflects growing recognition, yet persistent barriers, including reimbursement challenges, provider knowledge gaps, and laboratory standardization issues, perpetuate underutilization. Second, we synthesize evidence establishing Lp(a)'s dual nature as both a biomarker and a causal factor. Observational studies demonstrate markedly increased cardiovascular risk with elevated Lp(a), while Mendelian randomization confirms causal relationships with coronary heart disease, large-artery stroke, peripheral artery disease, and aortic stenosis, with differential effects on stroke subtypes and non-atherosclerotic outcomes. Third, we examine the transformation from genetic determinism to pharmacological tractability. Despite 70-90% heritability, novel RNA-targeted therapies achieve unprecedented 80-95% reductions, with phase 3 cardiovascular outcome trials (completing 2026-2029) poised to determine whether dramatic Lp(a) lowering translates to clinical benefit. Finally, we provide a practical management algorithm bridging current evidence-based risk stratification with emerging therapies, stratifying patients by Lp(a) levels with corresponding interventions. The Lp(a) story exemplifies how genetic insights and technological innovation can transform immutable disease aspects into treatable conditions, offering a paradigm for precision cardiovascular medicine while highlighting the urgent need to close the gap between scientific knowledge and clinical implementation.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 2","pages":"47152"},"PeriodicalIF":1.3,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12959997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366363","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":"Association of Thyroid Function With Restenosis and Long-Term Outcomes After Drug-Coated Balloon Angioplasty in Euthyroid Patients With Coronary Heart Disease.","authors":"Yixin Duan, Chenyang Xu, Qian Zhao, Jun Gu, Junfeng Zhang, Yang Zhuo, Huili Zhang","doi":"10.31083/RCM46009","DOIUrl":"https://doi.org/10.31083/RCM46009","url":null,"abstract":"<p><strong>Background: </strong>The role of euthyroid hormone levels in clinical outcomes after drug-coated balloon (DCB) angioplasty in patients with coronary heart disease (CHD) remains unclear. Thus, this study aimed to explore the relationship between thyroid function and the risk of restenosis at one year, as well as the prognosis over five years in euthyroid patients with CHD following DCB angioplasty.</p><p><strong>Methods: </strong>This prospective study evaluated 189 euthyroid CHD patients who underwent successful DCB angioplasty. Coronary angiographic follow-up was performed 9-12 months post-procedure to assess the status of target lesions, with restenosis defined as ≥50% reduction in luminal diameter. All patients underwent five-year clinical follow-ups, during which major adverse cardiovascular events (MACEs) were recorded.</p><p><strong>Results: </strong>Following angiographic follow-ups, patients were categorized into two groups: those with restenosis (n = 66) and those without (n = 123). At baseline and during the follow-up, the restenosis group demonstrated significantly higher levels of thyroid-stimulating hormone (TSH), lymphocytes, hemoglobin A1c (HbA1c), lipoprotein(a), and platelet count, along with lower free triiodothyronine (FT3) levels. Multivariable logistic regression analysis revealed that the TSH levels both at the baseline (odds ratio (OR) 1.607, 95% confidence interval (CI) 1.238-2.085, <i>p</i> < 0.001) and angiographic follow-up (OR 2.970, 95% CI 2.000-4.411, <i>p</i> < 0.001) were independently associated with an increased risk of post-DCB restenosis. Furthermore, patients in the high TSH tertile had a 90% increased risk of MACEs during the 5-year follow-up period (hazard ratio (HR) 1.922, 95% CI 1.343-2.750, <i>p</i> < 0.001) compared with those in the low TSH tertile.</p><p><strong>Conclusions: </strong>A high-normal TSH level within the euthyroid range was strongly associated with an increased 1-year restenosis risk and decreased 5-year MACE-free survival following DCB angioplasty in CHD patients.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 2","pages":"46009"},"PeriodicalIF":1.3,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12959979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366560","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}