World Journal of Cardiology最新文献

{"title":"Non-traditional risk factors for myocardial infarction in adults under forty: A systematic review of emerging trends.","authors":"Tirath Patel, Muhammad Farhan, Nehal K Bhatt, Hewaz A Fatah, Joel J Peniel, Ved V Kaulgud, Tisimol Mathew, Aashita M Bapat, Waleed Ss Harazeen, Abdullatif N Alatta, Ayoola Awosika","doi":"10.4330/wjc.v18.i2.116172","DOIUrl":"10.4330/wjc.v18.i2.116172","url":null,"abstract":"<p><strong>Background: </strong>Myocardial infarction (MI) incidence is increasing in adults aged < 40 years, however, as many as 25% may occur with no traditional risk factors.</p><p><strong>Aim: </strong>To look at non-traditional risk factors for early onset MI.</p><p><strong>Methods: </strong>Based on the guidance of PRISMA-2020, search of PubMed, EMBASE, Web of Science, Scopus and Cochrane Central Register of Controlled Trials between April 2015 and April 2020 for observational studies focusing on the association between non-traditional risk factors and MI in adults aged 18-40 years. Two reviewers independently screened studies, extracted data and checked quality using Newcastle-Ottawa Scale or Agency for Healthcare Research and Quality checklist. The protocol was registered in PROSPERO, No. CRD420251061098.</p><p><strong>Results: </strong>Thirteen studies (7 cohort, 4 case-control, 2 cross-sectional) from 11 countries met inclusion criteria with a sample size ranging from 154 participants in a pilot case-control study to 5.7 million people in a United States National Inpatient Sample analysis. Psychosocial factors showed consistent associations: Depression showed an MI risk 1.6-3.1-fold higher and being unpartnered was associated with a post-MI readmission risk that was 28%-31% higher. Autoimmune conditions had the greatest associations, with human immunodeficiency virus infection quadrupling odds of MI (4.06), and the risk of systemic lupus erythematosus doubling (2.12). Obstructive sleep apnea increased major adverse cardiovascular events by almost four times (hazard ratio = 3.87). Adhering to the Mediterranean diet was protective (odds ratio = 0.55). Accelerated biological aging (shortening of telomeres) separated young patients with MI from controls. Traditional risk factors did not account for up to 30% of MI cases in each of the cohorts. Most studies were of moderate to high quality, although causes of heterogeneity in design and age stratification of participants mixtures limited causality inference.</p><p><strong>Conclusion: </strong>Non-traditional psychosocial, autoimmune, inflammatory, and lifestyle factors play an important role in the risk of MI in young adults. Integrating these factors into risk prediction models could improve the early identification of high-risk individuals and target prevention strategies for this vulnerable population.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"18 2","pages":"116172"},"PeriodicalIF":2.8,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12896991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Residual risk in atherosclerotic cardiovascular disease after statin therapy: Clinical mechanisms and management strategies.","authors":"Sze-Hua Tan, Jia-Lin Wu, Shu-Xiong Zhuo, Yi Zhang, Miao Wang","doi":"10.4330/wjc.v18.i2.114960","DOIUrl":"10.4330/wjc.v18.i2.114960","url":null,"abstract":"<p><p>Atherosclerotic is one of the leading causes of death worldwide. Although lowering low-density lipoprotein cholesterol (LDL-C) levels reduces cardiovascular risk, studies have shown that even when LDL-C is well controlled, patients may still develop atherosclerotic cardiovascular disease, a phenomenon known as residual risk. This review synthesizes current research on the definition, pathogenesis, and therapeutic strategies of residual risk, aiming to provide a theoretical basis for future advances in its diagnosis and management. Evidence derived exclusively from human clinical trials, cohort studies, and meta-analyses is summarized, excluding data from animal or <i>in vitro</i> experiments to maintain clinical relevance. We focus on lipid and inflammatory biomarkers beyond LDL-C, including non-high-density lipoprotein (HDL) cholesterol, apolipoprotein B, lipoprotein(a), triglycerides, triglyceride-rich lipoproteins, HDL dysfunction, and systemic inflammatory markers. Therapeutic interventions encompassing lifestyle modification, lipid-lowering agents, anti-inflammatory therapies, and novel gene-silencing approaches are reviewed. Evidence indicates that in patients receiving statin therapy, non-HDL-cholesterol and apolipoprotein B provide superior assessment of residual risk compared with LDL-C. Lipoprotein(a) remains predictive of cardiovascular events even when LDL-C levels are well controlled, while elevated triglycerides and triglyceride-rich lipoproteins consistently associate with higher cardiovascular risk. Inflammatory biomarkers such as high-sensitivity C-reactive protein and interleukin-6 serve as indicators of residual inflammatory risk. Persistent residual risk despite LDL-C control underscores the need for integrated, multi-target strategies to achieve comprehensive cardiovascular protection.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"18 2","pages":"114960"},"PeriodicalIF":2.8,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12897005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral anticoagulant therapy and outcomes in new-onset atrial fibrillation during acute myocardial infarction: A systematic review and meta-analysis.","authors":"Kristina G Pereverzeva, Ayoub Glenza, Sergey S Yakushin","doi":"10.4330/wjc.v18.i2.114265","DOIUrl":"10.4330/wjc.v18.i2.114265","url":null,"abstract":"<p><strong>Background: </strong>New-onset atrial fibrillation (NOAF) is observed in 2%-21% of patients with acute myocardial infarction (AMI) and is associated with adverse outcomes, including increased mortality, heart failure, and stroke. Despite guideline recommendations the long-term role of oral anticoagulant (OAC) therapy in this population remains unclear. Most randomized clinical trials evaluating anticoagulation excluded patients with NOAF following AMI, creating a gap in high-quality evidence. Whether long-term OAC therapy improves prognosis without excess bleeding risk in this setting remains uncertain. We hypothesized that OAC use reduces mortality in patients with NOAF complicating AMI.</p><p><strong>Aim: </strong>To determine the efficacy and safety of long-term OAC therapy in patients with NOAF during AMI.</p><p><strong>Methods: </strong>We conducted a systematic review of the PubMed and eLIBRARY databases through March 2025 following predefined patient, intervention, comparison, outcome criteria. Eligible observational studies included patients with AMI and newly detected atrial fibrillation during the index event who were prescribed OAC therapy with available outcome data. Methodological quality was evaluated using the Quality in Prognosis Studies tool. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using a random-effects model. Primary outcomes were all-cause mortality, ischemic stroke, and major bleeding.</p><p><strong>Results: </strong>Four studies including 7158 patients with a follow-up range of 1.0-8.6 years were analyzed. Long-term OAC therapy significantly reduced all-cause mortality (25.3% <i>vs</i> 33.6%; HR = 0.75; 95%CI: 0.64-0.90; <i>P</i> = 0.001) with no heterogeneity (<i>I</i> ² = 0%). There was no significant reduction in ischemic stroke (3.5% <i>vs</i> 4.2%; HR = 0.82; 95%CI: 0.57-1.17; <i>P</i> = 0.26). Major or hospitalization-requiring bleeding was not increased (4.8% <i>vs</i> 4.1%; HR = 1.15; 95%CI: 0.89-1.47; <i>P</i> = 0.28). The cohorts largely reflected vitamin K antagonist-based therapy with clopidogrel. Stroke prevention benefit was not statistically significant, and data specific to direct OACs remain sparse.</p><p><strong>Conclusion: </strong>Long-term OAC therapy after AMI with NOAF reduced mortality without consistent bleeding increase though findings mainly reflect warfarin-era practice and not direct OACs.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"18 2","pages":"114265"},"PeriodicalIF":2.8,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12896994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of nitroglycerin <i>vs</i> labetalol in hypertensive emergency among patients with a history of coronary artery disease.","authors":"Ahmed Jamal Chaudhary, Wasim Akbar Bhat, Affan Ul Haq, Haroon Ur Rashid, Irum Dad Khan, Mah Noor Dad Khan, Hafiz Muhammad Mubeen Nawaz, Sameer Ali, Muhammad Hamza Tariq","doi":"10.4330/wjc.v18.i2.115528","DOIUrl":"10.4330/wjc.v18.i2.115528","url":null,"abstract":"<p><strong>Background: </strong>Hypertensive emergencies, characterized by severe blood pressure elevation (> 180/120 mmHg) with end-organ damage, pose significant risks in patients with coronary artery disease (CAD), where rapid yet safe reduction is crucial to prevent ischemia and complications. Nitroglycerin and labetalol are common intravenous agents, but comparative data in CAD are limited.</p><p><strong>Aim: </strong>To compare efficacy and safety of nitroglycerin <i>vs</i> labetalol in hypertensive emergencies among CAD patients, assessing blood pressure control, reductions, adverse events, outcomes, and utilization.</p><p><strong>Methods: </strong>Retrospective cohort of 563 CAD patients with hypertensive emergency (2018-2024) receiving IV nitroglycerin (<i>n</i> = 282) or labetalol (<i>n</i> = 281). Primary: Time to target blood pressure [systolic blood pressure (SBP) < 160 mmHg, diastolic blood pressure < 100 mmHg]. Secondary: Blood pressure reductions, major adverse cardiovascular event, safety, utilization. Analyzed <i>via t</i>-tests, <i>χ</i> ², multivariable logistic regression adjusting for age, gender, myocardial infarction/heart failure history, diabetes, baseline SBP, chest pain.</p><p><strong>Results: </strong>Baseline characteristics were balanced. Labetalol achieved target blood pressure faster (25.14 ± 4.92 minutes <i>vs</i> 30.38 ± 5.16 minutes; <i>P</i> < 0.0001), but nitroglycerin yielded greater SBP (50.78 ± 9.45 mmHg <i>vs</i> 45.20 ± 10.46 mmHg; <i>P</i> < 0.0001) and diastolic blood pressure reductions (29.86 ± 8.63 mmHg <i>vs</i> 28.02 ± 7.74 mmHg; <i>P</i> = 0.0079). Nitroglycerin showed trends toward lower major adverse cardiovascular event [adjusted odds ratio (AOR): 0.72; 95% confidence interval (CI): 0.42-1.24], reduced bradycardia (AOR: 0.14; 95%CI: 0.05-0.38), shorter intensive care unit (2.99 ± 1.04 days <i>vs</i> 3.54 ± 1.02 days; <i>P</i> < 0.0001) and hospital stays (6.92 ± 1.93 days <i>vs</i> 7.99 ± 2.06 days; <i>P</i> < 0.0001), lower 30-day readmissions (AOR: 0.49; 95%CI: 0.27-0.88), and smaller biomarker increases (delta troponin: 0.10 ± 0.05 ng/mL <i>vs</i> 0.21 ± 0.10 ng/mL; <i>P</i> < 0.0001).</p><p><strong>Conclusion: </strong>While labetalol offers faster blood pressure control, nitroglycerin is associated with greater reductions, fewer adverse events like bradycardia, and improved utilization (shorter stays, fewer readmissions) in CAD-associated hypertensive emergencies, supporting its use in ischemic contexts.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"18 2","pages":"115528"},"PeriodicalIF":2.8,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12896946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phenomenon of \"de Winter\" pattern, sign, or syndrome: A systematic scoping review and data analysis.","authors":"Eman Elmenyar, Mohammad Adeeb Abbara, Zeina Al-Ghoul, Wael Al Mahmeed, Başar Cander, Ahmed Shaaban Abdelrahman, Hassan Al-Thani, Ayman El-Menyar","doi":"10.4330/wjc.v18.i2.114561","DOIUrl":"10.4330/wjc.v18.i2.114561","url":null,"abstract":"<p><strong>Background: </strong>The de Winter (dW) pattern, sign, and syndrome is an ST-elevation myocardial infarction (STEMI) equivalent. The first two forms describe the electrocardiographic characteristics of this phenomenon, while dW syndrome additionally has symptoms indicative of acute coronary syndrome. Emerging evidence suggests that dW pattern precedes or alternates with STEMI patterns.</p><p><strong>Aim: </strong>To improve the recognition of the dW pattern, dW sign, or dW syndrome, urge early aggressive treatment, and determine whether sex matters, by integrating contemporary knowledge through a systematic scoping review and data analysis.</p><p><strong>Methods: </strong>A comprehensive search was conducted across PubMed/MEDLINE and Google Scholar (November 2008 to June 2025), and literature data were analyzed. This scoping review adhered to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for scoping reviews checklist.</p><p><strong>Results: </strong>A total of 322 patients presenting with dW pattern were identified. Most patients were young males. Risk factors were primarily smoking, hypertension, and dyslipidemia. Sixteen cardiac arrest events occurred during hospitalization. The main culprit vessel was the left anterior descending artery (LAD) at 88.5%. Compared with the younger group, older patients had more LAD (84% <i>vs</i> 80%) and right coronary artery involvement (4% <i>vs</i> 1.0%). Left main coronary artery occlusion was more prevalent in the younger group (5.0% <i>vs</i> 2.4%). The frequency of total or near-occlusion of LAD and left main coronary artery was similar in the two age groups. Males showed a higher rate of severe LAD stenosis than females did (45.2% <i>vs</i> 17.7%). dW pattern followed by STEMI was noted in 40 cases, STEMI followed by dW pattern in 8 cases, and simultaneous STEMI and dW pattern in 10 cases. The overall mortality rate was 3%.</p><p><strong>Conclusion: </strong>dW pattern, dW sign, and dW syndrome are commonly used interchangeably describing the dW phenomenon. Patients presenting with this phenomenon have unique demographics, risk factors, pathophysiology, and angiographic characteristics (<i>i.e.</i>, distinct culprit lesions and coronary artery involvement). Early identification with a high index of suspicion is crucial and necessitates urgent intervention.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"18 2","pages":"114561"},"PeriodicalIF":2.8,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12896948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mothers against decapentaplegic homolog 4 as a proteomic hub in vascular remodeling and residual cardiovascular risk.","authors":"Davide Ramoni, Federico Carbone, Luca Liberale, Fabrizio Montecucco","doi":"10.4330/wjc.v18.i2.117277","DOIUrl":"10.4330/wjc.v18.i2.117277","url":null,"abstract":"<p><p>Translational cardiovascular medicine increasingly relies on systems-level approaches to uncover therapeutic targets that bridge molecular mechanisms and clinical outcomes. Recent proteomic analyses in experimental myocardial infarction models highlight how modulation of multiple protein networks can confer cardioprotection, emphasizing the complexity of post-infarction remodeling. Among this systems framework, mothers against decapentaplegic homolog 4 (SMAD4) has emerged as a pivotal mediator of transforming growth factor-β/bone morphogenetic protein signaling, integrating hemodynamic forces with endothelial, smooth muscle, and extracellular matrix responses. Experimental evidence demonstrates that SMAD4 governs endothelial mechanotransduction, vascular smooth muscle cell phenotype, fibrosis, and inflammation, while its loss promotes vascular instability, arteriovenous malformations and pulmonary vascular remodeling. High-throughput proteomics highlights SMAD4 as a network hub regulating cytoskeletal organization, oxidative stress, and extracellular matrix dynamics, providing mechanistic insight into processes contributing to plaque vulnerability and residual cardiovascular risk. Although not yet validated as a circulating biomarker, SMAD4 expression in vascular and immune cells may complement established markers such as low-density lipoprotein cholesterol and high-sensitivity C-reactive protein when integrated within multi-marker proteomic and artificial intelligence-assisted risk models. Therapeutically, cell-specific SMAD4 modulation, RNA-based strategies, and targeted interference with upstream signaling represent promising avenues for precision cardiology.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"18 2","pages":"117277"},"PeriodicalIF":2.8,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12896950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of total occlusion of the infarct-related coronary artery on mortality of 2483 patients with acute myocardial infarction.","authors":"Nikola Kos, Ivan Zeljković, Karlo Golubic, Vjekoslav Radeljic, Marijan Erceg, Diana Delic-Brkljacic, Maja Cigrovski Berkovic, Nikola Bulj","doi":"10.4330/wjc.v18.i1.111736","DOIUrl":"https://doi.org/10.4330/wjc.v18.i1.111736","url":null,"abstract":"<p><strong>Background: </strong>The electrocardiographic (ECG) presentation, with or without ST-segment elevation, has traditionally been the cornerstone for classifying and managing acute myocardial infarction (AMI). However, up to 20% of non-ST-segment elevation myocardial infarction (NSTEMI) patients may have a completely occluded infarct-related artery, which could have important prognostic implications regardless of ECG findings.</p><p><strong>Aim: </strong>To determine the prevalence, predictors, and impact of total occlusion of the infarct-related coronary artery on short-term mortality.</p><p><strong>Methods: </strong>We conducted a prospective, single-center cohort study that included consecutive patients treated for AMI with percutaneous coronary intervention (PCI) at the University Hospital Centre Sestre Milosrdnice in Zagreb, Croatia, between 2011 and 2018. Patients were divided into two groups based on the patency of the infarct-related artery: Those with an occluded coronary artery (OCA) and those with a patent coronary artery (PCA).</p><p><strong>Results: </strong>Among the 2483 patients (71.6% male) treated with PCI for AMI, 67.9% had an OCA, while 32.1% had a patent artery (PCA). Notably, 35.5% of NSTEMI patients had an OCA. Patients with OCA were younger, had fewer chronic comorbidities, and presented with more severe clinical symptoms. In contrast, patients with PCA were older and exhibited more extensive chronic atherosclerotic disease. Thirty-day mortality was significantly higher in the OCA group (7.29%) compared to the PCA group (3.52%, <i>P</i> < 0.001). OCA was identified as an independent predictor of mortality [hazard ratio (HR) = 3.0367, 95% confidence interval (CI): 1.4543-6.3411]. Other independent predictors included age (HR = 1.0626; 95%CI: 1.0341-1.0919), Global Registry of Acute Coronary Events score (HR = 1.0065; 95%CI: 1.0011-1.0120), and ventricular tachycardia before or during PCI (HR = 3.8458; 95%CI: 1.4600-10.1299). ECG presentation (STEMI <i>vs</i> NSTEMI) was not an independent prognostic factor (HR = 1.0404; 95%CI: 0.5659-1.9128). Chronic statin therapy prior to AMI [odds ratios (OR) = 0.0168, 95%CI: 0.3674-0.9057], older age (OR = 0.0023, 95%CI: 0.9547-0.9900), and lower troponin I values (OR = 1.0000, 95%CI: 1.0000-1.0001) were associated with a lower likelihood of having an OCA.</p><p><strong>Conclusion: </strong>Culprit-artery occlusion is a strong, independent determinant of short-term mortality. An occlusion-aware perspective refines risk stratification beyond ECG presentation and supports earlier invasive evaluation in NSTEMI patients with clinical/ECG signs of possible occlusion.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"18 1","pages":"111736"},"PeriodicalIF":2.8,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12836033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146094067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extended venous excess ultrasound: A promising addition to point-of-care ultrasound-based venous congestion assessment.","authors":"Abhilash Koratala","doi":"10.4330/wjc.v18.i1.112636","DOIUrl":"https://doi.org/10.4330/wjc.v18.i1.112636","url":null,"abstract":"<p><p>Systemic congestion is increasingly recognized as a major contributor to organ dysfunction and adverse outcomes in patients with heart failure and in those at risk of fluid overload. The venous excess ultrasound (VExUS) grading system, introduced in 2020, uses Doppler evaluation of the hepatic, portal, and intrarenal veins to quantify venous congestion at the bedside. While abnormal venous waveforms have been recognized for years, the formalization of VExUS has provided a structured and clinically meaningful framework, generating widespread academic interest with over 500 citations to date. This article blends current evidence with the author's perspective to review the principles, strengths, and limitations of VExUS and to outline the emerging concept of extended VExUS (eVExUS). VExUS has practical limitations when standard windows are inaccessible or unreliable, such as in patients with cirrhosis, advanced kidney disease, or difficult body habitus. The eVExUS approach addresses these challenges by incorporating additional venous Doppler assessments, including the internal jugular, superior vena cava, femoral, and splenic veins, as well as grayscale-based internal jugular measurements to estimate right atrial pressure when inferior vena cava imaging is suboptimal. While eVExUS offers a more adaptable, individualized strategy, its clinical adoption is still in the early stages. Further studies are required to validate eVExUS, link its findings to patient outcomes, and inform the development of tailored imaging protocols for diverse patient populations.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"18 1","pages":"112636"},"PeriodicalIF":2.8,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12836067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146093888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Importance of digital media in patient education for transcatheter aortic valve implantation.","authors":"Florian Genske, Anna Riepe, Elias Rawish, Thomas Stiermaier, Ingo Eitel, Christian Frerker, Tobias Schmidt","doi":"10.4330/wjc.v18.i1.113783","DOIUrl":"https://doi.org/10.4330/wjc.v18.i1.113783","url":null,"abstract":"<p><strong>Background: </strong>Patient consent discussion is an essential part of preoperative patient preparation. It is the main basis of decision making for the patient. Transcatheter aortic valve implantation (TAVI) has been established as the standard treatment option for symptomatic aortic stenosis-patients. Current guidelines recommend transfemoral TAVI for patients aged 70 years or older, independently of the surgical risk and for patients below 70 years of age if they are at high surgical risk.</p><p><strong>Aim: </strong>To evaluate beneficial aspects of an explanatory video in addition to conventional medical counseling.</p><p><strong>Methods: </strong>The study was conducted as a prospective, single-arm, monocentric cohort study. Eligible patients received conventional medical counseling, followed by an educational video. Evaluation of the conventional counseling and the educational video was obtained through a 32-item questionnaire. Two hypotheses were tested: Hypothesis 1: Showing an explanatory video in addition to the standard patient consent discussion improves the mediation of medical facts; and hypothesis 2: Showing an explanatory video in addition to the standard patient consent discussion improves patient satisfaction and confidence.</p><p><strong>Results: </strong>In total, 66 patients, scheduled for transfemoral TAVI were included, 59% of them were male and 41% female, averaging 81 ± 6.1 years old. Conventional medical counseling by the attending physician was the major criterium for overall patient satisfaction and had more influence on the absence of preprocedural tension than the transfer of additional factual knowledge through the video. Nearly two-thirds (61%) reported that the video enhanced their understanding of the procedure's benefits, while 42% indicated a better understanding of the potential risks and 56% felt that watching the video contributed to decreased preprocedural tension.</p><p><strong>Conclusion: </strong>Conventional medical counseling was most important for overall patient satisfaction. Educational videos aid in information transfer, in the reduction of preprocedural tension and were strongly sought after by the patients.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"18 1","pages":"113783"},"PeriodicalIF":2.8,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12835982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146094130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative characteristics of <i>in vitro</i> models for studying angiogenesis in cardiovascular disease.","authors":"Anastasia Kalinina, Nina Mzhavanadze, Roman Kalinin, Igor Suchkov","doi":"10.4330/wjc.v18.i1.106885","DOIUrl":"https://doi.org/10.4330/wjc.v18.i1.106885","url":null,"abstract":"<p><p>Angiogenesis is a central mechanism in the development and progression of cardiovascular diseases. Experimental approaches for studying angiogenesis vary widely, and their translational value depends strongly on model characteristics. We aimed to provide a comparative analysis of contemporary <i>in vitro</i> models used to study angiogenesis and to assess their potential applicability in cardiovascular medicine. Fifty-four publications by domestic and international authors were analyzed. 2D models remain accessible tools for investigating endothelial proliferation, migration, and early angiogenic responses; they are easy to implement and highly reproducible, but lack physiological relevance. 3D models better recapitulate extracellular matrix architecture and cell-cell interactions, providing higher biological fidelity at the cost of increased technical complexity and expense. Microfluidic systems reproduce hemodynamic forces and microenvironmental gradients with the highest degree of physiological relevance, but are time- and resource-intensive. Models based on induced pluripotent stem cells enable patient-specific investigations and disease modeling, although they can be limited by variability and potential instability. No single <i>in vitro</i> platform fully reproduces the complexity of angiogenesis. Model selection should be aligned with specific research objectives. Integrating 3D culture systems, microfluidics, and artificial intelligence-assisted analysis is particularly promising for advancing angiogenesis research in cardiovascular medicine.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"18 1","pages":"106885"},"PeriodicalIF":2.8,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12836080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146094262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}