JRSM Cardiovascular Disease最新文献

{"title":"The present and future of antiarrhythmic drugs.","authors":"Samuel Nistor, G-Andrei Dan","doi":"10.1177/20480040261431981","DOIUrl":"10.1177/20480040261431981","url":null,"abstract":"<p><p>The saga of antiarrhythmic drug (AAD) therapy reflects a field shaped by empiricism and burdened by challenges related to safety. The Singh-Vaughan-Williams classification was a timely necessity that eventually slowed pharmacological innovation by prioritizing electrophysiologic properties over arrhythmogenic mechanisms. The present, limited pharmacological armamentarium demands efforts to reassess legacy antiarrhythmics, repurpose non-antiarrhythmic agents as upstream or downstream therapy, and develop novel compounds. Flecainide, propafenone, and dronedarone have demonstrated their reliable efficacy and safety, even in patients with structural heart disease, which should allow clinicians to reduce their reliance on amiodarone. Previous concerns regarding the proarrhythmic risk of dofetilide and ibutilide are currently managed through careful patient selection and adequate QT interval monitoring. Novel targeted AADs are advancing through the development pipeline, of which etripamil and landiolol have already been approved. Other emerging drugs, such as SK channel blockers (AP30663 and AP31969), RyR2 blockers, CaMKII inhibitors, and TASK-1 blockers (doxapram), are aligned with the new paradigm of atrial fibrillation that focuses on triggers and re-entry. Once triggered, arrhythmias are perpetuated by the underlying substrate, which could be directly targeted by antifibrotic therapy. Developing concepts such as atrial cardiomyopathy allows clinicians to characterize substrate objectively, in order to assess disease severity and individualize antiarrhythmic treatment. The future of antiarrhythmic therapy will be reshaped by artificial intelligence and digital twinning, which allow precise phenotyping and a tailored approach based on individual patient profiles, complemented by rhythm monitoring through wearables.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"15 ","pages":"20480040261431981"},"PeriodicalIF":0.6,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13198644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148017579","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":"Obstructive sleep apnea in hypertension evaluation: An underutilized component of cardiovascular risk assessment.","authors":"Aliza Ahmed, Muhammad Hassan Saeed","doi":"10.1177/20480040261451935","DOIUrl":"10.1177/20480040261451935","url":null,"abstract":"","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"15 ","pages":"20480040261451935"},"PeriodicalIF":0.6,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13191119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148017618","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":"Databases and registries recording the usage of cardiovascular implantable medical devices: A rapid review of the literature.","authors":"Patrícia V Marrone, Maria Lr Pinho Dias Scoton, Milana L Dos Santos, Fabio R Mathias, Irineu F Delfino Silva Massaia, Eduardo M Dias","doi":"10.1177/20480040261446457","DOIUrl":"10.1177/20480040261446457","url":null,"abstract":"<p><strong>Background: </strong>Implantable Medical Devices (IMDs) are essential for ensuring the quality of life in patients. They also play a crucial role in terms of the costs associated with surgical procedures, as well as incurring potential risks requiring continuous monitoring following implantation.</p><p><strong>Objective: </strong>The aim of this systematic review of public health intervention was to determine which countries collect data on the utilization of implantable cardiovascular medical devices (IMD-Cs), and how countries record the captured data. We identified parameters for comparing the use of IMD-Cs among countries that could serve as an example for Latin American countries.</p><p><strong>Method: </strong>A Rapid Systematic Review of the literature through a survey using three search engines was carried out between July and August 2024. Eligible studies measured the annual use of IMD-Cs based on nationwide data published between January 2014 and August 2024. Data were synthesized using tables and an analytical approach.</p><p><strong>Results: </strong>From 1602 identified publications, 23 studies measuring the use of IMD-Cs were selected. This made it possible to map the sites where national records repositories are located and the type of data held therein.</p><p><strong>Conclusions: </strong>Many countries collect countrywide information on IMD-Cs and use a variety of methods to register/record the data. There are substantial advantages for a country with IMD-C registries, including monitoring access to IMD-Cs; tracking the costs of the devices; assessing the levels of incorporation of relevant new technologies; and helping improve medical and nursing protocols.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"15 ","pages":"20480040261446457"},"PeriodicalIF":0.6,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13167271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147942993","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":"Coronary atherectomy versus balloon angioplasty before drug-eluting stent implantation in severely calcified lesions: A systematic review and meta-analysis.","authors":"Omar Kasimieh, Yashaswi Guntupalli, Prapti Atul Patel, Lydia Susan Abraham, Thomas Viji Pulickal, Md Arif Hasan Bhuiyan, Milikyas Abera Feyisa, Mohammed Bushnaq, Rohit Mote Reddy, Shiva Mokhtassi, Arooba Ejaz, Asma'a Munasar Ali Alsubari, Vaibhav Vats, Talal Almas, Huzaifa Ahmad Cheema","doi":"10.1177/20480040261446478","DOIUrl":"10.1177/20480040261446478","url":null,"abstract":"<p><strong>Background: </strong>Severe coronary calcification can impede stent delivery and affect long-term outcomes. Few trials have compared coronary atherectomy with balloon-first strategies for lesion preparation before drug-eluting stent (DES) implantation.</p><p><strong>Methods: </strong>We searched MEDLINE, Embase, and the Cochrane Library through October 2025 for randomized controlled trials (RCTs) comparing coronary atherectomy with balloon angioplasty for lesion preparation before DES implantation in severely calcified coronary lesions.</p><p><strong>Results: </strong>Across three RCTs, there was no significant difference in major adverse cardiovascular events between atherectomy and balloon angioplasty (risk ratio [RR] 1.05, 95% confidence interval [CI] 0.85-1.30; <i>I</i> ² = 0%). Strategy success trended higher with atherectomy but did not reach statistical significance (RR 1.10, 95% CI 0.99-1.23; <i>I</i> ² = 84%). No significant differences were observed for myocardial infarction (RR 1.06, 95% CI 0.80-1.42; <i>I</i> ² = 0%), any revascularization (RR 0.68, 95% CI 0.25-1.82; <i>I</i> ² = 83%), target lesion revascularization (RR 0.88, 95% CI 0.57-1.37; <i>I</i> ² = 83%), target vessel revascularization (RR 0.89, 95% CI 0.64-1.24; <i>I</i> ² = 0%), stent thrombosis (RR 2.75, 95% CI 0.94-8.06; <i>I</i> ² = 0%), cardiac mortality (RR 1.49, 95% CI 0.93-2.40; <i>I</i> ² = 0%), all-cause mortality (RR 1.10, 95% CI 0.79-1.54; <i>I</i> ² = 0%), or procedural complications (RR 0.95, 95% CI 0.69-1.30; <i>I</i> ² = 3%).</p><p><strong>Conclusions: </strong>Our meta-analysis showed that routine atherectomy was comparable with balloon angioplasty in severely calcified coronary lesions. These findings support a selective, imaging-guided balloon-first strategy, reserving atherectomy for lesions that remain undilatable or uncrossable. Randomized studies of imaging-guided algorithms and emerging technologies are needed to define optimal lesion-specific strategies.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"15 ","pages":"20480040261446478"},"PeriodicalIF":0.6,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13167278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147942961","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":"Clinical value of non-electrocardiogram-gated computed tomography angiography for planning transcatheter aortic valve implantation: A retrospective single-centre study.","authors":"Said Sanoussi, Lamyae Debbagh, Nasroola Damry, Jose C Rodriguez","doi":"10.1177/20480040261445492","DOIUrl":"10.1177/20480040261445492","url":null,"abstract":"<p><strong>Purpose: </strong>Computed tomography angiography (CTA) is a key component of preprocedural planning for transcatheter aortic valve implantation (TAVI). Although current guidelines recommend electrocardiogram (ECG)-gated acquisition of the aortic root, non-ECG-gated CTA protocols are still used in clinical practice. The present study aimed to evaluate the clinical feasibility and safety of a non-ECG-gated CTA protocol for TAVI planning.</p><p><strong>Methods: </strong>We conducted a retrospective, single-centre observational study including 194 consecutive patients who underwent TAVI between January 2012 and December 2024 and were planned using a non-ECG-gated, single-phase CTA protocol<b>.</b> CTA-derived anatomical measurements were used to guide prosthesis selection and vascular access planning. Clinical outcomes were assessed during the index hospitalization and up to 30 days.</p><p><strong>Results: </strong>CTA measurements were successfully used to guide prosthesis sizing in all patients. Thirty-day all-cause mortality was 3.6%, stroke or transient ischaemic attack occurred in 1.5% of patients, and vascular complications were observed in 6.7%. Conduction disturbances occurred in 38.1% of patients, while new permanent pacemaker implantation was required in 3.1%. Paravalvular leak (PVL) was predominantly mild; no cases of severe PVL were observed, and no patient required surgical or interventional correction for PVL.</p><p><strong>Conclusion: </strong>This study demonstrates that a non-ECG-gated CTA protocol appears feasible and may support TAVI planning in selected centres with experienced teams. In this single-centre experience, a non-ECG-gated CTA protocol provided sufficient anatomical information for TAVI planning, with acceptable short-term clinical outcomes. While ECG-gated CTA remains the reference standard, this approach may represent a pragmatic alternative when integrated into a structured workflow.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"15 ","pages":"20480040261445492"},"PeriodicalIF":0.6,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783381","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":"Extracorporeal membrane oxygenation as a rescue measure for postcardiotomy cardiogenic shock: A retrospective observational analysis.","authors":"Keenan Conley, Daniel Mohammadi, Sibu Saha","doi":"10.1177/20480040261445493","DOIUrl":"10.1177/20480040261445493","url":null,"abstract":"<p><strong>Background: </strong>Nearly 500,000 open-heart operations are performed annually in the United States, with complications such as postcardiotomy cardiogenic shock (PCCS) occurring in 2-9% of cases. Extracorporeal membrane oxygenation (ECMO) is a critical salvage therapy for patients unable to wean from cardiopulmonary bypass (CPB). This study aims to review our institution's experience with ECMO in managing PCCS and to analyze patient outcomes.</p><p><strong>Methods: </strong>Following IRB approval, a retrospective observational study was conducted on adult patients aged 32-84 years who underwent open-heart procedures with the use of CPB requiring ECMO support due to failed wean from CPB from 1 April 2014 to 31 December 2022. Data were analyzed from electronic medical records for demographics, procedural details, ECMO therapy duration, and outcomes.</p><p><strong>Results: </strong>Of 45 patients identified from 6346 open-heart procedures, 33 were male, and 12 were female, with an average age of 59.9 years. The majority of patients were Caucasian (88.8%, <i>n</i> = 40). Extracorporeal membrane oxygenation was initiated using venoarterial configurations in 100% (<i>n</i> = 45) of cases, with three patients transitioning to venovenous configurations. The median ECMO duration for all patients in the study was 4 days. In-hospital mortality was 51.1% (<i>n</i> = 23), while 48.9% (<i>n</i> = 22) of patients survived to discharge. Survivors were discharged to rehabilitation facilities (54.5%, <i>n</i> = 12), home (31.8%, <i>n</i> = 7), long-term acute care hospitals (9.1%, <i>n</i> = 2), or detention centers (4.5%, <i>n</i> = 1).</p><p><strong>Conclusions: </strong>Extracorporeal membrane oxygenation remains a valuable rescue therapy for PCCS, achieving a 48.9% survival rate. This study highlights the importance of timely intervention and underscores the need for future research into optimizing patient selection and perioperative management.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"15 ","pages":"20480040261445493"},"PeriodicalIF":0.6,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13111873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783371","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":"Electrical cardioversion in patients with left ventricular thrombus: A systematic review of safety and thromboembolic risk.","authors":"Carlson Sama, Muchi Ditah Chobufo, Ademola Ajibade, Leslie Tasha Mbapah, Efeturi Okorigba, Saim Rana, Mohamad Al-Saed, Lakshmi Muthukumar, Ruby Havistin, Sudarshan Balla","doi":"10.1177/20480040261445487","DOIUrl":"10.1177/20480040261445487","url":null,"abstract":"<p><strong>Background: </strong>The thromboembolic risk of electrical cardioversion in patients with left-ventricular (LV) thrombus is poorly defined, producing variable clinical practice. We performed a systematic review to synthesize reported thromboembolic outcomes after cardioversion in patients with imaging-documented LV thrombus.</p><p><strong>Methods: </strong>We searched PubMed and Scopus through 25 July 2025 for studies reporting outcomes after external direct-current cardioversion or internal/intra-procedural electrical shocks in patients with known LV thrombus. Case reports and pharmacological cardioversion studies were excluded. The primary outcome was clinically apparent thromboembolic complications. Data were extracted and synthesized narratively.</p><p><strong>Results: </strong>Three retrospective studies met criteria, comprising 68 patients with known, imaging-proven LV thrombus. Thrombus morphology was predominantly laminated/fixed, but about 8% of patients had mobile thrombi in one series. Anticoagulation practices varied; a subset (21%) had no anticoagulation prior to electrical cardioversion. In total, 60 patients underwent direct-current cardioversion while eight patients underwent multiple internal intra-procedural cardioversions in the setting of known LV thrombus. Overall, no thromboembolic events directly attributable to cardioversion were observed over a follow-up period of 3 months to 1 year.</p><p><strong>Conclusion: </strong>Available evidence, although limited, did not identify clinically overt thromboembolic events after electrical cardioversion in patients with known LV thrombus. Decisions should, however, be individualized, imaging-guided, accompanied by optimized anticoagulation whenever possible and multidisciplinary discussions.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"15 ","pages":"20480040261445487"},"PeriodicalIF":0.6,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783445","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":"Determinants of image quality in transthoracic echocardiography: A retrospective cohort study.","authors":"Aradhai Bana, Ciaran Grafton-Clarke, Rui Li, Zia Mehmood, Sunil Nair, Bahman Kasmai, Simon Eccleshall, Alisdair Ryding, Timothy Gilbert, Samer Alabed, Andrew J Swift, Peter Swoboda, Vassilios S Vassiliou, Gareth Matthews, Pankaj Garg","doi":"10.1177/20480040261445490","DOIUrl":"10.1177/20480040261445490","url":null,"abstract":"<p><strong>Objectives: </strong>To identify patient factors associated with poor transthoracic echocardiographic image quality and to evaluate whether a simple pre-test triage model could improve imaging efficiency.</p><p><strong>Design: </strong>Retrospective cohort study with derivation and independent validation cohorts, together with a model-based cost-effectiveness analysis.</p><p><strong>Setting: </strong>Single large UK tertiary centre using routinely collected data from 2010 to 2020.</p><p><strong>Participants: </strong>70,597 adult transthoracic echocardiograms, divided into a derivation cohort (n = 40,000) and an independent validation cohort (n = 30,597).</p><p><strong>Main outcome measures: </strong>Poor image quality (limited or non-diagnostic vs good or adequate), model discrimination, sensitivity, specificity and comparative imaging costs.</p><p><strong>Results: </strong>Of 70,597 studies, 24,213 (34.3%) were poor quality, including 8582 (12.2%) non-diagnostic and 15,631 (22.1%) limited studies. Lung disease was the strongest predictor (OR 2.04, 95% CI 1.59 to 2.61), followed by suspected heart failure, inpatient status, arrhythmia, prior cardiac surgery and permanent pacemaker (all <i>p</i> < 0.01). Validation performance was modest (AUC 0.58; sensitivity 67.3%; specificity 45.7%). In a model-guided simulation using 2024/25 NHS tariffs, total imaging costs were lower than with standard care (£11.85 million vs £12.16 million), yielding an estimated saving of £317,331.</p><p><strong>Conclusions: </strong>Several routinely available clinical factors influence transthoracic echocardiographic image quality. Although individual-level prediction is modest, pre-test triage may help direct higher-risk patients to contrast echocardiography or alternative imaging, reducing repeat testing and improving efficiency.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"15 ","pages":"20480040261445490"},"PeriodicalIF":0.6,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783365","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":"The prognostic utility of the pulmonary artery pulsatility and aortic pulsatility index in patients with heart failure: A systematic review.","authors":"Zain Albdour, Mohannad Qadri, Zaid Abdulraheem AlAbed, Zeid Mohannad Jarrar, Ahmad Fawzi Bayadreh, Oun Mohammad Abu-Shattal, Karam Albdour","doi":"10.1177/20480040261444452","DOIUrl":"10.1177/20480040261444452","url":null,"abstract":"<p><p>Heart failure (HF) continues to pose a major burden worldwide, and risk stratification is important to guide management. Hemodynamic indices such as the pulmonary artery pulsatility index (PAPI) and aortic pulsatility index (API) have gained attention as potential prognostic tools, but their role is still not well established. We conducted a systematic review to assess the prognostic role of PAPI and API in HF patients. We systematically searched PubMed, Web of Science, Scopus, and Cochrane Library for studies assessing PAPI and API in adults (≥18 years) with HF. We included cohort studies and randomized trials reporting outcomes such as mortality, hospitalization, left ventricular assist device implantation, or heart transplantation. Of 601 studies identified, 12 met the inclusion criteria, comprising 3681 patients. Across different HF populations, lower PAPI values were consistently associated with worse outcomes, with reported cutoffs ranging from ≤1.9 in cardiogenic shock to around ≤2.8-2.95 in broader HF populations, and up to ≤3.65 in advanced HF. Aortic pulsatility index showed a similar pattern, but with more consistent performance: values <1.45 were linked to mortality or rapid progression to advanced therapies, while values >2.9 were associated with better event-free survival. In studies that evaluated both indices, API generally showed stronger prognostic value. Overall, PAPI and API provide clinically useful prognostic information, particularly in advanced HF patients undergoing invasive hemodynamic assessment, though further large-scale prospective studies are needed to better define their role.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"15 ","pages":"20480040261444452"},"PeriodicalIF":0.6,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13087369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723975","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":"Sepsis-associated myocarditis: Epidemiology, pathophysiology, diagnosis, management, and future directions.","authors":"Kedir Negesso Tukeni, Mohammed Mecha Abafogi, Kidus Tesfaye Bezabih, Esayas Kebede Gudina, Nikolaus Alexander Haas","doi":"10.1177/20480040261432798","DOIUrl":"10.1177/20480040261432798","url":null,"abstract":"<p><p>Sepsis-associated myocarditis is a major challenge in critical care, driving global morbidity and mortality through cardiac dysfunction. Despite advances in diagnostics, consensus on optimal management remains lacking. This review explores epidemiology, clinical complexities, and research gaps. A systematic search of OVID MEDLINE and Scopus (2000-2025) using terms \"sepsis,\" \"myocarditis,\" \"cardiac dysfunction,\" and \"inflammatory cardiomyopathy\" identified 10,344 records. After removing duplicates (2323) and applying filters for human studies (1840), English language (1775), and publication year (1340), 87 articles were eligible. Thirty were excluded for lacking outcome data, leaving 57 studies for final analysis, supplemented by 13 additional articles that highlight therapeutic strategies, emerging directions, and supportive evidence. Study quality was assessed using PRISMA 2020 guidelines. Sepsis-associated myocarditis is characterized by myocardial inflammation and impaired cardiac function, often worsened by systemic inflammatory responses. Left ventricular dysfunction is frequent, influenced by infectious agents, immune dysregulation, and drug toxicities. While diagnostic modalities have improved, therapeutic approaches remain inconsistent, with no standardized protocols established. Current management typically involves intravenous fluids, antibiotics, and vasopressors, yet patient outcomes vary widely. The absence of consensus highlights an urgent need for targeted research to clarify mechanisms, define effective interventions, and improve survival in this high-risk population.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"15 ","pages":"20480040261432798"},"PeriodicalIF":0.6,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13009935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515324","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}