American journal of physiology. Heart and circulatory physiology最新文献

{"title":"Measured coronary stenosis pressure-flow physiology or flawed angiographic simulations?","authors":"K Lance Gould, Nils P Johnson, Richard L Kirkeeide","doi":"10.1152/ajpheart.00480.2026","DOIUrl":"10.1152/ajpheart.00480.2026","url":null,"abstract":"","PeriodicalId":7692,"journal":{"name":"American journal of physiology. Heart and circulatory physiology","volume":" ","pages":"H774-H778"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148306594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myeloid PD-1/PD-L1 signaling: an unexpected regulator of heart integrity.","authors":"Dinender K Singla, Jonatas M Rolando","doi":"10.1152/ajpheart.00525.2026","DOIUrl":"10.1152/ajpheart.00525.2026","url":null,"abstract":"","PeriodicalId":7692,"journal":{"name":"American journal of physiology. Heart and circulatory physiology","volume":" ","pages":"H1019-H1021"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thermal heterogeneity after deep hypothermic circulatory arrest: a new framework for understanding rewarming and physiological recovery.","authors":"André Timóteo Sapalo","doi":"10.1152/ajpheart.00454.2026","DOIUrl":"10.1152/ajpheart.00454.2026","url":null,"abstract":"<p><p>Deep hypothermic circulatory arrest (DHCA) is widely used during complex aortic arch surgery to reduce metabolic demand and protect vital organs. Conventional temperature management assumes that restoration of core temperature reflects systemic thermal homeostasis, and rewarming is generally considered complete once central monitoring sites return to normothermic values. However, emerging evidence suggests that thermal recovery may occur unevenly across different anatomical compartments. This review proposes an integrated physiological framework of thermal heterogeneity, defined as the persistence of regional temperature gradients despite restoration of core normothermia. Observations from thermal imaging and physiological assessments suggest that cranial and thoracic regions may rewarm more rapidly than abdominal and peripheral tissues, resulting in residual thermal gradients that remain undetected by conventional monitoring methods. Persistent thermal heterogeneity may contribute to physiological heterogeneity, characterized by asynchronous recovery of vascular, metabolic, myocardial, and organ function. Regional thermal differences may therefore be associated with delayed recovery of vascular function, metabolic homeostasis, microcirculatory perfusion, and myocardial performance, although these physiological systems likely recover along partially independent trajectories. Whether thermal heterogeneity contributes directly to these responses remains a hypothesis requiring validation in prospective DHCA-specific studies. Recognition of thermal heterogeneity broadens current concepts of postoperative recovery by providing an integrated physiological framework that extends beyond core temperature measurements alone. Future validation studies integrating regional thermal mapping, multisite temperature monitoring, Doppler-derived vascular indices, myocardial strain imaging, metabolic biomarkers, postoperative clinical outcomes, and artificial intelligence-guided predictive models may improve characterization of recovery and support individualized perioperative management after DHCA.</p>","PeriodicalId":7692,"journal":{"name":"American journal of physiology. Heart and circulatory physiology","volume":" ","pages":"H944-H956"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148597573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Loading conditions rather than contractility primarily determine biventricular ejection fraction in endotoxic shock.","authors":"M Ignacio Monge García, Brennan Schneider, George Ma, Feras Hatib, Zhongping Jian, Jos J Settels, Ignacio Fernández López, Thomas W L Scheeren, Michael R Pinsky","doi":"10.1152/ajpheart.00355.2026","DOIUrl":"10.1152/ajpheart.00355.2026","url":null,"abstract":"<p><p>Ejection fraction (EF) is widely used to assess cardiac function in sepsis, yet it is inherently load-dependent and may not reflect intrinsic contractility. We quantified the relative contribution of hemodynamic determinants to left (LVEF) and right ventricular EF (RVEF) in a porcine model of endotoxic shock. Twelve female pigs were instrumented with biventricular conductance catheters and studied at four stages: baseline, endotoxic shock, fluid resuscitation, and norepinephrine infusion. Six candidate determinants [effective arterial elastance (<i>E</i>_a), end-systolic elastance (<i>E</i>_es), end-diastolic volume (EDV), heart rate (HR), the time constant of isovolumic relaxation (τ), and internal flow fraction (IFF)] were evaluated using centering within clusters linear mixed models (LV: 12 animals; RV: 9 animals). <i>E</i>_a, EDV, and <i>E</i>_es were the dominant determinants of LVEF, accounting for 31%, 27%, and 19% of explained variance (combined: 77%), whereas HR exerted a negative effect. For RVEF, predictor importance was more evenly distributed, with EDV and <i>E</i>_a as the leading contributors in dominance analysis; HR was positively associated with RVEF, opposite to its LV effect. This loading-dominant hierarchy persisted when <i>E</i>_es was replaced by alternative load-independent indices: preload-recruitable stroke work (PRSW) and Starling contractility index (SCI). Despite substantial stage-to-stage changes in preload, afterload, and contractility, EF varied within a narrow range (LVEF: 37%-45%; RVEF: 50%-60%), reflecting offsetting changes among determinants. Within this pressure-volume framework, loading conditions rather than contractility were the primary within-animal determinants of LVEF during endotoxic shock. The RV data were consistent with a similar hierarchy, although with differing determinant profiles and greater analytical uncertainty.<b>NEW & NOTEWORTHY</b> This study provides a simultaneous quantification of six hemodynamic determinants of both left and right ventricular ejection fraction during endotoxic shock and resuscitation using biventricular pressure-volume analysis. Loading conditions dominated over contractility, and the determinant hierarchy differed between ventricles.</p>","PeriodicalId":7692,"journal":{"name":"American journal of physiology. Heart and circulatory physiology","volume":" ","pages":"H817-H831"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148597389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Right ventricular maladaptive functional and electrical remodeling in male Fischer rats during progressive pulmonary arterial hypertension.","authors":"Tony Eli El-Rabahi, Purvi C Trivedi, T Alexander Quinn, Ketul R Chaudhary","doi":"10.1152/ajpheart.00194.2026","DOIUrl":"10.1152/ajpheart.00194.2026","url":null,"abstract":"<p><p>Cardiac arrhythmias are suspected as a major cause of sudden cardiac death (SCD) in pulmonary arterial hypertension (PAH); however, the mechanisms underlying right ventricle (RV) electrical remodeling, arrhythmias, and SCD in PAH remain unclear. We investigated the mechanisms of increased susceptibility to SCD during progressive PAH in the Fischer CDF rat monocrotaline (MCT) model. Echocardiography, electrocardiogram, and cardiac catheterization were performed at 4 and 5 wk post MCT injection (MCT-4 and MCT-5 groups, respectively). Hearts were isolated and Langendorff-perfused, and changes in action potential (AP) duration (APD) were evaluated by voltage optical mapping. A progressive increase in RV systolic pressure was observed in MCT-4 and MCT-5 compared to control. In MCT-4, we observed RV hypertrophy with preserved cardiac function and chamber size, indicating adaptive RV remodeling. Conversely, maladaptive RV remodeling was seen in MCT-5, indicated by reduced cardiac function, along with increased RV internal diameter. Electrically, we observed delayed repolarization and prolongation of RV AP and QT interval in the MCT-5 compared to control and MCT-4. Electrical changes were consistent with decreased <i>Kcnh2</i>, <i>Kcnk2</i>, and <i>Scn7a</i> expression in the RV. Reduced RV vascular density together with upregulation of hypoxia-regulated genes were noted in MCT-5 compared to control, which along with the observed ST elevation suggests RV ischemia. In summary, Fischer CDF rats develop maladaptive RV functional and electrical remodeling at 5 wk post MCT that is associated with reduced RV potassium and sodium channel expression and elevated markers of RV ischemia. These changes may contribute to increased susceptibility to arrhythmias and SCD in PAH.<b>NEW & NOTEWORTHY</b> This study shows maladaptive right ventricle (RV) functional and electrical remodeling in pulmonary arterial hypertension (PAH) in Fischer CDF rats, a rat strain that is susceptible to sudden cardiac death in PAH. The electrical changes in the RV were associated with reduced expression of potassium and sodium channels in the RV, reduced RV vascular density, and elevated markers of RV ischemia. Combination of these changes may increase the risk of sudden cardiac death in PAH.</p>","PeriodicalId":7692,"journal":{"name":"American journal of physiology. Heart and circulatory physiology","volume":" ","pages":"H984-H999"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148704994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantum-informed perspectives on mitochondrial bioenergetics and redox signaling in cardiovascular disease.","authors":"Francesco Tona","doi":"10.1152/ajpheart.00308.2026","DOIUrl":"10.1152/ajpheart.00308.2026","url":null,"abstract":"","PeriodicalId":7692,"journal":{"name":"American journal of physiology. Heart and circulatory physiology","volume":" ","pages":"H737-H741"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A peripheral perspective on brain health: vascular and skeletal muscle contributions.","authors":"Joshua L Keller, Kase J Pennartz, Justin D Sprick, Ethan J Hein, Brian A Irving, Christopher G Vann, Evan-Angelo R Butlig, Sima Al-Masri, Amy R Nelson","doi":"10.1152/ajpheart.00462.2026","DOIUrl":"10.1152/ajpheart.00462.2026","url":null,"abstract":"<p><p>Age- and disease-related declines in brain health contribute to impairments in physical function, yet effective approaches to lessen these declines remain limited. Overall health is governed by a network of interdependent organ systems, such that dysfunction in one system can propagate across others. Although the brain has been viewed as a top-down regulator of vital functions, evidence indicates that cognition is affected by signals from peripheral organs. This interorgan communication likely explains the coexistence of Alzheimer's disease and related dementias with cardiovascular and metabolic disorders characterized by overlapping pathophysiology. Skeletal muscle and the peripheral vasculature are key contributors to this and represent modifiable systems that can alter brain structure and function. Skeletal muscle regulates myokine release through motor neuron function, contractile activity, and metabolic perturbations, thereby influencing neuroplasticity, mitochondrial function, and inflammatory signaling, and may affect measures of peripheral vascular function, like reactive hyperemia. Other properties of the vasculature, including arterial stiffness, directly affect cerebral perfusion and blood-brain barrier permeability. These systems form a muscle-vascular-brain axis that contributes to brain health and impacts the risk of cognitive impairment. Therefore, our aim was to synthesize the current understanding of interactions among skeletal muscle, the peripheral vasculature, and the brain, and their collective role in maintaining cognitive health. We also highlight recent clinical trials and emerging strategies affecting interorgan cross talk. These conclusions support a model in which lifestyle interventions targeting peripheral systems, such as resistance training, may preserve brain health across all populations, offering scalable approaches applicable across the lifespan.</p>","PeriodicalId":7692,"journal":{"name":"American journal of physiology. Heart and circulatory physiology","volume":" ","pages":"H957-H980"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can a computational model explain the role of sex hormones in atrial fibrillation?","authors":"Judith Weng Zhu, Pim J A Oomen","doi":"10.1152/ajpheart.00611.2026","DOIUrl":"10.1152/ajpheart.00611.2026","url":null,"abstract":"","PeriodicalId":7692,"journal":{"name":"American journal of physiology. Heart and circulatory physiology","volume":" ","pages":"H750-H752"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148597374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extracellular vesicles: a common mechanism for remote ischemic preconditioning and exercise-induced cardioprotection?","authors":"Sean M Davidson","doi":"10.1152/ajpheart.00569.2026","DOIUrl":"10.1152/ajpheart.00569.2026","url":null,"abstract":"","PeriodicalId":7692,"journal":{"name":"American journal of physiology. Heart and circulatory physiology","volume":" ","pages":"H744-H746"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148629334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulse waveform characteristics for diagnosis and longitudinal monitoring in heart failure with reduced ejection fraction.","authors":"Stefan Orter, Bernhard Hametner, Christopher C Mayer, Siegfried Wassertheurer, Eugenijus Kaniusas, Kathrin Danninger, Ronald K Binder, Antonios A Argyris, Athanase Protogerou, Thomas Weber","doi":"10.1152/ajpheart.00036.2026","DOIUrl":"10.1152/ajpheart.00036.2026","url":null,"abstract":"<p><p>Arterial waveforms are altered in left ventricular systolic dysfunction. We aimed to investigate the diagnostic implications of automatically analyzed pressure waveforms and their changes over time in patients with reduced ejection fraction (EF). Arterial waveforms were recorded noninvasively using applanation tonometry in patients with heart failure with reduced ejection fraction (HFrEF) and in matched controls. Waveform parameters were analyzed with respect to the left ventricular ejection time index (LVETI), the characteristics of antegrade and reflected waves, their interaction as quantified by the augmentation index, and wave intensity, expressed as the ratio of the S and D peak intensities (SDR). Overall, 78 HFrEF patients [ejection fraction (EF) 28 ± 9%] and 78 controls (EF 66 ± 8%), matched for sex, age, presence of hypertension and diabetes, systolic and diastolic blood pressure, and heart rate, were included. All waveform parameters were statistically different between patients and controls. In receiver-operator characteristic (ROC) analysis, HFrEF patients and controls could be separated best using LVETI [area under the ROC curve (AUC) 0.897; <i>P</i> < 0.0001] and SDR (AUC 0.911; <i>P</i> < 0.0001). In newly diagnosed and treated HFrEF patients, the AUC for discrimination between HFrEF patients and controls was almost ideal (0.978; <i>P</i> < 0.0001), when a combination of LVETI and SDR was used. Finally, in 46 HFrEF patients with available follow-up (FU) data, concordance analysis showed a high agreement of up to 0.8 between changes in the cardiac function (e.g., using EF) and changes in several waveform parameters. Pulse waveform parameters may be useful for screening and follow-up of patients with HFrEF.<b>NEW & NOTEWORTHY</b> Arterial pulse waveforms carry distinct signatures of heart failure with reduced ejection fraction (HFrEF). In this study, tonometry revealed differences in waveform timing, wave reflection, and wave intensity between HFrEF patients and matched controls. Combining left ventricular ejection time index and wave intensity ratios enabled near-perfect discrimination in newly diagnosed patients and closely tracked longitudinal changes in cardiac function. These findings highlight pulse waveform analysis as a promising tool for HFrEF screening and follow-up.</p>","PeriodicalId":7692,"journal":{"name":"American journal of physiology. Heart and circulatory physiology","volume":" ","pages":"H903-H913"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148629362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}