American heart journal最新文献

{"title":"Accuracy of site versus core laboratory interpretations of right heart catheterization hemodynamics","authors":"Omar Cantu-Martinez MD ,&nbsp;Marat Fudim MD, MHS ,&nbsp;David F. Kong MD ,&nbsp;Ryan J. Tedford MD ,&nbsp;Philip G. Jones MS ,&nbsp;Andrew J. Sauer MD ,&nbsp;Timothy J. Fendler MD, MS ,&nbsp;John A. Spertus MD, MPH","doi":"10.1016/j.ahj.2026.107351","DOIUrl":"10.1016/j.ahj.2026.107351","url":null,"abstract":"<div><div>An accurate interpretation of hemodynamics measured by right heart catheterization (RHC) is crucial for guiding the management of heart failure and pulmonary hypertension. We evaluated the concordance and variability between site-reported and core laboratory-adjudicated interpretations of invasive hemodynamic measurements.</div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"295 ","pages":"Article 107351"},"PeriodicalIF":3.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145984252","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":"Comparative performance of large language models on cardiovascular certification simulation exam","authors":"Eesha Nachnani ,&nbsp;Kashish Goel MD ,&nbsp;Alexander E. Sullivan MD MSCI","doi":"10.1016/j.ahj.2026.107353","DOIUrl":"10.1016/j.ahj.2026.107353","url":null,"abstract":"<div><div>Artificial intelligence (AI) is becoming increasingly prevalent in medical practice and has demonstrated sufficient clinical acumen to pass several licensing examinations. We tested the ability of 3 popular large-language models, ChatGPT-4.0 (OpenAI), Gemini (Google), and Bing AI (Microsoft), to pass a cardiovascular medicine board-style exam. Of these AI platforms, only ChatGPT-4.0 was able to achieve a score similar to human participants.</div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"295 ","pages":"Article 107353"},"PeriodicalIF":3.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145984263","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":"Secondary Prevention Strategies For Patients with Lower Extremity Peripheral Artery Disease After Successful Peripheral Vascular Intervention.","authors":"Pishoy Gouda, Eric A Secemsky, Connie N Hess, Shipra Arya, Foluso Fokorede, Roxana Mehran, Marc P Bonaca, Manesh R Patel, W Schuyler Jones","doi":"10.1016/j.ahj.2026.107446","DOIUrl":"https://doi.org/10.1016/j.ahj.2026.107446","url":null,"abstract":"<p><p>Individuals with lower extremity peripheral artery disease (LE PAD) represent a subset of patients with atherosclerotic cardiovascular disease that are among the highest risk for major adverse cardiovascular and limb events. Despite this, LE PAD is frequently under diagnosed, and an individual patient's risk for cardiovascular morbidity and limb loss is often underestimated and undertreated. To change the course of PAD disease progression, aggressive secondary prevention therapies are required. This is of particular importance among individuals undergoing surgical or endovascular lower extremity revascularization (LER), who represent the PAD subgroup with the highest risk of cardiovascular and limb adverse events. The cornerstone of secondary prevention is centered on symptom control, lifestyle and behavioural interventions that include exercise therapy, smoking cessation, healthy nutrition and weight management. Individuals with high-risk concomitant comorbidities, such as ongoing smoking, diabetes, and chronic kidney disease, represent an even higher risk population that warrant stringent monitoring and may benefit the most from pharmacological therapies. Guideline-recommended pharmacological therapies include antiplatelet and anticoagulant medications, lipid lowering therapies, diabetes medications, and cilostazol. Despite guideline recommendations, these medical therapies remain under-utilized in patients with PAD. Based on the elevated risk profile of individuals with LE PAD undergoing LER, increased efforts are required to initiate and escalate secondary prevention therapies. To achieve this, the development of effective, patient-centred and scalable implementation strategies remains a priority.</p>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":" ","pages":"107446"},"PeriodicalIF":3.5,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147809424","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":"The European Bifurcation Club randomised trial of stepwise provisional stenting versus Drug Coated Balloon therapy for non-left main true coronary bifurcations: The EBC DCB Trial.","authors":"Christopher J Broyd, Sandeep Arunothayaraj, Bruno Scheller, Simon Eccleshall, Jens F Lassen, Goran Stankovic, David Hildick-Smith","doi":"10.1016/j.ahj.2026.107463","DOIUrl":"https://doi.org/10.1016/j.ahj.2026.107463","url":null,"abstract":"<p><strong>Background: </strong>Drug eluting stents (DES) are associated with a 2% annual failure rate and have worse outcomes at coronary bifurcations. Recent randomised control data has shown the non-inferiority of drug-coated balloons (DCB) versus stents at 1 year. Possible benefits of DCBs include the lack of a metal prosthesis, absence of stent malapposition, lack of obligate antiplatelet treatment, and maintenance of vessel geometry and function.</p><p><strong>Hypothesis: </strong>The use of DCBs in the treatment of non-left main bifurcation disease is non-inferior to a DES strategy for Target Bifurcation Failure (TBF) at 1 year.</p><p><strong>Strategy design: </strong>The EBC DCB trial is a non-blinded, investigator-initiated, randomised control trial that will recruit 750 patients with non-left main bifurcations requiring revascularisation. Both main vessel and side branch must have significant atheroma. Subacute (NSTEMI and unstable angina) and elective presentations will be eligible for inclusion. Patients will be randomised to either a step-wise provisional DES or a DCB strategy. Major exclusion criteria include STEMI in the previous 48 hours, chronic total occlusions and in-stent restenosis. The primary endpoint of TBF is a composite of cardiovascular death, target bifurcation myocardial infarction or target bifurcation revascularisation. Patients will be followed up at 6 months, 1, 3, 5 and 8 years. If non-inferiority is met, superiority will be tested.</p><p><strong>Summary: </strong>EBC DCB is an open label, multi-centre, international randomized control trial comparing the use of DCB and DES in the treatment of coronary artery bifurcation disease. The trial is registered at clinicaltrials.gov (NCT06822322).</p>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":" ","pages":"107463"},"PeriodicalIF":3.5,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147809541","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":"Short-term outcomes of ticagrelor monotherapy after primary percutaneous coronary intervention for ST-elevation myocardial infarction; a randomized pilot study.","authors":"Eva C I Woelders, Bahram Yosofi, Denise A M Peeters, Clemens von Birgelen, Johannes B van Rees, Antonius A C M Heestermans, Bimmer E P M Claessen, Stijn C H van den Oord, Maurits T Dirksen, Daphne van Vliet, Lara S F Konijnenberg, Aysun Cetinyurek-Yavuz, Niels van Royen, Robert-Jan M van Geuns, Robin Nijveldt, Peter Damman","doi":"10.1016/j.ahj.2026.107460","DOIUrl":"https://doi.org/10.1016/j.ahj.2026.107460","url":null,"abstract":"<p><p>This randomized multicenter open-label pilot study assessed the safety of ticagrelor monotherapy directly after primary PCI versus dual antiplatelet therapy (DAPT) in 200 STEMI patients. At three months, major adverse cardiac and cerebral events occurred in 3.1% of the experimental group (n=99) versus 2.0% in the control group (n=101) (HR: 1.54; 95%CI: 0.26-9.24), clinically relevant bleeding was observed in 4.2% versus 8.9% (HR: 0.46, 95%CI: 0.14-1.48), and clinically relevant non-access site bleeding in 2.0% versus 7.9% (HR:0.25, 95%CI: 0.05-1.19). Although no significant difference in ischemic events was observed between the novel concept of ticagrelor monotherapy and DAPT, safety cannot be confirmed given the small number of events. Additionally, there was a tendency for a reduction in clinically relevant non-access site bleeding events. Clinical Trial Registration: ClinicalTrials.gov ID: NCT05986968 https://www.clinicaltrials.gov/study/NCT05986968.</p>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":" ","pages":"107460"},"PeriodicalIF":3.5,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147809514","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":"Direct oral anticoagulation interruption versus continuation in patients undergoing elective invasive coronary angiography or percutaneous coronary intervention: design and rationale of the South Limburg Myocardial Infarction study group trial 2 (SLIM-2).","authors":"Sanne Janssen, Jasper J P Luijkx, Wouter Swinnen, Pieter Vriesendorp, Jurrien M Ten Berg, W J van 't Hof Arnoud, Saman Rasoul","doi":"10.1016/j.ahj.2026.107462","DOIUrl":"https://doi.org/10.1016/j.ahj.2026.107462","url":null,"abstract":"<p><strong>Background: </strong>The periprocedural management of elective invasive coronary angiography (ICA) or percutaneous coronary intervention (PCI) of patients using direct oral anticoagulation (DOAC) remains debated. This trial aims to evaluate whether continuing DOAC therapy is as safe as temporary interruption, by comparing in-hospital and 30-day bleeding and ischemic outcomes.</p><p><strong>Methods: </strong>The South Limburg Myocardial Infarction 2 (SLIM-2) trial (NCT04977076) is an investigator-initiated, multicenter, randomized controlled trial. A total of 1270 patients using DOAC and scheduled for elective ICA or PCI will be randomized in a 1:1 ratio to uninterrupted or interrupted therapy. The primary endpoint is in-hospital bleeding, classified as type 2, 3 or 5 according to the Bleeding Academic Research Consortium (BARC). Secondary endpoints are 30-day bleedings, major adverse cardiac and cerebrovascular events (MACCE), and net adverse clinical events (NACE, MACCE plus bleeding events).</p><p><strong>Conclusion: </strong>The SLIM-2 trial is the first large-scale randomized controlled trial to evaluate the safety of uninterrupted DOAC therapy in elective ICA and PCI. Its results will provide critical evidence to guide periprocedural anticoagulation management and may inform future clinical practice guidelines.</p><p><strong>Trial registration: </strong>The trial is registered at ClinicalTrials.gov with number NCT04977076, https://clinicaltrials.gov/study/NCT04977076?term=NCT04977076&viewType=Card&rank=1.</p>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":" ","pages":"107462"},"PeriodicalIF":3.5,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760250","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":"Vasodilation, Loop Diuretics, or Their Combination in Acute Heart Failure: Rationale and Design of the Randomized Placebo-Controlled DECONGEST-AHF Trial.","authors":"Anne Sophie Overgaard Olesen, Jasmin Dam Lukoschewitz, Ida Arentz Taraldsen, Ahmed Najim, Nora Olsen El Caidi, Simone Bonde Haastrup, Sandra Tonning, Rasmus Gregersen Mottlau, Hanne Nygaard, Brett Doleman, Søren Junge Nielsen, Jakob Hartvig Thomsen, Jens Dahlgaard Hove, Ekim Seven, Fredrik Folke, Matias Greve Lindholm, Janus Christian Jakobsen, Jens Jakob Thune, Johannes Grand","doi":"10.1016/j.ahj.2026.107461","DOIUrl":"https://doi.org/10.1016/j.ahj.2026.107461","url":null,"abstract":"<p><strong>Background: </strong>Acute heart failure is the leading cause of hospitalization in older adults and carries a high risk of short-term death or readmission. Initial treatment involves intravenous loop diuretics, often combined with vasodilators, despite limited evidence. The individual and combined effects of loop diuretics and vasodilators have never been directly compared during the initial emergency phase, as previous studies have included patients after early stabilization, leaving the optimal first-line treatment unknown.</p><p><strong>Study design: </strong>DECONGEST-AHF is a pragmatic, multicenter, randomized, double-blinded, placebo-controlled trial evaluating early treatment strategies in patients with suspected acute heart failure. Patients are included no later than three hours after emergency department arrival. Inclusion criteria are acute dyspnea, clinical signs of congestion, oxygen saturation <94% or need for oxygen therapy, and systolic blood pressure ≥100 mmHg. Patients are randomized (1:1:1) to receive intravenous furosemide, intravenous isosorbide dinitrate, or both as initial in-hospital treatment. The primary outcome is days alive and outside of hospital at 30 days. The trial will enroll 1,041 patients across five Danish hospitals.</p><p><strong>Discussion: </strong>By initiating treatment during the hyperacute phase and applying a blinded and placebo-controlled design, we aim to clarify the individual and combined effects of two widely used therapies. The use of emergency consent procedures enables the inclusion of a real-world patient population, including patients who are often excluded from clinical trials. This approach ensures broad generalizability and reflects routine emergency care. Findings from DECONGEST-AHF may improve early management of patients with acute heart failure.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov (NCT05276219).</p>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":" ","pages":"107461"},"PeriodicalIF":3.5,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760189","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":"Cerebral Embolic Protection Devices for Transcatheter Aortic Valve Replacement: A Meta-Analysis and Trial Sequential Analysis.","authors":"Hossam Elbenawi, Ibrahim Hassan, Mahmoud Shaaban Abdelgalil, Mariam Hanna, Salma Almotawally, Mahmoud Fayed, Kareem A Mohamed, Hossam Elnaggar, Louna Abouainain, Belal Mohamed Hamed, Ahmed Ibrahim, Ahmed Al Khatib, Mohamed Elhelw, Ehab Hassan, Mahmoud Eisa, Morad Zaaya, Ramzi Ibrahim, Andrew M Goldsweig, Marwan Saad, Fernando Alfonso, Mohamad Alkhouli, Islam Y Elgendy","doi":"10.1016/j.ahj.2026.107449","DOIUrl":"https://doi.org/10.1016/j.ahj.2026.107449","url":null,"abstract":"<p><strong>Background: </strong>Transcatheter aortic valve replacement (TAVR) is associated with a periprocedural stroke risk due to embolic debris. The efficacy and safety of cerebral embolic protection devices (CEPDs) remain uncertain, with conflicting results between trials. We performed a meta-analysis of randomized controlled trials (RCTs) of current-generation CEPDs for TAVR.</p><p><strong>Methods: </strong>Electronic databases were searched for RCTs comparing clinical outcomes with routine CEPD use vs. no CEPD use. Outcomes of interest included any stroke, disabling stroke, and all-cause mortality. Risk ratios (RR) or mean differences (MD) with 95% confidence intervals (CIs) were pooled using random-effects models. The analysis was complemented by meta-regression and trial sequential analyses.</p><p><strong>Results: </strong>The meta-analysis included 8 RCTs (5 filter-based and 3 shield-based) with 11,597 patients. CEPD use was not associated with a lower incidence of any stroke (RR 0.92; 95%CI 0.75-1.14), disabling stroke (RR 0.80; 95%CI 0.55-1.15), new magnetic resonance imaging-detected lesions (RR 1.00; 95%CI 0.93-1.07), or all-cause mortality (RR 1.04; 95%CI 0.71-1.51). Trial sequential analysis provided conclusive meta-analytic evidence, affirmed the absence of CEPD benefit. Meta‑regression showed no significant association between stroke risk and patient-level covariates, including age, sex, or the presence of diabetes, prior stroke, or atrial fibrillation (all p>0.05).</p><p><strong>Conclusions: </strong>Current generation CEPD devices during TAVR did not significantly reduce the risk of any stroke, disabling stroke, or all-cause mortality. TSA indicates that, at least with available data, cumulative evidence appears sufficient to question the predefined benefit thresholds for existing systems. These findings suggest the lack of routine use of current-generation CEPD in TAVR.</p>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":" ","pages":"107449"},"PeriodicalIF":3.5,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760198","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":"Community-based recruitment with ankle brachial index testing to identify peripheral artery disease participants for randomized clinical trials.","authors":"Mary M McDermott, Madeline D Cetlin, Kathryn J Domanchuk, Shujun Xu, Mary O Whipple, Tamar Polonsky, Michael H Criqui, Jack M Guralnik, Lu Tian, Lihui Zhao, Karen J Ho, Philip Greenland, Diane Treat-Jacobson","doi":"10.1016/j.ahj.2026.107450","DOIUrl":"https://doi.org/10.1016/j.ahj.2026.107450","url":null,"abstract":"<p><strong>Background: </strong>This retrospective, cross-sectional study describes using community mailings followed by ankle brachial index (ABI) testing to identify participants for clinical trials of interventions to improve walking performance in people with peripheral artery disease (PAD). Clinical characteristics of clinical trial participants were compared between PAD participants identified with community-based recruitment vs. PAD participants recruited from the medical center.</p><p><strong>Methods: </strong>Between 01/09/2012 and 10/31/2025, approximately 10,000-60,000 postcards/month were mailed to residents aged 50 and older in Chicago or New Orleans, to recruit PAD participants for clinical trials testing therapies for walking impairment. Respondents with PAD risk factors and walking difficulty were invited to undergo ABI testing. Additional participants were identified from patients with PAD in medical centers in Chicago and New Orleans. The 6-minute walk and questionnaires were administered.</p><p><strong>Results: </strong>Of 2,856 people (49.9% women, 55.8% Black) who responded to a postcard and underwent ABI testing, 669 (23.4%) had ABI < 0.90, consistent with PAD. Compared to 275 PAD patients from a medical center, PAD participants from the community included a higher proportion of people who were Black (65.5% vs. 48.7%, P<0.001), with household income < $50,000 (36.7% vs. 28.5%, P=0.015), and without a college degree (67.6% vs. 58.1%, P=0.016). Compared to PAD participants identified from a medical center, those identified from the community had poorer 6-minute walk distance (308 vs. 334 meters, P=0.002).</p><p><strong>Conclusions: </strong>Approximately 23% of people living in the community who underwent ABI testing as part of a clinical trial recruitment method had PAD. Compared to PAD participants from the medical center, those identified from the community included more people traditionally underrepresented in clinical trials and had greater walking impairment.</p>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":" ","pages":"107450"},"PeriodicalIF":3.5,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760153","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":"Rationale and design of the Vericiguat in Vasospastic Angina (ViVA) trial: a double-blind placebo-controlled randomized cross-over study.","authors":"H F Namba, E A M de Jong, C K M Boerhout, A Mechroubi, T Nijkamp, P Damman, A C Dimitriu-Leen, M Meuwissen, A A C M Heestermans, M C den Haan, M A M Beijk, N S Vos, J Escaned, H M den Ruijter, Y Appelman, E C Eringa, R Delewi, J J Piek, T P van de Hoef","doi":"10.1016/j.ahj.2026.107451","DOIUrl":"https://doi.org/10.1016/j.ahj.2026.107451","url":null,"abstract":"<p><p>Coronary vasospasm is highly prevalent in patients with angina and no obstructive coronary arteries (ANOCA). In the pathophysiology of coronary vasospasm, endothelial dysfunction and vascular smooth muscle cell hyperreactivity may cause an imbalance between vasodilation and vasoconstriction. Within this pathophysiology, nitric oxide (NO) is crucial. NO activates soluble guanylate cyclase (sGC), which through the NO-sGC-cyclic guanosine monophosphate pathway, reduces intracellular calcium levels in vascular smooth muscle cells, resulting in vasodilation. sGC stimulators, such as vericiguat, enhance the sensitivity of sGC to NO. Vericiguat was shown to be well tolerated, safe, and clinically effective in both heart failure patients as well as in patients with coronary artery disease. We hypothesize that vericiguat restores the balance between vasodilation and vasoconstriction and thereby reduces coronary spasm episodes in ANOCA patients. In the Vericiguat in Vasospastic Angina (ViVA) trial, we will assess the impact of vericiguat on endothelial function and microvascular vasodilator responses, angina and quality of life. Additionally, we will evaluate the tolerability and safety of vericiguat in patients with coronary vasospasm as the pathophysiological substrate of ANOCA. The ViVA trial is registered at ClinicalTrials.gov ID NCT06415227.</p>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":" ","pages":"107451"},"PeriodicalIF":3.5,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760173","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}