Cardiology最新文献

{"title":"Right Atrial Strain as a Predictor of Atrial High-Rate Episodes in Pacemaker Patients: A Case-Control Pilot Study.","authors":"Waseem Omar Ahmed, Ahmed Ali Fahmy Mostafa, Hosam El Din Hosni Helal, Mohamed Adel Attia, Khaled Abouelmagd, Ayman Ahmed Gad","doi":"10.1159/crd/absag006","DOIUrl":"10.1159/crd/absag006","url":null,"abstract":"<p><strong>Introduction: </strong>Atrial high-rate episodes (AHREs) detected by cardiac implantable electronic devices represent subclinical atrial tachyarrhythmias that are strongly associated with an increased risk of progression to clinical atrial fibrillation and thromboembolic events. The underlying biatrial electrical and mechanical remodeling that precedes AHRE remains incompletely understood, particularly the role of right atrial (RA) function. This study aimed to identify combined electrocardiographic (ECG) and echocardiographic predictors of device-detected AHRE in patients with dual-chamber pacemakers, with 'a specific focus on the incremental predictive value of RA strain assessed by two-dimensional speckle-tracking echocardiography (2D-STE).</p><p><strong>Methods: </strong>A single-center, case-control study was conducted on a cohort of prospectively followed patients involving 60 adult patients with dual-chamber (DDD) pacemakers, divided into two groups: 30 patients with device-detected AHRE (AHRE+) and 30 age- and sex-matched controls without AHRE (AHRE-). All participants underwent detailed clinical evaluation, 12-lead ECG analysis (including P-wave duration and dispersion), and comprehensive transthoracic echocardiography, including 2D-STE for assessment of RA reservoir strain (RASr) and contractile strain (RASct). AHRE was defined as an atrial tachyarrhythmia ≥180 bpm lasting ≥6 min, verified by intracardiac electrograms.</p><p><strong>Results: </strong>AHRE+ patients exhibited significantly prolonged P-wave duration (118 ± 14 ms vs. 108 ± 12 ms; p = 0.04) and greater P-wave dispersion (PWD) (42 ± 8 ms vs. 36 ± 7 ms; p = 0.03). Echocardiographically, they demonstrated significantly higher left atrial volume index (LAVI) (34.2 ± 6.8 vs. 28.5 ± 5.2 mL/m2; p = 0.012) and right atrial volume index (26.4 ± 5.1 vs. 22.7 ± 4.3 mL/m2; p = 0.028), RA function was markedly impaired in the AHRE+ group, with reduced right atrial reservoir and contractile strain (RASr 15.8% vs. 25.9%, p = 0.041; RASct -2.0% vs. -11.6%, p = 0.012). Multivariate analysis identified four independent predictors of AHRE: RASr <20% (OR 3.8; 95% CI 1.7-8.4; p < 0.001), LAVI ≥34 mL/m2 (OR: 3.1; 95% CI: 1.5-6.2; p = 0.003), PWS ≥40 ms (OR: 2.6; 95% CI: 1.2-5.8; p = 0.008), ventricular pacing >90% (OR: 2.1; 95% CI: 1.0-4.4; p = 0.032). The model achieved strong discrimination (area under the curve = 0.84; 95% CI: 0.76-0.92) and good calibration (Hosmer-Lemeshow p = 0.47).</p><p><strong>Conclusions: </strong>The occurrence of AHRE in DDD pacemaker patients is independently associated with a combination of electrical and mechanical biatrial remodeling. Impaired right atrial strain (RASr <20%) provides significant incremental predictive value beyond conventional metrics like PWD and left atrial enlargement. Integrating RA strain into routine echocardiographic assessment may serve as a powerful, early marker for risk stratification of atrial arrhythmogenic remodeling in t","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1"},"PeriodicalIF":1.9,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cell-Specific Epigenetic Editing in Cardiovascular Disease: Mechanisms, Therapeutic Potential, and Translational Challenges.","authors":"Majed Alsulami, Mahmood Rasool, Ahmed N Masoud, Waleed A Al-Hoban, Ayat M Shorbaji, Isam M Abu Zeid","doi":"10.1159/000553321","DOIUrl":"10.1159/000553321","url":null,"abstract":"<p><strong>Background: </strong>Cell-specific epigenetic editing provides a new approach to the therapy of cardiovascular disease (CVD) by rewriting pathological chromatin and RNA marks in exactly those cell populations responsible for causing disease. CVD is caused by interactions of genetics and environment on cell-type-specific epigenomic programs. Interventions that alter DNA methylation, histone marks, or RNA modifications can therefore correct maladaptive gene expression without altering DNA sequence.</p><p><strong>Summary: </strong>Recently developed technologies such as dCas9 fused to writers/erasers allow programmable, locus-directed modulation of promoters, enhancers, and transcripts. Proof-of-principle in vivo work has shown durable target silencing, illustrating both the potency and persistence of epigenetic edits. To achieve therapeutic benefit, cell-targeting strategies and rigorous single-cell/multi-omic validation of on-target activity and off-target safety will be required. Major translational challenges include scalable, cardiac-selective delivery, immune responses to vectors/editors, long-term monitoring for unintended chromatin changes, and regulatory pathways for nongenotoxic but durable interventions.</p><p><strong>Key messages: </strong>Altogether, cell-specific epigenetic editing holds very high therapeutic value for atherosclerosis, cardiomyopathy, and fibrosis, provided that delivery, specificity, and safety challenges are also addressed.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-15"},"PeriodicalIF":1.9,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes Among Coronary Artery Disease Patients Undergoing PCI with Ridaforolimus-Eluting Stents: A Proportional Meta-Analysis.","authors":"Mohammed S Beshr, Ibrahem A Beshr, Ali R Al-Gburi, Hibah Al-Qubati, Muhammed Elhadi","doi":"10.1159/crd/absag003","DOIUrl":"10.1159/crd/absag003","url":null,"abstract":"<p><p>Background Drug-eluting stents (DES) have become increasingly valuable in the management of coronary artery disease. Ridaforolimus-eluting stents (RES) are a novel DES, an analog of sirolimus with a similar mode of action. Our objective is to evaluate the efficacy and safety profile of RES. Methods A systematic search was conducted on 1 January 2026 for articles on patients with coronary artery disease who underwent percutaneous coronary intervention (PCI) with RES. The endpoints that were evaluated include major adverse cardiac events (MACE), target lesion failure (TLF), target vessel failure (TVF), device success, and stent thrombosis. Results Six studies were included in the review, consisting of 1709 participants. The results for our endpoints were as follows: the MACE rate was 2.2% at 30 days and 4.4% at 12 months. At 12 months, the TLF rate was 3.6%, and the TVF rate was 4.4%. At the one-year follow-up, the myocardial infarction (MI) rate was 2.8%, target vessel-related MI was 1.8%, ischemia-driven target lesion revascularization (TLR) was 1.3%, and ischemia-driven target vessel revascularization (TVR) rate was 0.8%. Stent thrombosis (ST; definite and probable) was about 0.2% at 30 days and remained the same at 12 months. Conclusions In this single-arm meta-analysis, the findings suggest that PCI with RES has a favorable efficacy and safety profile, as evidenced by the low observed rates of MACE, TLF, and stent thrombosis. These findings suggest that RES may be a safe option for patients undergoing PCI. However, head-to-head comparisons with other second-generation DES are still needed to confirm these results.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1"},"PeriodicalIF":1.9,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148629499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review of Clinical Practice Guidelines for Physical Activity in Patients with Coronary Heart Disease.","authors":"Yujie Zhou, Jiuxin Zhou, Haoran Gao, Shan Liang, Linlin Niu, Ke Song, Yuanmei Qin, Xiao Yang","doi":"10.1159/crd/absag005","DOIUrl":"10.1159/crd/absag005","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to appraise clinical practice guidelines relevant to physical activity in patients with coronary heart disease (CHD) and summarize consensus and discrepant recommendations.</p><p><strong>Methods: </strong>The websites of organizations that develop guidelines, including those of cardiovascular and medical sports associations, were searched in addition to 9 literature databases from January 2014 to November 2024. The included guidelines were published in English or Chinese, labeled as a recommendation guideline, position paper, practice parameter, or consensus statement; and addressed physical activity for patients with coronary heart disease. Two authors independently extracted recommendations. Three reviewers independently assessed guideline quality using the AGREE II instrument.</p><p><strong>Results: </strong>A total of 32 guidelines were included, with the Scottish Intercollegiate Guidelines Network and the American Heart Association deemed to have the highest methodological quality. A total of 26 consensus recommendations were identified, including general recommendations, principles for early in-hospital rehabilitation, and the FITT-VP principles for outpatient rehabilitation exercise prescriptions, of which 4 were classified as having moderate consensus and 22 as having low consensus.</p><p><strong>Conclusion: </strong>The guidelines have developed consensus recommendations for routine physical activity in patients with coronary heart disease. However, inconsistencies in exercise prescriptions indicate a need to develop core FITT standards that are applicable across various clinical settings and can be flexibly adapted to individual needs. Furthermore, international collaboration and standardization efforts should be pursued to enhance the applicability of evidence-based guidelines, and implementation frameworks should be introduced to bridge the gap between clinical practice and guideline recommendations.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1"},"PeriodicalIF":1.9,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148629560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Impact of Frailty in Older Patients with Chronic and Acute Coronary Syndrome Referred for Coronary Angiography.","authors":"Hanna Ratcovich, Francis R Joshi, Pernille Palm, Lia E Bang, Hans-Henrik Tilsted, Golnaz Sadjadieh, Thomas Engstrøm, Lene Holmvang","doi":"10.1159/000553079","DOIUrl":"10.1159/000553079","url":null,"abstract":"<p><strong>Introduction: </strong>Frailty has been proposed as an important marker for predicting outcomes in older patients with cardiovascular disease. However, it remains unclear whether the relationship between frailty and unfavorable outcomes is consistent between patients with chronic coronary syndrome (CCS) and acute coronary syndrome (ACS).</p><p><strong>Methods: </strong>Patients of 70 years or older referred for coronary angiography (CAG) due to CCS or ACS were included and followed for 12 months. Frailty was assessed using the Clinical Frailty Scale (CFS). Patients were stratified by their CFS into frail/vulnerable (CFS ≥4) and robust (CFS = 1-3). The study endpoints comprised all-cause mortality and new hospital admissions for myocardial infarction, bleeding, unplanned revascularization or stroke.</p><p><strong>Results: </strong>678 patients of 70 years or older with available CFS underwent CAG and completed 12-month follow-up. Of these, 223 patients were referred due to CCS, and 455 to ACS. The prevalence of frailty/vulnerability was higher in patients referred with CCS compared to those with ACS (CCS: 43.0% vs. ACS: 32.2%, p = 0.009). Frail/vulnerable patients referred with CCS were younger (CCS: 76.6(±4.7) years vs. ACS: 79.6(±5.7) years, p < 0.001) and less frequently treated with percutaneous coronary intervention (CCS: 40.6% vs. ACS: 54.6%, p = 0.043). When compared to robust patients, cumulative all-cause mortality was higher in frail/vulnerable patients referred with ACS, but not in patients referred with CCS (log-rank p < 0.001).</p><p><strong>Conclusion: </strong>Among patients of 70 years or older referred for CAG 30-40% are frail/vulnerable. Frailty/vulnerability was related to higher all-cause mortality in ACS patients referred for CAG, but not in those referred due to CCS. This difference in outcome may reflect variations in clinical presentation as well as potential referral bias.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-14"},"PeriodicalIF":1.9,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stepwise Increasing Input to Machine Learning Models Predicting 30-Day Acute Myocardial Infarction or Death in Emergency Department Chest Pain Patients.","authors":"Pontus Olsson de Capretz, Axel Nyström, Anders Björkelund, Jonas Björk, Mattias Ohlsson, Ulf Ekelund","doi":"10.1159/crd/absag001","DOIUrl":"10.1159/crd/absag001","url":null,"abstract":"<p><strong>Introduction: </strong>This study evaluated the performance of neural network (NN) models with stepwise increasing input for identifying acute myocardial infarction (AMI) or death within 30 days among emergency department (ED) chest pain patients.</p><p><strong>Methods: </strong>Data from 40,312 chest pain patients were used to train NN models with stepwise increasing input information: (1) age and sex; (2) previous diagnoses, redeemed medications, and coronary angiographies; (3) ECG features; (4) blood creatinine, hemoglobin, and glucose results; (5) the first high-sensitivity cardiac troponin T (hs-cTnT) result. The area under the receiver operating characteristic curve (AUROC) was evaluated for each step alone and for each step combined with the previous steps. For each such combination, we also counted the number of patients safely ruled out by the NN, with the sensitivity for 30-day AMI/death set to 100% for steps 1-4 and >99% for step 5.</p><p><strong>Results: </strong>AUROC scores differed significantly between the isolated input steps, but when combined, the added value of past medical history (step 2) and creatinine, hemoglobin, and glucose (step 4) was not significant. The model using only age and sex (step 1) ruled out 16% of the patients, and the model using all information (steps 1-5) ruled out 49% with an AUROC of 93%. When the combined models were applied sequentially to the patients not ruled out in the previous steps, 51% of patients were ruled out, but 99% sensitivity could not be achieved. ECG and hs-cTnT were the most important predictor variables. Adding all prior information to hs-cTnT alone did not significantly improve AUROC.</p><p><strong>Conclusion: </strong>An NN model using age, sex, past medical history, ECG, and blood tests including hs-cTnT achieved an AUROC of 93%, ruling out 30-day AMI/death in 49% of the patients. When the NN models were applied sequentially, the desired sensitivity of 99% was not achieved.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1"},"PeriodicalIF":1.9,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Small Secundum Atrial Septal Defects Are Associated with Paradoxical Embolism: A Retrospective Study Using Intraoperative Transesophageal Echocardiography.","authors":"Takamori Kakino, Ayako Ishikita, Ichiro Sakamoto, Tomoyasu Suenaga, Akiko Nishizaki, Yuki Kodono, Soshun Asakawa, Yoshinobu Wakisaka, Kenichiro Yamamura, Kohtaro Abe","doi":"10.1159/crd/absag002","DOIUrl":"10.1159/crd/absag002","url":null,"abstract":"<p><strong>Introduction: </strong>Paradoxical embolism is a clinically important complication of secundum atrial septal defect (ASD), yet anatomical characteristics predisposing to embolic events remain incompletely defined. We investigated clinical and morphological factors associated with paradoxical embolism among adults undergoing transcatheter ASD closure, with particular focus on ASD size.</p><p><strong>Methods: </strong>We retrospectively analyzed 270 adults who underwent transcatheter closure of secundum ASD between 2013 and 2024. Patients were classified according to history of paradoxical embolism. ASD morphology, including maximum diameter, was assessed by intraoperative transesophageal echocardiography (TEE). Logistic regression evaluated ASD size continuously (per 1-mm increase) and as a categorical threshold (<10 mm vs. ≥10 mm).</p><p><strong>Results: </strong>Paradoxical embolism occurred in 14/270 patients. Patients with paradoxical embolism had a significantly smaller maximum ASD diameter on TEE (12.92 ± 5.79 vs. 16.94 ± 5.96 mm, p = 0.02). In univariable logistic regression, maximum ASD size (per 1-mm increase) was inversely associated with paradoxical embolism (odds ratio [OR] 0.88, 95% confidence interval 0.80-0.98; p = 0.02). In multivariable analysis adjusted for age, sex, and hypertension, ASD size <10 mm remained independently associated with paradoxical embolism (Firth's penalized likelihood, model 1: OR 7.75, 95% confidence interval 2.51-24.50; p < 0.001).</p><p><strong>Conclusion: </strong>Smaller maximum ASD diameter, particularly <10 mm, was consistently associated with paradoxical embolism, suggesting that even small ASDs may carry clinically meaningful embolic risk in this closure cohort.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1"},"PeriodicalIF":1.9,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148599389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment Disparities and Prognosis among Myocardial Infarction Patients without Standard Modifiable Risk Factors.","authors":"Konstantinos A Papathanasiou, Petros Kalogeras, Stylianos Daios, Donatos Tsamoulis, Nikolaos Makridakis, Despoina-Rafailia Benetou, Ilektra Stamou, Charalampos Kalantzis, Christos Eleftherios Roussos, Ioannis Leventis, Andriani Nikolaou, Vasileios Afentoulis, Stylianos Rallidis, Aristi Boulmpou, Vasileios Bouratzis, Andreas Ntalaoutis, Belkis Malkots, Niki Kakouri, Alexandros Sianis, Sofia Xanthopoulou, Tsampika Gaitanaki, Loukianos S Rallidis","doi":"10.1159/crd/absag004","DOIUrl":"10.1159/crd/absag004","url":null,"abstract":"<p><strong>Introduction: </strong>It is increasingly recognized that patients might suffer from acute coronary syndrome (ACS) in the absence of standard modifiable risk factors (SMuRFs). Their treatment remains largely empirical and follows the same principles for counterparts with SMuRFs. We examined whether the absence of SMuRFs affects hospital management and outcomes.</p><p><strong>Methods: </strong>CALLINICUS-Hellas Registry is an observational prospective study evaluating the adherence to lipid-lowering therapy among ACS patients. Two groups were created according to SMuRF status. The patients were followed for 12 months after hospital discharge, and the study's endpoints were the development of new ACS, cardiac death, and non-cardiac death.</p><p><strong>Results: </strong>A total of 2,718 consecutive patients with ACS were included, and 68 cases (2.5%) were SMuRF-less. Low-density lipoprotein-cholesterol (LDL-cholesterol), triglycerides, and waist circumference were higher among patients with SMuRFs. SMuRF-less patients were more likely to have one vessel or nonobstructive coronary artery disease and less likely to receive reperfusion or dual antiplatelet therapy. On the contrary, non-cardiac death, cardiac death, and new ACS did not differ between groups. B-blockers and angiotensin-converting enzyme inhibitor/angiotensin receptor blocker were equally prescribed between groups, yet patients with SMuRFs were more likely to receive ezetimibe combined with high-intensity statins at discharge. SMuRF-less patients were more likely to attain lower LDL-cholesterol levels after 12 months of follow-up and to achieve values below 55 mg/dL.</p><p><strong>Conclusion: </strong>SMuRF status is associated with treatment disparities among contemporary ACS patients, and the absence of traditional risk factors does not dictate benign prognosis.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1"},"PeriodicalIF":1.9,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148599322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary Artery Characteristics in Congenital Heart Diseases Evaluated by Optical Coherence Tomography.","authors":"Punyaporn Seubnuch, Mann Chandavimol, Alisa Limsuwan","doi":"10.1159/000553582","DOIUrl":"10.1159/000553582","url":null,"abstract":"<p><strong>Introduction: </strong>Assessment of pulmonary vascular disease in children with congenital heart disease (CHD) relies primarily on invasive hemodynamic measurements, including pulmonary vascular resistance index (PVRi). However, these parameters may not fully reflect the underlying structural changes associated with pulmonary vascular remodeling. This study aimed to evaluate the utility of optical coherence tomography (OCT) for in vivo assessment of pulmonary arterial remodeling and examined the relationship between OCT-derived parameters and pulmonary hypertension (PH) severity.</p><p><strong>Methods: </strong>In the present study, 11 patients with CHD (mean age 10 years, range 2-23 years; 7 females) undergoing clinically indicated cardiac catheterization were prospectively enrolled. OCT imaging was successfully performed in 63 pulmonary artery (PA) segments. Hemodynamic parameters, including mean pulmonary arterial pressure (mPAP), mPAP/systemic arterial pressure (MAP), and PVRi, were compared between the PH and control groups. Correlations between OCT-derived measurements and hemodynamic indices were analyzed.</p><p><strong>Results: </strong>Patients with PH had significantly higher mPAP (39 ± 16 vs. controls, p = 0.002), mPAP/MAP ratio (0.58 ± 0.24, p = 0.017), and PVRi (median 6.05 [IQR 2.27-6.60] WU·m2, p = 0.008). OCT demonstrated significantly greater %PA wall thickness in the PH group compared with controls (19.4 ± 1.1% vs. 13.5 ± 0.9%, p < 0.0001). Percentage wall thickness showed significant positive correlations with mPAP (r = 0.58), mPAP/MAP ratio (r = 0.62), transpulmonary gradient (r = 0.60), PVRi (r = 0.55), and Rp/Rs ratio (r = 0.45) (all p < 0.001). Notably, marked wall thickening (21.8%) was identified in a patient with only mildly elevated PVRi (2.2 WU·m2).</p><p><strong>Conclusions: </strong>OCT provides structural insights into pulmonary vascular remodeling and complements to conventional hemodynamic assessment in PH related to CHD in children. PA wall thickness percentage correlates closely with PH severity and may serve as a sensitive marker of pulmonary vascular disease in children with CHD.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-7"},"PeriodicalIF":1.9,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148577212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eugene Braunwald (1929-2026). Primus Inter Pares. Personal Reflections on the \"First Among Equals\" in Cardiovascular Medicine.","authors":"Heinrich Taegtmeyer","doi":"10.1159/000552950","DOIUrl":"https://doi.org/10.1159/000552950","url":null,"abstract":"","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-6"},"PeriodicalIF":1.9,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}