Cardiology journal最新文献

{"title":"Diagnostic performance of angiography-derived IMR for coronary microcirculation disease assessment in INOCA patients.","authors":"Marta Diachyshyn, Łukasz Niewiara, Piotr Szolc, Paweł Kleczyński, Paulina Judziało, Bartłomiej Guzik, Krzysztof Żmudka, Jacek Legutko","doi":"10.5603/cj.106088","DOIUrl":"10.5603/cj.106088","url":null,"abstract":"<p><strong>Background: </strong>Diagnosis of coronary microcirculatory dysfunction with wire-based methodology imposes a risk of unplanned revascularization in patients with ischemia and no obstructive coronary arteries (INOCA). Non-invasive, angiography-based methods are introduced to alleviate this risk. The angiography-based index of microcirculatory resistance (IMRangio) is a computational fluid dynamics (CFD)-based index utilizing high-quality angiography and aortic pressures to calculate a surrogate of the index of microcirculatory resistance (IMR).</p><p><strong>Aim of the study: </strong>This study aims to assess the correlation between IMRangio and invasive thermodilution-based IMR in INOCA patients qualified to the MOSAIC-COR registry.</p><p><strong>Methods: </strong>Data from 74 patients (92 coronaries including 52 left anterior descending arteries) from the MOSAIC-COR registry were used for this sub-analysis. All patients had undergone complex coronary physiology assessment using a thermistor-equipped wire and thermodilution-based methodology with subsequent vasomotor acetylcholine vasospasm testing. Post-hoc, CFD-based angiogram analysis was performed to calculate IMRangio values.</p><p><strong>Results: </strong>The median age of patients was 64 years, and 59.3% were female. The median calculated value of IMRangio was 29 (Q1-Q3: 22-46), whereas the invasively measured IMR median value was 17 (Q1-Q3: 13-26). A significant correlation between IMRangio and invasive-IMR was observed (Spearman rho 0.29, < 0.001). Angiography based index of microcirculatory resistance area under the curve (AUC) was 62.2, and a value > 46.5 U was identified as the best cut-off for prediction of IMR > 25 and provided 38% sensitivity and 82% specificity to detect coronary microcirculatory dysfunction (CMD).</p><p><strong>Conclusions: </strong>The angiography-based index of microcirculatory resistance significantly correlates with invasively measured IMR; however, a higher cut-off value should be considered to improve the specificity of the method to detect CMD.</p>","PeriodicalId":93923,"journal":{"name":"Cardiology journal","volume":" ","pages":"e00226026"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13189591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145598194","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":"Machine learning models of inflammatory markers used in the prediction of early and late atrial fibrillation recurrence in overweight and obese patients after catheter ablation.","authors":"Jan Budzianowski, Marcin Ostrowski, Raquel Fernandez-Peralta, Katarzyna Kaczmarek-Majer, Janusz Rzeźniczak, Dominika Kasprzak, Jarosław Hiczkiewicz, Pawel Burchardt","doi":"10.5603/cj.110248","DOIUrl":"10.5603/cj.110248","url":null,"abstract":"<p><strong>Background: </strong>Inflammation is associated with atrial fibrillation (AF) recurrence after catheter ablation. This study aimed to create machine learning models of inflammatory biomarkers and clinical parameters to predict early recurrence of atrial fibrillation (ERAF) and late recurrence of atrial fibrillation (LRAF) after catheter ablation.</p><p><strong>Methods: </strong>The study included 114 patients with abnormal body weight, defined as body mass index (BMI) > 25 kg/m², and paroxysmal, persistent, or long-standing persistent AF. Blood samples were collected at baseline and 24 hours after ablation. Almost 120 clinical and laboratory parameters were selected to develop machine learning models of ERAF and LRAF. Shapley additive explanations (SHAP) were derived to explain the obtained predictions. The models were trained and tuned for hyperparameters by five-fold cross-validation and subsequently evaluated on independent test sets using stratified sampling.</p><p><strong>Results: </strong>ERAF was observed in 20.3% of patients. LRAF was diagnosed in 26.3% of patients. The ERAF model with 5 variables - monocyte count, platelet-to-lymphocyte ratio (PLR), fibrinogen, and parameters measured before ablation, such as glomerular filtration rate (GFR) and left atrial volume - performed well in the studied cohort (mean AUC, 0.70 ± 0.06). The LRAF model with parameters such as neutrophil-to-lymphocyte ratio (NLR), soluble vascular cell adhesion molecule-1 (sVCAM-1), troponin, monocyte-to-HDL-C ratio (MHR), adiponectin, and ERAF also showed valuable performance (mean AUC, 0.77 ± 0.11).</p><p><strong>Conclusions: </strong>The machine learning model based on inflammatory biomarkers is a valuable tool for predicting ERAF. The combination of ERAF and inflammatory biomarkers significantly improves LRAF prediction.</p>","PeriodicalId":93923,"journal":{"name":"Cardiology journal","volume":"33 ","pages":"e00226057"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13262698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148145631","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":"Transcatheter aortic valve-in-valve implantation for failed surgical aortic bioprostheses using the Navitor platform: early outcomes in a consecutive single-center cohort.","authors":"Robert Sobczyński, Jarosław Trębacz, Paweł Kleczyński, Bogusław Kapelak, Maciej Stąpór, Filip Dudkowski, Janusz Konstanty-Kalandyk, Jacek Legutko","doi":"10.5603/cj.111703","DOIUrl":"10.5603/cj.111703","url":null,"abstract":"<p><strong>Introduction: </strong>Transcatheter heart valve implantation into a failed surgical heart valve (THV-in-SHV) is an established reintervention strategy for degenerated aortic bioprostheses; however, early procedural outcomes, discharge hemodynamics, and standardized safety remain clinically relevant in routine practice.</p><p><strong>Material and methods: </strong>We retrospectively analyzed consecutive patients who underwent aortic THV-in-SHV with the Navitor platform between 2022 and 2025. The primary endpoint was the mean aortic gradient at discharge. Secondary endpoints included peak gradient, maximum transvalvular velocity (Vmax), paravalvular leak (PVL), Valve Academic Research Consortium-3 (VARC-3) early safety, and time from surgical aortic valve replacement (SAVR) to reintervention according to leaflet mounting.</p><p><strong>Results: </strong>Thirty patients were included (age, 72.5 ± 9.2 years; 73.3% male). At discharge, the mean and peak aortic gradients were 16.8 ± 6.7 mmHg and 30.0 ± 11.7 mmHg, respectively. Paravalvular leak was absent, trace, or mild in 96.7%, with no severe PVL. Early safety according to VARC-3 was achieved in 86.7%. Mortality and stroke occurred in 3.3% each, and bleeding type ≥ 2 occurred in 6.7%. No acute kidney injury (AKI) stage 3, renal replacement therapy (RRT), major vascular complications, device-related intervention, or new permanent pacemaker implantation occurred. Smaller surgical valves were associated with higher residual gradients, whereas outside-mounted bioprostheses showed a shorter time to reintervention than inside-mounted designs.</p><p><strong>Conclusions: </strong>Aortic THV-in-SHV with the Navitor platform was associated with acceptable discharge hemodynamics, low rates of clinically relevant PVL, and favorable early safety according to VARC-3. Residual gradients were driven primarily by surgical valve size despite the intra-annular design.</p>","PeriodicalId":93923,"journal":{"name":"Cardiology journal","volume":"33 ","pages":"e00226072"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012877","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":"Intrapericardial cavernous hemangioma: a rare cause of persistent dyspnea and a diagnostic challenge.","authors":"Zhiyuan Jin, Jiancheng Han, Yaxi Wang, Dong Chen, Xiaoshan Zhang","doi":"10.5603/cj.106311","DOIUrl":"10.5603/cj.106311","url":null,"abstract":"","PeriodicalId":93923,"journal":{"name":"Cardiology journal","volume":"33 ","pages":"e00226060"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13313812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148320836","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":"Endoscopic implantation of an aortic valve prosthesis with a flexible support frame.","authors":"Paweł Czub, Krzysztof Wróbel, Beata Błaszczyk, Adam Arendarczyk, Dariusz Zieliński, Jakub Zieliński, Marcin Zygier, Ryszard Wojdyga, Agata Bilewska","doi":"10.5603/cj.106564","DOIUrl":"10.5603/cj.106564","url":null,"abstract":"","PeriodicalId":93923,"journal":{"name":"Cardiology journal","volume":"33 ","pages":"e00226056"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13262695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148019346","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":"MAPH score improves stroke risk prediction in paroxysmal atrial fibrillation: a comparison with CHA₂DS₂-VASc.","authors":"Ali Duygu, Fahri Er, Alkame Akgümüş, Ahmet Balun, Eren Tobcu","doi":"10.5603/cj.109105","DOIUrl":"10.5603/cj.109105","url":null,"abstract":"<p><strong>Background: </strong>Paroxysmal atrial fibrillation (PAF) increases the risk of ischemic stroke. The CHA₂DS₂-VASc score is commonly used for stroke risk assessment but has some limitations in low-risk individuals. The MAPH score has been suggested as a simple predictor of thrombotic events in patients with myocardial infarction, although its effectiveness in patients with PAF remains uncertain. This study aimed to compare the predictive performance of the MAPH score and the CHA₂DS₂-VASc-M score for ischemic stroke in patients with PAF.</p><p><strong>Methods: </strong>This retrospective study included 474 patients (253 with ischemic stroke and 221 without stroke) between January 2023 and July 2025. The MAPH score was calculated using mean platelet volume (MPV), age, total protein, and hematocrit (HCT). Age was excluded from the MAPH score when creating CHA₂DS₂-VASc-M to avoid redundancy. Receiver operating characteristic (ROC) analysis and logistic regression were used to evaluate predictive performance.</p><p><strong>Results: </strong>MPV, total protein, HCT, and MAPH scores were significantly higher in patients with stroke (p < 0.001 for all). ROC analysis showed that the MAPH score had an area under the curve (AUC) of 0.706, CHA₂DS₂-VASc 0.595, and CHA₂DS₂-VASc-M 0.667. In low-risk patients (CHA₂DS₂-VASc ≤1), MAPH (AUC 0.719) and CHA₂DS₂-VASc-M (AUC 0.711) performed better than CHA₂DS₂-VASc alone (AUC 0.510). Multivariate logistic regression identified MAPH, CHA₂DS₂-VASc-M, MPV, total protein, and HCT as independent predictors of ischemic stroke.</p><p><strong>Conclusions: </strong>The MAPH score, whether used independently or alongside CHA₂DS₂-VASc, enhances the prediction of ischemic stroke among patients with PAF, especially in low-risk groups. Including MAPH in standard risk evaluations could improve decisions regarding anticoagulant therapy.</p>","PeriodicalId":93923,"journal":{"name":"Cardiology journal","volume":"33 ","pages":"e00226052"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13189605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944039","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":"Lipoprotein(a) and clinical characteristics of Polish patients hospitalized in a tertiary referral hospital - an observational, cross-sectional study.","authors":"Julia M Umińska, Jakub Ratajczak, Jacek Kubica","doi":"10.5603/cj.109434","DOIUrl":"10.5603/cj.109434","url":null,"abstract":"","PeriodicalId":93923,"journal":{"name":"Cardiology journal","volume":"33 ","pages":"e00226024"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13170441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446389","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":"Remote ECG monitoring as a diagnostic tool for therapeutic strategies after transcatheter aortic valve replacement: rationale and design of the DRAGON-TAVI randomized trial.","authors":"Paulina Lis, Maciej Koźlik, Marta Chamera, Andrzej Kułach, Grzegorz Smolka, Malwina Smolarek, Michał Orszulak, Katarzyna Mizia-Stec, Krzysztof Szydło, Krzysztof Gołba, Sylwia Gładysz-Wańha, Łukasz Kuźma, Łukasz Morkisz, Radosław Gocoł, Damian Hudziak, Fabrizio D'Ascenzo, Gaetano Maria de Ferrari, Gregory Y H Lip, Wojciech Wojakowski, Krystian Wita, Wojciech Wańha","doi":"10.5603/cj.111069","DOIUrl":"10.5603/cj.111069","url":null,"abstract":"","PeriodicalId":93923,"journal":{"name":"Cardiology journal","volume":"33 ","pages":"e00226061"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13313813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148321094","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":"Artificial intelligence as the missing integrator in heart failure care - from remote monitoring to personalized therapy.","authors":"Jacek Kubica, Tomasz Topoliński, Robert Gajda, Przemysław Musz, Aldona Kubica, Łukasz Szarpak, Krzysztof Nowicki, Marcin Ziółkowski, Sebastian Meszyński, Sławomir Grzelak, Oleksandr Sokolov, Jakub Ratajczak, Julia M Umińska, Piotr Niezgoda, Klaudyna Grzelakowska, Przemysła Podhajski, Karolina Obońska, Ewa Laskowska, Ryszard Piotrowicz, Agnieszka Tycińska, Giuseppe Specchia, Stefan Frantz, Stefan Störk, Eliano P Navarese","doi":"10.5603/cj.111624","DOIUrl":"10.5603/cj.111624","url":null,"abstract":"<p><p>Heart failure (HF) remains a leading cause of morbidity, mortality, and healthcare utilization worldwide, despite the availability of effective evidence-based therapies. The principal challenge is no longer the absence of treatment options but the limited capacity of traditional care models to deliver guidelinedirected medical therapy (GDMT) consistently and at scale. The COVID-19 pandemic exposed the fragility of hospital-centered HF care, highlighting the need for more resilient, patient-centered management strategies. Remote monitoring (RM) has been proposed as a solution, yet its clinical impact has been inconsistent due to fragmented data streams, declining patient adherence, and heavy reliance on continuous human oversight. Artificial intelligence (AI) offers an opportunity to address these limitations by integrating multidimensional clinical data, enabling earlier detection of deterioration, supporting adherence, and prioritizing clinically meaningful interventions. Emerging evidence suggests that AI-assisted workflows can accelerate GDMT optimization and improve surrogate and clinical outcomes when implemented within supervised care pathways. This has led to the concept of next-generation remote monitoring (NGRM), in which AI analyzes longitudinal physiological and behavioral signals to generate context-aware alerts and actionable recommendations while reducing clinical workload. Successful implementation, however, requires rigorous validation, clear governance, integration with clinical workflows, and safeguards for safety, equity, and accountability. When embedded within structured HF care pathways, AI-enabled monitoring may help bridge the persistent gap between evidence and real-world implementation.</p>","PeriodicalId":93923,"journal":{"name":"Cardiology journal","volume":"33 ","pages":"e00226032"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13170452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505495","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":"One-time versus staged multivessel percutaneous coronary intervention in patients with non-ST-segment elevation acute coronary syndrome: a systematic review and meta-analysis.","authors":"Shu-Qing Yang, Ya-Hui Zhang, Tian-Qing Cao, Zhao-Ke Bu, Sha Hou, Jia-le Liu, Li-Ting Zhang, Ming-Xing Chen","doi":"10.5603/cj.110257","DOIUrl":"10.5603/cj.110257","url":null,"abstract":"<p><strong>Introduction: </strong>The optimal revascularization strategy for patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) and multivessel disease remains uncertain. This meta-analysis aimed to evaluate the impact of one-time versus staged multivessel percutaneous coronary intervention (PCI) on clinical outcomes.</p><p><strong>Material and methods: </strong>PubMed, Embase, and the Cochrane Library were searched for randomized controlled trials and cohort studies comparing one-time and staged PCI in NSTE-ACS patients with multivessel disease from January 1, 2000 to June 4, 2026. Study quality was assessed, data were extracted independently by two reviewers, and pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using R software and the meta package.</p><p><strong>Results: </strong>Ten studies involving 6,749 patients (4,235 one-time PCI; 2,514 staged PCI) were included. In randomized trials, one-time PCI significantly reduced repeat revascularization (RR = 0.71, 95% CI 0.51-0.98, p = 0.037) versus staged PCI, with no differences in mortality or recurrent myocardial infarction. Cohort studies and the pooled analysis showed no significant differences across outcomes.</p><p><strong>Conclusions: </strong>For NSTE-ACS patients with multivessel disease, multivessel revascularization in a single procedure may reduce repeat revascularization compared with staged PCI, but the evidence remains limited.</p>","PeriodicalId":93923,"journal":{"name":"Cardiology journal","volume":"33 ","pages":"e00226077"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129549","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}