Progress in cardiovascular diseases最新文献

{"title":"Effect of physical exercise-based cardiac rehabilitation on frail patients with heart failure: focus on endothelial dysfunction.","authors":"Rosanna Maniscalco, Rina Recchioni, Sara Caccese, Valeria Pellegrini, Angelica Giuliani, Lorenzo Pimpini, Daniele Caraceni, Gaia Cattadori, Andrea Passantino, Fabiola Olivieri, Francesco Prattichizzo, Giulia Matacchione","doi":"10.1016/j.pcad.2026.05.001","DOIUrl":"https://doi.org/10.1016/j.pcad.2026.05.001","url":null,"abstract":"<p><p>This narrative review examines the interplay between frailty, heart failure (HF), and endothelial dysfunction, with a specific focus on the role of exercise-based cardiac rehabilitation (CR) in older and frail adults. Frailty and HF frequently coexist and share pathophysiological mechanisms - including chronic inflammation, oxidative stress, and impaired nitric oxide (NO) signaling - that exacerbate endothelial dysfunction and contribute to reduced functional capacity and poor prognosis. We synthesize current evidence linking endothelial impairment to both frailty and HF progression, and we evaluate findings from clinical trials investigating exercise-centered CR, hybrid CR, and cardiac telerehabilitation in this population. Across studies, CR consistently improves physical performance, exercise tolerance, and quality of life, with several trials reporting measurable enhancements in endothelial function, such as improved flow-mediated dilation or increased mobilization of endothelial progenitor cells. Benefits appear strongest when programs are multidomain and individualized to the frailty phenotype, integrating aerobic, resistance, balance, and mobility training. However, heterogeneity in study designs, limited enrollment of frail older adults, and the frequent designation of endothelial outcomes as secondary endpoints constrain the ability to draw firm mechanistic conclusions. Overall, available evidence indicates that CR is a feasible and effective therapeutic strategy to counteract vascular dysfunction, reduce frailty severity, and potentially disrupt the negative cycle that accelerates HF progression in older patients. Future studies should prioritize frail populations, adopt standardized endothelial assessments as primary outcomes, and evaluate long-term clinical impact. Tailored CR models, including hybrid and telerehabilitation programs, are likely essential to improve access, adherence, and vascular outcomes in this vulnerable group.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IGF-1 and vitamin D: Risk biomarkers or causal mediators of recovery after acute MI?","authors":"Sumeet A Khetarpal, Antonio Abbate","doi":"10.1016/j.pcad.2026.05.002","DOIUrl":"https://doi.org/10.1016/j.pcad.2026.05.002","url":null,"abstract":"","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refining sudden cardiac death risk in hypertrophic cardiomyopathy: The interplay between atrial and ventricular arrhythmias.","authors":"Alexander Kukuev, Dor Ravid, Florian Rader","doi":"10.1016/j.pcad.2026.04.010","DOIUrl":"https://doi.org/10.1016/j.pcad.2026.04.010","url":null,"abstract":"","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of Corona virus disease - 2019 on coronary atherosclerosis: Rationale and design of the COrona VIrus Disease-2019 computed tomography (COVID-CT) registry.","authors":"Minel Soroa, Anastasia K Filimonov, Sophie E van Rosendael, Ali Dakroub, Marcos Ferrandez Escarabajal, Hassan Beesley, Solomon W Bienstock, Gina LaRocca, Krishna Patel, Jiwon Kim, Jonathan W Weinsaft, Lishomwa Ndhlovu, Mario J Garcia, Andrew J Einstein, Michael Poon, Jill E Jacobs, Lawrence M Phillips, Roosha Parikh, Rachel Eddy, Arthur Shiyovich, Leandro Slipczuk, Jonathon Leipsic, Jagat Narula, Deepak Bhatt, Fay Y Lin, Charalambos Antoniades, Ron Blankstein, Leslee J Shaw","doi":"10.1016/j.pcad.2026.03.008","DOIUrl":"10.1016/j.pcad.2026.03.008","url":null,"abstract":"<p><strong>Background: </strong>Infection with the severe acute respiratory syndrome coronavirus-2 (SARSCoV-2), the virus which causes the corona virus disease-2019 (COVID-19) has substantial evidence that patients with pre-existing coronary artery disease (CAD) have an increased risk of serious illness, adverse coronary events, and mortality following infection. The COVID-CT registry will assess whether COVID-19 alters progression of coronary atherosclerotic plaque in patients with previously defined anatomic CAD on coronary computed tomographic angiography (CCTA). Mediators and covariates such as disease severity, inflammation, and neighborhood deprivation will also be assessed.</p><p><strong>Design: </strong>The COVID-CT registry is a multicenter, longitudinal observational registry enrolling patients including patients with pre-pandemic atherosclerosis observed by CCTA from New York City and Long Island to determine the impact of COVID-19 infection. The primary aim is to test the hypothesis that patients with previously defined anatomic CAD by CCTA who are subsequently infected with SARS-CoV-2 have accelerated progression of total and noncalcified atherosclerotic plaque volumes when compared to uninfected patients. We hypothesize that systemic inflammation is a key promoter in the formation and progression of atherosclerotic plaque. Additionally, we will test whether measurement of the perivascular fat attenuation index detects high risk, coronary artery inflammation following COVID infection.</p><p><strong>Summary: </strong>The impact of this first in-kind registry will be foundational for revising standard diagnostic pathways and risk assessment used to guide preventive care for millions of patients with CAD at increased risk from viral infection.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lipoprotein(a), remnant cholesterol, and high-sensitivity C-reactive protein as complementary biomarkers for myocardial infarction risk assessment.","authors":"Richard Kazibwe, Christopher L Schaich, Jeff A Kingsley, Parag Chevli, Saeid Mirzai, Rishi Rikhi, Michael D Shapiro","doi":"10.1016/j.pcad.2026.04.011","DOIUrl":"10.1016/j.pcad.2026.04.011","url":null,"abstract":"<p><strong>Background: </strong>The predictive value of lipoprotein(a) (Lp[a]), high-sensitivity C-reactive protein (hsCRP), and remnant cholesterol (RC) beyond low-density lipoprotein cholesterol (LDL-C) varies across cardiovascular disease (CVD) outcomes. This analysis evaluates the extent to which concentrations of these non-LDL-C biomarkers improve MI-specific risk prediction in a primary prevention population.</p><p><strong>Methods: </strong>We analyzed 306,183 UK Biobank participants free of cardiovascular disease at baseline with available Lp(a), RC, and hsCRP measurements. RC was calculated as total cholesterol minus LDL-C minus high-density lipoprotein cholesterol (HDL-C). Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox regression across biomarker quintiles and cumulative biomarker burden. The primary endpoint was the first MI event.</p><p><strong>Results: </strong>Over 15 years of follow-up, 10,824 MI events occurred. In fully adjusted models comparing quintile 5 with quintile 1, HRs (95% CI) were 1.09 (1.08-1.11) for Lp(a), 1.14 (1.13-1.16) for RC, and 1.08 (1.06-1.10) for hsCRP. Per-SD increases were associated with higher MI risk for RC 1.22 (1.20-1.25), Lp(a) 1.16 (1.13-1.18), and hsCRP 1.13 (1.10-1.15). The risk of MI increased stepwise with cumulative biomarker burden; compared with individuals with no biomarker in the top quintile, HRs (95% CI) were 1.45 (1.39-1.51), 2.14 (2.02-2.26), and 2.83 (2.48-3.24) for those with one, two, or all three elevated biomarkers, respectively.</p><p><strong>Conclusions: </strong>Lp(a), RC, and hsCRP each provide independent and complementary information for MI risk. Their combined elevation identifies individuals at higher MI risk, suggesting selective testing of all three biomarkers in primary prevention.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147825339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Papillary muscle LGE for sudden cardiac death risk stratification: Another brick beyond the wall - But can we see it clearly?","authors":"Stefano Figliozzi, Dario Donia, Diego Penela","doi":"10.1016/j.pcad.2026.04.007","DOIUrl":"10.1016/j.pcad.2026.04.007","url":null,"abstract":"","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147825330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The cost of missing cardiovascular data in South Asia and the promise of lifecard.","authors":"Aleesha Shaik, Deepak L Bhatt","doi":"10.1016/j.pcad.2026.04.008","DOIUrl":"https://doi.org/10.1016/j.pcad.2026.04.008","url":null,"abstract":"","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147825336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advanced CCTA imaging, angiography-based Radial Wall strain and μFR versus IVUS-NIRS to enhance identification of lipid-rich vulnerable plaques: A multimodality imaging approach.","authors":"Stefano Galli, Ettore Ventura, Edoardo O Genta, Saima Mushtaq, Andrea Baggiano, Stefano De Martini, Chiara Morocutti, Alice Bonomi, Piero Montorsi, Gianluca Pontone","doi":"10.1016/j.pcad.2026.04.009","DOIUrl":"10.1016/j.pcad.2026.04.009","url":null,"abstract":"<p><strong>Background and aims: </strong>Identifying vulnerable coronary plaques (VP) is essential for stratifying cardiovascular risk in stable coronary artery disease (CAD). This is the first study to assess diagnostic performance in detecting VP of CCTA advanced plaque analysis, including maximal plaque burden (PB_max) and necrotic core area, angiography-derived radial wall strain (RWS_max) and Murray's quantitative flow ratio (μFR) by using Intravascular Ultrasound with Near-Infrared Spectroscopy (IVUS-NIRS) as gold standard.</p><p><strong>Methods: </strong>We analyzed fifty lesions from forty-three patients who underwent coronary angiography with IVUS-NIRS following CCTA. VP were defined using IVUS-NIRS criteria as maximal Lipid Core Burden Index ≥325. Regression analyses evaluated associations between the imaging parameters and VP. Receiver-operating-characteristic (ROC) curves and the corresponding areas under the curve (AUCs) were calculated to quantify the diagnostic performance of each model.</p><p><strong>Results: </strong>VP was found in 19 out 50 lesions (38%) and in 16 out of 43 patients (37%). About CCTA, PB_max and necrotic core area showed the highest accuracy in identification of VP (AUC = 0.839 and AUC = 0.876, respectively). Regarding invasive evaluation, angiography-derived RWS_max demonstrated significant discriminative ability for detecting VP, whereas μFR did not (AUC = 0.921 and AUC = 0.637, respectively). Two multivariate models were tested: the first, combining PB_max and RWS_max, achieved an AUC of 0.959; the second model, based only on CCTA-derived parameters (PB_max and necrotic core area), yielded an AUC of 0.939. Although the difference between the two AUCs was not statistically significant, the combined model substantially improved the positive predictive value compared to the CCTA-only model (93.8% vs. 76.2%).</p><p><strong>Conclusions: </strong>Integrating CCTA-derived PB_max with angiography-derived RWS_max provides high discrimination of VP and may guide selective referral to IVUS-NIRS for definitive characterization.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gout as a cardiovascular risk factor: implications beyond the joint.","authors":"Edoardo Cipolletta, Gianluca Moroncini","doi":"10.1016/j.pcad.2026.04.006","DOIUrl":"https://doi.org/10.1016/j.pcad.2026.04.006","url":null,"abstract":"","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CarDiac magnEtic resonance for prophylactic implantable cardioVerter defibrillAtor ThErapy in ischemic dilated CardioMyopathy: Prognostic implication of papillary muscles involvement.","authors":"Giuseppe Muscogiuri, Andrea Igoren Guaricci, Laura Fusini, Alberto Senatieri, Raffaele Abete, Giovanni Donato Aquaro, Andrea Baggiano, Andrea Barison, Jan Bogaert, Leonardo Calo', Giovanni Camastra, Maria Cristina Carella, Samuela Carigi, Nazario Carrabba, Grazia Casavecchia, Stefano Censi, Gloria Cicala, Carlo N De Cecco, Marco Matteo Ciccone, Manuel De Lazzari, Gabriella Di Giovine, Monica Dobrovie, Marta Focardi, Nicola Gaibazzi, Annalaura Gismondi, Matteo Gravina, Marco Guglielmo, Chiara Lanzillo, Massimo Lombardi, Valentina Lorenzoni, Jordi Lozano-Torres, Davide Margonato, Chiara Martini, Francesca Marzo, Pier-Giorgio Masci, Ambra Masi, Claudio Moro, Saima Mushtaq, Alberto Nese, Alessandro Palumbo, Anna Giulia Pavon, Patrizia Pedrotti, Martina Perazzolo Marra, Silvia Pradella, Cristina Presicci, Mark G Rabbat, Claudia Raineri, Jose' F Rodriguez-Palomares, Stefano Sbarbati, Akos Varga-Szemes, Angelo Squeri, Nicola Sverzellati, Rolf Symons, Emily Tat, Mauro Timpani, Giancarlo Todiere, Adele Valentini, Alessandra Volpe, Sandro Sironi, Juerg Schwitter, Gianluca Pontone","doi":"10.1016/j.pcad.2026.04.005","DOIUrl":"10.1016/j.pcad.2026.04.005","url":null,"abstract":"<p><strong>Aims: </strong>Implantable cardioverter-defibrillator (ICD) therapy is the most effective prophylactic strategy of sudden cardiac death (SCD) in patients with ischemic cardiomyopathy (ICM). The aim of current analysis is to evaluate the prognostic impact of late gadolinium enhancement-papillary muscles (LGE-PMs) at cardiovascular magnetic resonance (CMR) and specifically its capability to re-stratify the arrhythmic risk on top to the DERIVATE-ICM Risk Score previously published.</p><p><strong>Methods: </strong>Eighty-hundred-thirty-nine patients (mean age 65 ± 11 years; males:721[86%]) with ICM and TTE-LVEF <50% were enrolled from the DERIVATE-ICM registry (CarDiac MagnEtic Resonance for Primary Prevention Implantable CardioVerter DebrillAtor ThErapy- Ischemic Cardiomyopathy). Major adverse arrhythmic cardiac events (MAACE) were the primary endpoints.</p><p><strong>Results: </strong>During a median follow-up of 1054 days, MAACE occurred in 86 (9.7%). DERIVATE-ICM Risk Score quartiles Q2-Q3 (HR:2.124 [95% CI:1.084-4.162]; p = 0.028), Q4 (HR: 3.865 [95% CI: 1.875-7.970]; p < 0.001) and the involvement of isolated posteromedial (P)PM (HR:1.985 [95% CI:1.073-3.673]; p = 0.029) were independent predictors of MAACE. The Kaplan-Meier survival curves showed a higher event-free rate in absence of LGE-PPM in patients categorized in the DERIVATE-ICM Risk Score quartiles Q2-Q3 (p = 0.018). Finally, adding LGE-PPM involvement on top of the model included TTE LVEF<35% plus DERIVATE-ICM Risk Score quartiles Q2-Q3 provided a significant improvement of prognostic stratification (p = 0.044).</p><p><strong>Conclusion: </strong>This study suggests that, in a wide population of ICM patients, LGE-PPM is independently associated with the occurrence of MAACE. In the intermediate quartiles of the DERIVATE-ICM Risk Score, the absence of LGE-PPM, when added to the Score, may contribute to downward re-stratification of arrhythmic risk.</p><p><strong>Clinical trial registration: </strong>RCT#NCT03352648.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}