Progress in cardiovascular diseases最新文献

{"title":"Heart rate variability in patients with cardiovascular diseases.","authors":"Muhammad Shahzeb Khan, Syed Sarmad Javaid, Robert J Mentz, JoAnn Lindenfeld, Hau-Tieng Wu, Jürgen H Prochaska, Jens Brock Johansen, Philipp S Wild, Dominik Linz, Wilfried Dinh, Marat Fudim","doi":"10.1016/j.pcad.2025.06.003","DOIUrl":"https://doi.org/10.1016/j.pcad.2025.06.003","url":null,"abstract":"<p><p>Heart rate variability (HRV) has been reported to predict overall mortality and the risk of cardiovascular disease events in patients, including those with heart failure. However, inconsistent methods of recording and analyzing HRV parameters, along with a lack of randomized data substantiating its clinical efficacy and potential to guide treatment decisions for improved patient outcomes, have limited its use in clinical settings. With the advancements in technologies such as artificial intelligence and machine learning, and emergence of ablation procedures that can alter autonomic function, this article re-explores HRV assessment methods, their potential for clinical application, the issues encountered in using them in clinical research, and potential approaches to studying HRV in the future (Graphical Abstract).</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287688","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":"Updates on inherited arrhythmia syndromes (Brugada syndrome, long QT syndrome, CPVT, ARVC).","authors":"Benjamin M Moore, Thomas M Roston, Zachary Laksman, Andrew D Krahn","doi":"10.1016/j.pcad.2025.06.002","DOIUrl":"https://doi.org/10.1016/j.pcad.2025.06.002","url":null,"abstract":"<p><p>The inherited arrhythmia (IA) syndromes are a group of rare and complex conditions that may predispose individuals to ventricular arrhythmias and sudden cardiac death. Our understanding of the genetic architecture underlying these syndromes has evolved, with recent reappraisals of variant pathogenicity and quantification of polygenic influences. The IA population includes an increasing proportion of low-risk patients, often identified via familial screening; avoiding over-treatment in these patients is an important consideration. Conversely, high-risk patients have an expanding armamentarium of targeted therapeutic interventions available beyond the ICD, with many emerging novel therapies. Refined risk stratification in the intermediate risk group is critical, utilising novel risk factors, genotype and multiparametric risk scores. Artificial intelligence will almost certainly play a role in diagnosis and risk stratification moving forward. Durable phenotype correction with gene therapy (or precision ablation) is an ultimate goal. This review will focus on updates in pathophysiology, diagnosis, risk stratification and management of Brugada syndrome, long QT syndrome, catecholaminergic polymorphic ventricular tachycardia and arrhythmogenic right ventricular cardiomyopathy.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287689","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":"Is it safe to use class 1C antiarrhythmic drugs in patients with coronary artery disease and/or cardiomyopathy?","authors":"Peter G Pantlin, Sahil Bharwani, Mina K Chung, Daniel P Morin","doi":"10.1016/j.pcad.2025.06.001","DOIUrl":"https://doi.org/10.1016/j.pcad.2025.06.001","url":null,"abstract":"<p><p>Class 1C antiarrhythmic drugs (AADs) are a key treatment option for effective rhythm control in several common arrhythmias. Here, we review the relevant background on Class 1C AADs, these drugs' indications and contraindications, and potential safe ways to use them. The safety profile of 1C AADs, and related restrictions on their use, has been largely based on the decades-old CAST trial, but more recent evidence may favor re-evaluating previously excluded populations. This review examines opportunities to reconsider certain patient populations that have previously been excluded from the use of 1C AADs. This reconsideration is made feasible due to advances in cardiac reperfusion, medical therapies for heart failure, and cardiac imaging.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144277101","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":"Effect of inclisiran on lipid and mechanical vascular profiles in familial hypercholesterolemia subjects: results from a single lipid center real-world experience.","authors":"Giosiana Bosco, Francesco Di Giacomo Barbagallo, Maurizio Di Marco, Sabrina Scilletta, Nicoletta Miano, Stefano Esposto, Giovanni Pennisi, Simone Prezzavento, Antonio Gallo, Ernestina Marianna De Francesco, Roberta Malaguarnera, Antonino Di Pino, Francesco Purrello, Salvatore Piro, Roberto Scicali","doi":"10.1016/j.pcad.2025.05.008","DOIUrl":"10.1016/j.pcad.2025.05.008","url":null,"abstract":"<p><strong>Background and aims: </strong>Familial hypercholesterolemia (FH) is characterized by elevated LDL-C and an increased risk of premature cardiovascular events. Inclisiran is a small interfering RNA that inhibits hepatic PCSK9 synthesis and promotes LDL-C clearance by enhancing LDLR expression on hepatocytes. This study aimed to evaluate the efficacy of six-months add-on inclisiran on lipid profile and PWV in FH; furthermore, we investigated the association between LDL-C reduction and PWV variation.</p><p><strong>Methods: </strong>This prospective observational study involved 78 genetically confirmed FH subjects with an LDL-C off-target despite high-intensity statins plus ezetimibe. All subjects obtained biochemical analysis and PWV evaluation at baseline and after six months add-on inclisiran.</p><p><strong>Results: </strong>After six months add-on inclisiran, 41 % of subjects achieved LDL-C targets. Significant reductions of LDL-C (-41.5 %, p < 0.001), ApoB (-33.7 %, p < 0.01), Non-HDL-C (-35.9 %, p < 0.001), and Lp(a) (-18 %, p < 0.01) were observed, while PWV improved by 14.4 % (p < 0.001). In a secondary analysis, the Primary prevention group showed a higher prevalence of subjects on LDL-C target than the Secondary prevention group (59 % vs 23.1 %, p < 0.001). Both groups exhibited significant improvements of lipid profile and PWV (Δ - 14.1 %, p < 0.01 and Δ - 14.6 %, p < 0.001, respectively). Linear regression showed a significant association between ΔPWV and ΔLDL-C in the whole study population as well as in the Primary and Secondary prevention groups (p for all <0.001).</p><p><strong>Conclusion: </strong>Inclisiran significantly improved lipid profile and PWV in FH subjects. ΔPWV was significantly associated with ΔLDL-C.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144176383","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":"Pulsed field ablation: The basics relating to effectiveness, durability, and safety.","authors":"Sara Vázquez-Calvo, Deepti Ranganathan, Atul Verma","doi":"10.1016/j.pcad.2025.05.007","DOIUrl":"10.1016/j.pcad.2025.05.007","url":null,"abstract":"<p><p>Pulsed field ablation (PFA) represents an innovative energy delivery approach for cardiac arrhythmia treatment, characterized by a favorable safety profile and effective myocardial lesion formation. It has demonstrated high acute pulmonary vein isolation rates with a reduced incidence of injury to adjacent anatomical structures. Nonetheless, procedure-specific complications such as haemolysis, intravascular gas formation, and coronary vasospasm have been observed and warrant further evaluation. Clinical evidence supports efficacy comparable to conventional thermal ablation in terms of arrhythmia recurrence. Ongoing advancements in catheter engineering, pulse modulation, and multimodal energy strategies aim to enhance lesion durability and transmurality. These developments position PFA as a promising technology in the field of cardiac ablation.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121877","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":"Atherogenic dyslipidemia and incident cardiovascular events in high-risk hypertension.","authors":"Richard Kazibwe, Jeshuah Jehopio, Christopher L Schaich, Rishi Rikhi, Saeid Mirzai, Parag A Chevli, Juliana H Namutebi, Sneha Chebrolu, Shannon O'Connor, Joseph Yeboah, Michael D Shapiro","doi":"10.1016/j.pcad.2025.05.006","DOIUrl":"10.1016/j.pcad.2025.05.006","url":null,"abstract":"<p><strong>Background: </strong>Atherogenic dyslipidemia (AD), characterized by low high-density lipoprotein cholesterol (HDL-C) and elevated triglycerides (TG), is associated with increased cardiovascular disease (CVD) risk. This study evaluates the association between AD and CVD in hypertension treated to systolic blood pressure (SBP) targets of <120 mmHg (intensive) or < 140 mmHg (standard).</p><p><strong>Methods: </strong>We included 9361 participants from the Systolic Blood Pressure Intervention Trial (SPRINT). Based on baseline lipid profiles, low HDL-C was defined as <40 mg/dL in men or < 50 mg/dL in women, and high TG as ≥150 mg/dL. Participants were classified into four lipid categories according to these cutoffs. AD was defined as the combination of low HDL-C and high TG. We used multivariable Cox regression to evaluate the association between lipid categories and the primary SPRINT outcome, a composite of major CVD events.</p><p><strong>Results: </strong>Over a median 3.8-year follow-up, 726 primary outcome events occurred. The incidence of the primary outcome was 9.5% (n = 104) in those with AD and 7.4% (n = 434) with normal HDL-C and TG. Compared to the reference group (normal HDL-C with normal TG), the hazard ratios (HRs) for primary outcome were 1.07 (95 % CI: 0.85-1.35) for high TG alone, 1.20 (95 % CI: 0.95-1.52) for low HDL-C alone, and 1.41 (95 % CI: 1.12-1.77) for AD. Similarly, HRs for the primary outcome associated with AD were 1.38 (95 % CI: 1.02-1.87) and 1.44 (95 % CI: 1.01-2.05) in the standard and intensive SBP-lowering arms, respectively.</p><p><strong>Conclusion: </strong>Among SPRINT participants, AD was associated with a higher CVD risk. Early detection of AD in hypertensive patients, even without diabetes, may prompt greater therapeutic effort to reduce long-term CVD risk.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144113154","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":"Personalizing risk assessment for transcatheter aortic valve replacement: Value of CT imaging and AI.","authors":"Andrew Lin, Thomas A Treibel, Marc R Dweck","doi":"10.1016/j.pcad.2025.05.001","DOIUrl":"10.1016/j.pcad.2025.05.001","url":null,"abstract":"","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103451","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":"First presentation of atherosclerotic cardiovascular disease in previously healthy individuals: The multi-ethnic study of atherosclerosis.","authors":"Jonathan Kermanshahchi, Andrew S Kao, Charlotte C Ellberg, Edward Duran, Michael H Criqui, Michael D Shapiro, Harpreet S Bhatia","doi":"10.1016/j.pcad.2025.05.004","DOIUrl":"10.1016/j.pcad.2025.05.004","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the first presentation of atherosclerotic cardiovascular disease (ASCVD) in individuals without known ASCVD.</p><p><strong>Methods: </strong>Distribution of first ASCVD events (angina, stroke, myocardial infarction [MI], or death/resuscitated cardiac arrest [RCA]), and the association between traditional risk factors, coronary artery calcium (CAC) and lipoprotein(a) [Lp(a)] with these events in Cox proportional hazards models were evaluated in 6779 participants in the Multi-Ethnic Study of Atherosclerosis. Risk prediction improvement with addition of CAC to the pooled cohort equations (PCE) was evaluated using net reclassification improvement (NRI).</p><p><strong>Results: </strong>The mean age was 62.1 ± 10.2 years and 1037 participants (15.3 %) experienced an ASCVD event over a median of 15.8 years. The most common first presentation was cardiovascular death/RCA (n = 287;27.7 %). Among those with events, Black (35.6 %, p = 0.001)) individuals more often presented with death/RCA, Hispanic (29.3 %, p = 0.037) individuals more often presented with stroke compared to White individuals (24.8 % and 21.7 %, respectively). Compared to men, women more frequently presented with stroke (29.5 vs. 20.7 %, p = 0.002) and death/RCA (29.8 vs 26.3 %, p = 0.243) though this did not meet statistical significance. CAC score was significantly associated with first presentation of all events, including death/RCA (HR 1.13, 95 % CI 1.07-1.19) and improved risk prediction when added to the PCE (continuous NRI 0.6081, 95 % CI 0.4971-0.7141). Lp(a) was significantly associated with MI only (HR 1.15 per SD, 95 % CI 1.02-1.29).</p><p><strong>Conclusions: </strong>In previously asymptomatic individuals, the most common initial presentation of ASCVD was death/resuscitated cardiac arrest, particularly among women, minority groups, and those with CAC. CAC scoring may identify individuals at risk for death/resuscitated cardiac arrest as a first presentation of ASCVD.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144087113","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 implantable electronic devices in pediatric and congenital populations.","authors":"Douglas Y Mah, John K Triedman","doi":"10.1016/j.pcad.2025.05.005","DOIUrl":"10.1016/j.pcad.2025.05.005","url":null,"abstract":"<p><p>Pediatric patients and children and adults with congenital heart disease often will require implantation of cardiac implantable electronic devices (CIEDs) for management of a variety of cardiac rhythm pathologies. The safe and effective use of CIEDs in these patients requires an awareness of important differences between this special population and the adult populations for whom these devices were primarily developed and in whom they have been most thoroughly studied. These include issues of body size and growth, anticipated lifespan, anatomical issues related to implantation and the epidemiology of underlying rhythm issues. In this paper, we discuss these issues in the context of the current state of the art in pediatric and congenital heart disease patients with respect to implant and lead extraction strategies, physiological cardiac pacing and resynchronization, ICD indications and use of transvenous and subcutaneous devices, and the use of implantable monitoring devices.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144087073","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":"A social ecological perspective on interventions to address short sleep duration in adults with coronary heart disease.","authors":"Codie R Rouleau, Sheila N Garland","doi":"10.1016/j.pcad.2025.05.003","DOIUrl":"10.1016/j.pcad.2025.05.003","url":null,"abstract":"<p><strong>Background: </strong>Short sleep duration (<7 h/day) affects one-third of the population, is implicated in morbidity and mortality from coronary heart disease (CHD), and is driven by an interplay of individual, social, and societal factors.</p><p><strong>Objective: </strong>To review observational and experimental studies that have tested interventions to address short sleep in various clinical presentations (sleep disorders, behaviorally induced short sleep, lack of sleep opportunity) and describe considerations needed for CHD populations.</p><p><strong>Conclusions: </strong>Few existing interventions have a primary aim to increase sleep duration in individuals with insufficient sleep, and none specifically target individuals with established CHD. Short sleep duration may be modifiable via treatment of insomnia, behavioral sleep extension, and system-level changes to healthcare settings, workplace policies, and communities. With further research on interventions that address diverse phenotypes of short sleep-while assessing long-term cardiometabolic outcomes, patient preferences, and mechanisms-of-action-sleep health could become an important component of CHD secondary prevention.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082889","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}