Progress in cardiovascular diseases最新文献

{"title":"Evolution of patient characteristics and outcomes in ATTR-CM clinical trials: A systematic review.","authors":"Ahmad Masri, Richard Wright, Marissa Betts, Louis Lavoie, Liana Hennum, Jean-François Tamby, Heather Falvey, Sandesh Dev, Jose Nativi-Nicolau","doi":"10.1016/j.pcad.2026.04.004","DOIUrl":"https://doi.org/10.1016/j.pcad.2026.04.004","url":null,"abstract":"<p><strong>Background: </strong>Over the past decade, advancements in awareness, diagnosis, and new treatment options for transthyretin amyloid cardiomyopathy (ATTR-CM) have likely influenced the characteristics of patient populations enrolled in clinical trials. This systematic review aims to assess temporal trends in baseline characteristics of patients enrolled in ATTR-CM clinical trials.</p><p><strong>Methods: </strong>Systematic literature searches were conducted on September 25, 2024, using Embase, MEDLINE, and Cochrane databases via Ovid, and were supplemented by gray literature searches. Overall, 58 publications on 13 clinical trials enrolling patients with ATTR-CM during 2008-2022 were included. Baseline characteristics of participants enrolled in these trials and key clinical outcomes, including all-cause mortality (ACM), were analyzed.</p><p><strong>Results: </strong>Key baseline characteristics - including the proportion of participants with variant ATTR-CM; New York Heart Association class; N-terminal pro-B-type natriuretic peptide and troponin levels; and estimated glomerular filtration rate - varied according to enrollment year. ACM in placebo groups at 12 months decreased from 9.0% in ATTR-ACT (2013-2015) to 6.9% in ATTRibute-CM (2019-2020), 5.6% in APOLLO-B (2019-2021), and 4.3% and 5.5% in HELIOS-B (overall and monotherapy populations, respectively; 2019-2021).</p><p><strong>Conclusions: </strong>Patients enrolled in more recent clinical trials exhibited baseline characteristics consistent with less advanced ATTR-CM than earlier clinical trials. These descriptive findings are consistent with a temporal shift toward earlier identification and enrollment of patients with ATTR-CM, occurring alongside advances in diagnostic techniques and availability of disease-modifying treatments. These observations highlight the importance of evaluating the relevance of clinical outcomes and trial design in evolving patient populations and therapeutic landscapes.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147719198","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":"Beyond the treadmill: The evolving role of coronary CTA in perioperative risk stratification.","authors":"Omar Chehab, Armin Arbab-Zadeh","doi":"10.1016/j.pcad.2026.04.001","DOIUrl":"https://doi.org/10.1016/j.pcad.2026.04.001","url":null,"abstract":"","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679763","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":"Digital care in your pocket: The role of technology in exercise, fitness, prevention, and rehabilitation.","authors":"Patrick Dunn, Rachael Charbonneau, Cemal Ozemek, Ross Arena, Ulrik Wisløff","doi":"10.1016/j.pcad.2026.04.002","DOIUrl":"10.1016/j.pcad.2026.04.002","url":null,"abstract":"<p><strong>Purpose: </strong>The digital transformation of healthcare is creating new opportunities to enhance access, engagement, and outcomes in exercise, fitness, cardiovascular disease (CVD) prevention, and rehabilitation. This review synthesizes current evidence on digital health technologies across the cardiovascular care continuum, emphasizing their role in promoting physical activity in both primary and secondary prevention.</p><p><strong>Methods: </strong>A narrative review was conducted examining mobile health applications, wearable devices, artificial intelligence, remote monitoring platforms, and emerging technologies including virtual reality, 5G connectivity, and large language models. Applications were evaluated in the context of CVD prevention, rehabilitation, and behavior change.</p><p><strong>Results: </strong>Digital tools can personalize exercise prescriptions, monitor physiologic metrics, and support remote supervision in clinical and community settings. Wearables and mobile platforms demonstrate utility in improving adherence, fitness, and CVD risk. AI-driven systems enable adaptive programming, patient monitoring, and predictive modeling, while virtual and augmented reality offer immersive options for home-based rehabilitation. Persistent barriers include digital literacy, inequitable access, and data privacy concerns.</p><p><strong>Conclusion: </strong>Digital health technologies are reshaping exercise-based cardiovascular care. When coupled with behavior change strategies and ethical implementation, they can extend the reach and impact of physical activity interventions. Further research is needed to guide clinical integration, long-term evaluation, and equitable adoption.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647991","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":"Charting individualized pathways: IGF-1 and vitamin D in guiding personalized medicine for residual risk after AMI.","authors":"Aneta Aleksova, Milijana Janjusevic, Maria Marketou, Antonio Paolo Beltrami, Elena Dozio, Giulia Vanin, Lorenzo Zandonà, Andrea Chicco, Daria Beltrame, Francesco Perone, Giulia Barbati, Andrea Giustina, Gianfranco Sinagra, Alessandra Lucia Fluca","doi":"10.1016/j.pcad.2026.04.003","DOIUrl":"10.1016/j.pcad.2026.04.003","url":null,"abstract":"<p><strong>Background: </strong>Insulin-like growth factor-1 (IGF-1) and vitamin D are crucial for overall health. Imbalances in these markers are increasingly recognized as pivotal contributors to cardiovascular and residual risks following acute myocardial infarction (AMI). This study evaluated the prognostic value of IGF-1 and vitamin D levels for CAD severity and long-term outcomes in AMI survivors.</p><p><strong>Methods: </strong>We included 681 AMI patients admitted to the University Hospital of Trieste between 2014 and 2023.</p><p><strong>Results: </strong>Mean age was 66.3 years; 73.2% were male, and 71.9% had STEMI. The median IGF-1 level was 539 pg/ml and it was found to decline with ageing and with worsening kidney function. 56.1% of patients had hypovitaminosis D (HypoD), which was associated with higher levels of inflammation (CRP, IL-1β) and lower IGF-1 concentrations. Both low and high IGF-1 levels independently predicted severe CAD, indicating a U-shaped association. Over a median 51-month follow-up, 265 patients reached the composite endpoint and IGF-1 levels were lower in patients with events. Furthermore, continuous hazard ratio analysis revealed that IGF-1 levels below the median were linearly associated with adverse outcomes. Patients with the dual burden of low IGF-1 and HypoD exhibited higher probability of the composite endpoint. This combination independently predicted adverse outcomes (HR 1.43), alongside traditional risk factors such as age, LVEF, elevated HbA1C, CAD severity and impaired renal function.</p><p><strong>Conclusion: </strong>Low IGF-1 levels were associated with severe CAD and worse prognosis. This risk was further increased in patients with co-existing HypoD, thus additional studies are needed to determine how these biomarkers can be integrated into the clinical management of the patients.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147648036","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":"Obstructive sleep apnea and cardiac arrest in hypertrophic cardiomyopathy: An analysis of the nationwide inpatient sample database.","authors":"Maisha Maliha, Ahmed Abdelaziz, Vikyath Satish, Sananda Halder, Vishakha Modak, Diana Inshyna, Francesco Castagna, Ilir Agalliu, Annalisa Filtz, Daniel Lorenzatti, Adaya Weissler-Snir, Leandro Slipczuk, Mario J Garcia, Aldo L Schenone","doi":"10.1016/j.pcad.2026.03.007","DOIUrl":"10.1016/j.pcad.2026.03.007","url":null,"abstract":"<p><strong>Background: </strong>The association between OSA and sudden cardiac death (SCD) risk in patients with hypertrophic cardiomyopathy (HCM) is poorly defined. We hypothesized that OSA may be associated with the risk of cardiac arrest and ventricular fibrillation (CA-VF) in HCM patients.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of the National Inpatient Sample (2016-2020), including adults with HCM without prior history of SCD. Patients were stratified by the presence of OSA. The primary outcome was a composite of CA-VF. Multivariate logistic regression and propensity score matching (PSM) assessed the association between OSA and outcomes, adjusting for age, gender, family history of SCD, CIHD, AF, use of ICD, syncope, and LVEF<50%. Mediation analysis was performed to assess whether AF, a known outcome of OSA and predictor of SCD in HCM, mediates the association between OSA and the composite endpoint.</p><p><strong>Results: </strong>Of 52,106 HCM admissions, 8848 (16.98%) had OSA. In a multivariate model excluding AF, OSA was associated with CA-VF (OR 1.16, 95% CI 1.10-1.27, p = 0.002). However, after adjusting for AF, this association was no longer significant (OR 1.001, 95% CI 0.91-1.10, p = 0.97). Mediation analysis showed a significant average causal mediation effect (ACME, p < 0.001), with AF accounting for approximately 98.5% of the total effect of OSA on CA-VF.</p><p><strong>Conclusion: </strong>In this large cohort of HCM patients, the association between OSA and CA-VF appeared to be predominantly mediated by AF, with no significant independent direct effect observed. These findings suggest that OSA may contribute to arrhythmic risk in HCM primarily through its relationship with AF and should be considered hypothesis-generating.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147641104","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":"Beyond duration: The emerging role of sleep architecture in cardiovascular risk prediction.","authors":"Saifullah Khan, Shahid Karim, Virend K Somers","doi":"10.1016/j.pcad.2026.03.005","DOIUrl":"10.1016/j.pcad.2026.03.005","url":null,"abstract":"","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147577324","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":"Revascularization of patients with chronic total occlusion and left ventricular systolic dysfunction.","authors":"Giuseppe Vadalà, Kambis Mashayekhi, Cristina Madaudo, Michael Behnes, Giuseppe Panuccio, Alice Moroni, Davide Tomasello, Gianluca Campo, Emmanouil Brilakis, Alfredo Ruggero Galassi","doi":"10.1016/j.pcad.2026.03.006","DOIUrl":"10.1016/j.pcad.2026.03.006","url":null,"abstract":"<p><p>Heart failure (HF) due to left ventricular systolic dysfunction (LVSD) remains a major clinical challenge, particularly among patients with chronic total occlusions (CTO). CTO are present in up to 30% of patients with LVSD undergoing coronary angiography and are independently associated with worse outcomes. Although advances in interventional techniques have increased success rates of CTO percutaneous coronary intervention (CTO-PCI), high-quality evidence supporting this procedure in patients with LVSD remains limited. Observational studies report potential benefits, including improved survival, alleviation of HF symptoms, and recovery of left ventricular ejection fraction (LVEF). However, randomized controlled trials (RCTs) have largely excluded patients with LVEF <35% and those with advanced, complex coronary artery disease (CAD), including CTO, thereby restricting generalizability. Assessment of myocardial viability remains central to patient select for CTO-PCI, its prognostic value for hard clinical endpoints has not been definitively established. The use of mechanical circulatory support (MCS) during high-risk CTO-PCI is increasing, particularly in patients with reduced LVEF and complex coronary anatomy; available data provides inconsistent evidence regarding its impact on clinical outcomes and appears to be largely influenced by individual patient characteristics. Finally, in the setting of acute coronary syndromes (ACS), the effect of CTO revascularization on clinical endpoints and arrhythmic risk is unclear, with conflicting observational data. Future research should prioritize this underrepresented high-risk cohort and be conducted in experienced centers within an integrated multidisciplinary care framework.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517975","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":"Big data, blunt tools: What national registries still miss in aortic dissection.","authors":"Jes S Lindholt, Lasse Møllegaard Obel, Mads Liisberg","doi":"10.1016/j.pcad.2026.03.004","DOIUrl":"10.1016/j.pcad.2026.03.004","url":null,"abstract":"","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147492411","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 importance of diagnosing and treating cardiomyopathies.","authors":"Mary N Sheppard","doi":"10.1016/j.pcad.2026.03.003","DOIUrl":"10.1016/j.pcad.2026.03.003","url":null,"abstract":"","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147483186","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":"Beyond body weight and BMI: Shifting the focus to excessive, ectopic, and dysfunctional adiposity.","authors":"Emiliano Salmeri, Carolina Chacón, Almudena Castro Conde","doi":"10.1016/j.pcad.2026.03.001","DOIUrl":"10.1016/j.pcad.2026.03.001","url":null,"abstract":"","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147373765","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}