Progress in cardiovascular diseases最新文献

{"title":"Inflammation and atherogenic particle burden: Joint risk without proven synergy.","authors":"Allan D Sniderman, Kevin C Maki","doi":"10.1016/j.pcad.2026.09.007","DOIUrl":"10.1016/j.pcad.2026.09.007","url":null,"abstract":"","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027284","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":"Epicardial adipose tissue attenuation as an independent marker of cardiovascular outcomes in de novo heart failure (RECOVER-EAT).","authors":"Shaun Khanna, Nicholas McLellan, Sheran Vasanthakumar, Cheng Hwee Soh, Aditya Bhat, Andrew Lin, Damini Dey, Sriram Rao, Stephen J Nicholls, Thomas H Marwick, Clare Arnott, Nitesh Nerlekar","doi":"10.1016/j.pcad.2026.09.004","DOIUrl":"10.1016/j.pcad.2026.09.004","url":null,"abstract":"<p><strong>Background: </strong>Epicardial adipose tissue (EAT) is a visceral fat depot implicated in cardiovascular disease. While EAT volume has been associated with risk, it provides limited information regarding adipose tissue composition. Computed tomography (CT)-derived EAT attenuation is a marker of adipose tissue composition, but its prognostic significance in heart failure (HF) remains uncertain. We evaluated the association between EAT attenuation and adverse cardiovascular outcomes in HF.</p><p><strong>Methods: </strong>We studied patients with HF undergoing clinically indicated cardiac or non-cardiac CT at a tertiary referral centre. Patients were included if CT was performed within ±6 months of echocardiography. EAT volume and attenuation, defined as the mean Hounsfield unit (HU) value of voxels within the segmented EAT volume, were quantified. The primary endpoint was a composite of cardiovascular death, myocardial infarction, stroke/transient ischaemic attack, and HF hospitalisation. Associations were assessed using multivariable Cox proportional hazards models, and incremental prognostic value was evaluated using likelihood ratio testing.</p><p><strong>Results: </strong>Among 529 patients with de novo HF (mean age 58.0 ± 14.5 years; 29.7% female), 522 had sufficient longitudinal follow-up for time-to-event analysis. Of these, 87 experienced the primary composite outcome during a median follow-up of 24 months. In the fully adjusted model incorporating EAT attenuation and volume simultaneously, higher EAT attenuation was independently associated with increased risk of the primary outcome (HR 1.35 per 5-HU increase; 95% CI 1.14-1.60; p < 0.001), as was greater EAT volume (HR 1.06 per 10-mL increase; 95% CI 1.01-1.11; p = 0.019). Addition of EAT volume to the clinical model did not improve model fit (Δχ<sup>2</sup> = 0.87; p = 0.352), whereas subsequent addition of EAT attenuation significantly improved model fit (Δχ<sup>2</sup> = 11.98; p < 0.001). Kaplan-Meier analysis demonstrated lower event-free survival among patients with higher EAT attenuation (log-rank p = 0.03).</p><p><strong>Conclusions: </strong>EAT attenuation and volume were independently associated with adverse cardiovascular outcomes in HF when considered simultaneously. EAT attenuation provided incremental prognostic information beyond established clinical risk markers and EAT volume, supporting the potential relevance of CT-derived adipose tissue composition for cardiovascular risk assessment.</p><p><strong>Lay summary: </strong>Fat surrounding the heart undergoes important biological changes that may influence cardiovascular risk. In this study of patients with heart failure, both the amount and CT-derived composition of epicardial adipose tissue (EAT) were independently associated with adverse cardiovascular outcomes. Higher EAT attenuation, reflecting altered adipose tissue composition, provided additional prognostic information beyond clinical risk factors and EA","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149032183","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":"Back to the future: Revisiting \"leave nothing behind\" when managing coronary artery disease.","authors":"Filippo Luca Gurgoglione, Sandeep Basavarajaiah, Wojciech Wańha, Bharat Khialani, Jasim Hasan, Mouna Bader, Sara Malakouti, Bernardo Cortese","doi":"10.1016/j.pcad.2026.09.008","DOIUrl":"10.1016/j.pcad.2026.09.008","url":null,"abstract":"<p><p>Despite major technological advances, contemporary drug-eluting stents (DES) remain intrinsically limited by the permanent implantation of a metallic prosthesis, exposing patients to chronic vessel caging, impaired vasomotion, neoatherosclerosis, and persistent risks of restenosis and late thrombotic events. These limitations have renewed interest in implant-sparing coronary revascularization based on the \"leave-nothing-behind\" concept. Drug-coated balloons (DCB) have emerged as the most mature implant-free technology, with robust evidence supporting their use beyond in-stent restenosis and small-vessel disease to increasingly complex clinical scenarios, including chronic total occlusions, diffuse coronary artery disease, bifurcation lesions, diabetes mellitus, and patients at high bleeding risk. Successful DCB angioplasty, however, depends on meticulous lesion preparation, tailored plaque modification, and selective intracoronary imaging to optimize procedural outcomes. In parallel, new-generation bioresorbable scaffolds (BRS) and bioadaptors are revitalizing the concept of temporary vessel scaffolding. By incorporating thinner struts, improved mechanical properties, enhanced biocompatibility, and restoration of vascular physiology following resorption or uncaging, these technologies aim to overcome the thrombotic limitations that hindered first-generation devices. This review provides a comprehensive overview of the biological rationale, current clinical evidence, procedural optimization, and future perspectives of implant-sparing PCI, highlighting the ongoing transition from a device-centered strategy to a personalized, morphology-guided approach in which lesion characteristics, vascular biology, and patient-specific risk drive revascularization decision-making.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149032211","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":"Relationship between pancoronary inflammation and clinical outcome: a 3-vessel OCT study.","authors":"Jiawei Zhao, Lina Cui, Yubo Gao, Yuzhu Chen, Rui Zhao, Xianqin Ma, Jiaqing Guo, Jiawen Chen, Fuhong Dong, Tong Lin, Jinfeng Tan, Tianyu Wu, Chengmei Jin, Lili Xiu, Wei Wang, Lulu Li, Yini Wang, Xueming Xu, Huai Yu, Tao Chen, Jingbo Hou, Jiannan Dai, Bo Yu, Chao Fang","doi":"10.1016/j.pcad.2026.09.009","DOIUrl":"10.1016/j.pcad.2026.09.009","url":null,"abstract":"<p><strong>Aims: </strong>The risk of recurrent cardiovascular events remains high in acute myocardial infarction (AMI) patients even after revascularization. Coronary residual inflammation plays a promoting role in this process. This study aimed to address the clinical impact of pancoronary inflammation at long-term follow-up in AMI patients.</p><p><strong>Methods: </strong>Between January 2017 and December 2021, 1312 AMI patients underwent three-vessel optical coherence tomography (OCT) imaging following successful percutaneous coronary intervention. Patients were stratified by the median number (3) of inflammatory plaques (defined as macrophage-containing non-culprit lesions) into low-inflammation (≤3 lesions) and high-inflammation (>3 lesions) groups. The primary endpoint was major adverse cardiovascular events (MACE), defined as a composite of cardiac mortality, non-fatal MI, and unplanned revascularization, assessed over a 5-year follow-up period.</p><p><strong>Results: </strong>The number of inflammatory plaques (i.e. pancoronary inflammation) had a significant correlation with hs-CRP level (i.e. systemic inflammation) (r = 0.109; P < 0.001). OCT features of plaque vulnerability were significantly more common in patients with high pancoronary inflammation level, compared to those with low pancoronary inflammation level. During a median 4.1-year follow-up, non-culprit lesion-related MACEs occurred more frequently in patients with more inflammatory plaques (8.1% versus 3.1% [hazard ratio, 2.71 (95% CI, 1.52-4.84)]), primarily attributable to increased risk of unplanned coronary revascularization. In multivariable models, higher pancoronary inflammation, rather than higher systemic inflammation, was the independent predictor of non-culprit lesion-related MACEs.</p><p><strong>Conclusion: </strong>The high pancoronary inflammation was found to be associated with more vulnerable plaque characteristics and increased risk of long-term adverse cardiovascular events in AMI patients.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027280","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":"Changing directions on cardiovascular risk assessment by targeting young adults using comprehensive imaging and preventive care strategies.","authors":"Leslee J Shaw, Deepak L Bhatt","doi":"10.1016/j.pcad.2026.09.006","DOIUrl":"10.1016/j.pcad.2026.09.006","url":null,"abstract":"","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149013560","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":"Genetic testing for dilated and arrhythmogenic cardiomyopathies - A primer for cardiologists.","authors":"John C Dillon, Sonali Arora, Dinesh K Kalra","doi":"10.1016/j.pcad.2026.09.002","DOIUrl":"10.1016/j.pcad.2026.09.002","url":null,"abstract":"<p><p>Genetic testing for dilated and arrhythmogenic cardiomyopathies (DCM, ACM) is increasingly important as it can refine diagnosis, inform risk stratification, and enable cascade screening. However, its clinical application remains challenging due to variable penetrance, phenotypic overlap, and marked genetic heterogeneity. This review provides a practical framework for the use of genetic testing in DCM and ACM. We outline a stepwise approach to clinical phenotyping and patient selection, review the principles of genetic testing and result interpretation, and summarize key pre- and post-test counseling considerations. We also highlight clinically important genotypes with implications for prognosis, arrhythmic risk, decisions regarding implantable cardioverter-defibrillator (ICD) implantation, family screening, and lifestyle counseling. Finally, we discuss the two-hit model that determines disease expressivity, emerging targeted therapies, and future directions in precision care.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148979151","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":"Dynamic pericoronary fat attenuation as a non-invasive marker of CAV progression after heart transplantation.","authors":"G Cordoni, M T Savo, E Lassandro, M M Palmisano, G Toscano, N Pradegan, V Tarzia, C Tessari, F Roubille, F Tona, R Motta, V Pergola","doi":"10.1016/j.pcad.2026.09.003","DOIUrl":"10.1016/j.pcad.2026.09.003","url":null,"abstract":"<p><strong>Background: </strong>Pericoronary adipose tissue (PCAT) density on coronary computed tomography angiography (CCTA) has emerged as a non-invasive marker of perivascular inflammation and a potential prognostic biomarker in heart transplant recipients. However, relationship between the longitudinal changes in PCAT attenuation and cardiac allograft vasculopathy (CAV) progression remains poorly defined.</p><p><strong>Objectives: </strong>To evaluate whether static PCAT density values and their longitudinal change predict CAV progression and adverse evolution in stable heart transplant recipients.</p><p><strong>Methods: </strong>We retrospectively enrolled 127 recipients with clinical, echocardiographic, and biopsy-proven stability undergoing paired CCTA at Padua University Hospital. Proximal, pancoronary, and right coronary artery pericoronary fat attenuation were measured at baseline and follow-up CCTA.</p><p><strong>Results: </strong>Baseline CCTA was performed a median of 7.5 years after transplantation and follow-up 2.0 years later. Radiological CAV progression occurred in 14 patients (11.0%) according to International Society for Heart and Lung Transplantation criteria; 20 patients (15.7%) met the composite radiological or clinical endpoint (worsening of New York Heart Association functional class, or hospitalization for cardiovascular causes). Cohort-level PCAT density values and in event-free patients were stable, while subjects presenting composite events showed longitudinal increases in all six attenuation metrics. A newly proposed biomarker, the dynamic PCAT ratio (baseline/follow-up) was consistently higher than 1 in patients with radiological or clinical progression, while remaining close to 1 in event-free subjects. In Firth penalized regression, dynamic PCAT ratios remained associated with the composite endpoint after multivariable and multiplicity adjustment, whereas associations with static measurements did not remain significant after correction.</p><p><strong>Conclusions: </strong>In heart transplant recipients, temporal evolution of PCAT density, rather than single measurements, appears to capture the biological activity associated with subsequent clinical deterioration, but warrants prospective multicentre validation.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148915002","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":"Current state of carotid artery interventions: Clinical trial results and real-world challenges.","authors":"Hady Lichaa, Sameh Sayfo, Herbert D Aronow","doi":"10.1016/j.pcad.2026.09.001","DOIUrl":"10.1016/j.pcad.2026.09.001","url":null,"abstract":"<p><p>Carotid artery disease remains a major cause of acute ischemic neurologic syndromes. Contemporary care has evolved into a multi-disciplinary model, involving vascular medicine, neurology, vascular surgery, interventional radiology, interventional cardiology and others. An integrated approach that combines plaque characteristics, symptom timing, cerebral vulnerability, vascular anatomy, patient age and comorbidities is employed to identify optimal treatment strategies. This review focuses on mechanisms of carotid-related stroke, imaging, medical therapy, revascularization of symptomatic and asymptomatic patients and procedural planning. Emphasis is placed on vascular anatomy-driven procedural selection, embolic-risk mitigation, and the complementary roles of carotid endarterectomy, carotid artery stenting, and transcarotid artery revascularization. Optimal outcomes depend less on applying a single preferred revascularization procedure and more on selecting the strategy that most effectively reduces embolic risk and minimizes patient-specific hazards.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914961","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":"Mitral annular disjunction: rethinking a controversial arrhythmic risk marker.","authors":"Stefano Figliozzi, Yun Yun Go, Patrizio Lancellotti","doi":"10.1016/j.pcad.2026.08.014","DOIUrl":"10.1016/j.pcad.2026.08.014","url":null,"abstract":"","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148877066","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":"Defining inflammation in cardiovascular risk: A complex challenge.","authors":"Cheyenne Y Y Beverloo, Erik S G Stroes, Nick S Nurmohamed","doi":"10.1016/j.pcad.2026.08.011","DOIUrl":"10.1016/j.pcad.2026.08.011","url":null,"abstract":"","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835498","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}