Progress in cardiovascular diseases最新文献

{"title":"Impact of mitral valve intervention and frailty on outcomes of severe mitral regurgitation due to severe mitral annular calcification.","authors":"Mohammad Al Zein, Yuichiro Okushi, Shinya Unai, Gösta B Pettersson, A Marc Gillinov, Per Wierup, Richard A Grimm, Brian P Griffin, Bo Xu","doi":"10.1016/j.pcad.2026.01.001","DOIUrl":"10.1016/j.pcad.2026.01.001","url":null,"abstract":"<p><strong>Background: </strong>Mitral annular calcification (MAC) can be complicated by mitral regurgitation (MR). However, data on outcomes of severe MR caused by MAC are limited. This study evaluated outcomes of severe MR due to MAC and the prognostic significance of frailty and comorbidities in guiding management.</p><p><strong>Methods: </strong>In this single-center, retrospective cohort study, we reviewed our echocardiographic database to identify patients with isolated severe MR due to severe MAC. The primary endpoint was all-cause mortality. The Society of Thoracic Surgeons (STS) risk score, Charlson Comorbidity Index (CCI), and a 3-point frailty index (hemoglobin, albumin, inactivity) were calculated. Echocardiographic parameters were recorded.</p><p><strong>Results: </strong>Between January 2010 and August 2023, out of 10,061 patients with severe MAC on echocardiography, 128 patients with severe MR due to severe MAC were identified, and followed for a median of 134 days (IQR: 33-1812). Median age was 81 years; 72.7% were female. Forty-five patients (35.2%) underwent mitral valve (MV) intervention, and 83 (64.8%) received conservative management. During follow-up, 63 patients (49.2%) died. MV intervention improved survival, even after propensity score matching (p < 0.001). Higher frailty scores predicted poorer outcomes in the entire cohort (p = 0.004) and the conservative subgroup (p = 0.014) but not the surgical group (p = 0.406). CCI did not influence mortality when stratified by treatment.</p><p><strong>Conclusion: </strong>Patients with severe MR due to MAC were frail with multiple comorbidities and often managed conservatively. Frailty is associated with all-cause mortality, and MV intervention improves survival regardless of frailty status.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145954583","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":"Epidemiology, treatment, and data management trends in aortic dissection and related syndromes: Insights and limitations from the RAE-CMBD in Spain (2016-2021).","authors":"Francesc Canalejo-Codina, Maria Thiscal López-Lluva, José Ramón Rumoroso, Armando Pérez de Prado, Jordi Martorell, José M de la Torre Hernández","doi":"10.1016/j.pcad.2025.12.005","DOIUrl":"10.1016/j.pcad.2025.12.005","url":null,"abstract":"<p><strong>Objective: </strong>Aortic dissection presents significant variations in incidence, treatment, and outcomes based on demographic and clinical factors. This study leverages official databases to elucidate the epidemiological trends of aortic dissection and related syndromes in Spain while examining demographic, clinical, and economic variables.</p><p><strong>Methods: </strong>A Python-based workflow refined and classified data from the Spanish hospital database (2016-2021) of patients with aortic dissection, crosslinking age, sex, management, and resource use. The study examined sex- and age-specific differences, quantified treatment modalities in relation to outcomes such as procedure choice and in-hospital case fatality, and assessed hospitalization and intervention costs to evaluate the economic burden.</p><p><strong>Results: </strong>Findings from 9587 cases reveal persistently high case-fatality (∼20 %) despite advancements in diagnosis and highlight disparities in care. Case-fatality was significantly higher in females (29.3 %) than in males (22.4 %), with diagnoses occurring at an older age in females compared to males (70.4 vs. 65.5 years). Open surgery remains as the predominant strategy across all analyzed aortic locations despite the medical and economic advantages of percutaneous intervention, although the database's limitation in recording cases according to the Stanford classification hinders the ability to criticize the treatment selection.</p><p><strong>Conclusion: </strong>Clinical data highlight the need for innovative medical and technological solutions. Moreover, transitioning to a new data system could enhance epidemiological reliability and improve patient management.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145835945","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":"Medicolegal implications and litigation trends in the diagnosis and management of cardiomyopathies in the United States.","authors":"Samantha L Weller, Andrew Costa, Austen Suits, Abdul Zia, Bradley J Petek, Ahmad Masri","doi":"10.1016/j.pcad.2025.11.006","DOIUrl":"10.1016/j.pcad.2025.11.006","url":null,"abstract":"<p><strong>Background: </strong>Cardiomyopathies encompass a heterogeneous group of myocardial diseases with variable clinical manifestations and prognoses. Despite their complexity and association with high-risk outcomes, malpractice claims related to cardiomyopathies have not been well-characterized.</p><p><strong>Objective: </strong>To characterize medicolegal claims associated with non-ischemic cardiomyopathies in the United States and identify common clinical and systemic contributors to liability.</p><p><strong>Methods: </strong>A retrospective review of U.S. malpractice and negligence claims from inception to 2025 was conducted using Westlaw, vLex, and a sports cardiology litigation database. Included cases involved a diagnosis or clinical suspicion of cardiomyopathy directly linked to a legal claim. Case frequency, location, demographics, allegations, defendant profiles, and outcomes/awards were identified for all eligible cases.</p><p><strong>Results: </strong>Of 421 cases reviewed, 63 (15 %) met inclusion criteria, spanning 1990-2025 with 1.8 cases/year. Hypertrophic (38 %) and dilated (31 %) cardiomyopathies were the most frequently litigated subtypes. Sudden cardiac arrest/death occurred in 79 % of cases. Leading allegations were failure to diagnose cardiomyopathy (37 %), inappropriate treatment (27 %) and communication failures (19 %). Non-cardiology providers, particularly primary care, were the most frequently named defendants (83 %), while cardiologists were implicated in 29 % of cases. Incarcerated individuals accounted for 16 % of cases. Most outcomes favored defendants (54 %), while 13 % resulted in plaintiff-favorable verdicts or settlements, with awards ranging from $100,000-$21,568,710 ($200,999 - $28,039,323 adjusted for inflation).</p><p><strong>Conclusion: </strong>While rare, malpractice claims related to cardiomyopathies are often associated with preventable failures in diagnosis, treatment and communication. These findings underscore the need for improved provider education, standardized diagnostic pathways, and clinical decision support tools to mitigate liability and enhance patient safety.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145574968","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":"Innovations in cardiac computed tomography: Imaging in coronary artery disease.","authors":"Venkat Sanjay Manubolu, Keishi Ichikawa, Matthew J Budoff","doi":"10.1016/j.pcad.2024.05.005","DOIUrl":"10.1016/j.pcad.2024.05.005","url":null,"abstract":"<p><p>Coronary computed tomography angiography (CCTA) has emerged as a pivotal tool in the non-invasive evaluation of coronary artery disease (CAD). Recent advancements in imaging techniques, quantitative plaque assessment methods, assessment of coronary physiology, and perivascular coronary inflammation have propelled CCTA to the forefront of CAD management, enabling precise risk stratification, disease monitoring, and evaluation of treatment response. However, challenges persist, including the need for cardiovascular outcomes data for therapy modifications based on CCTA findings and the lack of standardized quantitative plaque assessment techniques to establish universal guidelines for treatment strategies. This review explores the current utilization of CCTA in clinical practice, highlighting its clinical impact and discussing challenges and opportunities for future development. By addressing these nuances, CCTA holds promise for revolutionizing coronary imaging and improving CAD management in the years to come. Ultimately, the goal is to provide precise risk stratification, optimize medical therapy, and improve cardiovascular outcomes while ensuring cost-effectiveness for healthcare systems.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":"51-59"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140961357","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}