Cardiology Research and Practice最新文献

{"title":"Corrigendum to \"Herceptin-Mediated Cardiotoxicity: Assessment by Cardiovascular Magnetic Resonance\".","authors":"","doi":"10.1155/crp/9818679","DOIUrl":"https://doi.org/10.1155/crp/9818679","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1155/2022/1910841.].</p>","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":"2025 ","pages":"9818679"},"PeriodicalIF":1.8,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12310305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144752502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exercise-Based Cardiac Rehabilitation Improves Left Ventricular Dysfunction, Mitophagy, and Oxidative Stress Postmyocardial Infarction.","authors":"Changyong Wu, Haojie Li, Shuangfeng Zhao, Jiang Liu, Ruijie Li, Huang Sun, Suli Bao, Menghan Li, Yunzhu Peng","doi":"10.1155/crp/7778063","DOIUrl":"10.1155/crp/7778063","url":null,"abstract":"<p><p><b>Aim:</b> Left ventricular dysfunction, disturbed mitophagy, and persistent oxidative stress after myocardial infarction (MI) are critical drivers of myocardial injury and cardiac remodeling. Exercise-based cardiac rehabilitation (CR) is a cornerstone of post-MI treatment and management, yet its mechanistic effects on myocardial repair remain incompletely elucidated. This study aimed to the effect of exercise-based CR on the left ventricular dysfunction, mitophagy, and oxidative stress post-MI. <b>Methods:</b> Mendelian randomization analysis elucidated causal relationship between six physical activities and MI. Subsequently, 70 MI patients were randomized to control or exercise-based CR groups (moderate-to-vigorous physical activity intensity, 3 days/week, 10-50 min/day, 12 weeks); left ventricular function, cardiopulmonary function, and SF-36 quality of life scale were assessed pre-/postintervention using standardized protocols. Additionally, 21 rats were allocated to Sham, MI, or MI + treadmill running groups (high-intensity interval exercise training, 5 days/week, 30-50 min/day, 10-25 m/min, 4 weeks); left ventricular function, mitophagy, and oxidative stress were detected postintervention. <b>Results:</b> Genetically predicted moderate-to-vigorous intensity physical activity was significantly associated with lower risk of MI (IVW OR = 0.66, 95% CI: 0.54-0.81), with no causal links for other activities. Critically, clinical and animal studies demonstrated that exercise-based CR improved left ventricular systolic function (LVEF) after MI. Four-week exercise in MI rats enhanced mitophagy levels (LC3, FUNDC1, PINK1, and Parkin) and attenuated oxidative injury (MDA, GSH, SOD2, and GPX4) post-MI. Additionally, exercise-based CR also improved cardiopulmonary function (peak VO₂/kg, peakVO₂/pred%, and MET) in patients with MI and ameliorated mitochondrial damage in MI rats. However, GLS, secondary cardiopulmonary parameters (Wmax, HRR1min, peakVO₂/HR, and peakVO₂/HRpred%), and SF-36 (PCS and MCS) showed no significant changes, which may be associated with shorter duration of exercise intervention. <b>Conclusion:</b> Exercise-based CR significantly ameliorated left ventricular dysfunction, enhanced mitophagy levels, and attenuated oxidative stress post-MI, establishing its role in critical pathological mechanisms. Future studies should validate long-term sustainability of exercise-based CR and explore the interaction mechanism between mitophagy and oxidative stress in cardiac remodeling, providing personalized and precise exercise protocols for people at high risk of exercise.</p>","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":"2025 ","pages":"7778063"},"PeriodicalIF":1.8,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12310327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144752503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Malnutrition Evaluated by CONUT Score and Its Association With Acute Kidney Injury in Acute Myocardial Infarction Patients: A Retrospective Study.","authors":"Masafumi Fukuda, Nobuhisa Hirayu, Masakazu Nabeta, Takehiro Homma, Kei Fukami, Norio Yamashita, Osamu Takasu","doi":"10.1155/crp/1118619","DOIUrl":"10.1155/crp/1118619","url":null,"abstract":"<p><p><b>Background:</b> The relationship between nutritional status at the start of treatment for acute myocardial infarction (AMI) and the onset of acute kidney injury (AKI) remains unclear. This study aimed to clarify the association between nutritional status, as assessed by the controlling nutritional status (CONUT) score before catheter treatment, and the development of AKI in patients with AMI. <b>Methods:</b> This retrospective study included AMI patients treated with percutaneous coronary intervention (PCI) immediately after admission at our institution between 2014 and 2018. Patients undergoing chronic hemodialysis were excluded. Nutritional status was evaluated using the CONUT score derived from blood tests at admission, with scores below 5 indicating good nutrition and scores of 5 or above indicating malnutrition. The two groups were compared retrospectively. <b>Results:</b> A total of 211 AMI patients were included, with a median age of 68 years (59-79), and 156 (74%) were male. The median door-to-balloon time was 74 min (59-94). There were 180 patients in the good nutrition group and 31 in the malnutrition group. The malnutrition group exhibited significantly higher mortality (1.1% vs. 12.9%, <i>p</i> < 0.001) and a higher incidence of AKI (19% vs. 52%, <i>p</i> < 0.001). Multivariable logistic regression analysis identified lactic acid (odds ratio [OR] = 1.570 and 95% confidence interval [CI] 1.310-1.882), baseline creatinine (OR = 7.403 and 95% CI 1.852-29.59), and malnutrition (OR = 3.715 and 95% CI 1.278-10.80) as independent risk factors for AKI. <b>Conclusions:</b> Malnutrition, assessed by the CONUT score before treatment, may be associated with an increased risk of AKI in AMI patients.</p>","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":"2025 ","pages":"1118619"},"PeriodicalIF":1.8,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144673964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Value of Electroacupuncture in the Treatment of Coronary Heart Disease: A Review of the Mechanisms and Clinical Studies of Electroacupuncture Therapy.","authors":"Yuming Shao, Yang Li, Bing Wang, Chengjia Li, Huijun Chen","doi":"10.1155/crp/4684871","DOIUrl":"10.1155/crp/4684871","url":null,"abstract":"<p><p>Electroacupuncture (EA) therapy combines electrical stimulation with traditional acupuncture therapy and is widely used as a physical therapy in various fields. Coronary heart disease (CHD) is a prevalent cardiovascular condition. Applying EA in the treatment of CHD patients has proven to effectively enhance therapeutic outcomes and improve prognosis. This paper summarizes the potential mechanisms of EA in the treatment of CHD, its therapeutic effects on CHD patients, and analyzes the current bottlenecks in the application of EA therapy for CHD. Furthermore, it discusses potential future directions for EA in CHD management.</p>","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":"2025 ","pages":"4684871"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Value of High-Sensitivity CRP Level on the No-Reflow Phenomenon in STEMI Patients.","authors":"Xhevdet Krasniqi, Josip Vincelj, Dardan Koçinaj, Blerim Berisha, Aurora Bakalli","doi":"10.1155/crp/9359830","DOIUrl":"10.1155/crp/9359830","url":null,"abstract":"<p><p><b>Background:</b> Increased level of high-sensitivity C-reactive protein (hs-CRP) is associated with no-reflow phenomenon. Therefore, even when timely coronary revascularization is performed through the primary percutaneous coronary intervention (pPCI), the process can induce reperfusion injury. <b>Purpose:</b> We evaluated the influence of hs-CRP level on the no-reflow phenomenon in patients with ST-segment elevation myocardial infarction (STEMI). <b>Methods:</b> In this study, we included one hundred and eighty-two consecutive patients with STEMI of onset < 12 h, who underwent pPCI. The levels of creatine kinase (CK), the MB fraction of creatine kinase (CK-MB), troponin I, hs-CRP, and other routine laboratory parameters were measured. Measurement of hs-CRP was done on the day of admission by Cobas assay (particle-enhanced immunoturbidimetric assay) on Cobas c501 (Roche). Thereafter, patients were divided in two groups according to the thrombolysis in myocardial infarction (TIMI) flow grade. <b>Results:</b> From a total of 182 STEMI patients who underwent pPCI, the median value of hs-CRP of the patients with TIMI grade flow 3 (successful reperfusion) was 8.5 (0.4-268) and of the patients with no-reflow phenomenon (unsuccessful reperfusion, TIMI flow grade ≤ 2) was 37.90 (1.8-271.20), <i>p</i> < 0.0001. Receiver operating characteristics (ROC) curve of hs-CRP plots the true positive rate against the false positive rate at different cutoff points, AUC = 0.73 (95% CI, 0.64-0.81), and the cutoff value for the hs-CRP was 18.0 mg/L, <i>p</i>=0.0001. <b>Conclusions:</b> hs-CRP may be associated with no-reflow phenomenon in STEMI patients. The cutoff value for hs-CRP may be used to identify patients at risk for reperfusion injury.</p>","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":"2025 ","pages":"9359830"},"PeriodicalIF":1.8,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Meta-Analysis of Randomized Controlled Trials (RCTs) Investigating the Efficacy and Safety of Acupuncture in Treating Myocardial Ischemia/Reperfusion (I/R) Injury.","authors":"Jian Xiong, Ying Wei, Xiaogang Huang, Jinqun Hu, Fayang Ling, Zhihao Shang, Wenchuan Qi, Qianhua Zheng, Dehua Li, Fanrong Liang","doi":"10.1155/crp/9970541","DOIUrl":"10.1155/crp/9970541","url":null,"abstract":"<p><p><b>Objectives:</b> This study systematically reviewed and meta-analyzed randomized controlled trials (RCTs) evaluating the efficacy and safety of acupuncture in myocardial ischemia/reperfusion (I/R) injury. <b>Methods:</b> A comprehensive literature search was conducted in PubMed, Cochrane Library, Web of Science, Chinese National Knowledge Infrastructure, China Science and Technology Journal Database, and Wanfang from database inception to November 3, 2024. Eligible RCTs assessing acupuncture for myocardial I/R injury were included. Statistical analyses were performed using Review Manager 5.3 and Stata 16. <b>Results:</b> A total of 26 RCTs of moderate methodological quality were included. Acupuncture significantly reduced myocardial enzyme levels compared to controls. Inflammatory markers (hs-CRP, TNF-α, IL-6, IL-8, and IL-1) were suppressed, while anti-inflammatory and immunoregulatory factors (IL-10 and IL-2) increased. Oxidative stress parameters showed improvements, with reductions in MDA and SOD levels. Echocardiographic findings demonstrated enhanced cardiac function, reflected by increased LVEF and LVESV, along with reductions in LVFS, LVEDD, LVEDV, and LVESD. Additionally, acupuncture alleviated TCM chest pain symptoms, shortened ICU stays, lowered MACE incidence, and improved 6MWT and SAQ indicators. No adverse reactions were reported. <b>Conclusion:</b> Acupuncture attenuates myocardial injury, inflammation, and oxidative stress while activating anti-inflammatory and immune responses, enhancing cardiac function, and mitigating ventricular remodeling. Furthermore, it alleviates chest pain, shortens ICU stays, reduces adverse cardiovascular events, and improves 6MWT and SAQ indicators.</p>","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":"2025 ","pages":"9970541"},"PeriodicalIF":1.8,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12213044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Natural Progression of Rheumatic Aortic Valve Disease Following Mitral Valve Intervention: A 16-Year Single-Center Experience.","authors":"Seok Hyun Kim, Ji Hoon Lim, Sang Hyun Lee, Mi Hee Lim, Chee-Hoon Lee, Min Ho Ju, Hyung Gon Je, Yong Hyun Park","doi":"10.1155/crp/6689214","DOIUrl":"10.1155/crp/6689214","url":null,"abstract":"<p><p><b>Background:</b> Recognizing the natural progression of the remaining valve disease following the intervention of a single valve is crucial in multiple rheumatic valvular diseases as often encountered in clinical practice. We aimed to investigate whether performing mitral valve (MV) intervention alone for multiple rheumatic MV and aortic valve (AV) disease is safe. <b>Hypothesis:</b> Rheumatic AV disease progresses slowly and severity does not differ significantly after MV intervention. <b>Methods:</b> We retrospectively investigated the progression of AV disease with rheumatic changes following MV intervention in a single tertiary center. Among 890 patients initially screened, 76 patients met the criteria for assessment. <b>Results:</b> Six patients fell under severe aortic stenosis (AS) definition-wisely and four of them were classified as low-flow low-gradient severe AS despite normal ejection fraction. Eventually, four patients were found to have true-severe AS at a median follow-up period of four years (mean 5.8 years) and only one of them underwent AV surgery for severe AS per se. None of the patients with aortic regurgitation deteriorated to severe. <b>Conclusions:</b> Only a small portion of rheumatic AV involvement progresses to severe AS after MV intervention, and performing MV intervention for severe mitral stenosis or mitral regurgitation in patients with concurrent mild or moderate AS or aortic regurgitation due to rheumatic changes is reasonable.</p>","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":"2025 ","pages":"6689214"},"PeriodicalIF":1.8,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12187430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fractal Laws for Bifurcation Quantitative Coronary Angiography to Assess Left Main Bifurcation Lesions.","authors":"Mattia Lunardi, Nozomi Kotoku, Carlo Briguori, Luc Maillard, Adam Kern, Franck Digne, Jacek Legutko, Maciej Lesiak, Adam Witkowski, Thierry Lefèvre, Anderzej Ochala, Wojciecj Jachec, Corrado Tamburino, Marco Contarini, Gilles Rioufol, Antonio Colombo, Javier Escaned, William Wijns, Yoshinobu Onuma, Patrick W Serruys, Robert Gil","doi":"10.1155/crp/7176161","DOIUrl":"10.1155/crp/7176161","url":null,"abstract":"<p><p><b>Background:</b> Visual angiographic assessment of left main (LM) bifurcation lesions is fraught with major limitations. Bifurcation-dedicated quantitative coronary angiography (Bif-QCA) assessment provides higher accuracy than standard QCA in bifurcation lesions. Fractal laws (e.g., Finet's and Murray's laws) can enhance the accuracy of reference diameter calculation when applied to angiography-derived algorithms and may serve as a surrogate for pressure-based assessment. <b>Aims:</b> To investigate the correlation between Bif-QCA, Finet's law derived Bif-QCA (Finet-QCA) and pressure-wire functional assessment for LM bifurcation stenosis. <b>Methods:</b> Using instantaneous wave-free ratio (iFR) as a reference standard (≤ 0.89), we compared the value of Bif-QCA and Finet-QCA (diameter stenosis ≥ 50%). Moreover, the differences in MEDINA classification according to site-reported visual assessment <i>vs</i> Bif-QCA or Finet-QCA were investigated. <b>Results:</b> Eighty-four patients were included in the analysis, of which 72 (85.7%) presented an abnormal iFR. Bif-QCA derived %DS was moderately correlated with iFR values; however, implementing Finet's law in the correlation resulted weak. Site-reported MEDINA (visual assessment) resulted in significant higher rate of 1,1,1 and lower rate of 1,0,0 patterns compared to Bif-QCA MEDINA (9.5% vs. 1.2%, <i>p</i> < 0.001 and 33.3% vs. 46.4%, <i>p</i> < 0.001, respectively) and to Finet-QCA MEDINA (9.5% vs. 2.4%, <i>p</i> < 0.001 and 33.3% vs. 40%, <i>p</i> < 0.001, respectively). <b>Conclusions:</b> The present study suggested that LM MEDINA bifurcation pattern should be based on QCA analysis rather than visual assessment, both in the context of clinical practice and clinical studies. Compared to conventional Bif-QCA, the implementation of fractal laws (Finet-QCA) did not appear to improve the determination of the reference diameters of the LM shaft.</p>","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":"2025 ","pages":"7176161"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"To Explore the Key Subgroup and Their Immune Microenvironment During the Formation of Coronary Plaque With scRNA-seq.","authors":"Xinhan Li, Qiulai Li, Haiying Liu, Ying Zhang, Jie Xia, Xin Wang, Tao Lei, Jun Ma","doi":"10.1155/crp/3221767","DOIUrl":"10.1155/crp/3221767","url":null,"abstract":"<p><p><b>Background:</b> The most important pathological basis of coronary heart disease is atheroma formation. If atheromatous plaque occurs and is not treated promptly and effectively, the plaque will gradually grow, causing the lumen of the coronary arteries to gradually narrow until it is completely occluded, causing angina pectoris and even myocardial infarction, but its cellular heterogeneity is not fully understood. <b>Methods:</b> We utilized various techniques including single-cell RNA sequencing, CytoTRACE, monocle, slingshot, CellChat, and SCENIC to investigate the significant subgroup of NK cells in 15 specimens from individuals in order to understand their contributions to the development of coronary plaque. <b>Results:</b> The analysis revealed that studying the subgroup C1 RACK1+ NK cells was crucial for this paper. We investigated its effect on coronary plaque and then analyzed C1 RACK1+ NK cells to explore the expression of this subgroup in pseudotime trajectories, cell interactions, and transcription factors. <b>Conclusion:</b> Single-cell RNA sequencing could provide a deeper understanding of the factors that have an important impact on the development of coronary plaque, improved the understanding of the microenvironment of coronary plaque, provided enlightenment for the treatment of coronary plaque in the future, and helped to improve the diagnosis of coronary plaque and design the best treatment strategy.</p>","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":"2025 ","pages":"3221767"},"PeriodicalIF":1.8,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Real-World Study on Pulmonary Arterial Hypertension in Bulgaria: A Single-Center Retrospective Study From 2012 to 2022.","authors":"Vasil Velchev, Arman Postadzhiyan, Sarkis Kalustian, Simona Markova, Mihaela Manolova, Damyan Boychev, Daniel Penchev, Martina Nacheva, Elina Petrova","doi":"10.1155/crp/5579064","DOIUrl":"10.1155/crp/5579064","url":null,"abstract":"<p><p><b>Purpose:</b> This study aimed to analyze the epidemiological, clinical, and therapeutic characteristics of patients with pulmonary arterial hypertension (PAH) treated at a major reference center in Bulgaria and to assess treatment patterns, patient compliance, and overall survival. <b>Principal Results:</b> The epidemiological data revealed that 69.5% of the patients were female, with a mean age of 52 years. The majority of patients were diagnosed at advanced stages of PAH, with 92.1% classified as World Health Organization Functional Class III. Monotherapy was the most common treatment regimen, used by 61.4% of patients, despite advanced disease. Patients who adhered to treatment demonstrated significantly longer overall survival (78.9 months) compared to those lost to follow-up (50.8 months). The study also identified a 31% rate of noncompliance, with patients missing follow-up visits and becoming ineligible for further therapy. <b>Major Conclusions:</b> The findings highlight the need for earlier diagnosis and more aggressive treatment strategies, as monotherapy appears insufficient for optimal outcomes in advanced PAH. Establishing a national PAH registry and increasing disease awareness could facilitate earlier interventions and improve patient outcomes in Bulgaria.</p>","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":"2025 ","pages":"5579064"},"PeriodicalIF":1.8,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12116199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}