Cardiology in Review最新文献_第4页

Very-Early Discharge After Transcatheter Aortic Valve Replacement: Updated Systematic Review and Meta-Analysis of Contemporary Readmission and Clinical Outcomes. 经导管主动脉瓣置换术后极早出院：当代再入院和临床结果的最新系统回顾和荟萃分析。

IF 3.2 4区医学

Cardiology in Review Pub Date : 2026-10-05 DOI: 10.1097/CRD.0000000000001487

Asad Ali Ahmed Cheema, Bakhtawara Alam, Ammarah Tayyebah, Hassan Waqar, Komal Hans, Abdullah Nofal, Hussain Abdullah, Abdul Haseeb, Ahmad Sharab, Mohd Modassir Islam, Jay Bhatt

{"title":"Very-Early Discharge After Transcatheter Aortic Valve Replacement: Updated Systematic Review and Meta-Analysis of Contemporary Readmission and Clinical Outcomes.","authors":"Asad Ali Ahmed Cheema, Bakhtawara Alam, Ammarah Tayyebah, Hassan Waqar, Komal Hans, Abdullah Nofal, Hussain Abdullah, Abdul Haseeb, Ahmad Sharab, Mohd Modassir Islam, Jay Bhatt","doi":"10.1097/CRD.0000000000001487","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001487","url":null,"abstract":"Very-early discharge after transcatheter aortic valve replacement (TAVR) is increasingly incorporated into contemporary care pathways, but comparative outcomes remain vulnerable to clinical selection and reverse causation. We aimed to evaluate contemporary readmission and clinical outcomes associated with very-early versus later discharge after TAVR. The Medical Literature Analysis and Retrieval System Online via PubMed and the Cochrane Central Register of Controlled Trials were searched from inception through June 2026. Comparative studies evaluating same-day discharge, next-day discharge, discharge within 24 hours, hospital length of stay of 1 day or less, or corresponding institutional strategies were eligible. Odds ratios (ORs) and 95% confidence intervals (CIs) were pooled using inverse-variance random-effects models. Thirteen observational studies were included; 12 contributed crude binary data from up to 24,984 patients. Very-early discharge was associated with lower 30-day all-cause readmission (OR, 0.74; 95% CI, 0.67-0.82), early mortality (OR, 0.40; 95% CI, 0.30-0.54), and stroke or cerebrovascular events (OR, 0.58; 95% CI, 0.45-0.76). Delayed or post-discharge permanent pacemaker implantation was inconclusive. The readmission association became nonsignificant after the exclusion of the largest study. Certainty ranged from very low to low. Very-early discharge was associated with favorable outcomes in selected cohorts, but serious bias and influential studies preclude causal or universal conclusions. Structured, criteria-based pathways require rigorous prospective validation and standardized follow-up across diverse contemporary clinical settings.","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Optimal Surgical Timing After Postinfarction Ventricular Septal Rupture: A Narrative Review With a Proposed Heart Team Decision Algorithm. 梗死后室间隔破裂后的最佳手术时机：一种建议的心脏团队决策算法的叙述回顾。

IF 3.2 4区医学

Cardiology in Review Pub Date : 2026-09-29 DOI: 10.1097/CRD.0000000000001481

Essam Ahmed Khalil, Mahmoud Ibrahim Ali Elshamy, Mohamed Kamal Rehan, Ahmed Mohamed Aboul Fotouh Eldaly, Mohammed Ahmed Ezzat, Abdelrahman Elhadary, Yasser Abdelgaleel Ramadan, Wasiem Atteya Mohammed, Marwa Ramadan Mohamed, Mohamed Hamouda Elkasaby, William H Frishman, Wilbert S Aronow

{"title":"Optimal Surgical Timing After Postinfarction Ventricular Septal Rupture: A Narrative Review With a Proposed Heart Team Decision Algorithm.","authors":"Essam Ahmed Khalil, Mahmoud Ibrahim Ali Elshamy, Mohamed Kamal Rehan, Ahmed Mohamed Aboul Fotouh Eldaly, Mohammed Ahmed Ezzat, Abdelrahman Elhadary, Yasser Abdelgaleel Ramadan, Wasiem Atteya Mohammed, Marwa Ramadan Mohamed, Mohamed Hamouda Elkasaby, William H Frishman, Wilbert S Aronow","doi":"10.1097/CRD.0000000000001481","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001481","url":null,"abstract":"Postinfarction ventricular septal rupture is a rare, frequently lethal mechanical complication of acute myocardial infarction, and the optimal timing of repair remains controversial. Early surgery is often unavoidable in refractory shock but is technically hazardous because necrotic, friable myocardium provides poor suture support. Delayed repair after tissue maturation is associated with lower operative mortality, although this apparent benefit is substantially inflated by survivorship and immortal time bias. Mechanical circulatory support, including intra-aortic balloon counterpulsation, venoarterial extracorporeal membrane oxygenation, and microaxial flow pumps, may stabilize selected patients, permit end-organ recovery, and bridge them to later repair. However, available evidence is almost entirely observational, and the certainty supporting major timing and device selection recommendations is low or very low. This narrative review synthesizes the biological basis of timing, diagnostic and anatomic considerations, surgical and transcatheter options, mechanical support strategies, and transplantation. We propose a practical Heart Team framework based on hemodynamic status, tissue maturation, rupture anatomy, and daily reassessment, with explicit clinical triggers for abandoning delay. Surgical timing should therefore be individualized according to physiology rather than dictated by a fixed chronological threshold, pending prospective multicenter validation.","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Efficacy and Safety of Sodium-Glucose Cotransporter-2 Inhibitors for Heart Failure in Children and Adolescents: A Single-Arm and Pairwise Systematic Review and Meta-Analysis with GRADE Assessment of the Evidence. 钠-葡萄糖共转运蛋白-2抑制剂治疗儿童和青少年心力衰竭的有效性和安全性：单组和两两系统评价和荟萃分析，对证据进行GRADE评估。

IF 3.2 4区医学

Cardiology in Review Pub Date : 2026-09-29 DOI: 10.1097/CRD.0000000000001483

Leen Adel Aldossary, Raghad Mamdouh Alanazi, Rana Motlk Almutairi, Tayba Abdulrahman Mugibel, Karen Deaa Ghanam, Robaiya Awadh Robaiya Ben-Obaidellah, Khloud Awadh Mohammed, Asrar Abdulkarim Alharbi, Joudi Ali Almahabi, Rawan Abdullah Saad Alzahrani, Hala Salim Abu-Qasem, Mohamed Hamouda Elkasaby, Omer A Algonaid, William H Frishman, Wilbert S Aronow

{"title":"Efficacy and Safety of Sodium-Glucose Cotransporter-2 Inhibitors for Heart Failure in Children and Adolescents: A Single-Arm and Pairwise Systematic Review and Meta-Analysis with GRADE Assessment of the Evidence.","authors":"Leen Adel Aldossary, Raghad Mamdouh Alanazi, Rana Motlk Almutairi, Tayba Abdulrahman Mugibel, Karen Deaa Ghanam, Robaiya Awadh Robaiya Ben-Obaidellah, Khloud Awadh Mohammed, Asrar Abdulkarim Alharbi, Joudi Ali Almahabi, Rawan Abdullah Saad Alzahrani, Hala Salim Abu-Qasem, Mohamed Hamouda Elkasaby, Omer A Algonaid, William H Frishman, Wilbert S Aronow","doi":"10.1097/CRD.0000000000001483","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001483","url":null,"abstract":"Sodium-glucose cotransporter-2 (SGLT2) inhibitors are a cornerstone of adult heart failure (HF) therapy and are increasingly prescribed off-label to children, yet pediatric outcomes have never been pooled. We searched PubMed/MEDLINE, Embase, Scopus, and Web of Science to 14 August 2026 for studies of any SGLT2 inhibitor in children or adolescents with HF and performed a single-arm meta-analysis of all exposed patients and a pairwise meta-analysis of the comparative studies with random-effects models. Nine studies contributed 599 exposed patients and 97 controls. Pooled rates were 3.8% (95% confidence interval [CI] 1.6-8.4) for mortality, 8.5% (6.2-11.5) for transplantation, 11.2% (8.2-15.1) for worsening HF, 0.2% (0.03-1.6) for ketoacidosis, 4.5% (1.2-14.9) for acute kidney injury, 3.7% (1.1-11.7) for urinary tract infection, and 4.1% (1.4-11.2) for discontinuation because of an adverse event. After initiation, left ventricular ejection fraction rose by 7.7 percentage points (3.6-11.8) and natriuretic peptide fell by 0.42 standard deviations (0.34-0.49). In the comparative synthesis (63 exposed, 97 unexposed), risk ratios were 0.80 (0.11-6.07) for mortality and 0.21 (0.03-1.68) for worsening HF; ejection fraction improved 3.34 percentage points more with SGLT2 inhibitors (0.22-6.46) whereas natriuretic peptide did not differ (standardized mean difference -0.09, -0.50 to 0.33).","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cardiovascular Mortality In Mental Health Disorders: A Population-Based Analysis of US Mortality Data, 1999-2024. 精神健康障碍中的心血管死亡率：1999-2024年美国死亡率数据的基于人群的分析

IF 3.2 4区医学

Cardiology in Review Pub Date : 2026-09-25 DOI: 10.1097/CRD.0000000000001480

Muhammad Shaheer Bin Faheem, Bibi Taseer Fatma, Syed Sheheryar Faraz, Ayesha Anwer

{"title":"Cardiovascular Mortality In Mental Health Disorders: A Population-Based Analysis of US Mortality Data, 1999-2024.","authors":"Muhammad Shaheer Bin Faheem, Bibi Taseer Fatma, Syed Sheheryar Faraz, Ayesha Anwer","doi":"10.1097/CRD.0000000000001480","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001480","url":null,"abstract":"Mental health disorders are linked with increased cardiovascular disease and mortality risk, yet national trends in cardiovascular mortality among US adults with mental health disorders remain incompletely characterized. We performed a nationwide multiple cause of death analysis using the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research Multiple Cause of Death database to evaluate long-term trends and demographic patterns in cardiovascular mortality among US adults aged 25 years or older with mental health disorders between 1999 and 2024. Adults with mental health disorders were identified using International Classification of Diseases, Tenth Revision codes F00-F99, and cardiovascular deaths were reported using circulatory system codes (I00-I99). Age-adjusted mortality rates and crude mortality rates were calculated, and Joinpoint regression was used to derive annual percentage change and average annual percent change (AAPC). Between 1999 and 2024, more than 7.2 million cardiovascular deaths occurred among US adults with mental health disorders. Cardiovascular mortality rose steadily through the study period, and across sex, race/ethnicity, age group, geographic region, and urbanization levels. The greatest increases were noted among adults ages 55-64 years (AAPC: 6.90%, P < 0.001), males (AAPC: 5.40%, P < 0.001), and individuals residing in rural counties and the Northeast. Cardiovascular mortality among US adults with mental health disorders increased significantly between 1999 and 2024, highlighting the persistent disparities in this vulnerable population. These findings reinforce the need for integrated cardiovascular and psychiatric care, targeted prevention strategies, and equitable access to healthcare.","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cyanotic Heart Disease. 紫绀型心脏病。

IF 3.2 4区医学

Cardiology in Review Pub Date : 2026-09-25 DOI: 10.1097/CRD.0000000000001482

Lucas Dolan, Rithvik Swamynathan, William H Frishman, Wilbert S Aronow

{"title":"Cyanotic Heart Disease.","authors":"Lucas Dolan, Rithvik Swamynathan, William H Frishman, Wilbert S Aronow","doi":"10.1097/CRD.0000000000001482","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001482","url":null,"abstract":"Cyanotic congenital heart defects are malformations of the heart that affect its structure and function. The etiology of most of these defects is multifactorial, but some common causes include maternal conditions, genetic defects, and genetic mutations. Six of the most common cyanotic congenital heart defects include Tetralogy of Fallot, transposition of the great arteries, persistent truncus arteriosus, total anomalous pulmonary venous return, tricuspid atresia, and Ebstein's anomaly. These defects share several common features, however, each is distinguished by key cardiac abnormalities and effects on systemic circulation. Tetralogy of Fallot is the most common cause of early cyanosis in infants due to a ventricular septal defect, overriding aorta, right ventricular outflow tract obstruction, and right ventricular hypertrophy. In transposition of the great arteries, the aorta arises from the right ventricle, and the pulmonary artery arises from the left ventricle. Persistent truncus arteriosus presents with failure of truncus arteriosus separation, resulting in a single arterial trunk. In total anomalous pulmonary venous return, all pulmonary veins drain into systemic circulation rather than the left atrium, and tricuspid atresia patients lack a tricuspid valve and possess a hypoplastic right ventricle. Lastly, Ebstein's anomaly is a defect associated with apical displacement of a malformed tricuspid valve into the right ventricle.","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Association of Preexisting Atrial Fibrillation or Flutter With 30-Day Outcomes After Septic Shock: A Propensity-Matched Federated Database Study. 先前存在的心房颤动或扑动与感染性休克后30天结局的关联：一项倾向匹配的联邦数据库研究

IF 3.2 4区医学

Cardiology in Review Pub Date : 2026-09-23 DOI: 10.1097/CRD.0000000000001462

Dominique Grayeb, Katherine Ripley, Navneet Gupta, Palwasha Zafar, Anam Javed, Humza Saeed, Abu Baker Sheikh, Adeel Nasrullah

{"title":"Association of Preexisting Atrial Fibrillation or Flutter With 30-Day Outcomes After Septic Shock: A Propensity-Matched Federated Database Study.","authors":"Dominique Grayeb, Katherine Ripley, Navneet Gupta, Palwasha Zafar, Anam Javed, Humza Saeed, Abu Baker Sheikh, Adeel Nasrullah","doi":"10.1097/CRD.0000000000001462","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001462","url":null,"abstract":"Preexisting atrial fibrillation (AF) or atrial flutter may impair cardiovascular reserve during septic shock, potentially leading to worse clinical outcomes; however, its independent association with short-term outcomes remains uncertain. Using the TriNetX U.S. Collaborative Network, we identified adults with septic shock and compared patients with preexisting AF/flutter, documented at least 1 month before the index event, with those without prior AF/flutter. Clinical outcomes were compared after 1:1 propensity score matching for demographic characteristics, comorbidities, and baseline cardiovascular medication use. Outcomes included 30-day all-cause mortality, cerebral infarction, renal replacement therapy, invasive mechanical ventilation, acute-care utilization, and vasopressor/inotrope use. Effect estimates were reported as relative risks (RRs) with 95% confidence intervals. After propensity score matching, 76,295 patients were included in each cohort. Preexisting AF/flutter was associated with significantly higher risks of all-cause mortality (RR 1.07, 95% CI, 1.06-1.09; P<0.001), renal replacement therapy (RR 1.30, 95% CI, 1.25-1.35; P<0.001), invasive mechanical ventilation (RR 1.14, 95% CI, 1.12-1.16; P<0.001), acute-care utilization (RR 1.06, 95% CI, 1.05-1.06; P<0.001), and vasopressor/inotrope use (RR 1.09, 95% CI, 1.08-1.10; P<0.001). There was no significant difference in cerebral infarction (RR 1.11, 95% CI, 1.00-1.24; P=0.054). Among patients with septic shock, preexisting AF/flutter was associated with higher mortality and greater use of organ-supportive therapies, including renal replacement therapy, invasive mechanical ventilation, and vasopressor/inotrope use, but not with a significant increase in cerebral infarction. Preexisting AF/flutter may serve as an important prognostic marker for early risk stratification in septic shock.","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149023839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

LDL-C vs Lp(a): What We Know, the "Zero-LDL" Hypothesis, and Where We Stand in the PCSK9 Era. LDL-C vs Lp(a)：我们所知道的，“零ldl”假说，以及我们在PCSK9时代的地位。

IF 3.2 4区医学

Cardiology in Review Pub Date : 2026-09-23 DOI: 10.1097/CRD.0000000000001477

Fnu Anamika, Prachi Dawar, Kanishk Aggarwal, Sakshi Dixit, Gowrisankar Kugalur Saravanan, Aravinda Nanjundappa

{"title":"LDL-C vs Lp(a): What We Know, the \"Zero-LDL\" Hypothesis, and Where We Stand in the PCSK9 Era.","authors":"Fnu Anamika, Prachi Dawar, Kanishk Aggarwal, Sakshi Dixit, Gowrisankar Kugalur Saravanan, Aravinda Nanjundappa","doi":"10.1097/CRD.0000000000001477","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001477","url":null,"abstract":"Despite significant breakthroughs in preventative medicine, atherosclerotic cardiovascular disease (ASCVD) is still the primary cause of morbidity and death worldwide. In this context, 2 apoB-containing particles-LDL and lipoprotein(a) [Lp(a)] have emerged as important but mechanistically separate causes of atherothrombotic illness. This review synthesizes current knowledge in lipid biology, epidemiology, measurement, and therapeutics to address 3 key questions: (1) how LDL-C/apoB and Lp(a) differ in structure, pathophysiology, and clinical risk; (2) what the evidence shows about the safety and efficacy of driving LDL-C to very low or near-zero levels; and (3) where PCSK9-based therapies and soon, dedicated Lp(a) -lowering agents-fit into modern prevention strategies. Randomized trials, MR studies, and population-level cohort data all contribute to a clear and convincing picture: LDL-C/apoB and Lp(a) are separate causative drivers of cardiovascular risk, with Lp(a) introducing an orthogonal risk axis determined by genetics rather than lifestyle. By combining both viewpoints, we propose a feasible, dual-axis strategy to ASCVD prevention that addresses both cumulative apoB load and genetically driven Lp(a) risk.","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149023822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Surgical Explantation of Transcatheter Aortic Valves: A Contemporary Analysis of Indications and Outcomes. 经导管主动脉瓣手术摘除：当代适应症和结果分析。

IF 3.2 4区医学

Cardiology in Review Pub Date : 2026-09-22 DOI: 10.1097/CRD.0000000000001476

Berk Inan, Fatima Iqbal, Marco Tagliafierro, Jack Nickles, Ali Fatehi Hassanabad

{"title":"Surgical Explantation of Transcatheter Aortic Valves: A Contemporary Analysis of Indications and Outcomes.","authors":"Berk Inan, Fatima Iqbal, Marco Tagliafierro, Jack Nickles, Ali Fatehi Hassanabad","doi":"10.1097/CRD.0000000000001476","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001476","url":null,"abstract":"Transcatheter aortic valve replacement (TAVR) has transformed the treatment of severe aortic stenosis across all surgical risk profiles. However, as TAVR expands into younger, lower-risk populations with longer life expectancies, the management of late bioprosthetic failure has emerged as a critical clinical challenge. While valve-in-valve TAVR offers a less-invasive reintervention strategy, absolute anatomical contraindications frequently render it infeasible, necessitating surgical explantation. Driven primarily by structural valve deterioration, acute device failure, and prosthetic valve infective endocarditis, TAVR explantation presents a uniquely hostile operative field. Unlike traditional redo-surgical aortic valve replacement, the endothelialized and fibrotic integration of transcatheter stent frames into the aortic root and subvalvular apparatus significantly complicates extraction. These procedures often require complex, unplanned concomitant reconstructive procedures. Consequently, explantation carries a substantial morbidity and mortality burden that significantly eclipses native redo-surgical aortic valve replacement, with a stark volume-outcome relationship highlighting the necessity of institutional expertise. This review synthesizes contemporary data from high-volume international registries to evaluate the evolving landscape of TAVR explantation, detailing the primary indications, anatomical hurdles, and clinical outcomes. Ultimately, we emphasize the necessity of rigorous, computed tomography-based lifetime management protocols at the time of the index procedure and the regionalization of explant operations to specialized multidisciplinary structural heart centers to mitigate the severe surgical risks of transcatheter valve failure.","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149023810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Sedentary Behavior and Early Cardiovascular Markers in Young Adults: A Narrative Review. 年轻人的久坐行为和早期心血管标志物：一项叙述性综述。

IF 3.2 4区医学

Cardiology in Review Pub Date : 2026-09-17 DOI: 10.1097/CRD.0000000000001469

Rubia Afzal, Syeda Midhat, Muhammad Misam Raza, Noor Ahmed, Hafsah Mehmood

{"title":"Sedentary Behavior and Early Cardiovascular Markers in Young Adults: A Narrative Review.","authors":"Rubia Afzal, Syeda Midhat, Muhammad Misam Raza, Noor Ahmed, Hafsah Mehmood","doi":"10.1097/CRD.0000000000001469","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001469","url":null,"abstract":"Sedentary behavior and physical inactivity are distinct but interrelated risk factors that independently influence cardiovascular health. This narrative review synthesizes current evidence on the association between sedentary behavior and early cardiovascular markers in young adults, particularly university students. Epidemiological data indicate high levels of sedentary time (7-10 hours/day) alongside low adherence to physical activity guidelines in this population. Mechanistic evidence suggests that prolonged sitting impairs endothelial function, reduces nitric oxide bioavailability, alters autonomic balance by decreasing heart rate variability, and promotes arterial stiffness and metabolic dysfunction. Evidence from randomized and controlled trials demonstrates that uninterrupted sitting can induce acute adverse changes in glucose metabolism and autonomic regulation, while frequent light-intensity activity breaks may mitigate these effects. However, findings remain heterogeneous, with limited long-term improvements in structural cardiovascular outcomes. Observational studies further support associations between sedentary time and elevated blood pressure, arterial stiffness, and impaired heart rate recovery. Despite growing evidence, limitations include small sample sizes, short intervention durations, and lack of diverse populations. Overall, reducing sedentary time through feasible behavioral and institutional strategies may represent an effective early intervention to prevent future cardiovascular disease in young adults.","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148981993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Intravascular Lithotripsy for Calcified Vascular Lesions: Mechanisms, Techniques, Clinical Applications, and Future Directions. 钙化血管病变的血管内碎石术：机制、技术、临床应用和未来方向。

IF 3.2 4区医学

Cardiology in Review Pub Date : 2026-09-16 DOI: 10.1097/CRD.0000000000001478

Bahaa Salama, Alaaeldin Hodhod, Mohamed Bassiony, Ryan Cheikhali, William H Frishman, Wilbert S Aronow

{"title":"Intravascular Lithotripsy for Calcified Vascular Lesions: Mechanisms, Techniques, Clinical Applications, and Future Directions.","authors":"Bahaa Salama, Alaaeldin Hodhod, Mohamed Bassiony, Ryan Cheikhali, William H Frishman, Wilbert S Aronow","doi":"10.1097/CRD.0000000000001478","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001478","url":null,"abstract":"Vascular calcification complicates endovascular intervention by reducing vessel compliance, impairing device delivery and expansion, and increasing the risk of suboptimal procedural outcomes. Intravascular lithotripsy (IVL) has emerged as a calcium-modification strategy that uses acoustic pressure waves to fracture vascular calcium while minimizing injury to surrounding tissue. This paper reviews the mechanisms, procedural applications, clinical evidence, and evolving role of IVL in calcified coronary and peripheral arterial disease. We summarize evidence from pivotal prospective trials, randomized studies, registries, observational cohorts, imaging studies, and expert consensus, with particular emphasis on complex coronary and peripheral applications. IVL has demonstrated high procedural success and a favorable acute safety profile in severely calcified coronary lesions, with randomized evidence also supporting its use in calcified femoropopliteal disease. Expanding observational evidence supports its feasibility in complex coronary subsets, including left main and bifurcation lesions, as well as iliac and common femoral disease. Evidence remains more limited for chronic total occlusions, calcified nodules, stent underexpansion, and infrapopliteal disease. Emerging technologies and applications may further broaden the role of lithotripsy, but randomized comparative studies and longer-term outcome data are needed to define its optimal use.","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0