Cardiovascular diagnosis and therapy最新文献

{"title":"Mid-term outcomes of using drug-coated balloon angioplasty for the treatment of large vessel <i>de novo</i> coronary lesions: comparison of large and small vessels.","authors":"Wenjie Wang, Zhonghua Sun, Yong Zeng, Xianpeng Yu","doi":"10.21037/cdt-2025-1-634","DOIUrl":"10.21037/cdt-2025-1-634","url":null,"abstract":"<p><strong>Background: </strong>Although a number of studies involving small-vessel <i>de novo</i> coronary disease have indicated that drug-coated balloons (DCBs) angioplasty, provides clinical benefits, the clinical value of DCB in large-vessel lesions remains unclear. We therefore conducted a real-world study to evaluate the midterm clinical outcomes of DCB treatment in patients with <i>de novo</i> coronary lesions >3.0 mm.</p><p><strong>Methods: </strong>We performed a retrospective study of 1,514 consecutive patients who received paclitaxel DCB angioplasty to treat <i>de novo</i> coronary lesions at Beijing Anzhen Hospital between June 2019 and November 2021. Lesions with a reference vessel diameter (RVD) ≥3.0 mm were defined as large-vessel disease (LVD), and lesions with an RVD ≤2.75 mm were defined as small-vessel disease (SVD). The LVD and SVD groups included 462 and 1,052 patients, respectively. The end points of the study were all-cause death, myocardial infarction (MI), stroke, and target vessel revascularization (TVR). Outcomes were compared between the LVD and SVD groups. The median follow-up was 34.2 months [interquartile range (IQR), 31.3 to 39.7 months] in the overall cohort.</p><p><strong>Results: </strong>Of the 1,514 patients, 43 (2.8%) died, 21 (1.4%) experienced MI, and 21 (1.4%) experienced stroke; 167 (11.0%) underwent TVR. No significant differences were observed in mortality rate (LVD: 2.4%; SVD: 3.0%; P=0.32), MI (LVD: 1.1%; SVD: 1.5%; P=0.37), stroke (LVD: 0.9%; SVD: 1.6%, P=0.19) and TVR (LVD: 11.9%; SVD: 10.6%, P=0.92). After multivariate adjustment, the adjusted hazard ratios (HRs) [95% confidence interval (CI)] for LVD versus SVD were 1.092 (0.447-2.670; P=0.85) for death, 1.424 (0.464-4.369; P=0.54) for MI, 1.604 (0.529-4.864; P=0.40) for stroke, and 0.995 (0.719-1.378; P=0.98) for TVR, with no significant differences observed in any endpoints between the two groups.</p><p><strong>Conclusions: </strong>The findings from this study indicate that the prognosis of DCB for patients with <i>de novo</i> lesions in vessels exceeding 3.0 mm are not significantly different compared to those of DCB for patients with SVD.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 3","pages":"46"},"PeriodicalIF":2.2,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitral regurgitation and atrial fibrillation recurrence in hypertrophic cardiomyopathy: association or modifiable substrate?","authors":"Teruhiko Imamura","doi":"10.21037/cdt-2026-0229","DOIUrl":"10.21037/cdt-2026-0229","url":null,"abstract":"","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 3","pages":"56"},"PeriodicalIF":2.2,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in coronary disease severity at time of acute coronary syndrome between Middle East and North America.","authors":"Firas J Al Badarin, Ahmad Edris, Shahrukh Hashmani, Manpreet Kaur, Shashank Shekhar, Oshin Kanwar, Samir Kapadia, Emin Murat Tuzcu","doi":"10.21037/cdt-2025-53","DOIUrl":"10.21037/cdt-2025-53","url":null,"abstract":"<p><p>Comparing angiographic findings of patients presenting with acute coronary syndrome (ACS) in the Middle East/Gulf (MEG) and North America (NA) may shed light onto how coronary artery disease (CAD) complexity at time of ACS presentation impacts immediate management and clinical outcomes. Therefore, we compared outcomes in concurrent ACS patients between MEG and NA. Consecutive patients with ACS were identified at 2 locations in an international health system. Extent of epicardial coronary disease was determined using Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score by trained investigators at both locations and compared using appropriate testing. In addition, in-hospital outcomes, including death, stroke and major bleeding were compared between the two groups. Between January and December 2017, 158 patients in MEG and 381 in NA were admitted with ACS. Patients in MEG were younger (57.3±11.5 <i>vs</i>. 65.0±12.1 years; P<0.001) than those in NA, more likely to have diabetes (51.9% <i>vs</i>. 28.9%; P<0.001). MEG patients had more complex CAD (SYNTAX score: 23.5±12.3 <i>vs</i>. 13.2±8.6; P<0.001) and were more likely to receive surgical or hybrid revascularization [odds ratio (OR) 2.1, 95% confidence interval (CI): 1.4-3.1] but less likely to receive percutaneous coronary interventions (OR 0.3, 95% CI: 0.2-0.5). These findings suggest that patients in the MEG present at the time of their first clinical event with more severe CAD, potentially driven by a higher prevalence and poorer control of diabetes. Further studies are needed to explore genetic, environmental, and metabolic factors contributing to rapid CAD progression in MEG populations.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 3","pages":"54"},"PeriodicalIF":2.2,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative assessment and clinical value of right-to-left shunt in patent foramen ovale using three-dimensional transesophageal echocardiography combined with right-heart contrast: a prospective study.","authors":"Xueqin Gong, Chunyan Li, Guangliang Yang","doi":"10.21037/cdt-2025-aw-602","DOIUrl":"10.21037/cdt-2025-aw-602","url":null,"abstract":"<p><strong>Background: </strong>A patent foramen ovale (PFO) is a common congenital cardiac condition characterized by a persistent communication between the right and left atria, which can facilitate a right-to-left shunt (RLS). This study aimed to determine the diagnostic accuracy, reproducibility, and prognostic value of PFO shunt volume quantified by three-dimensional transesophageal echocardiography (3D-TEE) combined with right-heart contrast echocardiography.</p><p><strong>Methods: </strong>In this prospective study, 100 patients with suspected PFO were prospectively enrolled and allocated in a 7:3 ratio to a training cohort (n=70) and a validation cohort (n=30). Each participant underwent two-dimensional transthoracic echocardiography (2D-TTE), two-dimensional transesophageal echocardiography (2D-TEE), and 3D-TEE. The total shunt volume (V_total) was calculated using voxel-based grey-scale integration. The optimal cut-off value was determined in the training set with the Youden index and then applied to the validation set. A multi-modality \"hard reference\" standard served as the diagnostic gold standard for method comparison. Reproducibility was evaluated with intraclass correlation coefficients (ICCs). All patients were followed for 36 months; stroke or transient ischemic attack (TIA) risk was analyzed with Kaplan-Meier curves and Firth-penalized Cox models, and changes in migraine frequency and residual shunt volume were recorded.</p><p><strong>Results: </strong>Eight baseline 3D structural indices, including tunnel length, slit width, leaflet excursion and shunt volume, showed no significant difference between cohorts (P>0.05). V_total, V_peak and t_dur demonstrated excellent repeatability (ICC =0.91-0.94; coefficient of variation 6.96-8.27%). The optimal threshold of 22.93 µL yielded an area under the curve (AUC) of 0.92 in the training set and 0.89 in the validation set (DeLong, P=0.27), with a sensitivity of 92%, specificity of 89%, and a diagnostic odds ratio (DOR) of 89.78, outperforming 2D-TTE and 2D-TEE. Kaplan-Meier analysis showed a 3-year stroke/TIA-free survival of 79% for shunt volume ≥22.93 µL versus 96% below the threshold (12 events, log-rank P=0.01); V_total ≥23 µL remained an independent predictor [hazard ratio (HR) =5.27, P=0.04]. Migraine frequency fell significantly over follow-up (P=0.001), and residual shunt volume at six months was lower after closure than with medical therapy (P<0.001).</p><p><strong>Conclusions: </strong>3D-TEE with right-heart contrast precisely quantifies PFO shunt volume; a threshold of 22.93 µL is reproducible and predicts both diagnostic status and long-term outcomes, supporting its use in stroke risk stratification, closure decision-making and therapeutic monitoring.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 3","pages":"44"},"PeriodicalIF":2.2,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ginsenoside Rb2 alleviates myocardial ischemia/reperfusion injury through IKKα lactylation regulation of macrophage polarization.","authors":"Peng An, Meiqi Zhang, Mengshi Cheng, Weihua Wu, Wei Zhang, Zhenfei Yu, Rui Liu","doi":"10.21037/cdt-2025-406","DOIUrl":"10.21037/cdt-2025-406","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Myocardial ischemia/reperfusion (I/R) injury (MIRI) is a major contributor to cardiovascular morbidity, characterized by inflammatory responses and cardiomyocyte death. Ginsenoside Rb2 (Rb2), a bioactive compound from &lt;i&gt;Panax ginseng&lt;/i&gt;, has shown potential cardioprotective effects, but its mechanisms in I/R injury remain unclear. Macrophage polarization refers to the process by which macrophages dynamically shift between pro-inflammatory (M1) and anti-inflammatory (M2) phenotypes in response to microenvironmental signals. This study aimed to investigate whether Rb2 could participate in the progression of MIRI by regulating macrophage polarization.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;&lt;i&gt;In vitro&lt;/i&gt;, THP-1-derived macrophages were co-cultured with AC16 cardiomyocytes under hypoxia/reoxygenation (H/R) conditions and treated with Rb2 (0, 25, 50, or 100 µM) for 24 h. Cell viability was assessed using the Cell Counting Kit-8 (CCK-8) assay. Macrophage polarization (CD86/CD206) was evaluated by immunofluorescence (IF), and apoptosis by terminal deoxynucleotidyl transferase (TdT) dUTP nick-end labeling (TUNEL) staining. Gene expression of inflammatory markers [interleukin (IL)-1β, tumor necrosis factor-α (TNF-α), IL-6, arginase-1 (Arg-1), IL-10, transforming growth factor-β (TGF-β)] was analyzed by reverse transcription quantitative polymerase chain reaction (RT-qPCR). Inhibitor of kappa B kinase (IKKα) lactylation was assessed by immunoprecipitation (IP) and Western blot. &lt;i&gt;In vivo&lt;/i&gt;, a murine MIRI model was established in male C57BL/6 mice by transient occlusion of the left anterior descending (LAD) coronary artery for 30 min, followed by 24 h of reperfusion. Rb2 was administered intraperitoneally at 10 mg/kg daily for 14 consecutive days prior to I/R induction. Cardiac function was assessed by echocardiography, infarct size by triphenyltetrazolium chloride (TTC) staining, and macrophage markers (CD86, CD206) by immunohistochemistry (IHC). Serum cardiac troponin T (cTnT) levels were measured by enzyme-linked immunosorbent assay (ELISA), and inflammatory gene expression in cardiac tissues was analyzed by RT-qPCR. IKKα lactylation in cardiac tissues was evaluated by IP and Western blot. Molecular docking, surface plasmon resonance (SPR), and bioinformatics were used to validate Rb2-IKKα interactions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Rb2 treatment enhanced cell viability (104.2±3.1 &lt;i&gt;vs.&lt;/i&gt; 88.7±2.8, P&lt;0.001), promoted M2 polarization (P&lt;0.001), reduced apoptosis (29.6±2.1 &lt;i&gt;vs.&lt;/i&gt; 10.1±1.8, P&lt;0.001), and improved cardiac function post-I/R [cTNT, 532±53 &lt;i&gt;vs.&lt;/i&gt; 125±22, P&lt;0.001; left ventricular ejection fraction (LVEF), 41±6 &lt;i&gt;vs.&lt;/i&gt; 61±4, P&lt;0.001; left ventricular fractional shortening (LVFS), 20±3 &lt;i&gt;vs.&lt;/i&gt; 31±2, P&lt;0.01; Infarct size, 63±4 &lt;i&gt;vs.&lt;/i&gt; 20±4, P&lt;0.001]. Mechanistically, Rb2 directly bound to IKKα, inhibited its lactylation at K617 site, and destabilized the protein. Overexpression of IKKα reversed ","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 3","pages":"43"},"PeriodicalIF":2.2,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association analysis of metabolic score for visceral fat with cardiovascular disease: a prospective cohort study based on the China health and retirement longitudinal study.","authors":"Linhua Feng, Hongbo Zhou, Bingjie Song, Xudan Ma, Huajun Wang","doi":"10.21037/cdt-2025-472","DOIUrl":"10.21037/cdt-2025-472","url":null,"abstract":"<p><strong>Background: </strong>Accumulation of visceral fat beyond normal levels is closely linked to the development of cardiovascular disease (CVD). The metabolic score for visceral fat (METS-VF), a novel composite indicator of intra-abdominal fat, has shown potential in predicting metabolic disorders, yet its long-term relationship with the incidence of CVD and its specific subtypes (heart disease and stroke) remains uncertain. Therefore, this study aims to explicitly evaluate the longitudinal association between METS-VF and the risk of CVD, heart disease, and stroke among a nationally representative middle-aged and older population in China.</p><p><strong>Methods: </strong>This prospective cohort study used data from the China Health and Retirement Longitudinal Study (CHARLS). The national baseline survey was conducted between May 2011 and March 2012, initially involving 17,705 participants, with subsequent follow-up assessments in 2013, 2015, and concluding in August 2018. Participants aged ≥45 years were included, while those with prevalent CVD at baseline or missing key variables were excluded, resulting in a final sample of 6,501 participants for analysis. Multivariate Cox regression models were employed to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). The nonlinear relationship was assessed through restricted cubic splines (RCS). Subgroup analyses of age and gender were undertaken, alongside sensitivity analyses using the Fine-Gray competitive risk model.</p><p><strong>Results: </strong>In the fully adjusted model, METS-VF was significantly and positively associated with the risk of CVD (HR =1.59, 95% CI: 1.38-1.83, P<0.001), heart disease (HR =1.49, 95% CI: 1.26-1.75, P<0.001), and stroke (HR =1.90, 95% CI: 1.47-2.45, P<0.001). Compared to the lowest quartile (Q1), the highest quartile (Q4, ≥7.05) of METS-VF showed a 77% increased risk of CVD (HR =1.77, 95% CI: 1.46-2.14, P<0.001). RCS analysis revealed no significant nonlinear relationship between METS-VF and CVD risk (P for nonlinear >0.05). Subgroup analysis revealed that age and gender did not exhibit significant interactive effects (P for interaction >0.05).</p><p><strong>Conclusions: </strong>METS-VF is positively linked with the risk of CVD among the middle-aged and older populations. This association remains stable across subgroups of individuals with smoking, hypertension, and diabetes status, as well as in individuals aged 45-74 years; however, no significant association was observed in individuals aged ≥75 years or in women with stroke risk. METS-VF, as a convenient and cost-effective tool for evaluating visceral fat, holds significant clinical application value in the early identification and risk stratification of CVD.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 3","pages":"40"},"PeriodicalIF":2.2,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of long-term survival in patients with concomitant pulmonary hypertension and its subtypes after successful transcatheter edge-to-edge mitral valve repair.","authors":"Felix Ausbuettel, Fares Kano, Nikolaos Patsalis, Christin Fichera, Dimitar Divchev, Carlo-Federico Fichera","doi":"10.21037/cdt-2025-1-654","DOIUrl":"10.21037/cdt-2025-1-654","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary hypertension (PH) is a comorbidity closely associated with high-grade mitral valve regurgitation (MR), for which transcatheter edge-to-edge mitral valve repair (M-TEER) is a valuable treatment method. To date, conflicting evidence exists regarding the impact of PH on treatment outcomes due to divergent PH definitions between studies and the updated guideline definitions. This study aimed to investigate the prevalence of PH and its respective subtypes and their impact on long-term survival after M-TEER.</p><p><strong>Methods: </strong>In this monocentric cohort study, all patients who underwent M-TEER and provided right heart catheterization (RHC) data were analyzed. PH and its respective subtypes were defined according to the current guidelines. Differences in long-term survival were analyzed using the Kaplan-Meier method, and independent predictors of mortality were analyzed using uni- and multivariable Cox regression analyses.</p><p><strong>Results: </strong>A total of 183 patients underwent M-TEER, but 58 patients had to be excluded from further analysis due to insufficient hemodynamic recordings. Among the included patients, 77.6% (97/125) revealed concomitant PH. Combined post- and precapillary PH (Cpc-PH) was the most common subtype in 56.7% (55/97) of patients. This subtype was associated with significantly greater morbidity compared with isolated postcapillary PH (Ipc-PH), which was the second most common subtype, observed in 39.2% (38/97) of the patients. Long-term survival significantly deteriorated in PH patients, while Ipc-PH patients presented a nonsignificant trend towards better survival compared to those with Cpc-PH. Although there was a significant correlation between noninvasive and invasive measurements of pulmonary artery systolic pressure (PASP) among Cpc-PH patients, PASP was significantly underestimated by noninvasive measurements in both PH cohorts.</p><p><strong>Conclusions: </strong>The early differentiation of patients undergoing M-TEER with respect to PH and its complicating comorbidities could represent a potential approach to improve long-term outcomes. Invasive RHC measurements remain crucial for classifying PH subgroups and their underlying PASP.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 3","pages":"49"},"PeriodicalIF":2.2,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary microvascular dysfunction: a narrative review.","authors":"Joseph M O'Brien, Thomas J Ford, Andy Yong, Vishal Goel, Jon Spiro, Peter J Psaltis, Adam J Brown, Derek P Chew, Dennis T L Wong","doi":"10.21037/cdt-2025-1-545","DOIUrl":"10.21037/cdt-2025-1-545","url":null,"abstract":"<p><strong>Background and objective: </strong>Coronary microvascular dysfunction (CMD) describes pathology within the microcirculation of the coronary arterial tree. Patients with this condition present similarly to macrovascular coronary disease, and it remains challenging to diagnose using invasive coronary angiography (ICA) alone. CMD is a cause of frequent hospital separations, and due to limitations in existing diagnostic techniques goes under-diagnosed. There is increasing interest amongst specialists, as reflected in recent American, European, and Japanese guidelines. This review seeks to present a thorough overview of recent research on CMD, outlining its pathophysiology, diagnostic insights, prognosis, available treatment options, and future directions of research and management.</p><p><strong>Methods: </strong>A systematic search of PubMed [1990-2024] was conducted, including English-language original research, reviews, and consensus documents. Articles were selected independently by two reviewers.</p><p><strong>Key content and findings: </strong>The incidence of CMD is increasing due to greater recognition and improved availability of coronary physiological assessment. CMD should be considered in patients with symptoms of angina without obstructive coronary artery disease (CAD) identified on ICA or computed tomography (CT). In addition to existing invasive techniques, non-invasive methods of diagnosis are emerging. There is a substantial body of evidence linking CMD with inflammatory conditions, potentially making this pathway a novel therapeutic target. Previously thought to bear no mortality effect, registry data is showing reduction in not only quality of life metrics but elevated risk of cardiovascular events in this cohort. Medical options are limited, with variable patient response.</p><p><strong>Conclusions: </strong>CMD is a heterogeneous condition presenting diagnostic challenges, refractory symptoms, and evolving recognition of its prognostic significance. Emerging research focuses on non-invasive diagnostics and novel therapies to bridge treatment gaps. Large-scale trials are needed to assess their impact on clinical outcomes.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 3","pages":"52"},"PeriodicalIF":2.2,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma alarmin S100A8/A9 serves as a potential biomarker of major adverse cardiovascular events after acute myocardial infarction.","authors":"Jingjiang Pi, Liang Geng, Chenghui Fan, Jing Xu, Xingxu Wang, Qi Zhang, Wei Wei","doi":"10.21037/cdt-2025-1-626","DOIUrl":"10.21037/cdt-2025-1-626","url":null,"abstract":"<p><strong>Background: </strong>S100A8/A9 is a key inflammatory protein significantly upregulated during acute myocardial infarction (AMI). Although previous small-scale studies suggest its potential for cardiovascular risk stratification, its long-term prognostic utility-especially compared to established biomarkers like TnI and BNP-lacks validation in large-scale cohorts. To evaluate the long-term prognostic value of admission plasma S100A8/A9 levels in a large cohort of hospitalized AMI patients, specifically assessing its ability to predict major adverse cardiovascular events (MACE) and its incremental predictive value over traditional clinical models.</p><p><strong>Methods: </strong>This prospective study enrolled 1,312 patients hospitalizing with AMI from August 2013 to June 2016. Plasma S100A8/A9 levels were quantified via ELISA at admission. Multivariable Cox regression and restricted cubic splines were utilized to assess the associations of S100A8/A9 levels with MACE and its components including all-cause mortality, hospitalization for heart failure (HF), and recurrent myocardial infarction (MI).</p><p><strong>Results: </strong>Over a median follow-up period of 2.93 years, 132 deaths occurred, and 392 patients reached the combined endpoint of MACEs. Even after multivariable adjustment for baseline clinical characteristics and established biomarkers, elevated S100A8/A9 levels remained significantly associated with an increased risk of MACE, all-cause mortality, recurrent MI, and hospitalization for HF (all P for trend <0.001). Furthermore, using Cox model-based Harrell's C-index, discrimination for MACE improved from 0.752 in the reference model to 0.822 after addition of log-transformed S100A8/A9, but not for all-cause mortality, as reflected in C-index (0.718 to 0.720), with bootstrap ΔC-index 0.002 (95% CI: -0.005, 0.013; P=0.58).</p><p><strong>Conclusions: </strong>Plasma S100A8/A9 concentrations demonstrate a strong correlation with heightened risk of MACE in AMI patients. Notably, the prognostic value of S100A8/A9 is significantly more pronounced for composite cardiovascular outcomes (MACE) compared to all-cause mortality. These findings indicate that S100A8/A9 serves as a valuable novel biomarker to guide targeted risk stratification of post-AMI patients.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 3","pages":"47"},"PeriodicalIF":2.2,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are elevated post-transcatheter aortic valve replacement gradients in obese patients pathological or flow-mediated?","authors":"Teruhiko Imamura","doi":"10.21037/cdt-2026-0177","DOIUrl":"10.21037/cdt-2026-0177","url":null,"abstract":"","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 3","pages":"57"},"PeriodicalIF":2.2,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}