Cardiovascular diagnosis and therapy最新文献

{"title":"Pre-hospital and emergency department point-of-care ultrasound in cardiovascular emergencies: a scoping review.","authors":"Matti Jubouri, Rohan Chikhal, Fatima Kayali, Luca Tin Yau Cheung, Mohamed Refaie, Wael I Awad, Ian M Williams, Damian M Bailey, Mohamad Bashir","doi":"10.21037/cdt-2025-1-646","DOIUrl":"10.21037/cdt-2025-1-646","url":null,"abstract":"<p><strong>Background: </strong>Point-of-care ultrasound (POCUS) is integral to emergency department (ED) and pre-hospital medicine, yet evidence comparing its diagnostic and operational performance across environments remains fragmented, especially in cardiovascular emergencies. This review aimed to evaluate and compare the diagnostic performance, workflow impact, and clinical influence of POCUS for six major cardiovascular emergencies across pre-hospital and ED settings, while examining the effects of operator training, device technology, and governance structures.</p><p><strong>Methods: </strong>A structured scoping review search was conducted using multiple electronic databases to identify adult studies evaluating pre-hospital or ED POCUS in cardiac arrest, cardiac tamponade, acute heart failure, shock, pneumothorax, and aortic dissection. Eligible designs included randomised, prospective, and observational studies reporting diagnostic accuracy, process efficiency, management impact, or outcomes. Data were synthesised comparatively rather than pooled.</p><p><strong>Results: </strong>ED POCUS demonstrated high diagnostic accuracy (typically >85-90%) and shortened time to diagnosis or intervention by 30-70 minutes in acute heart failure, pneumothorax, tamponade, and dissection representing meaningful process improvements. However, as seen in conditions like undifferentiated shock, these process gains do not consistently translate into improved patient-centred outcomes such as survival or reduced hospital length of stay. Pre-hospital POCUS achieved adequate views in 70-90% of cases and frequently changed triage or destination decisions (10-50%), though mortality effects were neutral across studies with follow-up data. Cardiac-arrest POCUS provided strong prognostic value but required disciplined choreography to avoid interrupting compressions. Device miniaturisation and brief targeted training enabled field feasibility, while structured curricula, image archiving, and quality assurance (QA) underpinned safety and accuracy.</p><p><strong>Conclusions: </strong>POCUS consistently improves diagnostic efficiency and decision-making in both ED and pre-hospital settings. However, evidence that these gains translate into improved patient-centred outcomes remains limited. Future research should focus on protocolised POCUS pathways integrated with governance structures and system-level responses.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 3","pages":"53"},"PeriodicalIF":2.2,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419028","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":"Apelin-13 attenuates doxorubicin-induced myocardial injury via the PI3K/AKT and ERK/MAPK signaling pathways.","authors":"Li-Sha Guo, Li Li, Qing-Hua Han","doi":"10.21037/cdt-2025-358","DOIUrl":"10.21037/cdt-2025-358","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Anthracyclines play a crucial role in the chemotherapy of various malignant tumors; however, they may cause myocardial injury, which limits their clinical application. Therefore, it is of great importance to investigate drugs for the prevention and treatment of anthracycline-induced myocardial injury. The aim of this study is to evaluate the cardioprotective effects of Apelin-13 in a murine model of doxorubicin (DOX)-induced myocardial injury and to elucidate its potential underlying mechanisms.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Male C57BL/6 mice (8 weeks old) were randomly assigned to four groups, with all mice received intraperitoneal injections: Control (normal saline), DOX (with a cumulative dose of 20 mg), Apelin-13 (Apelin-13 0.1 μmol/kg/d), and Apelin-13 + DOX (Apelin-13 0.1 μmol/kg/d; with a cumulative dose of 20 mg). Cardiac function was assessed using echocardiography. Histopathological changes were assessed via hematoxylin and eosin (HE) staining, and myocardial fibrosis was evaluated with Masson's trichrome staining. Immunohistochemical analysis and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling staining were conducted to assess protein expression and cardiomyocyte apoptosis, respectively. Protein expression levels were further validated by western blotting (WB). &lt;i&gt;In vitro&lt;/i&gt;, rat H9C2 cardiomyocytes were cultured and divided into four groups. Control, Apelin-13 (Apelin-13 1 μM), DOX (DOX 2 μM), and Apelin-13 + DOX group (first treated with Apelin-13 1 μM, followed by DOX 2 μM after 1-2 hours). Cell viability was measured using the Cell Counting Kit-8 (CCK-8) assay. Flow cytometry was employed to quantify apoptosis, and WB was used to analyze signaling pathway components.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In mice studies, no mice died during or after the drug intervention period. It was found that Apelin-13 could significantly increase left ventricular ejection fraction (LVEF) and fractional shortening (FS) (P&lt;0.05) and decrease left ventricular end-diastolic diameter (LVEDD) and left ventricular end-systolic diameter (LVESD) (P&lt;0.05) in mice with DOX-induced cardiomyopathy, as well as alleviate the disordered arrangement of myocardial cells and alleviate the reduction in cross-sectional area (CSA) induced by DOX. Masson staining and immunohistochemistry showed that Apelin-13 could alleviate myocardial fibrosis. WB indicated that Apelin-13 could reduce apoptosis induced by DOX and change the effects of DOX on the transforming growth factor-β (TGF-β)/mothers against decapentaplegic homolog (Smad) proteins. Further research confirmed that the protective effect of Apelin-13 on DOX-induced cardiomyopathy was related to the upregulation of P-ERK and P-AKT. Similarly, in H9C2 studies, it was found that Apelin-13 could reduce DOX-induced apoptosis, increase cell survival rate, and alleviate the decrease in P-ERK and P-AKT induced by DOX.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Apelin-13 exert","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 3","pages":"50"},"PeriodicalIF":2.2,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419167","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 of the triglyceride glucose-body roundness index with stroke risk in middle-aged and elderly Chinese adults without diabetes: a prospective cohort study.","authors":"Zhihan Liu, Ning Huo, Yingjie Li, Yingdi Yang, Hanbing Li, Jinjian Xu","doi":"10.21037/cdt-2025-477","DOIUrl":"10.21037/cdt-2025-477","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Both the triglyceride-glucose index (TyG) and body roundness index (BRI) are individually associated with stroke risk, yet, each single indicator has limitations in predicting long-term risk. This study aims to evaluate the prospective association of TyG, BRI, and their combined index (TyG-BRI) with stroke incidence in non-diabetic populations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;From the nationally representative China Health and Retirement Longitudinal Study (CHARLS), a multi-stage probability sampled cohort, we established an analytical cohort consisting of non-diabetic adults aged 45 years or older without pre-existing cardiovascular disease (CVD) at the May 2011 to March 2012 baseline. After excluding participants with missing data on blood glucose, lipids, or anthropometric measurements, a final sample of 7,396 participants was followed prospectively until September 2020. The TyG was computed using fasting serum levels of triglycerides (TG) and glucose, while the BRI was calculated from waist circumference (WC) and height. Incident stroke events were identified through interviews, linkage with health insurance claims data, and cross-checking of death registry records. Cox proportional hazards models estimated hazard ratio (HR) and 95% confidence interval (CI), while restricted cubic spline (RCS) analyses evaluated dose-response relationships with stroke incidence. Both multiplicative interaction terms and additive interaction indices [relative excess risk due to interaction (RERI), attributable proportion (AP), and synergy index (SI)] were used to assess joint effects. To compare the predictive performance of the models, we conducted a receiver operating characteristic (ROC) curve analysis and quantified the results using the area under the curve (AUC).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Index-specific exclusion for missing essential calculation parameters yielded distinct sample sizes for the analysis of stroke incidence associations with TyG (n=7,396), BRI (n=6,862), and TyG-BRI (n=6,315). During a median follow-up of 6.5 years, 440 incident stroke events were documented in the non-diabetic cohort of the TyG-BRI analysis. The mean age of the cohort was 58.17 years [with a standard deviation (SD) of 9.70]. Approximately 47% of the participants were male. In the fully adjusted model, elevated levels of TyG-BRI [comparing the highest quartile (Q4) to the lowest (Q1): HR =2.29, 95% CI: 1.58-3.33], BRI (HR =2.12, 95% CI: 1.49-3.02), and TyG (HR =1.82, 95% CI: 1.30-2.53) were all significantly associated with the risk of stroke. RCS analysis indicated a linear relationship between TyG-BRI and stroke risk (P non-linear =0.084). The TyG index and BRI exhibited a joint association with incident stroke; however, this relationship was characterized by an absence of both multiplicative and additive interaction effects. The TyG-BRI model demonstrated improved predictive performance for stroke risk relative to the basic model (","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 2","pages":"19"},"PeriodicalIF":2.2,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13184920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980684","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":"Mitophagy in cardiovascular diseases: a literature review.","authors":"Ran Zhang, Junyan Zhang, Shuangliang Ma, Li Rao, Zhongxiu Chen","doi":"10.21037/cdt-2025-438","DOIUrl":"10.21037/cdt-2025-438","url":null,"abstract":"<p><strong>Background and objective: </strong>Mitochondria generate nearly 90% of cellular adenosine triphosphate (ATP) and are essential for maintaining cardiac energetic homeostasis. Mitophagy, a selective autophagic process that removes damaged mitochondria, is critical for preserving mitochondrial quality and ensuring cardiomyocyte survival under stress. Given that cardiovascular diseases (CVDs) remain the leading cause of mortality worldwide and are profoundly influenced by mitochondrial dysfunction, understanding mitophagy has become increasingly important. This review aims to summarize the current mechanistic findings related to mitophagy, examine its roles across major CVDs, and evaluate emerging mitophagy-targeted interventions with potential clinical application.</p><p><strong>Methods: </strong>A comprehensive literature search of PubMed was conducted using keywords, including \"mitophagy\", \"cardiovascular disease\", \"myocardial ischemia-reperfusion\", to retrieve relevant studies published in English between January 2020 and March 2025. Original studies, reviews, and clinically relevant reports were included in the literature review to ensure broad coverage of mechanistic and translational findings.</p><p><strong>Key content and findings: </strong>The review synthesizes current knowledge on canonical and noncanonical mitophagy pathways, as well as their roles in myocardial ischemia-reperfusion injury, heart failure, cardiomyopathies, and metabolic cardiomyopathy. Recent evidence highlights the dual nature of mitophagy, where both insufficient and excessive activation impair cardiac function. The review further discusses innovative therapeutic strategies, including mitochondrial-targeted nanoparticles, small-molecule mitophagy activators, and exercise-induced mitochondrial remodeling, along with their potential benefits and limitations. Key knowledge gaps have been identified, including the tissue-specific regulation of mitophagy and uncertainties surrounding dose-dependent therapeutic activation.</p><p><strong>Conclusions: </strong>Mitophagy is a pivotal determinant of mitochondrial homeostasis and cardiac health. While emerging interventions show promise, precise modulation remains challenging. Advancing quantitative assessment tools, defining safe activation thresholds, and developing cell-type-specific targeting strategies will be essential for clinical translation. This review provides a comprehensive framework that may guide future research and inform the development of mitophagy-based therapies for CVDs.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 2","pages":"35"},"PeriodicalIF":2.2,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13184925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980137","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":"Artificial intelligence in cardiology in the current era: a narrative review.","authors":"Avilash Mondal, Harshith Thyagaturu, Sahas Reddy Jitta, Binita Bhandari, Emmett Helsel, Megha Dogra, Kesar Prajapati, Karthik Gonuguntla","doi":"10.21037/cdt-2025-510","DOIUrl":"10.21037/cdt-2025-510","url":null,"abstract":"<p><strong>Background and objective: </strong>Artificial intelligence (AI) has transformed cardiovascular healthcare by influencing multimodal imaging, interventional procedures, and remote patient monitoring systems. The rapid growth of available evidence presents challenges for researchers to evaluate the quality of AI systems and their readiness for clinical application. The review examines current AI uses in cardiology by assessing methodological quality to pinpoint key factors for implementing effective AI models.</p><p><strong>Methods: </strong>We performed extensive search on MEDLINE/PubMed, Web of Science, Scopus, EMBASE for original research, clinical trials, and consensus/guideline statements, published in English from January 2015 through December 2025.</p><p><strong>Key content and findings: </strong>AI applied to electrocardiography (AI-ECG) technology shows practical success in clinical trials for detecting left ventricular systolic dysfunction (LVSD) and predicting atrial fibrillation (AF) from normal heart rhythms. AI in echocardiography performs automated view detection, chamber measurement, and assists novice users. Cardiac magnetic resonance (CMR) uses deep learning (DL) for reconstruction and inline perfusion analysis. Coronary computed tomography angiography (CCTA) employs automated coronary artery calcium (CAC)/plaque analysis and machine learning (ML)-based fractional flow reserve computed tomography (FFRct), while nuclear cardiology uses AI to reduce doses and enhance image quality. The cath lab benefits from AI-assisted intravascular imaging, which helps optimize percutaneous coronary intervention (PCI) planning, robotics systems that lower operator radiation exposure, and angiography-derived physiology [e.g., quantitative flow ratio (QFR)], enabling wire-free ischemia assessment with context-dependent value. Challenges to AI adoption include limited external validation data, unclear calibration methods, and gaps in addressing subgroup fairness, decision impact, and post-deployment performance monitoring.</p><p><strong>Conclusions: </strong>AI technology has advanced from experimental development to practical solutions for specific cardiology procedures that improve operational efficiency and standardization. Turning accuracy into patient benefits requires researchers to conduct external validation studies, prospective impact assessments, cost-effectiveness evaluations, equity-focused design, workflow integration, and ongoing governance systems. Implementing AI as an assistive tool will enhance healthcare accessibility, reduce unnecessary treatment disparities, and improve outcomes through clinical support, while automation continues to streamline routine tasks.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 2","pages":"34"},"PeriodicalIF":2.2,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13184909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980718","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":"Small vessel disease in chronic thromboembolic pulmonary hypertension: a comprehensive narrative review of multimodality imaging evaluation.","authors":"Luciana Eltz Soares, Zaid Alkaabneh, Rahul D Renapurkar","doi":"10.21037/cdt-2025-1-652","DOIUrl":"10.21037/cdt-2025-1-652","url":null,"abstract":"<p><strong>Background and objective: </strong>Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare form of pulmonary hypertension (PH) resulting from unresolved, organized thromboemboli within the pulmonary arterial tree, most often following an acute pulmonary embolic event. A distinctive feature of CTEPH is the development of secondary microvascular or small vessel disease (SVD), which has been associated with adverse surgical outcomes and persistent PH after pulmonary endarterectomy (PEA). While macrovascular disease can be reliably assessed with current imaging techniques, preoperative evaluation of SVD remains a significant diagnostic challenge. This focused review aims to summarize current imaging approaches to SVD in CTEPH, discuss their limitations, and highlight emerging techniques and future directions for improved assessment.</p><p><strong>Methods: </strong>Comprehensive literature review was conducted between January 2025 and January 2026, primarily using PubMed/MEDLINE and Scopus as databases, focusing on peer-reviewed English-language publications, from the past 10 years. Search terms and combined keywords including CTEPH, microvasculopathy or SVD, and imaging modalities were used.</p><p><strong>Key content and findings: </strong>Imaging plays a crucial role in diagnosis and risk stratification of these patients. Preoperative imaging using various tools allows confident diagnosis of CTEPH and determines patients' surgical suitability for PEA or balloon pulmonary angioplasty (BPA). Assessment of SVD still continues to be a challenge, although significant progress has been made. The presence of distal pulmonary artery (PA) obstructions and pulmonary vascular resistance (PVR) out of proportion to the degree of mechanical obstruction, are strongly suggestive of underlying microvascular disease. Preoperative recognition of SVD is crucial as these are associated with worse clinical outcomes and may result in recurrent/residual PH following surgery.</p><p><strong>Conclusions: </strong>Several imaging findings on various imaging modalities can provide clue to the presence of microvascular disease, although requires careful assessment and multidisciplinary input.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 2","pages":"32"},"PeriodicalIF":2.2,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13184924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980518","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":"Artificial intelligence, extended reality and computational modelling in cross-sectional cardiovascular imaging in congenital heart disease: a narrative review.","authors":"Francesca Raimondi, Almudena Ortiz-Garrido, Inga Voges","doi":"10.21037/cdt-2025-1-616","DOIUrl":"10.21037/cdt-2025-1-616","url":null,"abstract":"<p><strong>Background and objective: </strong>Artificial intelligence (AI), extended reality (XR), and computational modelling are increasingly integrated with cross-sectional cardiovascular imaging, particularly computed tomography (CT) and cardiovascular magnetic resonance (CMR), to address the diagnostic and therapeutic complexity of congenital heart disease (CHD). Given the lifelong and heterogeneous nature of CHD, these technologies have the potential to enhance anatomical assessment, haemodynamic understanding, procedural planning, and personalised care. This narrative review aims to provide a structured overview of current developments, clinical applications, and translational challenges related to AI, XR, and computational modelling in CT- and CMR-based CHD imaging.</p><p><strong>Methods: </strong>A targeted literature search was performed in PubMed to identify representative and clinically relevant publications from January 2014 to October 2025, including early online articles. Search terms included combinations of \"artificial intelligence\", \"deep learning\", \"extended reality\", \"virtual reality\", \"computational modelling\", \"computational fluid dynamics\", \"3D printing\", \"congenital heart disease\", \"cardiovascular magnetic resonance\", and \"computed tomography\". English-language original articles, reviews, and consensus statements were considered. Given the narrative design, studies were selected based on relevance and methodological contribution rather than formal systematic screening.</p><p><strong>Key content and findings: </strong>AI applications now span the full imaging-to-decision continuum, including image reconstruction, automated segmentation, quantitative assessment, phenotype recognition, and decision support. XR technologies enhance spatial understanding and pre-procedural planning, while computational modelling and three-dimensional (3D) printing enable patient-specific haemodynamic simulation and procedural rehearsal. Public datasets and integrated AI-XR-modelling pipelines are emerging. However, most evidence derives from feasibility and single-centre studies, and lesion-specific external validation remains limited.</p><p><strong>Conclusions: </strong>AI, XR, and computational modelling hold significant promise for advancing cross-sectional imaging in CHD. Future progress will depend on multicentre collaboration, lesion-stratified validation, workflow integration, and governance frameworks tailored to lifelong congenital care. Demonstration of clinical outcome benefit will be essential for widespread adoption.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 2","pages":"29"},"PeriodicalIF":2.2,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13184912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980691","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":"Cardiac magnetic resonance-derived left heart parameters in pulmonary hypertension: diagnostic and prognostic value-a narrative review.","authors":"Gengmin Liang, Huaxin Yuan, Sitong Chen, Iokfai Cheang, Xu Zhu, Xinli Li, Yanli Zhou","doi":"10.21037/cdt-2025-332","DOIUrl":"10.21037/cdt-2025-332","url":null,"abstract":"<p><strong>Background and objective: </strong>Patients with pulmonary hypertension (PH) exhibit left heart alterations, in morphology, function, and tissue characteristics, which may critically correlate with the pathophysiological mechanisms and prognosis of PH. However, a comprehensive review that summarizes the role of left heart parameters derived from cardiac magnetic resonance (CMR) in PH remains lacking. This review summarizes CMR-derived left heart morphological, functional, and tissue characterization parameters for PH diagnosis, classification, severity assessment, and prognosis, aiming to enhance evidence-based PH management.</p><p><strong>Methods: </strong>A literature search was performed on the PubMed and China National Knowledge Infrastructure (CNKI) databases for articles published between January 2000 and December 2024. Key search terms incorporated \"pulmonary hypertension\", \"cardiac magnetic resonance\", \"left ventricle\", \"left atrium\", \"diagnosis\", and \"prognosis\". Studies were deemed eligible if they investigated the association between CMR-derived left heart parameters and the diagnosis or prognosis of patients with PH.</p><p><strong>Key content and findings: </strong>This review synthesizes the evidence on key CMR-derived left heart parameters in PH. Left atrial volume index and left ventricular eccentricity index aid in the diagnosis and mortality prediction of PH. Left atrial active strain and left ventricular global strain serve as sensitive markers for identifying left ventricular dysfunction and predicting prognosis in PH patients, respectively. Ventricular interdependence parameters, such as ventricular mass index and septal angle, have been confirmed to correlate with hemodynamic parameters in PH. Furthermore, a key tissue characterization parameter-the right ventricular/left ventricular blood pool T2 ratio (RVT2/LVT2)-demonstrates significant value in assessing disease severity in chronic thromboembolic PH (CTEPH) and may serve as a novel non-invasive imaging marker for predicting prognosis in these patients.</p><p><strong>Conclusions: </strong>CMR-derived left heart parameters provide valuable insights for the diagnosis, classification, severity assessment, and prognosis of PH.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 2","pages":"36"},"PeriodicalIF":2.2,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13184914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980822","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":"Myocardial mapping: anatomy in the era of digital cardiology.","authors":"Piotr Jan Bramora","doi":"10.21037/cdt-2026-0141","DOIUrl":"10.21037/cdt-2026-0141","url":null,"abstract":"","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 2","pages":"37"},"PeriodicalIF":2.2,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13184905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980105","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":"A narrative review on the use of artificial intelligence in cardiovascular medicine.","authors":"Mohamed Hamdy Serour, Hasan Alhouri, Musab Taha Ahmed Egaimi, Asmaa Alshazly, Ayub Khan, Zahid Khan","doi":"10.21037/cdt-2025-aw-595","DOIUrl":"10.21037/cdt-2025-aw-595","url":null,"abstract":"<p><strong>Background and objective: </strong>Cardiovascular diseases (CVDs) remain the leading cause of morbidity and mortality worldwide despite substantial advancements in prevention, diagnostics, and therapeutics. The integration of artificial intelligence (AI) and machine learning (ML) is transforming cardiovascular medicine, with applications spanning electrocardiogram (ECG) interpretation, advanced imaging analysis, and risk prediction modelling. Authoritative guidelines, observational studies, systematic reviews, and meta-analyses have highlighted the diagnostic and prognostic potential in various domains, including AI-derived physiological age from ECG, automated plaque quantification in coronary computed tomography angiography (CTCA), and time to event survival prediction models. This review aims to synthesise contemporary evidence on AI in cardiovascular diagnostics, prevention, and rehabilitation, and to outline the methodological, ethical, and translational considerations for safe clinical adoption.</p><p><strong>Methods: </strong>A narrative review was conducted. The literature search was performed on PubMed/MEDLINE, Scopus, Embase, and Web of Science using relevant keywords, and articles published between January 2015, and August 2025 were included. Peer-reviewed studies, systematic reviews and meta-analyses, and position statements pertinent to AI in cardiovascular medicine were selected.</p><p><strong>Key content and findings: </strong>AI has achieved high accuracy in imaging interpretation, ECG-based arrhythmia detection, multimodal risk stratification, wearable-based screening, and adaptive cardiac rehabilitation. Survival models, such as Random Survival Forests and DeepSurv, have outperformed traditional Cox models in select datasets. Additionally, AI-derived physiological age from ECG shows associations with incident cardiovascular events and mortality. However, external validation is inconsistent, calibration is often inadequate, and reporting standards are variable. Equity, data privacy, interpretability, and workflow integration remain substantial barriers.</p><p><strong>Conclusions: </strong>AI can augment but not replace clinician judgment in cardiovascular care. Translation into routine practice requires rigorous multi-centre prospective trials, transparent reporting checklists, fairness assessments, and governance frameworks to ensure safety, generalizability, and equity. AI will likely play a significantly increasing role in enhancing patients' cardiovascular care.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 2","pages":"28"},"PeriodicalIF":2.2,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13184911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980741","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}