Cardiovascular diagnosis and therapy最新文献

{"title":"Five-year retrospective analysis of invasive <i>vs.</i> conservative strategies for non-ST elevation myocardial infarction in critically ill cancer patients.","authors":"Arif Timuroglu, Imran Ceren","doi":"10.21037/cdt-2025-525","DOIUrl":"10.21037/cdt-2025-525","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Management of non-ST segment elevation myocardial infarction (NSTE-MI) in critically ill cancer patients is challenging due competing risks such as bleeding, thrombocytopenia, organ dysfunction, and overall frailty. Evidence guiding the choice between interventional and pharmacological treatment strategies in this high-risk population is limited. This study aimed to compare in-hospital outcomes between interventional and pharmacological treatment strategies in critically ill cancer patients who developed NSTE-MI during intensive care unit follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective study was conducted in the intensive care unit of Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, a tertiary referral center, between January 2020 and December 2024. All consecutive adult patients with an active or prior cancer diagnosis who developed non-ST-elevation myocardial infarction (MI) during their intensive care unit (ICU) stay were included. Patients with ST-elevation MI or incomplete medical records precluding confirmation of diagnosis or outcome assessment were excluded. Patients were managed according to the initial treatment strategy determined by the treatment team. Demographics, clinical parameters, and in-hospital mortality rates were analyzed. Multivariable logistic regression was performed to identify factors independently associated with in-hospital mortality, acknowledging that causality cannot be inferred due to the study design.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 99 patients were included; 39 underwent interventional management and 60 received pharmacological therapy. Pharmacologically treated patients more often had elevated serum creatinine, hemodynamic instability, and a history of recent cancer surgery. Among the interventional group, 12 patients underwent percutaneous coronary intervention (PCI), with a mortality rate of 16.7%. Overall, hospital mortality was observed lower in the interventional group compared with the pharmacological group (13/39, 33.3% &lt;i&gt;vs.&lt;/i&gt; 41/60, 68.3%, P&lt;0.001). Multivariable analysis indicated that metastatic disease [odds ratio (OR) =4.46, 95% confidence interval (CI): 1.55-12.86, P=0.006] and treatment type (interventional &lt;i&gt;vs.&lt;/i&gt; pharmacological) (OR =0.25, 95% CI: 0.09-0.70, P=0.008) were independently associated with in-hospital mortality. These results suggest a possible association between interventional management and lower in-hospital mortality in critically ill cancer patients, though baseline differences and the retrospective design require cautious interpretation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In this retrospective analysis, an interventional treatment strategy was associated with lower in-hospital mortality in critically ill cancer patients with NSTE-MI. When clinically feasible, this approach may provide a survival benefit; however, prospective studies are needed to confirm these findings and optimize patien","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 2","pages":"23"},"PeriodicalIF":2.2,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13184918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980770","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":"Clinical outcomes of drug-coated balloons <i>vs.</i> drug-eluting stents for coronary chronic total occlusion: a retrospective cohort study.","authors":"Xianglin Liu, Lei Guo, Haichen Lv","doi":"10.21037/cdt-2025-478","DOIUrl":"10.21037/cdt-2025-478","url":null,"abstract":"<p><strong>Background: </strong>Drug-coated balloons (DCBs) have emerged as a promising treatment option for chronic total occlusion (CTO). However, direct comparisons of standalone DCB versus drug-eluting stents (DESs) are scarce, and evidence to guide device selection based on vessel anatomy or patient comorbidities is limited. This study aimed to compare the 12-month clinical outcomes between DCB and DES in CTO patients, with emphasis on vessel size and heart failure history.</p><p><strong>Methods: </strong>This study retrospectively analyzed 445 patients who underwent CTO-percutaneous coronary intervention (PCI) at the First Affiliated Hospital of Dalian Medical University from March 31, 2020 to March 31, 2023. The primary endpoint was major adverse cardiovascular events (MACEs), including cardiac death, myocardial infarction, target lesion revascularization, target vessel revascularization, and repeat revascularization at 12 months post-procedure. Secondary endpoints included all-cause mortality, recurrent heart failure, new-onset heart failure, and recurrent angina within the 12-month follow-up period. Multivariate Cox proportional hazards regression and subgroup analyses were conducted to compare the incidence of MACE between the two groups.</p><p><strong>Results: </strong>Among these patients, 163 were treated with DCB and 282 with DES. No significant differences were observed between the two groups in terms of MACE [hazard ratio (HR) 1.37; 95% confidence interval (CI): 0.82-2.26; P=0.21], all-cause mortality (HR 0.68; 95% CI: 0.14-3.13; P=0.62), new-onset heart failure (HR 0.80; 95% CI: 0.08-7.80; P=0.84), or recurrent angina (HR 1.03; 95% CI: 0.66-1.61; P=0.88) during follow-up. However, heart failure recurrence was significantly higher in the DCB group compared to the DES group (HR 0.08; 95% CI: 0.01-0.52; P=0.007). Subgroup analysis indicated a significant interaction (P for interaction =0.008) between treatment strategy (DCB/DES) and vessel size (≤2.75 <i>vs.</i> >2.75 mm). In patients with large-vessel CTO (>2.75 mm), the DCB group had a significantly lower incidence of MACE compared to the DES group (HR 3.46; 95% CI: 1.22-9.78; P=0.02).</p><p><strong>Conclusions: </strong>DCB angioplasty is safe and effective for treating CTO, demonstrating comparable clinical outcomes at 12 months to DES implantation. Patients with large-vessel CTO (>2.75 mm) who received DCB following optimal lesion preparation might experience improved prognoses. However, DES might be preferred for CTO patients with heart failure.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 2","pages":"22"},"PeriodicalIF":2.2,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13184913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980775","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":"Electrocardiographic changes in immune checkpoint inhibitor-associated cardiac injury: a narrative review.","authors":"Shaqi Rao, Guangying Wang, Jinjing Wu, Jiawei Ouyang, Zhuoqi Liu, Xiaohong Yang, Daya Luo, Shuhua Zhang","doi":"10.21037/cdt-2025-1-617","DOIUrl":"10.21037/cdt-2025-1-617","url":null,"abstract":"<p><strong>Background and objective: </strong>Immune checkpoint inhibitors (ICIs) are widely used in cancer treatment and have shown substantial clinical benefit. Although the incidence of ICI-associated cardiac injury is uncommon, such events may lead to severe complications and high mortality. Current tools for evaluating cardiac injury include serum biomarkers, electrocardiogram (ECG), echocardiography, cardiac magnetic resonance imaging, coronary angiography, and endomyocardial biopsy. Among these, ECG is widely used because of its convenience and practicality and serves as an important screening tool. This review summarizes ECG manifestations associated with ICI-associated cardiac injury to further clarify the clinical role of ECG in this setting.</p><p><strong>Methods: </strong>A literature search was conducted in PubMed for English-language literature published from February 23, 2010 to February 13, 2026 using predefined keywords related to immune checkpoint inhibitors, ECG, and cardiac injury.</p><p><strong>Key content and findings: </strong>ECG, as a diagnostic and monitoring tool for cardiotoxicity, has both advantages and limitations. Common ECG manifestations include arrhythmias such as premature atrial contractions, premature ventricular contractions, atrial fibrillation or atrial flutter, ventricular tachycardia (or ventricular fibrillation), and atrioventricular block, as well as QRS complex prolongation, low QRS voltage, and ST-segment and T-wave (ST-T) abnormalities. Among these findings, conduction disturbances, tachyarrhythmias (particularly ventricular tachycardia), and ST-T segment abnormalities are associated with higher mortality. However, ECG alone has limited diagnostic specificity, and its value is improved when combined with other diagnostic modalities.</p><p><strong>Conclusions: </strong>ECG is an important noninvasive tool for monitoring ICI-associated cardiac injury and plays a crucial role in screening and diagnosis. However, important knowledge gaps remain, including the lack of specific ECG markers for early diagnosis, limited evidence on ECG features that distinguish ICI-associated myocarditis from other causes of cardiac injury, insufficient understanding of the temporal evolution of ECG abnormalities, and the absence of validated ECG-based risk stratification or early warning models. Future research should focus on the development of early prediction models and further elucidation of injury mechanisms to improve cardiac safety during ICI therapy.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 2","pages":"26"},"PeriodicalIF":2.2,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13184919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980849","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":"Tiaozhi Tongmai Formula attenuates atherosclerosis by modulating the JAK1/STAT3 pathway to inhibit phenotypic transformation of vascular smooth muscle cells.","authors":"Lu Zhang, Kaidinuer Maimaiti, Jia-Li Sun, Meng-Meng Zhang, Min-Yu Zhang","doi":"10.21037/cdt-2025-aw-596","DOIUrl":"10.21037/cdt-2025-aw-596","url":null,"abstract":"<p><strong>Background: </strong>Atherosclerosis (AS) progression is closely associated with phenotypic transformation of vascular smooth muscle cells (VSMCs) and activation of the Janus kinase 1/signal transducer and activator of transcription 3 (JAK1/STAT3) signaling pathway. This study aimed to elucidate the active components and underlying mechanisms of the Tiaozhi Tongmai Formula (TZTMF) in ameliorating AS through both in vivo and in vitro experiments.</p><p><strong>Methods: </strong>The chemical constituents and serum pharmacochemistry of TZTMF were characterized using ultra-performance liquid chromatography-electrospray ionization-tandem mass spectrometry. An AS model was established in apolipoprotein E-deficient mice fed with a high-fat diet. The therapeutic effects of TZTMF were evaluated using hematoxylin and eosin, Movat pentachrome, and immunohistochemical staining, as well as western blot analysis. In hypoxia-stimulated mouse VSMCs, enzyme-linked immunosorbent assay, Transwell migration, wound-healing, immunofluorescence, western blot, and reverse transcription-quantitative polymerase chain reaction assays were conducted to assess cell viability and cellular responses to TZTMF.</p><p><strong>Results: </strong>A total of seventy-eight compounds were identified in TZTMF, of which thirty-nine were detected in serum. <i>In vivo</i>, TZTMF reduced AS progression, promoted plaque stabilization, and attenuated inflammation, abnormal proliferation, and phenotypic transformation of smooth muscle cells (SMCs) through downregulation of the JAK1/STAT3 signaling pathway. <i>In vitro</i>, TZTMF-containing serum suppressed hypoxia-induced SMC proliferation and migration, prevented the transition from the contractile to the synthetic phenotype, and decreased JAK1 and STAT3 expression at both the messenger RNA (mRNA) and protein levels. Furthermore, the regulatory effects of TZTMF on mouse aortic vascular smooth muscle (MOVAS) cells were largely mediated through the JAK1 pathway.</p><p><strong>Conclusions: </strong>TZTMF exerts anti-atherosclerotic effects in both <i>in vivo</i> and <i>in vitro</i> models. It contributes to plaque stabilization by enhancing collagen deposition, reducing inflammation, and suppressing SMC proliferation and phenotypic transformation, primarily through inhibition of the JAK1/STAT3 signaling pathway.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 2","pages":"16"},"PeriodicalIF":2.2,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13184923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980488","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 across the cardiovascular diagnostic pathway: a case-based narrative review.","authors":"Hesham M Abdalla, Adam Bacon, Hunter VanDolah, Luke Dreher, Isabel Scalia, Abdulrahman Eldeib, Todd Laffaye, Mahmoud Abdelnabi, Ramzi Ibrahim, Girish Pathangey, Reza Arsanjani, Chadi Ayoub","doi":"10.21037/cdt-2025-aw-550","DOIUrl":"10.21037/cdt-2025-aw-550","url":null,"abstract":"<p><strong>Background and objective: </strong>Artificial intelligence (AI) is increasingly embedded across cardiovascular care, serving as a powerful adjunct for symptom assessment, bedside examination, electrocardiography, and multimodality imaging interpretation. We aim to thoroughly review current evidence for AI applications across the cardiovascular diagnostic pathway and to highlight key considerations for clinical integration.</p><p><strong>Methods: </strong>We performed a narrative review of clinical trials and observational studies retrieved from MEDLINE/PubMed, Embase, and Google Scholar (January 1^st 2000-July 10^th 2025), limited to publications in English, using AI- and cardiovascular diagnostic specific search terms. Regulatory resources [e.g., U.S. Food and Drug Administration (FDA) clearance databases and publicly available summaries] were also reviewed to identify cardiovascular AI software with regulatory authorization.</p><p><strong>Key content and findings: </strong>Across diagnostic domains, AI has demonstrated potential to improve diagnostic performance and workflow efficiency. Large language models and other AI systems can support structured history-taking, triage, and automated clinical documentation. Digital stethoscope and phonocardiography algorithms enable scalable screening for murmurs and valvular disease with a higher sensitivity for murmur detection compared with conventional auscultation. Electrocardiography-based AI models have been reported for rapid detection of arrhythmias, ischemia, and heart failure with reduced ejection fraction (EF). In echocardiography, AI enables automated view classification, chamber quantification, EF estimation, and valve assessment, while substantially reducing acquisition and processing time. Advanced imaging tools support coronary computed tomography (CT) angiography plaque characterization, calcium scoring, and CT-derived fractional flow reserve (FFR), as well as cardiac magnetic resonance segmentation and scar/late gadolinium enhancement (LGE) quantification. However, much of the evidence remains retrospective with heterogeneous endpoints, and outcome-improving, prospective, real-world integration studies remain limited.</p><p><strong>Conclusions: </strong>Future work should prioritize multicenter prospective validation and implementation studies that address model generalizability, quality control, bias, data drift, and governance. Multimodal, workflow-embedded AI systems that fuse clinical and imaging signals may ultimately enable individualized risk prediction and improve access and cardiovascular outcomes.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 2","pages":"33"},"PeriodicalIF":2.2,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13184929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980711","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":"Printing the future of surgical education: a randomized trial of digital tools in cardiovascular training.","authors":"Davi Shunji Yahiro, Carlos Henrique Bonfim Osaka, Claudio Tinoco Mesquita","doi":"10.21037/cdt-2025-aw-546","DOIUrl":"10.21037/cdt-2025-aw-546","url":null,"abstract":"","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 2","pages":"14"},"PeriodicalIF":2.2,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13184916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980473","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 robust endothelial injury model inducing medial arterial calcification in C57BL/6J mice on a standard diet.","authors":"David Magne","doi":"10.21037/cdt-2025-1-613","DOIUrl":"10.21037/cdt-2025-1-613","url":null,"abstract":"","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 2","pages":"15"},"PeriodicalIF":2.2,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13184921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980749","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":"Age-related progression of myocardial dysfunction in patients with Duchenne muscular dystrophy assessed by cardiac magnetic resonance tissue tracking: a case-control study.","authors":"Hui Liu, Hua-Yan Xu, Rong Xu, Hang Fu, Ying-Kun Guo, Liang-Geng Gong","doi":"10.21037/cdt-2025-514","DOIUrl":"10.21037/cdt-2025-514","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular complications are the primary cause of mortality in patients with Duchenne muscular dystrophy (DMD). However, the dynamic progression underlying myocardial damage in DMD has not yet been fully elucidated. This study aimed to quantitatively assess myocardial dysfunction in patients with DMD across different age groups via cardiac magnetic resonance (CMR) tissue tracking technology.</p><p><strong>Methods: </strong>Between August 2018 and January 2020, 110 patients with DMD diagnosed at the Pediatric Neurology Outpatient Department of West China Second University Hospital were consecutively and prospectively included in the study. The patients were categorized into three age groups: 3-6, 7-10, and 11-14 years. Based on left ventricular ejection fraction (LVEF), the patients were further divided into a normal LVEF group (LVEF ≥55%) and a decreased LVEF group (LVEF <55%). Furthermore, based on the presence of delayed enhancement, patients were classified into late gadolinium enhancement (LGE)-positive and LGE-negative groups. Additionally, 69 healthy controls were recruited for comparison. Left ventricular functional parameters and CMR tissue tracking-related parameters, such as global and regional myocardial strain of the left ventricle, were assessed. These included radial, circumferential, and longitudinal peak strains at the base, middle, and apex of the left ventricle. Statistical analyses were conducted via the t-test.</p><p><strong>Results: </strong>A total of 99 patients and 61 healthy controls were included in the study. In comparison to the control group (n=21), patients aged 3-6 years in the DMD group (n=15) did not exhibit any decline. Patients aged 7-10 years in the DMD group (n=63), as compared with the control group (n=18), had lower LVEF (59.58%±7.09% <i>vs.</i> 63.39%±5.27%, P=0.044) and left ventricular global radial (37.34%±9.78% <i>vs.</i> 42.95%±9.22%, P=0.03), circumferential (-20.75%±3.77% <i>vs.</i> -22.09%±2.46%, P=0.03), and longitudinal (-13.91%±2.81% <i>vs.</i> -15.69%±2.52%, P=0.04) strain. Patients aged 11-14 years in the DMD group (n=21), as compared with the control group (n=22), demonstrated an even greater reduction in strain in the left ventricle for all parameters, except for LVEF. For patients in the normal LVEF group (n=77) or LGE-negative group (n=51), despite there being no significant difference in cardiac function compared with the control group, the global and regional myocardial strain of left ventricle was decreased.</p><p><strong>Conclusions: </strong>Myocardial dysfunction predominantly manifests in DMD among children older than 7 years, exhibiting a subtle progression that exacerbates with advancing age. The myocardial injury tends to develop from the basal epicardium toward the apical and endocardial regions.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 2","pages":"25"},"PeriodicalIF":2.2,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13184907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980701","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-enhanced electrocardiography for acute myocardial infarction detection: a systematic review.","authors":"Yangyoun Lee, Jung Hwan Ahn, Hyoung-Mo Yang","doi":"10.21037/cdt-2025-aw-561","DOIUrl":"10.21037/cdt-2025-aw-561","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) shows promise for improving electrocardiogram (ECG)-based acute myocardial infarction (AMI) detection, but clinical readiness remains uncertain. We aimed to conduct a systematic synthesis informed by a structured search of AI-enhanced ECG systems to evaluate their performance, validation quality, and implementation readiness.</p><p><strong>Methods: </strong>We conducted a structured search of PubMed and Embase (publication date limits: January 1, 2017, to August 31, 2025; last searched: February 18, 2026) for English-language human studies that developed or validated AI models for ECG-based AMI diagnosis, extracting data on architectures, clinical applications, validation approaches, and performance metrics; we excluded non-original publications and studies that were non-English or non-human studies or did not use ECG input or did not address AMI diagnosis.</p><p><strong>Results: </strong>We included 88 studies; the total number of participants was not estimable because sample sizes were inconsistently reported across studies. Among 88 identified studies, convolutional neural networks predominated (51/88, 58%). Most studies were retrospective (80/88, 91%) and used 12-lead ECG (64/88, 73%). Reported performance varied widely [area under the receiver operating characteristic curve (AUROC), 0.700-0.999; sensitivity, 67.7-100.0%; specificity, 73.3-100.0%], with promising results for detecting subtle ischemic patterns in non-ST-elevation and occlusion myocardial infarction (OMI). However, only 33/88 (37.5%) performed external validation. Public datasets were used in 50/88 (57%) and institutional patient cohorts in 43/88 (49%); several studies used both sources. More complex architectures did not consistently demonstrate superior accuracy, though heterogeneity in study designs limits definitive conclusions.</p><p><strong>Conclusions: </strong>AI demonstrates substantial technical potential for AMI detection, particularly for subtle ischemic patterns. However, critical gaps impede clinical deployment: insufficient external validation, reliance on curated datasets with limited generalizability, absence of standardized evaluation frameworks, and insufficient evidence on patient-centered outcomes. Future research must prioritize prospective multicenter validation, standardized benchmarks with rigorous reference standards, and real-world implementation studies examining clinical outcomes and workflow integration. Technical feasibility is established; clinical impact now depends on validation rigor and pragmatic deployment.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 2","pages":"30"},"PeriodicalIF":2.2,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13184927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980678","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":"Certain role of extra-domain A containing fibronectin in the development of pulmonary hypertension in the sugen/hypoxia mouse model.","authors":"Clara Gutte, Katja Grün, Laura Tempel, Isabell Singerer, Andrea Schrepper, Alexander Berndt, Reinhard Bauer, P Christian Schulze, Marcus Franz","doi":"10.21037/cdt-2025-443","DOIUrl":"10.21037/cdt-2025-443","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Pulmonary hypertension (PH) is a heterogeneous condition with diverse aetiologies and clinical presentations, driven by remodelling of the pulmonary vasculature and right ventricular (RV) myocardium, progressing to right heart failure (RHF) with poor prognosis. Cardiovascular remodelling is characterized by re-expression of extra-domain A containing fibronectin (ED-A&lt;sup&gt;+&lt;/sup&gt; Fn), which our prior studies identified as a key pathogenetic mediator in monocrotaline-induced PH. This study investigated the role of ED-A&lt;sup&gt;+&lt;/sup&gt; Fn in the progression of hypoxia-associated PH and subsequent RHF, corresponding to clinical group 3 PH, associated with lung diseases and/or hypoxia. We employed the mouse model of Sugen5416/hypoxia (SuHx) induced PH, that reproduces essential features of both group 1 (pulmonary arterial hypertension) and 3 PH, comparing ED-A&lt;sup&gt;+&lt;/sup&gt; Fn knockout (KO) mice with wild-type (WT) controls (strain: Black 6, C57BL/6).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;PH was induced in male mice (n=26) employing the Sugen5416/hypoxia model. Animals were allocated to four experimental groups: normoxic WT controls (WTNx, n=8), WT mice with SuHx-induced PH (WTSuHx, n=8), normoxic ED-A&lt;sup&gt;+&lt;/sup&gt; Fn KO controls (KONx, n=5) and ED-A&lt;sup&gt;+&lt;/sup&gt; Fn KO mice with SuHx-induced PH (KOSuHx, n=5). Echocardiographic assessment of RV morphological structure and function was conducted, including measurements of basal RV diameter (RV&lt;sub&gt;basal&lt;/sub&gt;), right atrial (RA) area (RA&lt;sub&gt;area&lt;/sub&gt;), tricuspid annular plane systolic excursion (TAPSE) and fractional area change (FAC). Right heart catheterization (RHC) was performed to measure RV systolic pressure (RVP&lt;sub&gt;sys&lt;/sub&gt;), followed by histological and immunohistochemical analyses of tissue samples.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;RHC demonstrated a significant increase in RVP&lt;sub&gt;sys&lt;/sub&gt; in WTSuHx mice (85.2±11.4 mmHg) as opposed to WTNx (45.2±4.6 mmHg, P=0.006), KONx (38.9±4 mmHg, P=0.02) and KOSuHx (49.8±9.5 mmHg, P=0.02). Echocardiographic assessment revealed significant impairment in WTSuHx mice, including a markedly increased RV&lt;sub&gt;basal&lt;/sub&gt; (2.57±0.15 mm, P=0.01) relative to KOSuHx mice (2.14±0.19 mm). Histological analysis showed pronounced pulmonary tissue damage induced by PH in WTSuHx (5.63±0.7, P=0.006) and KOSuHx (2.7±0.98, P=0.03) compared to their respective normoxic controls, with significantly greater impairment observed in WTSuHx versus KOSuHx (P=0.01). The degree of RV myocardial injury was markedly greater in WTSuHx (0.88±0.41) versus WTNx (0.06±0.17, P=0.006), while KO groups displayed no significant differences. Pulmonary vasculopathy and immune cell infiltration, assessed by immunohistochemical analysis, were significantly exacerbated in WTSuHx relative to all other experimental groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Beyond its established pathogenetic role in monocrotaline-induced PH, our study additionally identifies ED-A&lt;sup&gt;+&lt;/sup&gt; Fn a","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 2","pages":"17"},"PeriodicalIF":2.2,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13184926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980843","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}