Cardiovascular diagnosis and therapy最新文献

{"title":"Gradients after transcatheter aortic valve replacements are impacted by both body mass index and valve size: a retrospective cohort study.","authors":"Rafferty I Koontz, James T Watson, Samantha Roark, Shreeya Shabari, Riya Murugesan, Divya Chawla, Akhil R Reddy, Spencer M Ng, John P Vavalle","doi":"10.21037/cdt-2025-256","DOIUrl":"10.21037/cdt-2025-256","url":null,"abstract":"<p><strong>Background: </strong>Obesity is a common comorbidity among patients undergoing transcatheter aortic valve replacement (TAVR) and may influence valve hemodynamics. The impact of body mass index (BMI) and valve size on post-TAVR echo-derived gradients is not fully understood; however, it is clinically important for optimizing outcomes, particularly in high-BMI populations, where procedural success may be affected. This study aims to determine the relationship between BMI and post-procedural gradients.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted at a single large academic medical center to study patients who underwent balloon-expandable TAVR between 2021 and 2023. Patients had pre-procedural computed tomography (CT) and echocardiographic data and completed a 30-day follow-up echocardiogram. Patients were stratified based on BMI (<30 <i>vs.</i> ≥30 kg/m²) and valve size (20/23 <i>vs.</i> 26/29 mm). Mean 30-day echocardiogram gradients, measured with Doppler echocardiography, were compared across groups. A total of 180 patients were identified and stratified into 4 groups: high-BMI small valve (n=26); high-BMI large valve (n=33); low-BMI small valve (n=47); and low-BMI large valve (n=74). Both univariate analysis and multivariate analysis compared different groups and the impacts of individual variables on mean 30-day echocardiogram gradients.</p><p><strong>Results: </strong>The groups were similar in demographics and clinical characteristics, except for age, which was significantly lower in the high BMI group (P<0.001). Low-BMI patients with large valves had significantly lower gradients than high-BMI patients with small valves (P=0.002). Among high-BMI patients, small valves were associated with significantly higher gradients than large valves (P=0.009). In low-BMI patients, gradients were similar regardless of valve size (P=0.16). In small valve patients, there was a trend for higher gradients in high versus low BMI (P=0.056).</p><p><strong>Conclusions: </strong>Both BMI and valve size impact 30-day echo-derived gradients after balloon-expandable TAVR. High BMI and small valves are associated with higher gradients. With larger valves, the impact of BMI on valve gradient is attenuated. Additionally, for low-BMI patients, valve size has less impact on gradients. This study suggests that BMI is a crucial factor impacting gradients, and suggests that future research into the role of weight loss in TAVR treatment should be conducted.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 2","pages":"18"},"PeriodicalIF":2.2,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13184910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980814","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":"AI-driven radiomics in vascular disease: a narrative review of image analysis and clinical translation.","authors":"Dongmei Zhu, Yishen Fu, Yuyao Wang, Zhixiu Li, Anying Cheng, Fan He","doi":"10.21037/cdt-2025-531","DOIUrl":"10.21037/cdt-2025-531","url":null,"abstract":"<p><strong>Background and objective: </strong>Conventional interpretation of vascular imaging is often limited by qualitative assessments and inter-observer variability. Artificial intelligence (AI)-driven radiomics addresses these limitations by extracting high-dimensional quantitative features, providing superior characterization of complex vascular lesions, such as atherosclerotic plaques and calcifications. This review aims to summarize current AI applications in vascular imaging, focusing specifically on diagnosis, risk prediction, and the emerging field of radiogenomics.</p><p><strong>Methods: </strong>A comprehensive literature search of the PubMed database was conducted to retrieve relevant English-language articles published between 2015 and 2025. The search strategy strictly prioritized large-scale multicenter studies and pivotal clinical trials concerning AI in vascular imaging.</p><p><strong>Key content and findings: </strong>Integrating machine learning (ML) with multimodal imaging [ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI)] significantly enhances automated vascular identification, diagnostic consistency, and precise outcome prediction. Additionally, radiogenomics links imaging phenotypes with genetic profiles, providing deeper insights into the molecular mechanisms of vascular diseases. The review also critically addresses key challenges hindering the clinical translation of these AI technologies, particularly data heterogeneity, the lack of standardized protocols, and limited model interpretability.</p><p><strong>Conclusions: </strong>AI radiomics holds significant transformative potential for advancing personalized vascular medicine. Future efforts must prioritize methodological standardization and robust multicenter validation to facilitate the reliable clinical adoption of AI tools and inform healthcare policy making.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 2","pages":"31"},"PeriodicalIF":2.2,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13184915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980680","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":"Rethinking heart rate modulation in heart failure: physiological basis, clinical evidence, and individualized targets: a narrative review.","authors":"Yusuke Yumita, Yuji Nagatomo, Akane Kawai, Midori Iwashita, Kota Mizutani, Ayami Naito, Toshiki Chishiki, Yukinori Ikegami, Takeshi Adachi","doi":"10.21037/cdt-2025-1-676","DOIUrl":"10.21037/cdt-2025-1-676","url":null,"abstract":"<p><strong>Background and objective: </strong>Heart rate (HR) is a key determinant of cardiovascular performance and an established prognostic marker in heart failure (HF). While HR reduction improves outcomes in patients with HF with reduced ejection fraction (HFrEF) and sinus rhythm (SR), its role across different HF phenotypes remains uncertain. This review aims to synthesize physiological principles, clinical evidence, and emerging concepts to clarify the role of HR modulation in HF and to explore the potential of individualized HR targets.</p><p><strong>Methods: </strong>We conducted a narrative review of experimental studies, observational analyses, and randomized controlled trials evaluating the physiological and clinical impact of HR and HR modulation strategies across HF phenotypes, including HFrEF, HF with preserved ejection fraction (HFpEF), and atrial fibrillation (AF).</p><p><strong>Key content and findings: </strong>In HFrEF with SR impaired force-frequency and relaxation-frequency relationship render tachycardia maladaptive, and HR reduction with β-blockers or ivabradine is associated with improved outcomes. However, optimal HR targets have not been prospectively defined, and achieved HR thresholds are largely derived from post hoc analyses. In AF, the relationship between HR and prognosis is inconsistent, and HR reduction does not uniformly translate into clinical benefit. In HFpEF, higher resting HR is associated with adverse outcomes, but randomized trials have not demonstrated consistent benefits of pharmacological HR lowering. Emerging evidence suggests that HR modulation in HFpEF may require phenotype-specific approaches, including both HR reduction and HR support, such as pacing-based strategies. Beyond uniform HR thresholds, an individualized target HR (THR), based on diastolic filling dynamics and minimizing E-A overlap, has been proposed for HFrEF with SR. Observational data suggest that achieving HR below the estimated THR is associated with improved outcomes, although this concept remains hypothesis-generating.</p><p><strong>Conclusions: </strong>HR modulation plays a central role in HF management, particularly in HFrEF with SR. However, uniform HR targets may be suboptimal, and individualized approaches based on patient-specific physiology may be required. While preliminary data support the concept of individualized HR targets, prospective studies are needed to validate their clinical utility and to define phenotype-specific HR strategies across the HF spectrum.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 2","pages":"27"},"PeriodicalIF":2.2,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13184922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980493","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":"Automated right ventricle-to-left ventricle diameter ratio predicts ICU stay for acute pulmonary embolism on CTPA examinations in the emergency department.","authors":"Kiran Batra, Yin Xi, Kaj Anderson, Trushil Shah, Maya Wiessman, Saiabhiroop R Govindu, Aashna Vajramani, Ronald M Peshock","doi":"10.21037/cdt-2025-aw-526","DOIUrl":"10.21037/cdt-2025-aw-526","url":null,"abstract":"<p><strong>Background: </strong>A reproducible and reliable automated tool to measure right ventricle-to-left ventricle diameter ratio (RV/LV) in acute pulmonary embolism (PE) examinations on computed tomography pulmonary angiography (CTPA) can suggest right ventricle (RV) enlargement, however the relationship to outcomes has not been investigated. The purpose of this study was to assess the relationship between an automated RV/LV ratio determined by an artificial intelligence (AI) algorithm, on a set of examinations deemed positive for acute PE by an AI algorithm on CTPA studies in the emergency department (ED) and various clinical parameters in predicting mortality and outcomes.</p><p><strong>Methods: </strong>This retrospective study included ED patients who underwent CTPA from April 2022 to October 2023. A commercial AI algorithm was applied to CTPA images with acute PE. Associations of automated RV/LV >1 in acute PE examinations with variables including interventional treatment, 30- and 90-day mortality, intensive care unit (ICU) admission and stay length were studied. Results were analyzed with a logistic regression model and reported as odds ratios (ORs).</p><p><strong>Results: </strong>In a cohort of 408 examinations from 408 patients, 142 examinations (35%) had an RV/LV ≤1 and 266 (65%) had an RV/LV >1. Patients with RV/LV >1 were more likely to be admitted into ICU ±12 hours of CTPA (25% <i>vs.</i> 15%, P=0.02) and more likely to undergo interventional radiology (IR) procedures (6.8% <i>vs.</i> 0.7%, P=0.006) compared to those RV/LV ≤1. The same group had higher odds of ICU admission both before and after adjusting for simplified pulmonary embolism severity index (sPESI) [unadjusted OR: 1.90 (1.12, 3.33), P=0.02; adjusted OR: 2.00 (1.14, 3.64), P=0.02].</p><p><strong>Conclusions: </strong>Automated detected RV/LV >1 in acute PE examinations on CTPA in the ED has an association with ICU admission.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 2","pages":"24"},"PeriodicalIF":2.2,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13184917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980757","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 neutrophil to lymphocyte ratio with the severity of coronary artery lesions in patients undergoing coronary angiography for the first time.","authors":"Tiankun Wu, Xing Meng, Qingyu Yang, Honghui Yang, Yiming Guo, Yue Wu, Qingman Li, Yapan Yang, Tingjie Yang, Guian Xu","doi":"10.21037/cdt-2025-aw-537","DOIUrl":"10.21037/cdt-2025-aw-537","url":null,"abstract":"<p><strong>Background: </strong>The neutrophil-to-lymphocyte ratio (NLR), an easily obtained inflammatory biomarker, has an unclear relationship with the severity of coronary artery disease (CAD) in first-time coronary angiography (CAG) inpatients. This single-center retrospective study aimed to explore the correlation between the baseline NLR and the severity of coronary artery lesions measured by the Gensini score in such patients.</p><p><strong>Methods: </strong>Consecutive data from patients who first underwent CAG at Zhengzhou People's Hospital's Cardiology Department from July to December 2024 were used. NLR was analyzed as continuous and categorical variables for the assessment of its association with the severity of coronary artery lesions. Subgroup analyses stratified by age, gender, body mass index (BMI), diabetes mellitus (DM), hypertension, and smoking status, as well as curve fitting, were also carried out. Statistical analyses included multivariable linear regression models, restricted cubic spline (RCS) analysis, and bootstrap resampling for robustness validation.</p><p><strong>Results: </strong>Among 229 first-time CAG patients (65.9% male), smoothed curve fitting showed a linear NLR-Gensini score relationship (P for non-linearity =0.38). Covariate analysis indicated that diabetes [β=16.3, 95% confidence interval (CI): 6.91-25.69, P<0.001], smoking (β=10.23, 95% CI: 1.65-18.81, P=0.02), white blood cell (WBC) count (β=2.69, 95% CI: 1.16-4.23, P<0.001), and uric acid (β=0.04, 95% CI: 0-0.08, P=0.04) were related to higher Gensini scores, while high-density lipoprotein (HDL) (β=-20.53, 95% CI: -34.97 to -6.08, P=0.006) was associated with a lower score. NLR was significantly correlated with lesion severity both in the crude model (β=3.37, 95% CI: 1.67-5.08, P<0.001) and fully adjusted model (β=2.39, 95% CI: 0.28-4.51, P=0.02). Analyzing NLR categorically (quartiles: Q1: <1.75, Q2: 1.75-2.32, Q3: >2.32-3.48, Q4: >3.48), Q3 (β=13.70, 95% CI: 2.03-25.38, P=0.02) and Q4 (β=14.91, 95% CI: 2.28-27.53, P=0.02) had significant associations with CAD severity in the fully adjusted model, with a significant trend (P for trend=0.007).</p><p><strong>Conclusions: </strong>Among hospitalized patients undergoing first-time CAG, the NLR is significantly associated with the severity of coronary artery lesions.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 2","pages":"21"},"PeriodicalIF":2.2,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13184908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980681","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":"Left ventricular flow components and myocardial deformation following treatment for hypertrophic obstructive cardiomyopathy: a retrospective cardiac magnetic resonance-based cohort of mavacamten <i>vs.</i> septal myectomy.","authors":"Yinzhu Chen, Xinyi Luo, Yuelong Yang, Jiehao Ou, Hui Liu","doi":"10.21037/cdt-2025-aw-547","DOIUrl":"10.21037/cdt-2025-aw-547","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The differential therapeutic effects of the novel medication mavacamten and septal myectomy in patients with hypertrophic obstructive cardiomyopathy (HOCM) remain unclear. This study combined cardiac magnetic resonance (CMR) feature tracking (CMR-FT) with four-dimensional flow (4D-flow) imaging to compare the differential improvements in myocardial deformation function and ventricular hemodynamics achieved by these two treatments.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective study reviewed CMR images from all HOCM patients treated with mavacamten or septal myectomy (February 2021-May 2023) at baseline and 30 weeks (during continued mavacamten or post-operation), along with 10 healthy volunteers without cardiovascular disease or risk factors. CMR parameters included: FT-based left ventricular (LV) global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS); and LV flow components derived from 4D-flow, including direct flow (DF), retained inflow (RIF) component, delayed ejection flow (DEF), and residual volume (RV). Intra-group differences were compared using paired t-tests, while inter-group differences were assessed using independent samples &lt;i&gt;t&lt;/i&gt;-tests. Differences between HOCM patients and healthy volunteers were analyzed using one-way analysis of variance (ANOVA) and Tukey's post-hoc tests.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;This single-center study analyzed CMR images from 10 HOCM patients treated with mavacamten, 10 HOCM patients treated with myectomy, and 10 healthy volunteers. From baseline to 30 weeks, the mavacamten group and myectomy group showed similar degrees of improvement in LV structure, function, and myocardial deformation (mavacamten &lt;i&gt;vs&lt;/i&gt;. myectomy): LV mass index (LVMI): -24.00±13.78 &lt;i&gt;vs&lt;/i&gt;. -17.66±10.91 g/m&lt;sup&gt;2&lt;/sup&gt;, mean between-group difference: 6.28 g/m&lt;sup&gt;2&lt;/sup&gt; [95% confidence interval (CI): -3.97 to 16.53], P=0.21; GLS: -2.54%±1.57% &lt;i&gt;vs&lt;/i&gt;. -2.77%±1.44%, mean between-group difference: -0.24% (95% CI: -1.65% to 1.18%), P=0.73; GCS: -1.46%±0.54% &lt;i&gt;vs&lt;/i&gt;. -3.31%±3.05%, mean between-group difference: -1.85% (95% CI: -3.91% to 0.21%), P=0.09. However, compared to the mavacamten group, the myectomy group showed a slight advantage in improving LV flow components (mavacamten &lt;i&gt;vs&lt;/i&gt;. myectomy): DF: 5.54%±2.02% &lt;i&gt;vs&lt;/i&gt;. 9.43%±5.63%, mean between-group difference: 3.89% (95% CI: 0.27% to 7.86%), P=0.02; RV: -9.92%±4.23% &lt;i&gt;vs&lt;/i&gt;. -13.47%±4.38%, mean between-group difference: -6.25% (95% CI: -10.39% to -2.11%), P=0.005. Moreover, at baseline, both the mavacamten and myectomy groups of HOCM patients had lower DF and higher RV compared to the healthy control group: mavacamten group (all P&lt;0.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;For HOCM patients, short-term treatment with either mavacamten or septal myectomy yields comparable improvements in LV structure, function, and myocardial deformation. However, septal myectomy appears to ","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 2","pages":"20"},"PeriodicalIF":2.2,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13184928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980794","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":"Transforming clinical documentation with ambient artificial intelligence (AI) scribes: a narrative review of technology, impact, and implementation.","authors":"Mahshad Razaghi, Abdelrahman Hafez, Juan M Farina, Isabel G Scalia, Milagros Pereyra, Fatmaelzahraa E Abdelfattah, Hesham Sheashaa, Kamal Awad, Steven J Lester, Chadi Ayoub, Reza Arsanjani","doi":"10.21037/cdt-2025-454","DOIUrl":"10.21037/cdt-2025-454","url":null,"abstract":"<p><strong>Background and objective: </strong>Electronic health records (EHRs) have modernized care but increased documentation burden and clinician burnout. Ambient artificial intelligence (AI) scribes, combining automated speech recognition (ASR), natural language processing (NLP), and generative AI, aim to address this by capturing encounters and generating documentation. Related technologies, including virtual assistants and autonomous patient-facing systems, extend these capabilities beyond the clinician's physical presence. This narrative review synthesizes current evidence on the real-world performance, implementation, and impact of these AI tools.</p><p><strong>Methods: </strong>A narrative literature search was conducted using PubMed, supplemented by a manual review of reference lists from key articles. The search covered studies published between January 2019 and June 2025. After screening and full-text review, 18 studies met inclusion criteria and were incorporated into this review.</p><p><strong>Key content and findings: </strong>AI scribes consistently reduce documentation burden and cognitive load, improve workflow efficiency, save time, and enhance patient-clinician interaction by allowing greater clinician focus. However, studies also report frequent documentation omissions and occasional clinically significant hallucinations. Implementation remains a sociotechnical challenge involving workflow redesign, medico-legal considerations, and preservation of the patient-clinician relationship. In cardiology, where documentation requires precise, time-sensitive detail, AI-related errors may carry greater risk, underscoring the need for specialty-specific validation.</p><p><strong>Conclusions: </strong>Ambient AI scribes show promise in reducing workload, improving efficiency, and decreasing burnout, but current systems still generate high omission rates and intermittent factual inaccuracies that may affect clinical decision-making. Evidence remains limited by small cohorts and methodological variability, warranting cautious interpretation. More rigorous, standardized evaluations are needed before routine clinical adoption.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 1","pages":"11"},"PeriodicalIF":2.2,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12973079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147431042","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":"Postoperative complications of coronary artery bypass grafting: a narrative review on pathophysiology, management strategies, and the emerging role of artificial intelligence.","authors":"Rohan Kumar, Fadi Ali Jamaleddin Ahmad, Mayyas Al Sheikh Fattouh, Iqrah Aalia Issimdar, Aneek Ghosh, Amin Omer Amin Ahmed, Youssef El Soussi, G A Chathra Erandi, Jayalekshmi Leena, Khaled Abu Hejleh, Maneeth Mylavarapu","doi":"10.21037/cdt-2025-480","DOIUrl":"10.21037/cdt-2025-480","url":null,"abstract":"<p><strong>Background and objective: </strong>Coronary artery bypass grafting (CABG) remains a vital treatment option for high-risk patients with advanced coronary artery disease, especially those with multivessel disease, extensive left main disease, or refractory angina. While CABG effectively lowers long-term mortality and morbidity, it is still associated with many postoperative complications that can hinder recovery and affect quality of life. This review aims to thoroughly explore risk factors, prevention, and management strategies of major postoperative complications after CABG, categorized by physiological systems.</p><p><strong>Methods: </strong>A comprehensive literature review was conducted on PubMed and Google Scholar from January 1, 2005, to August 6, 2025, without applying filters, but only including English-language publications, to gather a wide range of studies. Full texts were chosen based on set criteria, followed by a qualitative analysis to identify common themes, results, and gaps.</p><p><strong>Key content and findings: </strong>Post-CABG complications span neurological, cardiac, pulmonary, renal, gastrointestinal/hepatobiliary, infectious, endocrine, and psychosocial domains. Across systems, consistently identified significant risk factors include advanced age, diabetes, renal dysfunction, prolonged cardiopulmonary bypass time, prior stroke, chronic obstructive pulmonary disease (COPD), and impaired left ventricular (LV) function. Effective preventive strategies included optimized glycemic control, early mobilization and rehabilitation, targeted use of anti-inflammatory and antioxidant therapies, prophylactic amiodarone or magnesium for atrial fibrillation (AF), strict infection-control measures, renal-protective protocols, and multimodal pain management. Recently, artificial intelligence (AI)-based tools, including machine learning models for predicting acute kidney injury, delirium, stroke, arrhythmias, and surgical-site infections, are emerging as promising adjuncts for earlier risk identification and personalized postoperative care.</p><p><strong>Conclusions: </strong>Post-CABG complications remain across organ systems, emphasizing the need for early risk identification and targeted prevention. Major risk factors include age, diabetes, renal dysfunction, and prolonged bypass time. Multidisciplinary care and emerging AI-based prediction tools may improve individualized risk assessment and postoperative outcomes.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 1","pages":"10"},"PeriodicalIF":2.2,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12973092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430964","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 disclosure in scientific writing: a step beyond policy awareness.","authors":"Himel Mondal, Shaikat Mondal","doi":"10.21037/cdt-2025-aw-603","DOIUrl":"10.21037/cdt-2025-aw-603","url":null,"abstract":"","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 1","pages":"12"},"PeriodicalIF":2.2,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12973080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147431013","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":"Digital cardiac rehabilitation versus traditional cardiac rehabilitation in improving health parameters, patient satisfaction and adherence to guidelines-a systematic review and a meta-analysis.","authors":"Zahid Khan, Nestor Lemos Ferreira, Adelowo Abiodun Bamidele, Maureen Wahinya, Patricia Wambua, Animesh Gupta","doi":"10.21037/cdt-2025-404","DOIUrl":"10.21037/cdt-2025-404","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Cardiovascular diseases (CVD) remain the leading cause of death worldwide. Digital cardiac rehabilitation (DCR) has emerged as a supplementary concept alongside traditional cardiac rehabilitation (TCR) since the coronavirus disease 2019 (COVID-19) pandemic. Several studies have compared the efficacy of DCR with TCR, with mixed results. This study, registered with PROSPERO (CRD420251029747), aimed to compare the efficacy of DCR with TCR and highlight knowledge gaps for future interventions. The objectives of this study were divided into primary and secondary. The primary endpoints were all-cause hospital readmissions, cardiac-related readmissions, major adverse cardiac events (MACE), all-cause mortality, exercise capacity, and adherence. The secondary endpoints were glycated haemoglobin (HbA1c), low-density lipoprotein cholesterol (LDL-c), systolic blood pressure, quality of life, physical inactivity, healthy diet, smoking status, and medication adherence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Cochrane, MEDLINE, PubMed, EMBASE, Google Scholar and ClinicalTrials.gov were searched for relevant studies. Randomised studies published in the English language, including randomised controlled trials (RCTs) and observational studies, were included in this review. These studies were selected from peer-reviewed journals between January 2010 and January 2025. Critical assessments were conducted using the Critical Appraisal Skills Programme (CASP) tool and the Risk of Bias 2 (ROB2) tool for RCTs, and the Risk of Bias in Non-Randomised Studies of Interventions (ROBINs-I) tool for observational studies. We extracted relevant demographic data for primary and secondary outcomes, and the analysis was performed using RevMan statistical software. A random- or fixed-effects model was used for the meta-analysis, depending on the level of heterogeneity across studies. Funnel plots were created to assess publication bias.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 36 eligible studies were included in this systematic review and meta-analysis. A total of 7,257 patients from 36 selected RCTs were included in this study, with 3,340 in the DCR group and 3,917 in the TCR group, respectively. Compared to TCR, DCR was associated with significantly lower all-cause hospital readmission 0.37 [95% confidence interval (CI): 0.25-0.56; P&lt;0.001], cardiac-related readmissions [odds ratio (OR): 0.35; 95% CI: 0.23-0.51; P&lt;0.001], 1.4 times higher cardiac rehabilitation adherence, and better exercise capacity [peak oxygen uptake (PVO&lt;sub&gt;2&lt;/sub&gt;) and 6-minute walk test (6MWT)]. Also, compared to TCR, DCR resulted in lower physical inactivity (OR: 0.32; 95% CI: 0.25-0.41; P&lt;0.001), unhealthy diet (OR: 0.59; 95% CI: 0.39-0.90; P=0.01), and current smoking OR: 0.65; 95% CI: 0.52-0.81; P&lt;0.001). There was no statistical difference betw","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 1","pages":"4"},"PeriodicalIF":2.2,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12973088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147431034","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}