Inoue T, Takahama H, Suzuki H
… +11 more, Arai M, Kikuchi N, Satoh T, Yaoita N, Yamamoto S, Nochioka K, Nakano M, Tatebe S, Takahashi J, Minamino N, Yasuda S
Int J Cardiol Heart Vasc
· 2026 Feb · PMID 42112512
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BACKGROUND: Patients with heart failure (HF) often present with a relative deficiency of cyclic guanosine monophosphate (cGMP) despite elevated B-type natriuretic peptide (BNP) levels. Sacubitril/valsartan and vericiguat...BACKGROUND: Patients with heart failure (HF) often present with a relative deficiency of cyclic guanosine monophosphate (cGMP) despite elevated B-type natriuretic peptide (BNP) levels. Sacubitril/valsartan and vericiguat target the cGMP pathway, but the relative contribution of cardiac versus systemic cGMP production remains uncertain. This study evaluated the association between cGMP changes and hemodynamic changes in patients with HF with reduced ejection fraction (HFrEF) receiving these agents. METHODS: Fourteen symptomatic HFrEF patients (median age 65.0 [IQR: 56.0-72.3]years, EF 25.5 [24.0-33.3]%) and 20 control patients without HF (66.0 years, EF 66.5 %) were enrolled. Of the HFrEF patients, five received sacubitril/valsartan alone and nine received vericiguat (newly initiated or added to sacubitril/valsartan). All HFrEF patients underwent right heart catheterization before the treatment and two months after treatment. Blood samples were collected from the coronary sinus, arteries, and veins. RESULTS: HFrEF patients showed higher coronary sinus cGMP levels compared with controls (15.8 ± 1.7 vs. 10.9 ± 1.2 nM, p < 0.05) but a markedly lower cGMP/BNP ratio (0.09 ± 0.02 vs. 1.71 ± 0.63, p < 0.05), suggesting a relative cGMP deficiency. After the therapy, the cGMP/BNP ratio significantly increased (0.278, p < 0.05). The change in coronary sinus cGMP correlated with improvement in cardiac index (r = 0.57, p = 0.039). cGMP levels rose consistently across all sampling sites, indicating a systemic augmentation of the cGMP pathway. CONCLUSION: Elevation of cGMP levels were associated with hemodynamic improvement in HFrEF patients treated with sacubitril/valsartan and vericiguat. These findings highlight the therapeutic relevance of cGMP pathway augmentation and provide mechanistic insights aligned with the known clinical effects of these agents in HFrEF.
Goldschmied A, Sigle M, Toskas I
… +8 more, Senel M, Dingemann L, Kranert M, Harm T, Gawaz M, Droppa M, Brendlin A, Lydia Mueller KA
Int J Cardiol Heart Vasc
· 2026 Feb · PMID 42112511
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INTRODUCTION: Transcutaneous cardiac pacing (TCP) is an important emergency treatment option in patients with symptomatic bradycardia. With the help of a portable pulse generator an electrical current is delivered throug...INTRODUCTION: Transcutaneous cardiac pacing (TCP) is an important emergency treatment option in patients with symptomatic bradycardia. With the help of a portable pulse generator an electrical current is delivered through the patient́s thorax in order to induce ventricular contractions. Data on patients in sinus rhythm suggests favorable pacing thresholds when using an anteroposterior (AP) compared to an anterolateral (AL) pacer pad positioning. However, evidence in bradycardic patients is lacking. METHODS: We conducted a prospective crossover clinical study which included 16 patients with symptomatic bradycardia. Patients received consecutive TCP in an AP and AL position under sedoanalgesia. TCP was carried out in an AP and an AL pacer pad position if patients were hemodynamically stable (systolic blood pressure > 90 mmHg). Minimal required current and other variables were noted for both pacer pad positions and Wilcoxon Signed Rank tests were used to compare differences. RESULTS: We did not overserve a significant difference in minimal required pacing current between the AP and AL pacer pad position (median threshold AP = 125 mA [±48], median threshold AL = 140 mA [±78], p = 0.53). However, a linear mixed-effects model revealed higher pacing thresholds in patients on beta blockers (B = 72.1, p < 0.001, 95 % CI = 36.6-107.7) and with lower myocardial mass (B = -0.41, p < 0.001, 95 % CI = -0.59- -0.23). CONCLUSION: We observed no significant difference in pacing thresholds between an AP and AL pacer pad position in patients with symptomatic bradycardia. These results do not align with prior work investigating a monitor with pulsed current delivery.
Björn R, Lehto J, Malmberg M
… +7 more, Anttila V, Gunn J, Nieminen T, Hartikainen JEK, Biancari F, Airaksinen KEJ, Kiviniemi T
Int J Cardiol Heart Vasc
· 2026 Feb · PMID 42112509
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BACKGROUND: Despite advancements in surgical techniques and perioperative care, postoperative bleeding and neurological complications remain significant concerns after bioprosthetic surgical aortic valve replacement (SAV...BACKGROUND: Despite advancements in surgical techniques and perioperative care, postoperative bleeding and neurological complications remain significant concerns after bioprosthetic surgical aortic valve replacement (SAVR). The present study assessed the incidence of short-term and long-term major bleeding and strokes and their association with antithrombotic treatment after isolated bioprosthetic SAVR. METHODS: The CAREAVR study included 721 patients who underwent isolated bioprosthetic SAVR at four Finnish university hospitals between 2002 and 2014. The day-to-day information on short-term antithrombotic treatment was available from a subgroup including 227 patients. RESULTS: The median follow-up time was 4.9 (interquartile range 3.0-7.0) years. During the 30-day postoperative period, in the subgroup of 227 patients, 31 (13.7 %) patients experienced a major bleeding event, and 13 (5.7 %) patients a major stroke. A vast majority of the bleedings (80.6 %) occurred within two days after the surgery, and the tail effect of preoperative aspirin was present in 54.8 % of episodes, indicating unintentional antithrombotic effect. During the long-term follow-up (>30 days after the index surgery), major bleeding episodes occurred in 40 (5.5 %) patients, and 47 (6.5 %) patients experienced a major stroke. Overall, 23 (57.5 %) of the patients with major bleeding and 13 (27.7 %) of the patients experiencing major stroke were on OAC during the event. CONCLUSION: The incidence of perioperative major bleeding was over two-fold compared to major stroke, the majority occurring during the tail effect of preoperatively used aspirin. During the long-term follow-up, the rates of stroke and major bleeds were similar, and most bleeding episodes occurred while on OAC.
Yimei H, Xinyun C, Yuchi H
… +7 more, Songyuan D, Siqi N, Hongning L, Shenghai W, Guanghui H, Baotong H, Lulu Z
Int J Cardiol Heart Vasc
· 2026 Feb · PMID 42112507
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BACKGROUND: The pathophysiology of heart failure with preserved ejection fraction (HFpEF) remains incompletely understood. OBJECTIVE: This study aimed to identify potential protein biomarkers for the accurate diagnosis a...BACKGROUND: The pathophysiology of heart failure with preserved ejection fraction (HFpEF) remains incompletely understood. OBJECTIVE: This study aimed to identify potential protein biomarkers for the accurate diagnosis and phenotyping of HFpEF and to construct a machine learning-based diagnostic model incorporating these biomarkers and key clinical features. METHODS: In a cross-sectional study of 249 cardiac patients, HFpEF-associated plasma proteins were identified using Olink PEA and validated by ELISA. A machine learning nomogram was developed and its diagnostic performance was evaluated. RESULTS: Analysis identified 92 plasma proteins,among which Serine protease 27(PRSS27), P-selectin glycoprotein ligand 1 (PSGL-1), Biregional Cell Adhesion Molecule-related (BOC), NF-κB essential modulator (NEMO), Glyoxalase 1(GLO1))) were specifically expressed in HFpEF group. Enrichment analysis indicated these differential proteins were primarily involved in inflammatory response, immune response, and the Phosphatidylinositol 3-kinase-AKT serine/threonine kinase (PI3K-AKT) signaling pathway. A diagnostic model integrating three proteins with clinical features (LDL-C, ALB) demonstrated excellent performance (AUC: 0.895), showing strong discriminatory power, good calibration, and potential clinical applicability. CONCLUSION: This study identifies potential protein biomarkers for HFpEF diagnosis, provides new insights into its pathophysiology, and offers a practical diagnostic tool for clinical use.
Wattchow NE, Salagaras T, Nguyen MT
… +7 more, Sandeman LYJ, Figtree GA, Giovanni GD, Wong DTL, Nicholls SJ, Bursill CA, Psaltis PJ
Int J Cardiol Heart Vasc
· 2026 Feb · PMID 42112506
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BACKGROUND: Syndecan-1 and endocan are biomarkers of endothelial damage, which associate with worse outcomes after myocardial infarction (MI). As it is unclear how this is mediated, we investigated how they associate wit...BACKGROUND: Syndecan-1 and endocan are biomarkers of endothelial damage, which associate with worse outcomes after myocardial infarction (MI). As it is unclear how this is mediated, we investigated how they associate with the composition of residual, non-culprit coronary atherosclerotic plaques following acute MI. METHODS: This analysis of the COCOMO-ACS trial used serum samples from forty-five patients with non-ST elevation MI who underwent blood collection and optical coherence tomography (OCT) imaging of non-culprit, lipid-rich coronary plaques at baseline and after a median of 17.8 months. Serum syndecan-1 and endocan concentrations at both time-points were measured by ELISA. Relationships between these biomarkers and OCT parameters of rupture-prone plaque were examined. RESULTS: Serum levels of syndecan-1 (median 161.0 ng/mL at baseline vs 93.5 ng/mL at follow-up, P < 0.0001) and endocan (225.7 pg/mL vs 191.2 pg/mL, P = 0.003) both decreased from time of MI to follow-up, with strong correlation between their changes (R = 0.64, P < 0.0001). Only syndecan-1 showed a weak negative correlation with minimum fibrous cap thickness at baseline (R = 0.10, P = 0.03) and a weak positive correlation with maximum lipid arc at follow-up (R = 0.14, P = 0.01). While syndecan-1 and endocan showed no relationship with plasma lipid concentrations, there were weak associations between follow-up syndecan-1 and interleukin-1-beta (R = 0.21, P = 0.001), and follow-up endocan and interleukin-6 (R = 0.15, P = 0.008). CONCLUSIONS: Although serum syndecan-1 and endocan levels decreased in peripheral blood over time post-MI on guideline-directed therapy, this study identified only modest relationships between syndecan-1 (and not endocan) and OCT compositional characteristics of lipid-rich, rupture-prone plaque.
Murray PC, Pollock A, Hewitt K
… +3 more, O'Sullivan J, Sheahan A, Sheahan R
Int J Cardiol Heart Vasc
· 2026 Feb · PMID 42112505
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BACKGROUND / AIMS: Cardiomyopathy is universally penetrant in young adults with Duchenne muscular dystrophy (DMD), and is increasingly the preponderant cause of death. We describe the ECG, echocardiography and cardiac MR...BACKGROUND / AIMS: Cardiomyopathy is universally penetrant in young adults with Duchenne muscular dystrophy (DMD), and is increasingly the preponderant cause of death. We describe the ECG, echocardiography and cardiac MRI (CMR) findings associated with this disease, and the level of agreement between imaging modalities, highlighting the obstacles encountered in high rates of failed diagnostic cardiac imaging in our DMD multidisciplinary care centre. METHODS AND RESULTS: We followed all patients attending a Comprehensive Multidisciplinary Adult DMD clinic over 4 years. All attendees underwent transthoracic echocardiography (TTE) and were offered referral for cardiac MRI (CMR). We recorded baseline demographics, ECG characteristics and imaging findings, comparing TTE and CMR derived LVEF. A total of 33 patients enrolled, median age 20, with mean follow-up of 3 years and 3 months. Common ECG abnormalities were dominant R in V1, pathological Q waves and right axis deviation. Mean LVEF was 51 % at enrollment and 45 % at follow-up by TTE. Presence of any degree of mitral regurgitation correlated strongly to left ventricular systolic dysfunction. CMR was completed in just 25 % of patients, all of whom had extensive midwall fibrosis. Of those in whom CMR failed, 52 % were unable to lie flat or position correctly for scanning, predominantly due to muscle contractures. Despite suboptimal TTE imaging in 75 %, there was good agreement in LVEF between CMR and TTE. CONCLUSION: We found a high rate of failure to complete diagnostic cardiac imaging in this group of patients with impaired mobility predominantly due to fixed flexion deformities, inability to lay flat or to tolerate the scan. Our study highlights the critical need to provided specially trained Echo and CMR sonographers who understand the challenges to optimal quality imaging in these patients, and who are appropriately supported by Health Care Assistants (HCA) who are familiar with careful positioning to facilitate optimal imaging. Never the less, the study highlights the importance of multimodality imaging, and practical strategies to overcome environmental obstacles to diagnostic imaging, to better guide aggressiveness of treatment for DMD and its inherent cardiomyopathy.Key Learning Points.What is already known:•In addition to significant mobility impairment, Duchenne muscular dystrophy (DMD) is associated with development of severe cardiomyopathy in childhood / early adulthood. Due to relatively recent improvements in survival, the evolution of ECG and imaging correlates in adulthood are poorly described.•The accuracy and degree of correlation between transthoracic echocardiography (TTE) and cardiac MRI (CMR) in this cohort is not known. Myocardial fibrosis, not evaluated on TTE, can be seen on cardiac CMR, and is thought to be predictive of earlier and more severe cardiomyopathy phenotype. Its prevalence in this form of cardiomyopathy is unknown.•Patients with DMD are likely to encounter difficulty in achieving diagnostic cardiac imaging due to factors inherent to the condition as well as environmental obstacles, and an optimal strategy for imaging is not well defined in this particular patient group with unique practical challenges and imaging findings.What the study adds:•We describe the typical and common ECG, TTE and CMR findings in an adult cohort of patients with DMD cardiomyopathy, and the barriers to completing these investigations.•Extensive midwall fibrosis was seen on CMR in 100% of patients scanned, supporting the hypothesis of a universally penetrant cardiomyopathy, and a strategy of early pharmacotherapy in all patients, prior to symptom onset.•We report a good degree of correlation between TTE and CMR -derived LVEF, and therefore highlight the importance of multimodality imaging, with an individually tailored approach in this cohort, in order to guide decisions around escalation of treatment, ICD implantation and prognostication.
Ishii Y, Watabe H, Usami K
… +5 more, Terauchi T, Yaguchi T, Hiraya D, Hoshi T, Ishizu T
Int J Cardiol
· 2026 Aug · PMID 42106075
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BACKGROUND: This study aimed to investigate the association between high-intensity plaque (HIP) on cardiac magnetic resonance (CMR) imaging and pericoronary adipose tissue attenuation (PCATA) and plaque burden on coronar...BACKGROUND: This study aimed to investigate the association between high-intensity plaque (HIP) on cardiac magnetic resonance (CMR) imaging and pericoronary adipose tissue attenuation (PCATA) and plaque burden on coronary computed tomography angiography (CCTA) in patients with chronic coronary syndrome (CCS). METHODS: We retrospectively analyzed 104 coronary lesions in 86 patients with CCS who underwent CMR imaging and CCTA before elective percutaneous coronary intervention. HIP was defined as a plaque-to-myocardium signal intensity ratio (PMR) of ≥1.4 on T1-weighted CMR imaging. The PCATA of the target lesion was assessed, and the mean value was used for the analysis. The plaque morphology and volume of the target lesion were assessed on CCTA based on attenuation values and stratified into calcified, fibrous, fibrous-fatty, and low-attenuation plaques (LAPs). RESULTS: Forty-five lesions were assigned to the HIP group (43%). The PCATA and LAP volume on CCTA were significantly higher in the HIP group than those in the non-HIP group (-69.3 Hounsfield units [HU] vs. -73.9 HU; p = 0.022; 27.4 mm vs. 7.2 mm; p < 0.001). PMR was correlated with both PCATA and LAP volume. On adjusted multiple regression analysis, PCATA ≥ -67 HU and LAP volume were associated with HIP. The prevalence of HIP on CMR was the highest in the high PCATA and high LAP volume group and the lowest in the low PCATA and low LAP volume group. CONCLUSIONS: HIP on CMR is associated with higher PCATA and larger LAP volume, linking coronary inflammation with plaque vulnerability.
Ledingham L, Conroy S, Kanwar K
… +5 more, Wood P, Cripe L, Gunsaulus M, Hor K, Mah ML
Int J Cardiol
· 2026 Aug · PMID 42106074
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BACKGROUND: Female Duchenne and Becker muscular dystrophy carriers (MDC) have heterozygous dystrophin mutations with an unclear disease phenotype. While cardiomyopathy is the leading cause of death in affected males, the...BACKGROUND: Female Duchenne and Becker muscular dystrophy carriers (MDC) have heterozygous dystrophin mutations with an unclear disease phenotype. While cardiomyopathy is the leading cause of death in affected males, the natural history of MDC is not known. We describe changes in ventricular volumes, function, and fibrosis by late‑gadolinium enhancement (LGE) using cardiac MRI (CMR) in a prospective cohort of MDC and non-carrier females. METHODS: 75 genetically-confirmed MDC and 22 non-carriers underwent CMR at three annual visits. RESULTS: Follow-up included 85 (65 MDC, 20 non-carriers) and 62 (46 MDC, 16 non-carriers) subjects who underwent CMR at visits 2 and 3, respectively. Mean ejection fraction and LV volumes remained within normal limits for both cohorts and did not show evidence of different slope of change. 36/75 MDC and 1/22 non-carriers had LGE at visit 1. In those with LGE positivity at visit 1, 13/28 progressed extent of LGE within 2 years. Non-progressors and progressors had similar characteristics of age, cardiac medications and LV function and volume. CONCLUSION: Longitudinal changes in cardiac volumes and function in MDC are similar to non-carrier controls. Subjects free of LGE at visit 1 remained free of LGE through the study period. In subjects with LGE positivity at first CMR, half progressed in LGE extent. Current CMR screening guidelines for MDC of 3-5 years appears appropriate for those without fibrosis and with normal LVEF and LV volumes. For those with fibrosis on imaging, surveillance intervals should be shorter based on findings of progression in a 2 year period.
Int J Cardiol Cardiovasc Risk Prev
· 2026 Sep · PMID 42100682
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BACKGROUND: Adults aged 75 years and older carry the highest absolute risk of cardiovascular disease (CVD) yet remain substantially underrepresented in randomized trials evaluating statin therapy for primary prevention....BACKGROUND: Adults aged 75 years and older carry the highest absolute risk of cardiovascular disease (CVD) yet remain substantially underrepresented in randomized trials evaluating statin therapy for primary prevention. This evidence gap creates uncertainty regarding the appropriateness of initiating lipid-lowering therapy in this population. METHODS: We conducted a narrative review of randomized controlled trials, meta-analyses, and large observational studies evaluating statin therapy for primary CVD prevention in adults aged 75 years and older. We searched PubMed and reference lists of relevant articles through December 2024. RESULTS: Direct randomized evidence for primary prevention in adults over 75 years is limited. The PROSPER trial included a mixed population of primary and secondary prevention patients aged 70-82 years. Post-hoc analyses of ALLHAT-LLT showed no benefit and a trend toward harm in patients aged 75 years and older. Meta-analyses of observational data suggest mortality reductions of 12-14% associated with statin use, though subject to confounding. The time to benefit for cardiovascular event reduction is approximately 2.5 years, which must be weighed against individual life expectancy. CONCLUSIONS: Current evidence does not support routine statin initiation for primary prevention in all adults over 75 years. Treatment decisions should be individualized based on cardiovascular risk, life expectancy, frailty status, patient preferences, and competing health priorities. Results from the STAREE and PREVENTABLE trials, expected in 2025-2027, will provide definitive guidance.
Alarfaj M, Mohamad Alahmad MA, Wallisch WJ
… +4 more, Flynn BC, Rali AS, Tonna JE, Shah Z
Int J Cardiol
· 2026 Aug · PMID 42097309
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BACKGROUND: Despite advancements in management strategies, patients with refractory cardiogenic shock (CS) have high mortality. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is increasingly utilized as temp...BACKGROUND: Despite advancements in management strategies, patients with refractory cardiogenic shock (CS) have high mortality. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is increasingly utilized as temporary mechanical support in these patients. Current predictive models for mortality suffer from practical limitations, including complexity and the extensive variables required. OBJECTIVES: We aimed to develop a simplified, practical predictive model, the Extracorporeal Life Support Outcome score (ELSO-Score), using readily available pre-ECMO variables to predict in-hospital mortality among VA-ECMO patients. METHODS: This retrospective study utilized data from 8495 VA-ECMO patients collected by the Extracorporeal Life Support Organization (ELSO) registry between January 2017 and December 2022. We developed a simple neural predictive model, validated on training, validation, and test cohorts. RESULTS: The training cohort comprised 6029 analyzed cases, with an overall in-hospital mortality rate of 55.5%. Significant predictors of mortality were elevated lactate levels, age, bilirubinemia, acute kidney injury, and the requirement for renal replacement therapy at the time of ECMO cannulation. The predictive model demonstrated moderate discriminatory performance, achieving area under the ROC curve values of 0.70, 0.69, and 0.68, 95% CI [0.63-0.73], in the training, validation, and test cohorts, respectively. CONCLUSIONS: Our study demonstrates that the ELSO-Score may be a practical and effective predictive tool facilitating informed clinical decision-making and resource allocation for patients considered for VA-ECMO therapy.
Caratti di Lanzacco L, Vogiatzakis N, Fabbricatore D
… +4 more, Yao-Cheng Ho C, Rahneva T, Gatzoulis MA, Wong T
Int J Cardiol Congenit Heart Dis
· 2026 Jun · PMID 42094079
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Adults with congenital heart disease (ACHD) represent a rapidly growing population with a high burden of bradyarrhythmias and ventricular arrhythmias requiring cardiac implantable electronic devices. However, conventiona...Adults with congenital heart disease (ACHD) represent a rapidly growing population with a high burden of bradyarrhythmias and ventricular arrhythmias requiring cardiac implantable electronic devices. However, conventional transvenous pacing and defibrillator systems often present important challenges in this population due to complex anatomy, limited venous access, intracardiac shunts, and the cumulative risk of lead-related complications over a patient's lifetime. Recent technological advances-including conduction system pacing, leadless pacemakers, subcutaneous and extravascular implantable cardioverter-defibrillators, and emerging modular pacing-defibrillator platforms-have expanded the range of device strategies available for ACHD patients. These innovations aim to reduce intravascular hardware, improve physiological ventricular activation, and enable device therapies tailored to complex congenital anatomy. However, the evidence supporting both conventional and emerging technologies in ACHD patients remains limited and is derived largely from small observational studies and registry data. In addition, the substantial heterogeneity of congenital heart diseases and their prior surgical repair complicates extrapolation of outcomes across patient subgroups. Careful patient selection, anatomical assessment, and consideration of long-term device management therefore remain central to clinical decision-making. In this narrative review, we summarise recent developments in pacing and defibrillator technologies and discuss their potential implications for adults with congenital heart disease. To support clinical decision-making, we also propose a pragmatic ACHD-specific device-selection algorithm integrating anatomical, electrophysiological, and long-term management considerations.
Nguyen TVN, Emral HG, Voges I
… +10 more, Ho SY, Michael RL, Daubeney PEJ, Nicol E, Padley S, Izgi C, Mohiaddin R, Pennell DJ, Semple T, Krupickova S
Int J Cardiol Congenit Heart Dis
· 2026 Jun · PMID 42094078
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This imaging review highlights the spectrum of Scimitar Syndrome (SS) as seen on cardiac computed tomography (CT) and cardiovascular magnetic resonance (CMR), illustrating its variants and linking imaging findings with c...This imaging review highlights the spectrum of Scimitar Syndrome (SS) as seen on cardiac computed tomography (CT) and cardiovascular magnetic resonance (CMR), illustrating its variants and linking imaging findings with clinical presentation and management strategies. SS is a rare congenital cardiopulmonary anomaly characterized by partial or total right anomalous pulmonary venous drainage to the hepatic vein or inferior vena cava (IVC), hypoplastic right lung and pulmonary artery, abdominal aortopulmonary collateral(s) to the right lower lobe and other cardiac and bronchial malformations. Management options range from surgical lobe resection, rerouting of the anomalous pulmonary vein to the left atrium, catheter-based embolization of aorto-pulmonary collaterals, and intracardiac shunt device closure, to conservative observation. While surgical outcomes are generally favorable, postoperative complications can be substantial, and the indications for surgery-especially in asymptomatic patients-remain unclear and should be individualized. A multimodal imaging approach is essential for accurate diagnosis, hemodynamic assessment, and follow-up, enabling tailored treatment planning. This manuscript presents role of cardiac CT and CMR using representative imaging examples, highlighting the diagnostic value and discussing implications of the findings for clinical management and longitudinal follow-up.
Luo L, Liu Q, Wu Q
… +4 more, Hou H, Xie Z, Wang Y, Shu X
Int J Cardiol Cardiovasc Risk Prev
· 2026 Sep · PMID 42093901
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OBJECTIVE: This study aimed to investigate the effects of gender, age and other physiologic parameters on left ventricular (LV) myocardial work (MW) in healthy subjects and to explore the potential correlation between th...OBJECTIVE: This study aimed to investigate the effects of gender, age and other physiologic parameters on left ventricular (LV) myocardial work (MW) in healthy subjects and to explore the potential correlation between the MW and the ventricular myocardial band (VMB). METHODS: According to the inclusion criteria 479 subjects aged ≥20 years old who visited our hospital from September 2019 to August 2022 were enrolled and were divided into three groups by 15 years as the age interval. Among them, 187 were 20-39 years old {(39.04%), including 87 men (46.52%) and 100 women (53.47%)}; 153 were 40-54 years old {(31.94%), including 63 men (41.18%) and 90 women (58.82%)}; 139 were aged ≥55 years {(29.02%), including 75 men (53.96%) and 64 women (46.04%)}. All subjects underwent echocardiography and apical views were analyzed. Blood pressure (BP) was measured after the examination. RESULTS: MW exhibited distinct gender- and age-specific characteristics. Within the same age group, females demonstrated higher MW values than males. Furthermore, a significant age-related decline in MW was observed in females, particularly after 55 years of age. Additionally, the distribution patterns of MW, especially active work, suggested a potential correlation with the VMB. CONCLUSION: 1. MW evaluating by using echocardiography may be a good method for the assessment of real time, quantitative global and regional MW and the MW has obvious gender and age characteristics.2. There is a certain potential correlation between the MW and the VMB.
Schaffner C, Spahr Y, Spirito A
… +9 more, Tersalvi G, Majcen I, Erdogan F, Zhi Y, Spahr A, Seiler T, Attinger A, Cuculi F, Bossard M
Int J Cardiol Heart Vasc
· 2026 Jun · PMID 42088550
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BACKGROUND: Oral P2Y inhibitors (P2Yi) may have reduced efficacy in critically ill patients undergoing Impella-supported PCI. The intravenous P2Yi cangrelor offers rapid and reversible platelet inhibition, but its role i...BACKGROUND: Oral P2Y inhibitors (P2Yi) may have reduced efficacy in critically ill patients undergoing Impella-supported PCI. The intravenous P2Yi cangrelor offers rapid and reversible platelet inhibition, but its role in this setting remains unclear. OBJECTIVE: Comparison of outcomes in patients undergoing Impella-supported PCI receiving oral P2Yi only versus loading with cangrelor. METHODS: We analyzed consecutive patients managed at a Swiss tertiary cardiology facility who underwent Impella-supported PCI. Patients received either (1) oral P2Yi or (2) cangrelor followed by oral P2Yi. Periprocedural major bleeding (BARC ≥ 3) within 48 h, in-hospital major adverse cardiovascular events (MACE) and 6-month MACE were analyzed. RESULTS: Among 295 patients, 201 received oral P2Yi and 94 received cangrelor. Patients in the oral P2Yi group were less likely to present with STEMI (55.7% versus 67.0%) or cardiogenic shock (55.2% versus 72.3%), whereas high-risk protected PCI was more frequent (17.9% versus 6.4%) compared to cangrelor group. No significant differences were observed in major bleeding, in-hospital MACE and 6-month MACE. Major bleeding was numerically lower in the oral P2Yi group (26.4% versus 33.0%, p = 0.2). Early stent thrombosis rates were relatively low and not significantly different (1.0% versus 2.1%, p = 0.6). Presentation with cardiogenic shock was associated with a higher risk for post-PCI major bleeding (OR 7.09, 95%CI 2.97-18.49) and 6-month MACE (HR 2.01, 95% CI 1.01-3.97). CONCLUSION: In Impella-supported PCI, cangrelor was associated with no statistically significant differences in outcomes compared to oral P2Yi, with consistent results after adjustment. Given the observational design, these findings require confirmation in randomized trials.