Reviews In Cardiovascular Medicine[JOURNAL]
Sun
200 papers
The Influence of Congenital Heart Defect Repair Through a Right Subaxillary Thoracotomy on Postoperative Pulmonary Function and Prognosis in Small Infants.
Wang X, Li X, He C … +2 more , Li H, Wang S
Rev Cardiovasc Med · 2026 May · PMID 42238653 · Full text
BACKGROUND: The influence of repair of congenital heart defect (CHD) via a right subaxillary thoracotomy (RSAT) on postoperative pulmonary function and prognosis in small infants is a key consideration. METHODS: Data wer...
BACKGROUND: The influence of repair of congenital heart defect (CHD) via a right subaxillary thoracotomy (RSAT) on postoperative pulmonary function and prognosis in small infants is a key consideration. METHODS: Data were collected from infants who underwent ventricular septal defect (VSD) repair or VSD and atrial septal defect (ASD) between March 2020 and September 2024. Based on propensity score matching, 80 small infants (weight <5 kg and age <6 months) were selected, of which 40 underwent VSD repair or VSD, and ASD repair through an RSAT, while 40 underwent VSD repair or VSD and ASD repair through a standard median sternotomy (SMS). Perioperative respiratory parameters, morbidity, and mortality were compared to assess the influence of the RSAT approach on pulmonary function and postoperative outcomes in small infants. RESULTS: Primary outcome: there were no significant differences ( > 0.05) in the perioperative oxygenation index and alveolar-arterial oxygen gradient between the two surgical approaches. No significant differences were also observed between the two groups in the other respiratory parameters, including peak airway pressure, partial pressure of oxygen, and partial pressure of carbon dioxide. The operating time (150 ± 20 min vs. 163 ± 28 min; < 0.05) was shorter in the RSAT group compared to the SMS group. There were no deaths in either group. The complication rate was low in both groups, with no significant difference between the groups ( > 0.05). CONCLUSION: Compared with SMS, the RSAT approach for the repair of congenital heart defects does not increase the risk of postoperative respiratory insufficiency and yields comparable outcomes in low-weight small infants.
Left Ventricular Hypertrabeculation: Historical Evolution, Diagnostic Pitfalls, and a Pragmatic Clinical Approach.
Parodi A, Martini M, Cecere A … +3 more , Iezzi L, Rigato I, Bauce B
Rev Cardiovasc Med · 2026 May · PMID 42238652 · Full text
Left ventricular hypertrabeculation (LVHT), previously referred to as left ventricular non-compaction (LVNC), has experienced fluctuating recognition in cardiology. Once defined as a primary genetic cardiomyopathy, this...
Left ventricular hypertrabeculation (LVHT), previously referred to as left ventricular non-compaction (LVNC), has experienced fluctuating recognition in cardiology. Once defined as a primary genetic cardiomyopathy, this intriguing myocardial feature is now considered a "trait" in the most recent guidelines. However, the understanding of this phenomenon remains incomplete. Moreover, data on the association between this feature and other syndromes are inconclusive, and further advances in understanding the associated molecular mechanisms and genetic background are needed. A systematic collection of clinical data is essential to avoid both over- and underdiagnosis, thereby reducing current uncertainties in LVHT management. This review examines the diagnostic, pathophysiological, and management aspects of LVHT, highlighting the challenging nature of this feature and proposing a practical approach for clinicians.
Study on the Role and Mechanism of γδ T Cells in Atherosclerosis Under a High-Fat Diet.
Zhang Q, Zhang X, Cao M … +4 more , Ma J, Yan R, Wang H, Jia S
Rev Cardiovasc Med · 2026 May · PMID 42238651 · Full text
BACKGROUND: This study aimed to investigate the effects of γδ T cell inhibition under a high-fat diet (HFD) on metabolic function, immune inflammation, gut microbiota, and atherosclerosis (AS) progression in mice. METH...
BACKGROUND: This study aimed to investigate the effects of γδ T cell inhibition under a high-fat diet (HFD) on metabolic function, immune inflammation, gut microbiota, and atherosclerosis (AS) progression in mice. METHODS: mice were assigned to three groups: a control group (normal diet), a model group (HFD), and an intervention group (HFD + γδ T cell receptor (TCR) monoclonal antibody). After 12 weeks, flow cytometry was used to assess γδ T cell levels, and cytokines (interferon-gamma (IFN-γ), IL-17A) were measured. Inflammatory markers in blood and adipose tissue were quantified, gut microbiota composition was analyzed via fecal metagenomics, and atherosclerosis was evaluated using Oil Red O, Masson's trichrome, and hematoxylin and eosin (HE) staining methods. RESULTS: The HFD activated γδ T cells and increased pro-inflammatory cytokines in mice. Treatment with the γδ TCR monoclonal antibody suppressed γδ T cells, reduced IFN-γ and IL-17A expression, improved lipid profiles, and decreased tumor necrosis factor-alpha (TNF-α), IL-1β, and IL-6 levels. Gut microbiota analysis showed an increase in beneficial bacteria, and histological staining (Oil Red O, HE, and Masson's trichrome) confirmed a reduction in atherosclerotic lesion burden. CONCLUSION: The γδ T cells contribute to AS development under the HFD. Inhibition of γδ T cells reduces inflammation, improves gut microbiota composition, and attenuates atherosclerosis progression.
The Role of Stress Granules in Cardiovascular Diseases.
Li X, Zhang Z, Tang L … +1 more , Li S
Rev Cardiovasc Med · 2026 May · PMID 42238650 · Full text
Recent research has highlighted the pivotal role of RNA metabolism-related stress responses in the pathophysiology of cardiovascular diseases, particularly atherosclerosis, stroke, atrial fibrillation (AF), and heart fai...
Recent research has highlighted the pivotal role of RNA metabolism-related stress responses in the pathophysiology of cardiovascular diseases, particularly atherosclerosis, stroke, atrial fibrillation (AF), and heart failure (HF). Stress granules (SGs) are dynamic, membraneless organelles that arise during RNA metabolism via liquid-liquid phase separation (LLPS), in which mRNA associates with RNA-binding proteins (RBPs). SGs form following translation arrest in response to various external stimuli, resulting in cytoplasmic accumulation of mRNA and RBPs, which subsequently aggregate into membraneless messenger ribonucleoprotein (mRNP) granules, including Cajal bodies, SGs, P bodies, RNA transport granules, and germinal bodies. This review focuses specifically on SGs. SG formation is typically a transient and protective cellular response to stress; however, the dysregulation or persistence of SG formation has been implicated in a range of diseases, including cardiovascular conditions, neurodegenerative disorders, cancers, immune responses, and viral infections. Thus, this review examines the physiology and pathology of SGs, detailing the associated formation, composition, regulation, and function, with a particular focus on the involvement of SGs in cardiovascular diseases (CVDs) and potential therapeutic strategies targeting SGs. Moreover, this review outlines the complete life cycle of SGs and the associated implications in CVD. SGs originate near the endoplasmic reticulum (ER) and mitigate apoptosis by curbing mitochondrial production of reactive oxygen species. SGs can also disrupt the trafficking of specific cargo from the ER to the Golgi apparatus. Furthermore, SGs can repair damaged lysosomes and eventually undergo self-clearance via the autophagy-lysosome pathway. This model provides new perspectives for researchers in cardiovascular medicine, physicians, and translational medical researchers, and may advance our understanding of SG-related pathophysiology and facilitate the identification of novel therapeutic targets for CVDs.
Computed Tomography-Based Radiomics Provides New Insights Into Associations Between Pericoronary Fat Characteristics and Low-Density Lipoprotein Cholesterol.
Zhou F, Liu X, Yang L … +12 more , Zhang Y, Yang Y, Tang S, Zhou X, Duan X, Tan N, Zuo S, Liu F, Xu Y, Zhu C, Shao L, Sun G
Rev Cardiovasc Med · 2026 May · PMID 42238649 · Full text
BACKGROUND: Pericoronary adipose tissue (PCAT) is an established imaging biomarker of coronary inflammation; however, the influence of low-density lipoprotein cholesterol (LDL-C) remains unclear. This study aimed to expl...
BACKGROUND: Pericoronary adipose tissue (PCAT) is an established imaging biomarker of coronary inflammation; however, the influence of low-density lipoprotein cholesterol (LDL-C) remains unclear. This study aimed to explore the associations between PCAT and LDL-C using coronary computed tomography angiography (CCTA)-based radiomics. METHODS: This retrospective study stratified 150 patients undergoing CCTA into two groups according to serum LDL-C levels (≥3.4 mmol/L vs. <3.4 mmol/L). A total of 288 radiomic features were extracted from the PCAT surrounding the left anterior descending artery, left circumflex artery, and right coronary artery. After the initial filtering using the Wilcoxon rank-sum test, univariate logistic regression and Pearson correlation analyses were applied to identify features associated with elevated LDL-C levels. Key features were further validated using a gradient boosting machine (GBM) ensemble model combined with Shapley Additive Explanations (SHAP) analysis. RESULTS: A total of 11 radiomic features were significantly associated with elevated LDL-C levels ( < 0.05), including both first-order and texture-based features. Mantel correlation analysis revealed that the gray level size zone matrix (GLSZM)-derived feature, GLSZM.LCXLargeAreaHighGrayLevelEmphasis, demonstrated the strongest association (Mantel's r ≈ 0.15; < 0.01). The GBM model achieved the best performance, with an area under the receiver operating characteristic curve (AUROC) of 0.889 in the training set and 0.724 in an internal hold-out test set. SHAP analysis identified first-order energy and large-area high gray-level features as the most important contributors to the discrimination of high LDL-C status. CONCLUSION: Elevated LDL-C levels are significantly associated with increased spatial heterogeneity and high gray-level clustering in PCAT, thereby providing imaging-based evidence supporting the association between LDL-C and PCAT.
Association of Triglyceride-Glucose Index With In-Hospital Malignant Arrhythmias in Older Patients With Diabetes Mellitus and Left Ventricular Aneurysm: A Retrospective Study.
Zhou J, Lu Q, Jin J … +4 more , Chen B, Chen S, Zhou J, Shi S
Rev Cardiovasc Med · 2026 May · PMID 42238648 · Full text
BACKGROUND: Left ventricular aneurysm (LVA), a severe post-myocardial infarction (MI) complication, predisposes patients to malignant arrhythmias. The triglyceride-glucose (TyG) index, a marker of insulin resistance, is...
BACKGROUND: Left ventricular aneurysm (LVA), a severe post-myocardial infarction (MI) complication, predisposes patients to malignant arrhythmias. The triglyceride-glucose (TyG) index, a marker of insulin resistance, is linked to adverse cardiac outcomes. Nevertheless, the association between the TyG index and in-hospital malignant arrhythmias in older, diabetic patients with LVA remains unclear. METHODS: This retrospective study (the First Affiliated Hospital of Wenzhou Medical University, China) consecutively enrolled 655 patients with LVAs (aged ≥60 years with confirmed diabetes) from 2004 to 2024. The relationship between the TyG index quartiles and in-hospital malignant arrhythmias was evaluated using Kaplan-Meier (K-M) curves, Cox regression, and restricted cubic spline (RCS) analyses. Mediation analysis was employed to investigate underlying inflammatory pathways. RESULTS: Participants had a median age of 75 years, and 57.56% were males. The RCS analysis indicated that elevated TyG index values were associated with a higher risk of in-hospital malignant arrhythmias; compared with the lowest quartile (Q1), the highest quartile (Q4) showed a nearly threefold higher risk (hazard ratio [HR] = 2.99; 95% confidence interval [CI]: 1.26-7.13). Exploratory pathway analyses indicated that neutrophils (NEs), white blood cells (WBCs), and the systemic inflammation response index (SIRI) partially accounted for this association. Subgroup analyses revealed no significant interactions. CONCLUSIONS: This study shows that the TyG index is independently associated with in-hospital malignant arrhythmias in older patients with LVA, serving as a simple, clinically relevant marker to identify high-risk individuals and guide targeted management.
Serum Hemoglobin-to-Creatinine Ratio and Post-Discharge Readmission or Mortality in Older Patients With Heart Failure: A Retrospective Cohort Study.
Xu HB, He Y, Xu YH … +1 more , Zhang HG
Rev Cardiovasc Med · 2026 May · PMID 42238647 · Full text
BACKGROUND: Older patients with heart failure (HF) experience poor prognoses after hospital discharge, underscoring the importance of risk stratification for improving out-of-hospital management. Therefore, this study ai...
BACKGROUND: Older patients with heart failure (HF) experience poor prognoses after hospital discharge, underscoring the importance of risk stratification for improving out-of-hospital management. Therefore, this study aimed to investigate the association between a composite index of anemia and renal impairment, defined as the serum hemoglobin-to-creatinine ratio (HCR), and post-discharge readmission or mortality in older patients with HF. METHODS: Data were obtained from the Zigong Fourth People's Hospital. HF was diagnosed in accordance with the 2016 European Society of Cardiology guidelines. The HCR was employed, while the outcome was a composite of readmission or mortality assessed at 180 and 90 days after discharge. The association between the HCR and outcomes was analyzed using Cox proportional hazards models, with robustness evaluated through subgroup and sensitivity analyses. RESULTS: The study cohort included 1781 older patients (age ≥60 years) with HF, of whom 41.6% experienced readmission or mortality within 180 days after discharge. Multivariable Cox regression indicated that a higher HCR was associated with a lower risk of 180-day readmission or mortality (hazard ratio (HR) = 0.76; 95% confidence interval (CI): 0.67-0.87). When analyzed using the HCR tertiles, the middle and highest tertiles exhibited progressively reduced risks (HR = 0.74, 95% CI: 0.61-0.88 and HR = 0.58, 95% CI: 0.47-0.71), respectively; for trend < 0.001) compared with the lowest tertile. Similar associations were observed for the 90-day composite outcome. The stability of these associations was confirmed through subgroup and sensitivity analyses. CONCLUSIONS: A higher HCR is independently associated with a reduced risk of readmission or mortality within 180 days of discharge in older patients with HF. The HCR may serve as a useful prognostic marker for risk stratification in this population.
Additional Value of Cardiac Assessment With Oncologic F-FDG PET/CT in Pre-Treatment Tumor Patients.
Lin R, Bing Y, Wang J … +3 more , Tian A, Yu J, Xie W
Rev Cardiovasc Med · 2026 May · PMID 42238646 · Full text
BACKGROUND: To study the occurrence, site, reasons, metabolism, and texture features of unusual heart absorption in cancer patients undergoing their first Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography/Compu...
BACKGROUND: To study the occurrence, site, reasons, metabolism, and texture features of unusual heart absorption in cancer patients undergoing their first Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (F-FDG PET/CT) full-body scan. METHODS: A total of 2159 patients who underwent their first F-FDG PET/CT full-body scan and received hospital care between July 2017 and December 2022 were included. Of these, 1611 were diagnosed with tumors, and 548 were non-tumor cases, based on clinical, pathological, and PET/CT evaluations. Abnormal uptake was categorized as a "known cause" when supported by clinical evidence of the associated origin and as an "unknown cause" when evidence was insufficient. We compared metabolic parameters and texture features between groups and constructed receiver operating characteristic (ROC) curves. RESULTS: Among the patients studied, 118 with tumors exhibited abnormal cardiac uptake patterns, while 14 non-tumor patients showed similar abnormalities. The occurrence of abnormal cardiac uptake without a known cause among cases of abnormal cardiac uptake was higher in tumor patients than in non-tumor patients (62.71% vs. 35.71%; > 0.05). Within the tumor group, the high-tumor-burden subset had a significantly higher proportion of unexplained abnormal cardiac uptake than the low-tumor-burden subset (72.9% vs. 52.5%; < 0.05). ROC curve analysis revealed that a combined assessment of selected metabolic parameters and texture features yielded an area under the curve (AUC) of 0.809 (0.732, 0.886), sensitivity of 77.3%, and specificity of 71.6%. CONCLUSION: Unusual cardiac uptake observed in tumor patients during F-FDG PET/CT scans could be linked to existing heart conditions and the extent of the tumor. Metabolic parameters and texture characteristics provide valuable insights into the underlying causes.
Exploration of the Effects of SGLT-2 Inhibitors and GLP-1 Receptor Agonists on Coronary Inflammation in Type 2 Diabetes Patients Based on the Peri-Coronary Fat Attenuation Index.
Wang T, Li Y, Yao W … +6 more , Zhang S, Chi S, Wang Y, Wang C, Dang Y, Zhang F
Rev Cardiovasc Med · 2026 May · PMID 42238645 · Full text
BACKGROUND: The peri-coronary fat attenuation index (FAI) is a novel imaging biomarker of inflammation. This study aimed to investigate the association between combination therapy with sodium-glucose transporter 2 inhibi...
BACKGROUND: The peri-coronary fat attenuation index (FAI) is a novel imaging biomarker of inflammation. This study aimed to investigate the association between combination therapy with sodium-glucose transporter 2 inhibitors (SGLT-2i) and glucagon-like peptide-1 receptor agonists (GLP-1RAs) and coronary artery inflammation, as assessed by the peri-coronary FAI, in patients with type 2 diabetes mellitus (T2DM). METHODS: This retrospective analysis included 292 patients with T2DM who underwent coronary computed tomography angiography (CCTA) at Hebei General Hospital. Patients were divided into three groups: (1) non-SGLT-2i/GLP-1RA users (non-users, n = 125): Patients not receiving SGLT-2i or GLP-1RA therapy; (2) SGLT-2i/GLP-1RA monotherapy group (mono-tx, n = 124): Patients treated with either SGLT-2i or GLP-1RA alone; (3) SGLT-2i + GLP-1RA combination therapy group (combo-tx, n = 43): Patients receiving concurrent SGLT-2i and GLP-1RA therapy. Clinical parameters, laboratory biomarkers, and the peri-coronary FAI of patients were collected and comparatively analyzed among the three groups. Finally, multivariate linear regression models were constructed to elucidate the independent association between combined GLP-1RA and SGLT-2i therapy and the peri-coronary FAI. RESULTS: One-way analysis of variance (ANOVA) revealed significant differences in the peri-coronary FAI among the three therapy groups. Specifically, compared with the non-user group, the combo-tx group had significantly lower peri-coronary FAI values in the left circumflex artery (LCX) and left anterior descending artery (LAD). Compared with the mono-tx group, the combo-tx group also had a significantly lower LCX FAI. Multivariate regression analysis further confirmed that combination therapy was independently associated with a lower FAI in the LAD, LCX, and right coronary artery (RCA). Subgroup analysis revealed a significant interaction by sex in the association between treatment regimen and LCX FAI. CONCLUSION: The combined use of SGLT-2 inhibitors and GLP-1RAs may be associated with a decrease in the peri-coronary FAI in patients with T2DM, suggesting a potential role in reducing coronary inflammation. Thus, this combination therapy might offer advantages over monotherapy.
Mitochondrial-Endothelial Crosstalk in Cardiometabolic Disease: Mechanisms and Translational Opportunities in the Multi-omics Era.
Liu D, Sun J, He Y … +4 more , Sun Y, Yin M, Zhang J, Zhao X
Rev Cardiovasc Med · 2026 May · PMID 42238644 · Full text
Mitochondria and endothelial cells engage in bidirectional crosstalk to maintain vascular tone, barrier integrity, and inflammatory quiescence. In cardiometabolic diseases (CMDs), metabolic overload and chronic inflammat...
Mitochondria and endothelial cells engage in bidirectional crosstalk to maintain vascular tone, barrier integrity, and inflammatory quiescence. In cardiometabolic diseases (CMDs), metabolic overload and chronic inflammatory cues disrupt endothelial mitochondrial bioenergetics, dynamics, and quality-control mechanisms. As protective systems weaken, redox imbalance and impaired nitric oxide signaling-further exacerbated by barrier dysfunction-trigger endothelial activation and loss of homeostasis. Clinical translation has lagged largely because endothelial responses vary across vascular beds and microenvironments, and most clinical trials fail to align patient selection or endpoints with mitochondrial mechanisms. This review addresses a major translational gap: how mitochondrial stress programs map onto context-specific endothelial phenotypes in human CMDs, and how this mapping can inform the selection of actionable therapeutic strategies. Indeed, this review integrates single-cell and spatial multi-omics data to link mitochondrial stress and metabolic remodeling to specific anatomical niches, transforming the broad notion of "endothelial dysfunction" into defined biological programs for biomarker selection and target discovery. Moreover, this review categorizes translational opportunities by the strength of human evidence. Near-term priorities include repurposed cardiometabolic drugs (e.g., sodium-glucose cotransporter 2 (SGLT2) inhibitors, glucagon-like peptide-1(GLP-1) receptor agonists) and circulating biomarkers for patient stratification or pharmacodynamic monitoring (e.g., growth differentiation factor 15 (GDF15), cell-free mitochondrial DNA (cf-mtDNA), endothelium-derived extracellular vesicles). In contrast, gene and cell therapies, as well as advanced delivery and regenerative platforms, remain at the preclinical stage and require stronger mechanistic validation, improved safety profiles, and scalable delivery systems before clinical evaluation. Thus, a key unmet need is for multicenter, mechanism-informed trials that integrate endothelial functional endpoints (e.g., flow-mediated dilation (FMD)/peripheral arterial tonometry (PAT) with mitochondrial-associated molecular readouts under harmonized protocols and standardized reference criteria to enhance reproducibility and cross-study comparability. Collectively, these insights establish mitochondrial-endothelial biology as an evidence-based entry point for precision vascular medicine in CMDs.
The Role of Multimodality Imaging in Guiding Ventricular Tachycardia Ablation: An Updated Review.
Habib E, Abdelnabi M, Ibrahim R … +11 more , Kanaan C, Pham HN, Alkhatib A, Abdalla H, VanDolah H, Bacon A, Tahsin M, Jamal F, Eldeib A, Arsanjani R, Masry HE
Rev Cardiovasc Med · 2026 May · PMID 42238643 · Full text
Multimodality imaging plays a pivotal role in ventricular tachycardia (VT) ablation by providing critical insights into arrhythmogenic substrates and guiding procedural strategies. This updated review explores the integr...
Multimodality imaging plays a pivotal role in ventricular tachycardia (VT) ablation by providing critical insights into arrhythmogenic substrates and guiding procedural strategies. This updated review explores the integration of various imaging techniques, including echocardiography, cardiac magnetic resonance (CMR), multidetector computed tomography (MDCT), electroanatomical mapping (EAM), and nuclear imaging, to optimize VT ablation outcomes. Echocardiography, particularly transthoracic echocardiography (TTE), is an essential first-line tool for evaluating structural heart disease and left ventricular function. Moreover, echocardiography aids in risk stratification and procedural planning by detecting regional wall motion abnormalities and thrombus formation. Meanwhile, intracardiac echocardiography (ICE) enhances ablation precision by providing real-time catheter visualization, improving procedural success, and reducing complications such as cardiac tamponade. Nonetheless, CMR is the gold standard for myocardial tissue characterization, enabling the identification of scar burden and conduction channels critical for VT pathogenesis. Late gadolinium enhancement (LGE) facilitates preprocedural planning by localizing arrhythmogenic substrates, predicting VT recurrence risk, and informing ablation strategies. Additionally, T1- and T2-mapping techniques refine the assessment of myocardial fibrosis and inflammation, further improving patient selection and outcomes. MDCT complements CMR by offering high-resolution anatomical visualization and aids in delineating scar distribution, epicardial fat, and vascular structures, informing safe and effective ablation approaches. The integration of these imaging modalities significantly enhances VT ablation precision, reduces recurrence rates, and improves patient outcomes.
Identification and Validation of an Explainable Predictive Model For Heart Failure in Patients With Hypertension.
Han J, Zhao T, Shi Y … +10 more , Zhao Z, Wang W, Ye Y, Bai Y, Lin Z, Meng X, Guo L, Feng R, Ding Y, Zeng Y
Rev Cardiovasc Med · 2026 May · PMID 42238642 · Full text
BACKGROUND: Heart failure (HF) is a heterogeneous syndrome affecting over 60 million individuals globally. Patients with hypertension are particularly susceptible to developing HF. Therefore, timely identification and pr...
BACKGROUND: Heart failure (HF) is a heterogeneous syndrome affecting over 60 million individuals globally. Patients with hypertension are particularly susceptible to developing HF. Therefore, timely identification and predictive assessment of HF risk have significant clinical implications in this population. Thus, this study aimed to develop a new interpretable machine learning (ML) model for HF prediction. METHODS: Using data from the Systolic Blood Pressure Intervention Trial (SPRINT), a random under-sampling technique was applied to address class imbalance in the target variable, achieving a 1:1 ratio between positive and negative samples. By randomly matching 162 individuals without HF events to those with events, a balanced dataset comprising 324 participants was constructed. The test set comprised 40% of the total dataset to ensure a robust evaluation of model performance. Seven ML algorithms, including support vector machine (SVM), adaptive boosting (Adaboost), naïve Bayes (NB), logistic regression (LR), gradient boosting machine (GBM), random forest (RF), and multilayer perceptron (MLP), were employed to construct the predictive models. Model performance was evaluated using the area under the curve (AUC), decision curve analysis (DCA), calibration curves, and other metrics. The SHapley Additive exPlanations (SHAP) approach was employed to rank feature significance and provide interpretability for the final model. RESULTS: Over a median follow-up of 3.88years, 162 patients (1.8%) developed incident HF. Among the seven ML models, GBM demonstrated the best performance. A total of 14 features were retained after the least absolute shrinkage and selection operator (LASSO) selection. The final model exhibited robust predictive capability for identifying HF risk, with an overall accuracy of 0.731, a precision of 0.770, and an AUC (95% confidence interval (CI)) of 0.763 (0.676-0.840). CONCLUSION: The GBM-based explainable prediction model demonstrated robust performance in predicting HF risk among patients with hypertension.
Cardiac Responses to Alcohol: A Review of Mechanisms and Clinical Implications.
Johnston KE, Kamble A, Lee J … +2 more , Garley K, Figueredo VM
Rev Cardiovasc Med · 2026 May · PMID 42238641 · Full text
Alcohol has been appreciated by civilizations for thousands of years. Nonetheless, alcohol has recently been linked to serious cardiovascular diseases. Therefore, this review summarizes the effects of alcohol on the hear...
Alcohol has been appreciated by civilizations for thousands of years. Nonetheless, alcohol has recently been linked to serious cardiovascular diseases. Therefore, this review summarizes the effects of alcohol on the heart based on the most current literature available. This review covers the effects of alcohol on blood pressure (BP), heart rate (HR), autonomic dysfunction, coronary artery disease (CAD), cardiomyopathy, and cardiac arrhythmias. Evidence supports the harmful effects of both acute (binge) and chronic heavy alcohol consumption on BP, HR, autonomic dysfunction, and the risk of CAD, cardiomyopathy, and various arrhythmias. Some studies suggest that mild to moderate drinking may reduce the risk of CAD and arrhythmias, consistent with a potential J-shaped relationship. However, other evidence contradicts this, thereby indicating that alcohol use may increase the risk of developing hypertension, CAD, and atrial fibrillation. At the time of this review, evidence supports the harmful effects of acute and chronic heavy alcohol consumption on the heart. Findings are mixed for mild to moderate drinking and may be influenced by confounding factors, underscoring the need for further research. Given the inconclusive benefits, the authors recommend that no level of alcohol consumption be promoted as beneficial for cardiac health.
ST-Elevation Myocardial Infarction Complicated by Ventricular Septal Defect Is Associated With Very High Mortality Without Improvement Over Time.
Movahed MR, Rasti A, Hashemzadeh M
Rev Cardiovasc Med · 2026 May · PMID 42238640 · Full text
BACKGROUND: This study aimed to examine mortality trends among patients who presented with ST-elevation myocardial infarction (STEMI) complicated by ventricular septal defect (VSD) between 2016 and 2022. METHODS: Using t...
BACKGROUND: This study aimed to examine mortality trends among patients who presented with ST-elevation myocardial infarction (STEMI) complicated by ventricular septal defect (VSD) between 2016 and 2022. METHODS: Using the Nationwide Inpatient Sample (NIS) database and International Classification of Diseases (ICD)-10 codes for patients with STEMI and VSD from 2016-2022, we evaluated mortality trends over these years. RESULTS: A total of 2735 patients with STEMI-associated VSD were identified. Total average mortality was 50.65%, with no significant average improvement over the years studied. In the multiple logistic regression analysis, the only clinical or demographic predictors of mortality were increasing age, which was associated with higher mortality (multivariate odds ratio (MVOR) 95% confidence interval (CI) = 1.05 (1.03-1.07); < 0.001) and Asian race, which was associated with lower mortality (MVOR 95% CI = 0.26 (0.07-1.00); = 0.05). CONCLUSIONS: STEMI complicated by VSD is associated with very high mortality (>50%) and shows no significant improvement over the study period. Furthermore, increasing age is an independent predictor of mortality, whereas Asian populations may be associated with a lower mortality risk.
Pyroptosis: Novel Targets in Molecular Mechanisms and Drug Therapy Research for Myocardial Ischemia Reperfusion Injury.
Zhang D, Wu H, Gong S … +4 more , Zhou G, Zhang Q, Li S, Yang W
Rev Cardiovasc Med · 2026 May · PMID 42238639 · Full text
Myocardial ischemia-reperfusion injury is a significant complication of reperfusion therapy and a primary cause of mortality in patients with acute myocardial infarction. The pathogenic mechanism involved in myocardial i...
Myocardial ischemia-reperfusion injury is a significant complication of reperfusion therapy and a primary cause of mortality in patients with acute myocardial infarction. The pathogenic mechanism involved in myocardial ischemia-reperfusion injury is intricate, and effective preventive and therapeutic strategies remain limited in clinical practice. Recently, pyroptosis has emerged as a novel regulatory form of cell death and has attracted widespread attention as a key focus in the study of disease mechanisms and therapeutic targets. Studies indicate a close association between pyroptosis and the pathophysiological processes underlying myocardial ischemia-reperfusion injury. This article provides a comprehensive review of recent advances in research on pyroptosis in the context of myocardial ischemia-reperfusion injury. Therefore, this review aims to offer new insights into the prevention and treatment of myocardial ischemia-reperfusion injury while minimizing redundancy in the existing literature.
Non-Dipping Blood Pressure in Pediatric Hypertension: A Narrative Review.
Gherbesi E, Faggiano A, Carugo S … +3 more , Grassi G, Tadic M, Cuspidi C
Rev Cardiovasc Med · 2026 May · PMID 42238638 · Full text
Ambulatory blood pressure monitoring (ABPM) provides a unique opportunity to assess day-night blood pressure (BP) variability. Individuals whose night-time BP is 10-20% lower than the subsequent daytime BP values are def...
Ambulatory blood pressure monitoring (ABPM) provides a unique opportunity to assess day-night blood pressure (BP) variability. Individuals whose night-time BP is 10-20% lower than the subsequent daytime BP values are defined as dippers, whereas those with a nocturnal BP decrease of <10% are considered non-dippers. A non-dipping (ND) pattern has been shown to occur in a substantial proportion of adults with hypertension and is influenced by age, sex, ethnicity, and comorbidities. More importantly, the ND pattern has been reported to adversely affect hypertension-mediated organ damage (HMOD) and cardiovascular prognosis, due to a greater nighttime pressure overload that promotes more severe cardiovascular damage. Notably, current evidence on alterations in circadian BP rhythm in children and adolescents with hypertension remains scarce. Therefore, this narrative review aimed to analyze the available literature on this important topic and to provide updated, comprehensive information on the prevalence of the ND pattern and its association with cardiac and extracardiac HMOD markers. The prevalence of ND patterns (based on data from 16 studies) ranged from 35% to 72% (mean 59%). Regarding the association between ND and HMOD, particularly echocardiographic left ventricular hypertrophy, results have been mixed, leaving uncertainty about whether a blunted nocturnal BP decline in pediatric hypertension contributes to HMOD. Thus, large prospective studies are needed to improve definitions of the clinical significance of alterations in BP circadian rhythm in children and adolescents with hypertension, focusing on methodological issues not yet fully addressed, such as the use of pediatric diagnostic criteria and the reproducibility of the ND pattern over time.
Technological Innovations and Research Frontiers in Interventional Therapy for Mitral Regurgitation.
Wang S, Wang A, Huang Y … +2 more , Liu J, Wang B
Rev Cardiovasc Med · 2026 May · PMID 42238637 · Full text
Mitral regurgitation (MR) is a common valvular heart diseasewhose prevalence continues to increase with population aging, posing a serious threat to human health in the advanced stages of the disease. Sole reliance on me...
Mitral regurgitation (MR) is a common valvular heart diseasewhose prevalence continues to increase with population aging, posing a serious threat to human health in the advanced stages of the disease. Sole reliance on medication and traditional surgical treatments can no longer meet the therapeutic needs of all patients. Transcatheter interventional therapy is gradually emerging as a promising new treatment option. Recently, technologies for the transcatheter interventional treatment of MR have advanced rapidly, with expanding indications and a continuous stream of new devices. The field has entered a phase of accelerated development in the treatment of structural heart disease, demonstrating broad clinical prospects. This article reviews the key technologies and developmental trends in the current transcatheter interventional treatments for MR, aiming to provide a theoretical basis and rationale for the safe and standardized implementation and broader adoption of these technologies.
Sedation Strategies, Drugs, and Protocols Used in Catheter Ablation of Atrial Fibrillation: A Focused Review.
Catuzzo B, Meynet I, Denti S … +14 more , Amellone C, Coppola G, De Bonis S, Nesti M, Pellegrino PL, Rossillo A, Ziacchi M, Boriani G, D'Onofrio A, Priori SG, Themistoclakis S, Anselmino M, De Ponti R, Italian Association of Arrhythmology and Cardiac Pacing (AIAC)
Rev Cardiovasc Med · 2026 May · PMID 42238636 · Full text
Catheter ablation is the mainstay of rhythm control in atrial fibrillation (AF), and its use is steadily increasing worldwide. To optimize procedural safety and efficacy, an appropriate sedation or anesthesia regimen is...
Catheter ablation is the mainstay of rhythm control in atrial fibrillation (AF), and its use is steadily increasing worldwide. To optimize procedural safety and efficacy, an appropriate sedation or anesthesia regimen is essential, ensuring adequate analgesia and a stable respiratory pattern while minimizing patient movement. However, the optimal sedation strategy remains a matter of debate, with approaches ranging from general anesthesia to deep or conscious sedation. Since anesthesiologists administer general anesthesia, attention focuses on hypnotics, defined as drugs that induce and/or maintain sleep by depressing the central nervous system, and analgesics. In many centers, these agents are administered by electrophysiology laboratory staff in accordance with local regulations and institutional protocols, which vary among countries. This warrants caution, as individual responses to commonly combined agents are unpredictable and may result in deeper-than-intended sedation. Therefore, respiratory or hemodynamic support may become necessary in selected patients. Notably, protocols incorporating hypnotic communication have also been proposed and implemented. The selection of sedation and analgesia strategies for AF ablation has become increasingly important for balancing patient safety, procedural effectiveness, and resource utilization. The approach should be individualized based on patient characteristics, procedural complexity, energy source, institutional resources, and the relevant national regulatory framework.
Histamine in Diabetic Cardiovascular Complications.
Hu S, Zeng G, Tang Y … +3 more , Wang Q, Wu J, Yang X
Rev Cardiovasc Med · 2026 May · PMID 42238635 · Full text
Diabetic cardiovascular complications are the primary cause of diabetes-associated mortality. The pathogenesis of diabetic cardiomyopathy is complex; the main clinical manifestations include inflammation, hyperinsulinemi...
Diabetic cardiovascular complications are the primary cause of diabetes-associated mortality. The pathogenesis of diabetic cardiomyopathy is complex; the main clinical manifestations include inflammation, hyperinsulinemia, mitochondrial dysfunction, endoplasmic reticulum stress, and coronary microcirculation disorders. Among these factors, inflammatory responses play a pivotal role in diabetic cardiomyopathy. The accumulation of histamine secreted by macrophages in multiple tissues of patients with diabetes mellitus is crucial for the onset and progression of the disease, particularly diabetic cardiovascular complications. Histamine and associated receptor-mediated signaling pathways are implicated in diabetic cardiovascular complications; however, the specific mechanisms remain unclear and warrant further investigation.
Cardioneuroablation: A Comprehensive Review.
Conti S, Porto AG, Zappulla P … +1 more , Sgarito G
Rev Cardiovasc Med · 2026 May · PMID 42238634 · Full text
Cardioneuroablation (CNA) has emerged as a promising therapeutic strategy for functional bradyarrhythmias, particularly in cases of cardioinhibitory neurocardiogenic syncope and certain forms of atrial fibrillation. Inde...
Cardioneuroablation (CNA) has emerged as a promising therapeutic strategy for functional bradyarrhythmias, particularly in cases of cardioinhibitory neurocardiogenic syncope and certain forms of atrial fibrillation. Indeed, by targeting vagal innervation through endocardial radiofrequency catheter ablation, CNA can obviate the need for pacemaker (PM) implantation. This technique involves denervation of specific vagal nerve structures within the atria to modulate autonomic balance and prevent symptomatic bradycardia. The efficacy of this approach stems from the recognition that an imbalance between sympathetic and parasympathetic tones, often characterized by excessive vagal activity, underpins these arrhythmogenic conditions. Indeed, CNA may be more effective than a permanent PM implantation in some patients, as this method addresses the underlying etiology rather than merely treating symptoms. Specifically, modulating autonomic nervous system (ANS) signaling through procedures such as CNA holds considerable promise for preventing and treating a range of cardiac arrhythmias. This review aims to synthesize current knowledge regarding various CNA techniques, exploring the associated mechanisms, clinical applications, and outcomes across diverse patient populations.
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