Frontiers in Cardiovascular Medicine

BackgroundFever is a common clinical manifestation following acute myocardial infarction(AMI). However, differentiating its etiology-specifically, distinguishing between fever caused by the absorption of necrotic tissue and fever due to concurrent infection is critical, as this distinction directly influences treatment decisions and patient prognosis. MethodsThis retrospective study reviewed AMI patients from two centers. Participants were divided into two groups: a fever of non-infectious orig...

BackgroundRight heart failure (RHF) leads to an elevation in central venous pressure and causes hepatic congestion. Apolipoprotein M (ApoM), a hepatocyte-derived lipocalin bound to high-density lipoprotein, transports sphingosine-1-phosphate (S1P), which maintains vascular integrity and modulates inflammation. Although low ApoM predicts adverse outcomes in heart failure (HF), its role in RHF is unclear. We sought to investigate the impact of RHF on circulating ApoM, its prognostic value in RHF m...

BackgroundSodium glucose co-transport inhibitors (SGLT2i), although established heart failure (HF) therapy in acquired heart disease, are not well-studied in adult congenital heart disease (ACHD). We aimed to conduct a systematic review and meta-analysis of SGLT2i therapy in moderate or severe complexity ACHD. MethodsFive databases (Pubmed, Medline, Embase, SCOPUS, and Cochrane) were searched for peer-reviewed journal articles describing SGLT2i HF therapy in moderate or severe complexity ACHD. ...

BackgroundGuideline-directed medical therapy (GDMT) has been shown to improve mortality and/or symptoms in heart failure with reduced ejection fraction (HFrEF). Medical devices also play an important role in improved quality of life and overall symptom relief for HFrEF patients. Baroreflex Activation Therapy (BAT) increases parasympathetic nervous system activity by stimulating the carotid baroreceptors, thereby reducing symptoms. Herein, we analyzed the effects of BAT on hospitalization, atrial...

BackgroundAcute type A aortic dissection (AAAD) complicated by cardiopulmonary arrest is characterized by high mortality rates, rendering the selection of surgical candidates a subject of intense debate. Despite the necessity for cardiopulmonary resuscitation (CPR) prior to the completion of a definitive intervention, the prognostic impact of CPR duration on postoperative survival and neurological outcomes remains insufficiently elucidated. This study sought to evaluate the association between p...

AbstractRespiratory training benefits chronic heart failure (CHF) patients but is underused due to multiple barriers. Lifestyle-based active pursed-lip diaphragmatic breathing (PLDB) offers a feasible, device-independent alternative. This study aimed to evaluate its impact on CHF patients exercise tolerance, cardiac function, quality of life, and clinical outcomes. A prospective cohort study enrolled 58 hospitalized CHF patients (NYHA II-IV, Jan 2023-Feb 2024). All received standard therapy and...

BackgroundComputed tomography (CT) is routinely performed for planning transcatheter aortic valve implantation (TAVI) procedures. Aortic valve calcium score (AVCS) is recommended to ascertain the severity of degenerative aortic stenosis (AS) in low-flow states, with the role of CT-AVA (aortic valve area) being uncertain. In this study, we determined the best AVCS and CT-AVA thresholds in patients referred for TAVI. MethodsA retrospective multicentre study evaluated 1162 patients undergoing TAVI...

BackgroundCoronavirus disease 2019 (COVID-19) has had a profound impact on cardiovascular health, influencing both the presentation and outcomes of acute myocardial infarction. This study aimed to evaluate the demographic and clinical profiles of patients with ST-segment elevation myocardial infarction (STEMI) presenting to a tertiary care center during the COVID-19 pandemic and to compare early and late presenters in terms of outcomes. MethodsA retrospective cohort study was conducted on 885 p...

BackgroundCombination therapy with atherectomy and intravascular lithotripsy (IVL) has emerged as a promising strategy for the treatment of severely calcified occlusive coronary lesions, which potentially enhances procedural efficacy without increasing complication risk. MethodsThe Dual-Prep Registry is a multicenter, prospective registry designed to evaluate the safety and efficacy of IVL after atherectomy in severely calcified lesions. Combined use was selectively applied when the risk of com...

BackgroundBorderline pulmonary hypertension (mean pulmonary artery pressure 20-24 mmHg) is increasingly recognized as a clinically significant condition that may influence perioperative outcomes in patients undergoing aortic valve replacement. This study aims to explore the 30-day composite complication rates and mortality among patients with borderline pulmonary hypertension who received transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR). MethodsThe retro...

BackgroundVascular tortuosity in the right subclavian artery (RSA) region may impede guidewire advancement during right upper limb access for coronary angiography. AimsTo develop a morphology-based classification of guidewire configurations in the RSA region and evaluate their association with difficulty in guidewire manipulation. MethodsData were collected from patients who underwent coronary angiography via the right upper limb at the Geriatric Cardiovascular Center of Beijing Anzhen Hospita...

BackgroundKetone bodies have shown potential to improve cardiac metabolism and function in patients with heart failure (HF). ObjectiveTo evaluate the effects of exogenous ketone-based interventions on cardiac function in patients with HF or related cardiometabolic risk factors. MethodsWe conducted a systematic review based on a search of MEDLINE, EMBASE, CINAHL, Cochrane Library, and Scopus from inception to January 2025. Eligible studies included randomized controlled trials evaluating exogen...

Structured AbstractO_ST_ABSBackgroundC_ST_ABSCardiogenic shock (CS) remains a leading cause of in-hospital mortality in acute myocardial infarction (AMI). Although advanced age is associated with worse outcomes, the prognostic relevance of chronological age may vary by clinical presentation, particularly in the presence of out-of-hospital cardiac arrest (OHCA). We investigated the prognostic impact of octogenarian status in patients with AMI complicated by cardiogenic shock (AMI-CS). MethodsWe ...

Subclinical rheumatic valvular disease is a significant yet underdiagnosed contributor to the global rheumatic heart disease (RHD) burden. Early detection through population screening is essential to prevent its progression to severe RHD. Rhythm changes and prolongations of PR and QTc intervals in the ECG are described in the advanced RHD cases. However, these parameters were not yet studied in asymptomatic RHD. We aimed to investigate the potential of ECG biomarkers for screening RHD in asympto...

Structured AbstractO_ST_ABSBackgroundC_ST_ABSVericiguat and sacubitril/valsartan both modulate the nitric oxide-soluble guanylate cyclase-cyclic guanosine monophosphate signaling pathway and may improve myocardial function in patients with heart failure. ObjectivesTo compare the effects of vericiguat, sacubitril/valsartan, and their combination on left ventricular function and clinical outcomes in heart failure with nonpreserved ejection fraction patients. MethodsIn this retrospective real-wor...

BackgroundThe optimal timing and efficacy of pharmacological rhythm control in patients with preoperative atrial fibrillation (AF) undergoing cardiopulmonary bypass (CPB) surgery remain unclear. We aimed to evaluate the effectiveness of intravenous amiodarone administration during rewarming on early cardioversion and short-term outcomes, and to develop a predictive model for postoperative AF recurrence. MethodsThis retrospective cohort study included adult patients with preoperative atrial fibr...

BackgroundScreening for atherosclerosis focuses on identifying Standard Modifiable Risk Factors (SMuRFs), including diabetes, hypertension, hyperlipidaemia, and smoking. PurposeTo compare the extracardiac thoracoabdominal atherosclerotic plaque burden, as measured by computed tomography angiography (CTA), among heart transplant candidates with ischemic or non-ischemic cardiomyopathy (ICM, NICM), and evaluate potential associations between plaque burden and SMuRFs. MethodsThis retrospective stu...

BackgroundRight ventricular (RV) function is an important predictor of morbidity and mortality in various cardiovascular conditions. Nevertheless, its echocardiographic assessment is challenging due to its complex anatomy and location in the chest, resulting in limited inter-observer reproducibility. ObjectivesWe aimed to develop a novel deep learning model - EchoNet-RV - to segment the RV in apical 4-chamber view (A4C) echocardiographic videos and estimate RV fractional area change (RVFAC). M...

Structured abstractO_ST_ABSBackgroundC_ST_ABSTransthyretin amyloid cardiomyopathy (ATTR-CM) has historically been underdiagnosed but has recently become increasingly recognized due to advances in diagnostic techniques and heightened clinical awareness. Despite this progress, treatment options remain limited, as current approved therapies are costly and not widely accessible. Given the benefits of sodium-glucose cotransporter 2 (SGLT2) inhibitors in broader heart failure (HF) populations, we aime...

BackgroundLeft atrial (LA) remodeling, a hallmark of chronically elevated LA pressure, is characterized by enlargement and functional impairment. While global and reservoir LA functions are well described, the role of LA booster function and its failure remains poorly defined. ObjectivesTo characterize LA booster function using cardiac computed tomography angiography (CCTA) and to evaluate the relationship between LA preload, booster performance, remodeling, and clinical outcomes. MethodsWe re...