Progress in cardiovascular diseases最新文献

英文中文

Integrating cardiovascular implementation science research within healthcare systems 在医疗保健系统中整合心血管实施科学研究。

IF 5.6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Progress in cardiovascular diseases

Pub Date : 2025-05-01 DOI: 10.1016/j.pcad.2025.04.005

Muhammad Shahzeb Khan , Ahmed Mustafa Rashid , Harriette G.C. Van Spall , Stephen J. Greene , Ankeet S. Bhatt , Ambarish Pandey , Neil Keshvani , Robert J. Mentz , Andrew P. Ambrosy , J. Michael DiMaio , Javed Butler

Only 1 in 5 evidence-based interventions make it to routine clinical practice and the evidence generated from clinical research may take 17 years to be implemented. This represents a lost opportunity to improve clinical care in healthcare systems. Implementation science refers to the study of methods to promote the adoption and integration of evidence-based practices, interventions, and policies into real-world clinical settings to positively impact population health. Therefore, implementation roadmaps can be crucial for learning healthcare systems (LHS) to bridge the research-to-practice gap, particularly for cardiovascular disease which remains the leading cause of death in the United States. Implementation models exist, all of which require a thorough understanding of the key phases of implementation for effective healthcare system incorporation and optimization (pre-implementation, implementation, monitoring the implementation, evaluation, sustaining, and scaling-up or de-implementation). This review serves as a call-to-action for involvement of large-scale LHS for cardiovascular implementation science, and provides a roadmap by summarizing various implementation science models, highlighting key implementation phases and discussing successful initiatives to improve the process. We also assess challenges associated with implementation science and provide possible solutions to improve translation of evidence in real-world clinical settings.

只有五分之一的循证干预措施能够进入常规临床实践，临床研究产生的证据可能需要17年才能得到实施。这意味着失去了改善卫生保健系统临床护理的机会。实施科学是指研究方法，以促进采用和整合循证实践、干预措施和政策到现实世界的临床环境中，以积极影响人口健康。因此，实施路线图对于学习医疗保健系统（LHS）至关重要，以弥合研究与实践之间的差距，特别是对于心血管疾病，这仍然是美国死亡的主要原因。存在各种实施模型，所有这些模型都需要对有效的医疗保健系统整合和优化的关键实施阶段（实施前、实施、监督实施、评估、维持、扩大或取消实施）有透彻的了解。本综述旨在呼吁参与心血管实施科学的大规模LHS，并通过总结各种实施科学模型、突出关键实施阶段和讨论改进过程的成功举措提供路线图。我们还评估了与实施科学相关的挑战，并提供了可能的解决方案，以改善现实世界临床环境中的证据翻译。

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引用次数: 0

Personalizing risk assessment for transcatheter aortic valve replacement: Value of CT imaging and AI 经导管主动脉瓣置换术个体化风险评估：CT和人工智能的价值。

IF 5.6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Progress in cardiovascular diseases

Pub Date : 2025-05-01 DOI: 10.1016/j.pcad.2025.05.001

Andrew Lin , Thomas A. Treibel , Marc R. Dweck

引用次数: 0

Incremental benefits of combined inhibition of SGLT1 and SGLT2 with sotagliflozin 索他列净联合抑制SGLT1和SGLT2的益处增加。

IF 5.6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Progress in cardiovascular diseases

Pub Date : 2025-05-01 DOI: 10.1016/j.pcad.2025.04.004

Ram D. Bhatt , Bertram Pitt , Ph. Gabriel Steg , Deepak L. Bhatt

引用次数: 0

Prognostic value of the right ventricular to left ventricular volume ratio on cardiac magnetic resonance imaging in predicting adverse outcomes for adults with pulmonary hypertension 心脏磁共振成像右室与左室容积比预测成人肺动脉高压不良结局的预后价值。

IF 5.6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Progress in cardiovascular diseases

Pub Date : 2025-05-01 DOI: 10.1016/j.pcad.2025.04.002

Robert S. Zhang , Lily Jin , Giorgia Falco , Rachel Axman , Pablo Villar-Calle , Annie Tsay , Matthew C. Lam , Udhay Krishnan , Andre Cheng , Yuchi Han , Monica Mukherjee , Jonathan W. Weinsaft , Jiwon Kim

Background

Right ventricular (RV) performance impacts clinical outcomes across pulmonary hypertension (PH), yet noninvasive tools for early detection and risk stratification are limited. Cardiac MRI (CMR) derived RV to left ventricular (LV) volume ratio (RV/LV_vol ratio) provides a relative assessment of RV size by normalizing chamber size to the LV. However, its prognostic utility remains underexplored. In the present study, we investigate the association between the RV/LV_vol ratio and outcomes in patients with PH.

Methods

This prospective study included patients with PH (pulmonary arterial systolic pressure > 35 mmHg by echocardiography or mean pulmonary artery pressure > 20 mmHg on invasive right heart catheterization), who underwent CMR. Abnormal RV/LV_vol ratio cutoff (≥1.27) was applied and further tested using established gradation thresholds. The primary outcome was a composite of all-cause mortality and heart failure hospitalizations.

Results

Of 135 patients, 56 (41.5 %) had an abnormal RV/LV_vol ratio. After a mean follow-up of 1.9 ± 1.3 years, 75 patients experienced the primary outcome. Patients with an abnormal RV/LV_vol ratio had higher rates of the primary outcome (64.3 % vs 50.0 %, p = 0.02). After multivariable analysis adjusting for age and CMR indices, abnormal RV/LV_vol ratio was independently associated with the primary outcome (HR 1.81 [95 % CI 1.06–2.97]; p = 0.003). RV/LV_vol ratio added incremental prognostic value over age and traditional RV indices (global χ2 value increasing from 6.7 to 17.4, p = 0.006).

Conclusions

The RV/LV_vol ratio is a simple clinical tool associated with an increased risk of adverse outcomes in PH patients, offering prognostic information beyond traditional RV parameters.

背景：右心室（RV）功能影响肺动脉高压（pH）的临床结果，但用于早期检测和风险分层的无创工具有限。心脏MRI （CMR）衍生的左室与左室容积比（RV/LVvol ratio）通过将室大小与左室大小归一化，提供了左室大小的相对评估。然而，其预测效用仍未得到充分探索。在本研究中，我们研究了PH患者RV/LVvol比值与预后之间的关系。方法：这项前瞻性研究纳入了接受CMR的PH患者（超声心动图肺动脉收缩压 > 35 mmHg或有创右心导管平均肺动脉压 > 20 mmHg）。采用异常的RV/LVvol比值截止值（≥1.27），并采用建立的分级阈值进一步检验。主要结局是全因死亡率和心力衰竭住院的综合结果。结果：135例患者中，56例（41.5 %）的RV/LVvol比值异常。在平均1.9 ± 1.3 年的随访后，75名患者经历了主要结局。RV/LVvol比值异常的患者的主要转归率更高（64.3 % vs 50.0 %,p = 0.02）。在对年龄和CMR指数进行多变量分析后，异常的RV/LVvol比值与主要结局的高风险相关(HR 1.81[95 % CI 1.06-2.97]； = 0.003页)。RV/LVvol比值增加了随年龄增加的预后价值和传统RV指数（整体χ2值从6.7增加到17.4,p = 0.006）。结论：RV/LVvol比值是与PH患者不良结局风险增加相关的简单临床工具，提供了传统RV参数之外的预后信息。

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引用次数: 0

Cultural influences on dietary choices 文化对饮食选择的影响。

IF 5.6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Progress in cardiovascular diseases

Pub Date : 2025-05-01 DOI: 10.1016/j.pcad.2025.02.003

Sisitha Jayasinghe , Nuala M. Byrne , Andrew P. Hills

Food choices and dietary behaviors are inherently complex and influenced by numerous interconnected factors including individual preferences such as taste, meal timing, and social interactions, alongside external elements like affordability, cultural norms, marketing, and policy environments. The physical contexts of food consumption - homes, schools, workplaces, and neighborhoods- further shape these behaviors, as do societal expectations and generational food literacy. Underpinning these dynamics are food systems, which are influenced by health, ethical, and sustainability considerations throughout the food production and consumption continuum. Cultural influences, encompassing traditions, rituals, and shared beliefs, play a pivotal role in shaping dietary practices. Distinctions between “cultural food” and “food culture” illustrate the deep integration of cuisine within identity and daily life. Historical events, globalization, and modernization have reshaped food traditions, leading to the adoption of new eating patterns and the erosion of others. Religion, socioeconomic status, and social networks also critically impact dietary behaviors, while contemporary challenges such as the nutrition transition and fast-food culture contribute to rising chronic disease burdens. Addressing these issues requires culturally tailored interventions and a focus on food environments, integrating modern tools like social media to promote healthier, community-oriented behaviors while recognizing the social and emotional roles of food.

食物选择和饮食行为本质上是复杂的，并受到许多相互关联的因素的影响，包括个人偏好，如口味、用餐时间和社会互动，以及外部因素，如负担能力、文化规范、市场营销和政策环境。食物消费的实际环境——家庭、学校、工作场所和社区——进一步塑造了这些行为，社会期望和代际食物素养也是如此。支撑这些动态的是粮食系统，它受到整个粮食生产和消费连续体中健康、伦理和可持续性因素的影响。包括传统、仪式和共同信仰在内的文化影响在塑造饮食习惯方面发挥着关键作用。“文化饮食”和“饮食文化”的区别说明了烹饪在身份和日常生活中的深度融合。历史事件、全球化和现代化重塑了饮食传统，导致了新的饮食模式的采用和对其他饮食模式的侵蚀。宗教、社会经济地位和社会网络也对饮食行为产生重大影响，而营养转型和快餐文化等当代挑战导致慢性病负担增加。解决这些问题需要针对不同文化的干预措施和对食物环境的关注，整合社交媒体等现代工具，以促进更健康、面向社区的行为，同时认识到食物的社会和情感作用。

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引用次数: 0

CTA in roadmapping post-CABG evaluation CTA在道路测绘cabg后评价中的应用。

IF 5.6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Progress in cardiovascular diseases

Pub Date : 2025-05-01 DOI: 10.1016/j.pcad.2025.04.009

Ilana S. Golub , Angela Misic , Srikanth Krishnan , Logan Hubbard , Dhananjay Chatterjee , Rosa Lopez , Travis Benzing , Sina Kianoush , Keishi Ichikawa , Jairo Aldana-Bitar , Matthew J. Budoff

Although coronary artery bypass grafting (CABG) outcomes are typically highly successful, outpatient evaluation of bypass grafts is an important step. Moreover, the return of myocardial ischemia and acute coronary syndrome (ACS) events after bypass is not uncommon. Whether due to failure of prior bypass grafts or progression of underlying arteriosclerosis in native coronaries, regularly evaluating if a patient requires intervention (and assessing graft patency vs. closure) is essential. Imaging via cardiac computed tomography angiography (CTA) offers a gold standard anatomical map to facilitate efficiency and accuracy in later invasive coronary angiography (ICA) or surgical re-CABG intervention.

This review discusses the utility of CTA as a safe pre and post CABG evaluation tool, in guiding outpatient evaluation of graft patency and roadmapping subsequent reintervention if needed. We seek to ameliorate clinical uncertainties and synthesize growing amounts of research, to help encourage a homogenous approach to post-CABG evaluation. This comprehensive review paper introduces the indications for bypass grafting surgery and transcatheter PCI approaches, details techniques and strategies for bypass surgery, discusses CTA in evaluating post-CABG graft patency, and consolidates research surrounding pre-reintervention CTA in post-CABG patients. Last, this review explores future directions in standardizing post-CABG evaluation guidelines.

尽管冠状动脉旁路移植术（CABG）的结果通常是非常成功的，但旁路移植术的门诊评估是重要的一步。此外，旁路手术后心肌缺血和急性冠脉综合征（ACS）事件的复发并不罕见。无论是由于先前旁路移植失败还是原生冠状动脉粥样硬化进展，定期评估患者是否需要干预（并评估移植物通畅与关闭）是必要的。通过心脏计算机断层血管造影（CTA）成像提供了金标准解剖图，以提高后期有创冠状动脉血管造影（ICA）或手术再冠状动脉搭桥介入的效率和准确性。这篇综述讨论了CTA作为CABG前后安全的评估工具，在指导门诊评估移植物通畅以及在必要时绘制后续再干预路线图方面的作用。我们寻求改善临床不确定性并综合越来越多的研究，以帮助鼓励采用统一的方法进行cabg后评估。本文介绍了旁路移植术的适应症和经导管PCI入路，详细介绍了旁路手术的技术和策略，讨论了CTA在评估cabg后移植物通畅方面的作用，并整合了cabg后患者再介入前CTA的研究。最后，本文对cabg术后评价指南规范化的发展方向进行了探讨。

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引用次数: 0

An ecological framework for population health and well-being 人口健康和福祉的生态框架。

IF 5.6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Progress in cardiovascular diseases

Pub Date : 2025-05-01 DOI: 10.1016/j.pcad.2025.03.013

Nicolaas P. Pronk , Colin Woodard , Frederick J. Zimmerman , Ross Arena

Social structures have become focal points in considering how to address the circumstances and conditions under which people live their lives. Yet, the many interactions among multiple factors that make up social and structural determinants are complex, interdependent, interactive, dynamic, and multilevel. This paper introduces an evidence-informed ecological framework that organizes drivers and feedback mechanisms collectively representing a generative force towards population health and well-being. The proposed ecological framework supports explanatory and exploratory considerations for prevention and management of population health and well-being issues. The framework explicitly includes a recognition that successful health and well-being outcomes are often dependent on the presence of social capital and healthy power dynamics.

Dominant cultural norm is positioned as an overarching driver in this framework because it shapes the political realities and power dynamics responsible for infrastructure as well as the habits and behaviors of people at both the individual and social levels.

社会结构已成为考虑如何处理人们生活的环境和条件的焦点。然而，构成社会和结构决定因素的多种因素之间的许多相互作用是复杂的、相互依存的、相互作用的、动态的和多层次的。本文介绍了一个以证据为依据的生态框架，该框架组织了驱动因素和反馈机制，共同代表了人口健康和福祉的生成力量。拟议的生态框架支持对预防和管理人口健康和福祉问题的解释性和探索性考虑。该框架明确承认，成功的健康和福祉成果往往取决于社会资本的存在和健康的权力动态。在这个框架中，主导文化规范被定位为首要驱动力，因为它塑造了负责基础设施的政治现实和权力动态，以及个人和社会层面上人们的习惯和行为。

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引用次数: 0

Cardiovascular magnetic resonance in pulmonary hypertension: Keeping it simple 肺动脉高压的心血管磁共振：保持简单。

IF 5.6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Progress in cardiovascular diseases

Pub Date : 2025-05-01 DOI: 10.1016/j.pcad.2025.04.010

Daniel Lorenzatti , Manish Motwani

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Cover 2 (Masthead) 封二（报头）

IF 5.6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Progress in cardiovascular diseases

Pub Date : 2025-05-01 DOI: 10.1016/S0033-0620(25)00091-X

引用次数: 0

The culture of healthy living – The international perspective 健康生活文化-国际视野。

IF 5.6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Progress in cardiovascular diseases

Pub Date : 2025-05-01 DOI: 10.1016/j.pcad.2025.02.001

Sisitha Jayasinghe, Nuala M. Byrne, Andrew P. Hills

A culture of health or healthy living can be envisioned as a society where well-being, including essential aspects like sleep, stress management, social connections, and leisure - is not merely an aspiration but a tangible reality for diverse communities, free from systemic inequities. However, the concept of a healthy lifestyle, and by extension a culture of healthy living, varies widely across the globe, shaped by cultural norms, government policies, and social structures. Defining a universally acceptable “culture of healthy living” for every population or subgroup is inherently complex, making it more practical to focus on addressing the barriers and leveraging the enablers associated with leading a healthy life. At its core, discussing the foundational elements of a healthy life - such as diet and nutrition, physical activity, mental health, and access to healthcare - is crucial. To ensure the sustainability of healthy living practices, a multifaceted approach is needed, emphasizing these pillars alongside equity. Existing global initiatives offer promising frameworks to tackle these challenges, highlighting the importance of collaboration, innovation, and systemic change. By fostering mutual support and collective action, we can advance toward a global culture of healthy living that benefits all individuals and communities, leaving no one behind.

健康或健康生活文化可以设想为这样一个社会：福祉，包括睡眠、压力管理、社会联系和休闲等基本方面，不仅是一种愿望，而且是不同社区的有形现实，没有系统性的不平等。然而，健康生活方式的概念以及健康生活文化在全球范围内存在很大差异，受到文化规范、政府政策和社会结构的影响。为每个人口或子群体定义一种普遍可接受的“健康生活文化”本身就很复杂，因此更实际的做法是侧重于解决障碍，并利用与过上健康生活有关的促进因素。其核心是，讨论健康生活的基本要素——如饮食和营养、身体活动、心理健康和获得医疗保健——是至关重要的。为确保健康生活方式的可持续性，需要采取多方面的办法，在强调公平的同时强调这些支柱。现有的全球倡议为应对这些挑战提供了有希望的框架，突出了协作、创新和系统性变革的重要性。通过促进相互支持和集体行动，我们可以朝着健康生活的全球文化迈进，使所有个人和社区受益，不让任何人掉队。

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