Frontiers in Cardiovascular Medicine心血管医学前沿
Frontiers in Cardiovascular Medicine(英文缩写 FRONT CARDIOVASC MED),ISSN 2297-055X,eISSN 2297-055X,中文译名:心血管医学前沿 是一本学术期刊。本页汇总该期刊的最新影响因子、分区信息以及最新收录于 PubMed 的文献,帮助您快速了解期刊全貌。
发文量统计区间：2025-09-27 至 2026-09-27，按本站收录文献的发表日期统计。
期刊介绍
历年影响因子趋势
| JCR 数据年份 | 影响因子 | JCR 分区 |
|---|---|---|
| 2021 | 5.848 | Q2 |
| 2022 | 3.600 | Q2 |
| 2023 | 2.800 | Q2 |
| 2024 | 2.900 | Q2 |
| 2025 | 3.000 | Q2 |
Frontiers in Cardiovascular Medicine 最新收录文献
-
1. Fulminant immune checkpoint inhibitor-associated myositis presenting with concurrent myocardial injury and secondary cardiogenic shock in a patient with thymoma: a case report and literature review.
PMID:日期:2026-01-01Immune checkpoint inhibitor (ICI)-associated toxicities are uncommon but may rapidly progress to cardiogenic shock and death. Patients with thymoma are considered particularly vulnerable to severe immune-related adverse events because thymic malignancy is closely associated with impaired central immune tolerance and autoimmune dysregulation. We report a 34-year-old man with stage IV type B2 thymoma who developed initial myalgia and fatigue approximately 15 days after the most recent pembrolizumab-containing treatment cycle and progressed to fulminant ICI-associated myositis with respiratory failure and secondary cardiogenic shock by day 19. He presented with severe immune-mediated myositis, concurrent myocardial injury, left ventricular systolic dysfunction, cardiogenic shock, metabolic acidosis, acute kidney injury, acute liver injury, coagulopathy, and respiratory failure. Coronary angiography excluded obstructive coronary disease, and microbiological and virological investigations did not identify an infectious cause. Endomyocardial biopsy and cardiac magnetic resonance imaging were not feasible because of profound hemodynamic instability, VA-ECMO support, and coagulopathy. The patient was treated with early venoarterial extracorporeal membrane oxygenation (VA-ECMO), high-dose methylprednisolone, intravenous immunoglobulin, continuous renal replacement therapy, mechanical ventilation, and comprehensive organ support. Cardiac function improved from a left ventricular ejection fraction of 25% to 51%, VA-ECMO was discontinued on hospital day 7, and the patient survived to discharge. This case and a focused literature review suggest that thymoma-associated ICI myositis with secondary cardiac dysfunction may represent a high-risk phenotype characterized by early onset, overlap neuromuscular toxicity, severe hemodynamic compromise, and potential reversibility when early immunosuppression and advanced circulatory support are implemented.
-
2. Investigation into the efficacy of fully automated three-dimensional echocardiographic quantification software (3D Auto RV) for assessing right ventricular systolic function in patients suffering from chronic mountain sickness.
PMID:日期:2026-01-01To evaluate the efficacy of fully automated three-dimensional echocardiographic right ventricular quantification software (3D Auto RV) for assessing right ventricular (RV) systolic function in patients with chronic mountain sickness (CMS). In this prospective study (December 2023-March 2025), 32 CMS patients and 32 propensity score-matched controls (by age and sex) underwent 3D echocardiography. Conventional echocardiography measured main pulmonary artery diameter (MPA) and estimated pulmonary artery systolic pressure (PASP). The 3D Auto RV software was employed to obtain tricuspid annular plane systolic excursion (TAPSE), RV ejection fraction (RVEF), RV fractional area change (RVFAC), septal longitudinal strain (SLS), free-wall longitudinal strain (FWLS), and tissue Doppler S'. Intraclass correlation coefficients (ICC) were calculated for intra- and inter-observer agreement. The CMS group exhibited significantly lower RVEF, TAPSE, RVFAC, SLS, FWLS, and S', alongside higher PASP and MPA, compared with controls (all < 0.001). Spearman correlation showed RVEF was positively correlated with SLS (r = 0.890, < 0.01) and FWLS (r = 0.840, < 0.01), and negatively correlated with PASP (r = -0.707, < 0.01). ROC analysis revealed excellent diagnostic efficacy: RVEF (AUC 0.982, cut-off 46.7%), RVFAC (AUC 0.970, cut-off 36.75%), TAPSE (AUC 0.965, cut-off 16.2 mm), SLS (AUC 0.975, cut-off 21.8%), and FWLS (AUC 0.968, cut-off 19.85%). All parameters demonstrated good to excellent repeatability, with intra- and inter-observer ICCs exceeding 0.85. 3D Auto RV provides an accurate, reproducible, and feasible method for assessing RV systolic function in CMS patients, establishing a foundation for its routine clinical use.
-
3. Incremental prognostic value of pan-immune-inflammation value in conservatively treated acute myocardial infarction: derivation and MIMIC-IV validation.
PMID:日期:2026-01-01Immune-inflammatory activation contributes to adverse outcomes after acute myocardial infarction (AMI). the study evaluated whether the pan-immune-inflammation value (PIV) was associated with 6-month all-cause mortality and provided prognostic information beyond conventional clinical predictors. This retrospective two-cohort study included 2,008 conservatively treated patients with AMI in the derivation cohort and 2,679 patients with AMI from the Medical Information Mart for Intensive Care IV (MIMIC-IV) in an independent evaluation cohort. PIV was prespecified as the primary index, with the systemic inflammation response index (SIRI) and systemic immune-inflammation index (SII) assessed as complementary indices. Associations were examined using multivariable logistic regression. Incremental performance was assessed against a prespecified clinical model, with 1,000-resample bootstrap internal validation and Firth penalized logistic regression. Owing to differences in variable availability, MIMIC-IV analyses used a cohort-specific adjustment model. Within 6 months, 57 patients died in the derivation cohort and 773 died in MIMIC-IV. In the derivation cohort, each 1-standard-deviation increase in log-transformed PIV was independently associated with mortality (odds ratio [OR], 1.56; 95% confidence interval [CI], 1.19-2.04; = 0.001), with a similar Firth estimate (OR, 1.55; 95% CI, 1.19-2.01; = 0.001). Adding PIV increased the area under the receiver operating characteristic curve from 0.844 to 0.854 (Δ = 0.010; = 0.169); the corresponding optimism-corrected values were 0.813 and 0.823 (corrected Δ = 0.0106). SIRI and SII yielded supportive findings. In MIMIC-IV, PIV remained associated with 6-month mortality (OR, 1.20; 95% CI, 1.10-1.32; < 0.001), while the area under the curve increased only from 0.770 to 0.775 after adding PIV. Higher PIV was independently associated with mortality after AMI across both cohorts, but its incremental discrimination beyond conventional clinical factors was modest and statistically nonsignificant. The MIMIC-IV findings support the reproducibility of the association rather than direct validation of an unchanged prediction model. PIV may therefore be considered a complementary marker rather than a stand-alone risk-stratification tool. Prospective multicenter studies are required before clinical implementation.
-
4. Multiparametric CMR evaluation of myocardial remodeling in dystrophinopathy.
PMID:日期:2026-01-01Cardiac involvement in dystrophinopathy progresses from diffuse myocardial remodeling to overt systolic failure. Multiparametric cardiac magnetic resonance (CMR) offers simultaneous insights into myocardial mechanics and tissue characterization, yet the optimal diagnostic parameters for tracking disease severity remain to be fully characterized. To objectively evaluate the descriptive and discriminative performance of integrating strain and quantitative T1 mapping parameters for identifying myocardial fibrosis burden and stratifying systolic dysfunction in patients with dystrophinopathy. This retrospective study analyzed 55 patients with genetically confirmed dystrophinopathy and 30 healthy controls who underwent CMR between January 2020 and December 2024. Patients were sequentially stratified by late gadolinium enhancement (LGE) status (Group A: LGE-negative, = 16; Group B: LGE-positive, = 39), and further sub-stratified by left ventricular ejection fraction (LVEF) (Group C: LVEF ≥ 50%, = 23; Group D: LVEF < 50%, = 16). Least absolute shrinkage and selection operator (LASSO) regression with 10-fold cross-validation was applied for non-zero feature selection, followed by the construction of multivariable Firth penalized logistic regression models. Model comparisons were made using the non-parametric DeLong test. Compared with Group A, Group B exhibited significant differences in LVEF ( < .001), mid-ventricular circumferential strain (CS_Mid, < .001), and native T1 in segment 11 (T1map_seg11, mid-inferolateral, = .004). In single-parameter ROC analysis, CS_Mid, LVEF, and T1map_seg11 exhibited an area under the curve (AUC) of 0.842 [95% confidence interval (CI): 0.735-0.949], 0.828 (95% CI: 0.714-0.942), and 0.715 (95% CI: 0.549-0.880), respectively. The combined model of CS_Mid and T1map_seg11 achieved the AUC of 0.888 (95% CI: 0.793-0.983). Compared Group C with Group D, CS_Global and T1map_seg5 models yielded AUCs of 0.921 (95% CI: 0.822-1.000) and 0.823 (95% CI: 0.694-0.953). The combined model (CS_Global + T1map_seg5) achieved the AUC of 0.951 (95% CI, 0.864-1.000, DeLong = .567 vs T1map_seg5, DeLong = .101 vs. T1map_seg5). In dystrophinopathy, multiparametric CMR enables structural and functional assessment of myocardial remodeling. Segmental native T1, particularly in the basal and mid-inferolateral segments, provides complementary information on regional myocardial tissue abnormalities. In contrast, CS accounts for most of the discrimination of disease severity. These findings suggest that the distinctive contribution of CMR may lie in regional myocardial tissue characterization rather than conventional functional assessment.
-
5. Label-efficient cross-population transfer learning for electrocardiographic risk stratification: evaluation across German, Chinese and US cohorts.
PMID:日期:2026-01-01Electrocardiography (ECG) is the most widely deployed cardiac screening modality, but demographic, acquisition and label-space heterogeneity across cohorts obstructs clinical translation. Cross-population studies rarely quantify which conditions transfer, how much target labelling is needed, or whether the adapted score stays calibrated and clinically useful. We harmonised 12,521 recordings from PTB-XL (Germany; 7,371 records, 6,643 patients), Chapman-Ningbo (China; 4,574) and the MIT-BIH Arrhythmia Database (USA; 576 segments, 48 recordings) into 13 SNOMED-CT super-classes. A 38-dimensional interpretable feature set, computed in physical units and standardised on the source training partition alone, fed a compact multi-task backbone (30,400 parameters) trained on patient-separated partitions. It was evaluated zero-shot on both targets and adapted with 5%-50% of Chapman-Ningbo labels by linear probing on the frozen embedding, with partial and full fine-tuning as comparators; prevalence-aware sampling made four target classes (NORM, STD, LVH, TINV) evaluable. The composite diagnostic score was recalibrated on a dedicated split and assessed on untouched test data using bootstrap intervals, Holm-corrected comparisons and subgroup interaction tests. The source backbone reached macro-AUROC 0.866 (0.837-0.891) across 13 classes. Zero-shot transfer recovered 88% of the four-class source reference on Chapman-Ningbo (0.754, 0.727-0.779) and 0.642 (0.546-0.735, record-clustered) on MIT-BIH. Linear probing reached 0.795 with 5% of target labels and 0.829 with 50%, below the four-class source reference of 0.859; after Holm correction the gain over zero-shot was significant for NORM (+0.135), STD (+0.093) and TINV (+0.065) but not LVH (+0.004). Full fine-tuning added 0.021 at 50% labels but was inferior at 5% and less well calibrated. The recalibrated composite score attained AUROC 0.791 (0.743-0.836), Brier score 0.055 and expected calibration error 0.018 on Chapman-Ningbo, where 97% of positives were left-ventricular hypertrophy, and 0.834 on the seven-condition PTB-XL composite. Discrimination varied across age strata (0.708-0.863; interaction = 0.012). Cross-population transfer of ECG models is feasible with label-efficient fine-tuning of a compact, interpretable feature backbone, and the resulting composite diagnostic score remains well-calibrated in a geographically distinct population. Subgroup heterogeneity nonetheless persists, with lower discrimination in participants aged 65 years and over and a sex-dependent calibration slope, and requires further validation.
-
6. Clinical characteristics of gut microbiota translocation after acute myocardial infarction and its impact on prognosis.
PMID:日期:2026-01-01To systematically analyze the clinical characteristics of gut microbiota translocation in patients after acute myocardial infarction (AMI), explore the relationships among intestinal barrier dysfunction, gut microbiota changes, inflammatory response, and cardiac function impairment, and further evaluate its association with short-term prognosis, so as to provide new clinical evidence for risk stratification and comprehensive intervention in AMI patients. This study adopted a single-center retrospective cohort design. A total of 148 patients with AMI who were hospitalized in the Department of Cardiology of our hospital and received standardized treatment from April 2023 to June 2025 were selected as the study subjects (AMI group), and 110 healthy volunteers who underwent physical examination during the same period were included as the control group. Venous blood and fecal samples had been collected within 24 h after admission or on the day of physical examination as part of the routine clinical laboratory or health examination workflow, and the corresponding laboratory results were retrospectively extracted for this study. Serum D-lactic acid (D-LA), diamine oxidase (DAO), and lipopolysaccharide (LPS) levels were detected by enzyme-linked immunosorbent assay to evaluate intestinal barrier function and microbiota translocation; the quantities of five representative gut microbiota, including Bifidobacterium, Lactobacillus, Bacteroides, Enterobacter, and Enterococcus, were detected by gut microbiota culture. According to serum LPS levels and intestinal barrier indicators, the presence of gut microbiota translocation was comprehensively determined, and patients were divided into a translocation group ( = 52) and a non-translocation group ( = 96). General clinical data and relevant laboratory indicators were collected, including C-reactive protein (CRP), white blood cell count (WBC), N-terminal pro-brain natriuretic peptide (NT-proBNP), and left ventricular ejection fraction (LVEF). All patients were followed for 90 days after discharge, and newly occurring major adverse cardiovascular events (MACE) during the follow-up period, including heart failure, malignant arrhythmia, recurrent myocardial infarction, and cardiac death, were recorded. Pearson correlation analysis was used to explore the relationships between gut-related indicators and inflammatory indicators as well as cardiac function indicators, and multivariable logistic regression analysis was used to explore factors associated with short-term poor prognosis in patients with AMI. Compared with the control group, serum D-LA, DAO, and LPS levels were significantly increased in the AMI group ( < 0.05). Meanwhile, the gut microbiota structure of AMI patients was markedly disturbed, manifested by a significant decrease in putatively beneficial or commensal bacteria, including Bifidobacterium, Lactobacillus, and Bacteroides, and a significant increase in opportunistic/pathobiont bacteria such as Enterobacter and Enterococcus (P<0.05). Further subgroup analysis showed that, compared with the non-translocation group, the translocation group had more obvious gut microbiota disturbance, characterized by decreased levels of Bifidobacterium, Lactobacillus, and Bacteroides and increased levels of Enterobacter and Enterococcus ( < 0.05). Because D-LA, DAO, and LPS were used to define translocation status, their subgroup differences were not interpreted as independent findings. In addition, CRP, WBC, and NT-proBNP levels were significantly higher in the translocation group than in the non-translocation group, whereas LVEF was significantly lower in the translocation group ( < 0.05). Follow-up results showed that the incidence of MACE within 90 d was significantly higher in the translocation group than in the non-translocation group, with the most significant increases observed in acute heart failure and malignant arrhythmia ( < 0.05). Correlation analysis showed that D-LA, DAO, LPS, Enterobacter, and Enterococcus were significantly positively correlated with CRP, WBC, and NT-proBNP levels and significantly negatively correlated with LVEF ( < 0.05); Bifidobacterium, Lactobacillus, and Bacteroides were negatively correlated with CRP, WBC, and NT-proBNP and positively correlated with LVEF (P < 0.05). These correlation results remained statistically significant after Benjamini-Hochberg FDR correction. Exploratory multivariable logistic regression analysis suggested that elevated levels of LPS, DAO, and NT-proBNP, decreased LVEF, and increased abundances of Enterobacter and Enterococcus were associated with poor short-term prognosis in patients with AMI ( < 0.05). However, because only 32 patients experienced at least one MACE, these regression results should be interpreted cautiously because of the limited events-per-variable ratio. AMI patients exhibit marked intestinal barrier dysfunction and gut microbiota translocation during the acute phase, characterized by elevated levels of D-LA, DAO, and LPS, with concomitant decreases in putatively beneficial or commensal bacteria, including Bifidobacterium, Lactobacillus, and Bacteroides, and increases in opportunistic/pathobiont bacteria such as Enterobacter and Enterococcus. The degree of gut microbiota translocation is closely associated with enhanced inflammatory response, worsening cardiac function, and the occurrence of short-term adverse cardiovascular events, suggesting that the " gut-heart axis " may play an important role in disease progression and prognostic evolution after AMI. Intestinal barrier function and microbiota translocation-related indicators may serve as potential auxiliary biomarkers for prognostic risk assessment in AMI patients and provide new research directions for future gut microbiota intervention strategies.
-
7. Bioprosthetic heart valve degeneration: new insights into structural remodeling and calcification.
PMID:日期:2026-01-01Bioprosthetic heart valves (BHVs) are widely used to treat aortic valve disease, and their demand is rising. However, BHV lifespan remains limited by degeneration, with patients often requiring surgical or transcatheter reintervention within a decade. BHVs lack intrinsic remodeling capabilities, and the mechanisms contributing to their failure remain poorly understood. In this review, we summarize current knowledge of BHV degeneration by integrating findings from native aortic valve disease with studies of explanted bioprosthetic valves. We discuss the structural hallmarks of degeneration, including collagen remodeling, calcification, and inflammatory cell accumulation, and examine evidence that circulating blood-derived factors infiltrate BHV tissue and contribute to degeneration progression. Particular emphasis is placed on macrophages, which are consistently identified in explanted BHVs and may promote extracellular matrix (ECM) degradation. We also highlight extracellular vesicles (EVs) as potential mediators of cardiovascular calcification and propose that macrophage-derived EVs may promote ECM remodeling beyond sites of direct cellular accumulation. In addition, we review experimental approaches, including histological imaging, cell culture models, and proteomic analyses, that may help define molecular pathways underlying degeneration. Together, we hypothesize a model of BHV degeneration driven by interactions among host immune cells, circulating factors, and bioprosthetic tissue. Improved understanding of these mechanisms may facilitate the development of therapeutic strategies to improve BHV durability and long-term clinical outcomes.
-
8. Silent controllers: non-coding RNAs drive autophagic response in myocardial ischemia reperfusion injury.
PMID:日期:2026-01-01Acute myocardial infarction (AMI) continues to be a major contributor to global illness and death. Restoring coronary blood flow is a key strategy for limiting myocardial damage after infarction. Nevertheless, the re-establishment of circulation can paradoxically trigger ischemia-reperfusion (IR) injury through multiple intricate mechanisms. Consequently, IR injury remains an important obstacle in the effective management of myocardial infarction. Aberrant autophagy represents a major factor causing IR-related cardiomyocyte death. Autophagy, a catabolic process essential for cellular homeostasis, plays a bimodal role in myocardial IR -protective during ischemia yet potentially deleterious during reperfusion. Recent research highlights the pivotal regulatory function of non-coding RNAs (ncRNAs) which include microRNAs (miRNAs), long non-coding RNAs (lncRNAs), and circular RNAs (circRNAs) in modulating autophagy during myocardial IR injury, particularly in murine models. ncRNAs influence key autophagy regulators such as Beclin-1, ULK1, ATG5, ATG7, ATG12, LC3 and mTOR, forming complex regulatory networks that determine cardiomyocyte fate. This review synthesizes current evidence on how ncRNAs orchestrate autophagy in the setting of myocardial IR injury, elucidating underlying mechanisms and translational potentials. Understanding ncRNA-mediated modulation of autophagy opens avenues for targeted interventions to ameliorate IR injury related cardiac damage.
-
9. Impact of anatomic complexity of congenital heart disease on growth retardation: a large retrospective cohort study.
PMID:日期:2026-01-01Growth retardation (GR) is a significant comorbidity in children with congenital heart disease (CHD), particularly those with complex CHD. This study aimed to characterize the growth patterns of pediatric CHD patients and to identify the factors associated with GR. This retrospective cohort study included CHD patients aged ≤18 years from the First Hospital of Hebei Medical University between January 2014 and March 2024. Patients were classified into complex or non-complex CHD groups based on echocardiographic diagnoses. Clinical, laboratory, and echocardiographic parameters were compared. Independent factors associated with GR were identified and used to construct a nomogram for identifying the likelihood of existing GR. A total of 2,784 patients were included (260 with complex CHD and 2,524 with non-complex CHD). Patients with complex CHD had higher prevalence of growth impairment than those with non-complex CHD. GR (35.4% vs. 16.0%), short stature (30.0% vs. 15.1%), and underweight (27.3% vs. 13.4%) were more common in complex CHD than in non-complex CHD patients. Complex CHD, younger age, presence of pulmonary arterial hypertension, and hypoalbuminemia were identified as independent factors associated with GR. A nomogram incorporating these factors demonstrated performance in screening for prevalent GR, with an area under the receiver operating characteristic curve of 0.75 in the temporal validation cohort. The prevalence of GR is high in children with CHD, especially among those with complex CHD. Our findings highlight the necessity of integrating routine growth surveillance into the standard of care for this population. The nomogram facilitates the identification of children with a high probability of GR, enabling timely intervention.
-
10. Sex differences in leptin levels but not in the leptin response to sacubitril/valsartan in patients with heart failure with reduced ejection fraction.
PMID:日期:2026-01-01Leptin is an adipokine involved in metabolic regulation and neurohormonal activation and has been implicated in the pathophysiology of heart failure. Sacubitril/valsartan (angiotensin receptor-neprilysin inhibitor, ARNI) improves outcomes in patients with heart failure with reduced ejection fraction (HFrEF) and may also influence metabolic pathways. However, it remains unclear whether ARNI therapy affects circulating leptin levels differently in men and women. In this observational study, patients with HFrEF from two clinical centres were evaluated before and after initiation of sacubitril/valsartan therapy. Serum leptin levels, N-terminal pro-B-type Natriuretic Peptide (NT-proBNP), echocardiographic parameters and New York Heart Association (NYHA) class were assessed at baseline and follow-up. Sex-specific differences in leptin levels and leptin dynamics were analysed. A total of 74 patients (20 women and 54 men) were included. Women exhibited significantly higher leptin levels compared with men at baseline (39.78 ± 31.95 vs. 10.39 ± 17.04 ng/mL, < 0.001) despite similar body mass index (BMI) values (ns). Following initiation of ARNI therapy, leptin levels increased significantly in both women (39.78 ± 31.95 to 50.10 ± 41.28, = 0.041) and men (10.39 ± 17.04 to 12.49 ± 16.62, = 0.006). However, the magnitude of absolute and relative leptin change did not differ significantly between sexes. Improvements in left ventricular ejection fraction (LVEF) were observed in both groups, while changes in NT-proBNP and NYHA class showed different within-group patterns but did not differ significantly between sexes. Women with HFrEF showed markedly higher circulating leptin levels than men at both baseline and follow-up. Leptin levels increased significantly in both sexes. However, there were no significant differences in absolute or relative leptin changes between women and men. Sex influences baseline leptin concentrations, but not the response to ARNI therapy. Further prospective studies are needed to clarify the mechanisms and clinical significance of leptin changes during sacubitril/valsartan treatment.