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Journal of Cardiovascular Development and Disease, Volume 12, Issue 8

2025 August - 42 articles

Cover Story: Epicardial radiofrequency ablation is often required when ventricular tachyarrhythmias originate from epicardial or subepicardial substrates that cannot be effectively ablated endocardially. Irrigated-tip catheters are commonly used for such procedures. Unlike endocardial ablation, where the irrigation fluid is mixed with and drained by the bloodstream, the irrigation fluid used in epicardial procedures accumulates within the pericardial space, which causes the sac to expand, requiring manual drainage multiple times throughout the procedure. Our computer simulations show that the accumulation of intrapericardial fluid plays a critical role: While it may offer some thermal protection to adjacent structures, it substantially reduces energy transmission to the myocardium, compromising lesion formation. View this paper
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Articles (42)

  • Review
  • Open Access
2,230 Views
17 Pages

Multimodality Imaging in Eosinophilic Myocarditis: A Rare Cause of Heart Failure

  • Vincenzo Viccaro,
  • Amabile Valotta,
  • Elena Checcoli,
  • Susanna Landi,
  • Fabio Cattaneo,
  • Andrea Milzi,
  • Mattia Duchini,
  • Giacomo Maria Viani,
  • Alessandro Caretta and
  • Anna Giulia Pavon
  • + 6 authors

Eosinophilic myocarditis (EM) is a rare and potentially fatal form of acute myocarditis. Currently, no validated diagnostic criteria exist, and definitive diagnosis relies on endomyocardial biopsy (EMB) not devoid of periprocedural complications. Thi...

  • Review
  • Open Access
2 Citations
3,023 Views
33 Pages

When Functional Assessment Meets Intravascular Imaging in Patients with Coronary Artery Disease

  • Grigorios Tsigkas,
  • Kassiani-Maria Nastouli,
  • Anastasios Apostolos,
  • Panagiota Spyropoulou,
  • Maria Bozika,
  • Michail I. Papafaklis,
  • Stella Rouzi,
  • Effrosyni Tsimara,
  • Antonios Karanasos and
  • Periklis Davlouros
  • + 1 author

Percutaneous Coronary Intervention (PCI) has advanced significantly with the incorporation of imaging and physiology assessment techniques. Fractional Flow Reserve (FFR) and Non-Hyperemic Pressure indices (NHPIs) provide information regarding the fun...

  • Article
  • Open Access
1,098 Views
15 Pages

Dysfunctional Electron Transport Chain Assembly in COXPD8

  • Gisela Beutner,
  • Heidie L. Huyck,
  • Gail Deutsch,
  • Gloria S. Pryhuber and
  • George A. Porter Jr.

Combined oxidative phosphorylation deficiency type 8 (COXPD8) is an autosomal recessive mitochondrial disorder caused by a mutation of the nuclear encoded mitochondrial alanyl-tRNA synthetase gene (AARS2). Clinical manifestations of COXPD8 include le...

  • Review
  • Open Access
2 Citations
3,633 Views
12 Pages

Blood Pressure Variability in Hypertension: A Rehabilitation Perspective

  • Manikandan Raju,
  • Marco Alfonso Perrone,
  • Anas R. Alashram and
  • Ferdinando Iellamo

The role of blood pressure variability (BPV) as an important marker of cardiovascular (CV) health, specifically its relationship with arterial stiffness and left ventricular remodeling in patients with hypertension, was investigated. This review aime...

  • Article
  • Open Access
1,044 Views
19 Pages

Echocardiographic Assessment of Pulmonary Hemodynamics and Right Ventricular Performance in Neonatal Murine Hypoxia

  • Kel Vin Woo,
  • Philip T. Levy,
  • Carla J. Weinheimer,
  • Amanda L. Hauck,
  • Aaron Hamvas,
  • David M. Ornitz,
  • Attila Kovacs and
  • Gautam K. Singh

Background: Right heart catheterization (RHC) is the gold-standard for diagnosis of pulmonary hypertension (PH) but is a terminal procedure in neonatal mice. The objective was to validate echocardiographic measures of PH to establish the diagnostic c...

  • Article
  • Open Access
1 Citations
971 Views
14 Pages

Markers in Acute Coronary Syndrome: Distal Coronary Embolism at Percutaneous Coronary Intervention

  • Niya Emilova Semerdzhieva,
  • Simeon Dimitrov,
  • Adelina Tsakova,
  • Mariana Gospodinova,
  • Petar Atanasov and
  • Vesela Lozanova

(1) Introduction: Distal coronary emboli occur in up to 15–30.5% of patients undergoing percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) and are associated with poor myocardial reperfusion in the territory of the i...

  • Review
  • Open Access
3 Citations
2,379 Views
28 Pages

Artificial Intelligence-Guided Neuromodulation in Heart Failure with Preserved and Reduced Ejection Fraction: Mechanisms, Evidence, and Future Directions

  • Rabiah Aslam Ansari,
  • Sidhartha Gautam Senapati,
  • Vibhor Ahluwalia,
  • Gianeshwaree Alias Rachna Panjwani,
  • Anmolpreet Kaur,
  • Gayathri Yerrapragada,
  • Jayavinamika Jayapradhaban Kala,
  • Poonguzhali Elangovan,
  • Shiva Sankari Karuppiah and
  • Shivaram P. Arunachalam
  • + 2 authors

Heart failure, a significant global health burden, is divided into heart failure with reduced ejection fraction (HFrEF) and preserved ejection fraction (HFpEF), characterized by systolic dysfunction and diastolic stiffness, respectively. While HFrEF...

  • Review
  • Open Access
844 Views
12 Pages

Hybrid Ablation in Atrial Fibrillation: Bridging Mechanistic Understanding and Clinical Practice

  • Flavia Ravelli,
  • Stefano Branzoli,
  • Alessandro Cristoforetti,
  • Silvia Quintarelli,
  • Alessio Coser,
  • Paolo Moggio,
  • Mark La Meir,
  • Carlo de Asmundis,
  • Luigi Pannone and
  • Massimiliano Marini
  • + 2 authors

Atrial fibrillation (AF), the most prevalent sustained cardiac arrhythmia, poses a significant burden on global morbidity and healthcare expenditure. Although endocardial catheter ablation and surgical ablation are established therapeutic strategies,...

  • Article
  • Open Access
1,911 Views
14 Pages

Late Gadolinium Enhancement Variation in Asymptomatic Individuals: Comparison with Dilated Cardiomyopathy

  • Seoyeon Park,
  • Soo Jin Cho,
  • Sung Mok Kim,
  • Moon Young Kim and
  • Yeon Hyeon Choe

Late gadolinium enhancements (LGEs) appear in asymptomatic individuals as septal stripes, which mimic abnormal LGEs in patients with dilated cardiomyopathy (DCM). We aimed to evaluate the frequency and extent of LGE variation in asymptomatic individu...

  • Review
  • Open Access
2 Citations
2,567 Views
14 Pages

Mitral Annular Disjunction: Epidemiology, Diagnostic Methods, Prognosis, and Novel Implications

  • Vasileios Tsimpiris,
  • Georgia Kousourna,
  • Aristi Boulmpou,
  • Magdalini Petridou,
  • Chalil Tsavousoglou,
  • Dimitrios Kotzadamis,
  • Christodoulos Papadopoulos,
  • Dimitrios Ntelios,
  • Theodoros Moysiadis and
  • Efstathios Pagourelias
  • + 1 author

Mitral annular disjunction (MAD) is an increasingly recognized structural abnormality of the mitral valve apparatus, often associated with mitral valve prolapse and a heightened risk of ventricular arrhythmias and sudden cardiac death. It is defined...

  • Review
  • Open Access
1 Citations
2,087 Views
11 Pages

Atrioventricular Node Dysfunction in Heart Failure: New Horizons from Pathophysiology to Therapeutic Perspectives

  • Isabella Fumarulo,
  • Elia Nunzio Maria Salerno,
  • Andrea De Prisco,
  • Salvatore Emanuele Ravenna,
  • Maria Chiara Grimaldi,
  • Francesco Burzotta and
  • Nadia Aspromonte

Heart failure (HF) is characterized by adverse myocardial remodeling involving both the contractile cardiomyocytes and the conduction tissue. HF is often associated with atrioventricular (AV) node dysfunction, which frequently leads to conduction del...

  • Article
  • Open Access
1,485 Views
15 Pages

Comparison of Surgical Treatment Outcomes in Patients with Symptomatic Severe Aortic Valve Stenosis Using the Perceval Sutureless Bioprosthesis Versus a Conventional Biological Valve

  • Dejan M. Lazović,
  • Milica Karadžić,
  • Filip Vučićević,
  • Gorica Marić,
  • Miloš Grujić,
  • Ivana Đurošev,
  • Mladen J. Kočica,
  • Svetozar Putnik and
  • Dragan Cvetković

Objectives: This single-center retrospective comparative cohort study aimed to compare the outcomes of aortic valve replacement using a Perceval sutureless bioprosthesis versus a conventional stented bioprosthesis in patients with symptomatic severe...

  • Article
  • Open Access
837 Views
10 Pages

Perinatal Socioeconomic Disadvantage and Cardiovascular Comorbidities: National and State-Level Results of a Novel Cardio-Obstetrics Program

  • Sakshi Sehgal,
  • Elinita Pollard,
  • Toscha Charles,
  • Marquetta Thomas,
  • Marlo Vernon,
  • Gyanendra Sharma and
  • Chadburn Ray

Perinatal cardiovascular disease accounts for nearly one-third of pregnancy-related deaths, with nearly 70% of these deaths preventable with appropriate cardio-obstetric care. The objective is to assess whether socioeconomic disadvantage, utilizing a...

  • Article
  • Open Access
1,072 Views
13 Pages

Background: After recovery from acute sepsis, patients can exhibit left ventricular systolic dysfunction (LVSD) and non-ischaemic myocardial fibrosis. The relationship between myocardial fibrosis and LVSD remains poorly defined. This study sought to...

  • Article
  • Open Access
923 Views
11 Pages

Coronary Artery Calcification in Patients with Radiographic Axial Spondyloarthritis: A Comparative Study with Matched Controls in Southwestern Sweden

  • Erik Hulander,
  • Anna Deminger,
  • Sofia Enegren,
  • Magnus Hallström,
  • Caroline Feldthusen,
  • Erika Fagman,
  • Oskar Angerås,
  • Tatiana Zverkova Sandström,
  • Mats Geijer and
  • Helena Forsblad-d’Elia

Radiographic axial spondyloarthritis (r-axSpA) is associated with increased cardiovascular disease (CVD) risk. The coronary artery calcification (CAC) score, an atherosclerosis burden indicator that predicts CVD risk, is not well studied in r-axSpA....

  • Article
  • Open Access
1,839 Views
14 Pages

Introduction: Previous studies have reported sex differences in stroke. There are few Asian studies. This study was performed to investigate sex differences in stroke risk factors and mechanisms in a multi-ethnic Asian population. Methods: Data on pa...

  • Article
  • Open Access
647 Views
10 Pages

Decreased Aortic Elasticity in Noncompaction Cardiomyopathy Compared to Dilated Cardiomyopathy

  • Martijn Tukker,
  • Sharida Mohamedhoesein,
  • Emrah Kaya,
  • Arend F.L. Schinkel and
  • Kadir Caliskan

Abnormal aortic elasticity serves as a marker for cardiovascular mortality and has a negative impact on the left ventricular (LV) afterload. Noncompaction cardiomyopathy (NCCM) is characterized by hypertrabeculation of the LV endomyocardial wall, wit...

  • Review
  • Open Access
3 Citations
4,425 Views
17 Pages

Advancing Heart Failure Care Through Disease Management Programs: A Comprehensive Framework to Improve Outcomes

  • Maha Inam,
  • Robert M. Sangrigoli,
  • Linda Ruppert,
  • Pooja Saiganesh and
  • Eman A. Hamad

Heart failure (HF) is a major global health challenge, characterized by high morbidity, mortality, and frequent hospital readmissions. Despite the advent of guideline-directed medical therapies (GDMTs), the burden of HF continues to grow, necessitati...

  • Article
  • Open Access
920 Views
13 Pages

Lipomatous Hypertrophy of the Interatrial Septum (LHIS) a Biomarker for Cardiovascular Protection? A Hypothesis Generating Case–Control Study

  • Pietro G. Lacaita,
  • Valentin Bilgeri,
  • Fabian Barbieri,
  • Yannick Scharll,
  • Wolfgang Dichtl,
  • Gerlig Widmann and
  • Gudrun M. Feuchtner

Background: While epicardial adipose tissue (EAT) is a known predictor of adverse cardiovascular outcomes, lipomatous hypertrophy of the interatrial septum (LHIS) is composed of metabolically active fat such as brown adipose tissue, which may exert a...

  • Review
  • Open Access
2 Citations
5,262 Views
16 Pages

Intensive Lipid-Lowering Therapy Following Acute Coronary Syndrome: The Earlier the Better

  • Akshyaya Pradhan,
  • Prachi Sharma,
  • Sudesh Prajapathi,
  • Maurizio Aracri,
  • Ferdinando Iellamo and
  • Marco Alfonso Perrone

Elevated levels of atherogenic lipoproteins are known to be associated with an increased risk of incident and recurrent cardiovascular events. Knowing that the immediate post-acute coronary syndrome (ACS) period is associated with the maximum risk of...

  • Case Report
  • Open Access
1,539 Views
8 Pages

Double QRS Transition Due to Anodal Capture During Left Bundle Branch Area Pacing: A Case Report

  • Angelo Melpignano,
  • Francesco Vitali,
  • Luca Canovi,
  • Jacopo Bonini,
  • Ludovica Rita Vocale and
  • Matteo Bertini

Anodal capture, characterized by a different QRS morphology compared to cathodal capture, is a well-known issue in cardiac resynchronization therapy (CRT). Left bundle branch area pacing (LBBAP), a novel physiological pacing technique, is also used a...

  • Article
  • Open Access
1,101 Views
15 Pages

Background: The influence of the initial ablation modality on pulmonary vein (PV) reconnection and substrate characteristics in redo procedures for recurrent atrial fibrillation (AF) remains unclear. We assessed how different thermal strategies&mdash...

  • Article
  • Open Access
1,302 Views
20 Pages

Ten-Year Results of a Single-Center Trial Investigating Heart Rate Control with Ivabradine or Metoprolol Succinate in Patients After Heart Transplantation

  • Fabrice F. Darche,
  • Alexandra C. Alt,
  • Rasmus Rivinius,
  • Matthias Helmschrott,
  • Philipp Ehlermann,
  • Norbert Frey and
  • Ann-Kathrin Rahm

Aims: Sinus tachycardia after heart transplantation (HTX) due to cardiac graft denervation is associated with reduced post-transplant survival and requires adequate treatment. We analyzed the long-term effects of heart rate control with ivabradine or...

  • Article
  • Open Access
813 Views
13 Pages

Importance of Imaging Assessment Criteria in Predicting the Need for Post-Dilatation in Transcatheter Aortic Valve Implantation with a Self-Expanding Bioprosthesis

  • Matthias Hammerer,
  • Philipp Hasenbichler,
  • Nikolaos Schörghofer,
  • Christoph Knapitsch,
  • Nikolaus Clodi,
  • Uta C. Hoppe,
  • Klaus Hergan,
  • Elke Boxhammer and
  • Bernhard Scharinger

Background: Transcatheter aortic valve implantation (TAVI) has revolutionized the treatment of severe aortic valve stenosis (AS). Balloon post-dilatation (PD) remains an important procedural step to optimize valve function by resolving incomplete val...

  • Article
  • Open Access
1 Citations
1,316 Views
11 Pages

The objective of the present study was to evaluate the association between liver cirrhosis (LC) and subsequent Heart failure (HF). This retrospective cohort study utilized data from the Disease Analyzer database (IQVIA) and included adults with a fir...

  • Review
  • Open Access
2,302 Views
16 Pages

A Rationale for the Use of Ivabradine in the Perioperative Phase of Cardiac Surgery: A Review

  • Christos E. Ballas,
  • Christos S. Katsouras,
  • Konstantinos C. Siaravas,
  • Ioannis Tzourtzos,
  • Amalia I. Moula and
  • Christos Alexiou

This review explores the advantages of ivabradine in the management of cardiac surgery patients, particularly highlighting its heart rate (HR)-reducing properties, its role in minimizing the impact of atrial fibrillation, and its contributions to imp...

  • Review
  • Open Access
1,630 Views
22 Pages

Patient Phenotypes Undergoing Tricuspid Transcatheter Edge-to-Edge Repair: Finding the Optimal Candidate

  • Kyriakos Dimitriadis,
  • Nikolaos Pyrpyris,
  • Eirini Beneki,
  • Panagiotis Theofilis,
  • Konstantinos Aznaouridis,
  • Aggelos Papanikolaou,
  • Alexios Antonopoulos,
  • Christina Chrysohoou,
  • Konstantina Aggeli and
  • Konstantinos Tsioufis

Tricuspid regurgitation (TR) is a well-recognized factor contributing to adverse outcomes and mortality. Recent developments in transcatheter valve repair techniques, with the emergence of tricuspid transcatheter edge-to-edge repair (TEER) devices, h...

  • Article
  • Open Access
761 Views
12 Pages

Clinical Outcomes of Surgical Revascularization in Patients Presenting with Critical Limb Ischemia and Aortic Valve Stenosis

  • Luca Attisani,
  • Alessandro Pucci,
  • Matteo A. Pegorer,
  • Luca Luzzani,
  • Francesco Casali,
  • Giorgio Luoni,
  • Stefano Tanagli,
  • Gabriele Piffaretti and
  • Raffaello Bellosta

(1) Background: Comparison of clinical outcomes between patients with moderate-severe aortic valve stenosis and those with mild or no aortic valve stenosis undergoing surgical revascularization for critical limb threating ischemia (CLTI). (2) Methods...

  • Review
  • Open Access
1,118 Views
18 Pages

Molecular Mechanisms of Cardiac Adaptation After Device Deployment

  • Letizia Rosa Romano,
  • Paola Plutino,
  • Giovanni Lopes,
  • Rossella Quarta,
  • Pierangelo Calvelli,
  • Ciro Indolfi,
  • Alberto Polimeni and
  • Antonio Curcio

Cardiac devices have transformed the management of heart failure, ventricular arrhythmias, ischemic cardiomyopathy, and valvular heart disease. Technologies such as cardiac resynchronization therapy (CRT), conduction system pacing, left ventricular a...

  • Article
  • Open Access
848 Views
14 Pages

Fibroblast Growth Factor 23 Is a Strong Predictor of Adverse Events After Left Ventricular Assist Device Implantation

  • Wissam Yared,
  • Leyla Dogan,
  • Ahsannullah Madad Fassli,
  • Ajay Moza,
  • Andreas Goetzenich,
  • Christian Stoppe,
  • Ahmed F. A. Mohammed,
  • Sandra Kraemer,
  • Lachmandath Tewarie and
  • Rachad Zayat
  • + 1 author

Heart failure (HF) and left ventricular hypertrophy (LVH) are linked to fibroblast growth factor 23 (FGF23). This study aims to analyze whether FGF23 can predict postoperative outcomes in unselected left ventricular assist device (LVAD) candidates. M...

  • Review
  • Open Access
2 Citations
1,509 Views
11 Pages

Minimally Invasive Surgical Strategies for the Treatment of Atrial Fibrillation: An Evolving Role in Contemporary Cardiac Surgery

  • Luciana Benvegnù,
  • Giorgia Cibin,
  • Fabiola Perrone,
  • Vincenzo Tarzia,
  • Augusto D’Onofrio,
  • Giovanni Battista Luciani,
  • Gino Gerosa and
  • Francesco Onorati

Atrial fibrillation remains the most frequent sustained arrhythmia, particularly in the elderly population, and is associated with increased risks of stroke, heart failure, and reduced quality of life. While catheter ablation is widely used for rhyth...

  • Review
  • Open Access
1 Citations
1,611 Views
17 Pages

Review of Optical Imaging in Coronary Artery Disease Diagnosis

  • Naeif Almagal,
  • Niall Leahy,
  • Foziyah Alqahtani,
  • Sara Alsubai,
  • Hesham Elzomor,
  • Paolo Alberto Del Sole,
  • Ruth Sharif and
  • Faisal Sharif

Optical Coherence Tomography (OCT) is a further light-based intravascular imaging modality and provides a high-resolution, cross-sectional view of coronary arteries. It has a useful anatomic and increasingly physiological evaluation in light of coron...

  • Article
  • Open Access
1,457 Views
16 Pages

The Influence of Blood Transfusion Indexed to Patient Blood Volume on 5-Year Mortality After Coronary Artery Bypass Grafting—An EuroSCORE II Adjusted Spline Regression Analysis

  • Joseph Kletzer,
  • Maximilian Kreibich,
  • Martin Czerny,
  • Tim Berger,
  • Albi Fagu,
  • Laurin Micek,
  • Ulrich Franke,
  • Matthias Eschenhagen,
  • Tau S. Hartikainen and
  • Dalibor Bockelmann
  • + 1 author

Background: While timely blood transfusion is critical for restoring oxygen-carrying capacity after coronary artery bypass grafting (CABG), allogeneic blood product transfusions are independently associated with increased long-term mortality, necessi...

  • Review
  • Open Access
1 Citations
2,561 Views
21 Pages

Spontaneous Coronary Artery Dissection Unveiled: Pathophysiology, Imaging, and Evolving Management Strategies

  • Constantin Andrei Rusali,
  • Ioana Caterina Lupu,
  • Lavinia Maria Rusali and
  • Lucia Cojocaru

Spontaneous coronary artery dissection (SCAD) is an increasingly recognized, non-atherosclerotic cause of acute coronary syndrome (ACS), particularly in younger women. This comprehensive review outlines SCAD’s unique pathophysiology, which is l...

  • Article
  • Open Access
2 Citations
1,974 Views
17 Pages

Nonclinical Human Cardiac New Approach Methodologies (NAMs) Predict Vanoxerine-Induced Proarrhythmic Potential

  • M. Iveth Garcia,
  • Bhavya Bhardwaj,
  • Keri Dame,
  • Verena Charwat,
  • Brian A. Siemons,
  • Ishan Goswami,
  • Omnia A. Ismaiel,
  • Sabyasachy Mistry,
  • Tromondae K. Feaster and
  • Ksenia Blinova
  • + 2 authors

New approach methodologies (NAMs), including microphysiological systems (MPSs), can recapitulate structural and functional complexities of organs. Vanoxerine was reported to induce cardiac adverse events, including torsade de points (TdP), in a Phase...

  • Article
  • Open Access
865 Views
11 Pages

Background: Peripheral endovascular intervention (PEVI) is routinely performed using standard-dose radiation (SDR), which is associated with elevated levels of radiation. No study has evaluated the outcomes of minimal-dose radiation (MDR) in PEVI. Me...

  • Article
  • Open Access
960 Views
17 Pages

Impact of Intrapericardial Fluid on Lesion Size During Epicardial Radiofrequency Ablation: A Computational Study

  • Luis Cuenca-Dacal,
  • Marcela Mercado-Montoya,
  • Tatiana Gómez-Bustamante,
  • Enrique Berjano,
  • Maite Izquierdo,
  • José M. Lozano,
  • Juan J. Pérez and
  • Ana González-Suárez

Background and aims: Epicardial RFA is often required when ventricular tachyarrhythmias originate from epicardial or subepicardial substrates that cannot be effectively ablated endocardially. Our objective was to evaluate the impact of intrapericardi...

  • Article
  • Open Access
1,949 Views
24 Pages

Despite the increased mortality due to ST-segment elevation myocardial infarction (STEMI) in South Africa (SA), SA lacks comprehensive data on STEMI clinical outcomes. This study aimed to determine the 30-day and one-year all-cause mortality rates of...

  • Review
  • Open Access
2 Citations
3,340 Views
30 Pages

Ischemic stroke is a complex, multifactorial disorder with a significant heritable component. Recent developments in genome-wide association studies (GWASs) have identified several common variants associated with clinical outcomes, stroke subtypes, a...

  • Article
  • Open Access
976 Views
11 Pages

Background: The onset of cardiomyopathy in Duchenne muscular dystrophy (DMD) is insidious and poorly defined. We proposed integrated wall stress (iWS) as a marker of total left ventricular (LV) workload and tested whether the increased iWS represents...

  • Review
  • Open Access
1 Citations
5,201 Views
20 Pages

Fractional Flow Reserve from Coronary CT: Evidence, Applications, and Future Directions

  • Arta Kasaeian,
  • Mohadese Ahmadzade,
  • Taylor Hoffman,
  • Mohammad Ghasemi-Rad and
  • Anoop Padoor Ayyappan

Coronary computed tomography angiography (CCTA) has emerged as the leading noninvasive imaging modality for the assessment of coronary artery disease (CAD), offering high-resolution visualization of the coronary anatomy and plaque characterization. T...

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J. Cardiovasc. Dev. Dis. - ISSN 2308-3425