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Diagnostics
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Interdisciplinary Approaches to Improve Cardiovascular Outcomes
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Interdisciplinary Approaches to Improve Cardiovascular Outcomes

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Clinical Diagnosis and Prognosis".

Deadline for manuscript submissions: 31 December 2026 | Viewed by 3300

Editor

Dr. Mihaela Hostiuc

E-Mail Website
Guest Editor
Department Internal Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
Interests: venous thromboembolism; thrombosis; thrombophilia; cancer associated thrombosis; COVID-19
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Cardiovascular diseases, the leading cause of mortality and morbidity worldwide, impose a substantial burden on health systems despite major advances in their diagnosis and treatment. The burden will continue to increase considering the increasing prevalence of obesity, social disparities throughout the world, climate changes, and air pollution. An interdisciplinary approach, which integrates knowledge from multiple fields, including cardiology, cardiovascular surgery, nutrition, psychology, nursing, public health, and data science, may aid the prevention, diagnosis, and treatment of heart diseases and improve cardiovascular outcomes.

Advances in wearable technology, digital health monitoring, and risk assessment models allow early detection of diseases, sometimes in subclinical forms. Research combining genetics, environmental factors, and health policies provides deeper insight into risk stratification.

Overall, an interdisciplinary approach stimulates innovation, improves patient adherence and engagement, and leads to more effective and holistic strategies for reducing morbidity and mortality associated with cardiovascular diseases.

We welcome both original studies and case reports, as well as reviews and meta-analyses.

Dr. Mihaela Hostiuc
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • cardiovascular disease
  • prevention
  • risk factors
  • cardiovascular outcomes
  • interdisciplinarity
  • burden of disease

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Published Papers (4 papers)

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Research

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13 pages, 1118 KB  
Article
The Association Between Glucagon-like Peptide-1 Receptor Agonists and Clinical Outcomes in Patients with Thoracic Aortic Aneurysm
by Mohammad Alaa Raslan, Hussein Abdul Nabi, Luke Dreher, Soad Al Osta, Vinicius De Sousa Barzon Serra, Chadi Ayoub, Hicham El Masry and Fadi E. Shamoun
Diagnostics 2026, 16(11), 1742; https://doi.org/10.3390/diagnostics16111742 - 5 Jun 2026
Viewed by 701
Abstract
Background/Objectives: Thoracic aortic aneurysm (TAA) often results from structural degeneration of the aortic wall. Traditional management focuses on hemodynamic control using beta-blockers (BB) and angiotensin receptor blockers (ARBs). Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), originally developed for diabetes and weight management, may offer [...] Read more.
Background/Objectives: Thoracic aortic aneurysm (TAA) often results from structural degeneration of the aortic wall. Traditional management focuses on hemodynamic control using beta-blockers (BB) and angiotensin receptor blockers (ARBs). Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), originally developed for diabetes and weight management, may offer additional vascular protective benefits through anti-inflammatory, antioxidative, and matrix-stabilizing mechanisms. However, their role in reducing mortality and thoracic aortic dissection (TAD) risk in patients with TAA has not been evaluated in human populations. In this study, we aimed to assess the association between GLP-1 RA use and the risks of mortality and thoracic aortic dissection. Methods: We conducted a retrospective cohort study of adults diagnosed with TAA between 2018 and 2024 across three Mayo Clinic sites. Patients receiving GLP-1 RAs were compared with non-users using 1:1 propensity score matching. Outcomes included all-cause mortality, cardiovascular mortality, and incident TAD. Kaplan–Meier and Cox proportional hazards analyses were performed. Results: A total of 32,279 patients with TAA, with a median age of 68.0 [IQR: 59.0–76.0] and 70.7% male, were included in a 1:1 propensity score match. This yielded a balanced cohort of 588 GLP-1 RA users and 588 non-users. Through a median follow-up of 4.1 (2.2, 5.9) years, GLP-1 RA use was associated with significantly lower 5-year cumulative incidence of all-cause mortality (5.0% vs. 14.5%, HR: 0.31; 95% CI: 0.19–0.50; p < 0.001), cardiovascular mortality (1.9% vs. 5.5%, HR: 0.30; 95% CI: 0.13–0.70; p = 0.005), and TAD (0.9% vs. 4.0%, HR: 0.19; 95% CI: 0.06–0.60; p < 0.0004). Conclusions: GLP-1 RAs are associated with reduced incidence of all-cause mortality, cardiovascular mortality, and TAD incidence in patients with TAA. Prospective studies are needed to confirm these findings and evaluate effects on aneurysm progression. Full article
(This article belongs to the Special Issue Interdisciplinary Approaches to Improve Cardiovascular Outcomes)
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18 pages, 251 KB  
Article
Driveline Infections in Durable LVAD Support: Risk Factors, Microbiology, and Resistance Patterns from a Large Cohort
by Umit Kahraman, Oguzhan Acet, Barkin Dost Bulut, Aysen Yaprak Kapkın, Osman Nuri Tuncer, Meltem Tasbakan, Sanem Nalbantgil, Emrah Oguz, Cagatay Engin, Mustafa Ozbaran and Tahir Yagdi
Diagnostics 2026, 16(9), 1303; https://doi.org/10.3390/diagnostics16091303 - 27 Apr 2026
Viewed by 678
Abstract
Background: Driveline infection (DLI) is the most common device-specific infection in patients supported with ventricular assist devices (VADs) and remains a major cause of morbidity during long-term mechanical circulatory support. This study aimed to evaluate the incidence, risk factors, microbiological characteristics, and [...] Read more.
Background: Driveline infection (DLI) is the most common device-specific infection in patients supported with ventricular assist devices (VADs) and remains a major cause of morbidity during long-term mechanical circulatory support. This study aimed to evaluate the incidence, risk factors, microbiological characteristics, and antimicrobial resistance patterns of DLIs in patients undergoing durable left ventricular assist device (LVAD) implantation. Methods: This retrospective cohort study included 772 consecutive patients who underwent durable LVAD implantation at a single tertiary center between January 2012 and December 2024. Patients were categorized according to the development of DLI: the DLI group (n = 158) and the non-DLI group (n = 614). Demographic, clinical, laboratory, perioperative, and postoperative variables were analyzed. Multivariate logistic regression analysis was performed to identify independent predictors of DLI. Microbiological isolates and antimicrobial resistance patterns were also evaluated. Results: Driveline infection developed in 20.5% of patients during follow-up. Patients with DLI had a significantly higher body mass index (26.4 vs. 24.8 kg/m2, p = 0.002) and a higher prevalence of diabetes mellitus (28.2% vs. 12.1%, p < 0.001). In multivariate analysis, diabetes mellitus (OR 3.29, p = 0.013) and longer LVAD support duration (p = 0.003) were independently associated with DLI. Device type showed differences in crude infection rates but was not an independent predictor. The most frequently isolated pathogens were Staphylococcus aureus (36%) and Pseudomonas aeruginosa (19%). The most common antimicrobial resistance patterns included fluoroquinolone resistance (23%), methicillin-resistant Staphylococcus aureus (10%), and resistance to piperacillin/tazobactam and carbapenems. Conclusions: In this large single-center cohort, diabetes mellitus and prolonged device support duration were the main independent predictors of driveline infection. Staphylococcus aureus and Pseudomonas aeruginosa were the predominant pathogens, with notable antimicrobial resistance patterns. These findings highlight the importance of metabolic optimization, meticulous driveline exit-site care, and structured long-term surveillance strategies for reducing infection risk in LVAD recipients. Full article
(This article belongs to the Special Issue Interdisciplinary Approaches to Improve Cardiovascular Outcomes)

Review

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38 pages, 1301 KB  
Review
Three-Dimensional Left Atrial Geometry in Atrial Fibrillation: Imaging Biomarkers, Substrate Phenotyping, and Ablation Outcome Prediction
by Paschalis Karakasis, Panagiotis Theofilis, Panagiotis Stachteas, Konstantinos Grigoriou, Panagiotis Iliakis, Athina Nasoufidou, Panayotis K. Vlachakis, Nikolaos Ktenopoulos, Anastasios Apostolos, Theodoros Karamitsos, Antonios P. Antoniadis and Nikolaos Fragakis
Diagnostics 2026, 16(14), 2255; https://doi.org/10.3390/diagnostics16142255 - 19 Jul 2026
Cited by 1 | Viewed by 506
Abstract
Assessment of left atrial remodeling in atrial fibrillation (AF) has traditionally relied on anteroposterior diameter, left atrial volume (LAV), and indexed left atrial volume (LAVI). Although these measures remain clinically useful, they reduce a complex, asymmetric, and anatomically constrained chamber to scalar descriptors [...] Read more.
Assessment of left atrial remodeling in atrial fibrillation (AF) has traditionally relied on anteroposterior diameter, left atrial volume (LAV), and indexed left atrial volume (LAVI). Although these measures remain clinically useful, they reduce a complex, asymmetric, and anatomically constrained chamber to scalar descriptors and therefore cannot fully capture the spatial substrate that underlies AF persistence, thromboembolic risk, or arrhythmia recurrence after catheter ablation. Three-dimensional left atrial reconstruction provides a more refined framework by preserving chamber shape, regional deformation, pulmonary vein (PV) orientation, left atrial appendage (LAA) geometry, posterior wall and roof configuration, left lateral ridge anatomy, wall-thickness heterogeneity, and computational surface features. In this review, we examine how three-dimensional left atrial geometry can extend conventional remodeling assessment from measurement of atrial size toward imaging-based substrate characterization. We discuss the relative strengths and limitations of computed tomography (CT), cardiovascular magnetic resonance (CMR), three-dimensional echocardiography, and electroanatomic mapping (EAM), and summarize key geometry-derived metrics, including LAV, LAVI, left atrial sphericity, asymmetry index, atrial eccentricity index, PV anatomy, LAA morphology, posterior wall geometry, wall thickness, radiomics, and artificial intelligence (AI)-derived shape descriptors. We further synthesize evidence linking geometric remodeling with atrial cardiomyopathy, mechanical dysfunction, fibrosis, low-voltage substrate, and catheter ablation outcomes. The clinical relevance of three-dimensional left atrial geometry may be further redefined by pulsed field ablation (PFA), whose non-thermal lesion biology and tissue selectivity may modify predictors of recurrence established in radiofrequency and cryoballoon cohorts. Finally, we outline the need for standardized segmentation, harmonized metric definitions, prospective multicenter validation, and integration with AI, digital twin modeling, biomarkers, EAM data, and wearable-derived AF burden. Three-dimensional left atrial geometry is not yet a standalone determinant of ablation strategy, but it may become a central component of individualized atrial phenotyping and rhythm-control decision-making. Full article
(This article belongs to the Special Issue Interdisciplinary Approaches to Improve Cardiovascular Outcomes)
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19 pages, 1641 KB  
Review
From Angiosome to Woundosome: An Interdisciplinary Approach to Personalized Revascularization in Chronic Limb-Threatening Ischemia
by Mircea Ionut Popitiu, Lorenzo Patrone, Giacomo Clerici, Serban Comsa, Gloria Gavrila-Ardelean, Nilima Rajpal Kundnani, Nicu Olariu and Mihai Edmond Ionac
Diagnostics 2026, 16(10), 1557; https://doi.org/10.3390/diagnostics16101557 - 20 May 2026
Viewed by 839
Abstract
Background/Objectives: Chronic limb-threatening ischemia (CLTI) is the most advanced stage of peripheral arterial disease and is associated with high rates of major amputation and mortality. The angiosome concept has become an important tool for planning targeted revascularization. However, its clinical value may [...] Read more.
Background/Objectives: Chronic limb-threatening ischemia (CLTI) is the most advanced stage of peripheral arterial disease and is associated with high rates of major amputation and mortality. The angiosome concept has become an important tool for planning targeted revascularization. However, its clinical value may be limited in patients with complex arterial disease, impaired collateral circulation, and microvascular dysfunction. This review explores the relationship between angiosome-guided revascularization and the emerging woundosome concept, which focuses on functional wound perfusion. Methods: A narrative review with a structured literature search was performed using PubMed/MEDLINE, Scopus, and Web of Science. Studies evaluating angiosome-guided revascularization, direct versus indirect revascularization, collateral circulation, pedal arch integrity, and perfusion-related outcomes in CLTI and diabetic foot disease were included. Results: Most observational studies and meta-analyses suggest that direct angiosome-targeted revascularization may improve wound healing and limb salvage in selected patients. However, clinical outcomes are also influenced by collateral circulation, anatomical variability, infra-malleolar perfusion, pedal arch integrity, and microvascular function. The woundosome concept expands the traditional angiosome model by emphasizing effective perfusion of the wound bed through direct arterial inflow, collateral pathways, and functional perfusion assessment. Conclusions: Combining the angiosome and woundosome concepts may provide a more practical and individualized approach to revascularization planning in CLTI by integrating anatomical vascular mapping with functional wound perfusion assessment. Full article
(This article belongs to the Special Issue Interdisciplinary Approaches to Improve Cardiovascular Outcomes)
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