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New Advances in Cardiovascular Diseases: The Cutting Edge

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiovascular Medicine".

Deadline for manuscript submissions: closed (20 January 2026) | Viewed by 8455

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Dr. Fabiana Lucà

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Department of Cariology, Big Metropolitan Hospital of Reggio Calabria, 89129 Reggio Calabria, Italy
Interests: atrial fibrillation; supraventricular arrhythmias; ventricular arrhythmias; sudden cardiac death (SCD); acute and chronic heart failure; ischemic heart disease; pacemaker; cardiac resynchronization therapy (CRT); implantable cardioverter defibrillator (ICD)
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Special Issue Information

Dear Colleagues,

Cardiovascular disease (CVD) is one of the foremost contributors to global mortality. Prevention, early identification, and efficacious treatment are paramount for enhancing quality of life and mitigating mortality rates. Within this context, cardiologists assume a pivotal role in mitigating risk factors, treating cardiac disorders and reducing the likelihood of recurrence. In recent years, continual advancements in research within the field have been reported, along with the development of novel therapeutic strategies and advancements in patient outcomes. This Special Issue aims to address contemporary challenges within clinical, interventional and preventive cardiology. It offers current and comprehensive insights into CVD, emphasizing recent breakthroughs in diagnostic and therapeutic techniques, cardiac pharmacology and the intricate cellular and molecular pathophysiology underlying CVD. Covering a broad spectrum within cardiology, it explores areas such as coronary artery disease (CAD), heart failure (HF), atrial fibrillation (AF), supraventricular and ventricular arrhythmias.

Dr. Fabiana Lucà
Guest Editor

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Keywords

cardiovascular disease (CVD)
preventive cardiology
cardiac pharmacology
coronary artery disease (CAD)
heart failure (HF)
atrial fibrillation (AF)
supraventricular and ventricular arrhythmias

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Published Papers (5 papers)

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Research

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13 pages, 491 KB

Open AccessArticle

Patient-Reported Outcomes After First Pulmonary Vein Isolation for ParoxYsmal Atrial Fibrillation: Cryoballoon vs. Radiofrequency (SPY-AF)

by Martina Nesti, Fabiana Lucà, Gianluca Mirizzi, Abay Bakytzhanuly, Raquel Adelino, Ioannis Doundoulakis, Dimitrios Tsiachris, Fotini Mitropoulou, Ana Jordan, Philippe Vanduynhoven, Valentina Faga, Panteleimon E. Papakonstantinou, Sotirios Xydonas, Iacopo Gezzi, Andrea Rossi, Silvia Garibaldi, Luigi Sciarra, Vincenzo Russo, Zefferino Palamà, Gabriele De Masi De Luca, Antonio Gianluca Robles and Federico Landra Show full author list Hide full author list

J. Clin. Med. 2025, 14(19), 6711; https://doi.org/10.3390/jcm14196711 - 23 Sep 2025

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Abstract

Background/Objectives: Patient-reported outcome after treatment is an important factor that positively correlates with the quality of care and can influence the patient’s future health choices. Both radiofrequency ablation (RFA) and cryoballoon ablation (CBA) are effective techniques for pulmonary vein isolation in patients with atrial fibrillation (AF) and have shown similar results in efficacy and safety, but they have not been thoroughly compared in terms of patient satisfaction. The aim of this study is to assess the satisfaction of paroxysmal AF patients who underwent RFA and CBA after their first procedure. Methods: Consecutive patients who underwent their first procedure of pulmonary vein isolation with RFA or CBA in eight international centres were included. A ten-point Likert scale was used for measuring patient-reported outcomes, evaluating anxiety before procedure, pain during and after ablation, motivation to repeat the procedure in future if necessary, and real and perceived procedural time. Results: A total of 483 patients were enrolled. Median age was 63 [56–69] years, and 281 (58.1%) patients were men. In total, 385 (79.7%) patients underwent RFA and 98 (20.3%) underwent CBA. RFA and CBA were equivalent in terms of the satisfaction of the patient, with the only exception being groin pain, which was lower in the CBA group (2 [0–3] vs. 3 [1–4], p = 0.002). Conscious sedation was used in 414 (86.7%) patients and general anaesthesia in 69 (14.3%) patients. The use of general anaesthesia reduced the perceived pain during and after the procedure in both techniques (p < 0.05), but it resulted in lower pre-procedural anxiety only in RFA patients compared to those under conscious sedation (4 [2–6] vs. 5 [3–7], p = 0.007). Anaesthetic management alone did not affect the willingness to repeat the procedure in RFA patients, while CBA patients under general anaesthesia were more motivated to repeat the procedure than those under conscious sedation (10 [8–10] vs. 7 [6–8], p < 0.001). The perceived procedure time was shorter than the actual time in all settings. Conclusions: Anaesthetic management seems to have a greater impact on patient-reported outcome than the technique used during ablation. Despite this, patients most motivated to repeat the procedure were those who underwent CBA under general anaesthesia. Full article

(This article belongs to the Special Issue New Advances in Cardiovascular Diseases: The Cutting Edge)

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13 pages, 249 KB

Open AccessArticle

Psychological Flexibility Processes Differentially Predict Anxiety, Depression, and Well-Being Throughout Cardiac Rehabilitation

by Chiara A. M. Spatola, Giada Rapelli, Christina L. Goodwin, Roberto Cattivelli, Giada Pietrabissa, Gabriella Martino and Gianluca Castelnuovo

J. Clin. Med. 2025, 14(14), 4937; https://doi.org/10.3390/jcm14144937 - 11 Jul 2025

Cited by 2 | Viewed by 3042

Abstract

Background. Several psychological processes can influence the adjustment of cardiac patients. Psychological flexibility has been linked to significant improvements in psychological well-being during cardiac rehabilitation (CR). It can be understood as the dynamic interaction of three key processes: openness to experience (OE), behavioral awareness (BA), and value-driven action (VA). This study aimed to (1) evaluate the distinct role of these processes in predicting anxiety, depression, and psychological well-being in cardiac patients, and (2) assess these associations over the course of CR. Methods. A total of 194 CR patients participated in this longitudinal study, with 156 completing follow-up assessments at T2. Anxiety and depression were measured using the Patient Health Questionnaire-4, psychological well-being with the Psychological Well-being Index-Short, and psychological flexibility using the Comprehensive Assessment of ACT Processes. Results. Cross-sectional regression analysis revealed that all three psychological flexibility dimensions were negatively associated with anxiety and depression and positively associated with psychological well-being at T1. However, longitudinal analyses showed that only VA was positively associated with a decrease in depressive symptoms following CR. A sensitivity analysis conducted on the subgroup of patients with mild to severe symptoms of anxiety and depression further confirmed the robustness of these findings. Conclusions. These results highlight the potential benefits of measuring specific psychological flexibility processes when examining the psychological status of cardiac patients and when planning psychological interventions during CR. Full article

(This article belongs to the Special Issue New Advances in Cardiovascular Diseases: The Cutting Edge)

13 pages, 284 KB

Open AccessArticle

Clinical and Psychological Factors Associated with Frailty in Patients with Heart Failure

by Bernadetta Żółkowska, Christopher S. Lee, Quin E. Denfeld, Maria Jędrzejczyk, Dorota Diakowska, Magdalena Lisiak, Marta Wleklik, Michał Czapla and Izabella Uchmanowicz

J. Clin. Med. 2024, 13(23), 7345; https://doi.org/10.3390/jcm13237345 - 2 Dec 2024

Cited by 3 | Viewed by 2306

Abstract

Background/Objectives: Heart failure (HF) is a significant public health issue with high morbidity and mortality rates. This study aims to investigate the interrelationships between frailty, cognitive impairment, and depression in older adults with HF, specifically focusing on how the physical and neuropsychiatric dimensions of frailty contribute to cognitive decline. Methods: This study included 250 patients aged 60 years or older, diagnosed with HF and hospitalized for acute decompensated HF. The patients were assessed using standardized protocols for frailty, cognitive function, and depression. The frailty was evaluated using Fried’s phenotype criteria, cognitive function with MMSE and MoCA, and depression and anxiety with HADS and PHQ-9. Statistical analyses included univariable and multivariable linear regression to identify the predictors of frailty. Results: Of the 250 patients, 151 (60.4%) were identified as frail. The frail patients were older (mean age 73.58 ± 6.80 years) compared to the non-frail patients (mean age 70.39 ± 6.16 years, p = 0.0002). Significant differences were observed in the NYHA class, length of the hospital stay, and prevalence of diabetes mellitus. The frail patients had worse cognitive (MMSE: 27.39 ± 2.12 vs. 28.13 ± 1.72, p = 0.004; MoCA: 24.68 ± 3.65 vs. 25.64 ± 3.98, p = 0.050) and psychological outcomes (higher prevalence of marked depression based on HADS categories: 8.61% vs. 1.01%, p = 0.021; and PHQ-9 categories: severe depression: 2.65% vs. 1.01%, p < 0.001). Conclusions: Age, C-reactive protein (CRP) levels, and anxiety were identified as independent predictors of frailty in the patients with heart failure. Depression, cognitive dysfunction, and the length of the hospital stay showed significant differences between the frail and non-frail patients in the group comparisons but were not independent predictors. Full article

(This article belongs to the Special Issue New Advances in Cardiovascular Diseases: The Cutting Edge)

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31 pages, 3479 KB

Open AccessSystematic Review

by Andrea Sonaglioni, Giulio Francesco Gramaglia, Gian Luigi Nicolosi, Massimo Baravelli and Michele Lombardo

J. Clin. Med. 2026, 15(8), 2859; https://doi.org/10.3390/jcm15082859 - 9 Apr 2026

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Abstract

Background: Left ventricular global longitudinal strain (GLS) measured by speckle-tracking echocardiography (STE) has become a key marker of myocardial systolic function, yet normal reference values remain heterogeneous, and the magnitude of physiological sex differences is not fully defined. We performed a systematic review and meta-analysis to establish pooled GLS reference estimates in healthy individuals, quantify sex-related differences, and contextualize deformation findings relative to conventional systolic function. Methods: A systematic search of PubMed, Scopus, and EMBASE identified observational studies reporting GLS in healthy adults assessed by two-dimensional or three-dimensional STE. Random-effects meta-analysis using standardized mean differences (SMD) compared GLS between women and men. Descriptive pooled reference values were derived using weighted median and interquartile range (IQR) reconstruction from study-level distributions. Meta-regression analyses explored demographic, clinical, and methodological sources of heterogeneity. A complementary analysis evaluated sex-related differences in left ventricular ejection fraction (LVEF) within the same populations. Results: Thirty-two studies, including 19,157 healthy individuals, were analyzed. The pooled population had a weighted median age of 47.5 years and 53% female participants. Overall, GLS demonstrated a weighted median of 20.3% (IQR 17.8–22.5). Women showed higher GLS values than men (20.8% [18.4–23.1] vs. 19.4% [17.0–21.6]). Meta-analysis of 28 studies confirmed significantly greater GLS in females (SMD 0.487, 95% CI 0.409–0.565; p < 0.001), with consistent findings across imaging modalities and no subgroup interaction. Between-study heterogeneity was substantial (I² = 82.7%), although effect direction was uniform. Meta-regression analyses identified no significant moderators, and sensitivity analyses confirmed stable estimates without publication bias. Segmental analysis demonstrated a physiological base-to-apex strain gradient. In contrast, LVEF was largely comparable between sexes, with no clinically meaningful difference (SMD 0.257, 95% CI 0.186–0.327; p < 0.001), indicating preserved global systolic performance despite differences in myocardial deformation. Conclusions: GLS demonstrates a consistent physiological range in healthy populations, with women exhibiting higher longitudinal deformation than men, independent of the imaging modality. These findings support the adoption of sex-specific GLS reference values and highlight the complementary roles of deformation and volumetric indices in improving the interpretation of myocardial function and reducing misclassification in clinical practice. Full article

(This article belongs to the Special Issue New Advances in Cardiovascular Diseases: The Cutting Edge)

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14 pages, 4125 KB

Open AccessSystematic Review

Efficacy of Bone Marrow-Derived Stem Cells on Non-Ischemic Cardiomyopathy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

by Tri Wisesa Soetisna, Fegita Beatrix Pajala, Harry Raihan Alzikri, Maasa Sunreza Millenia, Anwar Santoso and Erlin Listiyaningsih

J. Clin. Med. 2025, 14(21), 7610; https://doi.org/10.3390/jcm14217610 - 27 Oct 2025

Viewed by 1009

Abstract

Background/Objectives: Non-ischemic cardiomyopathy (NICM) refers to myocardial disease characterized by structural and functional impairment without coronary artery disease. Stem cell therapy has emerged as a potential treatment to restore heart function in NICM, but clinical results have been inconsistent. Methods: This meta-analysis comprises five randomized controlled trials with a total of 302 patients, retrieved from PubMed, ScienceDirect, the Cochrane Library, and SAGE Journals. Results: Compared with the control group, stem cell therapy group showed significant improvements in the left ventricular ejection fraction (LVEF) at the 3-month follow-up (MD = 4.55, 95% CI 2.12–6.98, p = 0.0002), a reduction in the left ventricular end-diastolic diameter (LVEDD) at the 3-month follow-up (MD = −3.83, 95% CI −7.27 to −0.39, p = 0.03) and an improvement in the New York Heart Association (NYHA) functional class both at 3 months (MD = −0.58 95% CI −0.97 to −0.19, p = 0.004) and 12 months (MD = −0.49 95% CI −0.91 to −0.07, p = 0.02). Additionally, there was a significant decrease in the Minnesota Living with Heart Failure Questionnaire (MLHFQ) score at the 6-month follow-up (MD = −14.05, 95% CI −25.97 to −2.13, p = 0.021). However, no significant differences were observed in the left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), 6-min walk test (6-MWT), or major adverse cardiovascular events (MACEs) between the two groups. Conclusions: Bone marrow-derived stem cell therapy could be a promising and safe method to improve cardiac function and quality of life in patients with NICM. Further large-scale randomized controlled trials are needed to validate these findings. Full article

(This article belongs to the Special Issue New Advances in Cardiovascular Diseases: The Cutting Edge)

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