Cardiovascular Biomedicine Journal

Editorial

Seyed Jalil Mirhosseini — 2026-02-24

The Article Abstract is not available.

The hidden cardiovascular crisis of long COVID

Razieh Parizad — 2026-02-24

The Article Abstract is not available.

Stress-induced cardiomyopathy in young military personnel during combat: a case report

Negar Jafari — 2026-02-24

Objectives: Takotsubo cardiomyopathy (TTC), referred to as stress-induced cardiomyopathy, is characterized as a transient syndrome of myocardial dysfunction mimicking acute coronary syndrome that occurs without significant coronary artery disease (1). While predominantly occurring in postmenopausal women, there is a growing number of young men experiencing extreme stress who are also being diagnosed with TTC.

Case Summary: We present a 21-year-old male soldier who presented with acute cardiac arrest with electrocardiographic signs of extensive anterior ST-elevation myocardial infarction while in active military service in a war zone. Despite an initial presentation suggestive of massive myocardial infarction with severely elevated cardiac biomarkers and cardiogenic shock necessitating prolonged cardiopulmonary resuscitation, coronary angiography revealed normal coronary arteries. Remarkably, full cardiac and neurological recovery occurred within days, confirming the diagnosis of stress- induced cardiomyopathy.

Conclusions: This case underscores the clinical importance of considering TTC for young patients who exhibit signs of acute coronary syndrome, particularly in high-stress settings such as military combat zones.

Targeting oxidized sGC in calcific aortic valve stenosis: a narrative review of ataciguat

Farid Taghavi — 2026-02-24

Objectives: No pharmacologic treatment has been shown to slow the course of calcific aortic valve stenosis (CAVS), an active fibrocalcific disease. A downstream signaling bottleneck in the NO–sGC–cyclic guanosine monophosphate (cGMP) pathway is created when oxidative stress transforms soluble guanylate cyclase (sGC) into nitric oxide (NO)–insensitive, oxidized/heme-free states. With an emphasis on the NO-independent sGC activator ataciguat (HMR-1766), this narrative review aims to highlight the molecular, translational, and clinical evidence supporting oxidized/heme-free sGC as a therapeutic target in CAVS.

Methods: We conducted a structured narrative literature search across PubMed/MEDLINE, Embase, Web of Science, Scopus, Cochrane Central, and trial registries (ClinicalTrials.gov/WHO ICTRP) through October 19, 2025. We prioritized original mechanistic/structural studies, preclinical pharmacology, valve-biology investigations, and human translational/clinical studies evaluating ataciguat, sGC redox biology, and disease-modification endpoints (e.g., CT-derived aortic valve calcium [CT-AVC] and ^18F-NaF PET).

Results: Across structural and biochemical studies, heme-mimetic sGC activators selectively bind oxidized/heme-free sGC and restore cGMP signaling by occupying the heme pocket, thereby bypassing NO insensitivity. Valve-biology studies indicate that NO–sGC–cGMP signaling and NO-dependent S-nitrosylation/NOTCH pathways function as complementary anti-calcific mechanisms linked to shear stress and endothelial integrity. Imaging biomarkers such as CT-AVC and ^18F-NaF PET provide sensitive readouts of calcification burden and activity. Early randomized clinical evidence in moderate CAVS suggests oral ataciguat is generally well tolerated and is associated with a directional slowing of CT-AVC progression over six months.

Conclusions: All currently available information suggests that oxidized/heme-free sGC is a biologically reasonable and treatable target in CAVS. Ataciguat exhibits early human signs of delayed calcific development and redox-selective restoration of NO–cGMP signaling. To verify long-term structural advantages and clinical impact, however, longer-term, well-powered clinical investigations are needed.

In-stent restenosis in patients with acute coronary syndrome: a case-control analysis of risk factors following drug-eluting stent implantation

Bahareh Azadmanesh — 2026-02-24

Objectives: In-stent restenosis (ISR) remains a significant complication following percutaneous coronary intervention (PCI) with drug-eluting stents (DES), contributing to recurrent cardiovascular events and increased healthcare burden. To assess the occurrence of ISR and identify related risk factors in patients receiving PCI at a tertiary cardiac facility in northwestern Iran.

Methods: The present study is a case-control study involving 593 patients who underwent repeat coronary angiography after prior DES placement between 2020 and 2024 at Seyed ol-Shohadai Hospital in Urmia. The samples consisted of patients in two categories: ISR-positive (n = 209, 35.2%) and ISR-negative (n = 384, 64.8%). The researchers analyzed demographic information, cardiovascular risk factors, laboratory results, and procedural variables between the groups using independent t-tests and chi-square tests.

Results: ISR-positive patients were significantly older (67.61±8.71 vs. 60.13±8.01 years, P=0.03) with a higher prevalence of hypertension (55% vs. 41.4%, P=0.002). Positive C-reactive protein (CRP) was more frequent in ISR patients (63.2% vs. 14.1%, P<0.001). Mean triglyceride (118.48±81.86 vs. 100.95±60.73 mg/dL, P=0.003), LDL-cholesterol (LDL-C) (66.77±30.17 vs. 57.01±19.25 mg/dL, P<0.001), and reduced left ventricular ejection fraction (LVEF) <30% (7.7% vs. 1%, P=0.005) were significantly associated with ISR. Longer intervals between initial and repeat angiography (59.93±38.01 vs. 50.51±32.62 months, P=0.002) and stent length ≥20mm (32.5% vs. 14.3%, P<0.001) increased ISR risk. Everolimus stents showed higher ISR rates compared to sirolimus stents.

Conclusions: Advanced age, hypertension, systemic inflammation, dyslipidemia, impaired ventricular function, longer follow-up intervals, and specific stent characteristics were significantly associated with ISR development in univariate analysis. These findings suggest potential risk factors warranting further investigation through multivariate analysis. Enhanced surveillance and aggressive modification of risk factors in high-risk patients may decrease the incidence of ISR.

Short-term success and recurrence of supraventricular arrhythmias after electrical cardioversion

Sepideh Ranjbar — 2026-02-24

Objectives: Electrical cardioversion is a common treatment for terminating supraventricular arrhythmias, particularly atrial fibrillation. However, factors related to immediate success and subsequent arrhythmia recurrence remain unclear in some populations. This study assessed the immediate success rate of electrical cardioversion and the recurrence rate among patients who initially responded.

Methods: This analytical cross-sectional study was conducted at Afshar Hospital in Yazd, Iran, from 2014 to 2019. A consecutive sample of 75 adults with supraventricular arrhythmias (atrial fibrillation, atrial flutter, or atrial tachycardia) who underwent electrical cardioversion was included. Patients with prior CABG, pregnancy, or incomplete records were excluded. Data were collected using a structured checklist covering demographics, clinical history (cardiac disease, valvular disease, diabetes, hypertension, smoking), and procedural outcomes (immediate success, number of attempts, recurrence). Analyses were performed in SPSS v 26.

Results: Among 75 patients (60% male; mean age 52 ± 15 years), atrial fibrillation was the most common arrhythmia (44%). Electrical cardioversion restored sinus rhythm immediately in 68 patients (90%). Immediate success was not significantly associated with baseline comorbidities (cardiac disease, valvular disease, diabetes, hypertension, or smoking), left ventricular ejection fraction, or arrhythmia subtype (all p > 0.05). During follow-up, recurrence occurred in 23 of 68 patients with immediate success (33.8%) and was not significantly related to comorbidities, LVEF, or arrhythmia type (all p > 0.05). However, recurrence differed significantly by immediate procedural outcome (p = 0.001).

Conclusions: Electrical cardioversion achieved a high immediate success rate in supraventricular arrhythmias, and successful cardioversion was associated with a substantially lower recurrence rate. Comorbid conditions did not significantly influence immediate procedural success in this cohort.

The impact of using morphine or meperidine on clinical outcomes of ST-elevation myocardial infarction patients undergoing primary percutaneous intervention

Farzaneh Hashemzadeh — 2026-02-24

Objectives: Opioids are commonly used for treating chest pain in patients with acute coronary syndrome. Despite the beneficial effects of opioids, they could have adverse effects on patients, too. This study aims to compare the effects of morphine and meperidine on major adverse cardiac events (MACE) and mortality in patients undergoing percutaneous intervention.

Methods: The researchers retrospectively reviewed data from 161 patients with the confirmed diagnosis of ST-elevation myocardial infarction undergoing primary percutaneous intervention. We compared the medical records of patients with MACE. In-hospital and one-year MACE were our primary measured outcomes.

Results: Patients treated with morphine were more likely to experience in-hospital MACE (P-value: 0.006). Heart failure in the hospital was more in the morphine group (p-value: 0.002). However, none of the one-year clinical outcomes were statistically different between the two groups treated with morphine or meperidine. Left ventricular ejection fraction, ischemic heart disease, and hospital length of stay remained independent variables for predicting both in-hospital and one-year MACE, but morphine or meperidine didn’t remain independent in multivariable analysis.

Conclusions: Although heart failure occurred more frequently in patients who received morphine, neither morphine nor meperidine independently predicted in-hospital or one-year MACE.

Knowledge of senior dental students regarding dental management of cardiovascular patients: a cross-sectional study in Yazd, Iran

Mohammadreza Mahdavifar — 2026-02-24

Objectives: Cardiovascular diseases (CVDs) are a leading cause of mortality worldwide. Patients with these conditions require special considerations during dental treatment to prevent adverse events. Therefore, the knowledge of dental practitioners is essential for the safe and effective management of such patients.

Methods: A descriptive cross-sectional study was conducted in 2023 at Shahid Sadoughi University of Medical Sciences in Yazd, Iran. A total of 65 final-year dental students were surveyed using a validated questionnaire consisting of demographic questions and 18 items assessing their level of awareness. Data were analyzed using SPSS version 23, employing both descriptive statistics and inferential tests, including the t-test and Pearson correlation.

Results: A total of 65 students participated (response rate: 100%). The mean awareness score was 13.04 ± 3.42 out of 20, with 78.5% of students demonstrating acceptable knowledge levels. Female students scored higher than males, but the difference was not statistically significant (p = 0.057). Term 12 students scored significantly higher than Term 11 students (p < 0.001). A significant inverse correlation was found between age and awareness (r = –0.327, p = 0.008).

Conclusions: Although the overall level of awareness was acceptable, certain demographic variables, such as age and academic term, were found to influence knowledge levels. These findings highlight the need for targeted training in cardiology-related dental care within the dental curriculum.