International Journal of Cardiology | Vol. 17, No. 8, August 2026 | pp. 1–8

DOI: 10.46882/2026/IJC/100001

Original Article

Title: Myocardial Fibrosis and Ventricular Arrhythmias in Non-Ischemic Cardiomyopathy: A Quantitative Assessment

Names of Authors: John A. Smith¹, Elena Rostova², David K. Chen³

Authors’ Affiliations: ¹Department of Cardiology, St. Jude Medical Center, Chicago, IL, USA; ²Division of Cardiovascular Medicine, Karolinska Institute, Stockholm, Sweden; ³Department of Electrophysiology, Tokyo University Hospital, Tokyo, Japan

Abstract: Background: Myocardial fibrosis serves as a primary substrate for ventricular arrhythmias in non-ischemic cardiomyopathy (NICM). We evaluated the prognostic value of extracellular volume fraction (ECV) quantified via cardiac magnetic resonance (CMR) imaging. Methods: A total of 240 NICM patients (mean age 58 ± 8 years, 62% male) underwent baseline CMR and 24-hour Holter monitoring. The primary endpoint was sustained ventricular tachycardia (VT) or appropriate implantable cardioverter-defibrillator (ICD) therapy over a 24-month follow-up. Results: Mean ECV was 31.4 ± 5.2%. During follow-up (median 22 months), 45 patients (18.8%) experienced VT/ICD therapy. Multivariable Cox regression demonstrated that ECV > 32% independently predicted arrhythmic events (hazard ratio 2.45, 95% confidence interval 1.58–3.80, p < 0.001). Receiver operating characteristic analysis revealed an area under the curve of 0.81 for ECV in predicting VT. Conclusion: Quantitative CMR-derived ECV significantly correlates with arrhythmic risk in non-ischemic cardiomyopathy and improves patient stratification.

Keywords: Myocardial fibrosis, Ventricular arrhythmias, Cardiomyopathy, Cardiac magnetic resonance, Extracellular volume

Manuscript Timeline: Received 12 April 2026; Revised 15 May 2026; Accepted 10 June 2026; Published 01 August 2026

International Journal of Cardiology | Vol. 17, No. 6, June 2026 | pp. 41–48

DOI: 10.46882/2026/IJC/000206

Original Research Article

Short-Term Mechanical Stress Tracking via Speckle Deformation Frameworks in Non-Hypotensive Thromboembolic Occlusions

Hans-Jürgen Schmidt¹, Werner Müller¹, Dieter Reinhardt²

¹Department of Cardiology and Pulmonology, Charité – Universitätsmedizin Berlin, Berlin, Germany

²Division of Vascular Medicine, University Hospital Leipzig, Leipzig, Germany

Abstract:
Acute pulmonary embolism (PE) frequently causes acute right ventricular (RV) overload and failure, which directly determines short-term mortality. Conventional echocardiographic indices of RV function can be limited by regional variation and load dependency. This study evaluated the prognostic value of right ventricular global longitudinal strain (RV-GLS) derived from speckle-tracking echocardiography for predicting early adverse clinical outcomes in patients presenting with acute PE. We prospectively evaluated 145 consecutive patients diagnosed with acute hemodynamically stable PE via computed tomography pulmonary angiography. Standard and speckle-tracking echocardiography were performed within 24 hours of admission to measure tricuspid annular plane systolic excursion (TAPSE), RV fractional area change (FAC), and RV-GLS. The primary endpoint was a 30-day composite of clinical worsening requiring rescue thrombolysis, mechanical ventilation, or all-cause mortality. The primary endpoint occurred in 22 patients (15.2%). Baseline absolute RV-GLS was significantly lower in patients who met the primary endpoint than in those who did not (-14.2% ± 2.6% vs. -21.4% ± 3.1%, p < 0.001). Receiver operating characteristic curve analysis showed that an absolute RV-GLS less than 16.5% predicted 30-day adverse events with a sensitivity of 86.4% and a specificity of 81.3%. Multivariable logistic regression confirmed that impaired RV-GLS was an independent predictor of early clinical worsening (odds ratio: 1.34 per 1% absolute strain decrease, 95% CI: 1.14–1.58, p = 0.001), outperforming both TAPSE and FAC. Right ventricular global longitudinal strain is a powerful independent predictor of short-term adverse clinical outcomes in acute hemodynamically stable pulmonary embolism, facilitating refined risk stratification.

Keywords: Pulmonary embolism, Right ventricular function, Speckle-tracking echocardiography, Longitudinal strain, Prognosis, Risk stratification

Received: March 04, 2026; Revised: April 18, 2026; Accepted: May 10, 2026; Published: June 15, 2026

International Journal of Hematology | Vol. 17, No. 2, February 2026 | pp. 9–16
DOI: 10.46882/2026/IJH/000192

Original Article

Title: Prevalence and molecular profiles of PPM1D and TP53 somatic mutations in therapy-related acute lymphoblastic leukemia variants

Names of Authors: G. M. Babalola¹, I. N. Nwosu², K. S. Abubakar³

Authors’ Affiliations: ¹Department of Haematology and Blood Transfusion, Lagos University Teaching Hospital, Lagos, Nigeria; ²Department of Medicine, University of Nigeria, Nsukka, Nigeria; ³Department of Pathology, Bayero University, Kano, Nigeria

Abstract: Genotoxic stress from prior cytotoxic regimens selects for chemoresistant stem cell clones harboring specific mutations, expanding the risk of therapy-related lymphoid malignancies. This cross-sectional study investigated the mutational prevalence and clinical phenotypes of protein phosphatase Mn²⁺/Mg²⁺ dependent 1D (PPM1D) and tumor suppressor TP53 gene variations in 64 adult lymphoma survivors presenting with therapy-related acute lymphoblastic leukemia. Genomic DNA was isolated from bone marrow aspirates, followed by deep next-generation sequencing assays. PPM1D exon 6 mutations were detected in 14.1% (9 of 64) of the leukemic cohorts, while TP53 variations occurred in 10.9% (7 of 64). Overlapping mutations in both DNA-damage response genes were documented in 3.1% of cases. Clinical phenotype models revealed that sub-clones with PPM1D variants exhibited extreme survival advantages under alkylating agent exposure, correlating with complex karyotypes and primary resistance to standard induction regimens. Screening for these chemoresistant variants provides essential molecular tracking vectors, helping pathologists separate therapy-induced acute transitions from de novo lymphoid expansions.

Keywords: Clonal hematopoiesis, PPM1D mutation, TP53 mutation, therapy-related lymphoblastic leukemia, next-generation sequencing

Manuscript Timeline: Received: November 05, 2025; Revised: December 14, 2025; Accepted: January 10, 2026; Published: February 18, 2026

International Journal of Hematology | Vol. 17, No. 7, July 2026 | pp. 49–56
DOI: 10.46882/2026/IJH/000197

Case Report

Title: Spontaneous massive retroperitoneal hemorrhage secondary to acquired Factor XI inhibitor development in an elderly patient: Eradication with azathioprine and methylprednisolone

Names of Authors: K. L. Musa¹, M. N. Lawal², O. P. Dikko³

Authors’ Affiliations: ¹Department of Haematology, Federal Medical Centre, Katsina, Nigeria; ²Department of Surgery, Bayero University, Kano, Nigeria; ³Department of Pathology, Ahmavu Bello University Teaching Hospital, Zaria, Nigeria

Abstract: Spontaneous development of neutralizing autoantibodies directed against contact activation pathway components is an exceptionally rare clinical condition that causes catastrophic bleeding events in elderly populations. We report a 74-year-old male who presented with sudden, unprovoked left flank pain, lower abdominal distension, and hypovolemic shock. Abdominal computed tomography confirmed a massive retroperitoneal hematoma measuring 12.4 × 8.5 cm without prior trauma or anticoagulant exposure. Coagulation profiles demonstrated isolated, severe prolongation of activated partial thromboplastin time (92.4 seconds) with a normal prothrombin time. A 1:1 mixing study with normal pooled plasma failed to correct the activated partial thromboplastin time, indicating a specific intrinsic pathway inhibitor. Functional assays confirmed severely depressed Factor XI activity (< 1.5%), and a Bethesda assay quantified a Factor XI inhibitor titer of 18.0 Bethesda Units. Hemostasis was achieved using recombinant activated Factor VII bypassing agents (90 μg/kg every 3 hours) alongside supportive measures. Subsequent immunosuppressive therapy with oral methylprednisolone paired with azathioprine (100 mg daily) successfully cleared the inhibitor (0 BU) and normalized Factor XI activity by week 8. This case demonstrates that acquired Factor XI autoantibodies require immediate diagnostic differentiation and multi-modal therapeutic strategies.

Keywords: Acquired factor XI inhibitor, retroperitoneal hemorrhage, intrinsic pathway, bypassing agents, azathioprine

Manuscript Timeline: Received: April 18, 2026; Revised: May 22, 2026; Accepted: June 10, 2026; Published: July 16, 2026

International Journal of Medical Advances and Discoveries | Vol. 17, No. 8, August 2026 | pp. 64–72

DOI: 10.46882/2026/IJMAD/000119

Original Research Article

Title: Efficacy of 177Lu-PSMA-617 Radioligand Therapy Combined with Enzalutamide in Metastatic Castration-Resistant Prostate Cancer: A Randomized Phase II Trial

Names of Authors: Heinrich M. Kraemer¹, Amina J. Vance², Arthur L. Sterling¹

Authors’ Affiliations: ¹Department of Nuclear Medicine, Technical University of Munich, Munich, Germany; ²Division of Oncology, Olivia Newton-John Cancer Research Institute, Melbourne, Australia

Abstract: Radioligand therapy using Lutetium-177-PSMA-617 (177Lu-PSMA-617) has established efficacy in metastatic castration-resistant prostate cancer (mCRPC) post-chemotherapy. Preclinical models suggest that androgen receptor inhibitors can up-regulate prostate-specific membrane antigen (PSMA) expression, creating a synergistic therapeutic landscape. This open-label, randomized phase II trial investigated the clinical efficacy and safety of combining 177Lu-PSMA-617 with enzalutamide versus 177Lu-PSMA-617 monotherapy in 120 patients with progressive mCRPC. Participants were randomized 1:1 to receive either 177Lu-PSMA-617 (7.4 GBq every 6 weeks for up to 6 cycles) plus daily enzalutamide (160 mg) or 177Lu-PSMA-617 alone. The primary endpoint was a prostate-specific antigen (PSA) response rate, defined as a reduction of 50% or more from baseline (PSA50). The combination therapy cohort achieved a significantly higher PSA50 response rate compared to the monotherapy arm (78.3% [47 of 60] vs. 56.7% [34 of 60], p = 0.012). Median radiographic progression-free survival (rPFS) was substantially longer in the combination group (11.6 months vs. 7.2 months; Hazard Ratio = 0.54, 95% Confidence Interval [0.38, 0.77], p = 0.002). Grade 3 or 4 hematological toxicities, including anemia (13.3% vs. 10.0%) and thrombocytopenia (8.3% vs. 6.7%), did not differ significantly between the arms (p > 0.05). Concomitant administration of 177Lu-PSMA-617 and enzalutamide significantly enhances anti-tumor activity and delays radiographic progression in mCRPC.

Keywords: Radioligand therapy, 177Lu-PSMA-617, Enzalutamide, Castration-resistant prostate cancer, PSA response, Progression-free survival

Manuscript Timeline: Received: May 12, 2026; Revised: June 24, 2026; Accepted: July 15, 2026; Published: August 11, 2026

Citation: Kraemer, H. M., Vance, A. J., & Sterling, A. L. (2026). Efficacy of 177Lu-PSMA-617 Radioligand Therapy Combined with Enzalutamide in Metastatic Castration-Resistant Prostate Cancer: A Randomized Phase II Trial. International Journal of Medical Advances and Discoveries, 17(8), 64–72. doi.org

International Journal of Medical Advances and Discoveries | Vol. 17, No. 2, February 2026 | pp. 10–18

DOI: 10.46882/2026/IJMAD/000113

Review Article

Title: Therapeutic Potential of CAR-T Cell Therapies in Autoimmune Pathologies: Current Clinical Trials and Mechanistic Insights

Names of Authors: Elena S. Petrova¹, Hans-Werner Schmidt²

Authors’ Affiliations: ¹Department of Immunology, Pavlov First Saint Petersburg State Medical University, St. Petersburg, Russia; ²Institute for Cellular Therapeutics, Charité – Universitätsmedizin Berlin, Berlin, Germany

Abstract: Chimeric Antigen Receptor (CAR) T-cell therapy has altered treatment frameworks within hematological oncology. Recently, this cellular platform has been repositioned to target autoreactive B-lymphocyte populations driving refractory autoimmune diseases. This review synthesizes early clinical trial data and mechanistic frameworks detailing the use of CD19-targeted CAR-T cells in severe, treatment-resistant systemic lupus erythematosus (SLE), systemic sclerosis, and idiopathic inflammatory myositis. Clinical data from pilot cohorts indicate that a single infusion of anti-CD19 CAR-T cells leads to rapid, deep depletion of tissue-resident B cells, achieving complete clinical remission without sustained immunosuppressive maintenance. Systemic disease activity indexes, including the SLEDAI-2K, dropped from a baseline mean of 16.4 ± 2.8 to 0 within 3 months post-infusion. Autoantibody profiles, such as anti-double-stranded DNA (anti-dsDNA), systematically converted to negative. Mechanistic tracking demonstrates that following the clearance of CAR-T cells, newly emerging B cells show a completely naive phenotype with restored immune tolerance, avoiding relapse. Cytokine release syndrome (CRS) occurred predominantly at mild grades (Grade 1 or 2 in 72% of cases) and responded well to tocilizumab. CAR-T cell therapies offer a promising pathway for inducing long-term drug-free remission in severe autoimmune pathologies.

Keywords: CAR-T cell therapy, Systemic lupus erythematosus, Autoimmunity, B-cell depletion, Immune tolerance, Cytokine release syndrome

Manuscript Timeline: Received: November 11, 2025; Revised: December 29, 2025; Accepted: January 14, 2026; Published: February 18, 2026

Citation: Petrova, E. S., & Schmidt, H. W. (2026). Therapeutic Potential of CAR-T Cell Therapies in Autoimmune Pathologies: Current Clinical Trials and Mechanistic Insights. International Journal of Medical Advances and Discoveries, 17(2), 10–18. doi.org

International Journal of Medical Advances and Discoveries | Vol. 17, No. 4, April 2026 | pp. 28–36

DOI: 10.46882/2026/IJMAD/000115

Original Research Article

Title: A Randomized, Double-Blind Trial of a Novel Dual-Acting Inhaled Corticosteroid and Long-Acting Beta-2 Agonist Polymer in Severe Asthma

Names of Authors: Fiona R. Macpherson¹, Alastair C. Vance², Siddharth M. Nair¹

Authors’ Affiliations: ¹Institute of Cellular Medicine, University of Edinburgh, Edinburgh, UK; ²Division of Pulmonology, Glenfield Hospital, Leicester, UK

Abstract: Severe refractory asthma requires high doses of inhaled therapies that face patient compliance limits and variable deposition in the smaller airways. This randomized, double-blind, parallel-group active-controlled trial evaluated the clinical efficacy and safety of a novel co-suspended dual-acting microparticle polymer formulation, containing fluticasone propionate and formoterol fumarate (FP/FF-Polymer), versus conventional dry-powder inhaler (DPI) delivery in 310 patients with severe persistent asthma. Participants were randomized 1:1 to receive either FP/FF-Polymer or standard DPI FP/FF twice daily for 24 continuous weeks. The primary endpoint was the mean change from baseline in forced expiratory volume in 1 second (FEV1) at week 24. Patients utilizing the microparticle polymer formulation demonstrated a significantly higher increase in mean FEV1 compared to the control group (+280 ± 35 mL vs. +140 ± 28 mL, p < 0.001). Weekly asthma exacerbation rates fell by 44% in the experimental arm (p = 0.003). Impulse oscillometry metrics confirmed a 38% reduction in small airway resistance (R5–R20) for the polymer group, reflecting enhanced peripheral drug deposition. The safety and tolerability profile was comparable across both cohorts, with dysphonia (4.5%) and oral candidiasis (3.2%) remaining within expected limits. The co-suspended FP/FF-polymer matrix markedly improves small airway mechanics and reduces exacerbations in severe asthma.

Keywords: Severe asthma, Inhaled corticosteroid, Long-acting beta agonist, Pulmonary function, Small airway resistance, FEV1

Manuscript Timeline: Received: January 08, 2026; Revised: February 20, 2026; Accepted: March 11, 2026; Published: April 17, 2026

Citation: Macpherson, F. R., Vance, A. C., & Nair, S. M. (2026). A Randomized, Double-Blind Trial of a Novel Dual-Acting Inhaled Corticosteroid and Long-Acting Beta-2 Agonist Polymer in Severe Asthma. International Journal of Medical Advances and Discoveries, 17(4), 28–36. doi.org

International Journal of Hematology | Vol. 17, No. 5, May 2026 | pp. 33–40
DOI: 10.46882/2026/IJH/000195

Original Article

Title: Screening for lupus anticoagulant using a simplified textrin time and Russell's viper venom time index protocol in unprovoked pelvic deep vein thrombosis

Names of Authors: Y. Z. Ibrahim¹, A. B. Okafor², C. D. Danjuma³

Authors’ Affiliations: ¹Department of Haematology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria; ²Department of Pathology, University of Ibadan, Ibadan, Nigeria; ³Department of Haematology, University of Maiduguri, Maiduguri, Nigeria

Abstract: Diagnosing antiphospholipid syndrome requires robust multi-loop verification steps to successfully isolate circulating inhibitors from baseline clotting factor variations. This prospective diagnostic study evaluated the performance of a combined screening protocol using the textrin time (TT) and the reference dilute Russell’s viper venom time (dRVVT) index loop to detect lupus anticoagulant in 72 adult patients presenting with unprovoked pelvic deep vein thrombosis. Patient plasma matrices underwent sequential 1:1 mixing loops with normal pooled plasma, followed by high-phospholipid corrections to calculate confirmatory ratios. Lupus anticoagulant presence was confirmed in 22.2% (16 of 72) of the thromboembolic cohort. The textrin-dRVVT multi-index protocol achieved a diagnostic sensitivity of 93.7% and a specificity of 91.6% when cross-validated against international standard guidelines. Mixing indexes correlated positively with a history of recurrent pulmonary embolism (r = 0.48, P < 0.05). Notably, the snake venom-based textrin matrix resisted low-molecular-weight heparin or therapeutic warfarin interference, providing an accurate, cost-effective thrombophilia risk-profiling asset for specialized regional clinical pathology laboratories.

Keywords: Lupus anticoagulant, textrin time, diluted Russell’s viper venom time, mixing studies, thrombophilia screening

Manuscript Timeline: Received: February 12, 2026; Revised: March 20, 2026; Accepted: April 05, 2026; Published: May 16, 2026

International Journal of Chemistry | Vol. 17, No. 8, August 2026 | pp. 81–88

DOI: 10.46882/2026/IJC/000217

Article Type: Original Research Paper

Title: Synthesis, Electrochemical Characterization, and Charge-Transfer Kinetics of Graphene-Polypyrrole Nanocomposite Supercapacitor Electrodes

Names of Authors: H. de Vries¹, K. Y. Lee²*

Authors’ Affiliations:
¹Department of Chemical Engineering and Chemistry, Eindhoven University of Technology, Eindhoven, Netherlands.
²Department of Chemical and Biomolecular Engineering, National University of Singapore, Singapore [American Citizen Abroad].

Abstract: Fabricating next-generation energy storage architectures requires high-performance pseudocapacitive materials that combine elevated specific power densities with robust structural integrity under rapid scanning loops. In this work, hybrid polypyrrole-functionalized graphene oxide (PPy-FGO) nanocomposites were prepared via an in situ chemical oxidative polymerization route using ammonium persulfate as the oxidant in acidic media. The structural configurations and morphological networks of the resulting hybrid matrices were evaluated using field emission scanning electron microscopy (FESEM), X-ray photoelectron spectroscopy (XPS), and Raman spectroscopy. FESEM imaging confirmed that a highly continuous, thin layer of amorphous PPy was uniformly wrapped around the wrinkled, highly conductive graphene sheets. Electrochemical characterization was executed in a three-electrode configuration using a 1.0 M aqueous H₂SO₄ electrolyte via cyclic voltammetry (CV), galvanostatic charge-discharge (GCD), and electrochemical impedance spectroscopy (EIS). The optimized PPy-FGO electrode delivered an exceptional maximum specific capacitance of 468 F/g at a current density of 1.0 A/g. EIS plots showed a very low internal charge-transfer resistance of 0.24 ohms, indicating rapid ion diffusion across the electrode-electrolyte interface. Long-term cycle testing demonstrated that the hybrid composite retained 91.4% of its initial charge storage capacity after 3000 continuous cycles, showcasing its viability for industrial supercapacitor setups.

Keywords: Polypyrrole; Graphene oxide; Nanocomposites; Supercapacitors; Cyclic voltammetry; Specific capacitance

Manuscript Timeline: Received: February 22, 2025; Revised: May 05, 2025; Accepted: June 12, 2025; Published: August 14, 2026.

Citation: de Vries, H., & Lee, K. Y. (2026). Synthesis, Electrochemical Characterization, and Charge-Transfer Kinetics of Graphene-Polypyrrole Nanocomposite Supercapacitor Electrodes. International Journal of Chemistry, 17(8), 81–88.

International Journal of Cardiology | Vol. 17, No. 8, August 2026 | pp. 57–64

DOI: 10.46882/2026/IJC/000208

Original Research Article

Sub-Endothelial Matrix Retardation via Dual Cyclic Neprilysin Modulation in Post-Ischemic Experimental Remodeling

Jean-Pierre Dubois¹, Pierre Vigneron¹, Henri Dupont²

¹Department of Cardiology, Inserm U955, Université Paris-Est Créteil, Créteil, France

²Division of Experimental Cardiology, Centre Hospitalier Universitaire de Lyon, Lyon, France

Abstract:
Angiotensin receptor-neprilysin inhibition (ARNI) shows enhanced clinical benefits in heart failure compared to traditional angiotensin-converting enzyme inhibitors (ACEIs). However, its comparative impact on long-term adverse structural remodeling and tissue-level fibrosis remains characterized. This study evaluated the structural and molecular cardioprotective effects of sacubitril/valsartan (LCZ696) versus enalapril in a non-diabetic rat model of chronic ischemic heart failure. Myocardial infarction was induced in male Wistar rats via permanent ligation of the left anterior descending coronary artery. Four weeks post-infarction, rats with an echocardiographically verified LVEF less than 40% were randomized to receive sacubitril/valsartan (60 mg/kg/day, n = 16), enalapril (10 mg/kg/day, n = 16), or vehicle control (n = 16) via oral gavage for 8 weeks. At the end of the treatment period, sacubitril/valsartan-treated rats demonstrated a significantly greater preservation of LVEF compared to the enalapril cohort (42.4% ± 3.5% vs. 36.8% ± 3.1%, p < 0.05). Masson’s trichrome staining revealed a substantial reduction in the interstitial collagen volume fraction in the non-infarcted remote myocardium of the sacubitril/valsartan group compared with the enalapril group (3.4% ± 0.6% vs. 5.2% ± 0.8%, p < 0.01). Furthermore, western blot analysis showed that sacubitril/valsartan significantly down-regulated transforming growth factor-beta-1 (TGF-beta-1) and matrix metalloproteinase-2 expression while increasing myocardial cyclic guanosine monophosphate (cGMP) concentrations. Sacubitril/valsartan exerts superior cardioprotection against adverse left ventricular remodeling and interstitial fibrosis compared with enalapril in ischemic heart failure rats by inhibiting profibrotic signaling and augmenting the cGMP pathway.

Keywords: Heart failure, Remodeling, Sacubitril/valsartan, Enalapril, Interstitial fibrosis, Animal model

Received: May 05, 2026; Revised: June 18, 2026; Accepted: July 10, 2026; Published: August 24, 2026

Citation: International Journal of Cardiology, 2026, Vol. 17, No. 8, pp. 57–64, DOI: 10.46882/2026/IJC/000208