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Open research questions in Cardiovascular Function and Risk Factors

751 gap statements mined from Cardiovascular Function and Risk Factors papers in our 7.9M-paper local library, which holds 2,954 papers on the topic — drawn mostly from each paper's own stated research gap, future-work, challenge and limitation notes, and its abstract. The ones listed below are a selection still marked open; each names the study that raised it, with a DOI link where the paper has one.

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What the literature leaves open

  • Measured baseline confounding may affect the accuracy of the results. The limited number of outcome events may affect the power of the statistical analysis. Multiple correlated echocardiographic measures may cause overfitting and multicollinearity.

    Comparative Outcomes of Heart Failure with Preserved vs. Mildly Reduced Ejection Fraction After Off-Pump Coronary Artery Bypass: A Single-Center Retrospective Study · 2026 · DOI

  • Conventional echocardiographic parameters may fail to detect early myocardial impairment. There is a need for non-invasive markers capable of integrating left-sided diastolic burden with pulmonary and right ventricular involvement.

    Left and Right Atrial Strain Across the Heart Failure Continuum: Multifaceted Markers of Subclinical Mechanical Dysfunction and Haemodynamic Burden · 2026 · DOI

  • The study had a limited number of events, which restricted the number of predictors that could be included in multivariable logistic regression models. The left atrial functional indices assessed were strongly intercorrelated.

    Left atrial contraction strain as a predictor of device-detected atrial fibrillation in patients with heart failure with reduced ejection fraction · 2026 · DOI

  • The relationship between biomarkers such as BNP, hs-CRP, and sST2 and diastolic function is not well understood. The impact of obesity on the relationship between these biomarkers and diastolic function is unclear. There is a need for longitudinal studies to examine how these biomarkers evolve over time.

    Elevated body mass index amplifies inflammation-linked diastolic dysfunction independent of diabetes: a two-year prospective study · 2026 · DOI

  • One of the challenges identified in the study is the difficulty in diagnosing diabetic cardiomyopathy before clinical symptoms manifest. Another challenge is the need for early identification and treatment of diabetic cardiomyopathy to prevent cardiovascular disease. The study also highlights the challenge of achieving tight glycemic control in people living with diabetes.

    Associations between cardiometabolic traits and diabetic cardiomyopathy: an imaging-based analysis · 2026 · DOI

  • Current practice involves considerable manual work for geometric model creation. Automated LV segmentation has focused on deep learning, but geometric model creation remains a challenge.

    Reconstruction of Left Ventricle Geometry for Finite Element Analysis Using 2D Echocardiography · 2026 · DOI

  • Early identification of HFpEF remains challenging, particularly in women with subtle symptoms. Noninvasive diagnosis is complex in the absence of fluid retention and overt congestion. Adherence to non-pharmacological interventions, such as lifestyle optimization and cardiac rehabilitation, remains a significant challenge.

    Gender-Specific Differences in Diastolic Dysfunction and HFpEF: Pathophysiology, Diagnosis, and Therapeutic Strategies · 2025 · DOI

  • The number of studies on the subject of LACI is limited. Some studies are based on the same cohort of patients. There is a need for future studies to investigate the LACI's value in daily clinical practice.

    The Possibilities and Importance of Assessing the Left Atrioventricular Coupling Index Using Various Diagnostic Imaging Methods in an Adult Population: A Comprehensive Review · 2025 · DOI

  • Further studies are needed to confirm the prognostic value of CMR-derived GLS and LV torsion in larger, more diverse populations. Research on the incremental predictive value of GLS beyond LVEF and LGE is warranted. Investigations into the potential of CMR-derived measures to guide therapeutic decision-making in DCM patients are necessary.

    CMR-Derived Global Longitudinal Strain and Left Ventricular Torsion as Prognostic Markers in Dilated Cardiomyopathy · 2025 · DOI

  • The lack of proper prognostication parameters for DCM. The need for advanced imaging tools to improve risk stratification and prognosis prediction. The gap in understanding the prognostic significance of CMR-derived measures of myocardial deformation and tissue characterization in DCM.

    CMR-Derived Global Longitudinal Strain and Left Ventricular Torsion as Prognostic Markers in Dilated Cardiomyopathy · 2025 · DOI

  • One challenge is the poor sensitivity of left ventricular ejection fraction in identifying LV systolic dysfunction in patients with HCM. Another challenge is the need for earlier and more accurate prediction of cardiovascular disease prognosis in patients with HCM.

    The Prognostic Implication of Left Atrial Strain Parameters with Conventional Left Atrial Parameters for the Prediction of Adverse Outcomes in Asian Patients with Hypertrophic Cardiomyopathy—An Echocardiographic Study · 2025 · DOI

  • One of the challenges is the rarity of pediatric dilated cardiomyopathy, making it difficult to recruit a large number of patients. Another challenge is the need for specialized equipment and expertise to perform speckle-tracking echocardiography.

    Global Longitudinal Strain as a Sensitive Marker of Left Ventricular Dysfunction in Pediatric Dilated Cardiomyopathy: A Case–Control Study · 2025 · DOI

  • There is a need for early detection of subclinical myocardial dysfunction in pediatric dilated cardiomyopathy. Conventional echocardiographic parameters may not be sufficient to detect subtle changes in left ventricular systolic function.

    Global Longitudinal Strain as a Sensitive Marker of Left Ventricular Dysfunction in Pediatric Dilated Cardiomyopathy: A Case–Control Study · 2025 · DOI

  • Limited data exist regarding the incidence and risk factors for new-onset type 2 diabetes mellitus in patients who have experienced acute myocardial infarction. The specific mechanisms and pathways linking AMI to diabetes onset remain incompletely understood.

    Incidence and Risk Factors for Developing Type 2 Diabetes Mellitus After Acute Myocardial Infarction—A Long-Term Follow-Up · 2025 · DOI

  • The effects of vericiguat therapy on cardiac remodeling are less well characterized. Current treatments have improved outcomes but a substantial residual risk persists. There is a need to evaluate the effects of vericiguat therapy on cardiac remodeling in patients with heart failure with reduced ejection fraction.

    Vericiguat Therapy Is Associated with Reverse Myocardial Remodeling in Chronic Heart Failure with Reduced Ejection Fraction · 2025 · DOI

  • The relationship between insulin resistance, pre-diabetes, and left ventricular systolic function is not fully understood. Prior studies have found inconsistent associations between these factors. The study aims to fill this gap by assessing global longitudinal strain in relation to insulin resistance and pre-diabetes.

    Left Ventricular Systolic Function in Asymptomatic Men Aged 65–75 Years, Relation to Insulin Resistance and Pre-Diabetes: A DANCAVAS Cross-Sectional Sub-Study · 2025 · DOI

  • Right heart catheterization remains the haemodynamic gold standard, but its invasive nature, limited feasibility, and inability to capture dynamic physiological states constrain widespread application, - Substantial between-study heterogeneity was observed (I 2 = 89.3%) in reported RASr reference values, - The current variability in reported RASr reference values highlights the need for further research, -…

    Left and Right Atrial Strain Across the Heart Failure Continuum: Multifaceted Markers of Subclinical Mechanical Dysfunction and Haemodynamic Burden · 2026 · DOI

  • Limited number of events (n = 15), - Models were restricted to two or three predictors to avoid overfitting, - No standardized prediction algorithms of NOAF in HF patients are widely used in clinical…

    Left atrial contraction strain as a predictor of device-detected atrial fibrillation in patients with heart failure with reduced ejection fraction · 2026 · DOI

  • Larger prospective cohorts are needed to confirm the study's findings, - Advanced modelling approaches such as restricted cubic splines or formal ANCOVA could provide additional…

    Elevated body mass index amplifies inflammation-linked diastolic dysfunction independent of diabetes: a two-year prospective study · 2026 · DOI

  • Future studies should investigate the longitudinal effects of DM duration on myocardial deformation, - Future studies should explore the relationship between glycemic control and myocardial function in larger cohorts, - Future studies should examine the potential benefits of early intervention on cardiovascular outcomes…

    Associations between cardiometabolic traits and diabetic cardiomyopathy: an imaging-based analysis · 2026 · DOI

  • The method assumes a circular cross-section in single-plane mode, which cannot represent an elliptical cross-section, - The error is largest when the imaging plane is aligned with the short axis of the ellipse, - The method is limited to 2D…

    Reconstruction of Left Ventricle Geometry for Finite Element Analysis Using 2D Echocardiography · 2026 · DOI

  • Early identification of HFpEF remains challenging, - Adherence to non-pharmacological interventions remains a significant challenge, - Substantial gaps remain regarding the mechanisms underlying the progression from LVDD…

    Gender-Specific Differences in Diastolic Dysfunction and HFpEF: Pathophysiology, Diagnosis, and Therapeutic Strategies · 2025 · DOI

  • Conventional echocardiographic parameters frequently fail to detect early functional changes, - LVEF has several limitations that reduce its diagnostic and prognostic utility, particularly in HFpEF, - Diagnosing HFpEF remains a major clinical challenge due to suboptimal performance of traditional parameters…

    Early Echocardiographic Markers in Heart Failure with Preserved Ejection Fraction · 2025 · DOI

  • Further investigation of the relationship between worsening glycemic control and reduced atrial compliance in larger cohorts - Assessment of the impact of SGLT2 inhibitors and GLP-1 receptor agonists on cardiac structure…

    Impaired Left Atrial Strain as an Early Marker of Cardiac Involvement in Type 2 Diabetes Mellitus: A Cross-Sectional Study · 2025 · DOI

  • Further studies needs to be conducted, specifically in the non-obstructive subgroup of patients, to validate its utility - more research into disease-directed therapy for non-obstructive HCM needs to be conducted for this underserved population - Further research is needed in this respect to determine whether LA strain could be useful in detecting diastolic dysfunction earlier, especially for female…

    The Prognostic Implication of Left Atrial Strain Parameters with Conventional Left Atrial Parameters for the Prediction of Adverse Outcomes in Asian Patients with Hypertrophic Cardiomyopathy—An Echocardiographic Study · 2025 · DOI

Most-cited papers in Cardiovascular Function and Risk Factors

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Open questions raised by papers listed on this page include: (1) There is a need for non-invasive markers capable of integrating left-sided diastolic burden with pulmonary and right ventricular involvement (“Left and Right Atrial Strain Across the Heart Failure Continuum: Multifaceted…”, 2026); (2) The relationship between biomarkers such as BNP, hs-CRP, and sST2 and diastolic function is not well understood (“Elevated body mass index amplifies inflammation-linked diastolic dysfunction…”, 2026); (3) There is a need for future studies to investigate the LACI's value in daily clinical practice (“The Possibilities and Importance of Assessing the Left Atrioventricular…”, 2025); (4) Further studies are needed to confirm the prognostic value of CMR-derived GLS and LV torsion in larger, more diverse populations (“CMR-Derived Global Longitudinal Strain and Left Ventricular Torsion as…”, 2025); (5) There is a need for early detection of subclinical myocardial dysfunction in pediatric dilated cardiomyopathy (“Global Longitudinal Strain as a Sensitive Marker of Left Ventricular…”, 2025). 751 gap statements have been mined from Cardiovascular Function and Risk Factors papers in our 7.9M-paper local library, which holds 2,954 papers on the topic; the gaps come from whichever of those papers state one. They are mostly the research gaps the authors state and the papers' abstracts, plus future-work, limitations and challenges passages. The ones listed below are a selection still marked open; each names the study that raised it, with a DOI link where the paper has one, so you can read the original claim in context.

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