Subclinical Myocardial Disease: The Next Frontier in Cardiovascular Prevention.

Authors

• Param Darpan Sheth, J.S.S Medical CollegeFollow
• Chandana S., J.S.S Medical CollegeFollow
• Nimrah Rehman, J.S.S. Medical CollegeFollow

Author ORCID Identifier

https://orcid.ord/0009-0000-4100-6271

Corresponding Author

Param Darpan Sheth
paramsheth8@gmail.com

Abstract

Subclinical myocardial disease refers to pathological cardiac changes that precede overt symptoms. It represents an emerging frontier in cardiovascular disease prevention; wherein early detection of myocardial dysfunction could allow timely intervention to avert heart failure (HF) and other outcomes. This narrative review summarizes the current and emerging tools for detecting subclinical myocardial disease, including advanced cardiac imaging and circulating biomarkers, and discusses their potential to improve risk stratification and preventive care in asymptomatic high-risk individuals. Novel echocardiographic measures such as global longitudinal strain (GLS) can unmask subtle systolic dysfunction despite preserved ejection fraction, while cardiac magnetic resonance (CMR) tissue mapping (T1 mapping and extracellular volume [ECV] fraction) enables quantification of diffuse myocardial fibrosis. Circulating biomarkers of cardiomyocyte injury and hemodynamic stress, namely high-sensitivity cardiac troponins and natriuretic peptides, offer quantitative indices of subclinical myocardial damage and wall stress that correlate with future HF risk. Positron emission tomography (PET) imaging provides sensitive detection of myocardial inflammation and microvascular dysfunction. We highlight how integrating these modalities can identify high-risk patients in the pre-HF stage (ACC/AHA Stage B), defined by structural or functional cardiac abnormalities without symptoms, allowing initiation of preventive therapies.

Publication Date

2025

Publisher

JSS Academy of Higher Education & Research

Conflict of Interest

none

Keywords

Myocardial Diseases, Ventricular Dysfunction, Echocardiography, Magnetic Resonance Imaging, Natriuretic Peptides

Word Count

2813

Comments

none

Recommended Citation

Darpan Sheth P, S. C, Rehman N. Subclinical Myocardial Disease: The Next Frontier in Cardiovascular Prevention.. Digital Journal of Clinical Medicine. 2025; 8(1): -. doi: https://doi.org/10.55691/2582-3868.1289

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.