Current Problems In Cardiology[JOURNAL]
Sun
200 papers
Impact of Weekend Admission on Outcomes in Sinus Node Dysfunction and AV Block Undergoing Permanent Pacemaker: A Nationwide Analysis.
Chestaro J, Adrejiya P, Nagabandi S … +1 more , Khouzam R
Curr Probl Cardiol · 2026 Sep · PMID 42034218 · Publisher ↗
BACKGROUND: The "weekend effect" is associated with adverse outcomes in several cardiovascular conditions. Limited data exist regarding its impact on patients with bradyarrhythmias requiring inpatient permanent pacemaker...
BACKGROUND: The "weekend effect" is associated with adverse outcomes in several cardiovascular conditions. Limited data exist regarding its impact on patients with bradyarrhythmias requiring inpatient permanent pacemaker (PPM) implantation. METHODS: Retrospective study using the 2022 National Inpatient Sample to identify adults hospitalized with sinus node dysfunction (SND) or atrioventricular (AV) block who underwent PPM implantation. Patients were stratified by admission day (weekend vs weekday). The primary outcome was in-hospital mortality. Secondary outcomes included temporary pacemaker (TPM) placement, time from admission to PPM implantation, and length of stay (LOS). Survey-weighted multivariable logistic and linear regression models were used to evaluate associations between weekend admission and outcomes. RESULTS: A total of 29,630 patients with SND and 44,150 patients with AV block undergoing PPM implantation were included. Among patients with SND, weekend admission was not associated with higher in-hospital mortality (adjusted odds ratio [aOR] 1.10; 95% CI 0.42-2.85) or TPM placement (aOR 1.13; 95% CI 0.86-1.48) but was associated with delayed PPM implantation (2.37 vs 2.02 days; p<0.001) and longer LOS (4.55 vs 4.27 days; p=0.006). Among patients with AV block, weekend admission was not associated with increased mortality (aOR 1.05; 95% CI 0.59-1.84) but was associated with higher TPM placement (aOR 1.53; 95% CI 1.34-1.75; p<0.001), delayed PPM implantation (1.89 vs 1.48 days; p<0.001), and longer LOS (4.30 vs 3.73 days; p<0.001). CONCLUSION: Weekend admission among patients with SND or AV block requiring PPM implantation was not associated with increased in-hospital mortality but was linked to delayed device implantation and longer hospitalization.
Clinical and echocardiographic predictors of reintervention after percutaneous or surgical treatment of rheumatic mitral stenosis: A systematic review.
Gómez-Gualdrón SA, Macias-Martinez JS, Pulido-Parra AM … +2 more , Higuera-Leal SA, Vesga-Angarita BE
Curr Probl Cardiol · 2026 Sep · PMID 42031036 · Publisher ↗
BACKGROUND: Rheumatic mitral stenosis remains an important cause of valvular heart disease worldwide. Although percutaneous and surgical interventions improve symptoms and hemodynamics, some patients develop restenosis,...
BACKGROUND: Rheumatic mitral stenosis remains an important cause of valvular heart disease worldwide. Although percutaneous and surgical interventions improve symptoms and hemodynamics, some patients develop restenosis, adverse events, or require repeat interventions during follow-up. Identifying clinical and echocardiographic factors associated with these outcomes is important for risk stratification. METHODS: A systematic review was conducted following PRISMA guidelines to identify predictors of clinical outcomes after percutaneous or surgical treatment of rheumatic mitral stenosis. A search was performed in PubMed, PMC, Ovid MEDLINE, ScienceDirect, and Scopus without language or date restrictions. Studies evaluating clinical or echocardiographic predictors and reporting OR, HR, or RR were included. Study selection, data extraction, and risk of bias assessment were performed using the Newcastle-Ottawa Scale. Due to heterogeneity among studies, a qualitative synthesis was conducted. RESULTS: Fourteen studies were included. The evaluated predictors mainly corresponded to clinical, echocardiographic, hemodynamic, and procedural variables. Some studies identified pulmonary hypertension, unfavorable valvular anatomy, and suboptimal hemodynamic results as factors associated with adverse events or reintervention. In contrast, achieving a post-procedural mitral valve area ≥2 cm² was associated with a lower risk of restenosis and cardiovascular events. CONCLUSIONS: Clinical and echocardiographic characteristics influence outcomes after intervention for rheumatic mitral stenosis. Baseline valvular morphology and the immediate hemodynamic result of the procedure appear to be key determinants of prognosis and risk of reintervention.
Quadruple therapy in heart failure: Why, when, and in whom?
Paraskevaidis I, Tsougos E, Kourek C
Curr Probl Cardiol · 2026 Aug · PMID 42031035 · Publisher ↗
Current heart failure (HF) guidelines recommend quadruple therapy as first-line treatment for patients with HF with reduced ejection fraction, consisting of angiotensin receptor-neprilysin inhibitors, beta-blockers, sodi...
Current heart failure (HF) guidelines recommend quadruple therapy as first-line treatment for patients with HF with reduced ejection fraction, consisting of angiotensin receptor-neprilysin inhibitors, beta-blockers, sodium-glucose cotransporter-2 inhibitors, and mineralocorticoid receptor antagonists. This strategy has significantly improved outcomes by reducing mortality and hospitalization and is now the corner-stone of guideline-directed medical therapy. However, despite these advances, residual morbidity and mortality remain high, indicating that important pathophysiological and therapeutic questions are still unresolved. Although the major HF phenotypes share common mechanisms, including neurohumoral activation, inflammation, oxidative stress, fibrosis, and metabolic disturbance, HF remains a highly heterogeneous syndrome. Differences in etiology, comorbidities, frailty, renal function, and individual biological response may influence both disease progression and treatment efficacy. Consequently, a uniform therapeutic strategy may not provide equal benefit across the HF spectrum. In this comprehensive review, we discuss the rationale and pathophysiological basis of quadruple therapy, its limitations across different HF phenotypes, and the need to move from a predominantly phenotype-based strategy toward a more personalized and mechanism-based therapeutic approach.
Evolution of psychocardiological research: A bibliometric analysis of 111,140 records and 100 highly cited papers.
Abdelwahab SI, Taha MME, Farasani A … +9 more , Moshi JM, Assiri A, Alshahrani S, Jali AM, Sahli KA, Qadri M, Alaajam F, Khardali A, Hassan W
Curr Probl Cardiol · 2026 Sep · PMID 42025786 · Publisher ↗
This bibliometric study analyzed psychocardiological and neuropsychiatric cardiovascular research using the Scopus database (1977-2020). Three search approaches-Title-Abstract-Keywords (TAK), abstract-only, and title-onl...
This bibliometric study analyzed psychocardiological and neuropsychiatric cardiovascular research using the Scopus database (1977-2020). Three search approaches-Title-Abstract-Keywords (TAK), abstract-only, and title-only-yielded 111,140, 47,402, and 6,060 records, respectively, with the title-only dataset used for detailed analyses. A total of 100 highly cited documents were further examined. The field demonstrated a moderate annual growth rate of 2.59%, with a high citation impact (average 659.5 citations per document) and an average document age of 22.5 years. Publication output increased markedly after 2000, peaking in 2025 (n = 470). The United States (n = 1,749), China (n = 1,291), and the United Kingdom (n = 505) were leading contributors, with strong institutional output from VA Medical Centers, Washington University, and Duke University. Co-word and clustering analyses identified dominant themes including psychosocial cardiovascular risk, depression in coronary and cerebrovascular disease, pharmacological and psychotherapeutic interventions, and prognostic outcomes in myocardial infarction and stroke. Overall, the findings highlight a rapidly expanding, interdisciplinary field integrating psychological factors into cardiovascular and cerebrovascular research, with increasing clinical and translational relevance. Cluster analysis of co-occurring keywords (≥2 occurrences) identified five major thematic domains within psychocardiological research. These included psychosocial determinants of cardiovascular disease, pharmacological and clinical management of heart failure, antidepressant effects on cardiovascular and cerebrovascular systems, prognostic outcomes in myocardial infarction, and evidence synthesis methodologies. Overall, the clusters reflect an integrated framework linking psychological factors, biological mechanisms, and clinical outcomes across cardiovascular and cerebrovascular disorders.
Cardiac dysfunction in HIV: Etiology, pathophysiology, and future directions.
Elnabawi YA, Marashi F, Aiad NN … +3 more , Dey D, Zaghlol R, Dey AK
Curr Probl Cardiol · 2026 Sep · PMID 42019564 · Publisher ↗
The advent of highly active antiretroviral treatment (HAART) has turned human immunodeficiency virus (HIV) from an acute, high mortality illness to a chronic, treatable disease. While people living with HIV are expected...
The advent of highly active antiretroviral treatment (HAART) has turned human immunodeficiency virus (HIV) from an acute, high mortality illness to a chronic, treatable disease. While people living with HIV are expected to have a normal life expectancy, this puts HIV infected individuals at risk of developing HIV- associated chronic diseases which includes cardiovascular disease. HIV-associated heart disease may lead to HIV associated cardiomyopathy (HIV CM), which mostly includes heart failure with reduced ejection fraction (HFrEF). There has also been growing evidence of diastolic dysfunction leading to heart failure with preserved ejection fraction (HFpEF) as part of HIV CM. While the underlying etiology for HIV CM has yet to be elicited, the proposed mechanisms include chronic low-grade inflammation, opportunistic infections, direct viral invasion of the myocardium and pericardium, and toxicity from HAART regimens. This review will serve to discuss potential immune and inflammatory mechanisms of HIV CM, the effects of certain HAART on cardiac function, as well as future directions in the work up and evaluation of HIV CM in people living with HIV.
Can the FIB-4 index predict mortality in patients with coronary artery disease? A systematic review and meta-analysis.
Alcântara RWA, Oliveira VMR, Schettino Samad N … +7 more , Barbosa LM, Barroso WKS, Nadruz W, Maranhão RC, Nascimento BR, Amat-Santos IJ, Moreira HG
Curr Probl Cardiol · 2026 Aug · PMID 42013984 · Publisher ↗
Abstract loading — click title to view on PubMed.
Myocardial infarction with non-obstructive coronary arteries: A multimodal imaging approach to diagnosis and etiology-targeted therapy.
Abdu FA
Curr Probl Cardiol · 2026 Aug · PMID 42002245 · Publisher ↗
Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a clinically heterogeneous working diagnosis accounting for 5-15% of acute myocardial infarction presentations. Its differential diagnosis spans mu...
Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a clinically heterogeneous working diagnosis accounting for 5-15% of acute myocardial infarction presentations. Its differential diagnosis spans multiple ischemic coronary mechanisms as well as important non-ischemic mimickers that must be systematically excluded. Despite its prevalence and significant associated risk of major adverse cardiovascular events, patients are frequently discharged without a definitive diagnosis or a targeted management plan, reflecting therapeutic inertia driven by pathophysiological complexity. Intracoronary optical coherence tomography and intravascular ultrasound identify culprit coronary mechanisms, including plaque disruption, spontaneous coronary artery dissection, and thrombus, in a substantial proportion of cases invisible to conventional angiography. Invasive functional coronary angiography with provocative vasomotor testing identifies epicardial and microvascular spasm as primary mechanisms in over half of patients tested. Cardiac magnetic resonance imaging serves as the non-invasive gold standard for myocardial tissue characterization, confirming ischemic injury, reclassifying non-ischemic mimics such as myocarditis and Takotsubo syndrome, and providing independent prognostic information. Combining these modalities identifies a specific etiology in the majority of cases and directly informs mechanism-based therapy, from antiplatelet and lipid-lowering agents for plaque disruption, to calcium channel blockers for vasospasm, to conservative management for spontaneous dissection. The recently published PROMISE trial provides the first prospective, randomized evidence that a stratified, imaging-guided approach improves patient-centered outcomes compared with standard care. This review synthesizes current evidence on the diagnostic and therapeutic framework for MINOCA, aiming to guide clinicians toward a systematic, etiology-targeted, and individualized management strategy.
Is the pre-balloon inflation ECG representative of the true baseline state before percutaneous coronary angioplasty?
Mc Loughlin MJ, Brugada P
Curr Probl Cardiol · 2026 Aug · PMID 42002244 · Publisher ↗
The electrocardiogram (ECG) is widely used to assess myocardial ischemia in both clinical and research settings. In percutaneous transluminal coronary angioplasty (PTCA), it remains unclear which ECG should be regarded a...
The electrocardiogram (ECG) is widely used to assess myocardial ischemia in both clinical and research settings. In percutaneous transluminal coronary angioplasty (PTCA), it remains unclear which ECG should be regarded as the true baseline reference, because several factors, including catheter presence, contrast injection, and procedural stress may already change the pre-balloon inflation tracing. We analyzed 44 patients (24 men, 20 women; mean age 60 ± 11.8 years) from the STAFF III Physionet database who underwent PTCA. Each patient had an ECG recorded in the hospital room before the procedure. In the catheterization laboratory, a continuous ECG recording was obtained, extending from before balloon inflation to after balloon deflation. For analysis, pre-inflation ECG segments were compared with room tracings and classified into four grades of change. Differences between the room ECG and the pre-inflation ECG were found in 37 of 44 patients (84%). Changes were overt in 20 patients (45.5%) and subtle in 17 (38.6%), and no difference was observed in 7 patients (16%). Alterations included T-wave modifications as well as ST-segment shifts. Importantly, all patients demonstrated significant ischemic changes during the interval of balloon occlusion (between the pre-inflation and the pre-deflation recordings), indicating severe ischemia. These findings demonstrate that the pre-balloon inflation ECG does not consistently represent the baseline state, but rather an intermediate stage already affected by the presence of the catheter, baseline state, contrast, or procedural stress. Misinterpretation of this tracing as baseline may bias the evaluation of ischemic burden and post-angioplasty improvement. We suggest that the true baseline ECG should be defined as the resting tracing obtained outside the catheterization laboratory, before the procedure.
Management of pulmonary arterial hypertension with intermediate-high-risk pulmonary embolism during pregnancy: Diagnostic challenges, catheter-directed thrombolysis, and intravenous treprostinil - A narrative review with an institutional case snapshot.
García-Cesar M, Cueto-Robledo G, Roldan-Valadez E … +4 more , Torres-Rojas MB, Navarro-Vergara DI, Ruiz-Domínguez D, Hernandez-Villa L
Curr Probl Cardiol · 2026 Aug · PMID 41937007 · Publisher ↗
BACKGROUND: Maternal mortality from pregnancy-related pulmonary arterial hypertension (PAH) is estimated at 7-12%. The superimposition of pulmonary embolism (PE) and COVID-19 further compromises right-ventricular (RV) fu...
BACKGROUND: Maternal mortality from pregnancy-related pulmonary arterial hypertension (PAH) is estimated at 7-12%. The superimposition of pulmonary embolism (PE) and COVID-19 further compromises right-ventricular (RV) function. Pregnancy-compatible PAH pharmacotherapy and catheter-directed techniques show promise; however, their intersection remains undocumented. METHODS: We performed a narrative review of imaging diagnosis, risk stratification, catheter-directed reperfusion, PAH-targeted pharmacotherapy, and multidisciplinary peripartum management of PAH complicated by acute PE during pregnancy. MEDLINE/PubMed, Embase, Scopus, and the Cochrane Library were searched up to March 2026. We also describe an institutional case from the Hospital General de México Dr. Eduardo Liceaga (Mexico City, Mexico). RESULTS: Evidence supports echocardiography for initial assessment, CT pulmonary angiography for embolic/vascular evaluation, right-heart catheterization for hemodynamic determination, and catheter-directed thrombolysis for intermediate-high-risk PE when systemic thrombolysis is contraindicated. The institutional case describes a 17-year-old primigravida (24.6 weeks' gestation) with undiagnosed idiopathic PAH (mean pulmonary artery pressure 64 mmHg; pulmonary vascular resistance (PVR) 13.8 Wood units), intermediate-high-risk PE (thrombotic burden 37.5%), and COVID-19 pneumonia. Catheter-directed thrombolysis combined with sildenafil and intravenous treprostinil achieved substantial hemodynamic improvement (cardiac index 2.8 to 4.2 L/min/m²; PVR 13.8 to 6.7 Wood units). Elective cesarean at 37 weeks resulted in satisfactory maternal and neonatal outcomes. CONCLUSIONS: Early, multidisciplinary approaches integrating invasive hemodynamics, catheter-directed thrombolysis, and pregnancy-compatible PAH therapy can decompress RV function and allow safe pregnancy continuation. Prospective international registries and pregnancy-specific PERT pathways are urgently needed.
Beta-blocker therapy and all-cause mortality after a coronary event: A matched nested case-control study using the Victorian Cardiac Outcomes Registry linked data.
Cataldo-Miranda P, Koh HJW, Stub D … +9 more , Zoungas S, Kaye DM, Gasevic D, Brennan A, Dinh D, Lefkovits J, Nanayakkara S, Chew DP, Talic S
Curr Probl Cardiol · 2026 Aug · PMID 41937006 · Publisher ↗
AIMS: Beta-blocker therapy has traditionally been recommended following coronary events based on clinical trials involving patients with systolic dysfunction. Its survival benefit in patients with preserved left ventricu...
AIMS: Beta-blocker therapy has traditionally been recommended following coronary events based on clinical trials involving patients with systolic dysfunction. Its survival benefit in patients with preserved left ventricular ejection fraction (LVEF), is being re-examined. This study assessed the association of beta-blocker therapy prescription and all-cause mortality following a coronary event and percutaneous coronary intervention (PCI), stratified by LVEF. METHODS AND RESULTS: A state-wide nested case-control study of data from the Victorian Cardiac Outcomes Registry linked to the Australian National Death Index (2014-2022) was conducted. Adults discharged alive after PCI were stratified by LVEF: preserved (≥50%), mildly reduced (45-49%), moderately reduced (35-44%), and severely reduced (<35%). Propensity score matching and logistic regression models with cluster-robust standard errors were used to assess associations. Sensitivity analyses evaluated missing LVEF data and cardiovascular mortality at 30-days. Among 71,053 patients, 67.3% received beta-blockers. After matching, beta-blocker therapy was associated with higher odds of all-cause mortality in patients with preserved (OR 1.46, 95% CI 1.29-1.65) and mildly reduced LVEF (OR 1.48, 95% CI 1.15-1.91), with no significant benefit in moderately or severely reduced LVEF. Subgroup analyses confirmed higher odds of mortality for these LVEF groups in several clinical contexts. Sensitivity analyses supported primary findings. CONCLUSION: Beta-blocker therapy was associated with increased all-cause mortality in patients with preserved and mildly reduced LVEF, with no clear benefit in those with lower LVEF. These real-world findings support recent trials and challenge the routine prescription of beta-blocker therapy post-MI, highlighting the need for individualised treatment.
Multidimensional care in transthyretin cardiac amyloidosis: Integrating extracardiac organ involvement and comorbidity management.
Magnano R, Rossi D, Saraullo S … +9 more , Pezzi L, D'Alleva A, Scollo C, Marino MD, Genovesi E, Vitulli P, Fortuni F, Forlani D, Marco MD
Curr Probl Cardiol · 2026 Aug · PMID 41937005 · Publisher ↗
BACKGROUND: Transthyretin amyloidosis (ATTR) is a progressive multisystem disorder caused by extracellular deposition of amyloid fibrils derived from mutant (hATTR) or wild-type (ATTRwt) transthyretin. Cardiac involvemen...
BACKGROUND: Transthyretin amyloidosis (ATTR) is a progressive multisystem disorder caused by extracellular deposition of amyloid fibrils derived from mutant (hATTR) or wild-type (ATTRwt) transthyretin. Cardiac involvement is the main determinant of prognosis and typically manifests as restrictive cardiomyopathy (ATTR-CM), leading to heart failure, arrhythmias, and conduction disturbances. However, ATTR frequently extends beyond the heart, involving peripheral and autonomic neuropathy, renal impairment, gastrointestinal dysfunction, musculoskeletal manifestations, anemia, nutritional decline, and frailty, all of which significantly contribute to clinical complexity, poorer outcomes, and reduced quality of life. AIM: To highlight the clinical relevance of extracardiac organ involvement in ATTR-CM and to support a multidimensional, patient-centered approach to care. EVIDENCE SYNTHESIS / MAIN FINDINGS: The effectiveness of disease-modifying therapies is maximized when incorporated into a comprehensive care model that balances therapeutic benefit with treatment tolerance and addresses both amyloid-related systemic organ damage and coexisting cardiac and extracardiac comorbidities. Optimal management therefore requires a coordinated multidisciplinary team including cardiology, neurology, nephrology, pulmonology, nutrition, geriatrics, psychology, rehabilitation, and social support services. CONCLUSIONS: A comprehensive strategy integrating early diagnosis, systematic assessment of organ damage, frailty evaluation, and individualized therapeutic planning is essential to improve outcomes and deliver holistic, high-quality care for individuals with ATTR-CM. This review synthesizes current evidence on diagnosis and management of ATTR-CM and proposes a structured framework for evaluating and treating systemic complications associated with transthyretin amyloid disease.
Transcatheter aortic valve replacement at metropolitan teaching hospitals among patients with heart failure.
Dixit S, Anamika F, Ramphul K … +2 more , Bin Firos JR, Aneja A
Curr Probl Cardiol · 2026 Aug · PMID 41937004 · Publisher ↗
INTRODUCTION: Heart failure is highly prevalent among patients undergoing transcatheter aortic valve replacement (TAVR). Prior literature well documents an increased risk of readmission in heart failure patients undergoi...
INTRODUCTION: Heart failure is highly prevalent among patients undergoing transcatheter aortic valve replacement (TAVR). Prior literature well documents an increased risk of readmission in heart failure patients undergoing TAVR; however, data comparing clinical outcomes between heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF) in this population remain limited. METHODS: We conducted a retrospective analysis using the Nationwide Readmissions Database (NRD) from 2016 to 2022. Patients undergoing TAVR at metropolitan teaching hospitals were identified and stratified into two cohorts: HFrEF and HFpEF. The primary outcome was the 30-day all-cause readmission rate. Secondary outcomes included in-hospital complications and all-cause in-hospital mortality. RESULTS: Among 120,199 patients undergoing TAVR, 16.25% had HFrEF and 83.75% had HFpEF. The HFrEF cohort had higher baseline comorbidities, including peripheral vascular disease, prior myocardial infarction, and chronic kidney disease. After adjusting for baseline comorbidities, the HFrEF cohort experienced higher rates of in-hospital complications, including mechanical circulatory support, cardiogenic shock, acute heart failure, extracorporeal membrane oxygenation, cardiopulmonary resuscitation, acute myocardial infarction, valvular complications, mechanical ventilation, intubation, and acute kidney injury, as well as higher in-hospital mortality. The 30-day all-cause readmission rate among survivors was also higher in the HFrEF cohort (11.29% vs. 9.74%; HR: 1.142, 95% CI: 1.127-1.156; p < 0.001). CONCLUSION: HFrEF was associated with worse in-hospital and early post-discharge outcomes following TAVR compared with HFpEF. Further studies are warranted to identify targeted strategies to mitigate risk in this high-risk population.
Machine learning for detection of regional wall motion abnormalities on transthoracic echocardiography: A systematic review and meta-analysis.
Koh T, Desai R, Sivapalan K … +3 more , Lal V, Jones M, Matta MG
Curr Probl Cardiol · 2026 Jul · PMID 41895481 · Publisher ↗
BACKGROUND: Regional wall motion abnormality (RWMA) assessment is fundamental in transthoracic echocardiography (TTE) for diagnosing ischaemic heart disease, yet visual interpretation is subjective and variable. Machine-...
BACKGROUND: Regional wall motion abnormality (RWMA) assessment is fundamental in transthoracic echocardiography (TTE) for diagnosing ischaemic heart disease, yet visual interpretation is subjective and variable. Machine-learning (ML) models may offer a more objective and reproducible RWMA evaluation, but their diagnostic accuracy has not been comprehensively synthesized. OBJECTIVE: To systematically evaluate the diagnostic performance of ML algorithms for detecting RWMA on TTE. METHODS: PubMed (MEDLINE) and EMBASE were searched from inception to 7 December 2025 for studies applying ML to RWMA detection using two-dimensional TTE. The primary outcomes were C-statistics, sensitivity and specificity of ML models. RESULTS: Eight studies comprising ≈36,000 echocardiographic examinations were included. RWMA prevalence ranged from 9 % to 75 %, with ground truth definitions primarily based on expert consensus. Reported C-statistics ranged between 0.67-0.99, reflecting substantial heterogeneity (I² = 98 %). The pooled C-statistic was 0.88 (95 % CI 0.81-0.95). Internally validated models demonstrated a pooled C-statistic of 0.90 (95 % CI 0.82-0.97), and externally validated models 0.88 (95 % CI 0.84-0.92). Across studies reporting diagnostic data, pooled sensitivity and specificity were 0.83 (95 % CI 0.64-0.93) and 0.84 (95 % CI 0.75-0.91) respectively. CONCLUSIONS: ML models demonstrate good diagnostic performance for RWMA detection on TTE, approaching the accuracy of human readers in existing studies. However, marked heterogeneity, limited external validation, and methodological limitations currently restrict clinical readiness. Future research should prioritize multicentre external validation, improved reference standards, and adherence to TRIPOD-AI framework to support safe clinical integration.
Comparative effectiveness of mineralocorticoid receptor antagonists in cardiovascular, renal and metabolic disease.
Filippatos C, Kourek C, Boutsikos I … +6 more , Tepetes NI, Kostakou P, Filippatos T, Xanthopoulos A, Duque ER, Briasoulis A
Curr Probl Cardiol · 2026 Jul · PMID 41887307 · Publisher ↗
PURPOSE: Mineralocorticoid receptor antagonists (MRAs) are pivotal in managing cardiorenal disease, yet head-to-head comparisons across distinct phenotypes remain limited. This real-world study aims to compare their effe...
PURPOSE: Mineralocorticoid receptor antagonists (MRAs) are pivotal in managing cardiorenal disease, yet head-to-head comparisons across distinct phenotypes remain limited. This real-world study aims to compare their effectiveness and safety profiles in the context of cardio-renal-metabolic disease. METHODS: Using the TriNetX global health research network, adult patients initiating spironolactone, eplerenone, or finerenone (concurrent with SGLT2 inhibitors) were identified. Stratification included five cohorts: HFrEF, HFpEF, CKD, DM and non-DM. Pairwise 1:1 propensity score matching was performed. RESULTS: In patients with heart failure, finerenone was associated with a significant reduction in HF events compared to steroidal MRAs (HFrEF: HR 0.75; HFpEF: HR 0.62; p < 0.001 for both), though no significant differences were observed in overall survival or in other cardiovascular outcomes. However, it also seemed to be associated with trend of increased risk of hyperkalemia (HFrEF: HR 1.42, p = 0.103; HFpEF: HR 1.41, p = 0.057), compared to steroidal MRAs. On the other hand, in the CKD, DM, and non-DM cohorts, finerenone exhibited comprehensive superiority, significantly reducing the risk of death and the risk of cardiovascular events, compared to steroidal MRAs. Regarding safety, the non-steroidal MRA was associated with a lower risk of acute kidney injury (AKI) across CKD, DM, and non-DM phenotypes and a significantly reduced risk of hyperkalemia in CKD and non-DM patients. CONCLUSION: Finerenone appears superior for cardiorenal protection in CKD and metabolic phenotypes, whereas steroidal MRAs offer a favorable efficacy-safety balance in HF. These observations are hypothesis-generating and support phenotype-specific, individualized selection of MRAs pending validation in further prospective research.
Cardiology research in 57 OIC countries (2001-2025): Trends, impact, and collaboration patterns.
Albasheer O, Abdelmola A, Ayish DAM … +8 more , Ayish F, Sadek AES, Alessa H, Madkhali A, Hakami A, Ahmed AE, Ali S, Hassan W
Curr Probl Cardiol · 2026 Jul · PMID 41871639 · Publisher ↗
Cardiovascular diseases (CVDs) remain the leading cause of global mortality, yet disparities exist in cardiovascular research, particularly in low- and middle-income countries. This study presents a bibliometric analysis...
Cardiovascular diseases (CVDs) remain the leading cause of global mortality, yet disparities exist in cardiovascular research, particularly in low- and middle-income countries. This study presents a bibliometric analysis of cardiology research across OIC member countries from 2001 to 2025, examining productivity, impact, journal quality, and collaboration. OIC countries produced 64,299 publications, accruing 888,087 citations and 1,008,023 views. Annual publications rose from 516 in 2001 to 5,813 in 2025, an eleven-fold increase. Citation peaks occurred between 2013 and 2016, reaching 71,096 in 2016, while views peaked at 70,670 in 2020, reflecting temporal recognition trends. Journal analysis showed that mid-tier journals (Q2-Q3) hosted most publications: Q3 (35 %), Q2 (28 %), Q1 (20 %), and Q4 (17 %). Notably, Q1 and Q2 publications increased after 2015, indicating improved quality and visibility. Collaboration analysis revealed institutional (38 %) dominated, followed by national (29 %), international (28 %), and single-authored papers (6 %). International collaborations had the highest impact (29.7 citations per paper, FWCI 1.62), compared to national (8.5 citations, FWCI 0.44), institutional (7.7 citations, FWCI 0.36), and single-authored papers (4.2 citations, FWCI 0.36), highlighting the importance of cross-border partnerships. Country-level analysis showed Turkey, Iran, Egypt, Pakistan, and Saudi Arabia contributed most publications, while lower-output countries such as Algeria, Libya, Kyrgyzstan, and Azerbaijan achieved high citations per paper and FWCI. Overall, OIC cardiology research expanded substantially in quantity and visibility, yet disparities in productivity, quality, and impact persist, emphasizing the need to strengthen research capacity, promote high-quality studies, and foster international collaboration across all member countries.
Rheumatic heart disease is not over: Cardiac cirrhosis and multivalvular sequelae in an endemic setting - A case series and review.
Sethi Y, Yadav ND, Singhal S … +7 more , Singh AP, Singh A, Agarwal S, Sharma A, Pavlovic C, Pavlovic T, Mehta S
Curr Probl Cardiol · 2026 Jul · PMID 41864251 · Publisher ↗
BACKGROUND: Rheumatic Heart Disease (RHD) remains a major cause of valvular morbidity in endemic regions despite declining incidence in high-income countries. While early disease manifests as acute rheumatic fever, conte...
BACKGROUND: Rheumatic Heart Disease (RHD) remains a major cause of valvular morbidity in endemic regions despite declining incidence in high-income countries. While early disease manifests as acute rheumatic fever, contemporary presentations increasingly reflect advanced structural sequelae. Congestive hepatopathy and cardiac cirrhosis secondary to chronic right-sided failure remain under-recognized manifestations of advanced rheumatic valvular disease. OBJECTIVES: To describe three cases of advanced rheumatic multivalvular disease presenting predominantly with ascites and hepatic congestion and to integrate these observations with current literature on pulmonary hypertension, right ventricular remodeling, and cardiac cirrhosis. METHODS: We conducted a retrospective case series at a tertiary referral center in North-India. Inclusion criteria comprised adult patients with echocardiographically confirmed rheumatic valvular disease, preserved left ventricular ejection fraction (≥50%), right-sided heart failure manifestations, and evidence of congestive hepatopathy. Comprehensive clinical, echocardiographic, laboratory, and hepatic Doppler assessments were performed. A structured literature review contextualized the findings. RESULTS: Three middle-aged women (46-52 years) presented with progressive dyspnea and tense ascites. All demonstrated severe left-sided rheumatic lesions (mitral stenosis or regurgitation), severe functional tricuspid regurgitation, pulmonary hypertension (PASP 55-64 mmHg), and preserved left ventricular systolic function (LVEF 58-62%). Marked left atrial enlargement (indexed volume 68-82 mL/m²) and varying degrees of right ventricular dysfunction (TAPSE 13-16 mm) were observed. High serum-ascites albumin gradients and hepatic Doppler abnormalities confirmed post-sinusoidal portal hypertension consistent with stage II-III congestive hepatopathy. All patients responded to diuretic therapy but were unsuitable for percutaneous intervention due to advanced rheumatic morphology and were referred for surgical valve replacement and tricuspid repair.
Pharmacologic rhythm control for atrial fibrillation with dronedarone versus sotalol in patients with and without heart failure.
Augusto SN, Kaelber DC, Kanj M … +2 more , Nakhla S, Tang WHW
Curr Probl Cardiol · 2026 Jul · PMID 41864250 · Full text
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Predicting major adverse cardiac events using radiomics models on coronary computed tomography angiography: A systematic review and meta-analysis.
Ramos JVO, Fernandes JVA, de Melo MDT
Curr Probl Cardiol · 2026 Jul · PMID 41861868 · Publisher ↗
INTRODUCTION: Cardiovascular diseases remain a leading cause of morbidity and mortality worldwide, necessitating advanced diagnostic tools for risk stratification. Coronary computed tomography angiography (CCTA) combined...
INTRODUCTION: Cardiovascular diseases remain a leading cause of morbidity and mortality worldwide, necessitating advanced diagnostic tools for risk stratification. Coronary computed tomography angiography (CCTA) combined with radiomics-a computational method extracting quantitative features from medical images-has emerged as a promising approach to predict major adverse cardiac events (MACEs) in patients who underwent CCTA for suspected coronary lesions. OBJECTIVES: This systematic review and meta-analysis aimed to evaluate the diagnostic performance of radiomics-based models derived from CCTA for predicting MACEs. METHODOLOGY: We conducted a comprehensive literature search across PubMed, Embase, and Cochrane Central. The main outcome was pooled MACEs predictability estimates, measured by pooled area under the curve (AUC), hazard ratios (HRs) and C-statistics. Subgroup analyses explored performance by radiomic features (e.g., pericoronary adipose tissue [PCAT]) and patient populations. Methodological quality was assessed by using the METRICS tool. RESULTS: Eleven studies meeting inclusion criteria were analyzed. The pooled AUC for radiomics models was 0.800 (95% CI: 0.732-0.868; I² = 75.1%). PCAT-based models showed lower consistency (AUC: 0.777, I² = 80.7%) compared to non-PCAT models (AUC: 0.859, I² = 0%). Subgroup analyses revealed AUCs of 0.754 for coronary artery disease (CAD), 0.901 for suspected/confirmed CAD. Univariate HR was 2.54 (95% CI: 2.00-3.24), while multivariate HR was 1.34 (95% CI: 1.04-1.72). Overall, the average METRICS total score was 70.32% ± 14.20%. CONCLUSIONS: Radiomics-based CCTA models demonstrate robust performance for MACE prediction, with variability tied to feature selection and patient populations. These findings highlight radiomics' potential to enhance risk stratification and guide personalized interventions.
Sex-based differences in mitral and tricuspid valve disease in the era of transcatheter therapies: a contemporary review.
Oletu H, Irivbogbe OA, Akhtar Y
Curr Probl Cardiol · 2026 Jul · PMID 41861867 · Publisher ↗
Sex-based differences in cardiovascular disease are well recognized; however, their implications in valvular heart disease (VHD), particularly mitral and tricuspid valve disorders, remain incompletely understood. As tran...
Sex-based differences in cardiovascular disease are well recognized; however, their implications in valvular heart disease (VHD), particularly mitral and tricuspid valve disorders, remain incompletely understood. As transcatheter therapies for structural heart disease rapidly expand, understanding how biological sex influences disease presentation, diagnostic evaluation, and procedural outcomes has become increasingly important. This review summarizes current evidence on sex-related differences in the epidemiology, pathophysiology, imaging assessment, and management of mitral and tricuspid valve disease in the era of transcatheter interventions. Women have a higher prevalence of mitral and tricuspid valve disease and often present with smaller cardiac chamber dimensions, distinct valvular morphology, and different patterns of ventricular remodeling compared with men. These differences may influence disease severity assessment, timing of intervention, and procedural outcomes. Multimodality imaging-including echocardiography, cardiac magnetic resonance, and cardiac computed tomography-plays a key role in identifying anatomical and functional variations that may contribute to these disparities. Despite increasing use of transcatheter mitral and tricuspid interventions, women remain underrepresented in clinical trials and registries, limiting the development of sex-specific treatment strategies. Available data suggest comparable procedural success across sexes, although disparities in complications, symptom burden, and referral patterns persist. Addressing these gaps through equitable trial enrollment, sex-specific imaging thresholds, and mechanistic research will be essential to advancing personalized and equitable care for patients with valvular heart disease.
Cardiac rehabilitation in overweight and obese patients: Challenges, strategies, and the role of emerging anti-obesity therapies.
De Luca M, Modestino MR, Alsergani A … +6 more , Gabriele M, Galzerano D, Mallardo M, Saldamarco L, Bossone E, Cittadini A
Curr Probl Cardiol · 2026 Jul · PMID 41802482 · Publisher ↗
Overweight and obesity are highly prevalent among patients with cardiovascular disease and are associated with reduced functional capacity, increased cardiometabolic risk, and worse clinical outcomes. Cardiac rehabilitat...
Overweight and obesity are highly prevalent among patients with cardiovascular disease and are associated with reduced functional capacity, increased cardiometabolic risk, and worse clinical outcomes. Cardiac rehabilitation (CR) is a cornerstone of secondary prevention, yet its implementation and optimization in patients with obesity remain challenging. This review summarizes current evidence on the role and effectiveness of CR in overweight and obese individuals, focusing on clinical outcomes, participation barriers, tailored intervention strategies, and the emerging role of anti-obesity pharmacotherapies. Available data show that CR significantly improves functional capacity, cardiovascular risk factors, and quality of life in patients with obesity, although weight loss during CR is generally modest and heterogeneous. Importantly, improvements in cardiorespiratory fitness and physical activity-rather than weight reduction alone-appear to be the main drivers of prognostic benefit and help explain the attenuation of the obesity paradox after adjustment for fitness. Patients with obesity face multiple barriers to CR participation and adherence, including musculoskeletal limitations, comorbidities, psychological factors, and structural constraints, and remain underrepresented in clinical trials. Tailored CR programs integrating individualized exercise prescription, nutritional and behavioral support, and extended follow-up show short-term benefits, but long-term weight maintenance remains difficult. Novel incretin-based and multi-agonist anti-obesity agents produce substantial weight loss and cardiometabolic improvements and may enhance CR participation and outcomes, although potential effects on lean mass and muscle function warrant careful monitoring. A personalized, fitness-centered, multidisciplinary CR model that integrates exercise training, lifestyle intervention, body composition assessment, and selected pharmacotherapy may optimize long-term results beyond weight loss alone.
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