Current Problems In Cardiology[JOURNAL]
Sun
200 papers
Correlation across modalities and clinical phenotypes between left Ventricular global longitudinal strain by echocardiography and cardiac magnetic resonance.
Pascalis L, Fazzini L, Pugliesi GM … +2 more , Restivo L, Cadeddu Dessalvi C
Curr Probl Cardiol · 2026 Jul · PMID 41802481 · Publisher ↗
BACKGROUND: Left Ventricular global longitudinal strain (LV-GLS) can be measured by speckle-tracking echocardiography (STE) and by cardiac magnetic resonance feature tracking (CMR-FT), but the strength of cross-modal cor...
BACKGROUND: Left Ventricular global longitudinal strain (LV-GLS) can be measured by speckle-tracking echocardiography (STE) and by cardiac magnetic resonance feature tracking (CMR-FT), but the strength of cross-modal correlation and its consistency across clinical phenotypes remain uncertain. METHODS: We performed a systematic review and meta-analysis of studies reporting LV-GLS by both STE and CMR-FT in the same cohorts. Reported patient-level correlation coefficients (Pearson r) between modalities were pooled using Fisher's z-transformation and random-effects models, with prespecified subgroup analyses for healthy cohorts and cohorts with cardiovascular disease (CD). RESULTS: Eleven studies met inclusion criteria; 18 cohorts (n = 624) reported patient-level correlations and were analyzed. Overall, STE GLS and CMR-FT GLS showed a moderate pooled correlation (sample-size-weighted r = 0.57; 95 % CI 0.32 to 0.74) with substantial heterogeneity (I = 91.6 %). In healthy cohorts (5 cohorts; n = 87) correlation was low and not statistically significant (r = 0.38; 95 % CI -0.37 to 0.83). In CD cohorts (13 cohorts; n = 537), correlation was higher and statistically significant (r = 0.62; 95 % CI 0.38 to 0.78). CONCLUSIONS: STE and CMR-FT GLS show a moderate cross-modal correlation overall, which is attenuated in health and stronger in CD. These findings quantify association rather than individual-level agreement and do not support numerical interchangeability between modalities.
VEXUS protocol as a prognostic tool in acute heart failure: A systematic review and Bayesian meta-analysis.
Chaves VB, Barbosa LM, Oliveira VMR … +6 more , de Almeida VP, Silva RP, Maciel LG, Gomes MFCF, Zawam Y, Nunes MDCP
Curr Probl Cardiol · 2026 Jun · PMID 41747972 · Publisher ↗
BACKGROUND: Systemic venous congestion is a key determinant of prognosis in acute heart failure (AHF). The Venous Excess Ultrasound (VExUS) score has emerged as a bedside tool to assess congestion, but its prognostic val...
BACKGROUND: Systemic venous congestion is a key determinant of prognosis in acute heart failure (AHF). The Venous Excess Ultrasound (VExUS) score has emerged as a bedside tool to assess congestion, but its prognostic value in AHF remains uncertain. We aimed to evaluate the association between VExUS and in-hospital mortality in patients hospitalized with AHF. METHODS: PubMed, Embase, and the Cochrane Library were searched for studies assessing the prognostic value of VExUS in AHF. Patients with VExUS ≤1 were compared to those with VExUS ≥2 for the primary endpoint of in-hospital mortality. A Bayesian random-effects meta-analysis estimated marginal posterior distributions for overall effect and heterogeneity. RESULTS: Five studies including 565 patients were analyzed, most with VExUS grade 3 and reduced ejection fraction. In-hospital mortality occurred in 1.9% of patients with VExUS ≤1 (4/210) and in 14.1% with VExUS ≥2 (50/355), corresponding to a mean odds ratio of 0.175 (95% CrI: 0.061-0.497). The posterior probability of an association (OR<1) was 99.91%, and of a clinically relevant effect (OR<0.8) was 99.93%. The predictive distribution showed a 95% probability that the true odds ratio in a future study would range from 0.045 to 0.681. Sensitivity analyses using weakly informative and vague priors yielded consistent results. CONCLUSION: Lower VExUS grades were associated with reduced in-hospital mortality, supporting the role of VExUS as a bedside tool for prognostic risk stratification in acute heart failure.
Recurrent myocardial infarction: In-Hospital mortality, cardiovascular complications, and comorbidity profiles.
Singh A, Ascandar N, Lishmanov A … +2 more , Thakore S, Oyesanmi O
Curr Probl Cardiol · 2026 Jun · PMID 41747971 · Publisher ↗
IMPORTANCE: Recurrent myocardial infarction (RMI) represents a growing clinical challenge due to advances in acute myocardial infarction (AMI) management that prolong survival yet inadvertently increase the prevalence of...
IMPORTANCE: Recurrent myocardial infarction (RMI) represents a growing clinical challenge due to advances in acute myocardial infarction (AMI) management that prolong survival yet inadvertently increase the prevalence of high-risk patients with prior infarctions. Understanding the unique trajectory and complications associated with RMI is critical for improving care. OBJECTIVE: To assess the clinical outcomes, complication rates, and comorbidity burden of patients hospitalized with recurrent myocardial infarction (RMI) compared to those with first-time AMI or NSTEMI. DESIGN, SETTING, AND PARTICIPANTS: A retrospective cohort study utilizing the Nationwide Readmissions Database (2016-2022), encompassing ∼60 % of U.S. hospitalizations. Adult patients admitted for acute coronary syndrome (ACS) were stratified into RMI and non-RMI (first-time AMI/NSTEMI) cohorts. Multivariable logistic and linear regression models were applied to assess outcomes, adjusting for demographic and clinical covariates. MAIN OUTCOME AND MEASURES: Primary outcome was in-hospital mortality. Secondary outcomes included acute heart failure (unspecified, HFrEF, HFpEF), ventricular arrhythmias (ventricular fibrillation, ventricular tachycardia), cardiac arrest, cardiogenic shock, mechanical circulatory support (tMCS), use of percutaneous coronary intervention (PCI), length of stay (LOS), hospitalization cost, non-home discharge, and 30-day readmission. RESULTS: Among 5,511,658 AMI admissions, 17,413 (0.3 %) involved RMI. After adjustment, RMI was associated with increased risk of mortality (AOR 1.59, 95 % CI 1.44-1.76), cardiac arrest (AOR 1.58), cardiogenic shock (AOR 1.96), ventricular fibrillation (AOR 1.91), ventricular tachycardia (AOR 1.44), and tMCS utilization (AOR 2.16). RMI patients experienced longer LOS (+2.46 days) and incurred higher hospitalization costs (+$11,400). Comorbidities such as diabetes, late-stage kidney disease, and chronic lung disease were significantly more prevalent in RMI. CONCLUSION AND RELEVANCE: RMI is independently associated with significantly worse in-hospital outcomes and greater healthcare utilization compared to first-time AMI/NSTEMI. Enhanced risk stratification, tailored management protocols, and expanded access to advanced therapies are urgently needed to address the complex needs of this vulnerable population.
Access to obesity medicine specialists and endocrinologists for the obese population in US counties, is there a rural-urban divide?
Chuang S, Khetpal V, Lu F … +1 more , Wu WC
Curr Probl Cardiol · 2026 Jun · PMID 41730442 · Publisher ↗
Given the obesity epidemic, access to obesity specialists such as endocrinologists and obesity medicine physicians is paramount to avoid long-term complications, but geographic distribution of obesity specialists in Unit...
Given the obesity epidemic, access to obesity specialists such as endocrinologists and obesity medicine physicians is paramount to avoid long-term complications, but geographic distribution of obesity specialists in United States (US) counties with respect to obesity prevalence is unclear. A cross-sectional analysis was conducted on 3230 US counties categorized by metropolitan status using data from the US Census, CDC Atlas, and NPI registry. 240 counties were excluded due to incomplete data, yielding 2990 counties. Predictors of obesity specialists per 100 K adults with obesity was determined using regression analysis. By county, the median demographic composition was: 50.0% men, 82.3% White, and 41.6 years old. The average percentage of adults with obesity was 37.5% (SD 4.5%) and the average number of obesity specialists per 100k adults with obesity was 5.3 (SD 13.7). However, substantial variation exists by metropolitan status on the ratio of obesity specialists/100 K adults with obesity, that ranged from 29.3 (SD 27.6) in large central metro, 9.1 (SD 17.6) in fringe metro, 10.1 (SD 18.3) in medium/small metro to 2.0 (SD 7.2) in non-metro counties, P < 0.001 for trend. Approximately 70% of US counties lacked obesity specialists. Regression modeling adjusted for demographics, socioeconomic status, and total physicians per county showed nonmetropolitan status as a negative independent predictor of obesity specialist presence. With a majority of US counties lacking access to obesity specialists and nonmetropolitan status negatively predicting access, we highlight the need for more obesity specialists in those communities or the general upskilling of primary physicians to treat obesity.
The role of sex and age in response to early post-myocardial infarction cardiac rehabilitation.
Popiolek-Kalisz J, Rabiej-Krzys P
Curr Probl Cardiol · 2026 Jun · PMID 41722832 · Publisher ↗
BACKGROUND: Cardiac rehabilitation (CR) is a key component of secondary prevention after myocardial infarction (MI). However, real-world effectiveness is limited by incomplete uptake and heterogeneity in participation, w...
BACKGROUND: Cardiac rehabilitation (CR) is a key component of secondary prevention after myocardial infarction (MI). However, real-world effectiveness is limited by incomplete uptake and heterogeneity in participation, with persistent disparities affecting women and older adults. METHODS: This review aimed to synthesize evidence on the role of sex and age in CR participation after MI (initiation, adherence, completion), functional and patient-reported response to CR, and clinical outcomes, and to identify actionable program implications and priority research gaps. RESULTS: Women and older patients are consistently less likely to initiate and complete CR, and these disparities persist even when referral is documented, indicating barriers beyond referral alone. Among participants, both sexes and all age strata generally improve in functional capacity, but women often enter CR with lower baseline fitness and demonstrate smaller absolute improvements in selected performance metrics. In older adults, functional benefit is commonly observed, but the magnitude and domains of improvement are strongly shaped by baseline performance, frailty-related limitations, sensory and cognitive impairment, and social support. Across broad post-MI and coronary populations, CR participation is associated with lower long-term mortality and reduced hospitalization in multiple cohorts, and recent randomized evidence in vulnerable older post-MI patients supports the clinical impact of multidomain, geriatric-informed CR on hard outcomes. CONCLUSIONS: Sex and age influence post-MI CR outcomes primarily through differential participation and vulnerability-related constraints rather than absence of benefit. Programs should incorporate sex- and age-focused pathways, including flexible and hybrid- or home-based models, psychosocial integration, and geriatric tailoring. Future studies should standardize outcome reporting and include sex-by-age interaction analyzes to distinguish access effects from true modification of rehabilitation response.
Mapping knowledge landscapes and emerging trends in AI for coronary artery disease imaging biomarkers: A bibliometric and visualization analysis.
Li M, Sun S, Liu M … +5 more , Wang N, Luo C, Sun G, Ma X, Shi D
Curr Probl Cardiol · 2026 May · PMID 41713756 · Publisher ↗
BACKGROUND: With the rapid advancement of artificial intelligence (AI) in medical imaging, its application to coronary artery disease (CAD) imaging biomarkers has become a key area of interdisciplinary research. Understa...
BACKGROUND: With the rapid advancement of artificial intelligence (AI) in medical imaging, its application to coronary artery disease (CAD) imaging biomarkers has become a key area of interdisciplinary research. Understanding the current developmental trajectory, research focus, and collaborative landscape in this field is of significant importance. OBJECTIVE: This study aimed to comprehensively assess the global research status, emerging trends, knowledge structure, and collaborative networks in the application of AI to CAD imaging biomarkers through a bibliometric and visual analysis. METHODS: Based on data from the Web of Science Core Collection (2015-2025), this study conducted a bibliometric analysis using tools such as VOSviewer, CiteSpace, and Bibliometrix. The analysis encompassed publication trends, author and institutional collaborations, national contributions, journal profiles, citation networks, keyword evolution, and interdisciplinary interactions. RESULTS: A total of 1,105 publications were included, involving 5,949 authors, 1,903 institutions, and 262 journals from 67 countries. Publication output grew rapidly, with an average annual growth rate of 58.74% during 2015-2018 and 64.33% during 2019-2022, before stabilizing at 12.67% in 2023-2025. The United States and China were the leading contributors in both publication volume and citations. Research hotspots centered on "deep learning," "machine learning," and "coronary computed tomography angiography," with keyword clustering revealing eight thematic groups, including image segmentation, radiomics, and multimodal prediction. Disciplinary analysis indicated strong links between radiology and cardiovascular systems, but limited integration with engineering and computer science. CONCLUSIONS: The field of AI for CAD imaging biomarkers is in a phase of steady growth, attracting widespread global participation. However, research collaboration remains fragmented, and interdisciplinary integration needs strengthening. Future directions may focus on advancing deep learning applications, enhancing multimodal data fusion, and promoting cross-disciplinary cooperation to translate AI tools into clinical practice.
Prognostic impact of vascular disease in patients with atrial fibrillation: The Loire Valley Atrial Fibrillation Project.
Fawzy AM, Bisson A, Lip GYH … +1 more , Fauchier L
Curr Probl Cardiol · 2026 May · PMID 41698493 · Publisher ↗
BACKGROUND: Vascular disease which comprises peripheral artery disease, significant coronary artery disease and aortic disease is associated with both an increased risk of atrial fibrillation (AF) and ischaemic stroke (I...
BACKGROUND: Vascular disease which comprises peripheral artery disease, significant coronary artery disease and aortic disease is associated with both an increased risk of atrial fibrillation (AF) and ischaemic stroke (IS) in AF patients. PURPOSE: We investigated the effect of vascular disease on the prognosis of AF patients. METHODS: In this retrospective analysis, all patients with AF were identified and classified into 2 groups depending on the presence of vascular disease. 3 patients were excluded due to missing data. Primary outcome was a composite of death, stroke and thromboembolic events. Secondary outcomes included all-cause mortality (ACM), stroke or systemic embolism (SSE), IS, haemorrhagic stroke and major bleeding. RESULTS: A total of 8962 patients were included; 3021 with vascular disease and 5941 without vascular disease and followed up over a mean period of 929±1082 days. On the univariate analysis, patients with vascular disease were at a higher risk of ACM hazard ratio (HR) 1.728 ((confidence interval (CI)1.549-1.928), SSE HR HR 1.477 (CI 1.274-1.714), IS HR 1.441 (CI 1.202-1.727), major bleeding HR 1.488 (CI 1.292-1.713) and a composite of death and SSE HR 1.643 (CI 1.489-1.812), compared to patients without vascular disease. On a multivariate analysis, after adjusting for components of the CHADSVASc score, oral anticoagulation (warfarin) use and antiplatelet use, the increased risk of ACM HR 1.460 (CI 1.285-1.658), SSE HR 1.226 (CI 1.030-1.458) and major bleeding HR 1.186 (CI 1.005-1.400) remained statistically significant but the risk of IS was no longer significant, HR 1.187 (CI 0.960-1.469). Compared to those without vascular disease, patients with vascular disease were at a lower risk of haemorrhagic strokes but this was not significant. CONCLUSION: AF patients with vascular disease are at a higher risk of ACM, SSE and major bleeding compared to patients without vascular disease, indicating that patients with this combination require careful and holistic management in terms of risk factor control and treatment of the condition. Additional research is required to further characterise the relationship between the two.
Prognostic role of invasively determined pulmonary hypertension in ambulatory patients with advanced heart failure: a prospective cohort study.
Manca P, Puglisi S, Pascalis L … +7 more , Nuzzi V, Cannata S, Raffa GM, Mulè M, Iacoviello M, Cipriani M, Lorusso R
Curr Probl Cardiol · 2026 May · PMID 41698492 · Publisher ↗
BACKGROUND: Pulmonary hypertension (PH) complicates advanced heart failure (AdvHF) and may limit access to life-saving therapies such as heart transplantation (HTx). However, the independent prognostic weight of PH in co...
BACKGROUND: Pulmonary hypertension (PH) complicates advanced heart failure (AdvHF) and may limit access to life-saving therapies such as heart transplantation (HTx). However, the independent prognostic weight of PH in contemporary cohorts of AdHF patients remains unclear. METHODS: We prospectively enrolled ambulatory patients with AdvHF referred to a tertiary center for evaluation of advanced therapies. All patients were on guideline-directed medical therapy (GDMT) and underwent a comprehensive assessment, including cardiopulmonary exercise testing, echocardiography, and right heart catheterization (RHC). PH was defined as a mean pulmonary pressure ≥20 mmHg at RHC. The primary endpoint was a composite of all-cause death/left ventricular assist device implantation/HTx. RESULTS: Among 149 patients (mean age 53±12 years, 75% male; on four-drug GDMT 75.2%), 70 (47%) had PH at baseline. During follow-up, 44 patients (29.5%) experienced the primary endpoint, with a higher event rate in the PH group (38.6% vs 21.5%). In multivariable Cox analysis, PH remained the only independent predictor of the composite endpoint (HR 3.46, 95% CI 1.08-11.05; p = 0.037). CONCLUSION: In ambulatory patients with AdvHF referred for advanced therapies, invasively confirmed PH is an independent prognostic determinant. Systematic assessment of PH should be integrated into risk stratification to optimize the timing of referral to advanced therapies.
Optimizing cardiac telerehabilitation programs: psychological, social, and implementation factors.
Micheluzzi V, Merella P, Burrai F … +5 more , Canu A, Sircana A, Marongiu B, Soro GM, Casu G
Curr Probl Cardiol · 2026 May · PMID 41690608 · Publisher ↗
BACKGROUND: Cardiac telerehabilitation (tele-CR) uses home-based or hybrid delivery to provide multidisciplinary cardiac rehabilitation reducing travel and time barriers. However, tele-CR outcomes may be influenced by en...
BACKGROUND: Cardiac telerehabilitation (tele-CR) uses home-based or hybrid delivery to provide multidisciplinary cardiac rehabilitation reducing travel and time barriers. However, tele-CR outcomes may be influenced by engagement, therapeutic relationships, and contextual and implementation constraints. This narrative review synthesizes evidence on psychological, social, and implementation factors that optimize tele-CR uptake, adherence, and effectiveness. METHODS: We conducted a targeted literature search in PubMed, Scopus, PsycINFO, and Embase (January 2021-January 2026). We included randomized and observational studies, qualitative and mixed-methods research, and systematic reviews/meta-analyses involving adults with cardiovascular disease participating in home-based, hybrid, or fully remote tele-CR. Reporting followed the Scale for the Assessment of Narrative Review Articles (SANRA). RESULTS: Tele-CR is a sociotechnical, biopsychosocial intervention in which outcomes emerge from the integration of digital tools (monitoring, feedback, interfaces), clinical workflows, and patients' everyday contexts. Self-monitoring and structured feedback can strengthen self-efficacy and habit formation when data are interpretable and linked to actionable guidance. Remote delivery can reduce non-verbal cues, but continuity may improve through routine check-ins and responsive follow-up. An equity-by-design approach tailors delivery to connectivity, privacy, health literacy, language needs, and caregiver capacity. Across studies, feasibility and acceptability were associated with usability, support, and perceived value. CONCLUSIONS: Tele-CR can broaden access to cardiac rehabilitation, but scalable benefit requires relationship-centred, equity-oriented service design. Priorities include calibrating monitoring to clinical actionability, reducing cognitive load through plain-language interfaces and structured onboarding, integrating routine mental health screening and patient-reported outcomes, supporting caregivers as end-users, and embedding implementation metrics and continuous quality improvement alongside clinical outcomes.
Takotsubo syndrome-2024: Changing trends in diagnosis and management of patients reported in the world literature.
Madias JE
Curr Probl Cardiol · 2026 May · PMID 41638538 · Publisher ↗
BACKGROUND: Increasing recognition of takotsubo syndrome (TTS) is being realized since its formal description in 1990/1991 with information provided in case reports, patient series, and multinational registries. The pres...
BACKGROUND: Increasing recognition of takotsubo syndrome (TTS) is being realized since its formal description in 1990/1991 with information provided in case reports, patient series, and multinational registries. The present study aimed at gathering all the patient reports published in the world literature in 2024 to evaluate possible changes in the diagnosis and management of TTS, as compared with TTS registries. METHODS: All the patients with TTS and granular data published in PubMed in response to the MeSH term "takotsubo" in 2024 were scrutinized with data tabulated pertaining to 85+ variables, and compared with the corresponding data deriving from the latest published reports of the InterTak, RETAKO, and GEIST TTS registries. RESULTS: The present study comprised 246 patients aged 58.2 ± 20.3, with 41 (16.7%) being male, reported from 51 countries, and were characterized by comparison with the 8,288 patients from the 3 registries, by lower rates of risk factors for CAD and cancer, very high comorbidity burden (86.2%), "physical stress"-triggered TTS (69.5% vs. 47.5%, 28.%, 35.5%, for the 3 registries, correspondingly, P = 0.00001), and higher rates of cardiogenic shock (20.7% vs 8.5%, 10.5%, and 8.1%, P = 0.00001), in-hospital mortality (6.9% vs 5.5%, 2.3%, P = 0.00001), and recurrence of TTS (7.3% vs 3.2%, P = 0.02). CONCLUSIONS: The patients with TTS published in the world literature in 2024 comprise a younger group revealing lower risks for CAD and cancer, and higher rates of comorbidity, "physical stress"-triggered TTS, in-hospital complications, mortality, and TTS recurrence, as compared to patients published heretofore.
Time to adopt a new standard method for assessing cardiac function in chemotherapy-induced cardiotoxicity in breast cancer? A systematic review and meta-analysis.
Linhares BG, Linhares DG, Vale RGS … +1 more , Gonçalves DM
Curr Probl Cardiol · 2026 May · PMID 41616961 · Publisher ↗
BACKGROUND: Anthracycline-induced cardiotoxicity is a major cause of morbidity in breast cancer survivors. Although left ventricular ejection fraction (LVEF) is the gold standard for monitoring cardiac function, it is of...
BACKGROUND: Anthracycline-induced cardiotoxicity is a major cause of morbidity in breast cancer survivors. Although left ventricular ejection fraction (LVEF) is the gold standard for monitoring cardiac function, it is often considered a late and insensitive marker of myocardial damage. New methods have emerged: global longitudinal strain (GLS) and cardiac magnetic resonance (CMR) derived parameters as potentially superior tools for detecting subclinical dysfunction. This study aimed to systematically compare the diagnostic accuracy and temporal sensitivity of GLS, LVEF, and CMR índices in the early detection of chemotherapy-induced cardiotoxicity. METHODS: A systematic review and meta-analysis of clinical studies was conducted to evaluate the outcomes and technical accuracy of the main methods for assessing cardiac function in breast cancer patients undergoing chemotherapy, using the PubMed, Web of Science, and Scopus databases. Twenty-nine studies were included in the systematic review and meta-analysis. RESULTS: The meta-analysis revealed a distinct temporal dissociation between methods. GLS detected a significant absolute reduction of 1.81% (95% CI: 1.14 - 2.49; z = 5.25, p < .001) as early as 1-3 months after treatment initiation. In contrast, LVEF showed a significant reduction of 3.59% only at mid-term follow-up (4-6 months), typically remaining within the range of clinical normality (>50%). The HSROC analysis for GLS (10 studies) demonstrated robust diagnostic performance, with an Area Under the Curve (AUC) of 0.818, a pooled sensitivity of 74.6% (95% CI: 64.8%-82.4%), and a specificity of 76.3% (95% CI: 68.2%-82.9%). CONCLUSION: Comparative analysis of data from our meta-analyses supports the recommendation of Global Longitudinal Strain (GLS) as the preferred method for screening for cardiotoxicity, over isolated assessment by Left Ventricular Ejection Fraction (LVEF).
Incidence, characteristics and long-term outcomes of peripartum cardiomyopathy: Insights from the Bergen peripartum cardiomyopathy study.
Kitsou V, Dingen H, Lunde T … +3 more , Engan B, Macsali F, Saeed S
Curr Probl Cardiol · 2026 Apr · PMID 41577158 · Publisher ↗
BACKGROUND: Peripartum cardiomyopathy (PPCM) is a rare but potentially fatal condition characterized by heart failure occurring at the end of pregnancy or within the first months after delivery in women without prior his...
BACKGROUND: Peripartum cardiomyopathy (PPCM) is a rare but potentially fatal condition characterized by heart failure occurring at the end of pregnancy or within the first months after delivery in women without prior history of structural heart disease. This single-center case-control study aimed to describe the incidence, clinical profile, echocardiographic findings and outcomes of PPCM in a West-Norwegian population. METHODS: Between 2011 and 2023, a total of 15 cases of PPCM were identified at Haukeland University Hospital. The Bergen Birth Registry was used to determine the total number of births in the same period, and to recruit 30 age-matched healthy controls. Clinical characteristics, echocardiographic data, and outcomes were collected. RESULTS: The incidence rate of PPCM was 1 in 4,182 births. Risk factors included higher pre-pregnancy body mass index (BMI) (OR 1.25) and elevated systolic blood pressure at presentation (OR 1.11). The prevalence of pre-eclampsia and primiparity was significantly higher in PPCM patients compared to controls (p < 0.01). Mean left ventricular (LV) ejection fraction increased from 35% at presentation to 58% at the 6-month follow-up (p < 0.001). There were no maternal or neonatal mortalities. Three patients required ICU treatment, but none experienced major cardiovascular events. CONCLUSIONS: The incidence of PPCM in this West-Norwegian study was relatively low. Higher pre-pregnancy BMI and elevated systolic blood pressure, both important modifiable cardiovascular risk factors, were identified as predictors of PPCM. All patients experienced successful clinical and LV function recovery. Future large collaborative studies are necessary to provide a reliable description of incidence and outcomes nationwide.
Urinary sodium-guided diuretic therapy in acute decompensated heart failure: A grade assessed systematic review and meta-analysis with trial sequential analysis.
Al-Shammari AS, Hamzah KA, Masanabadi M … +7 more , Asif M, Budhiraja M, Shafi N, Hamed BM, Kurmasha YH, Shweliya MA, Sattar Y
Curr Probl Cardiol · 2026 May · PMID 41571219 · Publisher ↗
BACKGROUND: Diuretic resistance remains a major challenge in acute decompensated heart failure (ADHF). Urinary sodium (UNa) concentration provides an early marker of loop diuretic responsiveness, yet its clinical utility...
BACKGROUND: Diuretic resistance remains a major challenge in acute decompensated heart failure (ADHF). Urinary sodium (UNa) concentration provides an early marker of loop diuretic responsiveness, yet its clinical utility remains uncertain. METHODS: We conducted a systematic review and meta-analysis (PROSPERO ID: CRD420251175306). PubMed, Embase, Scopus, and CENTRAL were searched from database inception to October 1, 2025, for studies evaluating UNa-guided diuretic titration in hospitalized ADHF patients. Primary outcomes were 24- and 48 h diuresis and natriuresis; secondary outcomes included congestion relief, renal function, length of stay, rehospitalization, and mortality. Data were pooled using random-effects models. Heterogeneity was assessed using I² and χ² statistics. Analyses were performed with the R software (version 4.4.3, meta package). Certainty of evidence was rated using the GRADE framework. RESULTS: Five studies were included (three RCTs, two observational cohorts). UNa-guided therapy significantly increased 24- and 48 h diuresis (MD = 0.59,95%CI [0.30-0.87] L; MD = 0.70 [0.37-1.03] L) and natriuresis (MD = 88 [52-124] mmol; MD = 138 [69-206] mmol; all P < 0.001). No significant differences were observed in mortality (RR = 0.99 [0.60-1.63]), rehospitalization (RR = 0.90 [0.57-1.41]), renal dysfunction, or length of stay. Safety outcomes, including hypotension, hypokalemia, and renal worsening, were similar (all P > 0.05). Certainty of evidence was moderate for natriuresis/diuresis and low for clinical outcomes. CONCLUSIONS: UNa-guided diuretic therapy enhances short-term natriuresis and diuresis without increasing adverse events but shows no proven impact on mortality, rehospitalization, or renal outcomes. Larger studies are needed to confirm its long-term benefit and feasibility.
Vascular surgery research 2001-2024: Growth, key contributors, and global inequities.
Abdelwahab SI, Taha MME, Farasani A … +8 more , Moshi JM, Sahli KA, Qadri M, Khardali A, Jeraiby M, Alarifi A, Alharbi AE, Hassan W
Curr Probl Cardiol · 2026 Apr · PMID 41571218 · Publisher ↗
This bibliometric analysis examines global vascular surgery research (2001-2024) from 64 Scopus-indexed journals. 69,487 publications were identified. The annual publications increased from 1,885 in 2001 to 4,252 in 2024...
This bibliometric analysis examines global vascular surgery research (2001-2024) from 64 Scopus-indexed journals. 69,487 publications were identified. The annual publications increased from 1,885 in 2001 to 4,252 in 2024, representing a 125.6% growth. Research output was concentrated in a core group of journals, led by Journal of Vascular Surgery (8,914 publications), Annals of Vascular Surgery (7,206), and Arteriosclerosis, Thrombosis, and Vascular Biology (7,121), underscoring their central role in shaping the field. Authorship was highly centralized, with 13 leading authors producing ≥150 publications each. The most prolific contributors were Moll, F.L. (262), Gloviczki, P. (210), and Schermerhorn, M.L. (189). Major institutional contributors included Harvard Medical School (1,520 publications), Mayo Clinic (1,010), and Massachusetts General Hospital (980). Research funding was primarily provided by public agencies, led by the National Institutes of Health (4,014 publications), the National Heart, Lung, and Blood Institute (3,698), and the U.S. Department of Health and Human Services (3,009), whereas industry support was comparatively limited. At the geographic level, the United States dominated global research with 29,422 publications, followed by Europe (27,205) and Asia (9,086), while Latin America (2,215), Australia/New Zealand (1,795), the Middle East (1,094), and Africa (456) remained underrepresented. Overall, vascular surgery research has experienced substantial global growth; however, it remains highly centralized in terms of journals, authors, institutions, and funding. Persistent regional disparities highlight the need for targeted investment, capacity building, and international collaborations to promote equitable research participation and foster worldwide advancement in vascular surgery.
Association of pre-hospital shock team implementation with outcomes in ST-segment elevation myocardial infarction patients.
Arabi A, Habib MB, Abdelghani MS … +6 more , AlAmeen O, Al-Hijji M, Alqahtani A, Arafa SE, Rafie I, Suwaidi JMSA
Curr Probl Cardiol · 2026 May · PMID 41571217 · Publisher ↗
BACKGROUND: Cardiogenic shock (CS) complicating ST-segment elevation myocardial infarction (STEMI) is associated with high mortality rates. While in-hospital shock teams have shown benefits, the impact of pre-hospital sh...
BACKGROUND: Cardiogenic shock (CS) complicating ST-segment elevation myocardial infarction (STEMI) is associated with high mortality rates. While in-hospital shock teams have shown benefits, the impact of pre-hospital shock team activation remains underexplored. METHODS: In July 2022, our high-volume primary percutaneous coronary intervention (PPCI) center serving the entire state population implemented a pre-hospital shock team. This multidisciplinary team comprises an emergency department physician, cardiac intensivist, interventional cardiologist, cardiac anesthesiologist, and extracorporeal membrane oxygenation (ECMO) specialists. Activation criteria include hypotension, tachycardia or bradycardia, acute heart failure, significant ST-elevation, ventricular arrhythmias, or elevated lactic acid levels. We compared mortality rates 18 months before and after implementation. RESULTS: Before implementation, 1,605 STEMI patients were admitted, compared to 1,735 after implementation. Of these, 217 (12%) met shock team activation criteria. Early Hospital mortality (in ED and in Cath lab) and Overall-hospital mortality rates significantly declined following implementation (1.2% vs. 0.3%, p = 0.03; and 2.1% vs. 3.3%, p = 0.02, respectively). CONCLUSION: This study suggests that pre-hospital shock team implementation is associated with a significant reduction in STEMI mortality.
National burden and future projections of hypertensive heart disease in China: a GBD 2021 analysis.
Wu R, Zhong X
Curr Probl Cardiol · 2026 Apr · PMID 41571216 · Publisher ↗
BACKGROUND: Hypertensive heart disease (HHD) remains a critical public health challenge, with increasing prevalence globally, especially in China. Research indicates that the HHD in Chin remain underexplored. METHODS: Ep...
BACKGROUND: Hypertensive heart disease (HHD) remains a critical public health challenge, with increasing prevalence globally, especially in China. Research indicates that the HHD in Chin remain underexplored. METHODS: Epidemiological data were sourced from the GBD 2021. Joinpoint analysis and decomposition analysis, have been applied to investigate the evolving patterns of the disease. Additionally, frontier analysis was utilized to estimate potential reductions in the burden of disease based on the sociodemographic index (SDI) across different stages, whereas autoregressive integrated moving average (ARIMA) models were employed to project the disease burden. RESULTS: In 2021, there were 3,912,158 prevalent cases of HHD in China, with 328,119 deaths cases and 5,589,287 disability-adjusted life years (DALYs). Analysis of the trends from 1990 to 2021 revealed increases in the number of prevalence, mortality, and DALYs. The contributions of age, period, and cohort to the disease burden varied. Frontier analysis indicated that although the Chinese SDI has improved, the disease burden trends remain inconsistent, with considerable room for reducing the age-standardized prevalence rate (ASPR). ARIMA projections suggest that while the ASPR will continue to rise, the age-standardized DALYs rate (ASDR) will decline over the next three decades. CONCLUSIONS: This study highlights the increasing burden of HHD in China, which is largely influenced by aging and population growth. The projected trends indicate a further rise in the ASPR, stressing the need for focused interventions in prevention and early diagnosis and increasing access to healthcare.
Ocular manifestations of transthyretin amyloidosis and their diagnostic value in cardiology: A comprehensive review.
Zhu Y, Gao S, Liu Q … +1 more , Shen C
Curr Probl Cardiol · 2026 Apr · PMID 41565044 · Publisher ↗
BACKGROUND: Transthyretin cardiac amyloidosis (ATTR-CM) is an increasingly recognized cause of heart failure with preserved ejection fraction (HFpEF); however, early diagnosis remains challenging. OBJECTIVE: From the per...
BACKGROUND: Transthyretin cardiac amyloidosis (ATTR-CM) is an increasingly recognized cause of heart failure with preserved ejection fraction (HFpEF); however, early diagnosis remains challenging. OBJECTIVE: From the perspective of cardiovascular physicians, this review systematically elucidates the ocular manifestations of ATTR, explores their clinical significance as early diagnostic clues, and proposes an integrated diagnostic pathway incorporating ophthalmologic assessment. CONTENT: This article focuses on the pathophysiological mechanisms and recognition criteria of characteristic ocular signs, including vitreous amyloidosis and secondary glaucoma, and constructs a multidisciplinary diagnostic workflow integrating cardiac imaging, ophthalmologic "red flags," and molecular diagnostic techniques. CONCLUSIONS: Incorporating ocular manifestations into routine cardiovascular history-taking and systematic evaluation holds significant clinical value for improving early ATTR-CM diagnosis rates and patient outcomes. Active promotion of cardiovascular-ophthalmology-neurology multidisciplinary collaboration is warranted.
Impact of disease-modifying therapies on imaging parameters in cardiac amyloidosis: A systematic review and meta-analysis.
Briasoulis A, Georgiopoulos G, Kourek C … +8 more , Patras R, Lama N, Theodorakakou F, Tepetes N, Zervas G, Androulakis E, Kastritis E, Stamatelopoulos K
Curr Probl Cardiol · 2026 Apr · PMID 41554387 · Publisher ↗
Transthyretin-mediated (ATTR) and immunoglobulin light-chain (AL) cardiac amyloidosis causes progressive myocardial dysfunction and poor prognosis. Disease-specific therapies in ATTR and anti-clonal therapies in AL cardi...
Transthyretin-mediated (ATTR) and immunoglobulin light-chain (AL) cardiac amyloidosis causes progressive myocardial dysfunction and poor prognosis. Disease-specific therapies in ATTR and anti-clonal therapies in AL cardiac amyloidosis may modify disease, but treatment-induced changes in prognostic cardiac imaging markers remain incompletely defined. We systematically searched PubMed/MEDLINE, Scopus, CINAHL, Web of Science, and EMBASE for studies reporting treatment-associated changes in global longitudinal strain (GLS), left ventricular (LV) wall thickness, and extracellular volume (ECV) assessed by echocardiography or cardiac magnetic resonance. Random-effects meta-analyses pooled mean changes. Seventeen studies met inclusion criteria. In ATTR cardiac amyloidosis, therapy with silencers or RNA-depleting agents was associated with improved GLS (pooled mean difference [MD] -0.97 %, 95 % CI -1.27 to -0.68) and reduced LV wall thickness (MD -0.72 mm, 95 % CI -1.26 to -0.17) versus no therapy, while ECV showed no significant change (MD -1.93 %, 95 % CI -15.27 to 11.41). In AL amyloidosis, complete hematologic response was linked to greater improvement than non-response in GLS (MD -1.19 %, 95 % CI -2.20 to -0.17) and LV wall thickness (MD -0.87 mm, 95 % CI -1.31 to -0.43). NMA in ATTR cardiac amyloidosis showed that patisiran (MD -1.04 %, 95 % CI -1.56 to -0.52), tafamidis (-0.91 %, -1.40 to -0.41), and vutrisiran (-0.90 %, -1.75 to -0.05) improved GLS versus placebo, compared to acoramidis. Disease-directed therapy in ATTR and hematologic response in AL cardiac amyloidosis are associated with preservation or improvement of GLS and LV wall thickness, supporting their use as surrogate endpoints for treatment monitoring.
Novel electrocardiographic criteria to determine the electrical position of the heart in baseline rhythm and in Post-TAVR left bundle branch block.
Robledo-Nolasco R, Andrade-Cuellar EN, Solis-Gómez JC … +8 more , Guillot-Castillo SY, Zamora-Diaz JJIY, Elizalde-Uribe IA, Aceves-Millan R, Maldonado-Tenesaca AP, Monroy-Jimenez MA, Acevedo-Gómez KJ, Medina-Santos FJ
Curr Probl Cardiol · 2026 Apr · PMID 41548627 · Publisher ↗
BACKGROUND: Left bundle branch block (LBBB) is a frequent complication after transcatheter aortic valve replacement (TAVR), altering ventricular activation and challenging ECG interpretation. This study sought to establi...
BACKGROUND: Left bundle branch block (LBBB) is a frequent complication after transcatheter aortic valve replacement (TAVR), altering ventricular activation and challenging ECG interpretation. This study sought to establish novel electrocardiographic criteria to define the electrical position of the heart (EPH) before and after LBBB post-TAVR. METHODS: In this single-center, retrospective study, 439 TAVR patients (2018-2023) were screened; 74 developed new LBBB. Patients with pre- and post-TAVR ECGs, without pacemaker, infiltrative disease, or baseline conduction disorders, were included. ECGs were analyzed for QRS duration, electrical axes (AQRS, AT), and patterns of concordance/discordance in leads II/III and aVL/aVF. EPH was categorized as intermediate (IEP), horizontal (HEP), or vertical (VEP) by AQRS. Morphology in leads I, aVL, V5, and V6 was also assessed. RESULTS: Among 74 patients with LBBB, 36 (48.6%) had IEP, 32 (43.2%) HEP, and 6 (8.1%) VEP. In patients without LBBB, AQRS averaged 50°±15° in IEP and -10°±20° in HEP (p < 0.0001). With LBBB, AQRS shifted to -20°±25° in IEP and -60°±30° in HEP (p < 0.0001). Positive concordance in II/III and aVL/aVF identified IEP, whereas positive discordance indicated HEP. In LBBB, negative concordance in II/III with positive discordance in aVL/aVF defined HEP, while positive discordance in II/III with positive concordance in aVL/aVF characterized IEP. CONCLUSION: Novel ECG criteria enable reliable classification of cardiac electrical position in both baseline and post-TAVR LBBB. Leftward axis deviation with LBBB often reflects intrinsic EPH rather than new pathology, enhancing interpretation and clinical decision-making.
Cardiovascular impact of neglected tropical diseases and their emergence in Europe due to new immigration patterns.
Dehkordi SR, Tso I, Gupta S … +8 more , Miranda Arboleda AF, Farina J, Bornancini N, Meghdadi A, Azanza DXC, Liblik K, García-Zamora S, Baranchuk A
Curr Probl Cardiol · 2026 Apr · PMID 41548626 · Publisher ↗
Neglected Tropical Diseases (NTDs) are a group of infectious conditions primarily affecting tropical and subtropical geographies, where the climate supports the spread of these pathogens. While traditionally uncommon in...
Neglected Tropical Diseases (NTDs) are a group of infectious conditions primarily affecting tropical and subtropical geographies, where the climate supports the spread of these pathogens. While traditionally uncommon in Europe, rising migration from endemic areas has led to an increasing presence of these diseases across the continent. Immigration patterns from various parts of the world were analyzed by referencing the Eurostat database. The four regions with the most significant inflow of immigrants were identified, and the NTDs in each of these areas were determined. These regions include Africa, Asia, Latin America, and the Middle East. This paper examines the cardiovascular manifestations of NTDs now emerging in Europe and highlights the diagnostic challenges they pose to the healthcare system.
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