Khairunnisa AR, Huang W, Fathoni MI
… +2 more, Samban SA, Retnoningrum IA
Future Cardiol
· 2026 Feb · PMID 41351281
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BACKGROUND: The link between birth weight and heart failure risk remains inconclusive. This study evaluates the relationship between birth weight categories and heart failure incidence in adults. METHODS: A systematic se...BACKGROUND: The link between birth weight and heart failure risk remains inconclusive. This study evaluates the relationship between birth weight categories and heart failure incidence in adults. METHODS: A systematic search was done on PubMed, Scopus, and Cochrane up to June 2024 included observational studies on adults Birth weight was categorized as low (0.9-3.38 kg), normal (3.38-4.00 kg), and high (≥4.00 kg). Heart failure incidence was analyzed using pooled hazard ratios (HR) with a random-effects model (95% CI). RESULTS: A total of four studies with 302,363 adults, with an average follow-up of 20.7 years, were included. Among participants, 3978 heart failure cases were identified, and 9.46% also had hypertension as a risk factor. In the pooled analysis of multivariate studies, individuals with low birth weight was associated with a 26% higher risk of heart failure (HR 1.26, 95% CI [1.17, 1.36], I = 2%, < 0.00001), compared to those with normal birth weight. In contrast, high birth weight did not show asignificant association with heart failure risk (HR 1.13, 95% CI [0.99, 1.29], I = 20%, = 0.08). Sensitivity analysis excluding a male-only study also showed no significant results ( > 0.05). No publication bias was found based on funnel plot assessment. CONCLUSIONS: Low birth weight is significantly associated with an increased risk of heart failure, highlighting the importance of recognizing birth weight history for early prevention efforts. https://www.crd.york.ac.uk/prospero identifier is CRD42024570800.
Sabati A, Alaeddine M, Quinones-Carrasquillo S
… +2 more, Almasarweh S, Bhat D
Future Cardiol
· 2025 Dec · PMID 41346285
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The Superior cavopulmonary connection (SCPC) is typically the second stage of the single ventricle palliation. There are modifiable factors that have a complex interplay in determining outcomes such as mortality or hospi...The Superior cavopulmonary connection (SCPC) is typically the second stage of the single ventricle palliation. There are modifiable factors that have a complex interplay in determining outcomes such as mortality or hospital length of stay. There is no clear consensus on the timing of SCPC as this involves a critical balance between the timing of operation and the length of the high-risk interstage period. Younger age has not been associated with reduced transplant-free survival but has been associated with longer hospital length of stay. Another critical decision is for children with viral respiratory infections; a patient with a symptomatic viral respiratory infection may need to be delayed for weeks but this extends time in the interstage. While age is an important consideration, weight-for-age-Z-score and rate of weight gain are also critical factors in reduced transplant-free survival with those poor weight gain. Atrioventricular valve regurgitation, pulmonary artery obstruction and arch obstruction can all impact outcomes of SCPC. A systematic approach to pre-operative evaluation can identify these residual lesions to individualize the approach and optimize outcomes of single ventricle palliation.
Doneva JG, Valkov VD, Donev IS
… +6 more, Atanasov AA, Sabit ZA, Sirakov IN, Kashlov YK, Stoyanova LI, Hadjiolova RT
Future Cardiol
· 2025 Dec · PMID 41332245
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BACKGROUND: Heart failure (HF) and ST-elevation myocardial infarction (STEMI) are the major causes of morbidity and mortality worldwide. Recent evidence indicates that long noncoding RNAs (lncRNAs) participate in cardiac...BACKGROUND: Heart failure (HF) and ST-elevation myocardial infarction (STEMI) are the major causes of morbidity and mortality worldwide. Recent evidence indicates that long noncoding RNAs (lncRNAs) participate in cardiac fibrosis, which develops to varying degrees in these conditions. PATIENTS AND METHODS: This retrospective study analyzed the plasma expression levels of lncRNA Wisper using RT-qPCR in 28 patients with HF (NYHA class III - IV, reduced ejection fraction), 37 patients with STEMI, and 15 healthy controls. Diagnostic accuracy was assessed using receiver operating characteristic (ROC) curve analysis, and correlations with clinical parameters were evaluated. RESULTS AND CONCLUSIONS: Patients with HF and STEMI showed significantly higher plasma Wisper expression than that of controls ( = 0.021 and = 0.03, respectively), with no significant difference between the HF and STEMI groups ( = 1.0). In patients with HF, Wisper expression negatively correlated with age (rho = -0.452, = 0.016). ROC analysis demonstrated good discriminatory power of Wisper in distinguishing HF (AUC = 0.783, 95% CI: 0.648-0.919, = 0.002) and STEMI (AUC = 0.780, 95% CI: 0.658-0.903, = 0.002) from controls. The elevated plasma expression of Wisper in patients with HF and STEMI suggests its potential role as a circulating biomarker of cardiac fibrosis.
Future Cardiol
· 2025 Dec · PMID 41311328
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Transthyretin amyloid cardiomyopathy (ATTR-CM) has long been considered a rare and inexorably fatal condition. However, advances in noninvasive diagnosis, disease awareness, and available treatments have enabled diagnosi...Transthyretin amyloid cardiomyopathy (ATTR-CM) has long been considered a rare and inexorably fatal condition. However, advances in noninvasive diagnosis, disease awareness, and available treatments have enabled diagnosis in asymptomatic stages, before development of clinical heart failure (HF). The emerging entity of asymptomatic ATTR-CM presents both challenges and new opportunities for improving patient care. Data remain limited, as asymptomatic patients have been excluded from clinical trials, and their management currently relies on empirical judgment. Understanding the natural history of asymptomatic ATTR-CM is essential for guiding individualized clinical decisions at the patient level and for designing future clinical trials in this population. While these patients do not exhibit overt HF, recent evidence suggests that a subset may experience disease progression and develop significant morbidity and mortality within a relatively short time. This review explores the rapidly evolving landscape of asymptomatic ATTR-CM with regard to diagnostic pathways, phenotypic variability, natural history, and prognostic stratification. It also discusses current barriers encountered in clinical practice for timely diagnosis, the clinical role of imaging and biomarkers, and potential indications for early therapeutic interventions in this under-recognized population, which is projected to exponentially increase in the coming years.
Leiva O, DeCara JM, Yang EH
… +3 more, Gozdecki L, Kanelidis A, Swat S
Future Cardiol
· 2025 Dec · PMID 41292504
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Despite advancements in treatment, cancer and cardiovascular disease remain the leading causes of morbidity and mortality in developed nations. Cancer therapies have led to improved cancer-specific outcomes at the potent...Despite advancements in treatment, cancer and cardiovascular disease remain the leading causes of morbidity and mortality in developed nations. Cancer therapies have led to improved cancer-specific outcomes at the potential risk of cardiotoxicity. Additionally, basic and translational research have demonstrated a common shared pathophysiology of cancer and cardiovascular disease. Recent clinical research has suggested a potential role of repurposing cancer and cardiovascular medications for the treatment of each other. This narrative review aims to review and examine current literature of repurposing cancer and cardiovascular drugs via exploitation of off-target effects to benefit each condition. A better understanding of underlying pathophysiologic effects of these off-target mechanisms of action may aid in identifying novel therapeutics for both cancer and cardiovascular disease.
Future Cardiol
· 2025 Dec · PMID 41277773
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BACKGROUND: Patients on maintenance hemodialysis (HD) face high cardiovascular (CV) mortality risk. Although electrocardiograms (ECGs) are routinely performed, the prognostic significance of chronic ECG abnormalities in...BACKGROUND: Patients on maintenance hemodialysis (HD) face high cardiovascular (CV) mortality risk. Although electrocardiograms (ECGs) are routinely performed, the prognostic significance of chronic ECG abnormalities in predicting mortality among HD patients remains unclear. METHODS: We retrospectively analyzed patients with kidney failure receiving maintenance HD at a single center between January 2000 and March 2022. ECGs obtained within two years of the end of follow-up were independently reviewed by two physicians. Multivariable logistic regression was used to identify predictors of mortality, integrating clinical and ECG parameters. Model performance was assessed using calibration and discrimination statistics. RESULTS: Of 291 records, 149 were included (mean age 67.1 ± 13.2 years; 64.4% male; median dialysis vintage 47 months [IQR 25-87]). Common comorbidities included hypertension (90%), diabetes (54.4%), and coronary artery disease (42.4%). Frequent ECG findings were ST depression (33.8%), left axis deviation (32.9%), and poor R-wave progression (26.4%), with sinus rhythm in 94%. Overall mortality was 55%, including31.7% sudden cardiac deaths. The final model showed good calibration and excellent discrimination (AUC 0.80 ± 0.04, < 0.001). CONCLUSION: ECG abnormalities enhance mortality risk prediction in HD patients and should be validated in larger prospective cohorts.
Sheffeh MA, Asnani H, Oujamaa I
… +6 more, Harmouch KM, Turkmani M, Sheffeh J, Basit J, AlJaroudi W, Alraies MC
Future Cardiol
· 2025 Dec · PMID 41255017
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BACKGROUND: Data on outcomes of surgical pulmonary valve replacement or repair (SPVR/SPVr) in patients with heart failure (HF) are limited. We aimed to assess the safety and complications of SPVR/SPVr in this population....BACKGROUND: Data on outcomes of surgical pulmonary valve replacement or repair (SPVR/SPVr) in patients with heart failure (HF) are limited. We aimed to assess the safety and complications of SPVR/SPVr in this population. METHODS: Adults (≥18 years) who underwent SPVR/SPVr between 2018-2021 were identified from the National Inpatient Sample. Patients were stratified by HF status. In-hospital outcomes included mortality, cardiac arrest, cardiogenic shock, mechanical ventilation (MV), vasopressor use, heart block, permanent pacemaker (PPM), ECMO, bleeding, and acute kidney injury (AKI). Propensity score matching was performed to adjust for comorbidities, hospital factors, income, and elective status. Logistic regression was used to assess associations between HF and outcomes. RESULTS: There were 4595 SPVR/SPVr; the median age was 35 (26-52). Patients with heart failure had an increased risk of mortality, odds ratio (OR) 3.42 (95% confidence interval [CI] 1.19-6.12); p-value < 0.0001, heart block 1.75 (1.45-2.13); < 0.0001, bleeding 1.31 (1.12-1.52); 0.0005, AKI 1.35 (1.12-1.61); 0.001, vasopressor use 1.33 (1.08-1.65); 0.007, cardiogenic shock 2.34 (1.87-2.93); < 0.0001, MV 1.45 (1.09-1.94); 0.01, in-hospital cardiac arrest 2.29 (1.35-3.91); 0.002, ECMO 2.23 (1.43-3.45); 0.0003. No significant difference in PPM 1.51 (0.85-2.67); 0.1. CONCLUSION: Heart failure is associated with worse in-hospital outcomes following surgical pulmonic valve replacement or repair. Preoperative optimization and considering earlier surgical intervention may improve outcomes in this high-risk population.
Chen YC, Zhan B, Fu FQ
… +3 more, Cao J, Chen YF, Ding HB
Future Cardiol
· 2025 Nov · PMID 41254950
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BACKGROUND: Endothelial dysfunction drives infective endocarditis (IE) pathogenesis, yet prognostic biomarkers for critically ill IE patients remain scarce. We assessed the Endothelial Activation and Stress Index (EASIX)...BACKGROUND: Endothelial dysfunction drives infective endocarditis (IE) pathogenesis, yet prognostic biomarkers for critically ill IE patients remain scarce. We assessed the Endothelial Activation and Stress Index (EASIX) for mortality prediction in this population. METHODS: Using MIMIC-IV, 298 adult IE patients were analyzed. Cox regression and Kaplan-Meier survival analyses evaluated EASIX-mortality associations. Restricted cubic splines tested nonlinearity. Subgroup and interaction analyses were conducted to identify potential effect modifiers. RESULTS: In 298 critically ill IE patients, multivariable regression revealed that the highest EASIX tertile (T3) was associated with increased mortality risk at 28 days (HR 2.56, 95% CI 1.19-5.53) and 180 days (HR 2.12, 95% CI 1.17-3.85). Kaplan-Meier survival curves and restricted cubic splines corroborated these findings. Moreover, subgroup analyses demonstrated generally consistent results across predefined strata. CONCLUSIONS: EASIX strongly predicts short- and long-term mortality in critically ill IE patients, with immediate clinical utility for risk stratification using routine labs.
Future Cardiol
· 2025 Nov · PMID 41208313
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Inflammatory bowel disease (IBD) has emerged as a significant risk factor for cardiovascular disease (CVD). Despite shared pathophysiological mechanisms including chronic inflammation, immune dysregulation, and endotheli...Inflammatory bowel disease (IBD) has emerged as a significant risk factor for cardiovascular disease (CVD). Despite shared pathophysiological mechanisms including chronic inflammation, immune dysregulation, and endothelial dysfunction, the relationship between IBD and cardiovascular outcomes remains incompletely characterized. This review provides updated evidence on the association between IBD and major cardiovascular events (ischemic heart diseases, stroke, and heart failure), examining epidemiological findings, underlying mechanisms, and the impact of therapeutic interventions on cardiovascular risk. These findings support the need for cardiovascular risk stratification in IBD management and highlight the importance of achieving sustained remission while considering the cardiovascular effects of therapeutic interventions.
Future Cardiol
· 2025 Dec · PMID 41105724
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Left atrial appendage closure (LAAC) during cardiac surgery is a pivotal strategy for stroke prevention in atrial fibrillation (AF), gaining recognition in guidelines (Class I AHA 2023, Class IIa ESC 2024). This review i...Left atrial appendage closure (LAAC) during cardiac surgery is a pivotal strategy for stroke prevention in atrial fibrillation (AF), gaining recognition in guidelines (Class I AHA 2023, Class IIa ESC 2024). This review identifies critical challenges and proposes solutions for optimizing outcomes. Challenges 1) Patient Selection: Significant controversy exists regarding extending LAAC to high-stroke-risk patients without documented AF ;(CHA₂DS₂-VASc ≥2), where 50% of post-cardiac surgery strokes occur, creating an evidence-practice gap. Conflicting meta-analyses exist (Baudo et al. vs. Kowalewski et al.). 2) Technique Standardization: Marked heterogeneity in surgical techniques (suture, excision, stapling) and lack of standardized protocols lead to highly variable success rates (0%-100%), unlike standardized clipping (AtriClip®; > 93% success). 3)Post-procedural Management: Unresolved debates persist on optimal post-surgical antithrombotic regimens and the standalone efficacy of LAAC vs. anticoagulation. Solutions 1) Ongoing RCTs (LeAAPS, LAA-CLOSURE, LAACS-2) aim to define LAAC efficacy in non-AF populations. 2) Implement evidence-based standardized operating procedures (SOPs) for each technique, prioritizing validated clipping devices. Promote unified imaging criteria (transesophageal echocardiography(TEE) intra-operation, Cardiac Computed Tomography Angiography(CCTA) follow-up) per AHA 2023 guidelines. 3) The LAA-CLIP trial is evaluating thoracoscopic clipping vs. DOACs, potentially supporting anticoagulation simplification post-LAAC. Addressing these challenges through standardization and targeted trials is crucial for maximizing LAAC efficacy.
Olariu ME, Burlacu A, Brinza C
… +1 more, Iftene A
Future Cardiol
· 2025 Nov · PMID 41074629
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The European Society of Cardiology (ESC) guidelines provide detailed, evidence-based recommendations for managing cardiovascular diseases. However, their complexity and frequent updates can make them challenging to apply...The European Society of Cardiology (ESC) guidelines provide detailed, evidence-based recommendations for managing cardiovascular diseases. However, their complexity and frequent updates can make them challenging to apply consistently in clinical settings. Artificial intelligence (AI), particularly large language models (LLMs), offers a novel solution by assisting in the interpretation and application of these guidelines more effectively. A narrative review was conducted to assess the role of large language models (LLMs) and related artificial intelligence (AI) systems in supporting the interpretation of ESC guidelines. From 102 records screened, seven studies met the inclusion criteria. Clinical Decision Support Systems (CDSSs) built on ESC guidelines demonstrated improvements in diagnostic accuracy and standardization. Comparative studies revealed that large language models (LLMs), including ChatGPT-4, showed high concordance with expert clinical decisions (up to 86% accuracy for acute coronary syndrome-related questions). Emerging tools, such as MedDoc-Bot, have highlighted the feasibility of direct ESC guideline interpretation by LLMs. LLMs show promise in enhancing clinician understanding and application of ESC guidelines. Although performance is encouraging, further validation and thoughtful integration into clinical practice are necessary to maximize their utility and safety.
Schoettler FI, Fatehi Hassanabad M, Webb NA
… +4 more, Clark J, Gotto G, Kidd WT, Fatehi Hassanabad A
Future Cardiol
· 2025 Nov · PMID 41071013
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Urothelial carcinoma (UC) rarely presents with an inferior vena cava (IVC) tumor thrombus. Herein, we report the case of a patient with UC in whom the thrombus embolized to the right atrium during resection. Intraoperati...Urothelial carcinoma (UC) rarely presents with an inferior vena cava (IVC) tumor thrombus. Herein, we report the case of a patient with UC in whom the thrombus embolized to the right atrium during resection. Intraoperative echocardiography identified the large embolus measuring greater than 4 cm and prolapsing through the tricuspid valve. The tumor thrombus was removed via sternotomy. This case is significant for the following learning points: 1) tumor thrombus should be managed with care during removal as it can embolize; 2) intraoperative transesophageal echocardiography is vital in these cases; and 3) a multidisciplinary approach including cardiac surgery is imperative to ensure optimal outcomes.