Liu H, Qian SC, Zhang YY
… +17 more, Tang CB, Yue HH, Fan GL, Zhao X, Jiang YY, Huang FH, Zeng ZH, Wang W, Lu XR, Luo XK, Bai XF, Zheng XX, Xie P, Ma C, Zhao S, Zhang HJ, On the behalf of China Additive Anti-inflammatory Actions for Aortopathy and Arteriopathy (5A) and PANDA Trial Investigators
Future Cardiol
· 2025 Jun · PMID 40367062
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This multicenter randomized controlled trial evaluates the efficacy of thymosin alpha 1 (Tα1) supplementation in preventing organ dysfunction following acute type A aortic dissection (ATAAD) repair. Over 330 patients wil...This multicenter randomized controlled trial evaluates the efficacy of thymosin alpha 1 (Tα1) supplementation in preventing organ dysfunction following acute type A aortic dissection (ATAAD) repair. Over 330 patients will be equally assigned to receive either Tα1 plus standard care or placebo with standard management. The primary endpoint involves calculating the difference in mean postoperative Sequential Organ Failure Assessment (SOFA) scores between groups, measured daily from postoperative days 7. By targeting post-operative immune system imbalance, this study aims to establish a novel therapeutic approach for reducing systemic inflammatory response syndrome (SIRS)-mediated organ injury and improving long-term outcomes in this high-risk population. Results will be disseminated through peer-reviewed publications and international conferences.: ClinicalTrials.gov Registry (NCT05339529).
Bertaina M, Galluzzo A, Carbonaro C
… +6 more, Marzulli A, Calcagnile C, Sbarra P, Franchin L, Boccuzzi GG, Iannaccone M
Future Cardiol
· 2025 Jun · PMID 40350454
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This review examines the evolving role of sodium-glucose cotransporter 2 inhibitors (SGLT2i) in acute cardiac care. Originally developed as antidiabetic agents, SGLT2i have demonstrated significant and early benefits in...This review examines the evolving role of sodium-glucose cotransporter 2 inhibitors (SGLT2i) in acute cardiac care. Originally developed as antidiabetic agents, SGLT2i have demonstrated significant and early benefits in chronic heart failure by reducing hospitalizations and cardiovascular mortality across all the ejection fraction spectrum. Recent evidence now suggests that these agents may also offer advantages in acute settings, including acute decompensated heart failure (ADHF) and post - acute myocardial infarction (AMI). Several clinical trials have explored early SGLT2i initiation during hospitalization, reporting improvements in diuretic efficiency, cardiac biomarkers, and favorable remodeling, without notable safety concerns. The present review discusses the multifaceted mechanisms underlying these benefits, which include osmotic diuresis, modulation of neurohormonal activation, anti-inflammatory effects, and direct myocardial protection. Together, these actions not only facilitate decongestion and renal preservation but also enhance cardiac energetics. Current data are promising and support a pivotal role of a SGLT2i as a therapeutic strategy in the whole acute cardiac care setting for their short and long-term benefit. Future research is essential to validate these findings and refine the best patients to be treated with early SGLT2i implementation in the acute cardiac care spectrum.
Future Cardiol
· 2025 Jun · PMID 40340705
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Mitral regurgitation (MR) is the most common heart valve disease, and severe MR is associated with a poor prognosis if left untreated. Although surgical repair or replacement constitutes the standard therapy when indicat...Mitral regurgitation (MR) is the most common heart valve disease, and severe MR is associated with a poor prognosis if left untreated. Although surgical repair or replacement constitutes the standard therapy when indicated, many high-risk patients are considered ineligible for surgery. Transcatheter mitral valve replacement (TMVR) offers a less invasive alternative to conventional surgery and may also overcome some of the limitations of percutaneous repair techniques. Currently, multiple TMVR devices are undergoing clinical evaluation, showing promising results. However, challenges mainly related to the complex mitral valve anatomy along with the interaction with the left ventricular outflow tract (LVOT) have resulted in high screen failure rates among TMVR candidates. The AltaValve System features a supra-annular design, ensuring secure fixation in the left atrium above the native mitral valve annulus without anchoring mechanisms that could interfere with the left ventricle (LV). These distinctive attributes aim to address the existing TMVR limitations across a broad patient population and help to avoid complications such as LVOT obstruction, LV damage, and/or prosthesis embolization. Initial safety and feasibility data are encouraging, but a larger cohort of patients with longer follow-up will be essential to confirm the safety and efficacy of the AltaValve system.
Shaukat A, Zahoor MA, Shakeel L
… +14 more, Ijaz M, Ahmad Z, Zehra W, Ali Z, Mian MU, Munsab R, Awan Z, Fatima I, Panjwani SS, Taha M, Yousuf J, Hasanain M, Anjum MU, Larik MO
Future Cardiol
· 2025 Jun · PMID 40340567
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INTRODUCTION: Contrast-induced nephropathy (CIN) is a feared complication of angiographic procedures, resulting in a sudden decline in renal function. METHODS: PubMed, ScienceDirect, and Google Scholar were searched for...INTRODUCTION: Contrast-induced nephropathy (CIN) is a feared complication of angiographic procedures, resulting in a sudden decline in renal function. METHODS: PubMed, ScienceDirect, and Google Scholar were searched for potentially relevant articles from inception till August 2024. The meta-analysis was conducted using RevMan 5.4 with risk ratios (RR), mean differences (MD), and 95% confidence intervals (95% CI) computed. RESULTS: Ultimately, 13 studies were incorporated in the analysis. Nicorandil portrayed a significant protective effect against CIN (RR: 0.42; 95% CI: 0.33-0.54; < 0.00001). Subgroup analysis revealed the superiority of the oral administration (RR: 0.38; 95% CI: 0.28-0.50; < 0.00001). Nicorandil was also effective in reducing CIN in renal dysfunction patients (RR: 0.40; 95% CI: 0.27-0.59; < 0.00001). Blood urea nitrogen (BUN) and cystatin-C 48-hours post-procedure (MD: -0.42; 95% CI: -0.53--0.30; < 0.00001 and MD: -0.27; 95% CI: -0.51--0.02; = 0.03, respectively) were superior in the nicorandil cohort. Serum creatinine was significantly lower in patients receiving nicorandil at 24- and 72-hour intervals (MD: -3.18, MD: -4.26, and MD: -3.75, respectively). There were no increased risks of adverse events in the nicorandil cohort. CONCLUSION: Nicorandil has promising efficacy and safety in reducing the risk of CIN. However, further trials are necessary in order to validate our conclusions.
Khalid N, Afzal MA, Abdullah M
… +9 more, Haiy AU, Shamoon Y, Elkattawy S, Laghari MA, Vasudev R, Fayez SE, Rajeswaran Y, Lanier GM, Aronow W
Future Cardiol
· 2025 Jun · PMID 40324865
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BACKGROUND: Acute heart failure (AHF) is leading cause of hospitalization and mortality. Empagliflozin, a Sodium Glucose Co-transporter 2 inhibitor (SGLT-2i), has demonstrated benefits in HFrEF and HFpEF, but its role in...BACKGROUND: Acute heart failure (AHF) is leading cause of hospitalization and mortality. Empagliflozin, a Sodium Glucose Co-transporter 2 inhibitor (SGLT-2i), has demonstrated benefits in HFrEF and HFpEF, but its role in AHF remains under-explored. OBJECTIVE: Assess safety and efficacy of empagliflozin in AHF. METHODS: A systematic review and meta-analysis adhering to PRISMA 2020 guidelines was conducted. A search on 25 February 2025, identified Phase IIb and III randomized controlled trials (RCTs) involving adults with AHF from databases like Medline®, Cochrane CENTRAL, Embase, and ClinicalTrials.gov. Outcomes included all-cause mortality, HF rehospitalization, cardiovascular deaths, and serious adverse events. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Heterogeneity was assessed with I2 and Cochrane Q-statistic. RESULTS: Three RCTs ( = 824) were included. Empagliflozin reduced all-cause mortality (OR: 0.47, 95% CI: 0.29-0.78, = 0.004) and cardiovascular death (OR: 0.56, 95% CI: 0.38-0.82, = 0.003) compared to placebo. It also lowered serious adverse events risk (OR: 0.62, 95% CI: 0.44-0.87, = 0.005) without significantly increasing adverse effects such as acute kidney injury, diabetic ketoacidosis, hypotension, or urinary tract infections. Sensitivity analyses confirmed these findings. CONCLUSION: Empagliflozin reduces mortality in AHF with a favorable safety profile, highlighting need for further trials.
Fanucci V, Chauhan D, Chaudhuri NR
… +2 more, Nayak HM, Kohli U
Future Cardiol
· 2025 Jun · PMID 40321014
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Desmoplakin, encoded by (Online Mendelian Inheritance in Man [OMIM]: 125647), is a central component of desmosomes. Mutations in have been implicated in the development of arrhythmogenic cardiomyopathy (ACM) and other...Desmoplakin, encoded by (Online Mendelian Inheritance in Man [OMIM]: 125647), is a central component of desmosomes. Mutations in have been implicated in the development of arrhythmogenic cardiomyopathy (ACM) and other cutaneous conditions. We report on a rare, myocarditis-like presentation of left-dominant arrhythmogenic cardiomyopathy (LDACM) in a 16-year-old girl with a novel familial frame-shift c.4751_4752del (p.Ala1584Valfs *42, rs2113694794) mutation. The patient developed sustained ventricular tachycardia, which was controlled with amiodarone and required implantation of a dual-chamber transvenous defibrillator for sudden cardiac death (SCD) prophylaxis as her 5-year risk of adverse outcomes was estimated to be 25%. The findings in this patient highlight the importance of including ACM in the differential diagnosis for patients presenting with myocarditis, given that the sequelae of ACM include early development of heart failure (HF), ventricular arrhythmia (VA), and SCD.
Vasileios C, Giorgos F, Antonios M
… +1 more, Anna K
Future Cardiol
· 2025 Jun · PMID 40298371
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BACKGROUND AND AIMS: Transcatheter Aortic Valve Implantation (TAVI) has revolutionized the treatment of severe aortic stenosis. Although its clinical efficacy is well established, the development of new-onset left bundle...BACKGROUND AND AIMS: Transcatheter Aortic Valve Implantation (TAVI) has revolutionized the treatment of severe aortic stenosis. Although its clinical efficacy is well established, the development of new-onset left bundle branch block (LBBB) following TAVI remains a frequent and concerning complication. This study aims to develop pre-implantation predictive models for new-onset LBBB after TAVI using both conventional machine learning (ML) algorithms and Large Language Models (LLMs). METHODS: Of the 1113 patients who underwent TAVI over a 15-year period, 469 were included after excluding those with preexisting LBBB, pacing rhythm, or missing relevant data. Pre-procedural clinical parameters - such as valve type, valve size, patient demographics, and comorbidities - were analyzed. The dataset was split into training and testing sets. Several ML algorithms were employed, and performance was evaluated using accuracy, precision, and F1 score. Additionally, LLMs (GPT-3.5 and GPT-4) were assessed using Few-Shot and Chain of Thought (CoT) prompting. RESULTS: New-onset persistent LBBB occurred in 15.29% of patients. Among ML models, XGBoost performed best. GPT-4 with CoT prompting demonstrated superior predictive performance compared to both conventional ML and GPT-3.5. CONCLUSIONS: The current study establishes a predictive model leveraging pre-implantation parameters to anticipate the occurrence of new-onset left bundle branch block (LBBB) post-Transcatheter Aortic Valve Implantation (TAVI).
Sood A, Pezet C, Parul F
… +3 more, Sood A, Kalavakunta J, Gupta V
Future Cardiol
· 2025 Jun · PMID 40296529
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Atrial fibrillation increases the risk of ischemic stroke by increasing left atrial appendage thrombus formation. Previously surgically ligated atrial appendages can recanalize, which increases stroke risk. Percutaneous...Atrial fibrillation increases the risk of ischemic stroke by increasing left atrial appendage thrombus formation. Previously surgically ligated atrial appendages can recanalize, which increases stroke risk. Percutaneous ligation of such appendages is technically challenging due to altered morphology but feasible. We present a case of a successful percutaneous closure of a previously incompletely ligated atrial appendage using a WATCHMAN FLX device and discuss our approach to similar cases with challenging anatomy. Thorough pre-procedural imaging for case planning is indispensable and dictates feasibility and procedural success.
Sohail MU, Aisha E, Waqas SA
… +10 more, Saad M, Arshad MS, Ahmed A, Sohail MO, Naveed Z, Amin E, Arora S, Jawaid H, Jain A, Memon MM
Future Cardiol
· 2025 Jun · PMID 40255196
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BACKGROUND: Obesity is a critical risk factor for ischemic heart disease (IHD), affecting 42% of the U.S. population. This study examines trends in obesity-related IHD mortality among U.S. adults aged 25 and older from 1...BACKGROUND: Obesity is a critical risk factor for ischemic heart disease (IHD), affecting 42% of the U.S. population. This study examines trends in obesity-related IHD mortality among U.S. adults aged 25 and older from 1999 to 2020, using the CDC WONDER database. RESEARCH DESIGN AND METHODS: We analyzed IHD as the primary cause and obesity as a contributing factor, calculating age-adjusted (AAMRs) and crude mortality rates (CMRs) per 100,000 individuals. Joinpoint regression assessed annual percent changes (APC), stratifying by race, sex, age, and region. RESULTS: From 1999 to 2020, 139,644 obesity-related IHD deaths were recorded. AAMR rose from 1.92 to 4.69 per 100,000. Rates were higher in men (3.79) than women (2.10), with Black Americans showing the highest AAMR (4.07). Older adults (65+) had the highest CMR (5.73). Nonmetropolitan areas exhibited higher AAMRs (3.47) than metropolitan regions (2.78). States with the highest mortality included Vermont, Oklahoma, Wyoming, Wisconsin and Iowa while Alabama, Virginia, Massachusetts, Connecticut and Georgia had the lowest. CONCLUSION: The findings indicate a 2.5-fold increase in obesity-related IHD mortality, highlighting the need for targeted public health interventions and further research to address this growing public health concern.
Bui QM, Silver E, Argiro A
… +7 more, Murray S, Korty L, Silva Enciso J, Urey MA, Chi NC, Hong KN, Adler ED
Future Cardiol
· 2025 May · PMID 40200748
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BACKGROUND: Genetic testing (GT) is clinically indicated for patients with suspected inherited cardiomyopathy (CM) but is underutilized. METHODS: This single-center study included patients with CM who underwent outpatien...BACKGROUND: Genetic testing (GT) is clinically indicated for patients with suspected inherited cardiomyopathy (CM) but is underutilized. METHODS: This single-center study included patients with CM who underwent outpatient GT from 2018 to 2023. Data were collected from the medical record. RESULTS: A total of 306 patients were included, with a mean age of 62 years and were predominantly male (63%) and White (59%). Heart failure (92%) cardiologists were most likely to order testing, followed by general cardiology (5%) providers at tertiary hospital clinics (89%). The most common phenotypes were hypertrophic (30%), amyloid (29%) and dilated (21%). There were 17% of patients who had a positive test and 53% of patients who had a variant of uncertain significance. Patients with a positive family history had a significantly higher positive yield compared to those without ( < 0.01). Genetic counselors were underutilized (17%). For patients who had a positive test result, only 40% had cascade screening. CONCLUSIONS: Outpatient GT for CM was primarily ordered by heart failure cardiologists in tertiary hospital clinics. Cascade screening was low, which may reflect the limited use of genetic counselors. Further research is needed to understand implementation barriers to GT.
Cichewicz A, Jawla S, Zuchinali P
… +4 more, Akin-Fajiye M, Massierer D, Porto I, Garcia-Moll X
Future Cardiol
· 2025 May · PMID 40172192
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AIM: Atrial fibrillation is the most commonly sustained cardiac arrhythmia, increasing the risk of stroke and systemic embolic events. This systematic review and network meta-analysis (NMA) aimed to compare real-world ev...AIM: Atrial fibrillation is the most commonly sustained cardiac arrhythmia, increasing the risk of stroke and systemic embolic events. This systematic review and network meta-analysis (NMA) aimed to compare real-world evidence (RWE) on the effectiveness and safety of edoxaban with other direct oral anticoagulants (DOACs) and vitamin K antagonists (VKAs) in patients with non-valvular atrial fibrillation (NVAF) in Europe. MATERIALS & METHODS: Searches from January 2013 to December 2022 identified comparative observational studies assessing effectiveness/safety outcomes in patients with NVAF. Bayesian NMA estimated comparative effectiveness/safety of edoxaban with other DOACs and VKAs. RESULTS: The review identified 57 studies analyzing data from 24 unique databases; 33 studies were included in the base-case analyses. DOACs showed benefit over VKAs for most outcomes, of which major bleeding and all-cause mortality were most commonly reported. Edoxaban demonstrated a comparable effectiveness/safety profile to other DOACs and significantly reduced risk of major bleeding (hazard ratio [95% credible interval]: 0.67 [0.54, 0.84]) and intracranial hemorrhage (0.69 [0.51, 0.94]) versus rivaroxaban. CONCLUSION: This NMA provides valuable insights into the real-world effectiveness and safety of DOACs and VKAs in Europe, supporting clinical decision-making and adding to the existing evidence base from clinical trials.
Ciocca N, Lu H, Tzimas G
… +7 more, Maurizi N, Skalidis I, Gissler MC, Monney P, Gräni C, Ge Y, Antiochos P
Future Cardiol
· 2025 Jun · PMID 40169536
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Cardiovascular Magnetic Resonance (CMR) is a noninvasive cardiac imaging modality with an increasing number of applications in cardiovascular medicine. The growth in its clinical indications is evident from the expanding...Cardiovascular Magnetic Resonance (CMR) is a noninvasive cardiac imaging modality with an increasing number of applications in cardiovascular medicine. The growth in its clinical indications is evident from the expanding recommendations by the European Society of Cardiology (ESC). The year 2024 marked a significant milestone for CMR, as the latest ESC guidelines incorporated several novel indications for its use. This article aims to provide a concise overview of the increasing indications for CMR based on current ESC-recommendations, aiding cardiologists to identify clinical scenarios for patient referral.