Alnatour L, Mahmoud A, Awashra A
… +2 more, Na J, Chamsi-Pasha M
Methodist Debakey Cardiovasc J
· 2025 · PMID 40322622
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Immune checkpoint inhibitor (ICI)-induced myocarditis is rare but carries a high morbidity and mortality rate. While cardiac magnetic resonance imaging (CMR) is the first-line imaging modality to support diagnosis, the n...Immune checkpoint inhibitor (ICI)-induced myocarditis is rare but carries a high morbidity and mortality rate. While cardiac magnetic resonance imaging (CMR) is the first-line imaging modality to support diagnosis, the need for endomyocardial biopsy is needed in negative CMR cases.
Ganguly P, Zhu Z, Babu S
… +3 more, Shettigar N, Duarte V, Lin CH
Methodist Debakey Cardiovasc J
· 2025 · PMID 40322621
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Aortic stenosis (AS) leads to a reduced effective orifice of the aortic valve, and severity is based on obstructions in flow and velocity. In some patients, coexisting structural cardiac abnormalities that increase left...Aortic stenosis (AS) leads to a reduced effective orifice of the aortic valve, and severity is based on obstructions in flow and velocity. In some patients, coexisting structural cardiac abnormalities that increase left ventricular volume, such as patent ductus arteriosus (PDA), may complicate evaluation and management. We present the case of a patient with severe AS and unrepaired PDA and discuss the hemodynamic implications and important physiological changes resulting from the interactions between these lesions. It is important for clinicians to consider the impact of PDA closure in the evolution of AS and related symptoms.
Methodist Debakey Cardiovasc J
· 2025 · PMID 40161383
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A 30-year-old patient with end-stage chronic kidney disease presented in critical condition due to the exhaustion of vascular access options and recurrent episodes of peritonitis precluding peritoneal dialysis. A percuta...A 30-year-old patient with end-stage chronic kidney disease presented in critical condition due to the exhaustion of vascular access options and recurrent episodes of peritonitis precluding peritoneal dialysis. A percutaneous, tunneled hemodialysis catheter was successfully placed via the right internal thoracic vein, providing life-saving vascular access and enabling immediate initiation of renal replacement therapy.
Odeh NB, Farina JM, Manchen PJ
… +2 more, Sell-Dottin KA, Barrus B
Methodist Debakey Cardiovasc J
· 2025 · PMID 40123942
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We discuss the case of a 47-year-old female who presented to our institution with progressive exertional shortness of breath. Her history was notable for severe acne medicated with 100 mg oral daily minocycline for 2 yea...We discuss the case of a 47-year-old female who presented to our institution with progressive exertional shortness of breath. Her history was notable for severe acne medicated with 100 mg oral daily minocycline for 2 years and a presumptive diagnosis of a bicuspid aortic valve. Investigations revealed severe aortic stenosis, prompting a decision for elective aortic valve repair. Intraoperatively, significant calcification of a unicuspid aortic valve, atypically blackened valve, and endocardium of the left ventricle and aorta were visualized.
Bcharah G, Zhuang J, Farina JM
… +2 more, Jenkins JA, Sell-Dottin KA
Methodist Debakey Cardiovasc J
· 2025 · PMID 40093863
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Transcatheter aortic valve replacement (TAVR) has become a widely utilized procedure for treating aortic stenosis (AS). However, TAVR-related complications are rising, with TAVR explants becoming the fastest growing card...Transcatheter aortic valve replacement (TAVR) has become a widely utilized procedure for treating aortic stenosis (AS). However, TAVR-related complications are rising, with TAVR explants becoming the fastest growing cardiac surgery procedure. We report a case of an 80-year-old female with severe AS status post TAVR and subsequent TAV-in-TAV a few years later. She was found to have severe stenosis of her more recent TAV and was scheduled for surgical TAVR explant. The inner, most recent TAV was completely removed, and only the leaflets of the outer, older TAV were resected, sparing the stent frame. This was followed by deployment of a new TAV within the preserved frame under direct visualization. The patient's postoperative recovery was uncomplicated, and 1-month follow-up was reassuring. We highlight the advantages of this approach in minimizing aortic manipulation, reducing the risk of aortic wall damage, and potentially optimizing overall outcomes in a high-risk procedure.
Sharma V, Maheshwari V, Thayumanavan T
… +3 more, Sahai A, Singh S, Kar B
Methodist Debakey Cardiovasc J
· 2025 · PMID 40093862
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Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare inherited arrhythmogenic disorder that can lead to sudden cardiac death (SCD) in young individuals with structurally normal hearts. This case report...Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare inherited arrhythmogenic disorder that can lead to sudden cardiac death (SCD) in young individuals with structurally normal hearts. This case report presents a novel instance of CPVT caused by a Ryanodine receptor channel-2 () gene mutation in a young adult. A 24-year-old male presented with recurrent syncope and pre-syncopal episodes. Initial cardiac evaluations, including electrocardiography and echocardiography, were unremarkable. The patient experienced multiple syncopal events, including an episode of aborted SCD. Implantation of a loop recorder and subsequent implantable cardioverter-defibrillator (ICD) revealed recurrent ventricular tachycardia (VT). Comprehensive genetic testing identified a pathogenic mutation in the gene, confirming the diagnosis of CPVT. The patient was initiated on beta-blocker therapy (propranolol) for primary prevention of VT episodes and to reduce ICD interventions. The ICD was maintained for secondary prevention. This case underscores the importance of considering genetic arrhythmia syndromes in the differential diagnosis of unexplained syncope in young adults, even when initial cardiac assessments appear normal. It also highlights the critical role of genetic testing in the diagnosis and management of inherited cardiac conditions and emphasizes the need for family screening due to the autosomal dominant inheritance pattern of mutations.
Methodist Debakey Cardiovasc J
· 2025 · PMID 40060973
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Inspired by the quality of computer-rendered images in the animated movie industry, cinematic rendering (CR) is a novel image visualization technique using proprietary rendering algorithms that simulate the propagation a...Inspired by the quality of computer-rendered images in the animated movie industry, cinematic rendering (CR) is a novel image visualization technique using proprietary rendering algorithms that simulate the propagation and interaction of light rays passing through 3-dimensional (3D) volumetric data, resulting in a photorealistic representation of bodily organs and vasculature. Due to its more realistic representative and intuitive format, it has become part of medical education, especially 3D anatomy teaching, patient education, and communication. It also plays an important role in the diagnostics and treatment planning for complex vascular pathologies, especially malformations. This short report highlights the additional diagnostic and clinical value of this image visualization technique by showing its value in treatment planning in a case of arteriovenous malformation (Figure 1).
Methodist Debakey Cardiovasc J
· 2025 · PMID 40060972
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We describe a case of a 59-year-old male who presented with intermittent episodes of atypical chest pain where computed tomography revealed intracavitary course of right coronary artery.The recognition of intra-atrial co...We describe a case of a 59-year-old male who presented with intermittent episodes of atypical chest pain where computed tomography revealed intracavitary course of right coronary artery.The recognition of intra-atrial course of RCA is important as it can predispose patients to inadvertent iatrogenic injuries during surgical or endovascular procedures that can prove catastrophic, even fatal.
Methodist Debakey Cardiovasc J
· 2025 · PMID 40060971
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Incidental detection of polysplenia associated with situs inversus totalis in an adult is rarely reported in literature.12 "Heterotaxy" refers to a wide spectrum of anomalies involving dysmorphism of thoracoabdominal org...Incidental detection of polysplenia associated with situs inversus totalis in an adult is rarely reported in literature.12 "Heterotaxy" refers to a wide spectrum of anomalies involving dysmorphism of thoracoabdominal organs across the right-left axis of the body. Polysplenia is observed in left isomerism along with bilateral bilobed bronchi and bilateral morphologic left atria. However, in this case, polysplenia was present without isomerism.
Tabatabaeishoorijeh A, Oh A, Sarfaraz ZK
… +1 more, Ramchandani M
Methodist Debakey Cardiovasc J
· 2025 · PMID 40060970
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Left atrial appendage (LAA) clipping during open cardiac surgery is widely used for stroke and embolization prevention in atrial fibrillation. Various devices are available for this purpose, including the AtriCure AtriCl...Left atrial appendage (LAA) clipping during open cardiac surgery is widely used for stroke and embolization prevention in atrial fibrillation. Various devices are available for this purpose, including the AtriCure AtriClip and the recently introduced Medtronic Penditure clip. We present a case of a 59-year-old male with multiple comorbidities, including chronic kidney disease and coronary artery disease, who underwent coronary artery bypass grafting with prophylactic LAA clipping using the Medtronic Penditure atrial clip. The procedure was complicated by an iatrogenic hematoma due to clip erosion into the atrioventricular groove, leading to left atrial tamponade and necessitating chest re-exploration. This case underscores the importance of understanding the structural interactions between different LAA occlusion devices and surrounding cardiac anatomy. Further evaluation is warranted to assess the safety profile of newer LAA occlusion devices and their impact on postoperative outcomes.
Valladares AC, Astudillo MA, Drinnon AR
… +4 more, Dowlatshahi S, Kansara A, Shakil J, Patham B
Methodist Debakey Cardiovasc J
· 2025 · PMID 39990761
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Obesity and overweight have become increasingly significant conditions, affecting more than 70% of the adult population in the United States. These conditions are caused by a combination of factors, including genetic, be...Obesity and overweight have become increasingly significant conditions, affecting more than 70% of the adult population in the United States. These conditions are caused by a combination of factors, including genetic, behavioral, environmental, and medical influences. Obesity is a major risk factor for cardiovascular and metabolic diseases. A comprehensive treatment plan for individuals with obesity must recognize the chronic nature of the condition and offer strategies for weight reduction and long-term cardiometabolic benefits. Over the past several decades, multiple therapeutic options have been implemented to address weight loss, appetite regulation, and caloric expenditure, with the goal of reducing the burden of obesity and improving cardiovascular outcomes. Pharmacological treatment of obesity has focused primarily on the central regulation of appetite and food intake behavior. The introduction of incretin agonists for obesity treatment has ushered in a new era of cardiometabolic health, with a multitargeted mechanism that achieves weight loss, glycemic control, decreased cardiovascular mortality, and other metabolic benefits. This review explores the current pharmacological options and the future of obesity treatment.
Methodist Debakey Cardiovasc J
· 2025 · PMID 39990760
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Philip Alexander, MD, is a native Texan, retired physician, and accomplished musician and artist. After 41 years as an internal medicine physician, Dr. Phil retired from his practice in College Station in 2016. A lifelon...Philip Alexander, MD, is a native Texan, retired physician, and accomplished musician and artist. After 41 years as an internal medicine physician, Dr. Phil retired from his practice in College Station in 2016. A lifelong musician and former music professor, he often performs as an oboe soloist for the Brazos Valley Symphony Orchestra. He began exploring visual art in 1980, evolving from pencil sketches-including an official White House portrait of President Ronald Reagan-to the computer-generated drawings featured in this journal. His images, which first appeared in this journal in the spring of 2012, are his own original creations. If you would like to see your art published in the , submit your creation online at journal.houstonmethodist.org as a "Humanities" entry.
Shahid I, Zakaria F, Chang R
… +5 more, Javed U, Amin ZM, Al-Kindi S, Nasir K, Javed Z
Methodist Debakey Cardiovasc J
· 2025 · PMID 39990759
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In the United States, two out of every five adults have obesity. The obesity epidemic is a significant public health concern and a major risk factor for atherosclerotic cardiovascular disease (ASCVD), contributing to its...In the United States, two out of every five adults have obesity. The obesity epidemic is a significant public health concern and a major risk factor for atherosclerotic cardiovascular disease (ASCVD), contributing to its development through a complex interplay of social, biologic and behavioral mechanisms. It exacerbates traditional cardiovascular risk factors such as dyslipidemia, hypertension, and type 2 diabetes, while visceral and epicardial fat deposition promotes inflammation and insulin resistance, thereby accelerating atherosclerosis. Beyond traditional pathophysiologic pathways, social determinants of health (SDoH) significantly contribute to obesity-related disparities, particularly among racial and ethnic minorities. SDoH factors such as socioeconomic status, access to health care, and limited availability of nutritious food and safe spaces for physical activity not only increase obesity prevalence but also exacerbate its psychological toll, including stress and anxiety, which further elevate cardiovascular risk. Environmental factors, such as limited green spaces and air pollution, further promote obesogenic behaviors and worsen cardiovascular outcomes. In this review, we explore the association between obesity and ASCVD and key mediating pathways including the role of SDoH and environmental risk factors. We also discuss potential strategies-including patient education, community engagement to address SDoH, and establishment of dedicated cardiometabolic and cardiovascular prevention clinics-to mitigate the population burden of obesity and improve downstream cardiovascular outcomes.
Shah A, Davarci O, Chaftari P
… +1 more, Avenatti E
Methodist Debakey Cardiovasc J
· 2025 · PMID 39990758
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Obesity is now recognized as a multifaceted chronic disease that is intricately linked to metabolic, biochemical, and psychosocial dysfunction. In this article, we review the epidemiology of obesity, current understandin...Obesity is now recognized as a multifaceted chronic disease that is intricately linked to metabolic, biochemical, and psychosocial dysfunction. In this article, we review the epidemiology of obesity, current understanding of its physiopathology, and the recommended staging system used to approach it as a chronic disease, and we include an overview of its health implications.
Alansari H, Lazzara G, Taha MB
… +1 more, Gorthi JR
Methodist Debakey Cardiovasc J
· 2025 · PMID 39990757
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Obesity and heart failure (HF) are two intersecting public health challenges, each with rising prevalence worldwide. Obesity alters cardiac structure and function, leading to ventricular systolic and diastolic dysfunctio...Obesity and heart failure (HF) are two intersecting public health challenges, each with rising prevalence worldwide. Obesity alters cardiac structure and function, leading to ventricular systolic and diastolic dysfunction. However, weight loss interventions, whether through lifestyle changes, pharmacological agents, or bariatric surgery, can improve cardiac function, reduce symptoms, and lower hospitalization rates. Interestingly, the "obesity paradox" suggests that HF patients with obesity may experience better survival outcomes than HF patients with normal weight despite the adverse cardiac effects of obesity. Most importantly, focusing on strategies that aim to prevent HF in patients with obesity can potentially curb the burden of this chronic condition. This review explores the complex relationship between obesity and HF, emphasizing pathophysiological mechanisms, the paradoxical survival benefit, and the impact of weight loss strategies. A deeper understanding of this relationship is critical for optimizing care and outcomes in HF patients with obesity.
Methodist Debakey Cardiovasc J
· 2025 · PMID 39990756
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The treatment of obesity and cardiovascular disease (CVD) is complex, and a variety of strategies are effective in the lifestyle interventions associated with these disease states. An interdisciplinary approach is the mo...The treatment of obesity and cardiovascular disease (CVD) is complex, and a variety of strategies are effective in the lifestyle interventions associated with these disease states. An interdisciplinary approach is the most effective treatment with the best results and outcomes. The lifestyle management of obesity includes interventions in nutrition, exercise, and behavioral health-all key components in managing most chronic illnesses. Effective nutrition interventions include the Mediterranean diet, DASH diet, and incorporation of more plant-based food options. Exercise is tailored to individual needs and emphasizes a gradual progression and incremental change with both aerobic and resistance training to manage weight and cardiovascular disease. Behavioral health focuses on practicing mindfulness, active self-awareness, sleep quality, stress management, and the use of therapy in overcoming barriers to success. These lifestyle factors are key in managing weight and cardiovascular disease.
Methodist Debakey Cardiovasc J
· 2025 · PMID 39990755
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Over the past two decades, numerous endoscopic bariatric and metabolic therapies (EBMTs) have been developed with the goal of providing additional effective and safe tools for the treatment of obesity. These treatments a...Over the past two decades, numerous endoscopic bariatric and metabolic therapies (EBMTs) have been developed with the goal of providing additional effective and safe tools for the treatment of obesity. These treatments are an ultra-minimally invasive option for patients with class I, class II, and class III obesity. Many of these EBMTs can be utilized as primary therapies for treatment-naïve patients or as a treatment for weight regain after bariatric surgery. While the role of EBMTs is not to compete with bariatric surgery, which provides the most effective treatment of obesity, they provide greater weight loss than lifestyle modifications and pharmacotherapy; additionally, when combined with pharmacotherapy, they may help achieve surgical weight loss without the risk of invasive surgery. This review summarizes the most currently available EBMTs, including intragastric balloons (IGBs), endoscopic sleeve gastroplasty (ESG), and endoscopic surgical revision procedures for treating obesity.
Methodist Debakey Cardiovasc J
· 2025 · PMID 39990754
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Obesity is one of the most difficult medical conditions to treat in the United States (US) and requires multidisciplinary treatment. Bariatric surgery is one of the most effective treatment options for morbid obesity. In...Obesity is one of the most difficult medical conditions to treat in the United States (US) and requires multidisciplinary treatment. Bariatric surgery is one of the most effective treatment options for morbid obesity. In this review, we describe the most up-to-date information regarding the impact of obesity on cardiovascular disease and other comorbidities as well as the various surgical approaches for treatment.
Anderson S, Benitez E, Gonzalez-Godinez E
… +3 more, Desai Y, Heer N, White J
Methodist Debakey Cardiovasc J
· 2025 · PMID 39990753
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This Points to Remember column outlines an approach to initiating the discussion of obesity with a patient in the clinical setting. Written by faculty and residents of the Houston Methodist Family Medicine Residency Prog...This Points to Remember column outlines an approach to initiating the discussion of obesity with a patient in the clinical setting. Written by faculty and residents of the Houston Methodist Family Medicine Residency Program, these points can help physicians develop a patient-centered approach to broaching the discussion of weight management that fosters an open dialogue and works to reduce weight stigma and biases surrounding obesity.
Methodist Debakey Cardiovasc J
· 2025 · PMID 39990752
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Atrial fibrillation (AF) remains the most common arrhythmia worldwide, but its pathophysiology remains complex and multifactorial. As obesity has increased over the past couple of decades, much interest has been generate...Atrial fibrillation (AF) remains the most common arrhythmia worldwide, but its pathophysiology remains complex and multifactorial. As obesity has increased over the past couple of decades, much interest has been generated about its relationship with other diseases. As a result, the interplay between AF and obesity has been rigorously investigated as risk factor modification has become more important for the management of AF. In this review, we discuss the epidemiology of AF and obesity, the pathophysiology connecting these two diseases, and how obesity affects the management of AF.