Cardiology Research And Practice[JOURNAL]
Sun
200 papers
Association of Cannabis use and Survival in patients with heart failure: A claims-based cohort study of commercially insured adults.
Ilonze OJ, Li X, Ouyang F … +6 more , Allen LA, Page RL, Quinney SK, Vidot DC, Chuzi S, Breathett K
Am Heart J Plus · 2026 Apr · PMID 41938984 · Full text
We aimed to examine the prevalence of documented cannabis use and its association with survival among patients with HF using the Optum Clinoformatics dataset, large, national informatics dataset. We demonstrated low peri...
We aimed to examine the prevalence of documented cannabis use and its association with survival among patients with HF using the Optum Clinoformatics dataset, large, national informatics dataset. We demonstrated low period prevalence of cannabis use among patients with heart failure and there was no statistically significant difference ( = 0.76) in all-cause mortality between individuals who use cannabis versus non-users.
Non-invasive estimation of coronary resistance and compliance: Prospective diagnostic study vs. angiography.
Lee BK, Hyeon SS, Hong Y … +2 more , Choi DW, Lee SS
Am Heart J Plus · 2026 Apr · PMID 41938983 · Full text
BACKGROUND: Early identification of coronary artery disease (CAD) remains challenging, particularly in patients who cannot undergo exercise-based or contrast-dependent diagnostic testing. We evaluated a non-invasive puls...
BACKGROUND: Early identification of coronary artery disease (CAD) remains challenging, particularly in patients who cannot undergo exercise-based or contrast-dependent diagnostic testing. We evaluated a non-invasive pulse wave-based device, Coronyzer (KH-3000), designed to derive resistance and compliance indices for early screening of CAD. METHODS: A prospective diagnostic accuracy study was conducted in 94 patients with suspected angina who underwent coronary angiography (CAG). Significant CAD was defined as ≥50% diameter stenosis. Diagnostic performance was assessed using pre-specified thresholds for resistance (R) and compliance (C). An independent retrospective validation study was performed in 136 patients who underwent CAG and computed tomography coronary angiography (CTCA). Diagnostic performance was evaluated using predefined OR and AND decision rules ( > 1.24 and/or C < 0.8). RESULTS: In the prospective cohort, sensitivity and specificity were 81% and 89%, respectively. In the validation cohort, the OR rule demonstrated high sensitivity (0.77) with lower specificity (0.41), whereas the AND rule showed lower sensitivity (0.53) but high specificity (0.78). Receiver operating characteristic (ROC) analysis demonstrated moderate overall diagnostic accuracy (area under the curve (AUC) = 0.67). CONCLUSIONS: Coronyzer demonstrated clinically meaningful diagnostic performance as a non-invasive screening and risk stratification tool for coronary artery disease. By avoiding radiation exposure, contrast agents, and exercise requirements, the device may support early clinical triage and referral for further diagnostic evaluation, particularly in patient populations for whom conventional testing is limited.
Heart rate circadian rhythm in patients with traumatic brain injury: A retrospective analysis of a nationwide multicenter ICU database.
Deng Y, Liu B, Li Y … +1 more , Wu L
Am Heart J Plus · 2026 Apr · PMID 41938982 · Full text
OBJECTIVE: This study aimed to determine whether the circadian rhythm in heart rate independently associated with in-hospital mortality among patients with TBI. METHODS: Data were extracted from the eICU-CRD. Heart rate...
OBJECTIVE: This study aimed to determine whether the circadian rhythm in heart rate independently associated with in-hospital mortality among patients with TBI. METHODS: Data were extracted from the eICU-CRD. Heart rate circadian rhythm was characterized using three parameters: mesor, amplitude, and peak time. The prognostic association and incremental discriminatory value of these circadian variables, alongside the APACHE IV score, was assessed in relation to in-hospital mortality. RESULTS: Among 3202 patients showing a circadian rhythm in heart rate, each 10-beat/min increase in mesor was associated with a 1.18-fold higher odd of in-hospital mortality (95% CI: 1.08-1.30; < 0.001), while each 5-beat/min increase in amplitude corresponded to a 1.14-fold increase (95% CI: 1.03-1.25; < 0.001). The link between mesor and in-hospital mortality varied with comorbidities such as heart failure ( = 0.039), atrial fibrillation ( = 0.014), infection ( = 0.003), and fever ( = 0.027). Adding circadian rhythm metrics to the APACHE IV score improved model discrimination (c-index 0.795; 95% CI: 0.747-0.844) compared to APACHE IV alone (c-index 0.719; 95% CI: 0.665-0.773; < 0.001). CONCLUSION: Circadian rhythm features of heart rate are independent prognostic factors associated with in-hospital mortality in TBI patients. Integrating these variables with conventional scoring systems may improve prognostic accuracy.
Multicenter, randomized controlled study evaluating percutaneous and non-fluoroscopic procedure of atrial septal defects-study protocol of the PANASD randomized controlled trial.
Chang J, Dong J, Zhang F … +5 more , Wang C, Ouyang W, Fang F, Wang C, Pan X
Am Heart J Plus · 2026 Apr · PMID 41938981 · Full text
BACKGROUND: Atrial septal defect (ASD) is one of the most common congenital heart diseases. Radiation exposure during transcatheter ASD closure poses cumulative risks for both patients and operators. We have pioneered a...
BACKGROUND: Atrial septal defect (ASD) is one of the most common congenital heart diseases. Radiation exposure during transcatheter ASD closure poses cumulative risks for both patients and operators. We have pioneered a percutaneous and non-fluoroscopic procedure (PAN procedure) for a broad spectrum of cardiovascular interventional therapies, which eliminates the need for radiation and contrast. The PANASD trial is designed to compare PAN procedure with the traditional fluoroscopy procedure for transcatheter ASD closure. This article outlines the protocol of the study. TRIAL DESIGN: PANASD is a prospective, multicenter, randomized controlled trial enrolling approximately 660 patients for elective percutaneous ASD closure from eight participating centers in China. In this RCT, patients diagnosed with secundum ASD are randomized into two groups: one undergoing echocardiography-guided percutaneous ASD closure without the use of radiation and the other following the conventional fluoroscopy-guided procedure. The primary endpoint is the success rate of occlusion, defined as no conversion to surgery, a well-positioned occluder during hospitalization, and no major adverse events. Secondary endpoints include complication rates, costs, length of hospital stay, etc. Follow-up of the last enrolled patients will be completed in early 2026, and results will be available by late 2026. Data will be collected via an electronic data capture (EDC) system, and adverse events will be systematically recorded and monitored. Adherence to ethical principles, including informed consent and confidentiality, is maintained. CONCLUSION: This RCT protocol represents the first clinical trial to compare the safety and efficacy of percutaneous and non-fluoroscopic ASD closure with the conventional fluoroscopic method.
Impact of influenza vaccination on in-hospital outcomes among patients with heart failure and acute respiratory illness.
Shafiq A, Javaid SS, Popat A … +13 more , Asif H, Ahmad M, Ali R, Zaheer I, Arshad U, Jabeen D, Mandokhail AK, Kumar D, Khanam S, Sagar FNU, Usman MS, Hasan A, Ahmed R
Am Heart J Plus · 2026 Apr · PMID 41938980 · Full text
BACKGROUND: Influenza vaccination is recommended to patients with heart failure (HF), who are vulnerable to severe complications from respiratory infections. However, data on its impacts on in-hospital outcomes remain li...
BACKGROUND: Influenza vaccination is recommended to patients with heart failure (HF), who are vulnerable to severe complications from respiratory infections. However, data on its impacts on in-hospital outcomes remain limited. METHODS: We analyzed the National Inpatient Sample (2018 to 2020), including adults (≥ 18 years) hospitalized with acute respiratory infection (ARI) and HF, identified using ICD-10 CM Codes(ARI: J09.x-J11.x, J12.x-J18.x, J20.x, J21.x; HF: I50.x, I0981, I110, I130, I132, I97130, I97131, O29121-O29129, Z95811, Z95812). The primary outcome was in-hospital mortality. Secondary outcomes included mechanical ventilation use, sepsis, length of stay (LOS) in hospital, and inflation-adjusted total hospital charges. Multivariable logistic and linear regression models assessed associations between influenza vaccination and outcomes, adjusting for demographic, clinical, socioeconomic and hospital-level factors. RESULTS: Among 491,210 hospitalizations for patients with HF and ARI, 28% (137,538) received influenza vaccination. Vaccinated patients with HF had significantly lower odds of in-hospital mortality (OR: 0.32; 95% CI, 0.23-0.46; < 0.001), mechanical ventilation (OR: 0.67; 95% CI, 0.54-0.83; p < 0.001), and sepsis (OR: 0.63; 95% CI, 0.45-0.88; = 0.006). They also had lower total hospital charges (β = -$3181; 95% CI, -$5264 to -$1098; = 0.003). No significant difference was found in LOS (β = -0.05; 95% CI, -0.21 to 0.12; = 0.6). CONCLUSION: Influenza vaccination for ARI is linked to lower mortality, fewer complications, and reduced health care costs. These findings support the promotion of inpatient vaccination to improve outcomes and reduce burden in the high-risk population.
Multiethnic community cardio-metabolic risk factor screening in Northeast Florida: The VIDASANA Project.
Velarde G, Bravo-Jaimes K, Sharma G … +5 more , Ganji M, Smotherman C, Klein C, Esmail K, Rivas J
Am Heart J Plus · 2026 Apr · PMID 41909491 · Full text
BACKGROUND: Cardiometabolic risk disproportionately affects racially and ethnically diverse United States populations. Few community-based studies have examined the intersection of metabolic syndrome (MS), functional cap...
BACKGROUND: Cardiometabolic risk disproportionately affects racially and ethnically diverse United States populations. Few community-based studies have examined the intersection of metabolic syndrome (MS), functional capacity, and cardiovascular disease (CVD) risk across multiple groups within a single region. OBJECTIVE: To evaluate MS prevalence, functional capacity, and 10-year CVD risk in adults from diverse communities in Northeast Florida. METHODS: A total of 345 adults were screened between 2017 and 2019 in a community-based, cross-sectional study. MS was defined by Adult Treatment Panel III criteria (≥3 of 5 thresholds). Functional capacity and 10-year CVD risk were assessed using Duke Activity Status Index (DASI), and Framingham Risk Score (FRS). Group differences were evaluated using appropriate univariate tests, and multivariable logistic regression identified independent predictors of MS ( < 0.05). RESULTS: MS prevalence was highest among Hispanic (H) subjects (47%), followed by non-Hispanic Black (NHB, 35%) and Southeast Asian participants (SEA, 33%). Adjusted odds of MS were higher in H (OR 7.3, 95% CI 1.8-28.6) and SEA participants (OR 5.2, 95% CI 1.2-22.2) compared to non-Hispanic White (NHW) subjects. DASI scores were significantly lower in women and minority (H and SEA) populations. MS further reduced functional capacity in H ( = 0.011) and SEA participants ( = 0.038). Median FRS differed by race/ethnicity ( = 0.0013); with NHB subjects showing the highest median risk (9.75%). CONCLUSIONS: This study identified marked disparities in MS prevalence, functional capacity, and cardiovascular risk across racial and ethnic groups with greater burden among minoritized populations across all domains. Findings support the need for more inclusive, culturally informed prevention strategies for diverse populations.
Investigating the necessity of preoperative coronary angiography for infection-related cardiac implantable electronic device explantation.
Caldonazo T, Scheler H, Fischer J … +7 more , Kirov H, Mukharyamov M, Gräger S, Runkel A, Reinartz S, Diab M, Doenst T
Am Heart J Plus · 2026 Apr · PMID 41909490 · Full text
BACKGROUND: Device-associated endocarditis is a potentially life-threatening condition that typically requires the removal of the cardiac implantable electronic device (CIED). The role of routine coronary angiography (CA...
BACKGROUND: Device-associated endocarditis is a potentially life-threatening condition that typically requires the removal of the cardiac implantable electronic device (CIED). The role of routine coronary angiography (CAG) as part of preoperative evaluation remains uncertain. OBJECTIVES: This study aims to assess the necessity of preoperative CAG and its impact on clinical outcomes in patients who underwent isolated CIED explantation due to infection. METHODS: A single-center retrospective analysis was conducted at Jena University Hospital between 2007 and 2023. The primary outcome was 30-day mortality. The secondary outcomes were major perioperative complications. The data were displayed using descriptive statistics and classic 2-sided tests. RESULTS: A total of 287 high-risk patients underwent isolated CIED explantation due to infection, of whom 120 underwent a preoperative CAG while 167 did not. Preoperatively, almost the half of the patients did not present history of coronary artery disease (No CAG: 53.9% and CAG: 45.0%), and the CAG group presented higher rates of lead vegetation (65.0% vs 52.7%, = 0.04). Preoperative CAG had no significant effect on 30-day mortality (9.2% vs 9.6%, = 1.00, mostly due to sepsis). Additionally, there was no significant difference in postoperative complications between the groups, including myocardial infarction ( = 1.00), bleeding (p = 1.00), acute renal failure ( = 0.76), or surgical conversion ( = 0.29). CONCLUSIONS: The analysis suggests that preoperative CAG does not significantly influence short-term outcomes after CIED explantation due to infection in our patient population. Systematic preoperative CAG may not be necessary for all patients. Moreover, non-invasive imaging modalities may have emerging importance in scenarios like this.
Improving dyadic quality of life for left ventricular assistive devices patients and caregivers: Rationale & design of the Compassion Strikes Back pilot.
Shonrock AT, Cohen T, Calkins T … +5 more , Bell J, Perez S, Rios I, Villarroel L, Ahmed MM
Am Heart J Plus · 2026 Apr · PMID 41909489 · Full text
BACKGROUND: When considering implanting a left ventricular assistive device (LVAD), the ability to care for and maintain the device requires significant levels of personal investment, medical care, and emotional resilien...
BACKGROUND: When considering implanting a left ventricular assistive device (LVAD), the ability to care for and maintain the device requires significant levels of personal investment, medical care, and emotional resilience. The availability of a caregiver support is also critical to long-term success. Adaptation to life with LVAD includes several challenges from both caregiver and patients' perspectives, creating a bidirectional interaction and creation of dyads. Dyads with protective social support and coping fare better psychologically, which serving as a proxy for improved physical health outcomes. Self-compassion interventions have been shown to be beneficial across various settings for improving psychological outcomes in chronically ill patients and caregivers. Both dyadic coping and self-compassion interventions have limited extant research examining these concepts in the LVAD space. The Compassion Strikes Back Pilot Study explores the feasibility, acceptability, and efficacy of a brief psychosocial intervention within an integrated care setting aimed at improving quality of life for LVAD dyads during early home adaptation. METHODS: 12 LVAD dyads will be randomized to control or a clinical psychologist led self-compassion intervention. RESULTS: Primary outcomes of interest include the feasibility and acceptability of the intervention, as well as whether the intervention increases quality of life in the immediate post-LVAD home discharge phase. Other outcome measures include perceived stress, cardiac and general self-efficacy, illness denial, and caregiver burden. CONCLUSION: This pilot study aims to explore the feasibility and acceptability of such an intervention to improve outcomes for LVAD dyads in the early home adaptation phase. Clinical trial registration: NCT06988995.
Prevalence and mortality of cardiovascular-kidney-metabolic syndrome in US adults, 1999-2018.
Cheema HA, Shahid A, Rahman SU … +6 more , Nasir K, Patel J, Kulkarni A, Rangaswami J, Ganatra S, Dani SS
Am Heart J Plus · 2026 Apr · PMID 41884775 · Full text
BACKGROUND: Cardiovascular-kidney-metabolic (CKM) syndrome is a novel staging construct that reflects the pathophysiological interplay between these individual conditions. The long-term trends in the prevalence of CKM sy...
BACKGROUND: Cardiovascular-kidney-metabolic (CKM) syndrome is a novel staging construct that reflects the pathophysiological interplay between these individual conditions. The long-term trends in the prevalence of CKM syndrome in the US have not been well characterized. METHODS: This serial cross-sectional study used data from the National Health and Nutrition Examination Survey (1999-2018) to define CKM stages from 0 (no risk factors) to 4 (clinical CVD). Participants younger than 20 years, pregnant patients, and those with missing mortality data and NHANES fasting subsample weights were excluded. We calculated the age- and sex-adjusted prevalence of each stage and its trends. Survey-weighted Cox regression was used to estimate the mortality risk with each stage. RESULTS: The prevalence of CKM syndrome at each stage was as follows: stage 0, 11.9%; stage 1, 24.9%; stage 2, 49.1%; stage 3, 4.6%; and stage 4, 9.5%. The prevalence of CKM stages 0 and 4 decreased between 1999 and 2018, but that of CKM stages 1 and 3 increased. The risk of all-cause and CVD mortality showed a graded increase from stage 1 to 4 compared to stage 0 (HRs for all-cause death in stage 4 = 2.87, 95% CI: 1.98-4.17, and CVD death = 4.68, 95% CI: 1.95-11.26). CONCLUSIONS: Nearly 90% of US adults have Stage 1 or higher CKM syndrome, and CKM stage is associated with graded mortality risk. Metabolic abnormalities explain the largest share of the mortality gradient, suggesting that population and clinical strategies focused on metabolic risk reduction should be prioritized to reduce CKM-related mortality.
Cardiovascular outcomes following bariatric surgery in obese patients with hypertrophic cardiomyopathy: A multicenter propensity-matched analysis.
Mahmoud AK, Awad K, Sheashaa H … +16 more , Mohammed A, Farina JM, Pereyra M, Scalia IG, Hafez A, Senjab A, Ibrahim R, Mital R, Shipman J, Alsidawi S, Lester SJ, Ommen SR, Geske JB, Patten R, Ayoub C, Arsanjani R
Am Heart J Plus · 2026 Apr · PMID 41884774 · Full text
Obesity is highly prevalent among patients with hypertrophic cardiomyopathy (HCM) and is associated with adverse outcomes. Bariatric surgery (BS) has been shown to reduce cardiovascular risk in obese populations, but its...
Obesity is highly prevalent among patients with hypertrophic cardiomyopathy (HCM) and is associated with adverse outcomes. Bariatric surgery (BS) has been shown to reduce cardiovascular risk in obese populations, but its impact in HCM remains uncertain. We performed a retrospective cohort study using the TriNetX Research Network, identifying adults with HCM and body mass index (BMI) ≥35 kg/m prior to January 2024. Patients were stratified into BS and non-BS cohorts. Propensity score matching (1:1) was performed to balance demographics, comorbidities, and medications. Cox regression models and Kaplan-Meier analyses evaluated outcomes. Of 26,345 patients, 2568 in each cohort were well matched (mean age: 53 years, 74% female, BMI 41.0 kg/m). Over a follow-up period up to 12 months, BS was associated with significantly reduced all-cause mortality (1.2% vs. 2.9%; HR = 0.40; 95% CI: 0.27-0.61, < 0.001) and acute heart failure hospitalization (8.6% vs. 10.7%; HR = 0.76; 95% CI: 0.63-0.90, < 0.002). BS achieved substantial BMI reduction (-5.0 kg/m, p < 0.001). Rates of arrhythmias and cardiac arrest were similar between both groups. In obese patients with HCM, bariatric surgery was associated with lower mortality and fewer heart failure hospitalizations, supporting obesity as a modifiable risk factor in this population.
Mortality trends related to cardiovascular disease subtypes among adult females in the United States, 2010-2023.
Akhtar M, Mughees M, Minhas AMK … +2 more , Hassan IN, Gulati M
Am Heart J Plus · 2026 Apr · PMID 41868438 · Full text
BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death among females in the US, but recent shifts in subtype-specific mortality patterns need closer examination. This study aimed to evaluate trends in CVD...
BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death among females in the US, but recent shifts in subtype-specific mortality patterns need closer examination. This study aimed to evaluate trends in CVD-related mortality and its major subtypes among adult females from 2010 to 2023. METHOD: This study used CDC WONDER multiple cause of death data for CVD and its subtypes for adult females aged ≥25. Age-adjusted mortality rates (AAMR) per 100,000 with 95% confidence intervals were reported. Temporal trends from 2010 to 2019 were analyzed using Joinpoint Regression Software to estimate the average annual percent change (AAPC). Data from 2020 to 2023 were reported descriptively and excluded from trend analysis. RESULTS: Between 2010 and 2023, 10,642,363 CVD-related deaths were reported. The overall CVD-related AAMR was higher in 2023 (535.4) than in 2010 (526.1). The AAMR decreased significantly from 2010 to 2019 (AAPC: -0.60), followed by a sharp rise in 2020 (570.8) and 2021 (604.5), and a subsequent decline in 2022 (559.1) and 2023 (535.4). Hypertensive diseases, heart failure/cardiomyopathy, and pulmonary heart diseases reported an increase in AAMR from 2010 to 2019, while ischemic heart diseases, cerebrovascular heart diseases, and valvular heart diseases reported a decrease. Nearly all subtypes reported marked increases during the peak pandemic years, followed by a partial recovery in 2022 and 2023. CONCLUSION: CVD-related mortality among adult females showed a decline before 2020 but rose sharply during the pandemic. Post-pandemic recovery strategies should prioritize targeted interventions for key CVD subtypes and resilience in cardiovascular care for females.
Beyond the 30-day metric: National trends and predictors of 90-day readmission after coronary artery bypass grafting.
Ahmed U, Sohail M, Hussain HS … +7 more , Valencia J, Manji AA, Khabbaz K, Schaefer MS, Mahmood F, Sharkey A, Matyal R
Am Heart J Plus · 2026 Apr · PMID 41868437 · Full text
STUDY OBJECTIVE: Evaluate the national burden, predictors, and causes of 90-day readmission following coronary artery bypass grafting (CABG), and to examine temporal trends and demographic disparities in readmission risk...
STUDY OBJECTIVE: Evaluate the national burden, predictors, and causes of 90-day readmission following coronary artery bypass grafting (CABG), and to examine temporal trends and demographic disparities in readmission risk. DESIGN: Retrospective cohort study. SETTING: United States hospitals participating in the Nationwide Readmissions Database. PARTICIPANTS: Adult patients (≥18 years) undergoing isolated CABG between 2016 and 2022 were identified using ICD-10 codes. Patients who died during the index hospitalization, underwent concomitant valve surgery were excluded. MAIN OUTCOME MEASURES: The primary outcome was all-cause 90-day readmission. Secondary outcomes included 30-day readmission, in-hospital complications, and causes of 90-day readmission. RESULTS: Among 681,833 patients undergoing isolated CABG, 111,024 (16.3%) were readmitted within 90 days; notably, 36% occurred between 31 and 90 days after discharge. Heart failure was the leading cause of readmission (13.6%), followed by infection (6.7%), coronary artery disease-related diagnoses (6.7%), and atrial fibrillation (4.1%). Readmitted patients had higher rates of perioperative complications, including acute renal failure (28% vs 17%), respiratory failure (26% vs 17%), pneumonia (7% vs 3%), and transfusion (18% vs 12%). Independent predictors included female sex (adjusted odds ratio [aOR] 1.38), age ≥ 85 years (aOR 1.27), congestive heart failure (aOR 1.46), diabetes with complications (aOR 1.38), peripheral vascular disease (aOR 1.39), chronic kidney disease (aOR 1.30), and chronic obstructive pulmonary disease (aOR 1.34). Risk-adjusted readmission rates remained consistently higher among women across all age groups, with age-related patterns differing by sex. CONCLUSION: Our findings suggest that reliance on 30-day metrics may underestimate postoperative morbidity and highlight opportunities for extended post-discharge surveillance and complication prevention.
Ultraslow deflation automated sphygmomanometry in continuous-flow-left ventricular assist device patients.
Hendricks E, Calkins T, Cohen T … +4 more , Parker AM, Vilaro JR, Aranda JM, Ahmed MM
Am Heart J Plus · 2026 Apr · PMID 41868436 · Full text
INTRODUCTION: Left ventricular assist device (LVAD) is indicated for short- and long-term mechanical circulatory support. As hypertension is a risk factor for complications and unfavorable outcomes in LVAD recipients, bl...
INTRODUCTION: Left ventricular assist device (LVAD) is indicated for short- and long-term mechanical circulatory support. As hypertension is a risk factor for complications and unfavorable outcomes in LVAD recipients, blood pressure (BP) control is essential. Accurate measurement of BP can be challenging, as the degree of pulsatility and aortic valve opening can vary between patients. The ultraslow deflation automated sphygmomanometer, designed for those with a weak pulse and whose cuff deflation algorithm allows for the detection of a narrower pulse pressure, may be useful for accurate and simple BP measurement in continuous-flow-LVAD patients. METHODS: This pilot study assessed the accuracy and ease of use of the ultraslow deflation automated sphygmomanometer in both the in-patient and ambulatory clinical settings. Seven consecutive in-patients had arterial line monitoring and a HeartMate 3 (HM3) LVAD. All patients underwent 3 BP measurements with each modality at 3 separate times. In the outpatient setting, 11 consecutive patients (9 HM3 and 2 HeartWare HVAD) had mean arterial pressure (MAP) measurement using both Doppler RTF and ultraslow deflation automated sphygmomanometer. RESULTS: There was no difference in mean MAP for each in-patient between modalities and across all patients based on BP measurement modality. In outpatients, there was no significant difference in MAP within each patient across modalities or users. CONCLUSION: Ultraslow deflating sphygmomanometer appears to be reliable, accurate, and easy to use for BP monitoring in LVAD patients and may represent a more accessible and patient friendly method for BP management.
Disparities in aortic stenosis and heart failure related mortality trends by sex, race, and geography in United States: A two-decade perspective.
Zehra M, Hussain SA, Siddiqui MA … +4 more , Sajid EU, Nadeem MM, Kumari P, Mohamad T
Am Heart J Plus · 2026 Apr · PMID 41868435 · Full text
OBJECTIVE: This study aimed to evaluate two decades of U.S. mortality patterns in patients with aortic stenosis (AS) and heart failure (HF), focusing on disparities by sex, race, and geography. DESIGN: Retrospective Stud...
OBJECTIVE: This study aimed to evaluate two decades of U.S. mortality patterns in patients with aortic stenosis (AS) and heart failure (HF), focusing on disparities by sex, race, and geography. DESIGN: Retrospective Study. SETTING: Using the CDC WONDER database, we examined national mortality data from 1999 to 2023. PARTICIPANTS: Individuals aged ≥45 years with AS and HF were included. MAIN OUTCOME MEASURE: Trends in age-adjusted mortality rates (AAMRs) across age, sex, race, geography, and urbanization using Joinpoint regression analysis. RESULTS: A total of 236,504 deaths were recorded. Overall AAMR increased until 2011 (APC: 0.78, AAMR 9.42), then stabilized through 2023 (APC: 0.07, AAMR 9.45). Mortality rates were consistently higher among males, older adults >65 years, non-Hispanic Whites, rural populations, and the Midwest region. AAMR in older adults was approximately 80 times higher than in middle-aged groups. CONCLUSIONS: Although national mortality rates for AS and HF have stabilized in recent years, they are still on the rise and significant disparities persist across demographic and geographic groups. These findings highlight the need for equitable healthcare access and targeted interventions to reduce preventable cardiovascular deaths.
Implantable cardioverter-defibrillator utilization in coronary artery spasm: A case series of cardiac arrest survivors and a patient with typical angiography.
Gao W, Li H, Zhao Y … +2 more , Xiong N, Li J
Am Heart J Plus · 2026 Apr · PMID 41868434 · Full text
BACKGROUND: Coronary artery spasm (CAS) can trigger severe angina pectoris, acute coronary syndrome, or sudden cardiac arrest (SCA). Calcium channel blockers and nitrates are recommended treatments, but the role of impla...
BACKGROUND: Coronary artery spasm (CAS) can trigger severe angina pectoris, acute coronary syndrome, or sudden cardiac arrest (SCA). Calcium channel blockers and nitrates are recommended treatments, but the role of implantable cardioverter-defibrillators (ICDs) remains controversial. This study explored ICD application in CAS via a case series of cardiac arrest survivors and a patient with typical angiography findings. CASE PRESENTATION: Four patients with recurrent angina (3 with prior cardiac arrest) were diagnosed with suspected or definite CAS based on predefined criteria and coronary angiography findings: transient ST-segment elevation, nitrate-responsive coronary narrowing, and no identifiable reversible triggers. Three patients with documented ventricular tachycardia/ventricular fibrillation (VT/VF) or SCA underwent ICD implantation, while the one without such history did not. During 3.6 ± 1.3 years of follow-up, all experienced recurrent angina (reduced by maximum-tolerated calcium antagonists plus long-acting nitrates). VT/VF events in two ICD recipients were successfully terminated by anti-tachycardia pacing or shocks. CONCLUSIONS: This case series confirms recurrent angina is common in CAS and highlights the efficacy of calcium antagonists and nitrates. ICD implantation may be warranted for CAS patients who survive VT/VF, a strategy supported by the literature.
From innovation to implementation: Addressing the AI adoption gap in cardiac surgery.
Ngwu D, Hamadi F, Akinyemi O … +2 more , Wokocha C, Arora N
Am Heart J Plus · 2026 Apr · PMID 41868433 · Full text
BACKGROUND: While artificial intelligence (AI) is advancing rapidly across cardiovascular medicine, its translation into cardiac surgery remains limited. Algorithms show promise in diagnostics, perioperative risk predict...
BACKGROUND: While artificial intelligence (AI) is advancing rapidly across cardiovascular medicine, its translation into cardiac surgery remains limited. Algorithms show promise in diagnostics, perioperative risk prediction, and workflow optimization, yet most applications remain confined to research environments. A focused synthesis is needed to clarify validated clinical value and persistent implementation barriers. METHODS: We conducted a systematic review following PRISMA 2020 guidelines, searching PubMed, Scopus, and Web of Science for studies published between January 2015 and September 2024. We included 45 primary studies (2019-2024) and eight foundational studies (2015-2018) reporting original data or validated AI models relevant to any stage of cardiac surgical care. Findings were synthesized across five domains: diagnostic support, personalized treatment planning, intraoperative decision support, operational efficiency, and equitable access to care. RESULTS: AI demonstrated strong performance in echocardiographic interpretation, outcome prediction, and perioperative resource planning, often surpassing conventional risk models. Computer-vision platforms supported surgical phase recognition and enhanced intraoperative imaging workflows, while operational tools improved scheduling accuracy, transfusion forecasting, and bed allocation. Evidence for AI-driven improvements in equitable care delivery was emerging but limited. Most studies were retrospective, single-center, and lacked external validation or clinical integration. CONCLUSION: AI is positioned to augment cardiac surgery, with the most mature applications in imaging and operational logistics. Adoption remains constrained by heterogeneous data, limited interpretability, regulatory uncertainty, and poor workflow integration. Progress will require multicenter data collaboratives, strong validation frameworks, and clinician-centered implementation strategies that position AI as an augmentative partner, enhancing precision, judgment, and system efficiency.
FIB-4 index predicts short-term mortality in Vietnamese acute heart failure patients.
Truyen TTTT, Tran DH, Do CN … +14 more , Le KL, Vo PD, Pham VNA, Phan TC, Le HMN, Tran HNT, Luu BMT, Nguyen HT, Tran TP, Nguyen VK, Truong TD, Pham TP, Nguyen MV, Nguyen MN
Am Heart J Plus · 2026 Apr · PMID 41858719 · Full text
BACKGROUND: Acute heart failure (AHF) has high early mortality. The FIB-4 index indicates hepatic dysfunction in AHF, but its predictive power for short-term outcomes in developing countries is not well established. METH...
BACKGROUND: Acute heart failure (AHF) has high early mortality. The FIB-4 index indicates hepatic dysfunction in AHF, but its predictive power for short-term outcomes in developing countries is not well established. METHODS: We conducted a prospective cohort study at Can Tho Central General Hospital, Vietnam, from May to December 2024 including adults aged ≥18, hospitalized with AHF and NT-proBNP levels ≥300 pg/mL. Exclusions were for those who died before blood sample collection, transferred, declined consent, or had chronic liver disease, active cancer, or end-stage renal disease. Survivors were followed up via phone for 30 days post-discharge. The primary endpoint was 30-day all-cause mortality. RESULTS: The final analysis included 413 patients (mean age 70, 47.7% male). In-hospital mortality was 5.1% and did not associate to FIB-4. At 30 days post-discharge, 42(17%) of 247 patients with follow-up data died (37.3% loss to follow-up). Non-survivors had higher FIB-4 scores than survivors (3.3 vs. 2.3, = 0.006). After adjusting for age, sex, comorbidities, LVEF, and NT-proBNP, each one-point increase in FIB-4 raised the 30-day mortality risk by 9% (RR 1.09; 95%CI: 1.01-1.17). A cut-off of 3.1 identified high-risk patients, with a RR of 1.82 (95%CI: 1.03-3.22). FIB-4 demonstrated an AUC of 0.634 (95%CI: 0.535-0.733) which was comparable to NT-proBNP (AUC 0.650; 95%CI: 0.559-0.742). CONCLUSION: In this exploratory single-center study of patients with AHF, FIB-4 demonstrated an independent association with 30-day mortality, with a threshold of 3.1 identifying high-risk individuals. These findings are hypothesis-generating, and external validation is warranted before FIB-4 can be recommended for risk stratification.
Utilizing the coronary artery calcium score to predict coronary artery disease in individuals with presumed cardiac symptoms: A diagnostic study.
Dindari M, Mehdizadeh Parizi MJ, Golchin Vafa R … +7 more , Heydarzadeh R, Zarifkar H, Zarifkar H, Zarifkar H, Hosseini N, Montaseri M, Kojuri J
Am Heart J Plus · 2026 Apr · PMID 41853616 · Full text
BACKGROUND: Coronary artery disease (CAD) remains the leading cause of global mortality, with coronary artery calcification (CAC) serving as a marker of atherosclerosis. While the CAC score is a well-established non-inva...
BACKGROUND: Coronary artery disease (CAD) remains the leading cause of global mortality, with coronary artery calcification (CAC) serving as a marker of atherosclerosis. While the CAC score is a well-established non-invasive tool for cardiovascular risk assessment, its precise role in predicting obstructive CAD in symptomatic patients remains debated. This study evaluates the diagnostic and screening utility of the CAC score in detecting significant CAD. METHODS: In this prospective analytical study, 498 symptomatic adults (>40 years) without prior CAD underwent CAC scoring via CT, followed by coronary angiography as the reference test (CAD defined as ≥50% stenosis). Receiver operating characteristic (ROC) analysis determined the optimal CAC cut-off for CAD detection. RESULTS: The median CAC score was 55 (IQR: 0-233). Among participants, 29.3% and 31.9% were classified as very low and low risk, respectively, based on CAC. A CAC score ≥ 109 predicted obstructive CAD (≥50% stenosis) with 66.6% sensitivity, 80.1% specificity, 65.5% PPV, and 80.95% NPV. For severe CAD (≥80% stenosis), a CAC ≥133 showed 78.6% sensitivity, 74.2% specificity, 35.12% PPV, and 95.15% NPV. CONCLUSION: A CAC score of ≥109 effectively identifies significant CAD, while a score < 133 strongly excludes severe stenosis. These findings support CAC scoring as a valuable rule-out tool in symptomatic patients over 40 without known CAD, aiding clinical decision-making. (ClinicalTrials.gov: NCT06311071).
Analgesic use and changes in renal function in patients with heart failure in a real-world setting: a descriptive study using an electronic medical record database.
Ishida R, Takano T, Tokumasu H … +1 more , Sato N
Am Heart J Plus · 2026 Apr · PMID 41853615 · Full text
OBJECTIVES: To evaluate the incidence of analgesic use and changes in the estimated glomerular filtration rate (eGFR) of patients with heart failure (HF), with and without analgesic use in a real-world Japanese setting....
OBJECTIVES: To evaluate the incidence of analgesic use and changes in the estimated glomerular filtration rate (eGFR) of patients with heart failure (HF), with and without analgesic use in a real-world Japanese setting. METHODS: This retrospective descriptive study collected data from a large electronic medical records database. Between 2012 and 2019, patients aged 18 years or older were included if they were tested for brain natriuretic peptide (BNP) or N-terminal pro-BNP for the first time and were diagnosed with HF within 30 days of the inspection date. We calculated the daily number of patients using any analgesic and described the patient characteristics for each prescribed analgesic, which were classified into acetaminophen (APAP), non-steroidal anti-inflammatory drugs (NSAIDs), selective cyclo‑oxygenase 2 inhibitors, opioids, concomitant users of any analgesic, and non-users. We longitudinally followed the eGFR trend for 2 years using a generalized additive model (GAM) in each group. RESULTS: Among 159,854 eligible patients, 17.8% received analgesics within 90 days of the study entry date. APAP was administered to 51.7% of single analgesic users, followed by NSAIDs (38.7%). GAMs revealed that the eGFR of patients with HF declined only slightly over 2 years, regardless of analgesic use. Even among patients with low renal function at the HF diagnosis, renal function tended to be preserved. CONCLUSION: This study showed that some patients with HF may need analgesics from the early period after initial HF diagnosis, and that eGFR may be preserved in the long term in real-world practice regardless of analgesic use.
Chronic ischemic heart disease: A nonuniform syndrome.
Alam S, Pepine CJ
Am Heart J Plus · 2026 Apr · PMID 41853614 · Full text
Ischemic heart disease (IHD) is a leading cause of morbidity and mortality worldwide. Decades of progress have focused on identification of obstructive coronary plaque ("stenosis" >50-70% diameter narrowing) as a thresho...
Ischemic heart disease (IHD) is a leading cause of morbidity and mortality worldwide. Decades of progress have focused on identification of obstructive coronary plaque ("stenosis" >50-70% diameter narrowing) as a threshold for diagnosis and target for therapy. Emerging evidence underscores the significance of a myriad of relevant isolated or coexisting biologic, physiologic, and radiologic mechanisms and features, beyond stenosis, as causes of ischemia and hence predictors of ischemia-related clinical outcomes. In the context of the chronic ischemic syndrome, a persistent challenge lies in the disconnect between obstructive plagues and symptoms, clinical outcomes, and responses to revascularization and guideline-based medical therapy. For instance, a study elucidating some mechanisms observed a 2.6- fold increase in identification of a nonobstructive cause for myocardial ischemia among symptomatic patients referred for invasive coronary angiography. This review aims at highlighting emerging impactful elements and mechanisms and proposes a broad spectrum of phenotypes, which better capture the heterogeneous characteristics of chronic coronary artery disease (CAD). We examine nontraditional factors, radiometric features, polygenic and genetic signatures, and biomechanical plaque characteristics, which underpin numerous coexisting and overlapping pathologic and clinical manifestations. The focus shifts from quantifying mechanical obstruction to identifying biologically active plaques, which may not be confined to Acute Coronary Syndromes but are present across the spectrum of chronic CAD. Recognizing these features carries important prognostic and therapeutic implications.
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