Cardiology Research And Practice[JOURNAL]
Sun
200 papers
Evaluation of palpitations in pregnancy using an ambulatory event monitor.
Navya A, Ramy Z, Devansh P … +6 more , Beshoy I, Nour T, Varun S, Sadeer A, Judy M, Chantal EA
Am Heart J Plus · 2026 Apr · PMID 41853613 · Full text
BACKGROUND: Palpitations are a common complaint in pregnancy, yet the clinical significance and diagnostic utility of ambulatory cardiac monitoring in this population remain unclear. METHODS: This single-center retrospec...
BACKGROUND: Palpitations are a common complaint in pregnancy, yet the clinical significance and diagnostic utility of ambulatory cardiac monitoring in this population remain unclear. METHODS: This single-center retrospective study included 111 pregnant patients referred to an obstetric cardiology clinic for palpitations. Demographic and clinical characteristics, echocardiographic findings, and ambulatory event monitor data were analyzed. The primary outcome was arrhythmia detection, with secondary outcomes including medical management changes and maternal and fetal outcomes. RESULTS: Of the 111 patients, 61 (55%) underwent ambulatory cardiac monitoring, with arrhythmias detected in 28 (46%) of those monitored. Symptom correlation with rhythm abnormalities was documented in 13 (46%) patients with arrhythmia. Beta-blockers were initiated or continued in 7 (25%) patients with detected arrhythmia, but this was not statistically different from patients without arrhythmia. There was no significant association between arrhythmia detection and patient age, gravidity, gestational age, or prior history of arrhythmia or valvular disease. Speckle tracking echocardiography was performed in 25 patients (28.7%), and global longitudinal strain (GLS) did not significantly correlate with arrhythmia detection (-12.6 ± 10 vs. -15.6 ± 9; Kendall's tau = 0.08, = 0.728). Pregnancy and fetal outcomes did not differ significantly based on arrhythmia detection. CONCLUSIONS: Symptom-guided ambulatory monitoring in pregnancy identified clinically relevant arrhythmias in a subset of patients, including those without prior cardiac history. While this occasionally influenced management, the therapeutic yield was modest. These findings support a selective monitoring approach and emphasize the need for larger studies to identify patients most likely to benefit.
Synergistic Effects of Compound Dendrobium Candidum and Antihypertensive Medications on Refractory Hypertension in Spontaneously Hypertensive Rats.
Chen X, Tong C, Wang J … +16 more , Wu Y, Feng T, Wang J, Gong Z, Chen Y, Chen S, Jin X, Chen S, Guo Z, Chen X, Ren Z, Dai G, Tong Y, Mei X, Wu R, Xue X
Cardiol Res Pract · 2026 · PMID 41821639 · Full text
BACKGROUND: Compound dendrobium candidum (CDC) is formulated from and fragrant peony. Preliminary studies have demonstrated that the combination of CDC with conventional antihypertensive medications exhibits significant...
BACKGROUND: Compound dendrobium candidum (CDC) is formulated from and fragrant peony. Preliminary studies have demonstrated that the combination of CDC with conventional antihypertensive medications exhibits significant synergistic effects in lowering blood pressure. The objective of this study was to evaluate the synergistic effect of combining CDC with antihypertensive medications on refractory hypertension in spontaneously hypertensive rats (SHRs) and to elucidate the underlying mechanisms involved. METHODS: SHRs were treated with either CDC alone or CDC combined with two or three antihypertensive agents including irbesartan, amlodipine, or terazosin, for a duration of 6 weeks. The alterations in blood pressure, angiotensin II (Ang II), insulin, blood sugar, angiotensin II type I receptor (ATR), angiotensin II type II receptor (ATR), insulin receptor, insulin receptor, and insulin β receptor levels were assessed. Glomerular endothelial cells from refractory SHR were then taken for overexpression and knockdown of ATR gene and co-cultured with CDC serum to measure the expression levels of Ang II receptor gene and protein. RESULTS: In comparison to the findings observed in the irbesartan + amlodipine + terazosin (IAT) group, the addition of CDC significantly enhanced antihypertensive efficacy. The rate of achieving blood pressure targets (< 150 mmHg) in SHRs with refractory hypertension increased from 0% to 100%. Treatment with CDC significantly reduced the compensatory increase in ATR and ATR levels caused by IAT treatment and showed a significant antihypertensive and synergistic effect. Primary glomerular endothelial cells extracted from SHRs and Wistar rats and treated with 0.5% CDC-containing serum showed significantly reduced ATR levels in the ATR-overexpression condition. The combination of CDC and antihypertensive drugs was effective in reducing the messenger RNA (mRNA) and protein expression levels of ATR and ATR in glomerular endothelial cells. CONCLUSIONS: CDC in combination with antihypertensive drugs showed a synergistic effect in controlling refractory hypertension. The mechanism of action may be related to the attenuation of excessive expression of ATR. This study offers a novel approach for the treatment of clinically resistant hypertension.
Analysis of the impact of pharmacological treatment on arterial stiffness in patients with connective tissue diseases.
Ramos-Becerra CG, Garcia-Ordoñez GP, Yeo-Reyes M … +5 more , Mercado MV, Salazar-Paramo M, Saldaña-Cruz A, Lopez-Gradilla C, Cardona-Muller D
Am Heart J Plus · 2026 Apr · PMID 41815562 · Full text
Arterial stiffness is a critical but underrecognized factor in cardiovascular morbidity among patients with connective tissue diseases, including rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, an...
Arterial stiffness is a critical but underrecognized factor in cardiovascular morbidity among patients with connective tissue diseases, including rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, and idiopathic inflammatory myopathies. This review synthesizes evidence on pharmacological interventions, emphasizing benefits and limitations. IL-6 inhibitors and TNF-α blockers improve vascular outcomes by reducing inflammation and enhancing endothelial function. Methotrexate offers modest effects, whereas glucocorticoids, though effective for acute control, contribute to long-term vascular damage. Emerging therapies show promise in modulating arterial compliance through novel mechanisms. The review underscores the value of integrating vascular biomarkers, such as pulse wave velocity and cardio-ankle vascular index, into clinical practice. By contextualizing vascular responses to immunomodulatory treatments, this work advocates for a more nuanced, personalized strategy to mitigate cardiovascular risk in connective tissue disease patients through combined pharmacological and non-pharmacological approaches.
Correction to "A Meta-Analysis of Randomized Controlled Trials (RCTs) Investigating the Efficacy and Safety of Acupuncture in Treating Myocardial Ischemia/Reperfusion (I/R) Injury".
Cardiol Res Pract · 2026 · PMID 41777525 · Full text
[This corrects the article DOI: 10.1155/crp/9970541.].
[This corrects the article DOI: 10.1155/crp/9970541.].
Cardiovascular sex differences and associated factors among adult population in Somaliland using insights from Somaliland demography and health survey.
Mohamed IF, Abdikarim H, Ali SM … +4 more , Mohamed H, Abdillahi AM, Mohamed SH, Muse AH
Am Heart J Plus · 2026 Mar · PMID 41742951 · Full text
STUDY OBJECTIVE: To examine sex differences and identify associated risk factors for cardiovascular disease (CVD) among adults in Somaliland, in order to inform targeted public health interventions. DESIGN: A cross-secti...
STUDY OBJECTIVE: To examine sex differences and identify associated risk factors for cardiovascular disease (CVD) among adults in Somaliland, in order to inform targeted public health interventions. DESIGN: A cross-sectional analysis of nationally representative survey data. SETTING: Community-based, covering all regions of Somaliland. PARTICIPANTS: A sample of 20,669 adults from the 2020 Somaliland Demographic and Health Survey (SLDHS). INTERVENTIONS: Not applicable (observational study). MAIN OUTCOME MEASURES: The primary outcome was the prevalence of self-reported, doctor-diagnosed CVD (including coronary heart disease, hypertensive heart disease, and stroke). Key determinants were assessed via adjusted odds ratios (AOR) from multivariable logistic regression. RESULTS: The overall CVD prevalence was 0.94%, with significant sex and geographic disparities. Hypertension was the strongest predictor overall (AOR = 4.68, 95% CI: 3.26-6.71), with a greater effect in females (AOR = 5.10, 95% CI: 3.23-8.04). Diabetes was a significant risk factor for males only (AOR = 2.59, 95% CI: 1.11-6.07). Widowhood and rural residence increased CVD risk for females, while nomadic residence was protective for males. CONCLUSIONS: This study reveals significant, sex-specific disparities in CVD determinants in Somaliland. Public health strategies must prioritize hypertension and diabetes control, improve healthcare access for women-particularly widowed and rural residents-and develop regionally tailored interventions to mitigate the growing CVD burden.
Effects of pericardial incision on circulation and body oxygenation in pediatric patients with congenital heart disease.
Sakamoto T, Matsumoto N, Yamazaki S … +3 more , Mitsumori R, Suto T, Saito S
Am Heart J Plus · 2026 Mar · PMID 41742950 · Full text
STUDY OBJECTIVE: To evaluate the influence of pericardial incision (PI) on circulation and body oxygenation and identify factors influencing them in pediatric patients undergoing surgery for congenital heart disease (CHD...
STUDY OBJECTIVE: To evaluate the influence of pericardial incision (PI) on circulation and body oxygenation and identify factors influencing them in pediatric patients undergoing surgery for congenital heart disease (CHD). DESIGN: Prospective observational study. SETTING: Gunma Children's Medical Center from August 4, 2022 to May 30, 2025. PARTICIPANTS: We evaluated 63 patients aged 0-18 years with CHD undergoing elective cardiovascular surgery. MAIN OUTCOME MEASURES: Blood pressure (BP), central venous pressure (CVP), and tissue oxygenation index (TOI), representing systemic oxygenation, were measured before and after PI during surgery and compared between the pre- and post-incision periods. Univariate (logistic) regression analysis was performed with the age and type of disease set as explanatory variables. RESULTS: Systolic (sBP), diastolic (dBP), and mean blood pressure (mBP) significantly decreased after PI. CVP significantly increased from 4.93 (1.96) to 6.08 (2.47), = 0.00005, CI = -1.6733 to -0.5889, ES = 0.53 (medium). TOI significantly decreased from 71.22 (7.25) to 70.41 (7.79), = 0.00631, CI = 0.403-1.56, ES = 0.37 (small to medium). Age was the only significant explanatory variable to decrease the TOI value (coefficient (coef) = 0.0004, = 0.0301, CI = 0.000113 to 0.0.000797). CONCLUSION: PI increases venous congestion and reduces arterial pressure, leading to a decline in systemic oxygenation in patients with CHD. Therefore, age exhibits the most detrimental effect on this pathological condition.
Predicting complications in emergency department patients with acute coronary syndrome - Existing risk scores versus a new logistic regression model.
Nilsson T, Strömfors M, Trägårdh A … +3 more , Mokhtari A, Khoshnood AM, Ekelund U
Am Heart J Plus · 2026 Mar · PMID 41732505 · Full text
BACKGROUND: Patients with acute coronary syndrome (ACS) are often admitted to monitored wards due to the risk of complications. Several risk prediction scores exist, but their use in the emergency department (ED) is limi...
BACKGROUND: Patients with acute coronary syndrome (ACS) are often admitted to monitored wards due to the risk of complications. Several risk prediction scores exist, but their use in the emergency department (ED) is limited. We aimed to compare the ability of existing risk scores with a new logistic regression model in predicting complications in ACS patients. METHODS: This was a secondary analysis of data from the ESC TROP trial (NCT03421873), including ACS patients from five EDs in Region Skåne, Sweden (2017-2018). Complications were identified via diagnosis and/or intervention codes and manual chart review. GRACE, GRACE FFE, TIMI, HEART, ACTION ICU, and CHA₂DS₂-VASc scores were calculated. A new logistic regression model was developed, and its predictive performance was assessed using the area under the ROC curve (AUROC) and a net reclassification improvement analysis (NRI). RESULTS: Among 2223 ACS patients, 164 (7.4%) experienced complications. Independent predictors for complications included age, STEMI, troponin and lactate at arrival, shock index, Killip class, and new ECG changes. The logistic regression model's AUROC 0.84 (95% CI 0.80-0.88) outperformed all known risk scores: GRACE FFE 0.79 (0.75-0.84), ACTION ICU 0.77 (0.72-0.82), GRACE 0.76 (0.70-0.81), TIMI 0.74 (0.68-0.79), HEART 0.69 (0.64-0.74), and CHA₂DS₂-VASc 0.64 (0.59-0.69). Logistic regression improved reclassification of non-events, with a positive non-event NRI compared with all other scores. CONCLUSIONS: Serious complications occurred in 7% of ACS patients. A logistic regression model based on simple ED variables showed excellent predictive performance, surpassing existing risk scores. Improved risk stratification may optimize resource allocation while maintaining patient safety.
Improving the management of acute myocardial infarctions: There's an App for that.
Cullen KJ, Mercuri M, Mir H … +9 more , Mosleh K, Setrak R, Jolly SS, Tsang M, Syal R, Nkurunziza J, Welsford M, Schwalm JD, Natarajan MK
Am Heart J Plus · 2026 Jan · PMID 41732318 · Full text
BACKGROUND: ST-Elevation Myocardial Infarction (STEMI) is a critical emergency. Managing care requires accurate diagnosis, shared communication between decision-makers, and timely transport and reperfusion at a hospital...
BACKGROUND: ST-Elevation Myocardial Infarction (STEMI) is a critical emergency. Managing care requires accurate diagnosis, shared communication between decision-makers, and timely transport and reperfusion at a hospital with capacity for such interventions. This study examines the implementation of a smartphone application (SMART AMI-ACS App) to facilitate real-time ECG sharing, enhancing communication and decision-making in STEMI management. METHODS: This multi-centre study evaluated the implementation, acceptability and uptake of the App among interventional cardiologists and emergency medicine (EM) physicians managing suspected STEMI patients between April 1st 2022 and March 31st 2023. Guided by the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework, STEMI registry data and post-implementation surveys from a large regional cardiac centre and its 13 partner emergency departments in Ontario, Canada, were used to assess App uptake and effectiveness. RESULTS: During the 12-month evaluation 254 (84 %) of the eligible 300 regional EM physicians downloaded the App, with > 1400 ECG images sent from 724 patients. Users reported the App helped in communication and timing of care. No degradation of ECG images was observed. App use was associated with lower door-in-door-out (DIDO) times 48 min (IQR 31-67) vs 55 min (IQR 39-77) and lower proportion of non-STEMI cases accepted to interventional cardiology (22 % vs 39 %, < 0.0001). CONCLUSION: Uptake of the SMART AMI-ACS App was positive and may be associated with lower non-STEMI cases and lower DIDO times. The App provided a secure channel for communication of information and point-of-care transfer of images across healthcare providers. Uptake of the App has expanded to other regions.
Differential effects of pre-procedural atorvastatin versus rosuvastatin on hematologic and inflammatory markers in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention: A randomized controlled trial.
Khameneh Bagheri R, Eshraghi A, Amirsoleimani H … +1 more , Keihanian F
Am Heart J Plus · 2026 Jan · PMID 41732317 · Full text
BACKGROUND: The pleiotropic effects of statins may benefit patients with acute coronary syndromes. This study compared the impact of pre-procedural atorvastatin versus rosuvastatin on hematologic and inflammatory indexes...
BACKGROUND: The pleiotropic effects of statins may benefit patients with acute coronary syndromes. This study compared the impact of pre-procedural atorvastatin versus rosuvastatin on hematologic and inflammatory indexes in the hyper-acute setting of ST-elevation myocardial infarction (STEMI). METHODS: In this pre-specified, multi-centric, triple-blind trial, STEMI patients were randomized to receive either 80-mg atorvastatin ( = 98) or 40-mg rosuvastatin ( = 102) before primary percutaneous coronary intervention (PPCI). Key hematologic indexes-neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and platelet distribution width (PDW)-were measured at baseline, 24, and 48 h post-PPCI. Contrast-induced nephropathy (CIN) incidence was also assessed. RESULTS: The incidence of CIN was similarly low in both groups (atorvastatin 3.0 % vs. rosuvastatin 3.5 %, = 0.99). However, hematologic markers showed significant differences. The atorvastatin group had a significantly lower NLR at 48 h compared to the rosuvastatin group (Median [IQR]: 5.1 [3.2-8.1] vs. 7.8 [4.9-10.2], = 0.003). Conversely, the rosuvastatin group demonstrated a significantly higher PDW at 24 h (15.6 ± 1.5 vs. 14.7 ± 1.5, < 0.001). No significant inter-group difference was found in the 48-h PLR. CONCLUSION: While both high-intensity statins provided similar nephroprotection, they exhibited distinct modulatory effects. Atorvastatin was associated with a more pronounced anti-inflammatory effect (lower NLR), whereas rosuvastatin was linked to increased platelet activity (higher PDW). These findings suggest differential pleiotropic properties that warrant further investigation for their impact on clinical outcomes.Registry Accessibility: http://irct.ir/trial/27377Trial registration code: IRCT2017101236737N1.
Impact of baseline anemia on outcomes following chronic total occlusion percutaneous coronary intervention.
Kharsa C, Sella G, Sammour Y … +7 more , Chaaya RGB, Kritya M, Philip J, Virk MHM, Maqsood MH, Kleiman NS, Shah AR
Am Heart J Plus · 2026 Jan · PMID 41732316 · Full text
BACKGROUND: Anemia is a common comorbidity in patients undergoing percutaneous coronary intervention (PCI) and may signal worse post-procedural outcomes. Its prognostic impact in the context of chronic total occlusion (C...
BACKGROUND: Anemia is a common comorbidity in patients undergoing percutaneous coronary intervention (PCI) and may signal worse post-procedural outcomes. Its prognostic impact in the context of chronic total occlusion (CTO) PCI remains underexplored. OBJECTIVES: To evaluate procedural and clinical outcomes following CTO PCI in patients with and without anemia using real-world data from a high-volume tertiary care center. METHODS: We conducted a retrospective observational study using data from 504 patients who underwent CTO PCI between January 2018 and December 2023 at Houston Methodist. Patients were stratified by anemia status, defined using World Health Organization hemoglobin thresholds. Primary endpoints included procedural success, one-year all-cause mortality, and target lesion revascularization (TLR). Secondary endpoints included target lesion failure (TLF) and in-hospital complications. RESULTS: Of the cohort, 163 patients (32.3 %) had anemia. Patients with anemia were older, more often female, and had a greater burden of comorbidities, including CKD and heart failure. Despite similar lesion complexity and procedural success rates (80.4 % vs. 81.5 %; = 0.79), patients with anemia had higher rates of in-hospital complications and one-year mortality (18.1 % vs. 5.0 %; HR = 4.0, < 0.001)one-year target lesion failure (HR = 1.9; 95 % CI [1.2-2.9]; = 0.005). Multivariate analysis identified age, heart failure, anemia and multivessel PCI as independent predictors of mortality at one-year, while CKD, and ISR lesion were predictors of TLF at one-year. The severity of anemia was not independently associated with all-cause mortality. CONCLUSION: Pre-procedural anemia is associated with markedly worse in-hospital and long-term outcomes in patients undergoing CTO PCI, despite comparable technical success. These findings highlight anemia as a marker of systemic vulnerability and underscore the need for comprehensive risk stratification and multidisciplinary care in this high-risk population.
Is predictive modeling the missing link for post-STEMI recovery in rural and resource-poor regions?
Lacsa JEM
Am Heart J Plus · 2026 Jan · PMID 41732315 · Full text
Abstract loading — click title to view on PubMed.
Impact of pre-procedural requirements on time to aortic valve replacement: Transcatheter AVR vs surgical AVR.
Stinis C, Tunis S, Lauck S … +5 more , Gupta A, Murphy S, Chikermane S, Clancy S, Russo M
Am Heart J Plus · 2026 Jan · PMID 41732314 · Full text
BACKGROUND/OBJECTIVE: This study aims to understand the extent that cardiac specialist visits and imaging requirements contribute to the difference in time to Aortic valve replacement (AVR) stratified by approach transca...
BACKGROUND/OBJECTIVE: This study aims to understand the extent that cardiac specialist visits and imaging requirements contribute to the difference in time to Aortic valve replacement (AVR) stratified by approach transcatheter AVR (TAVR) and surgical AVR (SAVR). METHODS: Optum Market Clarity Data was used to identify patients with clinically significant AS (CSAS) who received an AVR between 2016 and 2023 and whose AVR occurred within two years of their CSAS diagnosis. Patient characteristics were measured at baseline; pre-procedural factors, including the number of cardiac specialist visits and imaging events, were measured from CSAS diagnosis to AVR (TAVR vs SAVR). Stepwise generalized linear models were used to assess whether the number of cardiac specialist visits and imaging events contribute to the differences in time to TAVR and SAVR, after adjusting for baseline characteristics. RESULTS: Of the 14,225 patients in the cohort, 42 % received a TAVR. Compared to the SAVR cohort, the TAVR cohort was, on average, more male, older, sicker, and had more Medicare enrollees. TAVR patients had approximately two times more cardiac specialist visits (3.73 vs 6.37) and imaging events (1.18 vs 2.07) than SAVR patients. Time to TAVR is 65 days longer (RR = 1.77, 1.67-1.87) than SAVR, after adjustment for patient characteristics. This difference reduces to 11 days (RR = 1.12, 1.07-1.17) after accounting cardiac specialist encounters and imaging events. DISCUSSION: Pre-procedural encounters significantly contribute to the longer time to AVR for TAVR patients. Findings suggest a need for streamlining the pre-procedural process for TAVR to enhance timely care delivery for CSAS patients.
Symptom experience of women with ischemia and no obstructive coronary artery disease: A mixed-methods approach.
Thandra S, Dave E, Leon A … +6 more , Huang J, Schwartz A, Gaignard S, Higgins M, Kimble LP, Mehta PK
Am Heart J Plus · 2026 Jan · PMID 41732313 · Full text
BACKGROUND: Women with myocardial ischemia with no obstructive arteries (INOCA) often have coronary microvascular dysfunction (CMD) or coronary vasospasm. INOCA is associated with adverse cardiovascular event risk, recur...
BACKGROUND: Women with myocardial ischemia with no obstructive arteries (INOCA) often have coronary microvascular dysfunction (CMD) or coronary vasospasm. INOCA is associated with adverse cardiovascular event risk, recurrent angina hospitalizations, and reduced health-related quality of life (QoL). OBJECTIVES: In this mixed-methods study we used qualitative data to understand angina burden, while considering overall symptom experience of patients living with INOCA. METHODS: Twenty-four women with INOCA confirmed by coronary angiography were enrolled. A majority ( = 20) had coronary function testing to diagnose CMD or vasospasm. In addition to demographics and risk factors, angina and QoL were evaluated using the Seattle Angina Questionnaire (SAQ) (scored 0-100, higher score being better), along with Duke Activity Score Index and PHQ-8. Qualitative telephone interviews were conducted, recorded, transcribed, and analyzed for themes to explore patients' experiences. Descriptive statistics were performed for quantitative data. RESULTS: Mean age was 53.2 ± 10.8 years and body mass index was 30.8 ± 6.9 kg/m. Cardiac risk factors were prevalent with 63 % having hypertension, 75 % hyperlipidemia, and 25 % diabetes. SAQ scores indicated high angina frequency (50.5 ± 21.2), low angina stability (35.2 ± 31.5), physical limitations (37.7 ± 24.3), and poor QoL (41.3 ± 23.2). Qualitative analysis identified four major themes: , , , and "". All patients expressed both diagnosis related emotional burden and explicit frustration. CONCLUSIONS: This study highlights the substantial emotional and physical challenges women living with INOCA experience, emphasizing critical care gaps. Research efforts should prioritize understanding pathophysiologic mechanisms and improving symptom management to better support patient QoL.
The role of Id genes on pulmonary hypertension development in left heart failure.
Lteif C, Wachs P, Sharma RK … +1 more , Duarte JD
Am Heart J Plus · 2026 Jan · PMID 41732312 · Full text
OBJECTIVE: To investigate the role of genes in the development of pulmonary hypertension (PH) in heart failure (HF) and evaluate genetic variants of the genes associated with HF-PH. DESIGN: Experimental study using an...
OBJECTIVE: To investigate the role of genes in the development of pulmonary hypertension (PH) in heart failure (HF) and evaluate genetic variants of the genes associated with HF-PH. DESIGN: Experimental study using an AKR/J mouse model of HF-PH and a genetic association study using the UK Biobank cohort. SETTING: Laboratory animal study and population-based cohort study. PARTICIPANTS: AKR/J mice with HF-PH and participants with HF from the UK Biobank cohort. INTERVENTIONS: Administration of tacrolimus (Id signaling inducer) in the mouse model. MAIN OUTCOME MEASURES: Tissue-specific gene expression of , , and in HF-PH mice; severity of HF-PH after tacrolimus treatment; associations of single nucleotide polymorphisms of , , and with PH development and mortality in participants with HF. RESULTS: was upregulated in the left ventricle (Fold Change (FC) = 1.65; = 3.0 × 10) of HF-PH mice. In adipose tissue, and were downregulated (FC = 0.33; = 5.2 × 10 and FC = 0.50; = 0.01, respectively), while was upregulated (FC = 1.78; = 7 × 10). Tacrolimus worsened PH and diastolic dysfunction, upregulating only in adipose tissue. In the clinical cohort, rs7425561 and rs10174593 (expression quantitative loci for ) trended toward reduced risk of PH in HF and all-cause mortality in participants with HF-PH. CONCLUSION: The results suggest , , and are involved in HF-PH pathogenesis, but more research is needed to characterize their exact role.
The gut-heart axis: Exploring the role of the gut microbiome in cardiovascular health - A focused systematic review.
Makkieh Y, Shah HH, Imran SB … +8 more , Pathan SMK, Saju AC, Majooju M, Garg A, Naag T, Islam R, Fahima C, Ali R
Am Heart J Plus · 2026 Jan · PMID 41732311 · Full text
This focused systematic review examines the role of the gut microbiota in cardiovascular disease (CVD). The review explores mechanisms linking gut dysbiosis with CVD via microbial metabolites such as trimethylamine-N-oxi...
This focused systematic review examines the role of the gut microbiota in cardiovascular disease (CVD). The review explores mechanisms linking gut dysbiosis with CVD via microbial metabolites such as trimethylamine-N-oxide (TMAO) and short-chain fatty acids (SCFAs), which affect inflammation, endothelial function, and lipid metabolism. Interventions including dietary modifications, probiotics, prebiotics, fecal microbiota transplantation, and pharmacological agents such as statins, rifaximin, and empagliflozin are evaluated for their impact on microbial composition and cardiovascular outcomes. Probiotic strains and fiber-rich diets demonstrated modest improvements in blood pressure, lipid profiles, and inflammatory markers. Studies revealed that gut microbiome alterations influence drug metabolism and bleeding risk in patients taking oral anticoagulants. Limited evidence suggests that modulation of the microbiota may reduce chemotherapy-induced cardiotoxicity. However, only nine eligible studies met the inclusion criteria, reflecting the early and heterogeneous nature of this research area. Consequently, these findings should be interpreted as exploratory and hypothesis-generating. The focused review emphasizes the need for large-scale trials to validate microbiome-targeted strategies in CVD prevention and management. This focused systematic review is registered with PROSPERO (ID: CRD420251022190).
Mortality trends in heart failure and colon cancer: Insights into gender, ethnic, and regional disparities in the United States (1999-2020).
Rahman HAU, Iqbal N, Fahim MAA … +6 more , Salman F, Ahmed SH, Asim O, Mansoor T, Farooq MZ, Asghar MS
Am Heart J Plus · 2026 Jan · PMID 41732310 · Full text
BACKGROUND: Heart failure (HF) and colorectal cancer (CRC) are major public health concerns among the aging population in the United States. This study aimed to investigate temporal, regional, urbanization and racial tre...
BACKGROUND: Heart failure (HF) and colorectal cancer (CRC) are major public health concerns among the aging population in the United States. This study aimed to investigate temporal, regional, urbanization and racial trends in mortality among adults with HF and CRC aged ≥65 years. METHODS: Mortality data were sourced from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database, utilizing ICD-10 codes to identify deaths related to colon cancer and heart failure from 1999 to 2020. Age-adjusted mortality rates (AAMRs) per 100,000 individuals were calculated, along with Annual Percentage Changes (APCs) and their respective 95 % confidence intervals (CIs). RESULTS: The AAMRs remained relatively stable between 1999 (8.5) and 2004 (7.3) (APC: -2.61; 95 % CI: -3.86, 0.09). From 2004 to 2009, a significant decline to 5.0 was observed (APC: -7.08; 95 % CI: -9.28, -3.58). Subsequently, the rates stabilized by 2015 (3.8) (APC: -4.84; 95 % CI: -6.58 to 2.04) but demonstrated a modest increase to 4.4 by 2020 (APC: 2.55; 95 % CI: 0.08 to 8.19). Mortality rates were consistently higher among males (6.7 vs. 4.5 for females) and varied across racial/ethnic groups, with Non-Hispanic (NH) Whites (5.7) and NH Black/African Americans (5.4) exhibiting the highest rates, while Hispanics (2.8) and NH Asians/Pacific Islanders (2.3) had the lowest. Regional disparities showed that the Midwest had the highest AAMRs (6.5) followed by the Northeast (5.4), West (5.2), and South (4.8). Additionally, non-metropolitan areas exhibited significantly higher rates than metropolitan areas (7.1 vs. 5.0, respectively). The states in the 90th percentile for AAMRs were West Virginia, Mississippi, South Dakota, Nebraska, and North Dakota. CONCLUSION: Although there was an overall decline in mortality rates during the study period, disparities remained evident, with higher mortality observed among males, non-Hispanic Whites, residents of the Midwest, and individuals in non-metropolitan areas. This highlights the need for targeted public health intervention.
Coronary artery disease and cancer: Shared risk factors, pathogenesis, and treatment effects.
Charbel N, Aramouni K, Sater S … +1 more , Kreidieh F
Am Heart J Plus · 2026 Jan · PMID 41732309 · Full text
As cancer survival improves, cardiovascular health has become an increasingly important concern, particularly given the elevated risk of coronary artery disease (CAD) in patients with cancer. This review examines the com...
As cancer survival improves, cardiovascular health has become an increasingly important concern, particularly given the elevated risk of coronary artery disease (CAD) in patients with cancer. This review examines the complex relationship between cancer and CAD, focusing on shared epidemiological trends, overlapping risk factors, converging pathophysiological mechanisms, and cancer treatment-related cardiovascular toxicities. Cancer and CAD share modifiable risk factors, including obesity, diabetes, hypertension, hyperlipidemia, smoking, alcohol use, physical inactivity, and poor diet, that may act synergistically to promote both conditions. In addition, biological processes such as chronic inflammation, oxidative stress, platelet activation, and clonal hematopoiesis of indeterminate potential further contribute to disease progression. Several cancer therapies, including antimetabolites, platinum-based agents, immune checkpoint inhibitors, tyrosine kinase inhibitors, and radiotherapy, have been implicated in vascular injury, plaque destabilization, and accelerated atherosclerosis, increasing the risk of CAD. Understanding these shared mechanisms is essential for reducing cardiovascular complications in patients with cancer. This review outlines the epidemiology, risk factors, and biological mechanisms linking CAD and cancer, and evaluates the cardiotoxic effects of commonly used cancer therapies.
Letter to the editor: data accuracy.
Manti M, Tsioufis PA
Am Heart J Plus · 2026 Mar · PMID 41704229 · Full text
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Obesity paradox in patients with non-ST-elevation myocardial infarction undergoing percutaneous coronary intervention: A nationwide retrospective observational study.
Moore S, Thakkar A, Notta S … +4 more , Snipp J, McGuire C, Vedantam V, Jbara MH
Am Heart J Plus · 2026 Mar · PMID 41704228 · Full text
INTRODUCTION: The prevalence of obesity in the United States is high, with over 35% of the population classified as obese. Obesity, along with the lifestyle factors contributing to it, is considered a major risk factor f...
INTRODUCTION: The prevalence of obesity in the United States is high, with over 35% of the population classified as obese. Obesity, along with the lifestyle factors contributing to it, is considered a major risk factor for heart disease. However, research studies have reported controversial findings regarding its impact on morbidity and mortality. METHODS: Data was obtained from the Nationwide Inpatient Sample database from January 2016 to December 2020. The study included adult patients with a principal discharge diagnosis of NSTEMI who underwent PCI during hospitalization. They were divided into obese (BMI > 30) and not obese (BMI < 30). The primary outcome was inpatient mortality. Secondary outcomes were cardiogenic shock, cardiac arrest, arrhythmias, and acute renal failure, as well as the need for transfusions, pressors, ventilators, and ECMO. RESULTS: We analyzed 448,424 hospitalizations for NSTEMI, of which 172,665 patients underwent PCI. Among these, 39,548 (22.9%) were obese (BMI >30). Obesity was associated with lower in-hospital mortality compared to non-obese patients (1.2% vs. 1.8%; adjusted odds ratio [aOR]: 0.82; 95% CI: 0.74-0.90; < 0.001), after adjustment for age, sex, race, and Charlson Comorbidity Index. Obese patients also had lower rates of cardiogenic shock (2.7% vs. 3.3%; aOR: 0.84; 95% CI: 0.78-0.90; < 0.001), cardiac arrest (1.3% vs. 1.6%; aOR: 0.86; 95% CI: 0.78-0.95; < 0.005), and ventricular arrhythmias (5.2% vs. 5.7%; aOR: 0.93; 95% CI: 0.88-0.98; p < 0.005). They also required fewer blood transfusions (1.9% vs. 2.3%; aOR: 0.90; 95% CI: 0.83-0.98; < 0.05) and mechanical ventilation (2.9% vs. 3.2%; aOR: 0.91; 95% CI: 0.85-0.98; p < 0.05). No significant differences were observed in dialysis, vasopressor use, or ECMO. However, obese patients had higher rates of acute kidney injury (15.0% vs. 13.5%; aOR: 1.25; 95% CI: 1.21-1.29; < 0.001) and acute respiratory failure (9.1% vs. 8.2%; aOR: 1.17; 95% CI: 1.13-1.23; p < 0.001). CONCLUSION: The "obesity paradox" suggests that despite obesity's role in cardiovascular disease risk, individuals with obesity may have a survival advantage during acute cardiovascular events and certain surgeries. Our study aligns with these findings, underscoring the need for further research to comprehend the underlying pathophysiological mechanisms.
Novel cholesterol lowering drugs: Can phase 2/3 clinical trial safety assessments predict cardiovascular event outcome trial efficacy?
Shear C, Davidson MH, Ditmarsch M … +2 more , Kastelein JJP, Szarek M
Am Heart J Plus · 2026 Mar · PMID 41704227 · Full text
SETTING: Prior to a cardiovascular outcomes trial (CVOT), novel cholesterol-lowering therapies undergo phase 2/3 studies for their lipid and atherosclerotic effects and safety (non-CVOTs). Since the occurrence of major a...
SETTING: Prior to a cardiovascular outcomes trial (CVOT), novel cholesterol-lowering therapies undergo phase 2/3 studies for their lipid and atherosclerotic effects and safety (non-CVOTs). Since the occurrence of major adverse cardiovascular events (MACE) is part of the safety assessment, nominal reductions or increases may be observed prior to definitive testing of the effect in a CVOT. STUDY OBJECTIVE: To investigate if the observed MACE treatment effect in non-CVOT lipid-lowering registration studies holds value in predicting the outcome in a CVOT trial, typically reported later than the initial lipid-lowering studies. DESIGN/PARTICIPANTS/INTERVENTIONS: We reviewed recent development programs for cholesterol-lowering drugs that had completed non-CVOT and CVOT studies. MACE data were compared for phase 2/3 non-CVOT versus pivotal CVOT results. MAIN OUTCOME MEASURES: Our primary outcome was a qualitative comparison for directionally concordant consistency in MACE risk ratio treatment effects (harm, neutrality, or benefit). Correlation analysis was also performed. RESULTS: Seven drugs were reviewed in 3 cholesterol-lowering classes: CETP inhibitors, bempedoic acid, and PCSK9 inhibitors. Concordance in non-CVOT vs CVOT results was seen in 6 of 7 drugs. One drug (dalcetrapib) had a trend for benefit observed, albeit with very small numbers, in early development, but showed a neutral CVOT. There was a moderate correlation between the risk reductions or increases from the non-CVOTs and CVOTs: = 0.69, = 0.0893. CONCLUSION: Within the limitations of the drugs studied and the variability in MACE definitions, there is value in the results of non-CVOTs to predict the CVOT outcome.
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