Mitral valve dysplasia is a rare congenital etiology of primary mitral valve regurgitation. It can cause severe chronic mitral regurgitation, which may eventually lead to left atrial and ventricular dilation and dysfunct...Mitral valve dysplasia is a rare congenital etiology of primary mitral valve regurgitation. It can cause severe chronic mitral regurgitation, which may eventually lead to left atrial and ventricular dilation and dysfunction. Left ventricular non-compaction is a relatively rare cardiomyopathy that overlaps with hypertrophic and dilated cardiomyopathy. It can also lead to left or right ventricular dysfunction and failure. Papillary muscle hypertrophy may be a subtype of, or an early expression of, hypertrophic cardiomyopathy. Herein, we present a 42-year-old woman with a rare coexistence of mitral valve dysplasia, non-compaction left ventricular cardiomyopathy, and papillary muscle hypertrophy.
AIM: To assess the knowledge of healthcare professionals regarding cardiac complications of cancer treatments and their perspectives on cardio-oncology. MATERIALS AND METHODS: A web-based survey, adapted from the Ottawa...AIM: To assess the knowledge of healthcare professionals regarding cardiac complications of cancer treatments and their perspectives on cardio-oncology. MATERIALS AND METHODS: A web-based survey, adapted from the Ottawa Hospital Research Institute's questionnaire, was designed with 45 questions across seven sections, modified to local requirements. It was circulated among cardiologists, radiation oncologists, and medical oncologists practicing or training in multidisciplinary setups and academic centers. The survey explored respondents' understanding of cardio-oncology, awareness of cardiac complications of cancer treatment, availability of institutional services, and current practices. Descriptive statistics were used for analysis. RESULTS: Fifty-six professionals responded, including 13 cardiologists, 31 radiation oncologists, and 12 medical oncologists. Of these, 31 (46.4%) were trainees, while only 1.8% reported formal training in cardio-oncology; 19.6% indicated availability of institutional training programs. Most (90%) recognized cardio-oncology as a field for identifying treatment-related side effects and referral to cardiologists, while 72% acknowledged its role in follow-up and 67.3% emphasized patient education. Nearly 70% believed cardio-oncology services could improve prognosis. Awareness of international guidelines was limited (38.2%), and no institution reported a structured program. Lack of infrastructure (55.4%) and limited interest (48.2%) were major barriers. CONCLUSION: The survey underscores significant gaps in training, awareness, and structured program in cardio-oncology.
OBJECTIVE: Atrial fibrillation (AF) is a major predictor of heart failure, stroke, and mortality. Traditional Holter monitors and event recorders are limited by short recording times. Wearable electrocardiographic (ECG)...OBJECTIVE: Atrial fibrillation (AF) is a major predictor of heart failure, stroke, and mortality. Traditional Holter monitors and event recorders are limited by short recording times. Wearable electrocardiographic (ECG) and photoplethysmographic (PPG) devices enable continuous monitoring and large-scale AF screening. This review assesses their diagnostic performance, clinical usefulness, and implementation challenges. METHODS: Following PRISMA guidelines, PubMed, Embase, and Web of Science were searched for studies from 2010-2025. Included studies had ≥30 participants and reported AF detection accuracy or clinical outcomes. Studies evaluating PPG devices required ECG verification as the reference standard. RESULTS: Wearable ECG patches showed high sensitivity (92-98%) and specificity (85-97%) and detected more AF episodes than short-duration Holter monitoring. PPG-based smartwatches demonstrated moderate-to-high accuracy in irregular pulse detection, further improved by AI-assisted algorithms. Limitations included motion artifacts, false positives, adherence issues, clinician data burden, and limited evidence for stroke prevention. CONCLUSION: Wearable ECG devices are reliable for clinical AF detection. PPG-based devices are best used for screening, with subsequent ECG confirmation according to international AF management guidelines.
BACKGROUND: Psychiatric comorbidities are common among patients with ST-segment elevation myocardial infarction (STEMI) and may be associated with in-hospital outcomes, which may differ among sexes. METHODS: Using the Na...BACKGROUND: Psychiatric comorbidities are common among patients with ST-segment elevation myocardial infarction (STEMI) and may be associated with in-hospital outcomes, which may differ among sexes. METHODS: Using the National Inpatient Sample, an administrative claims database, we identified adults hospitalized with STEMI and psychiatric comorbidities and performed a retrospective cross-sectional observational study. Multivariable logistic regression and propensity-score matching were applied; outcomes were assessed between females and males with subgroup analyses for individual psychiatric conditions. RESULTS: Of 145,830 patients, 45.51% were female. Female sex was associated with higher odds of in-hospital mortality (aOR 1.13, 95% CI: 1.01-1.26, = 0.031) and pulmonary embolism (aOR 1.54, CI: 1.05-2.26, = 0.027), and lower odds of cardiogenic shock (aOR 0.85, 95% CI: 0.79-0.92, < 0.001). Female sex was also associated with lower odds of acute heart failure, acute kidney injury, cardiac arrhythmias, and device use ( < 0.05). Directional associations persisted after propensity-matching. Subgroup analyses corroborated trends and revealed female post-traumatic stress disorder patients demonstrated higher odds of in-hospital mortality (aOR 2.40, 95% CI 1.37-4.22, = 0.002). CONCLUSION: Among patients with STEMI and psychiatric disorders, female sex was associated with higher odds of in-hospital mortality and lower odds of several adverse complications. Psychiatric comorbidities are heterogeneous, however, and findings vary.
AIMS: To characterize lesion distribution, procedural strategy, and short-term outcomes after endovascular revascularisation for symptomatic lower-extremity peripheral arterial disease (PAD) in routine Vietnamese practic...AIMS: To characterize lesion distribution, procedural strategy, and short-term outcomes after endovascular revascularisation for symptomatic lower-extremity peripheral arterial disease (PAD) in routine Vietnamese practice. MATERIALS AND METHODS: This prospective observational cohort included 336 consecutive patients with symptomatic lower-extremity PAD who underwent endovascular revascularisation at a Vietnamese tertiary center from January 2019 to January 2025. Lesions were classified across aorto-iliac, femoropopliteal, and infrapopliteal segments using a TASC-based framework. Outcomes were assessed post-procedure and at 30 days, 3 months, and 6 months. RESULTS: Two-level disease was the most common anatomical pattern (47.3%), followed by three-level disease (36.0%). Contralateral femoral access was most frequently used (39.6%), and drug-coated balloons were the most common device strategy (63.7%). Technical success was achieved in 82.4% (95% CI 78.0-86.1). Access-site complications occurred in 5.7% (95% CI 3.6-8.7), in-hospital mortality was 2.9% (95% CI 1.6-5.4), and immediate hemodynamic success was 82.4% (95% CI 78.0-86.1). Landmark-based restenosis rates were 17.9%, 12.4%, and 24.7% at 30 days, 3 months, and 6 months, respectively. CONCLUSIONS: Endovascular revascularisation was feasible in this real-world Vietnamese PAD cohort, but restenosis remained frequent, supporting structured post-procedural surveillance.
Future Cardiol
· 2026 Jun · PMID 42294910
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Pulmonary embolism (PE) is the third leading cause of cardiovascular death globally and continues to carry high rates of morbdity and mortality despite advances in therapy. While risk stratification helps guide treatment...Pulmonary embolism (PE) is the third leading cause of cardiovascular death globally and continues to carry high rates of morbdity and mortality despite advances in therapy. While risk stratification helps guide treatment for both low- and high-risk patients, optimal management of intermediate-risk PE remains unclear. Although contemporary AHA/ACC guidelines introduce more granular clinical categories to better define risk and guide treatment selection within this heterogeneous population, uncertainty persists. Systemic fibrinolysis poses bleeding risks, whereas anticoagulation alone may not be sufficient to prevent clinical deterioration. Catheter-based approaches, such as ultrasound-assisted catheter-directed thrombolysis (UACDT), have therefore emerged as potential options that deliver lower-dose fibrinolytics directly into the pulmonary arteries. However, much of the existing literature combines UACDT with other catheter-based interventions, making it difficult to isolate its specific contribution. The data are also heterogeneous, limiting cross-study comparisons. This review summarizes the current evidence, influential clinical trials, and ongoing studies on UACDT, with a focus on its therapeutic potential, safety considerations, limitations, and evolving role in the management of intermediate-risk PE. A literature search was conducted using PubMed, Embase, and ClinicalTrials.gov from inception through early 2026, with supplementary searches performed using Google Scholar.
Future Cardiol
· 2026 Jun · PMID 42274311
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BACKGROUND: This survey gained insights into best practices and challenges at specialized hypertrophic cardiomyopathy (HCM) centers in the US to inform improvements in clinical practice and patient care, and support thos...BACKGROUND: This survey gained insights into best practices and challenges at specialized hypertrophic cardiomyopathy (HCM) centers in the US to inform improvements in clinical practice and patient care, and support those without proximity to specialized centers. METHODS: We conducted a qualitative survey of eligible health care providers employed at comprehensive HCM centers. Institutions offered septal reduction therapies, implantable cardioverter defibrillator implants, and heart transplants. Patients and a patient advocacy group were also interviewed. RESULTS: A high degree of consistency in care team structure and standardization of processes for HCM diagnosis, including imaging and management, was observed. Patient and care team education on treatments, including cardiac myosin inhibitors, was critical for informed decision-making and efficiency. Further primary cardiology education could include HCM detection and management, including assessing sudden death risk. Community setting education was recognized as important for continuity of care. Major challenges included funding, and lack of dedicated HCM teams including administrative staff, ancillary specialists, and experienced sonographers. CONCLUSIONS: Diagnostic testing expertise and understanding of optimal processes, including different treatment options, are important to improve quality of care and outcomes. Select management considerations and best practices from comprehensive HCM centers may be adoptable by primary cardiology centers and providers.
Future Cardiol
· 2026 Jun · PMID 42257396
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BACKGROUND: Premature atrial contractions (PACs) and premature ventricular contractions (PVCs) are among the most frequently observed arrhythmias in clinical practice. They represent early depolarizations originating fro...BACKGROUND: Premature atrial contractions (PACs) and premature ventricular contractions (PVCs) are among the most frequently observed arrhythmias in clinical practice. They represent early depolarizations originating from the atria or ventricles, respectively, and are often detected in both healthy individuals and patients with cardiovascular disease. PATIENTS AND METHODS: In the ETHAPRO study, 98 patients (58 males, 40 females; mean age 45 years) with either PACs ( = 46) or PVCs ( = 52) were enrolled. All participants had an ectopic burden of >1000 premature beats per 24 h despite prior antiarrhythmic therapy. Patients were treated with ethacizine (50 mg b.i.d.) and were followed at 30-45 days (short-term) and 150-210 days (long-term). The endpoints were a reduction in ectopic burden to ≤1000 beats per 24 h, symptomatic improvement and safety assessments. RESULTS AND CONCLUSIONS: Ethacizine treatment led to significant reductions in PACs (88.9%/ 91.7%; < 0.001) and PVCs (82.8%/ 84.8%; < 0.001). A total of 89.0% of PAC patients and 86.0% of PVC patients achieved the predefined target. Symptomatic improvement was reported in 91.0% of patients with PAC and 85.0% of patients with PVC. Ethacizine demonstrated robust and sustained antiarrhythmic efficacy with a favorable safety profile in patients with refractory PACs and PVCs.
Fudim M, Ferrante F, Vorgang CM
… +2 more, Rosner CM, Mentz RJ
Future Cardiol
· 2026 Jun · PMID 42233689
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Iron deficiency (ID) is a common comorbidity in patients with heart failure (HF). Treatment with intravenous (IV) iron is recommended by the ACC/AHA/HFSA and ESC guidelines to improve HF symptoms, exercise capacity, and...Iron deficiency (ID) is a common comorbidity in patients with heart failure (HF). Treatment with intravenous (IV) iron is recommended by the ACC/AHA/HFSA and ESC guidelines to improve HF symptoms, exercise capacity, and quality of life, and to reduce the risk of hospitalization. Ferric carboxymaltose (FCM) is indicated for ID in adults with HF (NYHA class II/III) to improve exercise capacity. There are challenges in ensuring that eligible patients with HF and ID achieve iron repletion and associated optimal outcomes in routine practice. These challenges include inpatient formulary restrictions which only allow for low-dose IV irons and care transitions when the course of IV iron treatment spans the inpatient and outpatient setting. Despite the ease of administration as a single rapid infusion of up to 1000 mg of iron, inpatient and outpatient formularies do not always include FCM. This guide shares a general workflow used at university-based and private hospital systems, to facilitate routine iron assessment and IV iron repletion in a typical HF care pathway. Perspectives from the cardiologist, nurse, advanced practice provider (APP), and pharmacist roles provide a comprehensive view and emphasize the importance of a multidisciplinary, collaborative approach to optimize outcomes for patients with HF and ID.
Crossley GH, Kowal J, Siehr A
… +2 more, Holmes TR, Aimo A
Future Cardiol
· 2026 Jun · PMID 42233410
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INTRODUCTION: Implantable cardioverter-defibrillators (ICD) terminate potentially deadly ventricular arrhythmias in at-risk patients. Retrosternal extravascular ICDs (EV-ICD) place a lead in the mediastinal space to prov...INTRODUCTION: Implantable cardioverter-defibrillators (ICD) terminate potentially deadly ventricular arrhythmias in at-risk patients. Retrosternal extravascular ICDs (EV-ICD) place a lead in the mediastinal space to provide both shock and antitachycardia pacing therapy without the need for venous access. A systematic review was performed to assess acute outcomes in patients implanted with a retrosternal EV-ICD. METHODS: A query of EMBASE and MEDLINE databases was performed to identify unique retrosternal EV-ICD cohort studies published between JAN-1-2020 and JAN-31-2026. Two known retrosternal EV-ICDs were included, the market-approved Medtronic substernal EV-ICD system and investigational AtaCor intercostal EV-ICD lead. Procedure and defibrillation testing details and acute safety data were collected. RESULTS: Fourteen articles ( = 806 patients) met criteria for inclusion. Lead placement success was 99.6% and 97.3% while defibrillation testing success was 98.5% and 97.2% for the substernal EV-ICD system and intercostal EV-ICD lead, respectively. Periprocedural complications were manageable with a rate of 1.5% ( = 11/731) for the substernal EV-ICD system and 8.2% ( = 6/73) for the intercostal EV-ICD lead. CONCLUSIONS: The available evidence suggests that periprocedural outcomes and acute safety of retrosternal EV-ICD systems, particularly the substernal EV-ICD system, is an effective and safe strategy that provide potentially lifesaving therapy while preserving the vasculature.: www.crd.york.ac.uk/prospero identifier is CRD420261328371.
Jukić T, Ivić L, Vukojević N
… +2 more, Bulum T, Tomić M
Future Cardiol
· 2026 Jun · PMID 42204857
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Choroidal melanoma (CM) is the most common intraocular malignant tumor in adults, with a high rate of metastasis and mortality. This study reports a case of systemic cardiac migration of perfluorocarbon liquid (PFCL) fol...Choroidal melanoma (CM) is the most common intraocular malignant tumor in adults, with a high rate of metastasis and mortality. This study reports a case of systemic cardiac migration of perfluorocarbon liquid (PFCL) following an unsuccessful endoresection of CM. A 61-year-old woman underwent gamma knife radiosurgery and pars plana vitrectomy endoresection for CM in her left eye. The procedure was complicated by intraocular bleeding, leading to incomplete tumor removal, with the eye filled with PFCL and blood before closure. The patient refused further surgery and later developed secondary glaucoma. Nearly three years later, during an acute increase in intraocular pressure reaching 50 mmHg, she experienced severe respiratory insufficiency requiring intubation and veno-arterial extracorporeal membrane oxygenation (V-A ECMO). Echocardiography showed a severely dilated right ventricle and echogenic material in the left atrium and ventricle, while acute coronary syndrome and pulmonary embolism were ruled out. The patient's respiratory status stabilized, and intracardiac echogenic material was observed during the first three days of V-A ECMO but was absent afterward. In summary, cardiac PFCL migration can occur after endoresection for choroidal melanoma; therefore, specific precautions should be taken to prevent and promptly detect this complication.
Abbas MS, Batool A, Hussain M
… +8 more, Hassan M, Sohaib A, Ahmed T, Athar M, Khan S, Kanwal W, Ali Akbar M, Hannan A
Future Cardiol
· 2026 Jun · PMID 42178931
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BACKGROUND: Dyslipidemia is a prevalent and major contributor to atherosclerotic cardiovascular disease; however, many patients do not achieve the recommended low-density lipoprotein cholesterol goals with statin monothe...BACKGROUND: Dyslipidemia is a prevalent and major contributor to atherosclerotic cardiovascular disease; however, many patients do not achieve the recommended low-density lipoprotein cholesterol goals with statin monotherapy. Thus, the efficacy of complementary therapeutic options must be investigated. OBJECTIVE: To evaluate the lipid-lowering efficacy and safety of pitavastatin combined with ezetimibe versus pitavastatin monotherapy in adults with hypercholesterolemia or mixed dyslipidemia. METHODS: A systematic search of PubMed, Embase, Cochrane Library, and Scopus (November 2025) identified randomized controlled trials that compared pitavastatin 2 mg or 4 mg plus ezetimibe 10 mg with pitavastatin 2 mg alone. The protocol for this systematic review and meta-analysis was prospectively registered in PROSPERO. A random-effects meta-analysis was used to pool lipid and safety outcomes. The risk of bias was assessed using RoB 2, and the certainty of evidence was graded using the GRADE tool. RESULTS: Non-high-density lipoprotein cholesterol, total cholesterol, and Apolipoprotein B. Changes in high-density lipoprotein cholesterol and triglyceride levels were modest but more pronounced at week 12. CONCLUSION: Combination therapy offers an apparent enhancement in lipid lowering and may serve as an effective supplementary option for patients who require more intensive low-density lipoprotein cholesterol management. However, the limited evidence warrants further research. PROTOCOL REGISTRATION: www.crd.york.ac.uk/prospero identifier is CRD420251233057.
Ikeda K, Kechichian A, Malhotra G
… +5 more, Bouisset F, Sakai K, Matsumura M, Mizukami T, Collet C
Future Cardiol
· 2026 Jun · PMID 42177706
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Coronary artery disease (CAD) remains the leading cause of death worldwide. Integrating coronary physiology into treatment decision-making is essential to optimize outcomes. Fractional flow reserve (FFR) is the gold stan...Coronary artery disease (CAD) remains the leading cause of death worldwide. Integrating coronary physiology into treatment decision-making is essential to optimize outcomes. Fractional flow reserve (FFR) is the gold standard for assessing the severity of CAD (ischemia) and guiding percutaneous coronary intervention (PCI). However, a single value of FFR cannot capture the spatial distribution of CAD along the vessel. The pullback pressure gradient (PPG) obtained from manual FFR pullbacks is a novel metric for characterizing pressure loss patterns on a continuous scale: values approaching 1.0 represent a focal CAD pattern, whereas values close to 0 represent diffuse disease. PPG predicts flow improvement and angina relief after PCI. This review summarizes the current evidence on PPG and discusses the integration of this novel approach in CAD management.
Future Cardiol
· 2026 May · PMID 42148877
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Left atrial myopathy in cardiac amyloidosis leads to structural, functional, and electrophysiologic changes in the left atrial myocardium that create substrate for atrial fibrillation. As a result, the incidence and prev...Left atrial myopathy in cardiac amyloidosis leads to structural, functional, and electrophysiologic changes in the left atrial myocardium that create substrate for atrial fibrillation. As a result, the incidence and prevalence of atrial fibrillation in patients with cardiac amyloid exceeds that of other cardiomyopathies. Management of atrial fibrillation in patients with cardiac amyloidosis is particularly challenging given poor hemodynamic tolerance to rate control, limited safety profile of antiarrhythmic drugs, and modest long-term effectiveness of rhythm control strategies. Data on outcomes after cardioversion and catheter ablation are based on retrospective observational studies with small sample size, making it difficult to understand the impact of rhythm control in cardiovascular outcomes of these patients. Moreover, patients with cardiac amyloidosis have a higher risk of thromboembolism than that of other populations with atrial fibrillation, along with a higher risk of bleeding due to alteration in coagulation pathways and fragility of vasculature infiltrated by amyloid fibrils. Decision-making on stroke prevention strategies therefore demands a careful and individualized risk assessment for each patient. In this review, we explore the intricacies of the association between atrial fibrillation and cardiac amyloidosis, including epidemiology, mechanisms of atrial arrhythmia, management considerations, as well gaps in research and future directions.
Pagliassotto I, Bocchino PP, Laiso LE
… +6 more, Pilia R, Carbone ML, Frea S, Gallone G, Angelini F, De Ferrari GM
Future Cardiol
· 2026 Apr · PMID 42108011
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Cardiogenic shock (CS) is a critical state of primary cardiac dysfunction characterized by tissue hypoperfusion and cellular hypoxia, with in-hospital mortality rates persistently between 30% and 50%. This review synthes...Cardiogenic shock (CS) is a critical state of primary cardiac dysfunction characterized by tissue hypoperfusion and cellular hypoxia, with in-hospital mortality rates persistently between 30% and 50%. This review synthesizes contemporary evidence to redefine risk stratification through a dynamic, multi-modal lens, moving beyond static snapshots to prioritize longitudinal assessment aimed at anticipating clinical instability, therapeutic response, or physiological recovery. The evolution of CS staging is evaluated, specifically the Society for Cardiovascular Angiography and Interventions (SCAI) five-stage continuum, which tracks patient progression from "At risk" (Stage A) to "Extremis" (Stage E) and identifies critical windows for preemptive stabilization in Stage B. Essential hemodynamic "signposts" are examined, including cardiac index, right atrial pressure over pulmonary capillary wedge pressure ratio and pulmonary artery pulsatility index, which help identify high-risk phenotypes like the right-dominant CS. We highlight the role of echocardiography, lung ultrasonography and Venous Excess Ultrasound (VExUS) score as real-time biomarkers for monitoring forward flow and central and systemic congestion. Ultimately, accurate prognostication requires a multi-modal risk portrait integrating shock severity, biological phenotype, and patient-specific modifiers to identify non-responders early and allow for the timely treatment escalation, or proper de-escalation of intensive therapies as clinical improvement occurs. In this context, predictive approaches are primarily intended to anticipate imminent clinical deterioration or recovery, whereas prognostic models aim to estimate outcome probabilities, particularly mortality risk, once cardiogenic shock is established.
Tewari J, Agrawal H, Dubey P
… +5 more, Dwivedi A, Neupane S, Singh V, Mallawaarachchi I, Mukherjee D
Future Cardiol
· 2026 Apr · PMID 42099262
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BACKGROUND: Stroke is a leading cause of death and disability. Patent foramen ovale (PFO) is more common in cryptogenic stroke, but the benefit of closure over antithrombotic therapy remains debated. We updated randomize...BACKGROUND: Stroke is a leading cause of death and disability. Patent foramen ovale (PFO) is more common in cryptogenic stroke, but the benefit of closure over antithrombotic therapy remains debated. We updated randomized evidence comparing PFO closure with antithrombotic therapy. METHODS: MEDLINE, Embase, and Cochrane Central were searched through September 2025. Primary outcomes were stroke, transient ischemic attack (TIA), and a composite of stroke, TIA, death, or systemic embolism. Serious adverse events and atrial fibrillation were assessed. RESULTS: Six trials ( = 3,560; closure 1,889; therapy 1,671) were included. Composite events occurred in 84 (4.4%) vs 152 (9.1%). Closure reduced the composite endpoint (HR 0.46, 95% CI 0.28-0.75; = 0.002) and recurrent stroke (37 [2.0%] vs 77 [4.6%]; HR 0.27, 95% CI 0.12-0.62; = 0.002). Benefit was greatest in men, age <45 years, and those with large shunts. Serious adverse events and mortality were similar, but atrial fibrillation increased (HR 4.46, 95% CI 2.00-9.92; < 0.001). CONCLUSION: In selected patients, PFO closure lowers recurrent stroke and composite events versus antithrombotic therapy, at the cost of higher atrial fibrillation. PROTOCOL REGISTRATION: www.crd.york.ac.uk/prospero identifier is CRD420251167260.
Future Cardiol
· 2026 May · PMID 42080619
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Rheumatic heart disease (RHD) remains a leading cause of mitral stenosis (MS), particularly in developing countries like India, China or countries within Africa. Characterized by a long latent phase after acute rheumatic...Rheumatic heart disease (RHD) remains a leading cause of mitral stenosis (MS), particularly in developing countries like India, China or countries within Africa. Characterized by a long latent phase after acute rheumatic fever, rheumatic MS often leads to significant morbidity and mortality. This paper explores its epidemiology, natural history, and clinical consequences, including associations with atrial fibrillation, pulmonary hypertension, heart failure, systemic embolism, and infective endocarditis. We review diagnostic tools, particularly echocardiography, and management strategies such as balloon mitral commissurotomy and surgical interventions. Emerging therapies, including lithotripsy-facilitated procedures and trans-catheter valve replacement, offer promise for high-risk patients. Early detection and comprehensive care are essential to reduce the global burden of rheumatic MS.
Kipourgos G, Tzenalis A, Andrikopoulou-Gkila E
… +1 more, Kounis NG
Future Cardiol
· 2026 Apr · PMID 42052969
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Kounis syndrome-acute coronary events triggered by allergic or hypersensitivity reactions-remains underrecognized across emergency and cardiology settings. Its heterogeneous presentation and overlapping mechanisms (vasos...Kounis syndrome-acute coronary events triggered by allergic or hypersensitivity reactions-remains underrecognized across emergency and cardiology settings. Its heterogeneous presentation and overlapping mechanisms (vasospasm, plaque erosion/rupture, stent thrombosis) challenge timely diagnosis and tailored therapy.This review synthesizes contemporary evidence on pathophysiology, clinical spectrum, and management of Kounis syndrome (Types I-III), and map how artificial intelligence (AI) could enhance care pathways. We outline data streams relevant to AI (ECG, biomarkers, imaging, clinical narratives), modeling approaches (machine learning, sequence models), and decision-support scenarios (early detection, risk stratification, treatment selection, and monitoring). We also address implementation barriers, including dataset shift, bias, transparency, and governance.Kounis syndrome is a prime candidate for AI-enabled diagnostic support given its pattern-based signatures at the interface of allergy and acute coronary syndromes. Near-term priorities include curated multicenter datasets with harmonized phenotyping, prospective validation of models embedded in clinical workflows, and hybrid rules-plus-learning systems aligned with guideline-based care. Integrating allergy severity, hemodynamics, and ischemic burden into dynamic risk tools may reduce missed diagnoses and optimize anti-allergic and antithrombotic strategies while safeguarding patient safety.
Future Cardiol
· 2026 May · PMID 42037587
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AIMS: This study evaluated the impact of effusion etiology, hemodynamic presentation, and comorbidity burden on in-hospital outcomes following pericardiocentesis. PATIENTS AND METHODS: A retrospective analysis of 62 adul...AIMS: This study evaluated the impact of effusion etiology, hemodynamic presentation, and comorbidity burden on in-hospital outcomes following pericardiocentesis. PATIENTS AND METHODS: A retrospective analysis of 62 adults who underwent pericardiocentesis at a tertiary academic hospital (2021-2024) was performed. The primary outcome was in-hospital mortality. The Charlson Comorbidity Index (CCI) and a post hoc Pericardial Risk Score (PRS) were evaluated as predictors. RESULTS: Median age was 72 years (55% male; median CCI 2). Complications occurred in 13% and recurrence in 10%. In-hospital mortality was 8.1% (5/62), limited to malignant, ischemic, infectious, or anticoagulation-related effusions. The PRS showed a stepwise increase in mortality from 0% (PRS 0) to 25% (PRS 2) ( = 0.037), while the CCI did not predict mortality ( = 0.27). CONCLUSIONS: Pericardiocentesis remains safe and effective with low recurrence. Mortality is driven by effusion etiology and hemodynamic severity rather than comorbidity burden. A simple etiology-physiology risk score outperformed the CCI and may help guide post-procedural management.