Cardiac disease during pregnancy is one of the leading causes of maternal mortality and morbidity in both the UK and the USA. Labour, delivery, and the initial postpartum phase are characterised by significant haemodynamic alterations that play a significant role in the clinical deterioration observed in women with heart disease. Heart failure, arrhythmia, and myocardial ischaemia can occur in women with high-risk cardiac lesions during labour. The cardio-obstetric multidisciplinary team, after risk stratification, should establish an individualised cardiac care plan that incorporates patients' preferences. This care plan should address the location, mode, timing of delivery, monitoring, analgesia, and anaesthetic options for operative intervention, uterotonics that may be administered, emergency contact numbers for relevant personnel along with appropriate postpartum care. High-risk patients need to be delivered in tertiary units. Clear haemodynamic objectives should be established along with a postpartum contraception plan with information cascaded to community midwifery teams and primary care providers to ensure surveillance and continuity of care. Co-ordinated multidisciplinary care can enhance preparedness for obstetric and cardiac emergencies, thereby decreasing morbidity and mortality associated with heart disease in pregnancy during childbirth.

Acute kidney injury (AKI) is increasingly associated with heart failure (HF), contributing to higher morbidity and mortality. Nonetheless, mortality remains under-explored. This study examines trends in AKI-related HF mortality trends among American adults. We sourced data from 1999 to 2023 from the CDC WONDER multiple cause-of-death database for AKI-related HF mortality in adults aged ≥ over 25. We calculated age-adjusted mortality rates (AAMRs) per 1,000,000 persons for year and sex from 1999 to 2023 and from 1999 to 2020 for ethnicity, census region, and urbanization status, analyzing annual percent change across these stratifications. From 1999 to 2023, 284,599 AKI-related HF deaths occurred, with AAMR rising from 34.42 to 86.53. Between 1999 (34.42) and 2010 (50.5), the AAMRs increased modestly, followed by relative stability until 2019 (46.93); the steepest increase occurred between 2020 (51.52) and 2022 (91.59), with a modest decline observed in 2023 (86.53). Men consistently had higher AAMRs than women. Male AAMRs increased from 43.45 to 108.3, while female rates rose from 29.12 to 69.79. Non-Hispanic (NH) Blacks had the highest AAMR (54.18), followed by NH American Indian/Alaska Natives (52.49), NH Whites (45.74), Hispanics/Latinos (33.38), and NH Asians/Pacific Islanders (26.53). The Midwest had the highest AAMR (49.66), followed by the South (46.24), West (42.85), and Northeast (41.09). Rural areas showed higher AAMRs (56.81) than urban (42.91). North Dakota reported the highest AAMR (69.29), while Florida had the lowest (24.38). While overall AAMRs were higher in 2023 compared to 1999, the sharpest rise was seen post-2020 after a period of relative stability from 2010 to 2019. AKI-related HF mortality remains disproportionately high among men, NH Blacks, and residents of the Midwestern and rural United States, highlighting the necessity of focused initiatives to address inequities and lower mortality.

To examine whether the factors determining discharge destination after acute-phase treatment for stroke differ based on recurrence risk levels. Retrospective study. General acute care hospital. Acute ischemic stroke survivors (n = 1219). Patients were stratified using the Stroke Prognosis Instrument II (SPI-II) and evaluated through forced-entry multiple logistic regression analysis. Among the independent variables, the primary outcome measure was the modified Rankin Scale (mRS) at discharge. Covariates included age, sex, and histories of diabetes, cerebral infarction, cerebral hemorrhage, coronary artery disease, hypertension, and congestive heart failure. The dependent variable grouped participants into those discharged home and those discharged to a medical facility. Among the 1219 included participants, 914 were classified into the home care group and 305 into the medical facility care group. SPI-II-based stratification revealed that 78.665% of the home care group had a moderate or higher risk of stroke recurrence. Multiple logistic regression analysis demonstrated that mRS at discharge was a significant factor across all stratified models, while age was a significant factor only within the moderate-risk group. Discharge decisions after acute-phase treatment were primarily influenced by short-term functional independence, as reflected by mRS, rather than recurrence risk levels. Thus, a substantial proportion of stroke survivors with a high recurrence risk transitioned to home care. These findings highlight the need to revise current medical and social welfare services and to develop targeted strategies for stroke recurrence prevention, based on a more detailed understanding of the living environments of stroke survivors.

Climate change and increasing environmental pollution are emerging as significant threats to global health, notably through their impact on cardiovascular diseases (CVD). The World Health Organization (WHO) attributes millions of premature deaths annually to air pollution and extreme temperatures. Despite extensive research on air pollution and temperature extremes separately, their combined effects on cardiovascular health remain inadequately explored. We plan to conduct a systematic review and meta-analysis to assess the impact of climate change, including extremes of temperature and air pollution, on CVD. We will search PubMed, CINAHL, SCOPUS, ClinicalTrials.gov, and additional databases for studies published between August 12, 2019, and August 11, 2024. The review will include observational and quasi-experimental (pre and post-test) studies. Data extraction and quality assessment will be performed using EndNote, Rayyan.ai, and the National Heart, Lung, and Blood Institute (NHLBI) quality appraisal tool. The statistical analysis will be conducted using RevMan 5.4, with risk ratios, mean differences, and heterogeneity evaluated. This review aims to synthesize evidence on how ambient air pollutants (PM2.5, CO, O3) and extreme temperatures contribute to cardiovascular morbidity and mortality. It will highlight the synergistic effects of air pollution and temperature extremes, with a particular focus on low- and middle-income countries where the burden is most pronounced. By integrating the impacts of both climate change and air pollution on cardiovascular health, this review will provide comprehensive insights into the global health burden of CVD. The findings will inform public health strategies and interventions to mitigate the adverse effects of environmental factors on cardiovascular health.

Background: A variety of studies have reported the associations between histone deacetylases (HDACs) genes and cardio-cerebrovascular diseases. The identification of variants in the HDACs genes and the determination of risk alleles could open novel therapeutic avenues for these diseases. This article summarized variants in HDACs genes and different sub-types of cardio-cerebrovascular diseases. Methods: A comprehensive literature search was conducted across PubMed, Web of Science and Scopus databases to identify studies published prior to 27 June 2025. We registered this protocol in the PROSPERO database (CRD420251010100). The Venice Criteria were applied to assess the statistically significant associations identified by meta-analyses. The single-nucleotide polymorphisms were mapped to their corresponding genes, and functional annotation was conducted using the Encyclopedia of DNA Elements tool, HaploReg and the UCSC Genome browser. Results: We finally included 34 published studies and 160 datasets to assess the associations between variants in HDAC genes and cardio-cerebrovascular diseases. Rs2107595 in HDAC 9 was the variant found to be associated with four sub-types identified by genome-wide association study or meta-analyses. Rs11984041 was related to ischemic stroke. Rs10230207 and rs2192476 were associated with intracranial aneurysm. Conclusions: HDACs genes were associated with multiple cardio-cerebrovascular diseases. However, ethnic disparities were observed in their effects. Therefore, ethnicity-targeted treatments, including specific HDAC inhibitors, should be developed in the future.

Improved aortic surgery outcomes are linked to a broader comprehension of the pathogenesis of thromboembolic complications. This study aims to evaluate the involvement of cholesterol microcrystals and neutrophil extracellular traps (NETs) in postoperative thrombotic complications following open aortic surgery. Aortic blood smears were examined precisely to identify the presence of cholesterol microcrystals (CMs) using polarized light microscopy, Coherent Anti-Stokes Raman spectroscopy (CARS), and fluorescence microscopy to detect NETs. The data obtained, including CMs quantity, perimeter, and NETs quantity, were evaluated as possible predictors of the postoperative complication rate. Fifty-five patients (85%) had an uneventful postoperative period, while 10 patients (15%) experienced early postoperative complications, there was a statistically significant positive correlation between the average perimeter of the CMs and the number of NETs in the blood smears in patients who experienced a complicated postoperative period (rho = 0.67; p = .03). In some cases, complications in the early postoperative period after aortae surgery may be caused by CMs embolism (CE) of the distal vascular bed, accompanied by NETs-mediated thrombosis. The protocol for assessing arterial blood allows for the identification and evaluation of CMs and NETs characteristics as predictors of perioperative thromboembolic complications.

This study aimed to evaluate the influence of dual-task (DT) on the spatiotemporal gait parameters of patients with cardiovascular diseases. This was an observational, cross-sectional, and comparative study. Participants: The study included 28 males, aged between 51 and 77 years, divided into two groups: Cardiovascular Disease Group (CVDG - N = 14) and Control Group (CG - N = 14). Main outcome measures: Participants performed the simple gait task and dual-task activities (including the cognitive and gait tasks) in a motion analysis system. For statistical analysis, it was conducted a mixed analysis of variance (Mixed ANOVA) and for significant main effects (condition or group) or interactions (group × condition) it was performed post-hoc tests with Bonferroni correction. A significance level (alpha) of 0.05 was set. Group comparisons revealed a significant difference solely in step width, where the CVDG showed lower mean values than the CG (p = 0.001). However, DTs similarly affected both groups, resulting in significant reductions in gait speed (p = 0.000), cadence (p = 0.002), step length (p = 0.000), and stride time (p = 0.007). Regarding the interaction effect, the CVDG exhibited a significantly longer step time during the verbal fluency and arithmetic DT conditions when compared to their own performance in the simple gait condition (p = 0.037). No significant differences between groups were found in both single-task and DTs gait across most of the analyzed parameters. Additionally, DT activities similarly affected the gait parameters of both groups. Although cardiovascular diseases are commonly associated with motor and cognitive declines, DTs did not affect participants with cardiovascular impairment differently.

Few studies have compared the prognostic value of the triglyceride glucose (TyG) index and atherogenic index of plasma (AIP) in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). We aimed to compare the prognostic value of the TyG index, AIP, and combined diagnosis in patients with ACS undergoing PCI. Patients with ACS who underwent PCI were enrolled and divided into two groups according to major adverse cardiovascular and cerebrovascular events (MACCEs). Univariate and multivariate Cox proportional hazard regressions were performed to determine independent risk factors for MACCEs. The area under the receiver operating characteristic curve (AUC) was used to evaluate the diagnostic value of the TyG index, AIP, and combined prediction. The study included 114 patients. Multivariate Cox regression revealed that the TyG index and AIP were independent predictors of MACCEs. The AUC of the TyG index and AIP were 0.710 (95% confidence interval [CI]: 0.618-0.791) and 0.626 (95% CI: 0.531-0.715), respectively, and the optimal cutoff points were 8.83 and 0.30, respectively. The difference between the TyG index and AIP was not significant. The AUC of the combined diagnosis was 0.706 (95% CI: 0.614-0.788), with no significant improvement compared with the TyG index or AIP. Both the TyG index and AIP were independent predictors of MACCEs in ACS patients undergoing PCI. The TyG index and AIP had similar predictive values for MACCEs, but the combined prediction did not improve significantly.

Influenza infection may increase the risk of cardiovascular diseases (CVDs), but the extent of this link is uncertain. This systematic review and meta-analysis aimed to quantify the association between influenza infection and CVDs. We conducted a comprehensive search of major databases from inception to 2024, identifying studies that investigated the association between influenza infection and CVDs. Eligible studies included cohort, case-control, and randomized controlled trials reporting on cardiovascular outcomes (acute CVDs) following influenza infection or risk of influenza infection in CVD patients (chronic CVDs). Data were extracted and pooled using random-effects models, and heterogeneity was assessed using the I 2 statistic. A total of 11 studies (15 datasets) involving 7327 participants were included in the meta-analysis. Overall, influenza infection was significantly associated with CVDs based on 10 datasets (odds ratio (OR) = 1.76, 95% confidence interval (CI): 1.02-3.03). However, the analysis of the five datasets indicated no significant association between pre-existing CVDs and an increased risk of influenza infection (OR = 0.91, 95% CI: 0.80-1.03). Subgroup analyses and meta-regression highlighted that study quality and design could significantly influence the risk of developing CVDs among patients with influenza. This meta-analysis provides quantitative evidence that influenza infection could be a potential risk factor for subsequent cardiovascular events. These findings emphasize the need for preventive measures, including vaccination, especially in high-risk populations. Further research is needed to explore the underlying mechanisms and impact of influenza on cardiovascular outcomes.

Dilated cardiomyopathy is defined by left ventricular dilatation and systolic dysfunction and may rarely be complicated by left ventricular thrombi, which carry a significant risk of systemic embolization. A 77-year-old woman with dyslipidemia and depression presented with progressive dyspnea (NYHA IV) and palpitations. Transthoracic echocardiography revealed severe biventricular dysfunction (left ventricular ejection fraction 24%) and multiple partially mobile thrombi in the left ventricular. Coronary angiography excluded obstructive coronary artery disease, and cardiac magnetic resonance confirmed severe left ventricular dilatation, diffuse hypokinesia, extensive fibrosis, and thrombotic appositions. Secondary causes of dilated cardiomyopathy and thrombophilia were excluded; genetic testing revealed a heterozygous BAG3 variant. The patient was treated with intravenous diuretics, non-invasive ventilation, unfractionated heparin followed by apixaban, and guideline-directed medical therapy for heart failure, including a beta-blocker, angiotensin receptor-neprilysin inhibitor, MRA, and SGLT2 inhibitor. Serial imaging at 7 days showed a reduction of thrombotic burden, with complete resolution confirmed at 2-month follow-up. At 4-month follow-up, the patient was asymptomatic (NYHA I-II) with improved left ventricular ejection fraction (35%) and no documented arrhythmias. Given functional recovery and absence of significant conduction delay, device implantation was not indicated. This case highlights the importance of early recognition and prompt anticoagulation in dilated cardiomyopathy complicated by left ventricular thrombi. A structured diagnostic and therapeutic strategy-integrating multimodality imaging, exclusion of secondary causes, and genetic assessment-can lead to complete thrombus resolution and favorable remodeling.