Proper cardiac function depends on adequate supply and metabolism of energy substrates. Aluminum chloride exposure has been linked to adverse cardiac events. This study investigated the ameliorative effect of ferulic acid and ascorbic acid in dysregulated cardiac energy metabolism in aluminum chloride-exposedmice. Thirty mice were randomized into five groups (n=6): control (0.1 % distilled water), aluminum chloride (AlCl3, 100 mg/kg, p.o), aluminum chloride and ferulic acid (AlCl3, 100 mg/kg; FA20, 10 mg/kg, p.o), aluminum chloride and ferulic acid (AlCl3, 100 mg/kg; FA10, 10 mg/kg, p.o), aluminum chloride and ascorbic acid (AlCl3, 100 mg/kg; Vit. C, 100 mg/kg), daily for 7days. Cardiac metabolic enzymes activities were analyzed spectrophotometrically; substrate transporters and regulators of energy metabolism were analyzed using immunohistochemistry. AlCl3 increased hexokinase activity and reduced pyruvate-dehydrogenase activity compared with the control. AlCl3 significantly reduced the expression of glucose transporter-4 (GLUT 4), carnitine palmitoyl-transferase 1β (CPT1β), peroxisome proliferator-activated receptor-alpha (PPARα) and AMP-activated protein kinase (AMPK) compared with the control. However, FA reversed the effect of AlCl3 by significantly increasing hexokinase and pyruvate dehydrogenase activities, increasing the expression of GLUT4, CPT1β, PPARα andAMPK. FA mitigate against cardiac metabolic disruption caused by acute exposure to AlCl3 through PPARα and AMPK modulation.

Cardiac activity is associated with changes in microstates of the electroencephalogram in healthy adults: A resting state study.

Point-of-care-ultrasound in in-hospital cardiac arrest.

Respiratory heart rate variability: Insights into mechanisms, measurements and interpretations.

Hypericum perforatum L. and Glycyrrhiza glabra L. preserve cardiac mitochondrial redox homeostasis in E2 deficiency via ERβ-MAO-A modulation.

POCUS in pediatric arrest (Res-US pulse check): development and evaluation of a simulation-based curriculum.

Bleeding Experience with Medication Abortion Prior to Embryonic Cardiac Activity.

Interactions linking the heart to changes in brain organization offer insights into how central and peripheral systems jointly contribute to affective processing. Conventional approaches to brain-heart interaction, which rely primarily on EEG rhythms and heart rate variability, fail to capture the heartbeat-resolved dynamics that characterize the bidirectional interaction between cortical and cardiac activity. We apply convergent cross mapping, a nonlinear causality framework, to 32-channel EEG and single-lead ECG signals recorded during validated virtual reality videos designed to elicit positive or negative affect. By modeling heartbeat-evoked potentials and full cardiac waveforms as evolving dynamical systems, we observed pronounced directional asymmetry in emotion-related brain-heart interactions: descending coupling patterns were stronger, more sustained, and spatially focused than ascending effects. Positive and negative emotional conditions were associated with differential bidirectional coupling patterns, with preferential enhancement of descending cortical-to-cardiac interactions. Spatially, modulation was left-lateralized, with a concentration in frontal and central electrodes. These findings advance embodied models of affect by demonstrating that such interactions are both directionally asymmetric and hemispherically organized, positioning cardiac dynamics as an actively involved component of emotion-related brain-heart coordination.

Background/Objectives: Anthracycline-induced cardiotoxicity remains a major challenge in cancer treatment, and researchers are showing interest in artificial intelligence (AI) to improve the prediction and detection of cancer therapy-related cardiac dysfunction (CTRCD). Current surveillance strategies rely mainly on left ventricular ejection fraction and, more recently, global longitudinal strain. Methods: The present study was designed to evaluate cardiac performance in a rat model of doxorubicin-induced cardiotoxicity and empagliflozin-mediated cardioprotection using a machine learning-based analytical framework. Eighteen adult male Sprague–Dawley rats were assigned to five experimental groups. We aimed to quantify ventricular wall dynamics and contractility using an advanced image-processing and object-detection model that has not been previously used to distinguish normal from impaired cardiac kinetics. During real-time recording, simultaneous electrocardiogram monitoring was performed, enabling direct correlation between deep learning-based ventricular wall motion metrics and cardiac electrical activity. The cardioprotective effects of empagliflozin were further validated by immunofluorescence staining (cTnI, vimentin, α-SMA, and Cx43) of rat cardiomyocytes and paraffin-embedded cardiac tissue, demonstrating attenuation of cellular injury and structural remodeling. Results: The integrated analysis of cardiac kinetic patterns derived via machine learning distinguishes not only extreme cardiotoxicity, but also tracks a graded pattern consistent with ECG-derived severity and treatment-related functional preservation. These findings indicate that the algorithm captures the gradient of empagliflozin’s cardioprotective effect within this internally validated preclinical setting. Additionally, immunofluorescence results validated the benefits of SGLT2 inhibition on myocardial integrity. Conclusions: The novelty of the present work lies at the intersection of advanced cardiac kinetic analysis using AI, preclinical modeling, and SGLT2-mediated cardioprotection in cardio-oncology.

This study aimed to examine autonomic nervous system responses during motor imagery (MI) in healthy adults, using different autonomic markers that reflect cardiac vagal activity and electrodermal activity. 24 healthy individuals were included in this study. Demographic data were assessed using a demographic data form, and MI ability was assessed using mental chronometry, mental rotation, and the Kinesthetic and Visual Imagery Questionnaire (KVIQ-20). Heart rate (HR), heart rate variability (HRV), and electrodermal activity (EDA) were recorded during each 5-min relaxation and MI sessions. HR and HRV were measured using a Polar H10 device, while EDA was measured using the BIOPAC MP36 system. During MI, decreased HRV parameters reflecting cardiac vagal activity, such as Root Mean Square of Successive Differences (RMSSD) and high frequency (HF) band power, were observed (p < 0.05 for all). In addition, significant increase was found in EDA values reflecting electrodermal activity during MI (p < 0.001). Residualized HR was strongly positively correlated with KVIQ-Visual scores (r = 0.511), moderately positively correlated with KVIQ-Total (r = 0.497) and Left-hand accuracy (r = 0.441) scores, while a moderately negative correlation was found between residualized HR and Left-hand reaction time (r = -0.466) (p < 0.05 for all). In conclusion, when assessing MI sessions and MI ability, it is important to use different autonomic indicators (e.g., HRV and EDA) together. The findings suggest that autonomous responses observed during MI may reflect different physiological mechanisms, offering significant implications for the potential use of autonomous biomarkers in MI-based rehabilitation interventions.

To evaluate the feasibility and accuracy of remote, clinician-guided biophysical profile (BPP) assessment using a handheld ultrasound device operated by lay users. This prospective, non-randomized, quasi-blinded study compared clinician-guided ultrasound-based BPP scans performed remotely by lay users using the Pulsenmore ES device with concomitant standard in-clinic ultrasound examinations performed by healthcare professionals, with both assessments conducted consecutively and immediately one after the other. Agreement between modalities was assessed for individual BPP components and overall BPP scores. A total of 30 pregnant women were enrolled at a mean gestational age of 33.0 ± 2.6 weeks. The mean maternal age was 31.4 ± 4.5 years, and mean body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters) was 27.4 ± 5.2. Overall agreement between remote and in-clinic BPP scores was 90%. Agreement was 100% for cardiac activity, fetal movements, fetal presentation, placental location, and subjective amniotic fluid volume assessment. Agreement for fetal tone and breathing movements was 96.7 and 93.3%, respectively. Sensitivity and specificity of remote BPP assessment for detecting abnormal overall BPP findings, using the standard in-clinical ultrasound examination as the reference standard, were 92.6 and 66.7%. The mean difference in total BPP score was 0.07 ± 0.64 points. Mean fetal heart rate and maximal vertical pocket measurements were comparable between modalities. Remote examinations required more time than in-clinic scans (8.0 ± 3.9 vs. 4.6 ± 3.3 min) but remained within recommended limits. Clinician-guided remote BPP assessment using a handheld ultrasound device operated by lay users demonstrates high agreement with standard in-clinic ultrasound under supervised conditions and may represent a reliable alternative for prenatal surveillance in selected populations.

Background/Objectives: Elevated homocysteine (Hcy) levels are associated with endothelial dysfunction, oxidative stress, and inflammation, contributing to cardiovascular disease development. The aim of this study was to examine the effects of vitamin B6 and folic acid on cardiometabolic biomarkers, cardiac oxidative stress, metabolic enzyme activities and cardiovascular histomorphometric parameters in homocysteine-loaded rats. Methods: Male Wistar albino rats were divided into four groups (n = 10, per group): C—saline 0.2 mL/day s.c. + saline 0.5 mL i.p; H: Hcy 0.45 µmol/g b.w./day s.c. + saline 0.5 mL i.p; C-B6+FA—saline 0.2 mL/day s.c. + vitamin B6 (7 mg/kg b.w. i.p./day) and folic acid (FA) (5 mg/kg b.w. i.p./day); and H-B6+FA—Hcy (0.45 µmol/g b.w./day s.c.) + vitamin B6 (7 mg/kg b.w. i.p./day) and FA (5 mg/kg b.w. i.p./day). Substances were applied s.c. for 2 weeks and i.p for 4 weeks. Results: B6+FA supplementation significantly reduced serum Hcy and LDL concentrations and attenuated Hcy-associated increases in cardiac SOD activity and right ventricular wall thickness. However, B6+FA was associated with increased cardiac MDA levels. MDH activity increased mainly in non-Hcy-loaded supplemented rats, whereas LDH activity, the cardio-somatic index, and aortic histomorphometric parameters remained unchanged. Conclusions: Combined B6+FA supplementation may improve Hcy metabolism, the LDL profile, and selected cardiac structural/oxidative alterations, but its association with increased lipid peroxidation suggests complex redox effects requiring cautious interpretation.

Effective extrahepatic activity of therapeutic oligonucleotides remains an unresolved and significant problem in the development of new genetic medicines. Targeted delivery to the heart is of particular interest due to the unmet need to treat an increasing health burden of cardiovascular diseases and the identification of potential genetic therapeutic targets. Drawing inspiration from literature, we investigate the potential of tannic acid (TA) modifications to improve the activity of a model siRNA sequence in the heart. We developed the synthesis of a series of conjugates containing 1-3 (TA) units to study how molecularly defined numbers of TA ligands influence activity. While we observe significant knockdown of the siRNA target gene in the liver, we did not in the heart, suggesting that although TA ligands confer improved function of siRNA in the liver, extrahepatic activity was not enhanced. In addition, hetero-bifunctional siRNA conjugates containing both TA and albumin binding motifs were designed and their synergistic effects explored. Similarly, in vivo data suggests that TA ligands do not increase cardiac activity of siRNA in this context; however, we can conclude that both C16 and AlbuTag ligands do significantly improve siRNA activity in the heart. We believe this work provides important bioconjugation insight for polyphenolic molecules, like tannic acid, as well as the synthesis of hetero-bifunctional siRNA conjugates generally. Moreover, our findings will inform the design of novel targeting ligands and nanomaterials, especially for molecules that may possess emergent properties when present in high multiplicity compared to their monomeric forms.

With increasing abortion restrictions, more people self-manage their abortions with medications. Little is known about geographic and demographic characteristics of those self-managing abortions in the US, particularly after the Dobbs v Jackson Women's Health Organization decision. To describe requests for self-managed medication abortion support in the US through Mexico-based accompaniment collectives. This is a cross-sectional study of records from 2023 from 2 Mexico-based accompaniment collectives. Participants were people in the US requesting support from Mexico-based accompaniment collectives to self-manage an abortion. State abortion policy context (complete abortion bans, 6-week and/or embryonic cardiac activity bans, 12- to 15-week bans, and abortion available past 15 weeks), sociodemographic characteristics (poverty, insurance status, and Spanish language), and driving distance from the nearest abortion facility. The primary outcomes were the sociodemographic characteristics of those requesting support from accompaniment collectives and the rate of requests to these collectives by zip code tabulation areas (ZCTAs). Demographic characteristics, pregnancy characteristics, and state policy context were described. Differences in request characteristics by state-level abortion policy category were tested using χ2 tests. Also, rates of requests per 100 000 female individuals aged 15 to 49 years within categories of ZCTA-level characteristics were estimated. A total of 2850 requests were analyzed, with 700 requests (24.6%) from people aged 20 to 24 years, 995 (34.9%) from people aged 25 to 34 years, and 192 (6.7%) from people younger than 20 years. Pregnancy duration was 6 weeks or less for 1441 requests (50.6%), 7 to 9 weeks for 677 requests (23.8%), and 12 weeks or more for 160 requests (5.6%). In total, 2363 requests (82.9%) were from states with complete abortion bans. Requests with pregnancies at 12 weeks or more ranged from 98 (4.2%) in complete-ban states to 36 requests (14.8%) in states where abortion was available past 15 weeks (P < .001). Spanish was spoken with accompaniers by 65 requesters (38.0%) in states where abortion was available past 15 weeks and by 282 requesters (13.2%) in complete-ban states (P < .001). The mean ZCTA-level request rate was 2.44 (95% CI, 1.81-3.08) per 100 000 female individuals aged 15 to 49 years and increased with ZCTA-level poverty (from 0.35 [95% CI, 0.23-0.53] to 1.63 [95% CI, 1.14-2.34] requests per 100 000 female individuals aged 15 to 49 years) and Spanish-speaking population share (from 0.25 [95% CI, 0.12-0.54] to 1.56 [95% CI, 1.03-2.39] requests per 100 000 female individuals aged 15 to 49 years). ZCTAs more than 8 hours from an abortion facility in complete ban states had the highest request rate (7.85 [95% CI, 4.53-13.61] requests per 100 000 female individuals aged 15 to 49 years). In this cross-sectional study of accompaniment network records, requests for Mexico-based accompaniment support were highest in states with abortion bans and in communities with elevated poverty, uninsurance, and Spanish-speaking populations, underscoring the role of accompaniment collectives in serving communities facing the greatest structural barriers to facility-based abortion care.

Cardiac optical mapping in fully contracting hearts is limited by motion artefacts, leading most investigations to rely on excitation-contraction uncoupling despite its impact on physiological relevance. Although motion tracking and ratiometric imaging have each been used to reduce motion artefacts, and their combined use has been demonstrated with excitation ratiometry, systematic validation of emission ratiometry combined with motion tracking against an established electrophysiological reference remains limited. In this study, we integrated emission ratiometry with two-dimensional, marker-free motion tracking to suppress motion-related artefacts during optical mapping of Langendorff-perfused rabbit hearts, leveraging the advantage that emission ratiometry derives both signals from the same excitation pathway and thereby reduces sensitivity to motion-related photometric fluctuations in fluorescence intensity. Motion-corrected optical action potentials were quantitatively validated against simultaneously recorded monophasic action potentials (MAPs), with optical signals extracted from regions adjacent to the MAP electrode. Compared with raw recordings and with either method applied alone, the combined approach produced the closest agreement with MAP-derived repolarization measurements. Bland-Altman analysis indicated no systematic bias at APD70 and APD80, with bias confidence intervals including zero. Cumulative probability analysis revealed a marked improvement in precision following combined motion correction, with the proportion of optical action potential duration (APD) measurements within ±10ms of MAP increasing from 16.9%, 29.2% and 26.2% in raw recordings to 75.4%, 87.7% and 80% for APD50, APD70 and APD80, respectively. Collectively, these findings establish the integrated motion-correction strategy as a validated framework for accurate quantification of action potentials in contracting hearts, supporting more physiologically relevant optical mapping. NEW & NOTEWORTHY: While motion tracking and ratiometric approaches have previously been used to mitigate motion artefacts in optical mapping, this study is the first to integrate emission ratiometry with fully marker-free motion tracking and to provide systematic validation against simultaneously recorded monophasic action potentials in freely contracting isolated rabbit hearts. This validated framework enables accurate optical assessment of cardiac electrical activity under physiologically relevant conditions without mechanical stabilization or excitation-contraction uncoupling.

Sex-specific associations between long-term exposure to ambient air pollution and the cardiac conduction system - a longitudinal analysis of the KORA cohort.

While photoplethysmogram (PPG) signals are physiologically linked to cardiac activity and widely used for cuffless blood pressure (BP) estimation, their correlation with BP remains limited in reliability due to inter-individual heterogeneity. This study aims to isolate the PPG components that have a strong causal relationship with BP, and leverage them to construct reliable cuffless BP estimation models. We propose a causal decomposition framework combining ensemble empirical mode decomposition (EEMD) with counterfactual inference to isolate physiologically causal components in PPG signals. First, PPG signals are adaptively decomposed into multi-scale intrinsic mode functions (IMFs) via EEMD. Then counterfactual PPG sequences are generated through sequentially excluding each IMF, and their causal relationships with BP are quantified via structure causal modeling to identify hemodynamically significant components. Subsequently, robust cuffless BP estimation models are constructed by selectively incorporating components demonstrating strong causal effects. To validate the framework, we benchmark our causality-based models against conventional approaches: pulse arrival time (PAT)-based physiological model, gradient-boosted regression tree (GBRT)-based feature model, and convolutional neural network (CNN)-based time-series model. mid-frequency PPG components (IMF4-6) showed strongest BP causality, with CNN model achieving superior estimation performance over PAT and GBRT when utilizing these components. Using IMF45 components, the CNN model achieved BP estimation mean absolute errors of 5.55/3.45 mmHg (systolic/diastolic BP), improving accuracy by 26.39%/17.86% over original PPG. Specific PPG frequency bands exhibit physiologically meaningful causal BP relationships. Our causality-driven approach enhances both accuracy and interpretability in cuffless BP estimation. This work establishes a theoretical framework for causal feature selection in BP estimation, and a novel paradigm for physiological signal analysis through causal decomposition.

Defocused speckle imaging (DSI) enables non-contact measurement of mechanocardiography (MCG) signals, such as seismocardiography (SCG) and gyrocardiography (GCG). As cardiac function is inherently governed by the coupling between mechanical motion and electrical excitation, this intrinsic relationship suggests that mechanical signals captured by DSI may further support the inference of electrical activities, i.e., the electrocardiogram (ECG). Therefore, we propose CardioNet, a physics-driven framework that leverages speckle motion signals together with physical model-based priors to reconstruct cardiac mechanical and electrical activities simultaneously. By coupling the MCG representations with the synchronized ECG, CardioNet captures the intrinsic electromechanical relationship of the heart, enabling non-contact and comprehensive cardiac monitoring. CardioNet was evaluated in a cross-subject study involving 20 laboratory subjects and 30 clinical patients, yielding Pearson correlation coefficients of 0.718/0.911 (SCG/ECG) in laboratory settings and 0.725/0.850 in clinical settings. Furthermore, it accurately captures fine-grained biomarkers, achieving mean timing errors of only 1.36/1.39 ms (lab) and 2.20/2.27 ms (clinic) for detecting aortic valve opening events in MCG signals and R-peaks in ECG signals, with similarly low timing errors for other hemodynamics-related markers. While promising for rhythm analysis, capturing subtle morphologies and spatial dynamics remains challenging. Future work will target 12-lead spatial reconstruction and broader pathological cohorts. To facilitate reproducibility, our dataset has been released at https://github.com/contactless-healthcare/CardioNet.

Omphalocele is a central abdominal wall defect that can be readily diagnosed at birth. Cantrell syndrome (CS) is an exceedingly rare disorder characterized by abnormalities involving the abdominal wall, sternum, diaphragm, pericardium, and heart, with a poor prognosis. The processes of diagnosis and treatment may pose challenges due to the variable presentation and severity of the condition. Here, we report our experiences in managing a neonate with Cantrell syndrome. A female neonate presented with an abdominal mass, initially diagnosed as an omphalocele accompanied by congenital heart disease based on its appearance, abdominal computed tomography, and echocardiography. The final diagnosis of Cantrell syndrome was confirmed during the omphalocele repair operation, where a pulsatile heart and a diaphragm defect were observed in the hernial sac. During the abdominal reconstruction procedure, an episode of pulseless electrical activity occurred, requiring immediate intracardiac compressions, which successfully restored cardiac activity. She subsequently underwent two cardiovascular surgeries to repair a ventricular septal defect (VSD), an atrial septal defect (ASD), and a patent ductus arteriosus (PDA) a few days later. However, she experienced frequent episodes of supraventricular tachycardia (SVT) postoperatively. During the 20 months of follow-up, the patient exhibited good recovery, although SVT persisted, necessitating long-term administration of antiarrhythmic medication. Concomitant anomalies should always be considered when diagnosing an omphalocele. Although rare, Cantrell syndrome ought to be suspected in cases exhibiting an epigastric omphalocele. Further detailed examinations and comprehensive assessments are essential for establishing a definitive diagnosis and developing an appropriate treatment plan. The involvement of a multidisciplinary team is imperative.

Heart rate variability (HRV) has been linked to cerebral small vessel disease (CSVD) development. This study aimed to investigate the relationship between white matter hyperintensity (WMH) and HRV in older patients with CSVD. Patients with CSVD aged ≥ 60years, diagnosed via magnetic resonance imaging and treated at Tianjin Huanhu Hospital in October 2022-April 2023, were included. WMH burden was defined as periventricular (PV-WMH) or deep WMH (D-WMH), with Fazekas scores of 3 or 2-3, respectively. Modified WMH burden was categorized based on total Fazekas scores (PV-WMH + D-WMH): grade0 for 0-2, grade1 for 3-4, and grade2 for 5-6. Patient demographics were documented, and HRV was analyzed through 10-min short-range electrocardiography recordings. Time-domain indices included standard deviation of N-N intervals, root-mean-squared differences of successive N-N intervals, and the proportion of N-N intervals exceeding 50ms. Frequency-domain indices included low-frequency power (LF, 0.04-0.15Hz), high-frequency power (HF, 0.15-0.4Hz), and LF/HF. Correlations were examined using univariable and multivariable analyses. Among 108 patients with CSVD (age 60-87years; median 66.0years [interquartile range 63.0-71.0]), WMH burden was associated with sex, age, stroke, LF, and LF/HF (p < 0.05), with LF/HF independently linked in multivariable analysis. Modified WMH burden showed similar associations and remained independently correlated with LF/HF (p < 0.05). The presence and severity of WMH in CSVD were related to decreased LF/HF. This is possibly due to decreased cardiac sympathetic activity, indicates that decreased LF/HF may be a potential risk factor for WMH, and can be detected via short HRV recordings.