Incremental prognostic value of left atrial strain for heart failure-related events following ST-Segment elevation myocardial infarction.

Long-term outcomes of abnormal global longitudinal left ventricular strain during sepsis: A retrospective cohort study.

SGLT2 inhibitors therapy in patients with acute Takotsubo syndrome.

Prevalence of cardiac dysfunction and longitudinal changes in cardiac function after breast cancer treatment with chemotherapy with/without radiation therapy compared with controls.

Effect of Yiqi Fumai lyophilized injection on B-type natriuretic peptide levels in patients with acute decompensated ischemic heart failure: a multicenter, open-label, blinded-outcome, randomized controlled trial.

A 20-year-old man was admitted for a 5-day acute left chest pain. Laboratory test showed an elevated urinary natriuretic peptide of 2527 pg/ml and troponin-T of 5059.0 ng/l. Coronary computed tomography angiography (CCTA) (Fig. 1a and b) on admission demonstrated three giant aneurysms with calcification in the left main (2.8 cm), left anterior descending (2.4 cm), and right (3.3 cm) coronary arteries, the two latter of which and adjacent proximal coronary arteries were occluded by thrombosis, and only faint contrast enhancement in the distal coronary arteries. Cardiovascular MRI (CMR) (Fig. 1c and d) revealed diffuse subendocardial and transmural late gadolinium enhancement (LGE) in both ventricular walls with poor left ventricular wall contraction in segments with LGE (Videos S1 and S2) and left ventricular ejection fraction (LVEF) of 24.5%. Resting myocardial perfusion imaging showed extensive myocardial ischemia in the inferior, high lateral, and septal left ventricular wall (Fig. 1e). Acute myocardial infarction by thrombosis in giant Kawasaki coronary aneurysms was diagnosed. {"href":"Single Video Player","role":"media-player-id","content-type":"play-in-place","position":"float","orientation":"portrait","label":"Video 1.","caption":"","object-id":[{"pub-id-type":"doi","id":""},{"pub-id-type":"other","content-type":"media-stream-id","id":"1_qj0tnb5j"},{"pub-id-type":"other","content-type":"media-source","id":"Kaltura"}]} {"href":"Single Video Player","role":"media-player-id","content-type":"play-in-place","position":"float","orientation":"portrait","label":"Video 2.","caption":"","object-id":[{"pub-id-type":"doi","id":""},{"pub-id-type":"other","content-type":"media-stream-id","id":"1_86d9ctbg"},{"pub-id-type":"other","content-type":"media-source","id":"Kaltura"}]} Fig. 1: Multimodality images of giant Kawasaki coronary artery aneurysms and myocardial infarction in a 20-year-old man. (a) Coronary CT angiography shows giant aneurysms in the left main, left anterior descending, and right coronary arteries, the two latter of which were nearly occluded by thrombosis. (b) Volume-rendered view of whole coronary CT angiography showed occlusion of proximal coronary arteries adjacent to the aneurysms and faint contrast enhancement in the distal coronary arteries. (c and d) Cardiovascular magnetic resonance images show diffuse subendocardial and transmural late gadolinium enhancement in both ventricular walls. (e) Resting myocardial perfusion image shows extensive myocardial ischemia in the inferior, high lateral, and septal LV wall. CT, computed tomography; LV, left ventricular.Both percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) were considered technically challenging and high-risk. PCI was limited by the risk of stent malapposition and thrombotic occlusion in lesions with giant aneurysms. Although CABG is the standard of care in complex multivessel aneurysmal disease, which can improve patient outcomes [1], it was not conducted in this patient, considering perioperative heart failure for extensive transmural LGE and severe left ventricular dysfunction, as well as the technical challenge of surgery posed by occlusion of adjacent coronary arteries and poor visualization of distal coronary arteries. After multidisciplinary discussion, and considering the patient’s hemodynamic stability, alternative medical therapy with long-term anticoagulation and antiplatelet agents (clopidogrel bisulfate 75 mg/day and aspirin 100 mg/day, administrated orally) was selected, consistent with current consensus that antithrombotic therapy is central when revascularization cannot be safely performed [1]. Follow-up CCTA 3 months and CMR 1 year after discharge showed essentially unchanged appearance of the aneurysms and distal coronary artery, as well as LGE and poor left ventricular contraction in the myocardium. Previous studies have reported that patients with LVEF less than 30% have significantly reduced long-term survival after CABG, with a 5-year survival rate of approximately 72% [2]. In the present case, despite the markedly reduced LVEF of 24.5%, the patient remained clinically stable during an 8-year follow-up – he experienced no recurrent ischemic events, and the antithrombotic strategy did not undergo adjustments or discontinuations during follow-up. This outcome not only confirmed the efficacy of the applied therapy but also highlighted the potential role of optimized medical therapy in carefully selected cases with left ventricular dysfunction. In addition, further advanced imaging was not performed in this patient because he remained clinically stable without recurrent events. Coronary artery aneurysms in Kawasaki disease are associated with high-risk cardiovascular events; myocardial infarction prevalence increases with aneurysm size [1]. Multimodality imaging plays an essential role in diagnosis, comprehensive evaluation, and surveillance of patient condition. Acknowledgements This work was supported by grants from the 1-3-5 project for disciplines of excellence of West China Hospital, Sichuan University (ZYGD23019) and Sichuan Provincial Science and Technology Plan Project (2024YFFK0259). The materials are available from the corresponding author upon reasonable request. Conflicts of interest There are no conflicts of interest.

A prediction model for the risk of developing HFpEF during hospitalization in patients with acute myocardial infarction.

Left bundle branch area pacing (LBBAP) has emerged as a promising alternative to conventional biventricular pacing (BIVP) for cardiac resynchronization therapy (CRT). While previous data suggest LBBAP may provide superior outcomes, existing evidence needs more data. This retrospective study included all patients who underwent de-novo CRT at two centers in France (2022-2024). Procedural and clinical outcomes were compared between LBBAP and BIVP groups for de-novo CRT indications, using inverse probability weighting propensity score. A total of 314 patients were included (75 LBBAP, 239 BIVP). Patients receiving LBBAP were older and more likely to have atrial fibrillation. Compared to BIVP, LBBAP was associated with shorter procedure time (96 vs. 128 min; p < 0.001), narrower paced QRS (128 vs. 139 ms; p < 0.001), and lower post-discharge device-related complications (1% vs. 11%; HR 0.10, 95% CI 0.01-0.84; p = 0.033). At 1-year, improvement in left ventricular ejection fraction (LVEF) was similar between groups (median ΔLVEF +15%; p = 0.438), as were hyper-response rates (52% vs. 60%; p = 0.231). After IPW-PS, no significant differences were observed in heart failure hospitalization (HR 0.99, 95% CI 0.40-2.64; p = 0.999), new-onset atrial fibrillation (HR 1.69, 95% CI 0.41-6.94; p = 0.492), sustained ventricular arrhythmias (HR 1.23, 95% CI 0.15-6.49; p = 0.828), overall (HR 1.10, 95% CI 0.44-2.62; p = 0.801), and cardiovascular deaths (HR 0.92, 95% CI 0.27-2.79; p = 0.927). LBBAP is associated with comparable resynchronization and clinical outcomes to BIVP, with fewer late complications.

Three-Year Outcomes of Contemporary Left Main Coronary Intervention in Patients With and Without Acute Coronary Syndrome.

Multi-biomarker approach for predicting cardiac magnetic resonance parameters at 30days after ST-segment elevation myocardial infarction.

Diagnostic and prognostic value of T2 mapping in cardiac sarcoidosis.

Accelerated reconstruction of 5D free-running MRI with variable projection-augmented Lagrangian (VPAL).

Heart failure with reduced ejection fraction carries high morbidity and mortality. Guideline-directed medical therapy (GDMT) improves outcomes, yet real-world use is often suboptimal. Multiple scoring tools quantifying GDMT optimization have been developed to identify areas of improvement, including GDMT count, Optimal Medical Therapy (OMT), modified OMT (mOMT), and Kansas City Medical Optimization (KCMO) scores. Their clinical utility in predicting readmissions is uncertain. To evaluate the association between four GDMT scoring systems and 30- and 90-day heart failure (HF) readmissions. This multi-center, retrospective cohort study included adults with a left-ventricular ejection fraction ≤40% hospitalized for HF across five academic medical centers between February 2021 and July 2023. Patients discharged on ≥1 GDMT class with ≥1 healthcare encounter within 90 days were included. GDMT scores were calculated at discharge, and their associations with 30- and 90-day HF readmissions were analyzed using mixed-effects Cox proportional hazards models adjusted for clinical covariates. Among 544 patients, 13.1% experienced 30-day and 26.8% experienced 90-day HF readmissions. At 30 days, no GDMT score was significantly associated with readmission. At 90 days, higher OMT (hazard ratios [HR]: 0.93, 95% CI: 0.86-0.99) and mOMT (HR: 0.94, 95% CI: 0.88-0.99) scores were associated with lower readmission risk, whereas GDMT count and KCMO scores were not. Patients on minimal GDMT regimens contributed disproportionately to 90-day readmissions. In this multi-center cohort, OMT and mOMT scores, but not GDMT count or KCMO, were associated with 90-day HF readmissions. Findings highlight the potential utility of simpler GDMT scoring systems while underscoring the need for refined tools incorporating dose intensity, class-specific weighting, and longitudinal therapy to better guide optimization efforts.

Obesity is a key contributor to heart failure, driving increased morbidity, mortality, and healthcare costs. This association is supported by multiple pathophysiological mechanisms and consistent epidemiological evidence, particularly not only in heart failure with preserved ejection fraction (HFpEF), but also in heart failure with reduced ejection fraction (HFrEF). Given the rising prevalence of both diseases, integrated management strategies are essential. This review outlines current management options in patients with heart failure and obesity, from lifestyle modification to pharmacological and surgical treatment, and explores emerging treatments aimed at mitigating this growing burden.

Real-world multi-institution analysis of tarlatamab in patients with small cell lung cancer.

This study aimed to investigate cardiac adaptations and energy expenditure of jumping horses after water treadmill (WT) training. Six trained horses were evaluated before (PRETR) and after (TR) a WT training (20 min, twice/week, water at carpus height) for 10 weeks. Transthoracic echocardiography was performed at PRETR and TR with phased array transducer (1.9-4 MHz) to obtain interventricular septal thickness (IVS), LV internal diameter (LVID), and posterior wall thickness (LVPW) at end-diastole (d) and systole (s) and heart rate (HR). Left ventricule end diastolic volume (Vd) and end systolic volume (Vs), fractional shortening (FS%), ejection fraction (EF%), stroke volume (SV) and cardiac output (CO) were calculated. Then, animals were performed a show jumping field test (SJT) using a HR monitor and energy expenditure (EE), cost of transport (COT) and metabolic power (Pmet) were calculated. Blood samples were obtained before and at 240 min of recovery for cardiac troponin analysis (cTnI). Data was analysed using paired t-test (p < 0.05). WT training led to significant increases of IVSd (∼2.56 vs. ∼2.79 cm; p = 0.001), LVPWs (∼4.21 vs. 4.48 cm; p = 0.032), EF% (∼75.0 vs. ∼78.6%; p = 0.049), FS% (∼46.8 vs. 50.2%; p = 0.048), CO (∼16.7 vs. ∼21.3 L/min; p = 0.015) and HR (31.2 vs. 36.3 bpm; p = 0.031); and a significant decrease of LVIDs (∼5.99 vs. 5.68 cm; p = 0.002) and cTnI levels. Significant improvements were observed for EE (1000.3 vs. 573.5 J/kg/min; p = 0.046) and COT (0.428 vs. 0.237 beats/kg/m x103; p = 0.036), with animals reaching higher speeds (12.9 km/h vs. 17.0 km/h) after the training program. The inclusion of WT in the routine training of show jumping horses induced cardiac structural and functional adaptations, enhancing myocardial contractility and overall cardiac efficiency.

Right ventricular pacing increases the risk of dyssynchrony, which raises the need for more physiological pacing strategies. Left bundle branch area pacing (LBBAP) has emerged, with most early studies utilizing lumen-less pacing leads. The feasibility and safety of LBBAP using conventional stylet-driven pacing lead (SDL) have been reported. We present prospective multicenter data, particularly in Asian clinical settings. The ACHIEVE-SYNC pilot study was a multicenter prospective observational cohort study conducted across several tertiary hospitals in South Korea. Patients with standard indications for pacemaker implantation underwent LBBAP using a 5.6Fr SDL with an extendable screw. Procedural success rate and LBBAP-related complications were evaluated. Pacing parameters, electrocardiographic features, and echocardiographic outcomes were assessed up to 12 months after implantation. LBBAP using SDL was successful in 100 of 101 (99.0%) patients. LBBAP lead-related adverse event occurred in 1 case (0.99%), which was lead dislodgement. The median pacing threshold at 12-month follow-up was 0.8 [0.7-1.0] V at 0.5 ms. At 12-month follow-up, the mean QRS duration changed from 119.2 ± 28.6 ms to 131.2 ± 23.8 ms. The mean left ventricular ejection fraction was 61.3% ± 8.5% before the procedure and 61.3% ± 7.5% at 12-month follow-up. In this prospective multicenter registry, LBBAP using SDL demonstrated a near-complete procedural success rate and a high incidence of confirmed Left bundle branch capture. Lead performance remained stable during long-term follow-up, and adverse events were rare, supporting the safety and technical feasibility of this approach in routine clinical practice.

Is Baduanjin beneficial and safe for the rehabilitation of patients with acute myocardial infarction undergoing percutaneous coronary intervention? A systematic review and meta-analysis of randomised controlled trials.

Myval Octacor and Octapro Trans-Catheter Heart Valves in Patients with Severe Pure Non Calcified Native Aortic Regurgitation.

Effect of Handheld Echocardiography by Trained Advanced Practice Providers on Heart Failure Management and Readmissions.