The use of multimodality imaging in heart transplant recipients: a case series.

Background: Acute cardiac allograft rejection and cardiac allograft vasculopathy are among the most common and dreaded complications occurring after successful heart transplantation and mandate lifelong monitoring. Non-invasive cardiac imaging with cardiac computed tomography (CCT) and cardiovascular magnetic resonance (CMR) has the potential to reduce the number of invasive exams needed with patient and economic benefits. We present our experience with these imaging techniques in the care of heart transplant recipients.

Transcatheter therapies for tricuspid regurgitation: A meta-analysis of randomized trials.

Background: Severe tricuspid regurgitation (TR) is prevalent in elderly patients and associated with poor prognosis. Transcatheter tricuspid valve interventions (TTVI) have emerged as a therapeutic option for patients at high surgical risk. However, the clinical benefit of TTVI compared with optimal medical therapy (OMT) remains uncertain.

[Artificial intelligence for randomized controlled trials in cardiology: applications and future perspectives].

Integrating artificial intelligence (AI) into cardiovascular clinical trials is emerging as a key factor in streamlining patient selection, data collection, endpoint monitoring, and outcome analysis. On the one hand, machine learning and deep learning algorithms facilitate the management and review of ever-increasing volumes of clinical, imaging, and telemonitoring data, identifying predictive patterns and automating repetitive tasks. On the other hand, the high cost and long duration of traditional trials, coupled with the need for adequate population diversity, underscore the urgency of re-engineering trial design.

Timing of Cardiac Resynchronization Therapy Following Stable Medical Therapy in Patients With Heart Failure.

Background: Guidelines' recommendations for cardiac resynchronization therapy (CRT) implantation in selected patients with heart failure (HF) exist. However, data on the best timing for CRT implantation after the achievement of stable medical therapy (SMT) and its association with outcomes are currently lacking.

Objectives: The aim of this study was to investigate the timing of CRT implantation after the achievement of SMT, associated patient profiles, and clinical outcomes in a real-world HF population.

Cardiac resynchronization therapy for enabling guideline-directed medical therapy optimization in heart failure.

Aims: We aimed to assess whether cardiac resynchronization therapy (CRT) might serve as an enabler for guideline-directed medical therapy (GDMT) optimization.

Methods And Results: Patients with heart failure with reduced ejection fraction (HFrEF) enrolled in the Swedish Heart Failure Registry between January 2009 and August 2022 were considered. Patients receiving a CRT close to the index registration were the cases, whereas controls had not received a CRT despite having an indication.

When a meta-analysis can be really useful?

Meta-analyses represent a key milestone in evidence-based medicine, integrating data from multiple studies to generate more robust estimates of an intervention's effects. By pooling information from various trials or observational studies, meta-analyses enhance statistical power, elucidate subgroup effects, and guide hypothesis generation. They have proven particularly useful in scenarios where individual randomized controlled trials (RCTs) cannot feasibly enroll enough participants (e.

Aetiological phenotypes of atrial and ventricular secondary tricuspid regurgitation and their prognostic implications: insights from the CARE-TR registry.

Aims: To report prevalence and clinical outcomes of different aetiological phenotypes of atrial and ventricular secondary tricuspid regurgitation (ASTR/VSTR).

Methods And Results: The Consecutive pAtients with seveRE Tricuspid Regurgitation evaluated in Heart Failure (HF) and Valve Clinics (CARE-TR) registry collected data from patients with at least severe tricuspid regurgitation (TR) enrolled at three Italian centres. The present analysis includes 648 patients with secondary TR, 22.

The use of cardiac imaging in patients undergoing atrial fibrillation ablation.

Cardiac imaging (CI), including echocardiography, multidetector computed tomography (MDCT), and cardiac magnetic resonance (CMR), is gaining increasing interest to aid atrial fibrillation (AF) ablation procedures, from pre-procedural planning to intra-procedural guidance. Transthoracic echocardiography is widely used for imaging, especially for preprocedural assessment, while transesophageal and intracardiac echocardiography (ICE) are used for intraprocedural guidance during transseptal puncture. Cardiac MDCT, leveraging its high spatial resolution, offers a detailed anatomical visualization of cardiac chambers and adjacent structures; moreover, left atrial wall thickness assessed by MDCT may guide radiofrequency energy titration to enhance procedural safety and efficiency.

Clinical Impact of Renal Dysfunction in Patients with Severe Tricuspid Regurgitation and Chronic Heart Failure.

Background: Renal dysfunction (RD) is common in patients with heart failure (HF), however its impact on clinical outcomes in patients with tricuspid regurgitation (TR) and HF is still debated; therefore, we aimed to assess the impact of RD on clinical outcomes in this population.

Methods: All patients with HF and a prevalent or incident diagnosis of TR presenting at two centers between January 2020 and July 2021 were enrolled, in both acute (in-hospitalized patients) and chronic settings (outpatient). Patients were stratified according to the degree of RD (Group 1 <30 mL/min (n = 70), Group 2 30-59 mL/min (n = 123) and Group 3 ≥60 mL/min (n = 56).

Predicting survival in patients with severe heart failure: Risk score validation in the HELP-HF cohort.

Aims: Accurate selection of patients with severe heart failure (HF) who might benefit from advanced therapies is crucial. The present study investigates the performance of the available risk scores aimed at predicting the risk of mortality in patients with severe HF.

Methods And Results: The risk of 1-year mortality was estimated in patients with severe HF enrolled in the HELP-HF cohort according to the MAGGIC, 3-CHF, ADHF/NT-proBNP, and GWTG-HF risk scores, the number of criteria of the 2018 HFA-ESC definition of advanced HF, I NEED HELP markers, domains fulfilled of the 2019 HFA-ESC definition of frailty, the frailty index, and the INTERMACS profile.

Prognostic value of hypochloremia on mortality in patients with heart failure: a systematic review and meta-analysis.

Aims: Electrolyte imbalances are common in patients with heart failure. Several studies have shown that a low serum chloride level is associated with adverse outcomes in hospitalized patients with acute heart failure and in outpatients with chronic heart failure. We performed a systematic review and meta-analysis to assess the association of hypochloremia with all-cause mortality in patients with heart failure.

Single-Cell RNA Sequencing Reveals Metabolic Stress-Dependent Activation of Cardiac Macrophages in a Model of Dyslipidemia-Induced Diastolic Dysfunction.

Background: Metabolic distress is often associated with heart failure with preserved ejection fraction (HFpEF) and represents a therapeutic challenge. Metabolism-induced systemic inflammation links comorbidities with HFpEF. How metabolic changes affect myocardial inflammation in the context of HFpEF is not known.

Prognostic role of mitral regurgitation in patients with advanced heart failure.

Aim: The impact of mitral regurgitation (MR) in patients with advanced heart failure (HF) is poorly known. We aimed to evaluate the impact of MR on clinical outcomes of a real-world, contemporary, multicentre population with advanced HF.

Methods: The HELP-HF registry enrolled patients with HF and at least one "I NEED HELP" criterion, at four Italian centres between January 2020 and November 2021.

Clinical burden and predictors of non-cardiovascular mortality and morbidity in advanced heart failure.

Background: The changing demographic of heart failure (HF) increases the exposure to non-cardiovascular (non-CV) events. We investigated the distribution of non-CV mortality/morbidity and the characteristics associated with higher risk of non-CV events in patients with advanced HF.

Methods: Patients from the HELP-HF registry were stratified according to the number of 2018 HFA-ESC criteria for advanced HF.

Guideline-directed medical therapy in severe heart failure with reduced ejection fraction: An analysis from the HELP-HF registry.

Aim: Persistent symptoms despite guideline-directed medical therapy (GDMT) and poor tolerance of GDMT are hallmarks of patients with advanced heart failure (HF) with reduced ejection fraction (HFrEF). However, real-world data on GDMT use, dose, and prognostic implications are lacking.

Methods And Results: We included 699 consecutive patients with HFrEF and at least one 'I NEED HELP' marker for advanced HF enrolled in a multicentre registry.