The Weight of Cardiovascular Diseases: Addressing the Global Cardiovascular Crisis Associated with Obesity.

Obesity is a growing global epidemic with significant implications for cardiovascular diseases (CVD). It couples as an independent risk factor and driver for multiple pathways leading to CVDs. Here we examine obesity's impact on CVD and propose actionable strategies.

Lupus-Associated Pulmonary Arterial Hypertension: A Success Story.

Background: Pulmonary arterial hypertension (PAH) is a severe and potentially life-threatening complication of systemic lupus erythematosus.

Case Summary: We present the case of a young woman with dyspnea at rest, hospitalized with a suspected systemic lupus erythematosus flare. Right heart catheterization confirmed pre-capillary pulmonary hypertension with a low cardiac index.

Management of patients with heart failure at high risk of hyperkalaemia: The CARE-HK in HF registry.

Aims: Patients with heart failure (HF) at high risk for hyperkalaemia are underrepresented in prospective HF registries. The CARE-HK in HF registry sought to characterize prospectively the clinical profile, management, and outcomes for patients with HF at high risk of hyperkalaemia.

Methods And Results: CARE-HK in HF was a multinational prospective registry of outpatients with HF (regardless of left ventricular ejection fraction [LVEF]) treated with an angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker/angiotensin receptor-neprilysin inhibitor (ACEI/ARB/ARNI) and either receiving or potential candidate for a mineralocorticoid receptor antagonist (MRA).

Intravenous ferric carboxymaltose in heart failure with iron deficiency (FAIR-HF2 DZHK05 trial): Sex-specific outcomes.

Aims: Intravenous iron has emerged as a guideline-recommended therapy in patients with heart failure and iron deficiency, but the potential sex-related differences in efficacy are unknown. We aimed to assess sex-specific outcomes in the Intravenous Iron in Patients with Systolic Heart Failure and Iron Deficiency to Improve Morbidity & Mortality (FAIR-HF2-DZHK05) trial.

Methods And Results: FAIR-HF2 included 1105 heart failure patients with a left ventricular ejection fraction ≤45% and iron deficiency.

Challenges in Diagnosing Systemic Amyloidosis.

Background: The diagnosis of cardiac amyloidosis can be achieved noninvasively for transthyretin amyloid cardiomyopathy through nuclear scintigraphy with bone tracers. For other subtypes of cardiac amyloidosis (eg, light-chain amyloid cardiomyopathy), or in cases of suspected transthyretin amyloid cardiomyopathy with nondiagnostic scintigraphy results, histologic confirmation via tissue biopsy and amyloid subtype identification is required.

Case Summary: We present a case of a 66-year-old male with heart failure and left ventricular hypertrophy with evidence of systemic amyloidosis.

Global Impact of Fixed-Dose Combination Therapies on Cardiovascular Mortality and Events, 2023-2050: A Modeling Study.

Background: Uptake of drugs for primary and secondary prevention of cardiovascular disease is low in many countries. Single-pill combination (SPC) therapies consisting of a statin and 1 or more antihypertensive drugs, with or without aspirin, can reduce rates of fatal and nonfatal cardiovascular disease, but their use is currently limited.

Objectives: The authors modeled the potential impact of widespread adoption of SPC therapies over 2023 to 2050.

iCARDIO Alliance Global Implementation Guidelines on Heart Failure 2025.

Inconsistencies in healthcare access, varying infrastructure, resource constraints and diverse local practices as well as practical and political issues restrict the global applicability of currently available guidelines. There is a need for universal recommendations that address the unique challenges faced by patients and healthcare providers worldwide. Our iCARDIO Alliance Global Implementation Guidelines emphasize the incorporation of novel therapies, while integrating standard of care with the most up-to-date evidence to enable clinicians to optimize patient care.

Isolated Rapid Deployment Aortic Valve Replacement in Patients with Aortic Stenosis: Single-Center Retrospective Study.

Background: Aortic valve stenosis remains the most prevalent valvular pathology in Western countries. Rapid deployment bioprosthesis (RD) has emerged as a promising alternative to conventional valves for surgical aortic valve replacement (SAVR), particularly in elderly and high-risk patients. This study reports the short- and long-term outcomes of RD in patients with isolated aortic stenosis.

The Placebo Effect in Chronic Thromboembolic Pulmonary Hypertension Trials: A Systematic Review and Meta-Analysis.

Placebo-controlled studies are crucial in clinical trials, but the placebo effect can vary across conditions. We aimed to assess the placebo effect in chronic thromboembolic pulmonary hypertension (CTEPH) trials. We conducted a systematic review and included randomized placebo-controlled trials investigating CTEPH interventions.

Long-term trials of colchicine for secondary prevention of vascular events: a meta-analysis.

Background And Aims: Colchicine has emerged as a safe and inexpensive anti-inflammatory medication to target the residual risk of cardiovascular events in the secondary prevention of coronary artery disease. Two recently published randomized controlled trials (RCTs) investigating colchicine in the post-stroke and post-myocardial infarction (MI) populations warrant a re-evaluation of colchicine. New evidence was synthesized in a systematic review and meta-analysis to determine the long-term efficacy and safety of colchicine for the secondary prevention of vascular disease.

Ferric carboxymaltose assessment of morbidity and mortality in patients with iron deficiency and chronic heart failure (FAIR-HF2-DZHK05) trial: Baseline characteristics and comparison to other relevant clinical trials.

Aims: Prior randomized trials have reported conflicting evidence regarding the efficacy of intravenous (IV) iron in patients with heart failure with reduced ejection fraction (HFrEF) and iron deficiency (ID).

Methods And Results: FAIR-HF2 is a double-blind, randomized, controlled trial evaluating the efficacy of IV ferric carboxymaltose in patients with HFrEF and ID. We report the baseline characteristics of enrolled patients and compare them with other major trials of IV iron in HFrEF (FAIR-HF, CONFIRM-HF, AFFIRM-AHF, IRONMAN, and HEART-FID).

Intravenous Ferric Carboxymaltose in Heart Failure With Iron Deficiency: The FAIR-HF2 DZHK05 Randomized Clinical Trial.

Importance: Uncertainty remains about the efficacy of intravenous iron in patients with heart failure and iron deficiency.

Objective: To assess the efficacy and safety of ferric carboxymaltose in patients with heart failure and iron deficiency.

Design, Setting, And Participants: This multicenter, randomized clinical trial enrolled 1105 patients with heart failure (defined as having a left ventricular ejection fraction of ≤45%) and iron deficiency (serum ferritin level <100 ng/mL; or if transferrin saturation was <20%, a serum ferritin level between 100 ng/mL and 299 ng/mL) at 70 clinic sites in 6 European countries from March 2017 to November 2023.

Association of Aspirin Use in Primary Prevention and Cardiovascular Events: A Retrospective Analysis of the VITAL Cohort.

Aspirin is part of the therapeutic antithrombotic armamentarium for the management of patients with established clinically relevant atherosclerosis or thrombotic cardiovascular disease. Personalized medicine identifies those who benefit most or face fewer risks from aspirin. The role of aspirin in primary prevention is still debatable.

From Persisting Diabetes to the Diagnosis of Pancreatic Cancer: A Case Report.

The diagnosis of new-onset diabetes mellitus (DM) in individuals with a consumptive syndrome warrants a comprehensive and systematic etiological investigation. This article presents the case of a 45-year-old male, smoker, with a history of a treated C hepatitis virus, diagnosed with type 2 diabetes, accompanied by complaints of fatigue, anorexia, and unintentional weight loss. Despite an initial workup by the general practitioner, including colonoscopy, endoscopy, and abdominal-pelvic CT scan, no neoplastic etiology was identified.

Exploring the impact of metabolic comorbidities on epicardial adipose tissue in heart failure with preserved ejection fraction.

Background: Heart failure (HF) with preserved ejection fraction (HFpEF) is increasingly prevalent worldwide due to aging and comorbidities. Epicardial adipose tissue (EAT), favored by diabetes and obesity, was shown to contribute to HFpEF pathophysiology and is an emerging therapeutic target. This study explored the relationship between ventricular EAT measured by cardiovascular magnetic resonance (CMR), metabolic factors, and imaging characteristics in controls, pre-HF patients, and HFpEF patients.

Upfront lipid-lowering combination therapy in high cardiovascular risk patients: a route to effective atherosclerotic cardiovascular disease prevention.

Despite three decades of using statin therapy, 20 years of experience with ezetimbe, and availability of innovative non-statin lipid lowering therapies (LLT), there are still about 70% patients over the low-density lipoprotein cholesterol (LDL-C) goal, with every 5th to 6th being over the target from the group of very high and extremely high cardiovascular disease (CVD) risk patients. Adding another even every 5th patient at very high CVD risk without any LLT makes this situation highly frustrating, especially lipid disorders are the most common CVD risk factor with the prevalence of over 60%, with the worst awareness within all cardiovascular risk factors (only about 15% people knows their LDL-C level). To answer this since 2021, there is an approach to apply upfront (immediate) lipid-lowering combination therapy of statin and ezetimibe in very high and extremely high-risk patients to be on the LDL-C target as low as possible, but especially as early as possible, enabling to introduce the third line therapy (i.

Non-invasive derivation of instantaneous free-wave ratio from invasive coronary angiography using a new deep learning artificial intelligence model and comparison with human operators' performance.

Invasive coronary physiology is underused and carries risks/costs. Artificial Intelligence (AI) might enable non-invasive physiology from invasive coronary angiography (CAG), possibly outperforming humans, but has seldom been explored, especially for instantaneous wave-free Ratio (iFR). We aimed to develop binary iFR lesion classification AI models and compare them with human performance.

Chronic coronary syndrome in Africa: current management and service challenges, and opportunities for optimizing patient care.

African populations have traditionally been considered at relatively low risk of cardiovascular diseases (CVD), such as chronic coronary syndrome (CCS), but this is rapidly changing in association with ageing populations, uncontrolled urbanization and lack of control of classical CV risk factors. In sub-Saharan Africa, CVD deaths have increased by more than 50% in the past three decades. For CCS care, limited availability of clinical expertise, diagnostic facilities, and access to optimal medical therapy (OMT), lack or inadequate reimbursement of healthcare costs, and scarcity of universal health coverage (UHC) are major challenges.

When the Shaft Breaks: Managing a Cath Lab Nightmare.

Objective: We describe the case of a 57-year-old male patient with anterior ST-segment elevation myocardial infarction in cardiogenic shock. Coronary angiography revealed severe left main (LM) and triple-vessel disease, and the patient was refused for surgery due to lack of distal grafting landing zone. A shaft fracture occurred during LM percutaneous coronary intervention, leaving the fractured stent hanging in the aorta.

Role of major cardiovascular surgery-induced metabolic reprogramming in acute kidney injury in critical care.

Purpose: Major cardiovascular surgery imposes high physiologic stress, often causing severe organ dysfunction and poor outcomes. The underlying mechanisms remain unclear. This study investigated metabolic changes induced by major cardiovascular surgery and the potential role of identified metabolic signatures in postoperative acute kidney injury (AKI).

Association of LDL-cholesterol with prognosis in patients admitted for acutely decompensated heart failure.

Introduction And Objectives: The association of low-density lipoprotein cholesterol (LDL-C) levels and prognosis in patients with heart failure (HF) remains uncertain. This study aimed to evaluate the prognostic significance of LDL-C in patients admitted for acutely decompensated HF and establish a safety cut-off value in this population.

Methods: This retrospective, observational study included 167 consecutive patients admitted for acute HF.

Enhancing Diagnostic Precision: Intracardiac Echocardiography-Guided Endomyocardial Biopsy for Complex Right Atrial Mass.

An 80-year-old woman with a history of B-cell non-Hodgkin lymphoma presented to the emergency department with exertional dyspnea and lower limb edema. A transthoracic echocardiogram revealed a large extracardiac mass invading the right atrium. A diagnostic transcatheter endomyocardial biopsy guided by intracardiac echocardiography was performed.