The Heart Health Yarning Tool: Co-Designing a Shared Decision-Making Tool With Aboriginal and Torres Strait Islander People for Cardiovascular Disease Prevention and Risk Management.

Introduction: Due to the ongoing impact of colonisation, Aboriginal and Torres Strait Islander people live with a greater burden of cardiovascular disease (CVD) than non-Indigenous Australians. Shared decision-making (SDM) is recognised as an essential component of person-centred care. However, there has been a lack of tools to support clinician communication and SDM to address CVD prevention in this important 'at-risk' population.

Emerging cytokines contribute to the clinical manifestation of carotid artery plaque formation and stability in patients with diabetes.

Background: Type 2 diabetes mellitus (T2DM) promotes atherosclerosis and plaque instability through chronic inflammation and immune dysregulation. Emerging evidence implicates members of the interleukin-1 family-particularly IL-36, IL-37, and IL-38-in the modulation of inflammatory responses in diabetic and non-diabetic vascular disease. However, their roles in carotid atherosclerosis remain poorly defined.

A Bayesian network analysis of the Pfizer COVID-19 vaccine in the paediatric population.

The Pfizer COVID-19 vaccines have been associated with an increased risk of myocarditis. However, COVID-19 infection is also associated with complications. A Bayesian network (BN), informed by Australian and international data, was created to determine individual risks and benefits of the Pfizer COVID-19 vaccine in the paediatric.

Surveillance and follow up outcomes of myocarditis after mRNA COVID-19 vaccination in Australia.

Clinical progression and medium-long term morbidity from myocarditis following mRNA COVID-19 vaccinations remains an important but undefined public health concern. We conducted prospective follow-up of individuals with either confirmed or probable myocarditis following monovalent Pfizer-BioNTech BNT162b2 or Moderna mRNA-1273 vaccination between 21 April 2021 and 5 July 2022 in Australia. Of 256 individuals who consented to follow up, mostly males following a second dose, 60% (133/221) had ongoing symptoms at 3-6 months and 35% (81/231) at 12-18 months.

Quality of Available Cardiovascular Disease Knowledge Tools: A Systematic Review.

Background: Cardiovascular disease (CVD) is the leading cause of morbidity and mortality. Most people can reduce their CVD risk through lifestyle improvements and medication. Having low health literacy is a barrier to CVD prevention and management and is associated with worse health outcomes.

CD19-targeting chimeric antigen receptor T-cell therapy is safe and effective for intra-cardiac B cell non-Hodgkin lymphoma.

Introduction: Chimeric antigen receptor T-cell (CAR-T) therapy is highly effective in B-cell blood cancers, but there is limited data on its safety and efficacy in intra-cardiac lymphoma, due to the potential risks of cardiotoxicity and pseudo-progression.

Discussion: We discuss four high-risk cases that were managed with a multi-disciplinary approach, including baseline cardiac risk assessment and surveillance with multimodal cardiac imaging and serum cardiac biomarkers, elective supportive care in the intensive care unit, and early treatment of cytokine release syndrome.

Conclusion: CAR-T therapy can be effective and safe in the treatment of B-cell blood cancers with intra-cardiac disease.

Comparison of 6-lead smartphone ECG and 12-lead ECG in athletes and a genetic heart disease population.

Background: Smartphone electrocardiograms (iECGs) are an innovative method of capturing transient arrhythmias that are occasionally experienced by athletes. This study aimed to assess the accuracy of a 6-lead iECG compared with 12-lead ECG in athletes and those with known genetic heart disease (positive controls).

Research Design And Methods: Each participant had a resting 12-lead ECG (supine) and a 30 s 6-lead iECG (seated) taken within 2 h.

A Call to Action to Improve Cardiac Arrest Outcomes: A Report From the National Summit for Cardiac Arrest.

Sudden cardiac arrest (SCA) represents a major cause of premature mortality globally, with enormous impact and financial cost to victims, families, and communities. SCA prevention should be considered a health priority in Australia. National Cardiac Arrest Summits were held in June 2022 and March 2023, with inclusion from multi-faceted endeavours related to SCA prevention.

Rationale and Design of the Australasian Registry of Screening ECGs in National Athletes Project.

Background: Cardiac screening of elite athletes is widely recommended by Australasian sporting federations, but data are not structured to be shared. Data are lacking from underrepresented groups to inform ECG interpretation guidelines. The ARENA (Australasian Registry of Screening ECGs in National Athletes) project is a retrospective and prospective, multicenter, longitudinal, observational registry of athlete cardiac screening results and outcomes.

Cardiac magnetic resonance imaging in systemic sclerosis: Heart involvement in high-resolution.

Cardiac magnetic resonance imaging (CMR) is the gold-standard non-invasive method of assessing cardiac structure and function, including tissue characterisation. In systemic sclerosis (SSc), heart involvement (SHI) is a leading cause of mortality yet remains poorly understood. SHI is underestimated by conventional echocardiography, and CMR provides an important opportunity to better identify and quantify subtle myocardial changes including oedema and fibrosis.

The role of genetic testing in management and prognosis of individuals with inherited cardiomyopathies.

Inherited cardiomyopathies are a heterogeneous group of heart muscle conditions where disease classification has traditionally been based on clinical characteristics. However, this does not always align with genotype. While there are well described challenges of genetic testing, understanding the role of genotype in patient management is increasingly required.

Hibernoma: a case report of a rare cardiac tumour.

Background: A cardiac hibernoma is a rare phenomenon, with just a handful of reports in the literature. They are difficult to characterize with conventional imaging including echocardiography, computed tomography (CT), cardiac magnetic resonance (CMR), or positron emission tomography (PET). Their definitive diagnosis relies primarily on histopathology via either endovascular or surgical biopsy.

Clinical outcomes of 10 years of cardiac screening in elite New Zealand athletes.

Objectives: To report findings from the High Performance Sport New Zealand cardiac screening programme, including comparisons between sexes and ethnicities.

Design: Retrospective cohort study.

Methods: Elite Olympic-sport athletes were screened (2012-2022) with personal/family history, physical examination, resting 12-lead ECG and followed from the date of first screening until July 2022.

Coronary microvascular dysfunction: A review of recent progress and clinical implications.

The coronary microcirculation plays a cardinal role in regulating coronary blood flow to meet the changing metabolic demands of the myocardium. Coronary microvascular dysfunction (CMD) refers to structural and functional remodeling of the coronary microcirculation. CMD plays a role in the pathogenesis of obstructive and non-obstructive coronary syndromes as well as myocardial diseases, including heart failure with preserved ejection fraction (HFpEF).

Longitudinal assessment of structural phenotype in Brugada syndrome using cardiac magnetic resonance imaging.

Background: Despite historically being considered a channelopathy, subtle structural changes have been reported in Brugada syndrome (BrS) on histopathology and cardiac magnetic resonance (CMR) imaging. It is not known if these structural changes progress over time.

Objective: The study sought to assess if structural changes in BrS evolve over time with serial CMR assessment and to investigate the utility of parametric mapping techniques to identify diffuse fibrosis in BrS.

Automatic segmentation of the great arteries for computational hemodynamic assessment.

Background: Computational fluid dynamics (CFD) is increasingly used for the assessment of blood flow conditions in patients with congenital heart disease (CHD). This requires patient-specific anatomy, typically obtained from segmented 3D cardiovascular magnetic resonance (CMR) images. However, segmentation is time-consuming and requires expert input.

Analysis of athlete QT intervals by age: Fridericia and Hodges heart rate corrections outperform Bazett for athlete ECG screening.

Background: Cardiac screening of elite athletes including a 12‑lead electrocardiogram (ECG) is recommended by numerous international bodies. Current athlete ECG interpretation guidelines recommend the Bazett method to correct the QT interval (QTc).

Objective: This study sought to investigate normative QTc changes by age using athlete screening ECGs and different QT correction methods in a population of elite cricketers.

A Bayesian network analysis quantifying risks versus benefits of the Pfizer COVID-19 vaccine in Australia.

The Pfizer COVID-19 vaccine is associated with increased myocarditis incidence. Constantly evolving evidence regarding incidence and case fatality of COVID-19 and myocarditis related to infection or vaccination, creates challenges for risk-benefit analysis of vaccination. Challenges are complicated further by emerging evidence of waning vaccine effectiveness, and variable effectiveness against variants.

Myocardial fibrosis in Type 2 Diabetes is associated with functional and metabolomic parameters.

Aims: To identify biomarkers of cardiomyopathy in patients with type 2 diabetes mellitus (T2DM) using cardiovascular magnetic resonance (CMR) and to identify associations between functional status, metabolomic profile and myocardial fibrosis.

Methods: In this prospective case control study, patients (n = 49) with T2DM without significant coronary artery disease, and matched controls (n = 18) underwent CMR, cardiopulmonary exercise testing, and plasma metabolomic analyses.

Results: Patients with T2DM (n = 49, median [interquartile range] age 61 [56-63] years, 61% male, diabetes duration 11 [7-20] years), historical HbA1c 7.

Exercise Intolerance, Benefits, and Prescription for People Living With a Fontan Circulation: The Fontan Fitness Intervention Trial (F-FIT)-Rationale and Design.

Despite developments in surgical techniques and medical care, people with a Fontan circulation still experience long-term complications; non-invasive therapies to optimize the circulation have not been established. Exercise intolerance affects the majority of the population and is associated with worse prognosis. Historically, people living with a Fontan circulation were advised to avoid physical activity, but a small number of heterogenous, predominantly uncontrolled studies have shown that exercise training is safe-and for unique reasons, may even be of heightened importance in the setting of Fontan physiology.

'Stay home when sick' advice: implications for sport and exercise.

The coronavirus pandemic has given everyone in society an education on the harms of spread of respiratory illness. Young healthy athletes are far less likely to suffer severe adverse consequences of viral illnesses than the elderly and frail, but they are not completely immune. Chronic fatigue (overtraining) is an uncommon outcome and myocarditis a rare one, but they both warrant due consideration.