Representation of women in cardiovascular disease management: a systematic analysis of ESC guidelines.

Objective: Sex differences play a critical role in the presentation, progression and treatment outcomes of cardiac diseases. However, historical male predominance in clinical studies has led to disparities in evidence supporting care for both sexes. Clinical guidelines are essential for cardiovascular care, shaping practice and influencing patient outcomes.

Integrating imaging and invasive pressure data into a multi-scale whole-heart model.

Cardiovascular diseases are the leading cause of death. Clinical data used to decide treatment are hard to integrate and interpret, making optimal treatment selection difficult. Personalised models can be used to integrate clinical data into a physics and physiology-constrained framework, but their clinical application faces limitations due to complex calibration and validation.

Three-dimensional left atrial strain from retrospective gated computed tomography: Comparison with speckle-tracking echocardiography in patients with aortic stenosis.

Background: Three-dimensional (3D) left atrial (LA) deformation assessment beyond the two-dimensional (2D) apical views circumvents atrial foreshortening and can be quantified from four-dimensional (4D) retrospective gated computed tomography (CT) using novel feature tracking methods. However, the consistency between CT-derived 3D and echocardiographic 2D peak left atrial longitudinal strain (PALS) has not been reported. We aimed to compare CT-derived 3D and echocardiographic 2D PALS in patients undergoing transcatheter aortic valve implantation (TAVI).

Joint Pacing and Vascular Intervention for the Management of Cardiac Device Associated Central Venous Obstruction.

Background And Aims: Central venous obstruction (CVO) increases the complexity of pacing interventions, whether it be with device-associated symptomatic superior vena cava syndrome (SVCS), or by impeding new implants. Endovascular treatment involves the joint expertise of both cardiac pacing and vascular specialists. We report the outcomes of such procedures at our institution.

Rhythm control benefits left ventricular function compared with rate control in patients with atrial fibrillation: A computational study.

Background: Atrial fibrillation (AF) alters heart rate, rhythm regularity, and atrial contraction, which may contribute to an increased risk of heart failure. Although rate and rhythm control target different aspects of these disturbances, their specific effects on left ventricular (LV) function remain unclear.

Objective: The purpose of this study was to predict the independent and combined contribution of heart rate, rhythm regularity, and atrial contraction to LV function in patients with AF.

Cardiac digital twins: a tool to investigate the function and treatment of the diabetic heart.

Diabetes increases the risk of cardiovascular disease (CVD) due to its multi-scale and diverse effects on cardiomyocyte metabolism and function, the circulation, and the kidneys. The complex relationship between organ systems affected by diabetes and associated comorbidities leads to challenges in estimating cardiovascular risk and stratifying optimal treatment strategies at the individual patient level. Most recently, sodium-glucose transport protein 2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP1) receptor agonists have been shown to offer substantial cardiac benefits.

Is regional atrial strain a useful surrogate of regional atrial fibrosis in atrial cardiomyopathy?

Aims: To determine whether atrial biomechanics measured using 3D regional strain, left atrial volume (LAV), and left atrial emptying fraction (LAEF) are associated with atrial fibrosis in patients with suspected atrial cardiomyopathy.

Methods And Results: Cardiovascular magnetic resonance (CMR) was performed in atrial fibrillation (AF) patients ( = 47). Healthy volunteer ( = 41) and familial dilated cardiomyopathy (DCM) ( = 31) cohorts were acquired for normalization and validation, respectively.

Developing cardiac biomechanical models beyond the clinic: modeling stressors of daily life.

There is growing motivation to exploit computational biomechanical modeling of the heart as a predictive tool to support clinical diagnoses and therapies. Existing patient-specific cardiac models often rely on data collected under highly standardized conditions in hospitals. However, disease progression and therapy responses often depend on stressors, encountered in daily life, that cannot be captured in a traditional clinical setting.

Effect of leadless left ventricular endocardial and left bundle branch area pacing on biventricular repolarization metrics.

Background: Cardiac resynchronization therapy (CRT) delivered with left ventricular (LV) epicardial pacing may increase arrhythmic risk through detrimental effects on ventricular repolarization. Leadless LV endocardial CRT including leadless left bundle branch area pacing (LBBAP) may mitigate this by preserving a more physiological transmural activation pattern.

Objective: This study aimed to evaluate the effect of leadless LV endocardial and leadless LBBAP on repolarization metrics derived from electrocardiographic imaging (ECGi).

Assessing Self-supervised xLSTM-UNet Architectures for Head and Neck Tumor Segmentation in MR-Guided Applications.

Radiation therapy (RT) plays a pivotal role in treating head and neck cancer (HNC), with MRI-guided approaches offering superior soft tissue contrast and daily adaptive capabilities that significantly enhance treatment precision while minimizing side effects. To optimize MRI-guided adaptive RT for HNC, we propose a novel two-stage model for Head and Neck Tumor Segmentation. In the first stage, we leverage a Self-Supervised 3D Student-Teacher Learning Framework, specifically utilizing the DINOv2 architecture, to learn effective representations from a limited unlabeled dataset.

An in silico guide for ventriculo-ventricular delay programming for left bundle branch-optimized cardiac resynchronization therapy.

Aims: Left bundle branch pacing (LBBP)-optimized cardiac resynchronization therapy (LOT-CRT) can improve left ventricular (LV) activation when LBBP alone or conventional biventricular pacing are ineffective. However, the optimal programming settings for ventriculo-ventricular delay (VVD) for LOT-CRT are unknown. We aim to investigate how to optimally program VVD for LOT-CRT in the presence of various LV conduction substrates using computational modelling.

Computational modelling for improved translation of cardiac inotropic and lusitropic drug effects from rats to humans.

Telemetered rats are widely used for early drug screenings but pronounced physiological differences between rat and human hearts limit translational relevance. To address this, the study investigates the potential of computer modelling to improve the translation of inotropic and lusitropic drug effects from rats to humans, beginning at the cellular scale. To this end, computer models of rat and human left ventricular cardiomyocytes were constructed to reproduce experimental data.

Probabilistic Richardson extrapolation.

For over a century, extrapolation methods have provided a powerful tool to improve the convergence order of a numerical method. However, these tools are not well-suited to modern computer codes, where multiple continua are discretized and convergence orders are not easily analysed. To address this challenge, we present a probabilistic perspective on Richardson extrapolation, a point of view that unifies classical extrapolation methods with modern multi-fidelity modelling, and handles uncertain convergence orders by allowing these to be statistically estimated.

Identification of atrial myopathy and atrial fibrillation recurrence after ablation using 3D left atrial phasic strain from retrospective gated computed tomography.

Aims: Reduced left atrial (LA) mechanical function associates with atrial myopathy and adverse clinical endpoints in atrial fibrillation (AF) patients; however, conventional 2D imaging modalities are limited by atrial foreshortening and sub-optimally capture 3D LA motion.

Objectives: We set out to test the hypothesis that 3D LA motion features from 4D (3D + time) retrospective gated computed tomography (RGCT) associate with AF phenotypes and predict AF recurrence in patients undergoing catheter ablation.

Methods And Results: Sixty-nine AF patients (60.

Optimizing outcomes from cardiac resynchronization therapy: what do recent data and insights say?

Introduction: Cardiac Resynchronization Therapy (CRT) is an effective treatment for heart failure (HF) in approximately two-thirds of recipients, with a third remaining CRT 'non-responders.' There is an increasing body of evidence exploring the reasons behind non-response, as well as ways to preempt or counteract it.

Areas Covered: This review will examine the most recent evidence regarding optimizing outcomes from CRT, as well as explore whether traditional CRT indeed remains the best first-line therapy for electrical resynchronization in HF.

Noninvasive assessment of hydroquinidine effect in Brugada syndrome (QUIET BrS).

Background: Hydroquinidine reduces arrhythmic events in patients with Brugada syndrome (BrS). The mechanism by which it exerts antiarrhythmic benefit and its electrophysiological effects on BrS substrate remain incompletely understood.

Objective: This study aimed to determine the effect of hydroquinidine on ventricular depolarization and repolarization in patients with BrS in vivo.

Optimizing electrical efficacy of leadless cardiac resynchronization therapy and leadless left ventricular septal pacing: Insights on left and right ventricular activation from electrocardiographic imaging.

Background: Leadless cardiac resynchronization therapy (CRT) is an emerging heart failure treatment. An implanted electrode delivers lateral or septal endocardial left ventricular (LV) pacing (LVP) upon detection of a right ventricular (RV) pacing stimulus from a coimplanted device, thus generating biventricular pacing (BiVP). Electrical efficacy data regarding this therapy, particularly leadless LV septal pacing (LVSP) for potential conduction system capture, are limited.

Observable Atrial and Ventricular Fibrillation Episode Durations Are Conformant With a Power Law Based on System Size and Spatial Synchronization.

Background: Atrial fibrillation (AF) and ventricular fibrillation (VF) episodes exhibit varying durations, with some spontaneously ending quickly while others persist. A quantitative framework to explain episode durations remains elusive. We hypothesized that observable self-terminating AF and VF episode lengths, whereby durations are known, would conform with a power law based on the ratio of system size and correlation length ([Formula: see text].

Heart Size Difference Drives Sex-Specific Response to Cardiac Resynchronization Therapy: A Post Hoc Analysis of the MORE-MPP CRT Trial.

Background: Studies have reported that female sex predicts superior cardiac resynchronization therapy (CRT) response. One theory is that this association is related to smaller female heart size, thus increased relative dyssynchrony at a given QRS duration (QRSd). Our objective was to investigate the mechanisms of sex-specific CRT response relating to heart size, relative dyssynchrony, cardiomyopathy type, QRS morphology, and other patient characteristics.

Cardiac length-dependent activation driven by force-dependent thick-filament dynamics.

The length-dependent activation (LDA) of maximum force and calcium sensitivity are established features of cardiac muscle contraction but the dominant underlying mechanisms remain to be fully clarified. Alongside the well-documented regulation of contraction via the thin filaments, experiments have identified an additional force-dependent thick-filament activation, whereby myosin heads parked in a so-called off state become available to generate force. This process produces a feedback effect that may potentially drive LDA.

Evaluation of deep learning estimation of whole heart anatomy from automated cardiovascular magnetic resonance short- and long-axis analyses in UK Biobank.

Aims: Standard methods of heart chamber volume estimation in cardiovascular magnetic resonance (CMR) typically utilize simple geometric formulae based on a limited number of slices. We aimed to evaluate whether an automated deep learning neural network prediction of 3D anatomy of all four chambers would show stronger associations with cardiovascular risk factors and disease than standard volume estimation methods in the UK Biobank.

Methods And Results: A deep learning network was adapted to predict 3D segmentations of left and right ventricles (LV, RV) and atria (LA, RA) at ∼1 mm isotropic resolution from CMR short- and long-axis 2D segmentations obtained from a fully automated machine learning pipeline in 4723 individuals with cardiovascular disease (CVD) and 5733 without in the UK Biobank.

Whole-heart electromechanical simulations using Latent Neural Ordinary Differential Equations.

Cardiac digital twins provide a physics and physiology informed framework to deliver personalized medicine. However, high-fidelity multi-scale cardiac models remain a barrier to adoption due to their extensive computational costs. Artificial Intelligence-based methods can make the creation of fast and accurate whole-heart digital twins feasible.