The role of multi-modality imaging for the assessment of left atrium and left atrial appendage. A clinical consensus statement of the European Association of Cardiovascular Imaging (EACVI), European Heart Rhythm Association (EHRA) of the European Society of Cardiology (ESC).

Structural, architectural, contractile or electrophysiological alterations may occur in the left atrium (LA). The concept of LA cardiopathy is supported by accumulating scientific evidence demonstrating that LA remodeling has become a cornerstone diagnostic and prognostic marker. The structure and the function of LA and left atrial appendage (LAA) which is an integral part of the LA, are key elements for a better understanding of multiple clinical conditions, most notably atrial fibrillation (AF), cardioembolism, heart failure and mitral valve diseases.

Valve Thrombosis Following Transcatheter Aortic Valve Replacement: State-of-the-Art Review.

Transcatheter aortic valve replacement (TAVR) is a well-established treatment for severe aortic stenosis, especially in patients over 75 or those at high surgical risk. While these prosthetic valves have a lower thrombogenic profile than mechanical heart valves, leaflet thrombosis in transcatheter aortic valves (TAV) occurs in an estimated 5%-40% of cases. Most TAV thromboses are subclinical and can be detected via cardiac computed tomography (CCT), which reveals hypo-attenuating leaflet thickening and reduced leaflet motion in asymptomatic patients without elevated transprosthetic gradients on echocardiography.

From the armchair to contemporary cardiac rehabilitation: the remarkable ongoing journey of exercise training in ischemic heart disease.

Exercise is an important physiological activity with several health benefits. In the setting of ischemic heart disease (IHD), the view toward exercise has greatly evolved throughout the years, concurrently to several major advances in the management of this complex entity. Currently, exercise training has broad applications across the IHD continuum as a powerful tool in its overall management, being a core component of comprehensive cardiac rehabilitation programs.

Impact of right ventricle-pulmonary artery coupling in patients undergoing transcatheter aortic valve implantation.

Right ventricle-pulmonary artery (RV-PA) coupling has been linked to clinical outcomes in patients with severe aortic stenosis (AS) undergoing transcatheter valve implantation (TAVI). However, the best timing for prognostic assessment remains uncertain. Our aim was to determine the impact of RV longitudinal function parameters and RV-PA coupling on mortality in patients undergoing TAVI.

Optimizing heart failure pathways to enhance patient care: the Program to Optimize Heart Failure Patient Pathways (PRO-HF).

Aims: Many European healthcare providers struggle to adopt multidisciplinary, integrated care pathways for people with heart failure (HF) as recommended by the European Society of Cardiology. PRO-HF (Program to Optimize Heart Failure Patient Pathways) was developed to help clinicians identify strengths, gaps, and shortcomings in their HF pathways and support tailored interventions to optimize pathways and enhance patient care. We report initial findings from baseline assessments of HF pathway characteristics and challenges from 10 hospitals in six European countries (France, Ireland, Portugal, Spain, The Netherlands, and United Kingdom).

Cost-effectiveness analysis of a cardio-oncology rehabilitation framework compared to an exercise intervention for cancer survivors with high cardiovascular risk.

Background: A cardio-oncology rehabilitation model among cancer survivors showed superior results comparing to a community-based exercise intervention. However, questions remain about its cost-effectiveness.

Aims: To assess the cost-effectiveness of a center-based cardiac rehabilitation (CBCR) program when compared to usual care encompassing a community-based exercise training (CBET), among cancer survivors with high cardiovascular risk.

Sex-based differences and risk of recurrence in patients with atrial fibrillation undergoing pulmonary vein isolation.

Introduction: Studies suggest increased likelihood of atrial fibrillation (AF) recurrence after catheter ablation (CA) in women than in men, indicating that sex may be an independent risk factor for recurrence. Nevertheless, the influence of sex on AF recurrence and underlying mechanisms remains unclear.

Methods: Retrospective, single-centre study including patients undergoing AF CA between 2017 and 2021.

Training and attitudes concerning cardiac rehabilitation in Portugal: A national survey of physician members of the Portuguese Society of Cardiology.

Introduction And Objectives: Cardiac rehabilitation (CR) is a central component in the management of cardiovascular disease. While its potential benefits have been extensively explored and confirmed, its implementation is still suboptimal, due to various possible barriers. This study aimed to assess training and attitudes concerning CR among physicians in a Portuguese setting.

Digital health and cardiovascular healthcare professionals in Portugal: Current status, expectations and barriers to implementation.

Introduction And Objectives: Digital health (DH) is a broad concept, bringing together technology and healthcare, that is playing an increasingly important role in the daily routine of healthcare professionals (HCPs) and promises to contribute to the prevention and treatment of cardiovascular disease. There are no solid data on the position of Portuguese HCPs toward the implementation of DH in cardiovascular medicine. This national cross-sectional study aims to provide a snapshot of DH implementation in Portuguese cardiovascular HCP routines and to identify both expectations and barriers to its adoption.

On the Impact of Synchronous Electrocardiogram Signals for Heart Sounds Segmentation.

In this paper we study the heart sound segmentation problem using Deep Neural Networks. The impact of available electrocardiogram (ECG) signals in addition to phonocardiogram (PCG) signals is evaluated. To incorporate ECG, two different models considered, which are built upon a 1D U-net - an early fusion one that fuses ECG in an early processing stage, and a late fusion one that averages the probabilities obtained by two networks applied independently on PCG and ECG data.

Automatic Contrast Generation from Contrastless Computed Tomography.

The use of contrast-enhanced computed tomography (CTCA) for detection of coronary artery disease (CAD) exposes patients to the risks of iodine contrast-agents and excessive radiation, increases scanning time and healthcare costs. Deep learning generative models have the potential to artificially create a pseudo-enhanced image from non-contrast computed tomography (CT) scans.In this work, two specific models of generative adversarial networks (GANs) - the Pix2Pix-GAN and the Cycle-GAN - were tested with paired non-contrasted CT and CTCA scans from a private and public dataset.

Prognostic value of flow-status in severe aortic stenosis patients undergoing percutaneous intervention.

Purpose: Low-flow status is a mortality predictor in severe aortic stenosis (SAS) patients, including after transcatheter aortic valve implantation (TAVI) treatment. However, the best parameter to assess flow is unknown. Recent studies suggest that transaortic flow rate (FR) is superior to currently used stroke volume index (SVi) in defining low-flow states.

Portuguese Heart Failure Prevalence Observational Study (PORTHOS) rationale and design - A population-based study.

Introduction And Objectives: Current epidemiological data on heart failure (HF) in Portugal derives from studies conducted two decades ago. The main aim of this study is to determine HF prevalence in the Portuguese population. Using current standards, this manuscript aims to describe the methodology and research protocol applied.

Value of cardiac magnetic resonance on the risk stratification of cardiomyopathies.

Cardiomyopathies represent a diverse group of heart muscle diseases with varying etiologies, presenting a diagnostic challenge due to their heterogeneous manifestations. Regular evaluation using cardiac imaging techniques is imperative as symptoms can evolve over time. These imaging approaches are pivotal for accurate diagnosis, treatment planning, and optimizing prognostic outcomes.

Sixty years of the Bruce protocol: reappraising the contemporary role of exercise stress testing with electrocardiographic monitoring.

The cardiovascular response to exercise has long been a focus of interest. Over a century ago, the first descriptions of electrocardiographic changes occurring during exercise highlighted the possible relevance of this dynamic assessment. In this background, the inception of the Bruce protocol circa 60 years ago allowed for a major leap in this field by providing a standardized framework with which to address this issue, by means of an integrated and structured methodology.