Prospective Pakistan Registry of Echocardiographic Screening in Asymptomatic Pregnant Women.

Background: Cardiovascular diseases are the primary cause of nonobstetric morbidity and mortality in pregnant women worldwide. Pakistan's high maternal and neonatal mortality rates underscore the need for effective screening protocols to detect cardiovascular diseases during pregnancy.

Objectives: The objective of this study was to assess the prevalence and factors associated with structural heart disease among pregnant women without active cardiorespiratory symptoms (no symptoms or symptoms attributed to pregnancy) attending routine antenatal appointments.

Valvular Heart Disease-Related Mortality Between Middle- and High-Income Countries During 2000 to 2019.

Background: Valvular heart disease (VHD) management has evolved rapidly in recent decades, but disparities in health care access persist among countries with varying socioeconomic backgrounds.

Objectives: The purpose of this study was to investigate global mortality trends from VHD and assess the difference between middle- and high-income countries.

Methods: We obtained mortality data from the World Health Organization Mortality Database for VHD and its subgroups (rheumatic valvular disease [RVD], infective endocarditis [IE], aortic stenosis [AS], and mitral regurgitation [MR]) from 2000 to 2019.

Ethnic Differences in Atrial Fibrillation in the United Kingdom.

Background: Within the United States, White individuals experience a higher risk of atrial fibrillation (AF) while exhibiting a lower AF-related stroke risk compared to other ethnic groups. It is possible that these observations stem from phenomena unique to the United States, such as differential health care access. The United Kingdom provides socialized medicine, which ostensibly promotes equitable health care access.

Electrical Heterogeneity in Hispanic Background Subpopulations: The HCHS/SOL.

Background: The Hispanic/Latino population is not uniform. Prevalence and clinical outcomes of cardiac arrhythmias in ethnic background subgroups are variable, but the reasons for differences are unclear. Vectorcardiographic Global Electrical Heterogeneity (GEH) has been shown to be associated with adverse cardiovascular outcomes.

A Scoping Review of Electronic Health Records-Based Screening Algorithms for Familial Hypercholesterolemia.

Background: Familial hypercholesterolemia (FH) is a common genetic disorder that is strongly associated with premature cardiovascular disease. Effective diagnosis and appropriate treatment of FH can reduce cardiovascular disease risk; however, FH is underdiagnosed. Electronic health record (EHR)-based FH screening tools have been previously described to enhance the detection of FH.

PREVENT and Pooled Cohort Equations in Mortality Risk Prediction: National Health and Nutrition Examination Survey.

Background: The Predicting Risk of CVD Events (PREVENT) equations were developed to address limitations of the Pooled Cohort Equations (PCEs) in predicting atherosclerotic cardiovascular disease (ASCVD) risk. The comparative effectiveness of the PREVENT equations versus the PCEs in predicting mortality risk remains unknown.

Objectives: The purpose of this study was to compare the risk discrimination value of the PREVENT equations with the PCEs for predicting mortality.

Left Atrial Dimension and CHADS-VASc Score in Predicting Stroke in Patients with Rheumatic Atrial Fibrillation.

Background: Rheumatic atrial fibrillation (AF) patients are at an elevated risk of stroke events, yet the associated risk factors remain unclear.

Objectives: This study aimed to evaluate the effectiveness of the CHADS-VASc score in predicting stroke events in rheumatic AF patients and explore potential enhancements for increased predicting accuracy in the Asian population, comparing it to nonvalvular AF.

Methods: A retrospective cohort study spanning March 2010 to December 2020 included 29,341 AF patients followed up for up to 10 years, with 1,942 identified as having rheumatic AF.

Incidence and Progression of Diastolic Dysfunction in People With HIV in Tanzania: A Comparative Cohort.

Background: People living with HIV (PLWH) have a higher prevalence of diastolic dysfunction and left ventricular hypertrophy (LVH) in cross-sectional studies. Longitudinal data are lacking, especially from Africa.

Objectives: The aim was to examine: 1) the incidence of diastolic dysfunction in PLWH compared to community controls in Tanzania; 2) the progression of diastolic function and LVH in PLWH after antiretroviral therapy initiation; and 3) traditional, endemic, and HIV-specific risk factors for diastolic function and LVH.

First in Asia: Ventricular tachycardia ablation in patients with mechanical aortic and mitral valves using right atrium to left ventricle approach.

With the cases of mechanical valves, especially double mitral and aortic valves, ablation at the left ventricle is very challenging. This case report used equipments that are readily available in the Electrophysiology laboratory, which can make the access feasible.

Gastrointestinal bleed mortality disparities in patients with atrial fibrillation: A cross-sectional analysis 1999-2020.

Introduction: Gastrointestinal bleeding (GIB) is often encountered among patients with atrial fibrillation (AF) due to the use of anticoagulation. This study assesses disparities in GIB-related mortality among decedents with AF in the United States.

Methods: GIB mortality data in patients with AF from 1999 to 2020 was queried from the CDC database.

Sex differences in atrial fibrillation in India: Insights from the Kerala-AF registry.

Background: Much data informing sex differences in atrial fibrillation (AF) comes from Western cohorts. In this analysis, we describe sex differences in Kerala, India, using the Kerala-AF registry-the largest AF registry from the Indian subcontinent.

Methods: Patients aged ≥18 years were recruited from 53 hospitals across Kerala.

Novel anticoagulation therapy using apple watch after catheter ablation for atrial fibrillation-Up to AF trial: Design and rationale.

Background: Continuous anticoagulation based on the CHA2DS2-VASc score is recommended to prevent embolism caused by atrial fibrillation (AF), but it does not consider AF episodes. The Apple Watch's continuous heart rhythm monitoring and fast-acting direct oral anticoagulants (DOACs) could enable precise, episode-tailored anticoagulation, reducing bleeding risks while preventing stroke. This study evaluates Apple Watch-guided personalized anticoagulation therapy, adjusting DOAC usage based on real-time AF detection.

A novel prediction model for survival in individual patients with cardiac resynchronization therapy with a defibrillator: Analysis of the new Japan cardiac device treatment registry database.

Background: Accurate prediction for survival in individualized patients with cardiac resynchronization therapy with a defibrillator (CRT-D) is difficult.

Methods: We analyzed the New Japan cardiac device treatment registry (JCDTR) database to develop a survival prediction model for CRT-D recipients.

Results: Four hundred and eighty-two CRT-D recipients, at the implantation year 2018-2021, with a QRS width ≥120 ms and left ventricular ejection fraction (LVEF) ≤35% at baseline, were analyzed.

Echocardiography of the right heart in pulmonary arterial hypertension: insights from the ULTRA RIGHT VALUE study.

Aims: Outcome in pulmonary arterial hypertension (PAH) is determined by right ventricular (RV) function adaptation to increased afterload. Echocardiography is easily available to assist bedside evaluation of the RV. However, no agreement exists about the feasibility and most relevant measurements.

Catheter ablation of atrial flutter in an adult with a univentricular heart, common atrium, and single atrioventricular valve: a case report-'complex things don't always require a complex solution'.

Background: The 'univentricular' heart encompasses a variety of congenital cardiac defects characterized by a single functional ventricle and an underdeveloped ventricular chamber. Surgical intervention, typically in infancy or childhood, aims to regulate pulmonary blood flow volume. In adulthood, untreated patients may experience limitations in physical activity and elevated morbidity due to persistent cyanosis and arrhythmias, notably after the Fontan procedure.

Focusing on antimicrobial resistant infections -are we missing the forest for the trees and the patients for pathogens?

Antimicrobial resistance (AMR) is a challenge because it is associated with worse patient outcomes. To solve the problem will take development of interventions and policies which improve patient outcomes by prolonging survival, improving patient symptoms, function and quality of life. Logically, we should look to focusing resources in areas that would have the greatest impact on public health.

Low serum serotonin is associated with functional decline, mild behavioural impairment and brain atrophy in dementia-free subjects.

Brain serotonin dysregulation is associated with dementia and neuropsychiatric symptomology. However, the prognostic utility of circulating serotonin levels in detecting features of prodromal dementia including functional decline, cognitive impairment, mild behavioural impairment and brain atrophy remains unclear. In this prospective study of memory clinic subjects followed-up for ≤5 years, dementia-free subjects, classified as having no cognitive impairment or cognitive impairment, no dementia at baseline, underwent annual neuropsychological assessments including Montreal Cognitive Assessment, Global Cognition scores and Clinical Dementia Rating Scale Global Scores (where a ≥ 0.

Camera-on-tip endoscope for cardiovascular diagnostics and surgical guidance.

Cardiovascular imaging with camera-on-tip endoscopes has the potential to provide physiologically relevant data on the tissue state and device placement that can improve clinical outcomes. In this work, we review the unmet clinical need for image-based cardiovascular diagnostics and guidance for minimally invasive procedures. We present a 7 Fr camera-on-tip endoscope with fibre-coupled multispectral illumination that includes methods for imaging in a blood-filled field of view (FOV).

Navigating the aftermath: Risk factors of recurrence following coronary bypass surgery in Indonesia.

Coronary heart disease (CHD) remains a leading cause of mortality in Indonesia, and coronary artery bypass graft (CABG) surgery is frequently employed to manage arterial blockages. Despite its efficacy, the recurrence of heart disease post-surgery is a significant concern, highlighting the need for a deeper understanding of its influencing factors. The aim of this study was to examine the factors associated with the incidence of heart disease recurrence after coronary bypass surgery.

Efficacy of angiotensin receptor neprilysin inhibitor in hypertension management: A systematic review and meta-analysis of clinical trials.

Dysregulation of renin-angiotensin-aldosterone system (RAAS) often leads to hypertension and severe cardiorenal complications. Although RAAS-targeted therapies have proven effective, it remains yet optimal in reducing cardiovascular events. The aim of this study was to evaluate the efficacy and safety of angiotensin receptor neprilysin inhibitor (ARNI) compared to control in patients with hypertension.

Validation of an acute kidney injury prediction model as a clinical decision support system.

Background: Acute kidney injury (AKI) is a critical clinical condition that requires immediate intervention. We developed an artificial intelligence (AI) model called PRIME Solution to predict AKI and evaluated its ability to enhance clinicians' predictions.

Methods: The PRIME Solution was developed using convolutional neural networks with residual blocks on 183,221 inpatient admissions from a tertiary hospital (2013-2017) and externally validated with 4,501 admissions at another tertiary hospital (2020-2021).

Constipation and risk of death and cardiovascular events in patients on hemodialysis.

Background: Constipation is a common gastrointestinal disorder and is often accompanied by alteration in the gut microbiota. Recently, several studies have disclosed its association with an increased risk of cardiovascular disease and mortality in the general population. Despite the high prevalence of constipation, data on the clinical impact of constipation in patients with chronic kidney disease are limited.

Emergency department early mortality model for patients admitted after presenting to a tertiary medical center emergency department.

Objectives: Identifying patients in the emergency department (ED) at higher risk for in-hospital mortality can inform shared decision making and goals-of-care discussions. Electronic health record systems allow for integrated multivariable logistic regression (LR) modeling, which can provide early predictions of mortality risk in time for crucial decision making during a patient's initial care. Many commonly used LR models require blood gas analysis values, which are not frequently obtained in the ED.