Intensive Lifestyle Intervention, Cardiac Biomarkers, and Cardiovascular Outcomes in Diabetes: Look AHEAD Cardiac Biomarker Ancillary Study.

Background: N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin T (hs-cTnT) are associated with cardiovascular outcomes and are recommended for measurement in type 2 diabetes (T2D). However, the effects of an intensive lifestyle intervention (ILI) targeting weight loss on cardiac biomarkers and the prognostic association of changes in these biomarkers with risk of adverse cardiovascular outcomes in T2D are not well-established.

Objectives: This study sought to evaluate the effects of an ILI on cardiac biomarkers and the association of changes in cardiac biomarkers with risk of cardiovascular outcomes in T2D.

Outcomes of mitral transcatheter edge-to-edge repair in patients with mitral annular calcification: A meta-analysis.

Background: The impact of mitral annular calcification (MAC) on the clinical outcomes of patients undergoing mitral transcatheter edge-to-edge repair (MTEER) remains unclear. This meta-analysis aims to evaluate the clinical outcomes of MTEER among patients with moderate to severe MAC compared to those with mild or no MAC.

Methods: We systematically searched PubMed, EMBASE, and Cochrane CENTRAL databases through March 31st, 2024, comparing clinical outcomes of MTEER among patients with moderate/severe (MAC+) versus no/mild MAC (MAC-).

Coronary Artery Calcium for Risk Stratification of Heart Failure Mortality: The Coronary Artery Calcium Consortium.

Background: There is increasing interest in predicting heart failure (HF), a major cause of morbidity and mortality with a significant financial burden. The role of coronary artery calcium (CAC), an accessible and inexpensive test, in predicting long-term HF mortality among asymptomatic adults remains unknown. We aimed to determine whether CAC burden is associated with HF-related mortality in the CAC Consortium.

Echocardiographic Evaluation of Chronic Aortic Regurgitation: Comparison With Cardiac Magnetic Resonance and Implications for Guideline Recommendations.

Background: Guidelines for echocardiographic evaluation of aortic regurgitation (AR) have not been validated against an independent quantitative standard.

Objectives: The aim of this study was to evaluate the accuracy of the ASE (American Society of Echocardiography) AR guidelines against cardiac magnetic resonance (CMR) and to develop simplified approaches for detection of significant AR.

Methods: Patients with AR underwent echocardiography and CMR <4 hours apart.

Vital Exhaustion and Biomarkers Associated With Cardiovascular Risk: The ARIC Study.

Background: Vital exhaustion, defined as excessive fatigue, demoralization, and irritability due to chronic stress, is independently associated with cardiovascular disease (CVD).

Objectives: The purpose of this study was to examine the association of vital exhaustion with biomarkers associated with CVD risk in the ARIC (Atherosclerosis Risk In Communities) study.

Methods: We examined the cross-sectional association of vital exhaustion (assessed using the Maastricht Vital Exhaustion Questionnaire [MVEQ]) with cardiac biomarker (high-sensitivity troponin T [hs-TnT], N-terminal pro-B-type natriuretic peptide [NT-proBNP]) and high-sensitivity C-reactive protein (hs-CRP) levels in 11,542 ARIC study participants without CVD at ARIC visit 2 using multivariable logistic and linear regression models.

Decision-Making Approach to the Treatment of Young and Low-Risk Patients With Aortic Stenosis.

Over a decade of randomized controlled trial data demonstrate excellent outcomes with transcatheter aortic valve replacement or surgical aortic valve replacement for patients with symptomatic severe aortic stenosis regardless of surgical risk. The 2020 American College of Cardiology/American Heart Association guidelines recommend both options for low-risk AS patients aged 65 to 80 years. However, the fastest growing population of patients receiving transcatheter aortic valve replacement in the United States is <65 years old, with little data to support the practice.

Green Streets, Healthy Hearts: Exploring the Roles of Urban Nature and Walkability in Cardiovascular Health.

With the growing evidence that connects urban environments with public health outcomes, the role of urban planning has become increasingly critical in addressing public health challenges. Cardiovascular diseases (CVDs) are the leading cause of mortality in urban areas and worldwide and are impacted by characteristics of the built environment, such as walkability and nature exposure. In this literature view, we explore the influence of the physical built environment, specifically green spaces and walkability, on cardiovascular health.

Intersectionality and Social Drivers of Health in Cardiovascular Care.

Social drivers of health (SDOH) are a significant contributor to persistent cardiovascular health disparities in the United States and globally. SDOH include psychosocial, environmental, socioeconomic, cultural, and governmental factors that impact health behaviors and outcomes. Multiple social drivers have been associated with trends in cardiovascular disease risk and health outcomes.

A Review of the Links Between Work and Heart Disease in the 21st Century.

This review explores the multifaceted exposures in the workplace that contribute to cardiovascular diseases (CVD), including physical, ergonomics, chemical, biological, psychosocial, and emerging occupational hazards. These well-documented occupational hazards have long been linked to heart disease. Exposures arising from these hazards present significant concerns for worker health and safety.

Big Data, Big Insights: Leveraging Data Analytics to Unravel Cardiovascular Exposome Complexities.

The exposome encompasses the full range of environmental exposures throughout a person's lifetime and plays an important role in cardiovascular health. Interactions with the social, natural, and built components of the exposome significantly impact cardiovascular disease prevalence and mortality. Robust data analytics, including machine learning and geospatial analysis, have advanced our understanding of how these factors converge to influence cardiovascular disease risk.

Zip Code Health Disparities: Mapping Cardiovascular Inequities at the Neighborhood Level.

This review examines the multifaceted impact of neighborhood-level social determinants of health (SDOH) on cardiovascular disease (CVD) and outlines strategic interventions for mitigating cardiovascular health inequities. Research highlights that environmental and socioeconomic factors within a neighborhood-including education, unemployment, healthcare access, racial segregation, systemic inequities, air quality, housing quality, and other SDOH-influence CVD outcomes. Addressing CVD disparities necessitates a comprehensive strategy that integrates policy reform, enhanced community infrastructure, improved healthcare access, and community empowerment and leverages innovative technology to create equitable health outcomes across diverse populations.

Myocardial Infarction with Normal Coronary Arteries.

This Points to Remember column discusses the differential diagnosis of acute myocardial infarction with normal coronary arteries, one example of which is Takotsubo cardiomyopathy. In the case presented below, the diagnosis of Takotsubo cardiomyopathy was based on the characteristic appearance of the left ventricular apical bulging, normal coronary arteries, and the resolution of the wall motion abnormalities within a relatively short period of time.

Associations of SGLT2i with Cardiorenal Outcomes Among Diabetics with Prostate Cancer on Hormone Therapy.

Purpose: Studies have reported associations between prostate cancer, type II diabetes mellitus (T2DM), and cardiovascular disease in the context of treatment with hormone therapy (HT). This study aimed to assess the role of Sodium-Glucose Cotransporter-2 Inhibitors (SGLT2i) in preventing adverse cardiovascular and renal outcomes in diabetics with prostate cancer.

Methods: Patients ≥ 18 years of age with T2DM and prostate cancer who received HT between August 1, 2013, and August 31, 2021, were identified using the TriNetX research network.

Food for Thought: Nourishing Cardiovascular Health Amidst the Exposome.

The cumulative exposures of an individual during their lifetime, known as the exposome, encompass environmental exposures and lifestyle factors that significantly impact cardiovascular health. The exposome concept aims to provide a comprehensive framework for understanding how various exposures combine to influence disease risk and health outcomes over a lifetime. Diet is a well-studied aspect of the exposome, recognized as a critical contributor to cardiovascular health and influencing various other health metrics and behaviors.

Inhaling Poor Health: The Impact of Air Pollution on Cardiovascular Kidney Metabolic Syndrome.

Air pollution, mostly from fossil fuel sources, is the leading environmental cause of global morbidity and mortality and is intricately linked to climate change. There is emerging evidence indicating that air pollution imposes most of its risk through proximate cardiovascular kidney and metabolic (CKM) etiologies. Indeed, there is compelling evidence linking air pollution to the genesis of insulin resistance, type 2 diabetes, hypertension, and other risk factors.

Harnessing Wearables and Digital Technologies to Decode the Cardiovascular Exposome.

The cardiovascular exposome encompasses the array of external and internal factors affecting cardiovascular health throughout life, inviting comprehensive monitoring and analysis to enhance prevention, diagnosis, and treatment strategies. Wearable and digital technologies have emerged as promising tools in this domain, offering longitudinal, real-time data on physiological parameters such as heart rate, heart rhythm, physical activity, and sleep patterns. This review explores the advancements in wearable sensor technology, the methodologies for data collection and analysis, and the integration of these technologies into clinical practice and research.

The future of hypertension pharmacotherapy: Ongoing and future clinical trials for hypertension.

Hypertension is among the most prevalent diagnoses across the world and increases the risk of many serious health problems, such as stroke, heart disease, and kidney disease. Pharmacological approaches to treat hypertension are often required and reduce blood pressure through mechanisms such as vasodilation, inhibition of the renin-angiotensin-aldosterone pathway, and increased urine output to reduce blood volume, among other mechanisms. Further research is ongoing to find novel pathways and mechanisms to treat hypertension, which we summarize in this review.

Revisiting the Efficacy and Safety of Bivalirudin in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention: Insights From a Mixed Treatment Comparison Meta-Analysis of Randomized Trials.

Background: Randomized trials of bivalirudin in patients with ST elevation myocardial infarction (STEMI) have yielded heterogeneous results.

Aims: Our aim was to evaluate the efficacy and safety of four antithrombin regimens-unfractionated heparin (UFH), bivalirudin (stopped soon after percutaneous coronary intervention [PCI]), extended bivalirudin (continued for a few hours after PCI), and combined UFH and a Gp2b3a inhibitors (GPI) in patients who present with STEMI.

Methods: A PubMed, EMBASE, and clinicaltrials.