Rheumatic Heart Disease Burden in Africa and the Need to Build Robust Infrastructure.

Rheumatic heart disease (RHD) is an important public health problem in Africa. Mapping the epidemiology of RHD involves elucidating its geographic distribution, temporal trends, and demographic characteristics. The prevalence of RHD in Africa varies widely, with estimates ranging from 2.

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.

Home-Based Cardiac Rehabilitation Among Attendees From a Large Health Care System During the Covid-19 Pandemic.

Background: Few studies have evaluated home-based cardiac rehabilitation (HBCR) during the pandemic, compared to prepandemic center-based CR (CBCR), with respect to patient characteristics, participation rates, and its efficacy on clinical metrics, health-related quality of life (QoL), and modifiable risk factors.

Objectives: We aimed to describe patient characteristics and participation rates for those attending HBCR compared to patients who attended CBCR and compare the effects of HBCR vs CBCR on clinical metrics, health-related QoL, and modifiable risk factors in CR patients pre vs during the COVID-19 pandemic.

Methods: A retrospective cohort study comparing 511 HBCR patients and 765 CBCR patients from the Mayo Clinic Health System.

Etiology and Phenotypes of Cardiomyopathy in Southern Africa: The IMHOTEP Multicenter Pilot Study.

Background: Cardiomyopathies are an important cause of heart failure in Africa yet there are limited data on etiology and clinical phenotypes.

Objectives: The IMHOTEP (African Cardiomyopathy and Myocarditis Registry Program) was designed to systematically collect data on individuals diagnosed with cardiomyopathy living in Africa.

Methods: In this multicenter pilot study, patients (age ≥13 years) were eligible for inclusion if they had a diagnosis of cardiomyopathy or myocarditis.

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.

Global Health Inequities in Electrophysiology Care: A State-of-the-Art Review.

This state-of-the-art review examines disparities in the diagnosis, management, and outcomes of cardiac arrhythmias globally. These arrhythmias include atrial fibrillation, ventricular tachyarrhythmias underlying sudden cardiac death, and bradyarrhythmias associated with sinus node and atrioventricular node disease. Arrhythmias in low- and middle-income countries often result in higher mortality rates due to complex and poorly documented risk factors, lack of clinical expertise among health care personnel, lack of sufficient infrastructure, and challenges in access to care.

Systemic Sirolimus Therapy Is Associated With Reduced Intervention Frequency in Pulmonary Vein Stenosis.

Background: Early clinical outcomes data for adjunctive systemic sirolimus therapy (SST) for moderate to severe pediatric pulmonary vein stenosis (PVS) are promising but limited.

Objectives: The authors aimed to characterize a cohort of patients treated with SST to determine if SST was associated with a reduction in frequency of PVS interventions.

Methods: Medical records of 45 patients with PVS treated with SST for ≥1 month from 2015 to 2022 were retrospectively reviewed.

Promotion of Cardiovascular Health in Africa: The Alliance for Medical Research in Africa (AMedRA) Expert Panel.

This proposed scientific statement is focused on providing new insights regarding challenges and opportunities for cardiovascular health (CVH) promotion in Africa. The statement includes an overview of the current state of CVH in Africa, with a particular interest in the cardiometabolic risk factors and their evaluation through metrics. The statement also explains the main principles of primordial prevention, its relevance in reducing noncommunicable disease and the different strategies that have been effective worldwide.

Associations With Adverse Postoperative Outcomes in Children Undergoing Atrial Septal Defect Closure in Lower-Resource Settings.

Background: Atrial septal defects (ASDs) are a common cause of congenital heart disease worldwide.

Objectives: The purpose of the study was to assess change over time in surgical outcomes for ASD repair and identify patient-level risk factors for adverse postoperative outcomes.

Methods: We analyzed cases of isolated ASD in patients <18 years from 2010 to 2020 from 71 sites participating in the International Quality Improvement Collaborative for Congenital Heart Disease.

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.

Promoting Global Cardiovascular Health to Advance the Sustainable Development Agenda.

The burden of cardiovascular disease has declined in high-income countries in the past 3 decades but is growing in low- and middle-income countries due to epidemiological, demographic, and socioeconomic shifts. A range of cost-effective policies and interventions are available for advancing cardiovascular health (CVH) through primordial, primary, and secondary prevention. We showcase multifaceted challenges that stifle the global progress of CVH including shortcomings in financial protection, health systems, primary health care, national health policies, service coverage, and surveillance.

Implementation of a Virtual Cardiology Curriculum to Address the Deficit of Cardiovascular Education in Haiti.

Background: Cardiovascular disease (CVD) is the leading cause of death in low- and middle-income countries such as Haiti. Our team has demonstrated in a pilot study the implementation of a virtual cardiology curriculum to address the deficit of cardiology education in Haiti among medicine residents.

Objectives: The objective of this study was to determine if cardiology education can be delivered nationwide in Haiti via a virtual platform with quantifiable improvement.

Sociodemographic disparities in everyday discrimination among a national sample of adults in the United States, 2023.

Objective: Discrimination is a social determinant contributing to health inequities in the United States (US). This study investigated the prevalence of, and sociodemographic disparities in, perceived everyday discrimination among a national sample of US adults.

Methods: We used data from the 2023 National Health Interview Survey ( = 27,538) and estimated the prevalence of three perceived everyday discrimination outcomes (1) any discrimination, (2) unique components of the discrimination experience, and (3) the Everyday Discrimination Scale (EDS) (range: 0-20) overall and by age, sex assigned at birth, race and ethnicity, sexual orientation, educational attainment, income-to-poverty ratio, and urban-rural status.

Effect of chronic total occlusion of coronary arteries on cardiovascular outcomes in patients undergoing transcatheter aortic valve replacement: A systematic review and meta-analysis.

Background: Transcatheter aortic valve replacement (TAVR) has significantly advanced the treatment of severe aortic stenosis (AS), particularly in elderly patients who often have coexisting coronary artery disease (CAD). Chronic total occlusion (CTO), a severe form of CAD, may negatively impact outcomes in TAVR patients, though data are limited. This meta-analysis aims to evaluate the impact of CTO on TAVR outcomes.

Iliac Crest Bone Block Autograft Transfer for Ballistic Posterior Glenoid Fracture: A Case Report.

A 25-year-old male presented with a ballistic fracture of the right glenoid resulting in > 30% loss of the posterior glenoid articular surface and acute posterior glenohumeral instability that was treated with open reduction internal fixation with iliac crest autograft transfer. There is limited consensus on the operative management of ballistic intra-articular fractures due to the heterogeneity of these injuries. Acute posterior glenohumeral instability secondary to a ballistic fracture is a rare injury pattern.

Strong Association Between HIV Incidence and Herpes Simplex Virus Type 2 in Zambia and South Africa: Prospective Data From the HPTN 071 (PopART) Trial.

Background: Herpes simplex virus type 2 (HSV2) is an important cofactor for HIV acquisition and transmission. Associations between the infections are reexamined in longitudinal data from an HIV prevention trial.

Methods: The HPTN 071 (PopART) trial evaluated a combination prevention intervention in 21 urban communities in Zambia and South Africa.

The Prevalence of Multidrug Resistance in Enterobacterales Is Higher in Patients Undergoing Hematopoietic Stem Cell Transplantation.

Background: Antimicrobial resistance is a global public health emergency. Patients undergoing hematopoietic stem cell transplantation (HCT) are at increased risk for severe infections with multidrug-resistant (MDR) organisms, although more data are needed on the relative burden of MDR Enterobacterales (MDR-E) in immunocompromised populations. In this study, we compare the prevalence of Enterobacterales resistance in cultures from patients undergoing HCT with that of non-HCT patients seeking care at a large healthcare system in North Carolina, USA.

Vaccination Against Influenza and Pneumococcus During Pretravel Health Consultations in the United States: Interventions and Missed Opportunities.

Background: Infections by and influenza viruses are vaccine-preventable diseases causing great morbidity and mortality. We evaluated pneumococcal and influenza vaccination practices during pre-international travel health consultations.

Methods: We evaluated data on pretravel visits over a 10-year period (1 July 2012 through 31 June 2022) from 31 sites in Global TravEpiNet (GTEN), a consortium of US healthcare facilities providing pretravel health consultations.

Preference for HIV Pre-exposure Prophylaxis Access Among Men who Have Sex With Men in China: A Discrete Choice Experiment.

Background: HIV pre-exposure prophylaxis (PrEP) is highly effective but not widely used by men who have sex with men (MSM; 27%) in China.

Methods: In June 2023, an online cross-sectional survey with a discrete choice experiment (DCE) was distributed to PrEP-eligible MSM in China who were at least 18 years old. The DCE explored attributes of PrEP modality (daily pill, on-demand pill, injections, implants), clinical care model (same-day, 2-visit, telehealth prescription), medication pickup (clinic, community health center, pharmacy, MSM-focused community-based organization, home delivery), enhanced support (self-management, smartphone app, text reminder, anonymous peer support group), and cost.