Vasoplegia in Heart, Lung, or Liver Transplantation: A Narrative Review.

Vasoplegia is a pathophysiologic state of hypotension in the setting of normal or high cardiac output and low systemic vascular resistance despite euvolemia and high-dose vasoconstrictors. Vasoplegia in heart, lung, or liver transplantation is of particular interest because it is common (approximately 29%, 28%, and 11%, respectively), is associated with adverse outcomes, and because the agents used to treat vasoplegia can affect immunosuppressive and other drug metabolism. This narrative review discusses the pathophysiology, risk factors, and treatment of vasoplegia in patients undergoing heart, lung, and liver transplantation.

Comparison of in-clinic assessment of 6MWT by conventional method and using wearable sensors for patients with ATTR-CM.

Introduction: The 6-minute walk test (6MWT) is used to assess submaximal exercise capacity in clinical trials. Conducting the 6MWT can be challenging when patients cannot visit the clinic due to physical/travel limitations. This pilot study assessed the feasibility of conducting the 6MWT using wearable sensors for patients with transthyretin amyloid cardiomyopathy.

Noncoding variants and sulcal patterns in congenital heart disease: Machine learning to predict functional impact.

Neurodevelopmental impairments associated with congenital heart disease (CHD) may arise from perturbations in brain developmental pathways, including the formation of sulcal patterns. While genetic factors contribute to sulcal features, the association of noncoding variants (ncDNVs) with sulcal patterns in people with CHD remains poorly understood. Leveraging deep learning models, we examined the predicted impact of ncDNVs on gene regulatory signals.

Free-breathing multi-parametric SASHA (mSASHA) mapping provides reliable non-contrast myocardial characterization in a pediatric and adult congenital population.

Parametric mapping has become a standard of care technique for the non-invasive assessment of myocardial edema and fibrosis. Conventional MOLLI-based T1 mapping is susceptible to many confounding effects particularly in the pediatric population. The requirement for compliant breath holds is a major limitation for younger or more ill patients.

Severe Maternal Morbidity Associated With Chronic Hypertension, Preeclampsia, and Gestational Hypertension.

Importance: Chronic hypertension and preeclampsia are leading risk enhancers for maternal-neonatal morbidity and mortality. Severe maternal morbidity (SMM) indicators include heart, kidney, and liver disease, but studies have not excluded patients with preexisting diseases that define SMM. Thus, SMM risks for uncomplicated chronic hypertension specific to preeclampsia remain unclear.

Advancements in Artificial Intelligence in Noninvasive Cardiac Imaging: A Comprehensive Review.

Background: Technological advancements in artificial intelligence (AI) are redefining cardiac imaging by providing advanced tools for analyzing complex health data. AI is increasingly applied across various imaging modalities, including echocardiography, magnetic resonance imaging (MRI), computed tomography (CT), and nuclear imaging, to enhance diagnostic workflows and improve patient outcomes.

Hypothesis: Integrating AI into cardiac imaging enhances image quality, accelerates processing times, and improves diagnostic accuracy, enabling timely and personalized interventions that lead to better health outcomes.

Exposomics: a review of methodologies, applications, and future directions in molecular medicine.

The exposome is the measure of all the exposures of an individual in a lifetime and how those exposures relate to health. Exposomics is the emerging field of research to measure and study the totality of the exposome. Exposomics can assist with molecular medicine by furthering our understanding of how the exposome influences cellular and molecular processes such as gene expression, epigenetic modifications, metabolic pathways, and immune responses.

Clin-STAR Corner: Rehabilitation for Older Adults With Heart Failure.

Heart failure is a major contributor to morbidity, mortality, and healthcare costs, especially among older adults. Despite a large body of evidence supporting the benefits of cardiac rehabilitation, less than 30% of eligible Medicare beneficiaries participate in cardiac rehabilitation. Thus, it is essential to examine alternatives, such as physical rehabilitation, a rehabilitation approach that focuses on physical activity and function.

Isolated subsegmental pulmonary embolism identification based on international classification of diseases (ICD)-10 codes and imaging reports.

Background: Isolated subsegmental pulmonary embolism (issPE) is a commonly encountered diagnosis. Although the International Classification of Diseases (ICD)-10 codes are used for research, their validity for identifying issPE is unknown. Moreover, issPE diagnosis is challenging, and the findings from radiology reports may conflict with those from expert radiologists.

Analysis of Calcium Patterns in the Thoracic Aorta and Clinical Outcomes of TAVR Patients Presenting with Porcelain Aorta.

: In the presence of porcelain aorta (PA), transcatheter aortic valve replacement (TAVR) has become a class I therapeutic indication for the treatment of severe aortic valve stenosis. To date, few studies have analyzed the clinical outcomes of TAVR in PA patients. We aim to analyze the calcification patterns of the thoracic aorta in PA patients and to evaluate their clinical implications for TAVR procedures.

Research Progress and Clinical Translation Potential of Coronary Atherosclerosis Diagnostic Markers from a Genomic Perspective.

Coronary atherosclerosis (CAD) is characterized by arterial intima lipid deposition, chronic inflammation, and fibrous tissue proliferation, leading to arterial wall thickening and lumen narrowing. As the primary cause of coronary heart disease and acute coronary syndrome, CAD significantly impacts global health. Recent genetic studies have demonstrated CAD's polygenic and multifactorial nature, providing molecular insights for early diagnosis and risk assessment.

Adapting and Implementing a Blended Collaborative Care Intervention for Older Adults with Multimorbidity: Quantitative and Qualitative Results from the ESCAPE Pilot Study.

Multimorbidity poses significant challenges for patients and healthcare systems, often exacerbated by fragmented care and insufficient collaboration across providers. Blended Collaborative Care (BCC) is a promising strategy to address care complexity by partnering care managers (CMs) with primary care providers (PCPs) and specialists. This study aimed to adapt and pilot a BCC intervention for patients aged 65+ with heart failure and physical-mental multimorbidity.

Lysosomal dysfunction and inflammatory sterol metabolism in pulmonary arterial hypertension.

Vascular inflammation regulates endothelial pathophenotypes, particularly in pulmonary arterial hypertension (PAH). Dysregulated lysosomal activity and cholesterol metabolism activate pathogenic inflammation, but their relevance to PAH is unclear. Nuclear receptor coactivator 7 () deficiency in endothelium produced an oxysterol and bile acid signature through lysosomal dysregulation, promoting endothelial pathophenotypes.

Association of neighborhood-level socioeconomic disadvantage and Life's Essential 8 in early pregnancy.

We examined whether neighborhood-level socioeconomic disadvantage per the Area Deprivation Index (ADI) was associated with maternal cardiovascular health (CVH) in early pregnancy per the American Heart Association Life's Essential 8 (LE8). This is a cross-sectional analysis from the prospective Nulliparous Pregnancy Outcomes Study-Monitoring Mothers-to-Be Heart Health Study (nuMoM2b-HHS) cohort. The exposure was the ADI in tertiles (T) from least (T1) to most (T3) socioeconomic disadvantage.

Racial/ethnic differences in post-acute sequelae of SARS-CoV-2 in children and adolescents in the United States.

Racial/ethnic differences are associated with the symptoms and conditions of post-acute sequelae SARS-CoV-2 infection (PASC) in adults. These differences may exist among children and warrant further exploration. We conducted a retrospective cohort study with difference-in-differences analyzes to assess these differences in children and adolescents under the age of 21.

Preoperative Hematocrit Is Not Associated With Stroke After Surgery for Acute Type A Aortic Dissection.

Objective: To determine the impact of hematocrit on adverse neurologic events after acute type A aortic dissection (ATAAD) repair under deep hypothermic circulatory arrest.

Design: Retrospective study of consecutive aortic surgeries from 2010 to 2021.

Setting: Single institution.

iForensic, multicentric validation of digital whole slide images (WSI) in forensic histopathology setting according to the College of American Pathologists guidelines.

Pathology has benefited from the rapid progress of image-digitizing technology during the last decade. However, the application of digital whole slide images (WSI) in forensic pathology still needs to be improved. WSI validation is crucial to ensure diagnostic performance, at least equivalent to glass slides and light microscopy.

Non-Canonical TERT Activity Initiates Osteogenesis in Calcific Aortic Valve Disease.

Background: Calcific aortic valve disease is the pathological remodeling of valve leaflets. The initial steps in valve leaflet osteogenic reprogramming are not fully understood. As TERT (telomerase reverse transcriptase) overexpression primes mesenchymal stem cells to differentiate into osteoblasts, we investigated whether TERT contributes to the osteogenic reprogramming of valve interstitial cells.

Evaluation of circadian rhythm and prognostic variability pre-and post-CEA or CAS treatment in patients with carotid artery stenosis.

Objective: Carotid artery stenosis, primarily caused by atherosclerosis, is a major risk factor for ischemic stroke. Carotid endarterectomy (CEA) and carotid artery stenting (CAS) are established interventions to reduce stroke risk and restore cerebral blood flow. However, the effect of these treatments on circadian rhythms, and their influence on stroke recovery, remains underexplored.

Association between procedure duration and adverse events in congenital cardiac catheterization.

Background: Procedure duration is an important predictor of patient outcomes in surgery. However, the relationship between procedure duration and adverse events in congenital cardiac catheterization is largely unexplored.

Methods: All cases entered into the Congenital Cardiac Catheterization Project on Outcomes from 2014 to 2017 were included.

Investigation of a Novel Noninvasive Risk Analytics Algorithm With Laboratory Central Venous Oxygen Saturation Measurements in Critically Ill Pediatric Patients.

Background: Accurate assessment of oxygen delivery relative to oxygen demand is crucial in the care of a critically ill patient. The central venous oxygen saturation (Svo) enables an estimate of cardiac output yet obtaining these clinical data requires invasive procedures and repeated blood sampling. Interpretation remains subjective and vulnerable to error.

Update to the PRISMA guidelines for network meta-analyses and scoping reviews and development of guidelines for rapid reviews: a scoping review protocol.

Objective: The objective of this scoping review is to develop a list of items for potential inclusion in the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) reporting guidelines for network meta-analysis (NMA), scoping reviews (ScRs), and rapid reviews (RRs).

Introduction: The PRISMA extensions for NMA and ScRs were published in 2015 and 2018. However, since then, their methodologies and innovations, including automation, have evolved.

The ACTION VAD registry: A collective five-year experience.

Background: The Advanced Cardiac Therapies Improving Outcomes Network (ACTION) began in 2018 as a collaborative learning health system committed to improving outcomes in pediatric heart failure, including children and adults with congenital heart disease, supported with ventricular assist devices (VADs). This report describes patient and device characteristics, and outcomes through 1-year post-implant.

Methods: The ACTION VAD registry report was created from data submitted to the ACTION learning network from April 2018 to June 2023.

Individualized transfusion decisions to minimize adverse cardiovascular outcomes in patients with acute myocardial infarction and anemia.

Background: Risk-benefit tradeoffs between restrictive versus liberal red blood cell transfusion strategies may vary across individuals. This exploratory analysis aimed to derive and evaluate individualized treatment effects of defined transfusion strategies in patients with acute MI and anemia with the goal of minimizing adverse cardiovascular outcomes.

Methods: This study analyzed 3,447 (98.