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Journal articlePalermi S, Zeidaabadi B, Vecchiato M, et al., 2026,
Development and external validation of AI-ECG models in athlete pre-participation screening: Performance, limitations, and clinical implications.
, Int J Cardiol, Vol: 461BACKGROUND: Pre-participation screening (PPS) in competitive athletes aims to identify cardiovascular diseases associated with sudden cardiac death (SCD). Although the 12‑lead electrocardiogram (ECG) represents the cornerstone of PPS, structural abnormalities may demonstrate limited or incomplete electrical expression, particularly in asymptomatic athletes with physiological remodeling. Artificial intelligence (AI)-enabled ECG models have shown promising performance in hospital-based populations, but their transportability to low-prevalence athlete screening environments remains uncertain. OBJECTIVES: To develop and externally validate a deep learning (DL)-based AI-ECG ensemble model for detecting imaging-confirmed structural heart disease in competitive athletes undergoing PPS. METHODS: A convolutional neural network (CNN) ensemble was trained using hospital-derived ECG images from Beth Israel Deaconess Medical Center (BIDMC, Boston, USA) and externally validated in the Italian Team for Athlete CARDiac evaluation and AI-based Risk prediction (ITACARD-AI) registry. Separate CNNs were developed for valvular heart disease (VHD) and cardiomyopathies (CM) and combined using XGBoost meta-learning. Model performance was assessed using area under the receiver operating characteristic curve (AUROC), subgroup analyses, and threshold-based evaluation. RESULTS: The ITACARD-AI cohort included 1115 competitive athletes (mean age 26 ± 13 years; 70% male), including 48 athletes (4.3%) with VHD and 30 (2.7%) with CM. External validation demonstrated substantial performance degradation compared with hospital-based internal validation. AUROC values decreased to 0.70 (95% CI 0.64-0.75) for VHD and 0.69 (95% CI 0.60-0.78) for CM, indicating only modest discrimination in the screening population. Threshold analyses showed high negative predictive values (∼99%) but persistently low positive predictive values (≤8%), reflecting limited disease enrichment and st
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Journal articleRisum N, Philbert BT, Svendsen JH, et al., 2026,
Direct His/LBB pacing as an alternative to biventricular pacing in patients with HFrEF and a typical LBBB: Design and rationale for the His-Alternative II trial.
, Am Heart J, Vol: 300BACKGROUND: Cardiac resynchronization therapy (CRT) using biventricular pacing (BiV-CRT) is an established treatment for patients with symptomatic heart failure, reduced left ventricular ejection fraction, and left bundle branch block (LBBB), leading to improvements in symptoms, ventricular function, exercise capacity and survival. Despite these benefits, up to one third of patients fail to respond optimally with no clinical improvement despite meeting current criteria for implantation. Conduction system pacing (CSP), delivered via His bundle pacing or left bundle branch area pacing, has emerged as an appealing alternative by directly engaging the native His-Purkinje system. However, randomized data directly comparing CSP-based CRT with conventional BiV-CRT remain limited. STUDY DESIGN: His-Alternative II is an investigator-initiated, multicenter, randomized non-inferiority trial designed to evaluate whether CRT delivered via CSP is non-inferior to conventional biventricular pacing with respect to left ventricular reverse remodeling. The study enrolls patients with symptomatic heart failure (New York Heart Association class II to III), left ventricular ejection fraction ≤35%, strict LBBB by electrocardiographic criteria, and optimal medical therapy. A total of 150 patients were randomized with a 1:2 randomization ratio to receive BiV-CRT or CSP-based CRT (His bundle pacing or left bundle branch pacing) and followed for 6 months. The primary endpoint is change in left ventricular end-systolic volume assessed by echocardiography; a surrogate endpoint consistently associated with long-term outcomes in CRT populations. Secondary endpoints include functional capacity, symptomatic status, quality of life, electrical resynchronization, and device-related complications. CONCLUSIONS: His-Alternative II is designed to determine whether CSP-based CRT can achieve left ventricular reverse remodeling comparable to that obtained with conventional BiV-CRT. The study will provide
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Journal articleHunt SE, Lemos D, Pericherla SR, et al., 2026,
Gene2Phenotype: A Database of Structured Human Monogenic Diseases and Pathomechanisms.
, J Mol Biol, Vol: 438To facilitate both disease research and personalised medicine, there is an urgent need for accessible, structured data models describing the molecular basis of genetically determined disease. Gene2Phenotype is a database of expert-curated monogenic gene-disease associations, which was established in 2012 to enable efficient prioritisation of likely diagnostic genomic variants. Initially focused on developmental disorders, it has since been extended to support cardiac, eye, skeletal and skin disorders and germline cancer predisposition. We have redesigned and extended Gene2Phenotype, which now openly shares standardised, structured models of rare monogenic diseases, detailing genotype, molecular mechanism and associated phenotypes, curated from scientific literature. The updated platform, which includes a new API, enabling programmatic access, improves the findability, accessibility, interoperability and reusability of detailed rare monogenic disease association data. These data have the potential to accelerate disease research, clinical diagnosis, treatment selection and the development of novel therapies. Gene2Phenotype is available at https://www.ebi.ac.uk/gene2phenotype/.
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Journal articleLuo Y, Ferreira PF, Wen K, et al., 2026,
Optimized Reduced Field of View and Fat Suppression Methods for Interleaved Multislice In Vivo Cardiac Diffusion Tensor Imaging.
, Magn Reson Med, Vol: 96, Pages: 1097-1110PURPOSE: Slice interleaving, a limited phase encode (PE) field of view (FOV), and effective fat suppression are vital for efficient cardiac diffusion tensor imaging (cDTI) with minimal artifacts. This study aimed to optimize reduced FOV and fat suppression methods for interleaved multislice cDTI to improve signal-to-noise ratio (SNR) and minimize artifacts. METHODS: Two-slice motion compensated spin echo datasets from 20 healthy volunteers were acquired. Four reduced PE FOV sequences were evaluated: 2DRF pulse; applying either 180 ° or 90 ° pulses in PE direction; and the proposed flip-back sequence with a nonselective 180 ° pulse after readout to restore inverted magnetization. Four fat suppression techniques were implemented: no fat suppression (standard); fat saturation; binomial water excitation and spectral attenuated inversion recovery (SPAIR). RESULTS: The proposed flip-back sequence with SPAIR achieved the highest median SNR, and its SNR values are significantly higher ( p < 0.01 ) than 2DRF with SPAIR as current state-of-the-art. SPAIR and water excitation demonstrated comparable performance when combined with the flip-back sequence, and both yielded superior image quality than with no suppression or fat saturation. SPAIR showed robust fat suppression across most subjects, whilst water excitation exhibited advantages in some subjects with a high body mass index. CONCLUSION: The proposed flip-back sequence with SPAIR enables efficient interleaved multislice imaging with reduced PE FOV and effective fat suppression, facilitating clinical translation of in vivo cDTI.
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Journal articleSanchez Alonso-Mardones J, 2026,
Neuro-mechanical regulation of vascular smooth muscle cell behaviour under ageing-associated substrate stiff-ness
, Current Issues in Molecular Biology, ISSN: 1467-3037Cardiovascular diseases (CVDs) remain a leading cause of mortality worldwide, and ageing is strongly associated with progressive arterial stiffening. Age-related alterations in extracellular matrix (ECM) mechanics influence vascular smooth muscle cell (VSMC) behaviour, while sympathetic innervation represents an additional regulator of vascular homeostasis. However, how neural signalling interacts with ageing-associated mechanical conditions to regulate VSMC behaviour remains unclear. In this study, an in vitro sympathetic neuron–VSMC co-culture model was established to investigate neuro-mechanical regulation. Primary rat sympathetic neurons and A7r5 VSMCs were cultured on glass or polydimethylsiloxane (PDMS) substrates with defined stiffness (20 and 130 kPa), representing healthy and ageing-associated stiffened arterial environments, respectively. VSMC behaviour was assessed through analysis of cell area, proliferation, migration, cellular Young’s modulus (YM), and DNA damage marker γH2AX. Sympathetic neuronal co-culture was associated with reduced VSMC spreading and decreased γH2AX levels. Under the conditions tested, neural signalling exerted limited effects on cell proliferation and migration. In contrast, increased substrate stiffness promoted cell proliferation and elevated YM. Both neuronal input and substrate stiffness were associated with increased cellular YM. Together, these findings indicate that neural and mechanical cues may jointly influence VSMC behaviour within ageing-associated mechanical environments. This co-culture system provides a controllable platform for studying neuro-mechanical interactions in vascular biology.
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Journal articleEllard S, Hanson H, Cassidy E-J, et al., 2026,
The British Society for Genetic Medicine guidance on managing incidental findings identified during rare disease genomic testing.
, J Med GenetBACKGROUND: Genomic testing will occasionally identify a highly actionable genetic variant or other finding that is not related to the reason for testing. Such incidental findings may be relevant to the patient undergoing testing or to their family members. METHODS: This guidance on managing incidental findings was developed by the British Society for Genetic Medicine to support clinicians requesting genomic tests and clinical scientists working in genomic laboratories within the National Health Service. RESULTS: Clinicians should include the possibility of incidental findings with a patient/parent(s) in discussions around genomic testing. Decisions regarding the reporting of a genetic variant unrelated to the referral reason will depend on clinical actionability, penetrance and the variant classification. Pathogenic variants may be reported if there is evidence of high penetrance and available treatment or surveillance that is likely to improve clinical outcome. Testing using large next generation sequencing gene panels and genome-wide array analysis increases the likelihood of revealing heterozygous carrier status for autosomal recessive disorders unrelated to the reason for testing. Reporting incidental heterozygous carrier status for autosomal recessive conditions is not recommended. CONCLUSION: This guidance provides a framework for the reporting of incidental findings with case examples and a cancer susceptibility gene list. Decision-making in accordance with guidelines will achieve greater consistency than case by case decisions. This guidance may be of use to healthcare professionals in other publicly funded healthcare systems with evolving genomic testing services.
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Journal articleRaman B, Prasad SK, 2026,
Late Gadolinium Enhancement in Nonischemic Dilated Cardiomyopathy.
, Circulation, Vol: 154, Pages: 512-516 -
Journal articleOng AQC, Ang C-S, Bojic I, et al., 2026,
Artificial intelligence in cardiovascular care: a systematic review and meta-analysis of randomised controlled trials
, EClinicalMedicine, Vol: 98, ISSN: 2589-5370Background: Artificial intelligence (AI) holds potential to transform cardiovascular care, but evidence on its effectiveness in clinical practice remains inconsistent. We aimed to synthesise evidence from randomised controlled trials (RCTs) on the effectiveness of AI-enabled cardiovascular care, summarise the trial design and characteristics of AI systems, and evaluate methodological quality and reporting transparency.Methods: In this systematic review and meta-analysis, we searched Embase, MEDLINE, Scopus, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov for RCTs that evaluated effectiveness of AI interventions in cardiovascular care, published in English from database inception to July 07, 2025. The search was updated on April 28, 2026. We followed Cochrane guidance for study selection and data extraction. Risk of bias was assessed using Cochrane’s Risk of Bias tools and reporting transparency using CONSORT-AI checklist. We calculated summary effects using inverse-variance-weighted random-effects meta-analyses and assessed the certainty of evidence using GRADE. Between-study heterogeneity was quantified using χ² (Cochran’s Q) test and I² statistic. Publication bias was not assessed due to small number of studies. This study was registered with PROSPERO (CRD420251090250).Findings: Of 12,217 records identified, 31 RCTs from 13 regions (n=1,685,717 patients) were included in the systematic review, and 11 of these (n=1,614,689) in the meta-analysis. Most RCTs were published after 2021 (90%), multicentre (58%), and had short follow-up duration (<12 months; 52%). Risk of bias was low in seven trials (23%), and overall reporting transparency was moderate. Twenty-two trials (71%) reported significant benefit of AI interventions on primary endpoints, mostly intermediate process measures, while nine trials (29%) found no significant effect. Compared with routine care, image-based AI-clinical decision support system had sig
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Journal articleGonzález CR, Huang B, Yan S, et al., 2026,
Benchmarking Image-Based Motion-Correction Methods for Ultrasound Localization Microscopy.
, Ultrasound Med Biol, Vol: 52, Pages: 1544-1558BACKGROUND: Ultrasound localization microscopy (ULM) achieves sub-diffraction resolution imaging in vivo through localizing and tracking microbubbles. However, the need to accumulate microbubble signals over time makes ULM highly sensitive to tissue motion, necessitating accurate motion correction. The accuracy of motion-correction techniques poses a limit to the attainable resolution, and there is currently no gold standard algorithm or approach. METHODS: This study benchmarked seven publicly available implementations of non-rigid image registration algorithms using two simulated datasets illustrating soft tissue and cardiac images, as well as in vivo acquisitions of a rabbit kidney and human breast tumor. Five benchmarks were used to evaluate the seven implementations using image-based similarity metrics, errors against ground truth deformation fields, robustness to hyperparameter choice and image quality, including data with varying contrast-to-noise ratios. Using Bayesian optimization and Sobol sensitivity analysis, optimal parameters for each algorithm were identified, with guidelines for data-adaptive algorithm selection proposed. RESULTS: Parameter sensitivity analysis was reported for all implementations, which can be used to prioritize parameters when performing optimization. Motion characteristics and image spatial heterogeneity were found to be important factors for implementation accuracy. Spline-based algorithms, such as free-form deformations implemented in Elastix, performed optimally with small deformations and low spatial heterogeneity. In contrast, methods designed for large deformations, such as large deformation metric matching, implemented by Ceritoglu et al., or free-form deformations with diffeomorphic constraints, such as Niftyreg, were effective at correcting larger data displacements with high heterogeneity, but struggled to identify accurate correspondences when deformation magnitudes were small. Invertibility was beneficial when correctin
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Journal articleBoichenko V, Frolova S, Voellenkle C, et al., 2026,
Unifying and unique roles of non-coding RNA biomarkers in liver and heart fibrosis.
, Biomed Pharmacother, Vol: 201Liver and cardiac fibrosis are critical drivers of chronic organ dysfunction, characterised by fibroblast activation, excessive extracellular matrix deposition, and inflammation. While these fibrotic processes are initiated by distinct triggers and monitored by organ-specific biomarkers, emerging evidence reveals both shared and unique regulatory networks, particularly involving non-coding RNAs (ncRNAs). This review focuses on the roles of microRNAs (miRNAs), long non-coding RNAs (lncRNAs), and circular RNAs (circRNAs), such as miR-21, miR-22, miR-29, miR-34a, miR-122, miR-133a, miR-210, miR-214, H19, MALAT1, MEG3, NEAT1, and circHIPK3, in modulating key fibrotic pathways including TGF-β/SMAD signalling, oxidative stress, and extracellular matrix remodelling in both hepatic and cardiac tissues. Some ncRNAs exhibit convergent regulatory functions across both organs, while others demonstrate divergent or context-dependent effects within and between tissues. Furthermore, circulating ncRNAs, potentially transferred via extracellular vesicles (EVs), hold potential as minimally invasive biomarkers for early detection of combined cardio-hepatic fibrosis, as exemplified in conditions like Fontan circulation, though extensive validation in large, prospective cohorts is essential. This article summarises established clinical biomarkers, discusses the ncRNA-mediated mechanisms operating in liver and heart fibrosis, distinguishing shared, divergent, and mixed evidence, and explores their translational potential in diagnostics and experimental therapeutics. Finally, it addresses remaining challenges and outlines future directions, emphasising multi-omic integration, longitudinal ncRNA profiling, and mechanistic validation to advance precision management of fibrotic diseases.
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Journal articleZeidaabadi Nezhad B, 2026,
Artificial intelligence-enhanced electrocardiography for prediction of cancer therapy-related cardiac dysfunction
, Europace, ISSN: 1099-5129 -
Journal articlePastika L, Patlatzoglou K, Sieliwonczyk E, et al., 2026,
Artificial Intelligence-Enhanced Electrocardiography for the Prediction of Future Type 2 Diabetes Mellitus: a model-development and multicentre validation study
, European Heart Journal - Digital Health<jats:title>Abstract</jats:title> <jats:sec> <jats:title>Background</jats:title> <jats:p>A significant proportion of type 2 diabetes cases remain undiagnosed despite screening advances, carrying substantial cardiometabolic risk. Artificial intelligence-enhanced electrocardiography (AI-ECG) detects subtle ECG changes in subclinical disease, potentially enabling opportunistic screening.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>We developed AIRE-DM, a convolutional neural network with discrete-time survival loss, for diagnosis of prevalent and prediction of incident type 2 diabetes. It was trained on 1,163,401 ECGs from 189,537 individuals from Beth Israel Deaconess Medical Center (BIDMC) and externally validated in UK Biobank (N = 65,606) and ELSA-Brasil (N = 13,739).</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>AIRE-DM demonstrated moderate discrimination for prevalent type 2 diabetes (AUC: BIDMC 0.724, UK Biobank 0.733, ELSA-Brasil 0.706) and incident type 2 diabetes (C-index: BIDMC 0.667, UKB 0.688, ELSA-Brasil 0.625). The highest AIRE-DM risk quartile had elevated incident diabetes risk versus the lowest (HR: BIDMC 4.75, UKB 7.52, ELSA-Brasil 3.96). AIRE-DM was non-inferior to the ADA Diabetes Risk Test in BIDMC, with improved predictive accuracy when combined. In normoglycaemic patients, AIRE-DM was superior to HbA1c for predicting incident diabetes in BIDMC and non-inferior in ELSA-Brasil. The highest risk quartile reached 5% cumulative T2DM incidence 5.4 years (BIDMC) and 4.8 years (ELSA-Brasil) earlier than the lowest risk quartile, after adjusting for HbA1c, age and sex.
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Journal articleKim JU, Kaza N, Zuhair M, et al., 2026,
Atrial Dyssynchrony and Bachmann Bundle Pacing: A Review.
, JAMA CardiolIMPORTANCE: Cardiac dyssynchrony disrupts coordinated chamber activation and is associated with impaired cardiac function and adverse clinical outcomes. While ventricular dyssynchrony has been targeted through biventricular and conduction system pacing, atrial dyssynchrony remains underrecognized and largely untreated. OBSERVATIONS: Interatrial dyssynchrony commonly arises from delayed or impaired conduction through Bachmann bundle or from nonphysiological atrial pacing. It is associated with impaired ventricular filling and increased atrial arrhythmia risk. Importantly, conventional atrial pacing strategies may exacerbate rather than correct abnormal atrial activation. Bachmann bundle pacing represents a potential strategy to restore physiological atrial activation by engaging the dominant interatrial conduction pathway. Emerging data suggest that this approach may improve atrial synchrony, optimize atrioventricular timing, and reduce arrhythmia burden. CONCLUSIONS AND RELEVANCE: In this review, we summarize the mechanisms and clinical consequences of interatrial dyssynchrony and evaluate the role of Bachmann bundle pacing as a novel target for atrial resynchronization and a potential next step in physiological pacing. Further studies are required to define optimal implantation strategies and determine Bachmann bundle pacing's clinical impact.
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Journal articleNikolaev VO, Gorelik J, 2026,
Cardiomyocyte T-tubule loss in heart failure - NFκB as a central signalling hub.
, Cardiovasc Res -
Journal articleXu W, Sa F, Song Y, et al., 2026,
Cardiac MRI-Derived Right Ventricular Strain for Risk Stratification in Pediatric and Adolescent Arrhythmogenic Cardiomyopathy: A Multicenter Cohort Study.
, JACC Cardiovasc ImagingBACKGROUND: Pediatric and adolescent arrhythmogenic cardiomyopathy (ACM) is a clinically severe phenotype that remains underrepresented in cardiac magnetic resonance (CMR) research. The prognostic value of CMR-derived right ventricular deformation analysis in this population is unclear. OBJECTIVES: This study sought to describe the burden of severe cardiac outcomes in pediatric and adolescent ACM, and to assess the prognostic and incremental value of CMR-derived right ventricular global longitudinal strain (RVGLS) for risk stratification when incorporated into conventional clinical and CMR markers. METHODS: This multicenter study included consecutive pediatric and adolescent patients (aged ≤21 years) with ACM who underwent baseline CMR evaluation. We assessed clinical, electrocardiographic, and CMR parameters according to the 2010 Task Force Criteria, along with biventricular strain parameters. Severe cardiac outcomes were defined as a composite of malignant ventricular arrhythmias (MVAs), heart transplantation, and heart failure-related death. RESULTS: The cohort included 102 patients (16.3 ± 3.4 years; 72% male) and 95 controls (mean age: 15.6 ± 3.3 years; 70% male). During a median of 58-month follow-up, 51 (50%) patients experienced severe cardiac outcomes and 28 (27.5%) MVA outcomes. Reduced RVGLS was independently associated with severe cardiac outcomes (HR: 1.14; P = 0.004) and MVA outcomes (subdistribution HR: 1.15; P < 0.001) after adjustment for clinical and conventional CMR parameters. Incorporation of RVGLS significantly improved prediction of severe cardiac outcomes beyond both right ventricular-based and left ventricular-based multivariable models, with significant improvement in discrimination and reclassification. Kaplan-Meier analysis further showed that RVGLS ≥-12.2% identified patients at higher risk of severe cardiac outcomes and MVA outcomes (both log-rank P < 0.001). CONCLUSIONS: Pediatric and adolescent ACM manifests
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Journal articleHua Z, Patlatzoglou K, Kappadan V, et al., 2026,
AI-enabled motion artefact correction to replace emission- and excitation-ratiometry in cardiac optical mapping: a proof-of-concept study.
, Cardiovasc Res, Vol: 122, Pages: 1283-1286 -
Journal articleMazzola M, Wang H, Lang D, et al., 2026,
Loss of caveolar A1 adenosine receptor signalling blunts anti-adrenergic control in heart failure.
, Cardiovasc Res, Vol: 122, Pages: 1329-1343AIMS: Adenosine, acting through A1 adenosine receptors (A1ARs), exerts anti-adrenergic effects by inhibiting β1-adrenergic receptor (β1AR)-mediated cyclic adenosine monophosphate (cAMP) production and contractility in the heart. While the functional interaction between A1ARs and β1ARs is well established in both atrial and ventricular myocytes, the subcellular compartmentalization of this crosstalk and how it is disrupted in heart failure (HF) remains incompletely understood. This study investigates the spatial confinement of A1AR-β1AR signalling within atrial microdomains and assesses how structural remodelling in HF alters this regulatory axis. METHODS AND RESULTS: Quantitative polymerase chain reaction (qPCR) analysis revealed that A1AR is the predominant adenosine receptor subtype in both rat and human atrial tissues. In healthy rat and mouse atrial myocytes, A1AR activation reduced β1AR-induced cAMP production and sarcomere shortening, with suppression of cAMP signals at sarcolemmal microdomains enriched in protein kinase A Type II. This was further supported by scanning ion conductance microscopy-guided scanning patch-clamp, which showed that A1AR suppressed β1AR-driven L-type Ca2+ channel activity at both T-tubule and crest membrane domains. In atrial myocytes isolated from failing rat and human hearts, A1AR-mediated inhibition of β1AR-induced cAMP production and contractility was impaired. Caveolar disruption by methyl-β-cyclodextrin in rat atrial myocytes or via cardiac-specific caveolin-3 (Cav3) knockout in mice abolished this A1AR-mediated inhibition. Notably, cholesterol repletion alone did not restore membrane cAMP regulation, whereas Cav3 overexpression rescued A1AR-dependent suppression, supporting a requirement for Cav3-dependent organization. In mouse atrial preparations isolated from failing hearts, high-resolution optical mapping showed that A1AR-mediated anti-adrenergic regulation of Ca2+ cycling was select
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Journal articleBlackman J, Quon S, Francis DP, et al., 2026,
Association Between Interventional Cardiologist Practice Characteristics, Coronary Artery Bypass Grafting Use, and Clinical Outcomes.
, Eur J Cardiothorac Surg, Vol: 68OBJECTIVES: Quantify inter-operator variation in referred coronary artery bypass grafting (CABG) following angiography and evaluate associations with practice patterns and long-term outcomes. METHODS: Observational study using administrative health data in British Columbia, Canada (2010-2024). Interventional cardiologist-level CABG Rate was defined as the proportion of referred CABGs to total angiograms performed. Variation across Interventionalists was correlated with other practice characteristics. Among patients undergoing angiography followed by revascularization, associations between operator CABG Rate and all-cause mortality, major adverse cardiovascular events (MACEs), and repeat revascularization were evaluated using hierarchical Cox regression. RESULTS: Among 252 408 angiograms by 40 Interventionalists, CABG Rate varied 13-fold (2.03%-26.4%) and was not explained by hospital-level factors alone (intraclass correlation coefficient [ICC]: 0.358; 95% confidence interval [CI], 0.054-0.621). Higher CABG Rates were associated with lower percutaneous coronary intervention (PCI) utilization (R = -0.60; P < .001), lower PCI extensiveness (R = -0.52; P < .001), and lower procedural volume (R = -0.36; P = .022). In 73,603 first-time revascularized patients, CABG Rate was associated with reduced repeat revascularization (hazard ratio [HR] = 0.075; P < .001), without differences in mortality or MACE. CONCLUSIONS: Referred CABG varies markedly between Interventionalists and reflects operator practice style. Higher CABG utilization is associated with more durable revascularization without impact on survival or MACE. Broader implementation of multidisciplinary Heart Teams may improve consistency of care.
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Journal articleMazzarotto F, Ware J, 2026,
An updated evidence assessment of the genetic causes of dilated cardiomyopathy
, Circulation, ISSN: 0009-7322Background: Evidence of the diverse genetic architecture of dilated cardiomyopathy (DCM) continues to emerge and requires reassessment of the clinical relevance of implicated disease genes. Building on the 2019-2020 Clinical Genome Resource (ClinGen) evaluation, the DCM Gene Curation Expert Panel (GCEP) reconvened in 2024-2025 to conduct a reassessment of genes in DCM.Methods: The ClinGen semi-quantitative clinical validity classification framework was applied with specifications to DCM to classify genes into categories based upon strength of published evidence for a DCM phenotype. Previously curated genes were reassessed and newly reported gene-disease-mode of inheritance (MOI) relationships, termed “curations,” were evaluated.Results: Sixty-eight genes were evaluated, inclusive of 72 unique gene-disease-MOI relationships across 51 previously evaluated and 17 newly assessed genes. Thirty-five curations were classified as high evidence (16 Definitive, 10 Strong, 9 Moderate), increasing by 16 from the prior assessment. Nine newly assessed genes were classified as high evidence, including BAG5, FLII, LMOD2, MYLK3, MYZAP, NRAP, PPA2, PPP1R13L, and RPL3L. Twelve genes (11 newly appraised) were rated as high evidence with an autosomal recessive (AR) MOI. Five re-evaluated genes from 2019-2020 had clinically significant changes in classification. Except for JPH2, for which curation was modified to separate autosomal dominant (-AD) and -AR MOI curations, clinically significant changes involved upgrades from low to high evidence categories (PLEKHM2, PRDM16, TBX20, TNNI3K), demonstrating the robustness of the ClinGen gene curation process over time. An additional 29 gene-disease-MOI curations were classified as Limited, including six newly evaluated genes and one new MOI for a previously evaluated gene, MYBPC3-AR; four were classified as No Known Disease Relationship, and four remained Disputed. Four previously evaluated genes were curated for both AD and AR MOIs
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Journal articleTonko JB, Okafor J, Qureshi N, 2026,
Myocardial Edema After Pulsed Field Ablation: Underrecognized Tissue Effects with Implications for concomitant LAA occlusion.
, Heart Rhythm
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