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Journal articleNaidoo P, Fernandes P, Dadashi Serej N, et al., 2026,
Robust fine-grained echocardiographic view classification with supervised contrastive learning.
, Med Image Anal, Vol: 110Accurate classification of echocardiographic views is fundamental for automated cardiac analysis. However, clinical practice relies on a large, heterogeneous set of fine-grained acquisitions that introduce substantial inter-observer variability. Existing studies have primarily focused on limited view sets, often collapsing specialised views into broad categories, which limits their clinical relevance. We address this limitation by introducing TTE47, the first publicly available benchmark comprising 47 clinically meaningful views annotated independently by three experts. This dataset enables the rigorous quantification of inter-observer agreement and establishes a foundation for reproducible, clinically relevant evaluation. To tackle the dual challenges of subtle inter-class distinctions and structured label variability, we propose a novel supervised contrastive learning framework incorporating a tailored loss function. Our method outperforms cross-entropy and standard supervised contrastive baselines, achieving leading performance among evaluated methods on TTE47 and surpassing prior work on TMED-2 without dataset-specific pretraining, using a model pretrained on TTE47. Beyond accuracy, we introduce clustering-based metrics, Detection Rate and Label Recovery Precision, that measure semantic coherence and the model's ability to resist annotation variability. Results show that the learned feature space aligns more strongly with underlying anatomical structure than with any single annotator's style, enabling resilience to label shifts and maintaining robustness comparable to human-level disagreement. By integrating multi-expert evaluation, robust representation learning, and interpretable feature-space analysis, this work establishes a scalable and clinically relevant framework for fine-grained echo view classification. Our findings highlight the potential of contrastive pretraining to standardise interpretation, mitigate subjectivity, and enhance the reliability of AI
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Journal articleStevens C, Smith J, Brandts J, et al., 2026,
Optimising lipid-lowering therapy for acute coronary syndrome using a decision support system: insights from a cluster randomised trial
, European Heart Journal: Digital Health, Vol: 7, ISSN: 2634-3916AIMS: Lipid-lowering therapy (LLT) after acute coronary syndrome (ACS) typically follows stepwise intensification, delaying use of combination therapies and LDL-C goal attainment. We assessed whether access to a Decision Support System (DSS) altered the intensity of LLT prescribing vs standard-of-care (SoC).METHODS: Pragmatic, multinational, parallel 1:1 cluster-randomised controlled trial of ACS patients comparingmandatory access to a DSS (providing estimates of cardiovascular events and benefits from different LLT scenarios) to SoC. The primary endpoint was the proportion receiving intensified monotherapy or initiated/escalated combination LLT by week 16 compared to pre-admission LLT; secondary endpoints included individual components of the primary endpoint, proportions at goal (LDL-C<1.4mmol/L), and timing of LLT escalations.RESULTS: 42 sites from UK, Italy and Spain were randomised, enrolling 1139 participants, 79% male, median age 62 years (IQR: 55, 69), 84% without prior CVD, 69% LLT-naïve at admission, median admission LDL-C 3.0 mmol/L (IQR: 2.46, 3.75). The primary endpoint was met in 71.7% (DSS) vs 65.7% (SoC), risk ratio (RR) 1.11 (95%CI:0.92-1.33, p=0.29). Intensification of monotherapy occurred in 9.0% vs 13.1% (RR:0.68, 95%CI:0.46-1.00), combination LLT in 61.6% vs 50.6% (RR:1.35, 95%CI:0.93-1.98). LDL-C goal achievement was 54.8% vs 50.3% (RR 1.06, 95%CI: 0.88-1.28), with LLT escalation before discharge in 64.8% vs 60.7%.CONCLUSIONS: Access to a DSS, in hospitals managing ACS, did not improve LLT intensification within 16 weeks or LDL-C goal attainment, but revealed a favourable trend towards earlier combination LLT use, which merits larger, longer studies in other settings.
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Journal articleZiaeian B, Shaw LJ, Sutton NR, et al., 2026,
Strategy to Reduce >350 000 Yearly Deaths From Atherosclerotic Coronary Artery Disease by 2050 in the United States.
, Circ Popul Health Outcomes -
Journal articleLuo Y, Sesia D, Wang F, et al., 2026,
Explicit differentiable slicing and global deformation for cardiac mesh reconstruction.
, Med Image Anal, Vol: 111Three-dimensional (3D) mesh reconstruction of the cardiac anatomy from medical images is useful for shape and motion measurements and biophysics simulations. However, 3D medical images are often acquired as 2D slices that are sparsely sampled (e.g., large slice spacing) and noisy, and 3D mesh reconstruction on such data is a challenging task. Traditional voxel-based approaches utilize non-differentiable pre- and post-processing that compromises fidelity to images, while mesh-level deep learning approaches require large 3D mesh annotations that are difficult to obtain. Differentiable cross-domain supervision from 2D images to 3D meshes is therefore crucial for enabling end-to-end optimization in medical imaging. While there have been attempts to approximate the voxelization and slicing of meshes that are being optimized, there has not yet been a method for directly using 2D slices to supervise 3D mesh reconstruction in a differentiable manner. Here, we propose a novel explicit differentiable voxelization and slicing (DVS) algorithm allowing gradient backpropagation to a 3D mesh from its slices, which facilitates refined mesh optimization directly supervised by the losses defined on 2D images. Further, we propose an innovative framework for extracting patient-specific left ventricle (LV) meshes from medical images by coupling DVS with a graph harmonic deformation (GHD) mesh morphing descriptor of cardiac shape that naturally preserves mesh quality and smoothness during optimization. The proposed framework achieves state-of-the-art performance in cardiac mesh reconstruction tasks from densely sampled (CT) as well as sparsely sampled (MRI stack with few slices) images, outperforming alternatives, including Marching Cubes, statistical shape models, algorithms with vertex-based mesh morphing algorithms and alternative methods for image-supervision of mesh reconstruction. Experimental results demonstrate that our method achieves an overall Dice score of 90% during a sparse
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Journal articleToth GG, Amabile N, Barbato E, et al., 2026,
Day-case percutaneous coronary procedures. A clinical consensus statement of the European Association of Percutaneous Cardiovascular Interventions (EAPCI) of the European Society of Cardiology (ESC) and the Association of Cardiovascular Nursing & Allied Professions (ACNAP) of the ESC.
, EuroIntervention, Vol: 22, Pages: 224-231Percutaneous coronary procedures performed in a day-case setting are intended to facilitate an optimised resource allocation and increase patient satisfaction without compromising procedural and long-term safety or efficacy. While an increasing number of centres have implemented a day-case approach, patient pathways and procedural aspects still lack standardisation, potentially leading to a large heterogeneity in practices. However, several centres and healthcare systems are still reluctant to adopt day-case diagnostic or therapeutic coronary procedures because of safety concerns, penalising reimbursement policies, or simple inertia. This clinical consensus statement summarises experience-based know-how and research-derived data on day-case coronary procedures with the objective of providing standardised practical guidance on patient selection, procedural considerations, and postprocedural management to facilitate wide-scale adoption of a day-case coronary programme. The document also provides clear advice on when such procedures must be converted into regular admissions to maximise patient safety.
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Journal articleMorrow A, Young R, Abraham GR, et al., 2026,
Exercise treadmill testing for efficacy evaluation in randomized, controlled trials.
, Am Heart J, Vol: 297Exercise treadmill testing measures functional capacity and inducible myocardial ischemia and has historically served as an endpoint in phase 2 trials. The Precision Medicine with Zibotentan in Microvascular Angina trial evaluated the selective endothelin-A receptor antagonist zibotentan as a potential disease-modifying therapy for microvascular angina. The trial had a randomized, double-blind, cross-over design and the primary outcome was exercise duration. Compared with placebo, zibotentan at a dose of 10-mg daily for 12-weeks did not improve exercise duration or angina symptoms. In this prespecified analysis, exercise duration was compared across four sequential study visits and the factors associated with within-trial changes were evaluated. Exercise test duration increased progressively in all participants during sequential trial phases, independent of treatment with either zibotentan or placebo. This improvement in exercise duration was associated with female sex (interaction p-value = .0213; effect estimate [95% confidence interval]) 34.95 [13.99, 55.78] seconds, P = .002). In conclusion, the exercise test has limitations as an objective endpoint of efficacy in randomized trials. PRIZE; https://clinicaltrials.gov/study/NCT04097314 Clinicaltrials.gov Registration: NCT04097314.
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Journal articleFarkowski MM, Szmit S, Boriani G, et al., 2026,
Contemporary management of atrial fibrillation in patients with cancer-the 2025 European Heart Rhythm Association survey.
, Europace, Vol: 28AIMS: This study aimed to assess current clinical practices in the diagnosis and management of atrial fibrillation (AF) among patients with active cancer or a history of cancer therapy. METHODS AND RESULTS: A 25-item, physician-based survey was developed by the European Heart Rhythm Association in collaboration with the European Society of Cardiology Council of Cardio-Oncology and the International Cardio-Oncology Society. The survey was disseminated electronically. A total of 380 participants from 74 countries completed the questionnaire, with respondents primarily working as electrophysiologists (30%), general cardiologists (25%), and cardio-oncologists (22%). Nearly two-thirds reported that active cancer 'definitely' or 'most probably' influenced clinical decisions regarding AF diagnosis and management. When AF was diagnosed, rhythm control was the preferred management strategy for symptomatic patients, while rate control was favoured for asymptomatic individuals. A little over 40% reported that a history of cancer therapy 'definitely' or 'most probably' influenced clinical decisions regarding AF. The rhythm control was the most common strategy (40%). In both populations, opportunistic screening for AF and direct oral anticoagulants (DOACs) were preferred strategies. A high level of uncertainty was noted concerning the role of invasive treatment options. CONCLUSION: The survey revealed that, despite the lack of robust evidence specific to this patient cohort, contemporary treatment of AF in patients with active cancer or a history of cancer therapy generally follows guidelines developed for the broader AF population. These findings highlight the urgent need for more dedicated data to inform clinical decision-making in cardio-oncology patients with AF.
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Journal articleMahmoudi M, Nicholas Z, Jabbour RJ, et al., 2026,
Anatomical, physiological and inflammatory characterization of nonculprit vessels in patients undergoing primary PCI for ST-elevation myocardial infarction in the presence of multivessel disease: Rationale and design of the PICNIC study
, AMERICAN HEART JOURNAL, Vol: 292, ISSN: 0002-8703 -
Journal articleSaleh K, Hadadi R, Liang Y, et al., 2026,
AI-ECG classification for Brugada syndrome: A study of machine learning techniques to optimise for limited datasets.
, PLOS Digit Health, Vol: 5Deep neural networks can classify ECGs with high accuracy when training data is abundant. Rare conditions like Brugada syndrome, an inherited arrhythmia syndrome predisposing to sudden death, pose challenges due to data scarcity hindering model training. We evaluated multiple machine learning (ML) approaches to optimise a Brugada ECG classification model using limited training data. The baseline model was trained on a dataset comprising 176 Brugada, 176 right bundle branch block (RBBB) and 352 normal ECGs from Zhongshan Hospital (Zhongshan-baseline dataset), framed as a binary classification task to distinguish Brugada from non-Brugada ECGs. A 25%-75% train-test split was used to exacerbate data scarcity. To enhance training, we incorporated three additional datasets: (i) a different, labelled ECG dataset from Zhongshan Hospital including normal and RBBB ECGs (Zhongshan-pretrain), (ii) an unlabelled ECG dataset from Hammersmith Hospital including Brugada and non-Brugada ECGs (Imperial), (iii) an open-access labelled ECG dataset (PTB-XL). Three strategies were tested: (1) supervised pretraining, (2) self-supervised pretraining with data augmentation, and (3) oversampling using SMOTE (synthetic minority oversampling technique). Each model was evaluated on the unseen internal test set and an external Brugada mimic dataset. The models were re-trained using an 80%-20% train-test split as a secondary analysis. The baseline model achieved 92.2% accuracy, F1-score 0.837, and area under the Receiver Operating Characteristic curve (AUC) 0.962. Supervised pretraining significantly improved performance when training data was scarce, with the best model pretrained on the Zhongshan-pretrain dataset boosting accuracy (+3.2%), F1-score (+0.071) and AUC + 0.019), with consistent cross-validation performance. Self-supervised pretraining produced smaller and more variable gains, although select models better mitigated against false positives on the Brugada mimic dataset.
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Journal articleSamways JW, Cheng T, Chow J-J, et al., 2026,
Ventricular repolarization is improved by His resynchronization therapy but not biventricular pacing.
, Heart Rhythm, Vol: 23, Pages: e220-e229BACKGROUND: Biventricular pacing (BVP) delivered cardiac resynchronization therapy (CRT) modestly improves activation synchrony in patients with heart failure and left bundle branch block (LBBB) but can trigger ventricular arrhythmias. His bundle pacing (HBP) can correct LBBB as an alternative CRT method, producing superior ventricular activation synchrony and hemodynamics. OBJECTIVE: The aim of the study was to investigate the relative effects of HBP-CRT and BVP-CRT on ventricular repolarization. METHODS: Patients with LBBB referred for BVP-CRT underwent intra-procedural non-invasive epicardial mapping during atrial pacing (intrinsic LBBB), BVP-CRT, and temporary HBP. When HBP corrected LBBB, changes from baseline (LBBB) in overall and left ventricular (LV) repolarization dispersion (ΔVRT, ΔLVRT), repolarization gradient (ΔVRG, ΔLVRG) and activation-recovery interval (ARI) dispersion (ΔVARI, ΔLVARI) were measured. RESULTS: 17 patients had full datasets. BVP-CRT had no effect on global repolarization dispersion, gradient steepness or ARI (ΔVRT -1.5 ms, 95% confidence interval [CI] -15.4 to +12.4, P = .82; ΔVRG -0.00549 ms/mm, -0.106 to +0.0954, P = .9; ΔVARI -5.0 ms, -24.3 to +14.3, P = .59) and worsened the parameters in the LV (ΔLVRT +14.5 ms, +0.05 to +28.9, P = .049; ΔLVRG +0.0931 ms/mm, -0.0635 to +0.25, P = .226, ΔLVARI +28.6 ms, 95% CI +6.0 to +51.2, P = .02). HBP-CRT significantly improved global repolarization dispersion, gradient steepness and ARI (ΔLVRT +14.5 ms, +0.05 to +28.9, P = .049; ΔLVRG +0.0931 ms/mm, -0.0635 to +0.25, P = .226; ΔVARI -49.5 ms, -69.0 to -29.9, P < .0001) and within the LV (ΔLVRT -38.2 ms, -48.7 to -27.6, P < .001; ΔLVRG -0.228 ms/mm, -0.334 to -0.122, P = .0003; ΔLVARI -37.2 ms, -59.4 to -15.0, P = .003). CONCLUSION: HBP-CRT improves LBBB-induced repolarization abnormalities through improved activation synchrony and AR
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Journal articleSimader FA, Rajkumar CA, Foley MJ, et al., 2026,
Association Between Age and PCI Effectiveness in Stable CAD: Secondary Analysis of ORBITA-2.
, J Am Coll Cardiol, Vol: 87, Pages: 253-265BACKGROUND: ORBITA-2 (Objective Randomized Blinded Investigation With Optimal Medical Therapy of Angioplasty in Stable Angina) was the first randomized placebo-controlled trial to show the efficacy of percutaneous coronary intervention (PCI) in patients with stable angina and single- or multivessel coronary artery disease without background antianginal medication. Whether the effect is consistent across age groups is unknown. OBJECTIVES: The authors sought to evaluate the interaction between age and symptom and stenosis severity, and the efficacy of PCI on the ORBITA-2 primary and secondary endpoints. METHODS: All patients from the primary ORBITA-2 trial contributed data to this post hoc analysis. For daily symptoms, a bayesian longitudinal Markov model was constructed. For treadmill exercise time, stress echocardiography, and questionnaires, a bayesian ordinal proportional odds model was used, including the prerandomization value and treatment arm, which were allowed to interact with age. RESULTS: The mean age was 64 ± 9 years, ranging from 40 to 82 years. There was little relationship between age and symptom and stenosis severity. In older patients, PCI was more effective for symptom relief (OR: 2.03; 95% CrI: 1.67-2.45; Pr > 0.99) than in younger patients (OR: 1.70; 95% CrI: 1.38-2.15; Pr > 0.99; Pr [interaction] = 0.99). In contrast, the effect of PCI on treadmill exercise time was far greater in younger than in older patients (50-year-old: +125 s [95% CrI: 35.8-215.0 s; Pr > 0.99]; 70-year-old: +31.9s [95% CrI: -12.6 to 78.3; Pr = 0.92]; Pr [interaction] = 0.96). CONCLUSIONS: PCI was effective across all ages in reducing angina frequency. Notably, there was limited improvement in treadmill exercise time in the elderly, challenging its role as a primary endpoint in many antianginal trials. These data should inform cardiovascular clinical trial design to ensure applicability across all ages. (Objective Randomized Blinded Investigation With Optimal
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Journal articleMohal JS, Whinnett ZI, Mohiddin SA, et al., 2026,
Electromechanically Optimized Right Ventricular Pacing for Obstructive Hypertrophic Cardiomyopathy: The EMORI-HCM Trial.
, J Am Coll Cardiol, Vol: 87, Pages: 124-139BACKGROUND: Many patients with symptomatic obstructive hypertrophic cardiomyopathy (oHCM) have devices capable of right ventricular pacing (RVP). Although pacing can reduce left ventricular outflow tract gradient (LVOTg), it can also reduce cardiac output, so its net effect is variable. OBJECTIVES: We tested whether electromechanical optimization of the programmed atrio-ventricular delay (AVD) allows RVP to achieve a net benefit on symptoms. METHODS: EMORI-HCM (Electromechanically Optimized Right Ventricular Pacing in Obstructive Hypertrophic Cardiomyopathy) is a multicenter, blinded, randomized, crossover trial of AVD-optimized RVP in patients with symptomatic oHCM with resting or provoked gradient of at least 30 mm Hg. Patients with existing dual-chamber devices were randomized to either 3 months of continuous AVD-optimized RVP (intervention) followed by 3 months of backup-only RVP (control), or vice versa. AVD was optimized using a high-precision multiple-alternation protocol assessing acute change in beat-by-beat blood pressure while varying AVD. The primary outcome was symptoms measured by the Kansas City Cardiomyopathy Questionnaire Clinical Summary Score. Secondary outcomes include patient-reported daily symptom data collected using a dedicated smartphone application (ORBITA-app), dichotomous patient preference, EQ-5D, exercise capacity, and LVOTg. Patients were blinded to treatment allocation. Symptom assessments were self-administered. Outcome measures were recorded at baseline, crossover, and completion. Analysis was by Bayesian ordinal mixed modeling. RESULTS: Between October 2021 and October 2024, 117 screened patients met the inclusion criteria, of whom 60 were randomized. AVD-optimized RVP improved Kansas City Cardiomyopathy Questionnaire Clinical Summary Score (+4.5; 95% credible interval [CrI]: 1.3-8.1; probability of benefit [Prbenefit] = 0.997) and daily symptom scores (OR: 1.29; 95% CrI: 0.98-1.68; Prbenefit: 0.969) compared with backup-only pacin
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Journal articleMonguillon V, Kelly PJ, O'Donoghue ML, et al., 2026,
Efficacy and Safety of Very Low Achieved LDL Cholesterol in Patients With Previous Ischemic Stroke.
, Circulation, Vol: 153, Pages: 86-93BACKGROUND: Patients with previous ischemic stroke are at high risk for recurrent stroke and other major adverse cardiovascular events. The benefits of achieving very low levels of low-density lipoprotein cholesterol (LDL-C) in such patients is unclear. METHODS: We analyzed patients with previous ischemic stroke enrolled in FOURIER (Further Cardiovascular Outcomes Research With PCSK9 Inhibition in Subjects With Elevated Risk), a randomized placebo-controlled trial studying evolocumab in patients with stable atherosclerotic cardiovascular disease (median follow-up, 2.2 years), and through the open-label extension (FOURIER-OLE) period (additional median follow-up, 5 years), to examine the relationship between achieved LDL-C and the long-term incidence of the primary end point (cardiovascular death, myocardial infarction, stroke, or hospitalization for unstable angina or coronary revascularization) and stroke-related end points. RESULTS: The analysis included 5291 patients with previous ischemic stroke (>4 weeks). Of these, 666 (12.6%), 1410 (26.6%), 586 (11.1%), 508 (9.6%), and 2121 (40.1%) patients achieved LDL-C values of <20, 20 to <40, 40 to <55, 55 to <70, and ≥70 mg/dL, respectively. The incidence of the primary end point, all stroke, and ischemic stroke each decreased in a monotonic fashion with lower achieved LDL-C levels on a continuous scale (Ptrend<0.001, 0.002, and 0.002, respectively). Compared with patients with LDL-C ≥70 mg/dL, those who achieved levels <40 mg/dL had incidence rate ratios of 0.69 (95% CI, 0.57-0.84), 0.73 (95% CI, 0.53-0.99), and 0.75 (95% CI, 0.54-1.05) for the outcomes of the primary end point, all stroke, and ischemic stroke, respectively. Hemorrhagic strokes were infrequent and unrelated to achieved LDL-C (Ptrend=0.85). CONCLUSIONS: In patients with previous ischemic stroke, it appeared that the lower the LDL-C, down to levels <40 mg/dL, the lower the risk of major adverse cardiovascular events, includi
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Journal articleHada M, Collet C, Storozhenko T, et al., 2026,
Rationale and design of European microcirculatory resistance and absolute flow team: The Euro-CRAFT registry
, AMERICAN HEART JOURNAL, Vol: 291, Pages: 136-143, ISSN: 0002-8703 -
Journal articleMcDonald A, Gales M, Rana BS, et al., 2026,
Development and validation of AI-Enhanced auscultation for valvular heart disease screening through a multi-centre study.
, NPJ Cardiovasc Health, Vol: 3Valvular heart disease (VHD) is a growing public health concern, yet over half of cases remain undiagnosed due to late symptom onset, limited public awareness, and low sensitivity of traditional stethoscope-based screening. Current AI-enabled tools rely on murmur detection as a proxy for VHD but lack sensitivity for common subtypes like mitral regurgitation and are limited by small datasets. This study presents a novel neural network that directly predicts clinically significant VHD from stethoscope recordings, trained using echocardiographic targets rather than heart murmur labels. A diverse dataset of 1767 patients across UK primary care and hospital settings was developed, combining stethoscope recordings with echocardiographic labels. The trained recurrent neural network achieved an AUROC of 0.83, outperforming general practitioners and demonstrating exceptional sensitivity for severe aortic stenosis (98%) and severe mitral regurgitation (94%). This algorithm shows promise as a scalable, low-cost screening tool, enabling earlier diagnosis and timely referral for intervention. This research was registered with ClinicalTrials.gov (CAIS: NCT04445012 registered on 2020-06-21, DUO-EF: NCT04601415 registered on 2020-10-19).
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Conference paperJevsikov J, Stowell CC, Ng T, et al., 2026,
Robustness of Human vs. AI Measurements Under Progressive Image Degradation
, 2nd International Conference on Artificial Intelligence in Healthcare-AIiH, Publisher: SPRINGER INTERNATIONAL PUBLISHING AG, Pages: 261-268, ISSN: 0302-9743 -
Book chapterNaidoo P, Fernandes P, Ufumaka I, et al., 2026,
Spatiotemporal Contrastive Learning for Echocardiography View Classification
, Editors: Rittman, Ni, Cafolla, Publisher: SPRINGER INTERNATIONAL PUBLISHING AG, Pages: 247-260, ISBN: 978-3-032-00627-1 -
Book chapterFernandes P, Naidoo P, Ufumaka I, et al., 2026,
Deep Learning for Assessing Rotational Misalignment in Echocardiographic Imaging
, Editors: Rittman, Ni, Cafolla, Publisher: SPRINGER INTERNATIONAL PUBLISHING AG, Pages: 269-282, ISBN: 978-3-032-00627-1 -
Journal articleZiotti SDV, Dourado LOC, Silva RD, et al., 2026,
Coronary Sinus Reduction for the Treatment of Refractory Angina: What Have We Learned after 70 Years of the Beck Surgery?
, Arq Bras Cardiol, Vol: 122With the increasing prevalence of chronic coronary syndromes, many patients with extensive atherosclerosis experience uncontrolled angina, even while receiving optimal medical therapy. This is especially true for patients who are not suitable candidates for surgical or percutaneous revascularization. Numerous treatments have been investigated for managing angina pectoris, and in this context, the coronary sinus reducer has emerged as a promising therapeutic option. Since the 1950s, beginning with Beck's surgery, the coronary venous sinus has been a focal point of research in anti-ischemic therapies. Significant scientific advances have been made in narrowing the venous sinus in the past two decades. Thanks to technological improvements in minimally invasive procedures and better methods for assessing myocardial blood flow, a new therapeutic option has become available for patients suffering from refractory angina and, possibly, for microvascular dysfunction. In this review, we aim to examine key concepts related to angina pectoris and myocardial ischemia, highlighting the historical background, pathophysiological rationale, and technical aspects of coronary sinus reduction as a therapy for refractory angina. Additionally, we will explore the scientific evidence from recent decades, as well as identify existing gaps and outline future research directions concerning this emerging treatment.
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Journal articleRajendra S, Salmasi Y, Raj B, et al., 2025,
Perioperative Predictors of Right Ventricular Failure Following Left Ventricular Assist Device Implantation.
, ASAIO JRight ventricular failure (RVF) is an important complication following implantation of a left ventricular assist device (LVAD) in patients with advanced heart failure. This study aims to identify perioperative hemodynamic predictors of RVF following LVAD implantation and develop an internally validated predictive model. Patients who underwent LVAD implantations between March 2013 and March 2023 at a large-volume tertiary center were retrospectively analyzed. The primary outcome was early post-implant RVF, defined by need for right ventricular assist device (RVAD), prolonged inotrope dependence (> 14 days), or death within 14 days while on inotropes. Perioperative hemodynamic variables were analyzed using univariate logistic regression. A prediction model was then developed using stepwise multivariate logistic regression, and internally validated using k-fold cross-validation. Among 210 patients, 73 patients (34.8%) developed early post-implant RVF. Decreased post-implant cardiac index (odds ratio [OR]: 0.0122, p = 0.001), decreased mean arterial pressure (OR: 0.932, p = 0.008), and simultaneously increased cardiac index and pulmonary pulse pressure (OR: 1.13, p = 0.021) independently predicted RVF. Preimplantation IV inotrope therapy was a significant confounder (OR: 3.96, p = 0.021). Our proposed predictive model achieved strong discriminatory power (area under the curve [AUC] of 0.830) and stable cross-validation performance. External validation with multicenter cohorts is warranted to confirm predictive accuracy and clinical applicability.
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Journal articleKose O, Sahal A, Zhang GK, et al., 2025,
Framework for Analytical Validation of DHT-Based Actigraphy and Signal Measures in HF Trials: The VALIDATE-HF Program.
, JACC Heart Fail -
Journal articleRajkumar CA, Foley MJ, Ahmed-Jushuf F, et al., 2025,
The Role of the Collateral Circulation in Stable Angina: An Invasive Placebo-Controlled Study
, CIRCULATION, Vol: 152, Pages: 1541-1551, ISSN: 0009-7322 -
Journal articleMielniczuk LM, Ahmad T, Borovac JA, et al., 2025,
Management of Ischemic Heart Disease in Patients With Heart Failure<i> JACC:</i><i> Heart</i><i> Failure</i> Position Statement
, JACC-HEART FAILURE, Vol: 13, ISSN: 2213-1779 -
Journal articleHaworth PAJ, Bent C, Chapman N, et al., 2025,
Renal denervation for hypertension management in the UK: a Delphi expert consensus
, HEART, ISSN: 1355-6037 -
Journal articleKhialani B, Alfonso F, Malakouti S, et al., 2025,
Preventive Percutaneous Intervention of Vulnerable Coronary Plaques
, AMERICAN JOURNAL OF CARDIOLOGY, Vol: 255, Pages: 89-98, ISSN: 0002-9149- Cite
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