Cardiology Commons^™

Depression And Anxiety In Pulmonary Hypertension Associated With Congenital Heart Disease: Pathophysiology And Clinical Implications Of The Heart–Brain Axis, Nicodemus N. Triatmojo, Valerinna Y.S. Putri

Journal of the Saudi Heart Association

Pulmonary hypertension associated with congenital heart disease or PH-CHD is an increasingly prevalent disorder in modern cardiology. It is characterized by progressive pulmonary vascular remodeling, chronic right ventricular (RV) pressure overload, and abnormal cardiopulmonary hemodynamic. Due to advances in congenital cardiology and treatments for pulmonary hypertension, survival rates have increased. As a result, the focus has switched to long-term functional status and quality of life. Depression and anxiety are currently recognized as prevalent and clinically significant manifestations in PH-CHD; nonetheless, they remain underdiagnosed and undertreated within cardiovascular care frameworks.

More study shows the disease's severity or symptom count cannot explain …

Efficacy Of Sirolimus Versus Paclitaxel-Coated Balloons For Coronary Revascularization: An Updated Meta-Analysis With Grade Assessment, Matthew Aldo Wijayanto, Christopher Daniel Tristan, Erlangga Masykur Kynaya, Annisa Aghnia Rahma, Putri Saskia Harimurti, Arwin Saleh Mangkuanom, Amir Aziz Alkatiri, Doni Firman, Bambang Budi Siswanto

Journal of the Saudi Heart Association

Drug-coated balloons are an emerging strategy for coronary revascularization. Despite their increasing use, the comparative efficacy of sirolimus- versus paclitaxel-coated balloons (SCB vs PCB) remains uncertain. This updated meta-analysis evaluated clinical and angiographic outcomes of SCB and PCB in percutaneous coronary intervention (PCI). A comprehensive search of PubMed, Scopus, and ScienceDirect was performed on August 28, 2025. Studies directly comparing SCB and PCB were included. The primary endpoint was target lesion failure (TLF), which was defined as cardiac death, target vessel myocardial infarction (TVMI), or target lesion revascularization (TLR). On follow-up angiography, secondary endpoints consisted of minimal lumen diameter (MLD), …

Association Between Trainee Involvement During Pediatric And Congenital Cardiac Catheterization And Procedural Outcomes., Natalie Jayaram, John A. Spertus, Kevin F. Kennedy, Andrew C. Glatz

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Participation in the cardiac catheterization laboratory is a requirement of cardiology fellowship training. We sought to determine whether trainee presence is associated with outcomes during pediatric and congenital cardiac catheterization.

METHODS: We identified catheterizations between January 2011 and September 2020 within the IMPACT (Improving Pediatric and Adult Congenital Treatment) Registry. Multivariable multilevel regression was used to determine the association between trainee presence and procedural outcomes.

RESULTS: Of 122 760 catheterizations at 107 academic hospitals, a trainee was present in 71 651 (58.4%) cases. Rates of major adverse events were similar between trainee and nontrainee cases (9.0% versus 8.0%). Contrast …

Prenatal Predictors Of Fetal And Neonatal Death In Truncus Arteriosus: A Fetal Heart Society Research Collaborative Study., Kelly Cox, Nazia Husain, Deidra Ansah, Tiffany Knight, Alexandra Channing, Bettina Cuneo, Preeta Dhanantwari, Mary Donofrio, Miwa Geiger, Lisa Howley, Lisa K. Hornberger, Simone Javeri, Edward G. Jones, Michelle Kaplinski, Ann Kavanaugh-Mchugh, Maria Kiaffas, Katherine Kosiv, Christina Laternser, Olivia Low, Anita J. Moon-Grady, Shabnam Peyvandi, Nelangi Pinto, Avaliese Porlier, Aaron Prosnitz, Rashmi Rao, David Schidlow, Elena Sinkovskaya, Ranjini Srinivasan, Corey Stiver, Emilio Quezada, Bhawna Arya, Sheetal Patel

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Fetal and neonatal outcomes and factors increasing mortality risk in fetal truncus arteriosus are not well characterized. We aimed to examine the prenatally encountered cardiac spectrum, define extracardiac and genetic associations, explore clinical outcomes and identify prenatal factors associated with worse outcomes in a contemporary large cohort.

METHODS: A multicenter retrospective cohort study was conducted via the Fetal Heart Society Research Collaborative including fetal truncus arteriosus cases encountered between January 1, 2010, and September 1, 2021, within 22 North American cardiac centers. Demographic, clinical, anatomic, and functional fetal echocardiographic variables were analyzed for associations with presurgical death (fetal death/neonatal …

Greater Weekly Exercise Volume Is Associated With Lower Prevalence Of Metabolic Comorbidities, Psychiatric Conditions, And Exertional Symptoms In Youth Athletes Undergoing Pre-Participation Screening: An Observational Study, Grace Qiu, Seong Kyu Kim, Douglas Corsi, Alexander G. Hajduczok, Imran Masood, Daniel Underberg, Brian Osler, Drew Johnson, David Shipon

Division of Cardiology Faculty Papers

INTRODUCTION: Physical activity has been associated with improved cardiovascular health outcomes in adults. However, the specific associations between physical activity volume and cardiovascular outcomes in youth athletes are less defined.

METHODS: This study analyzed data from the HeartBytes National Youth Database, compiled from Simon's Heart. Simon's Heart is a nonprofit organization that includes information from sports pre-participation examinations for adolescents. The dataset encompasses demographics, electrocardiogram (ECG) findings, and exercise-related symptoms. Youth athletes' self-reported weekly physical activity volume was classified into four levels: < 2 h, 2-5 h, 5-10 h, and >10 h, with less than 2 h taken as the reference group. Given the physical diMerences among athletes …

Ct-Derived Epicardial Adipose Tissue Density And Its Association With Systemic Inflammation And Functional Impairment In Heart Failure With Preserved Ejection Fraction: A Prospective Cross-Sectional Study From Oman, Arif Albulushi, Ahmed Tawfek, Ahmed Basuoni

Journal of the Saudi Heart Association

Background: Heart failure with preserved ejection fraction (HFpEF) is strongly influenced by cardiometabolic comorbidity and systemic inflammation. Epicardial adipose tissue (EAT) is a biologically active visceral fat depot in direct contact with the myocardium, and CT-derived EAT density (attenuation) may reflect inflammatory adipose remodeling beyond adipose quantity alone. However, the clinical relevance of EAT density in HFpEF remains uncertain.

Objectives: To evaluate the association of CT-derived EAT density with systemic inflammatory biomarkers, functional capacity, health status, and echocardiographic indices of HFpEF severity in a prospective cross-sectional cohort.

Methods: In a prospective cross-sectional study conducted between January and July 2024 at …

Proteogenomics Of Hypertrophic Cardiomyopathy Reveals Subtype-Specific Therapy, Ke Ma, Jie Yang, Hongchang Guo, Ping Li, Xiaowei Li, Zhujun Dong, Jing Zhang, Congcong Zhang, Pengli Yang, Chongpei Hua, Shuolin Zhu, Guoqing Li, Jianchao Zhang, Ningyu Ding, Jizheng Wang, Xin-Liang Ma, Zhuofeng Lin, Jianzeng Dong, Yang Li, Yulin Li

Department of Emergency Medicine Faculty Papers

BACKGROUND: Hypertrophic cardiomyopathy (HCM) is a heterogeneous disease with diverse prognosis. The underlying mechanisms remain unknown, resulting in limited risk stratification and therapeutic strategies. This study aimed to elucidate molecular subtypes of HCM through integrated proteogenomic analysis and explore subtype-specific therapeutic strategies.

METHODS: We conducted an integrated proteogenomic analysis of 132 patients with HCM using myocardial samples, incorporating whole-exome sequencing, RNA sequencing, and proteomics. Unsupervised clustering was used to identify HCM subtypes, which were validated in heart tissues and human induced pluripotent stem cell-derived cardiomyocytes from 2 independent HCM subsets. Subtype-specific signatures and pathways were explored, and their causal link …

Donor-Derived Cell-Free Dna As A Prognostic Biomarker After Heart Transplantation: The Define-Ht Study, Palak Shah, Paul J. Kim, Kelly H. Schlendorf, David A. Baran, Monica M. Colvin, Adam D. Devore, Howard Eisen, Kambiz Ghafourian, Michael M. Givertz, Eileen Hsich, Jaime L. W. Kennedy, Evan P. Kransdorf, Jose N. Nativi-Nicolau, Jignesh Patel, Eleni Tseliou, Omar Wever-Pinzon, Andrew Doud, Michelle S. Bloom, Sandra A. Carey, Navchetan Kaur, D Giovanni Biagini, Kyle E. Marshall, Michael Olympios, Mandeep R. Mehra, Josef Stehlik

Department of Medicine Faculty Papers

BACKGROUND: Measurement of donor-derived cell-free DNA fraction (dd-cfDNA%) and donor quantity score (DQS) is a noninvasive biomarker of acute rejection in heart transplantation (HT). Its prognostic value beyond histopathology remains uncertain.

OBJECTIVES: This study sought to evaluate associations between donor-derived cell-free DNA (dd-cfDNA) and clinically meaningful outcomes using a composite endpoint of treated rejection, graft dysfunction, retransplantation, or death within 1 year post-HT.

METHODS: The DEFINE-HT (Development of Noninvasive Cell-free DNA to Supplant Invasive Biopsy in Heart Transplantation) was a prospective, observational study following adult HT recipients at 10 U.S. centers for 1-year post-HT; blood was collected for dd-cfDNA testing …

Regional Hemodynamic Characterization Of The Thoracic Aorta Using 4d Flow Mri: A Single-Center Pilot Study, John H. Major

Summer Research Program Abstracts

No abstract provided.

How To Assess Ventricular Function By Fetal Echocardiography: Expert Guidance From The Fetal Heart Society., S R Patel, Nitin Madan, L Eckersley, Z Roytman, M Perez, L Gindes, L K Hornberger

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Immediate Postoperative Pacing Dependency Is Not Associated With Worse Mid-Term Survival In Redo Mitral Valve Surgery, Devon Kelley, Joyce Ho, Andrew Belec, Takahiro Tashima, Victoria Li, James Lao, Varun Kathawate, Kazuhiro Ueno, Amit Iyengar, Jessica Dominic, Pavan Atluri

Division of Cardiology Faculty Papers

Risk factors (RF) for permanent pacemaker (PPM) placement in cardiac surgery include valvular operations and redo operations. We aim to identify RF for PPM placement prior to discharge (DC) specifically among redo mitral valvular operations, and to analyze outcomes in this population. Our retrospective review considered 943 patients undergoing redo MV operations between 01/2002 and 12/2021, excluding patients experiencing in-hospital death within 48 hours of their operation and patients with existing PPM or implanted cardiac defibrillator (ICD). Patients (n = 742) were categorized based on whether they received a PPM before DC or not. Of the 742 patients analyzed, 47 …

In Vivo Evidence Of Blood Flow Slippage: Failure Of The No-Slip Boundary Condition Assumption, Alena Jarolímová, Jaroslav Hron, Karel Tůma, Radomír Chabiniok, Josef Málek, Keshava Rajagopal

Division of Cardiology Faculty Papers

The assumption that blood adheres to vessel walls with zero tangential velocity component, the so-called "no-slip" boundary condition, is a foundational premise of cardiovascular fluid dynamics. Whether the no-slip condition holds in vivo, however, remains unknown. Seven healthy adult volunteers underwent cardiovascular magnetic resonance imaging. With four-dimensional flow magnetic resonance imaging of the descending thoracic aorta and modeling blood as a Navier-Stokes fluid, near-wall blood velocities were quantified, and wall shear stress was calculated based on the measured velocity fields. Within the Navier-Stokes data assimilation framework, tangential wall velocities of ∼30-80% of the mean luminal velocity were consistently obtained. These …

Determinants Of Early Mortality After Congenital Heart Surgery: A 7-Year Single-Center Experience In Saudi Arabia, Saud Abdulaziz Bahaidarah, Jowana Mahmoud Aljinaid, Amal Ahmad Alzahrani, Jana Mohammad Banjer, Lujain Abdulsalam Kofiyah, Nesmah Amin Noaman, Rahaf Adel Badkook, Raghad Abdulaziz Aljabri, Raghad Saeed Alghamdi, Renad Mohammed Alamoudi, Sarah Salem Bawazir, Gaser Abdelmohsen Abdelmohsen

Journal of the Saudi Heart Association

Objectives:

To determine predictors of early mortality among pediatric patients undergoing congenital heart surgery at a tertiary care center in Saudi Arabia.

Methods:

This retrospective cohort study included 955 pediatric patients who underwent congenital heart surgery at King Abdulaziz University Hospital, Jeddah, between January 2017 and December 2023. Demographic, clinical, operative, and postoperative variables were collected.

Results:

Overall mortality was 4.9%. Mortality was higher among neonates and infants and among patients with RACHS categories 4–6. Non-survivors had longer cardiopulmonary bypass times and more frequent delayed chest closure. Postoperative complications, including the need for extracorporeal membrane oxygenation (ECMO), depressed cardiac function, …

Time For A New Whole-Person Care Pathway For Chest Pain Admissions, Dana Kajan, Sabbir Mirza, Alexander M. Ruiz, Anthony Degennaro, Mohamad S. Saad

HCA Healthcare Journal of Medicine

Background

Emergency department (ED) visits for chest pain are common and costly, and ED workup often shows no clear cardiac etiology in low-risk patients. Emerging evidence suggests that social determinants of health (SDOH) such as loneliness, social isolation, and food insecurity contribute to cardiovascular outcomes and chest pain presentations.

Methods

We interviewed 114 patients (>18 years) presenting with chest pain and a thrombolysis in myocardial infarction (TIMI) score less than 4 at our community teaching hospital ED. Structured questionnaires assessed the SDOH triad of loneliness, social isolation, and food insecurity. Dependent variables included systolic blood pressure (SBP) at admission, …

Miopati Atrium, Fibrilasi Atrium, Dan Stroke: Mengungkap Hubungan Tersembunyi, Muhammad Yamin, Mohamad Syahrir Azizi, Anneira Amanda Putri

Jurnal Penyakit Dalam Indonesia

Atrial fibrillation (AF) is the most common arrhythmia and has been long recognized as a cause for atrial thrombus formation leading to cardioembolic stroke. However, recent studies reveal that the relationship between atrial fibrillation and stroke is an association rather than a temporal relationship. Left atrial thrombus formation is associated with vascular risk factor, atrial remodeling, and thrombogenesis. Various atrial electrical and structural markers of atrial myopathy have been linked to ischaemic stroke, even in the absence of AF. In addition to the CHA2DS2-VASc score as a consideration for anticoagulant administration, accurate atrial myopathy markers are needed to allow early …

Risk-Based Nurse-Managed Personalized Heart Failure Interventions: The Alleviate-Hf Trial., Javed Butler, Rami Kahwash, Muhammad Shahzeb Khan, David Zhang, Jonathan W Dukes, Madhu Reddy, Anupam Basuray, Elie Gharib, Bart Gerritse, Aimee Laechelt, Jennifer Wehking, Shantanu Sarkar, Brian Van Dorn, Nirav Patel, Verla Laager, Michael R Zile, Alleviate-Hf Investigators

Heart and Vascular Articles

BACKGROUND: Early identification of worsening heart failure (HF) may improve outcomes.

OBJECTIVES: This study aims to assess if insertable cardiac monitor (ICM)-based high-risk detection combined with centrally managed, nurse-facilitated, individually protocolized diuretic interventions is safe and improves HF outcomes.

METHODS: A Reveal LINQ (Medtronic) ICM with an investigational HF risk-status software was implanted in participants with HF who were randomized 1:1 to an intervention arm (high-risk HF alert triggering protocolized diuretic regimen) or an observation arm (standard care). The primary safety endpoint was intervention-related serious adverse events and the primary efficacy endpoint was a 5-component hierarchical composite including cardiovascular death …

Arrhythmia Burden And Clinical Responses Under Continuous Monitoring In Heart Failure: Observations From The Alleviate-Hf Trial., Rami Kahwash, Javed Butler, Muhammad Shahzeb Khan, David Zhang, Jonathan Dukes, Madhu Reddy, Rachel M Kaplan, Anish Amin, Rahul Kanwar, Shantanu Sarkar, Verla Laager, Jennifer Wehking, Brian Van Dorn, Bart Gerritse, Nirav Patel, Aimee Laechelt, Michael R Zile, Alleviate-Hf Investigators

OhioHealth Research Institute Articles

BACKGROUND: Arrhythmia burden in ambulatory patients with symptomatic heart failure (HF) without cardiac implantable electronic devices (CIEDs) is not well defined, and it remains uncertain whether device-guided remote congestion management modifies arrhythmia occurrence.

OBJECTIVES: The goal was to assess whether arrhythmia burden differed between randomized congestion-management strategies and characterize the occurrences and associations of insertable cardiac monitor (ICM)-detected arrhythmias with therapeutic actions and clinical events.

METHODS: In ALLEVIATE-HF, patients with NYHA functional class II-III HF with any ejection fraction (EF) and a recent HF event, without prior CIEDs, underwent ICM implantation and were randomized to ICM-guided, physician-directed, nurse-facilitated congestion management …

Comments On The Letter – Intraoperative Tissue Oxygenation And Postoperative Creatinine Rise: Interpreting The Microcirculatory Context, Bhakti Banerjee, Haripada Das, Lini Srivastava, Snigdha Pramanik, Diptimay Majumder

Journal of the Saudi Heart Association

No abstract for this article type.

Intraoperative Tissue Oxygenation And Postoperative Creatinine Rise: Interpreting The Microcirculatory Context, Bedirhan Buğra Bayıcı,, Fatih Kızılyel

Journal of the Saudi Heart Association

No Abstract for this article type

Patent Ductus Arteriosus Spasm During Percutaneous Device Occlusion In Infants And Children, Hani M. Adel, Ashraf K. Mahmoud

Journal of the Saudi Heart Association

Background: Spasm of ductus arteriosus is an uncommon but significant phenomenon associated with transcatheter patent ductus arteriosus (PDA) occlusion. It can lead to procedural failure, improper device sizing, or even embolization of the occluder device as the spasm subsides post-procedure. Aim of this study is to report the frequency, features, management and outcome of PDA spasm during device closure in a single Egyptian center.

Patients and methods: Over about 3 years, 200 infants and children underwent percutaneous device occlusion. The echocardiographic and catheterization data of patients who developed spasm of PDA before or during or shortly after anesthesia …