The HOMAGE randomised trial found that spironolactone reduced left atrial volume index (LAVI), E:A ratio, and a marker of collagen type I synthesis (PICP) in patients at risk of heart failure (HF). Previous trials showed that patients with HF, preserved ejection fraction and low serum collagen type I C-terminal telopeptide to matrix metalloproteinase-1 (CITP:MMP-1) ratio, associated with high collagen

Much has changed in the decade since the 2012 Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease was published. There has been substantial advances in technology, a growing evidence base around diagnostic testing, and more emphasis placed on patient-centered care. The natural history of patients with stable coronary artery disease has also been better clarified

Background:A proportion of patients with embolic stroke of undetermined source have silent atrial fibrillation (AF) or develop AF after the initial evaluation. Better understanding of the risk for development of AF is critical to implement optimal monitoring strategies with the goal of preventing recurrent stroke attributable to underlying AF. The RE-SPECT ESUS trial (Randomized, Double-Blind Evaluation

Background:Chronic kidney disease is associated with adverse outcomes among patients with established cardiovascular disease (CVD) or diabetes. Commonly used medications to treat CVD are less effective among patients with reduced kidney function.Methods:REDUCE-IT (Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention Trial) was a multicenter, double-blind, placebo-controlled trial that

Background:Loss of dystrophin protein causes Duchenne muscular dystrophy (DMD), characterized by progressive degeneration of cardiac and skeletal muscles, and mortality in adolescence or young adulthood. Although cardiac failure has risen as the leading cause of mortality in patients with DMD, effective therapeutic interventions remain underdeveloped, in part, because of the lack of a suitable preclinical

Background:Hutchinson-Gilford progeria syndrome (HGPS) is a rare disorder characterized by premature aging and death mainly because of myocardial infarction, stroke, or heart failure. The disease is provoked by progerin, a variant of lamin A expressed in most differentiated cells. Patients look healthy at birth, and symptoms typically emerge in the first or second year of life. Assessing the reversibility

Nicotinamide adenine dinucleotide (NAD+) is a central metabolite involved in energy and redox homeostasis as well as in DNA repair and protein deacetylation reactions. Pharmacological or genetic inhibition of NAD+-degrading enzymes, external supplementation of NAD+ precursors, and transgenic overexpression of NAD+-generating enzymes have wide positive effects on metabolic health and age-associated

A 51-year-old man was admitted to the hospital with palpitation that had been occurring for 3 years. He described each episode as presenting with “sudden onset and termination” that lasted for several minutes and alleviated spontaneously. His admission echocardiography was normal. ECG indicated supraventricular tachycardia with complete left bundle-branch block (LBBB). He received intravenous verapamil

Aim:This executive summary of the clinical practice guideline for the evaluation and diagnosis of chest pain provides recommendations and algorithms for clinicians to assess and diagnose chest pain in adult patients.Methods:A comprehensive literature search was conducted from November 11, 2017, to May 1, 2020, encompassing studies, reviews, and other evidence conducted on human subjects that were published

Aim:This clinical practice guideline for the evaluation and diagnosis of chest pain provides recommendations and algorithms for clinicians to assess and diagnose chest pain in adult patients.Methods:A comprehensive literature search was conducted from November 11, 2017, to May 1, 2020, encompassing randomized and nonrandomized trials, observational studies, registries, reviews, and other evidence conducted

In the article by Gulati et al, “2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines,” which published ahead of print on October 28, 2021, and appeared in the November 30, 2021, issue of the journal (Circulation. 2021;144:e•••–e•••. doi:

In the article by Alexander et al, “Chest Pain Redux: Updated and Patient Centered,” which published online on October 28, 2021, and appears in the November 30, 2021, issue of the journal (Circulation.2021;144:1735–1737. DOI: 10.1161/CIRCULATIONAHA.121.056714), a correction is needed. The authors regret that the sentence “Some new technologies included for the first time in these GLs include PET (Class

Remote monitoring of pulmonary artery (PA) pressure has reduced heart failure (HF) hospitalizations in chronic HF as elevation of PA pressure provides information that can guide treatment. The venous system is characterized by high capacitance, thus substantial increases in intravascular volume can occur before filling pressures increase. The inferior vena cava (IVC) is a highly compliant venous conduit

Radoslaw Sierpinski, Krystian Josiak, Tomasz Suchocki, KatarzynaWojtas-Polc, Grzegorz Mazur, Aleksandra Butrym, Piotr Rozentryt, Peter van der Meer, Josep Comin-Colet, Stephan von Haehling, Wojciech Kosmala, Monika Przewlocka-Kosmala, Waldemar Banasiak, Jolanta Nowak, Adriaan A. Voors, Stefan D. Anker, John G.F. Cleland, Piotr Ponikowski, and Ewa A. Jankowska. The affilaition of the author Stephan

Tricuspid repair during mitral valve surgery slowed the progression of tricuspid regurgitation, but did not reduce mortality in patients with mild-to-moderate tricuspid regurgitation.

In the phase II AXIOMATIC-TKR trial, the oral, selective factor XIa inhibitor milvexian provided dose-dependent protection against venous thromboembolism in patients undergoing knee arthroplasty.

According to data from the GOAL trial, when latent rheumatic heart disease (RHD) is detected by echocardiographic screening, secondary prophylaxis with antibiotics is effective in preventing progression of the disease.

Importance In the Rehabilitation Therapy in Older Acute Heart Failure Patients (REHAB-HF) trial, a novel 12-week rehabilitation intervention demonstrated significant improvements in validated measures of physical function, quality of life, and depression, but no significant reductions in rehospitalizations or mortality compared with a control condition during the 6-month follow up. The economic implications

Importance Spontaneous coronary artery dissection (SCAD) has been associated with fibromuscular dysplasia (FMD) and other extracoronary arterial abnormalities. However, the prevalence, severity, and clinical relevance of these abnormalities remain unclear. Objective To assess the prevalence and spectrum of FMD and other extracoronary arterial abnormalities in patients with SCAD vs controls. Design

Importance Despite lower baseline fitness levels, women in cardiac rehabilitation (CR) do not typically improve peak aerobic exercise capacity (defined as peak oxygen uptake [peak Vo2]) compared with men in CR. Objective To evaluate the effect of high-intensity interval training (HIIT) and intensive lower extremity resistance training (RT) compared with standard moderate intensity continuous training

The comparison of the outcomes of different surgical techniques is the foundation of progress in cardiac surgery. Still, estimating treatment effects is a complex methodological challenge. Randomized trials have low risk of bias but limited external validity. On the other hand, observational studies have a higher risk of bias and confounders but are more representative of clinical practice. While in

As the number and price of novel medical treatments accelerate, there is heightened interest in determining their value. A price typically reflects a manufacturer’s estimate of society’s willingness to pay for their product. Treatments that improve survival appropriately command higher prices, although the correlation is not close, as noted by recent prices of proprotein convertase subtilisin/kexin

In the Original Investigation titled “Effect of a Self-care Intervention on 90-Day Outcomes in Patients With Acute Heart Failure Discharged From the Emergency Department: A Randomized Clinical Trial,”1 published in the February 2021 issue, an affiliation was omitted. A second affiliation for Sean P. Collins, MD, MSc, and Jin H. Han, MD, should have been given as “Geriatric Research, Education, and

Whereas the combination of anaemia and chronic kidney disease (CKD) has been extensively studied in patients with heart failure (HF), the contribution of iron deficiency (ID) to this dysfunctional interplay is unknown; we aimed to assess clinical associates and pathophysiological pathways related to ID in this multimorbid syndrome.

To evaluate the performance of the WATCH-DM risk score, a clinical risk score for heart failure (HF), in patients with dysglycaemia and in combination with natriuretic peptides (NPs).

Posterior left pericardiotomy at the time of surgery reduces the incidence of postoperative atrial fibrillation in patients undergoing surgery on the coronary arteries, aortic valve or ascending aorta, or a combination of these operations, with no additional risk of postoperative complications, according to results from the PALACS trial.

Early surgical aortic valve replacement in asymptomatic patients with severe aortic stenosis reduces the risk of all-cause death, acute myocardial infarction, stroke or unplanned hospitalization for heart failure compared with conservative care and surgical aortic valve replacement only after symptom onset, according to findings from the AVATAR trial.

Large differences in cardiovascular disease (CVD) morbidity and mortality exist between migrant populations and host populations. Understanding the drivers behind these disparities may help to mitigate the unequal burden of CVD and identify new causal pathways that contribute to CVD risk in the population at large.

Background: The sarcoplasmic reticulum (SR) Ca2+-ATPase 2 (SERCA2) mediates a2+-reuptake into SR and thereby promotes cardiomyocyte relaxation, whereas the ryanodine receptor (RYR) mediates a2+-release from SR and triggers contraction. a2+/calmodulin (CaM)-dependent protein kinase II (CaMKII) regulates activities of SERCA2 through phosphorylation of phospholamban (PLN) and RYR through direct phosphorylation

Background: Mutations in genes encoding sarcomeric proteins lead to failures in sarcomere assembly, the building blocks of contracting muscles, resulting in cardiomyopathies that are a leading cause of morbidity and mortality worldwide. Splicing variants of sarcomeric proteins are crucial at different stages of myofibrillogenesis, accounting for sarcomeric structural integrity. RNA-binding motif protein

Background: Plasma proteins are critical mediators of cardiovascular processes and are the targets of many drugs. Previous efforts to characterize the genetic architecture of the plasma proteome have been limited by a focus on individuals of European descent and leveraged genotyping arrays and imputation. Here we describe whole genome sequence analysis of the plasma proteome in individuals with greater

Background: Various non-invasive intermittent rhythm monitoring strategies have been used to assess arrhythmia recurrences in trials of atrial fibrillation (AF) ablation. We determined whether a frequency and duration of non-invasive rhythm monitoring could be identified that accurately detects arrhythmia recurrences and approximates the AF burden derived from continuous monitoring using an implantable

Background: Smaller randomized studies have reported conflicting results regarding the optimal electrode position for cardioverting atrial fibrillation. However, anterior-posterior electrode position is widely used as a standard and believed to be superior to anterior-lateral electrode position. Therefore, we aimed to compare anterior-lateral and anterior-posterior electrode position for cardioverting