Prognostic Value of New Proposed Criteria for Atrial Cardiomyopathy in Patients With Heart Failure.

Undetected Heart Failure in Cardiology: Prevalence, Characteristics, and Outcome.

Prevalent and incident heart failure hospitalization in patients with significant tricuspid regurgitation: insights from a competing risk analysis.

INTRODUCTION AND OBJECTIVES Tricuspid regurgitation (TR) is closely linked to heart failure (HF). However, the burden and predictors of HF hospitalization at diagnosis and during follow-up have not been fully characterized, particularly after accounting for the competing risk of death. METHODS We conducted a retrospective multicenter cohort study including 757 patients with significant TR. Prevalent HF was defined as HF hospitalization at the time of diagnosis. Among patients without prevalent HF, the cumulative incidence of first HF hospitalization was assessed using competing risk analysis, with all-cause mortality treated as a competing event. Multivariable models were used to identify independent predictors. RESULTS At diagnosis, 260 patients (34.4%) were hospitalized for HF. Male sex, right-sided HF, left ventricular systolic dysfunction, and TR etiologies related to ventricular dysfunction or pulmonary hypertension were independently associated with prevalent HF. Among patients without prevalent HF (n = 497), the cumulative incidence of HF hospitalization was 16.4% at 1 year and 44.3% at 7 years. Independent predictors of incident HF included prior HF hospitalization (sHR, 2.08; 95%CI, 1.50-2.87), NYHA functional class III-IV (sHR, 1.70; 95%CI, 1.24-2.35), and higher pulmonary artery systolic pressure (sHR, 1.01; 95%CI, 1.00-1.02). Tricuspid valve surgery was associated with a lower risk of HF hospitalization (sHR, 0.56; 95%CI, 0.33-0.96). CONCLUSIONS HF hospitalization is common in patients with significant TR, both at diagnosis and during follow-up. HF hospitalization at the time of diagnosis identifies an advanced clinical phenotype, while incident hospitalization remains frequent after accounting for the competing risk of death.

Atrial fibrillation in patients with left ventricular non-compaction: incidence and associations with stroke, heart failure, and mortality.

AIMS Left ventricular non-compaction (LVNC) is a genetic cardiomyopathy with presentations ranging from asymptomatic disease to heart failure, stroke, and sudden cardiac death. LVNC-related structural and functional abnormalities may increase atrial fibrillation (AF) risk, but data are limited. We assessed AF incidence in LVNC and compared outcomes in patients with versus without AF. METHODS AND RESULTS Two cohorts of patients were identified using the TriNetX platform: (i) patients with LVNC without a prior history of AF or stroke; and (ii) patients with LVNC and AF without a prior history of stroke. The primary objective was to assess the 3-year risk of a composite of all-cause mortality, stroke, acute myocardial infarction, and heart failure in the two cohorts. Hazard ratios (HRs) were derived from univariable cox proportional models before and after propensity score matching (PSM). Matching was conducted using a greedy nearest-neighbour approach with a caliper of 0.1.Patients with LVNC and AF (N=29,356) were older and exhibited a higher burden of comorbidities compared with LVNC patients without AF (N=39,339). In this observational analysis, after PSM, AF in patients with LVNC was associated with higher risks of stroke (HR 1.466, 95% CI 1.359-1.581), new-onset heart failure (HR 1.439, 95% CI 1.358-1.526), all-cause death (HR 1.255, 95% CI 1.200-1.312), and the composite outcome (HR 1.301, 95% CI 1.269-1.334) compared with LVNC patients without AF. The 1-year incidence of AF in patients with LVNC was 36 per 1000 person-years. CONCLUSION In this observational cohort, LVNC was associated with a high incidence of AF, and the presence of AF was associated with higher risks of stroke, heart failure, and all-cause death. Further prospective studies are warranted to assess the prognostic impact of AF in patients with LVNC.

Analysis of accuracy of risk assessment tools for predicting new-onset atrial fibrillation in ST-elevation myocardial nfarction with percutaneous coronaty intervention (a systematic review)

The occurrence of NOAF was associated with increased in-hospital mortality, which was 2–3 times higher in patients with arrhythmia, and most NOAF prediction models developed specifically in STEMI cohorts undergoing PCI demonstrated higher discriminative ability.

Impact of Catheter Ablation on LVEF in Patients with Atrial Fibrillation and Heart Failure with Reduced Ejection Fraction: A Systematic Review

Abstract Atrial fibrillation (AF) is a condition that frequently affects patients with heart failure with reduced ejection fraction (HFrEF) and is associated with worsening left ventricular ejection fraction (LVEF) and unfavorable clinical outcomes. Catheter ablation has been proposed as a strategy to restore sinus rhythm; however, its effects on LVEF remain heterogeneous in the literature. To evaluate the impact of catheter ablation, compared with medical therapy, on LVEF in patients with AF and HFrEF. A systematic review of randomized clinical trials was conducted in accordance with the PRISMA guidelines. The primary outcome was improvement in LVEF, while secondary outcomes included cardiovascular mortality, all-cause mortality, and hospitalizations due to heart failure. Other exploratory outcomes were also considered. The included randomized clinical trials demonstrated improvement in LVEF among patients undergoing catheter ablation compared with those receiving medical therapy. In the CAMERA-MRI study, an absolute increase of 18.3% in LVEF was observed after six months. In the CASTLE-AF trial, catheter ablation was also associated with a lower incidence of cardiovascular mortality and heart failure hospitalizations. In the absence of a meta-analysis, no quantitative synthesis of the effects was performed. The available evidence from individual randomized trials suggests that catheter ablation may be associated with improvement in LVEF and more favorable clinical outcomes in patients with AF and HFrEF. However, given the lack of quantitative synthesis, these findings should be interpreted with caution.

Clinical, laboratory and echocardiographic features of patients with ST-elevation myocardial infarction complicated by ventricular arrhythmias: an observational study

Background: Early malignant ventricular arrhythmias (VAs) during ST-elevation myocardial infarction (STEMI) significantly contribute to in-hospital mortality but appear to have little impact on long-term prognosis, likely because the arrhythmic substrate is reversed after revascularization. Methods: The study included 91 patients with STEMI who were admitted to the Grodno State Cardiological Center for treatment between February 2024 and February 2025. Group 1 included 64 patients with STEMI, whereas Group 2 included 29 patients with STEMI and ventricular arrhythmias (sustained VT or VF). All patients underwent clinical, laboratory, and instrumental examinations, including coronary angiography. Statistical analyses were performed using STATISTICA 12.0 software. Results: Among 29 patients with VAs, six had ventricular fibrillation treated with electrical cardioversion, three had sustained VT, and 20 had episodes of non-sustained VT. According to the results of coronary angiography, 24 patients had undergone percutaneous coronary intervention, and five patients had stenosis of the left main coronary artery; therefore, they underwent coronary artery bypass graft operation. Patients with STEMI and ventricular tachyarrhythmias were characterized by a higher prevalence of inferior localization of MI (p=0.001), higher WBCs counts (0.008), higher glucose levels (p=0.008), higher troponin levels (p=0.004), lower left ventricular ejection fraction in both M- and B-modes (p=0.001), and higher contractility index (p=0.001). Conclusions: These results demonstrates that inflammatory markers, myocardial injury, compromised ventricular function, and metabolic disruptions depict that the pathophysiology of arrhythmias in STEMI patients, highlighting the significance of early observation and timely treatment program to decrease the arrhythmic risk.