Background Beta thalassaemia, an inherited blood disorder, exhibits a broad range of phenotypes from asymptomatic to severe anaemia. Pulmonary hypertension (PH) is a major complication in thalassaemia patients, significantly impacting morbidity and mortality. This study aimed to assess the clinical condition of thalassaemia patients with PH over the course of one year while receiving treatment in accordance with the guidelines of the European Society of Cardiology (ESC). Methods A prospective cohort study was carried out at Rohani Hospital in Iran from May 2020 to May 2021. The study included patients diagnosed with beta thalassaemia intermedia who also had PH confirmed by echocardiography. Treatment was administered according to ESC guidelines, incorporating vasodilators and other supportive medications. Clinical and laboratory data were gathered, and statistical analyses were conducted. Results Nineteen patients, with a mean age of 42.57 ± 8.62 years, participated in the study. Treatment resulted in notable improvements in the 6-minute walk test (6MWT) (p < 0.001), reduced proBNP levels (p = 0.016), and a lower E/e’ ratio (p = 0.01), suggesting enhanced right ventricular (RV) function. However, there were no significant changes in pulmonary artery pressure (PAP) or RV size. Additionally, repeated blood transfusions were linked to RV dysfunction. Conclusions Repeated blood transfusions correlate with RV dysfunction in thalassaemia patients with PH. Vasodilatory treatment improves 6MWT, proBNP levels, and E/e’ ratio, indicating RV function enhancement. This study underscores the importance of comprehensive management strategies for thalassaemia patients with PH to mitigate associated complications and improve outcomes.

Background The predictive role of right ventricular dysfunction (RVD) in patients with functional mitral regurgitation (FMR) undergoing transcatheter edge-to-edge repair (TEER), as well as RV remodelling following the procedure, remains uncertain. We evaluated the prognostic impact of pre-procedural three-dimensional (3D) right ventricular ejection fraction (RVEF) in patients with FMR. Additionally, we assessed the RV reverse remodelling (RVRR) based on 3D volumes and ejection fraction six months after the procedure. Methods Data from 74 patients treated with TEER for FMR were prospectively collected. Pre-procedural RVD, defined as 3D RVEF ≤45%, was observed in 47 patients (63.5%). Patients were divided into three groups according to pre-procedural 3D-RVEF: no RVD (No-RVD, RVEF >45%, n = 27), mild-to-moderate RVD (MRVD, RVEF 31-45%, n = 36), and severe RVD (SRVD, RVEF ≤30%, n = 11). Results Patients with SRVD demonstrated a significant higher rate of all-cause mortality compared with the other two groups (p = 0.04) and RVEF ≤ 30% was associated with all-cause death, independently of left ventricular ejection fraction (LVEF) and left atrial volume index (LAVi) (HR: 3.72, 95% CI 1.12–12.30, p = 0.03). At 6-month follow-up, only patients with pre-procedural MRVD showed a significant reduction in 3D RV volumes and an improvement in RVEF compared to baseline (p < 0.05). Conclusions RVD was common among patients undergoing mitral TEER for FMR. Those with pre-procedural SRVD had worse mid-term survival compared to patients with MRVD and No-RVD. The group with MRVD was the only one to demonstrate an RVRR six months after the procedure.

Background This study aimed to evaluate the predictive value of the triglyceride-glucose (TyG) index in combination with inflammatory markers—systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and high-sensitivity C-reactive protein (hsCRP)—for the severity of coronary artery disease (CAD) and the incidence of major adverse cardiovascular events (MACEs) following percutaneous coronary intervention (PCI). Methods A retrospective cohort study was conducted with 759 acute coronary syndrome (ACS) patients who underwent PCI from September 2022 to December 2023. The primary outcome was the occurrence of MACEs within one year, defined as a composite of all-cause death, myocardial infarction, stroke, and angina. TyG index was calculated at admission, and multivariable regression models were used to explore the associations between TyG, inflammatory markers, and coronary lesion severity. Cox proportional hazards models evaluated the predictive ability for MACEs. Results Compared with non-MACEs patients, the MACEs group had significantly elevated hsCRP, NLR, and SII levels, and a higher TyG index (8.8 vs. 8.9, p = 0.007). The interaction between TyG and hsCRP remained an independent predictor of MACEs (HR = 1.014, p < 0.001). ROC analysis showed the highest predictive accuracy for MACEs with the TyG-hsCRP combination (AUC = 0.708). Conclusion The TyG index–inflammation composite is an independent and effective predictor of post-PCI MACEs and may aid in refining current cardiovascular risk prediction models.

Background and aims Loop diuretic maintenance therapy has been associated with worse clinical outcomes in heart failure (HF) patients. Despite this, recent HF trials report high prescription rates. Optimal guideline-directed medical therapy (GDMT) may reduce need for loop diuretics and improve long-term outcomes. This study evaluated loop diuretic and GDMT prescription patterns in a HF clinic of a Belgian tertiary hospital cohort and compared findings to recent HF trials. Methods This prospective registry included consecutive HF patients with a left ventricular ejection fraction (LVEF) ≤50% from the HF outpatient clinic starting from 23 November 2023 to 22 May 2024 up to the inclusion of 1000 patients. Data on baseline characteristics, medications, echocardiography and laboratory were extracted from electronical health records. Results Among the included patients, 543 (54.3%) had HF with reduced ejection fraction. Median age was 72 (63–80) years, with a median LVEF of 45% (35–45). Most were male (72.6%), with serum creatinine of 1.15 (0.93–1.45) mg/dL and eGFR of 60 (43–77) mL/min/1.73 m2. Hypertension (56%), atrial fibrillation (47%), and coronary revascularisation (53%) were common comorbidities. GDMT prescription rates were high, with 68.7% on triple or quadruple therapy, while only 27% received loop diuretics. Baseline characteristics and GDMT prescription rates were comparable to recent registries and trials, but loop diuretic prescriptions were significantly lower in the current cohort. Conclusions This study highlights progress in HF management but emphasises the need for a patient-centred approach in a HF clinic which enables optimisation of care, allows addressing comorbidities, and reduction in loop diuretic dependence.

Background This study aimed to evaluate the accuracy and readability of ChatGPT-4 responses related to cardiac rehabilitation (CR) for patients with heart failure (HF), with the objective of assessing its potential as a patient education tool. Methods The study involved 16 open-ended questions related to CR, developed by two specialists (one cardiologist and one physical medicine and rehabilitation specialist). These questions were submitted to ChatGPT-4, and its responses were evaluated for accuracy and readability. Accuracy was assessed using a 6-point Likert scale, while readability was analysed using the Flesch Reading Ease (FRE), Flesch-Kincaid Grade Level (FKGL), Coleman-Liau Index (CLI), and Gunning Fog Index (GFI). Inter-evaluator reliability was assessed by the intraclass correlation coefficient (ICC). Results The mean accuracy score of ChatGPT-4 responses was high (5.25 ± 0.77 and 5.38 ± 0.62 for two raters), with 81.25% of responses rated 5 or above. The readability analysis revealed a median FRE of 59.5, indicating moderate readability, with FKGL at 7.1 and CLI at 11.2. The ICC between the two evaluators was 0.854, indicating good agreement. Conclusion ChatGPT-4 provided accurate and reliable information on CR for HF patients. Although the readability was slightly above the ideal level, its overall performance suggests potential as a supportive tool in patient education. Further improvements in language simplicity are needed to optimise its usability.