Introduction: Percutaneous IntraMyocardial Septal Radiofrequency Ablation (PIMSRA, Liwen procedure) is a novel septal reduction therapy (SRT) for drug-refractory hypertrophic obstructive cardiomyopathy (HOCM) patients. Due to the lack of SRT risk tools, EuroSCORE-II, STS-PROM, and HCM Risk-SCD have been considered as potential alternatives for risk assessment prior to SRT. We aim to evaluate the predictive value of these models for short-term adverse events in HOCM patients undergoing PIMSRA. Methods: A total of 571 HOCM patients treated with PIMSRA in Xijing Hospital from October 2016 to June 2024 were retrospectively enrolled and their risk scores were calculated. The primary outcome was the 30-day incidence of major adverse cardiovascular events (MACEs), including a composite of all-cause death, cardiac tamponade, arrhythmic events, cardiogenic shock, and stroke. Results: During the 30-day follow-up, 61 (10.7%) patients experienced MACE. Multivariate analysis revealed that EuroSCORE-II (OR = 2.30), STS-PROM (OR = 1.18), history of syncope, and peak left ventricular outflow tract (LVOT) gradient were independently associated with MACE risk after PIMSRA. The area under the receiver operating-characteristic curve values were 0.657 (95% CI: 0.581–0.733) for EuroSCORE-II, 0.623 (95% CI: 0.551–0.696) for STS-PROM, and 0.550 (95% CI: 0.469–0.631) for HCM Risk-SCD. Calibration metrics for three models were favorable because of the low incidence of MACE. DCA showed limited benefit to using any score. Conclusion: EuroSCORE-II, STS-PROM, history of syncope, and peak LVOT gradient were independently associated with increased risk of 30-day MACE following PIMSRA. Developing SRT-specific risk prediction models is essential for optimizing SRT risk assessment.

Introduction: Molecular genetic testing is increasingly offered to patients with dilated cardiomyopathy (DCM). The diagnosis of an inherited cardiomyopathy has major implications for medical care of patients and relatives. We report the results of a genotype-phenotype analysis of DCM investigated in Austria. Methods: Overall, 194 patients with DCM underwent genetic testing over a period of 6 years. We analyzed the clinical and genetic characteristics of 105 DCM patients who showed a genetic variant and compared the genetic findings and outcome measures of patients with myocardial inflammation on endomyocardial biopsy and those without. Results: In 51.4% (54/105) patients, at least one likely pathogenic or pathogenic genetic variant (LP/P) was detected. Fifty one of 105 patients (48.6%) showed only variants of unknown significance (VUSs). Most LP/P variants (34.3%) were detected in the TTN gene. Clinical characteristics of the most prevalent genetic subgroups (TTN, LMNA, MYH7, MYH6, DMD, SCN5A) were not significantly different. DCM patients with inflammation had significantly higher frequency of memory of infection, left bundle branch block, mitral valve insufficiency but normal CK-MB levels. We added a case report where two family members initially were considered to have an inflammatory cardiomyopathy before a pathogenic variant in LMNA was found. Conclusion: Cardiac features of DCM were not predictive of a specific genetic subgroup. We recommend applying multigene panels extensively since a large proportion of patients without a family history or with evidence of myocardial inflammation showed a genetic predisposition for DCM. However, the large number of VUS remains a challenge.

Introduction: Cervical cancer ranks first for cancer-related deaths among women. Having metastasis to the heart from the cervical cancer holds a poor prognosis with average survival being under 6 months. This metastasis is an understudied phenomenon. For this crossroad of gynecological oncology and cardio-oncology, this scoping review maps the available evidence on cervical cancer with cardiac metastasis to better understand how, when, where cervical cancer spreads in the heart and what can be done with current diagnostic and treatment modalities. Methods: A scoping review was conducted in accordance with PRISMA-ScR guidelines with 41 case reports published between 1965 and 2025 globally were included through systematic search using PubMed and Google Scholar. Data on histologic subtype, time of metastasis, clinical symptoms, echocardiogram findings, and treatment modalities and outcomes were extracted and studied. Results: The women aged between 40 and 60 years. Squamous cell carcinoma was the most common subtype of cervical cancer. Cardiac metastasis primarily involved the right ventricle followed by the right atrium, interventricular septum and pericardium. Asymptomatic presentations delayed clinical recognition of metastasis while symptomatic findings led to a misdiagnosis. Echocardiography, MRI, and PET-CT played important diagnostic roles. Treatments included chemotherapy, radiotherapy, immunotherapy, and surgical excision; however, after intervention, prognosis remained poor, with death in most cases within 6–9 months. Conclusion: This review emphasizes the need for heightened clinical suspicion of cardiac metastasis in patients with advanced or recurrent cervical cancer presenting with cardiac symptoms. Timely detection and treatment may improve clinical outcomes in patients.

Plain Language SummaryAs people age, they are more likely to develop multiple long-term health problems such as heart disease, stroke, high blood pressure, and diabetes. When someone has two or more of these conditions at the same time, it is called cardiometabolic multimorbidity (CMM). Identifying people who are at higher risk of developing CMM early on can help prevent these diseases and improve quality of life. This study looked at a simple measure called the lipid accumulation product (LAP), which combines a person’s waist size and blood fat levels (specifically, triglycerides). LAP is thought to be a good indicator of harmful belly fat, which is closely linked to heart and metabolic diseases. We used data from a long-term study of over 3,000 adults in England aged 50 years and older. At the beginning of the study, none of the participants had CMM. We followed them for up to 15 years to see who developed two or more conditions like heart disease, stroke, high blood pressure, or diabetes. We found that people with higher LAP scores were more likely to develop CMM. This link remained even after accounting for other known risk factors like age, smoking, blood pressure, cholesterol levels, physical activity, and muscle strength. We also found that adding LAP to existing risk assessment tools slightly improved our ability to predict who would go on to develop CMM. Our findings suggest that LAP may be a helpful, low-cost tool for identifying older adults at risk for multiple long-term health conditions.

Introduction: Vericiguat has been shown to improve clinical outcomes in patients with heart failure (HF) with reduced ejection fraction in several randomized controlled trials. However, there is limited real-world evidence regarding its effectiveness in clinical practice outside of the controlled research setting. Methods: Patients hospitalized due to symptomatic HF between January 1 and December 30, 2023, were consecutively enrolled and divided into the vericiguat group and the control group. A total of 207 patients with left ventricular ejection fraction <45% were enrolled. Results: Patients in the control group had a higher incidence of clinical endpoints than the vericiguat group: cardiac mortality and hospitalization for symptomatic HF during the median follow-up duration of 11.25 months. Patients in the vericiguat group demonstrated a higher event-free survival rate for both cardiac mortality and hospitalization for HF. In the univariable Cox regression analysis, vericiguat was found to be associated with a reduced risk of cardiac mortality (hazard ratio [HR]: 0.299, 95% confidence interval [CI]: 0.104–0.863, p = 0.026) and hospitalization for HF (HR: 0.586, 95% CI: 0.348–0.988, p = 0.045). After propensity score matching for age and sex, we observed that vericiguat’s benefit on cardiac mortality was maintained. Conclusion: This prospective study is the first to report, using real-world data from a Chinese population with ventricular ejection fraction <45%, that vericiguat is associated with a lower incidence of clinical endpoints, including cardiac mortality and hospitalization for HF. These findings align with the results of previous clinical trials.

Introduction: Transition of care (ToC) is a critical time that requires effective management, especially for patients with cardiovascular disease, who have complex health needs. Pharmacists can play an integral role in improving medication safety and care coordination at ToC. This review determined the types of pharmacist-led multidisciplinary ToC services and associated outcomes in patients with cardiovascular disease. Methods: A systematic literature search of four databases: PubMed, Embase, CINAHL, and Scopus, was undertaken from inception until June 2023. s and full text were screened against eligibility criteria. Extracted data included study characteristics, ToC service descriptions, primary and secondary outcomes, limitations, and key findings. Study findings were synthesised narratively. The types of in-patient and post-discharge activities and their effect on patient outcomes were critiqued and presented. Results: Of the 1,822 studies identified, 37 were included in the final review. The most common primary outcome reported was 30-day all-cause readmissions (n = 14). Pharmacist-led ToC services incorporated a diverse combination of in-patient and post-discharge activities. The most common in-patient activities were medication history and reconciliation, patient medication education, and medication review and optimisation. The most common post-discharge activities were medication review and optimisation, adherence assessments, and medication education. Multifaceted ToC services that involved both in-patient and post-discharge activities demonstrated statistically significant changes in readmission rates and other patient-reported outcomes. Conclusion: A variety of multifaced approaches to pharmacist-led ToC services have been evaluated within many studies, reporting favourable effects on outcomes for patients with cardiovascular disease. Tailoring ToC services to specific patient populations and settings, targeting activities to high-risk patients, and a multidisciplinary approach, are important to optimise ToC and patient outcomes.

Introduction: Rheumatic heart disease (RHD) is a globally important public health issue. China, as a populous country, has daunting challenges posed by RHD-related morbidity and mortality in the public health system. Evaluating and comparing the differences in the RHD burden of children and adolescents versus adults in China not only helps optimize domestic prevention and control strategies but also provides a reference for regional practices in RHD control. Methods: Open data from the 2021 Global Burden of Disease database were utilized to analyze the characteristics of the RHD burden of children, adolescents, and adults in China, including changes in morbidity and mortality. Joinpoint was utilized to calculate the average annual percentage change (AAPC). A comprehensive comparative analysis was undertaken on the differences in RHD burden in Chinese children, adolescents, and adults from multiple dimensions such as age, gender, and time. Results: From 1990 to 2021, the number of deaths of RHD in children and adolescents in China exhibited a declining trend compared to that in adults. In terms of the number of incidences, all age groups showed a declining trend except for those aged 55 and above, which manifested an upward trend. The crude incidence and crude mortality rates both declined during the same period, with their AAPC being −0.53 (95% CI: −0.61, −0.46) and −8.13 (95% CI: −8.65, −7.61) for those aged under 20 years, and −1.92 (95% CI: −2.05, −1.80) and −2.98 (95% CI: −3.18, −2.79) for those aged 20 years and above. The incidence and mortality rates had a bearing on patient age, with higher incidence rates observed in children and adolescents and higher mortality rates observed in adults. According to the analysis of gender differences, the incidence of children and adolescents was higher in men, while women always had a higher crude incidence rate (CIR) and mortality rate (CDR) than men (CIR in 2021: 21.31/100,000 for women vs. 20.08/100,000 for men; CDR: 0.05/100,000 for women vs. 0.06/100,000 for men). The mortality rate of adult women was particularly prominent. The number of cases in children and adolescents exhibited a “W-shaped” fluctuation, while the adult group showed an “M-shaped” trend. The overall CIR and CDR both exhibited a downward trend. Conclusion: The burden of RHD is linked to age and gender, with a high incidence in young people and a high mortality rate in adults. Women are more prone to develop the disease and have a higher risk of mortality. Given China’s large and aging population, RHD remains a major public health challenge in China. Effective prevention and control strategies should be underscored.

Introduction: Myocardial infarction (MI) is one of the leading causes of death from cardiovascular diseases (CVDs). Despite various drugs and treatments, the outcomes have often been unsatisfactory. The purpose of this meta-analysis aimed to analyze the effects of polypill intervention on the incidence of MI and the related risk factors, blood pressure, and blood lipids. Methods: We conducted a systematic search of appropriate randomized controlled trials (RCTs) in various databases, utilizing preset search terms. Then, we performed a meta-analysis of individual participant data, including studies that investigated the effectiveness of polypill (a fixed-dose combination drug) as compared to usual care in preventing MI. The primary outcomes are MI, CVD mortality, major adverse cardiovascular event (MACE), and all-cause mortality. Secondary outcomes include blood pressure levels (systolic blood pressure [SBP], diastolic blood pressure [DBP]), serum lipid levels (total cholesterol [TC], low-density lipoprotein cholesterol [LDL], and high-density lipoprotein cholesterol [HDL]). Results: A total of 14 trials (N = 59,346) were included, with a mean age of 63.2 ± 10.0 years. The results showed that compared to the usual care group, polypill group was associated with a significant reduction of the incidence of MI (OR = 0.76; 95% CI: 0.59 to 0.99; p = 0.04) and MACE (OR = 0.79; 95% CI: 0.65 to 0.97; p = 0.03). The risk reduction for CVD mortality (OR = 0.85; 95% CI: 0.65 to 1.11; p = 0.20) and all-cause mortality (OR = 0.99; 95% CI: 0.95 to 1.03; p = 0.59) did not reach statistical significance contrast with the usual care group. Participants who were in polypill group was observed that the change of SBP level (SMD = −0.13; 95% CI: −0.25 to 0.00; p = 0.04), DBP level (SMD = −0.13; 95% CI: −0.19 to −0.06; p = 0.00), and LDL level (SMD = −0.21; 95% CI: −0.36 to −0.06; p = 0.01) reached statistical significance. However, the change of HDL level (SMD = −0.01; 95% CI: −0.06 to 0.04; p = 0.62) and TC level (SMD = −0.15; 95% CI: −0.32 to 0.01; p = 0.06) did not show remarkable difference. Conclusion: These findings suggested that polypill not only is highly effective for preventing MI and reducing the incidence of MACE but also can lower blood pressure levels and blood lipid levels.