Survival after Fontan palliation for single ventricle heart disease has improved substantially, yet the long-term trajectory remains poorly defined. The Fontan Outcomes Network, a learning health network of 38 congenital heart centers in the United States and Canada, was established to address this gap. We report baseline characteristics and early findings from the first 1121 participants enrolled in this prospective clinical registry.

Rare variant genetics have been associated with peripartum cardiomyopathy (PPCM), but the role of genetics remains unsettled. The study sought to compare dilated cardiomyopathy (DCM) genetic risk in first-degree relatives (FDRs) of female patients (probands) with DCM or PPCM to gain causal inference, and to assess DCM-relevant rare variant prevalence in DCM/PPCM probands and population controls.

The Get With the Guidelines-Heart Failure program is a national quality improvement initiative that was established in 2005 with the goal of improving the quality of care for patients hospitalized with heart failure.

Peptides such as angiotensin II and brain natriuretic peptide are pivotal in diagnosing and treating heart failure (HF). However, unbiased systematic studies of the peptidome in patients with HF are lacking. Deciphering the plasma peptidome might significantly improve the diagnosis, prognostication, and treatment of patients with HF.

Mild congenital heart diseases such as atrial septal defect, ventricular septal defect, patent ductus arteriosus, and pulmonary valve stenosis constitute a significant public health problem. Understanding long-term outcomes after interventions for mild congenital heart disease is essential to inform lifelong care.

In patients with obstructive coronary artery disease, early revascularization does not improve outcomes but may reduce angina symptoms. The objective of this study was to examine whether changes in health status outcomes following revascularization are explained by the extent of myocardial perfusion defects and improvement in myocardial perfusion.

Surgical aortic valve (AV) replacement has been the standard treatment for patients with severe symptomatic degenerative AV stenosis (AS). In recent years, transcatheter AV replacement has emerged as an established alternative in selected patient populations, supported by robust evidence in tricuspid AS. However, there has been limited evaluation of transcatheter AV replacement in bicuspid AV AS. Recently, several observational studies have demonstrated the feasibility and safety of transcatheter AV replacement in bicuspid AV AS, and the use of newer-generation devices has shown encouraging outcomes. However, the incidence of procedural complications such as paravalvular regurgitation, permanent pacemaker implantation, and aortic root injury was more frequent in patients with bicuspid AV AS compared with tricuspid AS. We review the clinical evidence of transcatheter AV replacement for bicuspid AV AS and suggest the appropriate criteria for patient and device selection, implantation techniques, and further management.

Premature atrial contractions (PACs) are independently associated with atrial fibrillation, stroke, and heart failure, yet no pharmacological therapy is approved for PAC suppression. Experimental studies have identified a functional cardiac glutamatergic system in which N-methyl-D-aspartate receptors regulate atrial electrophysiology. Preclinical studies show that pharmacological antagonism of N-methyl-D-aspartate receptors with memantine suppresses atrial arrhythmias.

Patients with a transient ischemic attack (TIA) or minor stroke have an increased risk of subsequent stroke that persists for at least 10 years. We aimed to identify prognostic factors associated with long-term risk of stroke in this patient group, and estimate their population attribution fraction (PAF).

Pericarditis spans acute, recurrent/incessant, effusive, and constrictive phenotypes, and accurate assessment of inflammatory activity and chronicity is essential to guide therapy and anticipate outcomes. Although transthoracic echocardiography remains the first-line modality to evaluate pericardial effusion, tamponade physiology, and constrictive hemodynamics, it is limited for tissue characterization. Multimodality imaging integrates complementary strengths: cardiac magnetic resonance provides the most sensitive noninvasive assessment of pericardial edema and late gadolinium enhancement to phenotype active inflammation versus chronic fibrotic disease and to support prognostication (including identification of potentially reversible constriction); cardiac computed tomography offers superior anatomic detail for pericardial thickness, calcification, complex effusions, and preoperative planning for pericardiectomy, and can serve as an alternative when cardiac magnetic resonance is contraindicated; and 18F-fluorodeoxyglucose positron emission tomography/computed tomography adds targeted value by detecting metabolically active pericardial inflammation in diagnostically ambiguous or refractory cases and may inform escalation to advanced therapies. We synthesize practical, guideline-aligned applications of these modalities, highlight common pitfalls and system-level constraints, and propose a simplified framework using key imaging biomarkers edema/inflammation, neovascularization (late gadolinium enhancement), thickening, effusion/tamponade, constriction, and fibrosis/calcification to enable imaging-guided therapy, including treatment escalation and tapering strategies in recurrent disease and selection of patients for pericardiectomy.

Clopidogrel may have ischemic benefit over aspirin as long-term monotherapy in patients receiving percutaneous coronary intervention.