Circulating microRNAs are promising biomarkers of acute cellular rejection (ACR) and antibody-mediated rejection (AMR) in heart transplantation. The study objective was to assess the characteristics and diagnostic performance of previously identified microRNAs and clinical rejection scores (CRS) in distinct blood samples obtained at the time of an endomyocardial biopsy (EMB).

Myocarditis is a severe complication of immune checkpoint inhibitors (ICIs). The major risk factor for ICI myocarditis is the use of combination ICI treatment, especially when relatlimab, a novel anti-LAG-3 (lymphocyte-activation gene 3) antibody, is combined with anti-PD-1 (programmed cell death protein 1) therapy. Although pathogenic T cells are necessary for ICI myocarditis, the specific signaling and T-cell populations that drive cardiac infiltration have not been fully elucidated, especially in setting of anti-LAG-3/PD-1 treatment.

Contemporary hemodynamic testing intersects with many aspects of cardiovascular disease management. There is a growing understanding that accurate diagnosis, phenotyping, and management of cardiogenic shock, heart failure with preserved ejection fraction, and pulmonary hypertension, and left ventricular assist device support, require both baseline and provocative invasive hemodynamic testing, and often serial measurements. However, there is limited consensus regarding the standardization and interpretation of hemodynamic data. Provocative hemodynamic studies-whether related to volume, drugs, exercise, or device speed-are similarly nonuniform. A frequent limitation to their routine use relates to a lack of concise information regarding provocative study protocols. The aim of this scientific statement is to provide the evidence and rationale underlying best practices for static and provocative right heart catheterization, as well as actionable protocols to standardize their practice. In addition to outlining optimal resting right heart catheterization assessment, indications, and methods for vasodilator challenges to assess pulmonary hypertension reversibility in heart failure, this scientific statement includes discussion on volume challenges, invasive exercise hemodynamic testing, and vasodilator testing for acute pulmonary hypertension. Ramp, reverse-ramp, and exercise studies in patients with left ventricular assist devices are also detailed to help guide care and aid assessment for recovery. The utility and practical application of temporal changes in invasive hemodynamics are covered, from cardiogenic shock to remote patient monitoring. The standardization and advancement of invasive hemodynamic assessment in heart failure represent crucial steps toward optimizing patient outcomes. Continued collaboration across disciplines, enhanced focus on standardization, and investment in emerging technologies are crucial for bridging these gaps and driving innovation.

The universal definition of percutaneous coronary intervention (PCI)-related myocardial infarction (MI) has been substantially updated over the years, including an increase in the biomarker threshold (from 3 to 5 times the upper reference limit) and the introduction of ancillary criteria such as ischemic symptoms and electrocardiographic or angiographic complication. The impact of these changes in patients with acute coronary syndrome (ACS) remains incompletely understood. The objective of this study was to compare prognostic implications of evolving universal definitions of PCI-MI in a large cohort of patients with ACS from the MATRIX trial (Minimizing Adverse Haemorrhagic Events by Transradial Access Site and Systemic Implementation of AngioX).

Imbalances in cardiac branched-chain amino acid (BCAA) metabolism and mitochondrial homeostasis are implicated in the onset and development of heart failure. However, the mechanisms triggering the downregulation of cardiac BCAA metabolism in heart failure remain unclear. Here, we identify a novel role of the RNA-binding protein GRSF1 (guanine-rich RNA sequence binding factor 1) in post-transcriptionally regulating cell-intrinsic BCAA metabolic pathways, ultimately contributing to the pathogenesis of heart failure.

Cardiac reverse remodeling occurs in a small subset of patients with heart failure treated with guideline-directed therapies. This phenomenon, which is defined by reduced ventricular dilatation and improved systolic function, is most common in patients receiving left ventricular assist device (LVAD) therapy. Identifying therapeutic targets for initiating reverse remodeling is an area of great clinical interest, because these patients experience improved outcomes and quality of life. Targets may be discovered among the unique molecular changes associated with LVAD-induced partial myocardial functional recovery; however, the mechanisms underlying this favorable response are incompletely understood.

Vascular smooth muscle cells (VSMCs) undergo phenotypic changes during the development of aortic aneurysm and dissection (AAD). Metabolism shifts from oxidative phosphorylation to glycolysis. Recent studies suggest that epigenetics plays a crucial role in AAD.

Left ventricular noncompaction cardiomyopathy (LVNC; OMIM No. 604169) is anatomically characterized by excess trabeculation and deep intertrabecular recesses. It is the third most prevalent pediatric cardiomyopathy. Despite its clinical significance, the pathogenesis of LVNC remains uncertain.

Accurate aortic stenosis (AS) phenotyping requires multimodality imaging which has limited availability. The digital aortic stenosis severity index (DASSi), an artificial intelligence biomarker of AS-related remodeling on single-view 2-dimensional echocardiography, predicts AS progression independent of Doppler measurements. We sought to evaluate the ability of DASSi to define personalized AS progression profiles and to validate its performance as a scalable alternative to multimodality imaging features of functional, structural, and biological AS severity.

People with HIV (PWH) may have a higher risk of heart failure (HF) due to traditional and HIV-related factors. Incidence and risk prediction of HF in PWH are not well characterized. We aimed to quantify the risk of HF events in a global population of PWH with low-to-moderate estimated atherosclerotic cardiovascular disease risk.

This study aims to develop a diffusion model-based framework for generating late gadolinium enhancement (LGE)-like images without contrast. The resulting synthetic images are then comprehensively evaluated for subjective and objective image quality, as well as their clinical utility for quantifying scar in acute myocardial infarction.

Despite the rise of pulsed-field ablation (PFA), predicting and titrating lesion geometry remains challenging. This study aimed to find modifiable parameters that can accurately and repeatedly predict focal PFA lesions across a range of dimensions and to develop a model to predict lesion geometry.

GLP-1 (glucagon-like peptide-1) receptor agonists (GLP-1RAs), initially developed for glycemic control in type 2 diabetes, have shown cardiometabolic benefits including weight loss, improved endothelial function, and reduced inflammation. Recent data suggest potential anti-arrhythmic effects via modulation of atrial substrate and autonomic tone. Their impact on obese, nondiabetic patients remains underexplored. This study examines whether GLP-1RA use is associated with reduced atrial fibrillation recurrence after catheter ablation in obese patients, using real-world data from a large multicenter database.

Apolipoprotein B (apoB) is essential for lipoprotein assembly and secretion and plays a central role in the development of cardiovascular disease and metabolic dysfunction-associated steatotic liver disease. Although apoB protein degradation during very-low-density lipoprotein maturation has been extensively studied, the regulation of Apob mRNA stability under physiological and pathological conditions remains unexplored.