{"title":"Leveraging AI-enhanced digital health with consumer devices for scalable cardiovascular screening, prediction, and monitoring.","authors":"Aline F Pedroso, Rohan Khera","doi":"10.1038/s44325-025-00071-9","DOIUrl":"10.1038/s44325-025-00071-9","url":null,"abstract":"<p><p>Traditional cardiovascular care relies on episodic, resource-intensive evaluations. Consumer wearable and portable devices, combined with artificial intelligence (AI), offer a scalable, low-cost alternative. These devices can enhance care with high-fidelity cardiovascular data captured outside traditional care settings, with AI further increasing their value. This review explores how AI-enhanced digital health tools can transform cardiovascular care, improving early detection, personalized risk assessment, and proactive management, particularly in resource-constrained settings, while bridging gaps in traditional care models.</p>","PeriodicalId":501706,"journal":{"name":"npj Cardiovascular Health","volume":"2 1","pages":"34"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12221986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zixuan Wang, Qiuyan Yu, Charlotte Warren-Gash, Krishnan Bhaskaran, Clémence Leyrat, Ka Shing Cheung, Celine S L Chui, Esther W Chan, Ian C K Wong, Amitava Banerjee, Liam Smeeth, Ian J Douglas, Angel Y S Wong
{"title":"The association between proton pump inhibitors and the risk of gastrointestinal bleeding in oral anticoagulants users.","authors":"Zixuan Wang, Qiuyan Yu, Charlotte Warren-Gash, Krishnan Bhaskaran, Clémence Leyrat, Ka Shing Cheung, Celine S L Chui, Esther W Chan, Ian C K Wong, Amitava Banerjee, Liam Smeeth, Ian J Douglas, Angel Y S Wong","doi":"10.1038/s44325-024-00037-3","DOIUrl":"https://doi.org/10.1038/s44325-024-00037-3","url":null,"abstract":"<p><p>Current evidence of whether proton pump inhibitor (PPI) reduces the risk of gastrointestinal bleeding (GIB) associated with oral anticoagulants (OACs) is limited. Propensity score-weighted cohort and case-crossover studies were conducted separately in England and Hong Kong between 2011.01.01 and 2019.12.31. In the cohort design, we compared the hazards of hospitalised GIB in <b><i>OAC</i></b> + <b><i>PPI</i></b> users with <b><i>OAC only</i></b> users in people with atrial fibrillation and found higher hazard of GIB in <b><i>OAC</i></b> + <b><i>PPI</i></b> users in both settings. In the case-crossover design, elevated odds of exposure to <b><i>PPI only</i></b> , <b><i>OAC only</i></b> and <b><i>OAC</i></b> + <b><i>PPI</i></b> associated with GIB between 30-day hazard and referent periods were similarly found in both settings. Overall, the evidence of an elevated risk of <b><i>OAC</i></b> + <b><i>PPI</i></b> associated with GIB compared with <b><i>OAC only</i></b> was modest in the cohort study. Our case-crossover study suggested that residual confounding is likely to explain the association, suggesting that concomitant prescription of PPI with OAC did not modify GIB.</p>","PeriodicalId":501706,"journal":{"name":"npj Cardiovascular Health","volume":"2 1","pages":"11"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11993357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Mechanisms and implications of vascular-homing CD8 T cells in atherosclerosis.","authors":"Xi Su, Katelyn A O'Hare, Michael L Freeman","doi":"10.1038/s44325-025-00056-8","DOIUrl":"10.1038/s44325-025-00056-8","url":null,"abstract":"<p><p>CD8 T cells likely contribute to atherosclerosis. Here, we review the relationship of vascular-homing CD8 T cells to atherosclerotic cardiovascular disease, with discussions of atherogenic and atheroprotective CD8 T cell subsets, encompassing their origin, activation, antigen-specificity, trafficking, and functionality. Furthermore, we explore factors that promote CD8 T cell vascular-homing phenotypes, such as infections and inflammation, and describe innovative therapeutic strategies targeting vascular-homing CD8 T cells in people with atherosclerosis.</p>","PeriodicalId":501706,"journal":{"name":"npj Cardiovascular Health","volume":"2 1","pages":"19"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12119338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rahul Kumar Sevakula, Patrícia J Bota, Mohamad B Kassab, Sandeep Chandra Bollepalli, Geerthy Thambiraj, Richard Boyer, Eric M Isselbacher, Antonis A Armoundas
{"title":"Machine learning based, subject-specific, gender and race independent, non-invasive estimation of the arterial blood pressure.","authors":"Rahul Kumar Sevakula, Patrícia J Bota, Mohamad B Kassab, Sandeep Chandra Bollepalli, Geerthy Thambiraj, Richard Boyer, Eric M Isselbacher, Antonis A Armoundas","doi":"10.1038/s44325-025-00075-5","DOIUrl":"https://doi.org/10.1038/s44325-025-00075-5","url":null,"abstract":"<p><p>Software-based blood pressure (BP) measurement offers non-invasive, continuous, real-time monitoring compared to traditional methods. This study explores a non-invasive machine learning approach to estimate arterial BP from ECG and SpO<sub>2</sub> signals, using intra-arterial catheter BP readings as ground truth. A random forest (RF) algorithm was trained on a large dataset (~30 M beats, ~400 patient days), using extracted signal morphological features and patient characteristics. The RF model achieved low mean absolute error (MAE) for systolic/diastolic BP (4.29 ± 5.00 mmHg/2.38 ± 3.25 mmHg), independent of gender and race. Personalized models further improved performance (MAE: 3.51 ± 4.24 mmHg/1.85 ± 2.60 mmHg). We assessed different ECG lead combinations for estimating BP and observed that two limb leads, or a precordial lead were sufficient for an estimation below 5 mmHg MAE. These findings highlight the potential of real-time, personalized BP monitoring for early detection of hypertension, enhancing healthcare accessibility through non-invasive, continuous monitoring.</p>","PeriodicalId":501706,"journal":{"name":"npj Cardiovascular Health","volume":"2 1","pages":"41"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12316593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Scott William, Julee McDonagh, Sabine M Allida, Ayele Semachew Kasa, Christopher Patterson, Hiba Deek, Lorna Moxham, Timothy Wand, Caleb Ferguson
{"title":"A systematic review to identify assessment instruments for social isolation or loneliness in adults with heart failure.","authors":"Scott William, Julee McDonagh, Sabine M Allida, Ayele Semachew Kasa, Christopher Patterson, Hiba Deek, Lorna Moxham, Timothy Wand, Caleb Ferguson","doi":"10.1038/s44325-025-00044-y","DOIUrl":"10.1038/s44325-025-00044-y","url":null,"abstract":"<p><p>Social isolation and loneliness are frequently associated with heart failure. It is unclear how these constructs are assessed in adults living with heart failure which warrants further exploration. This review aimed to identify how social isolation and loneliness is assessed in adults living with heart failure. This is a systematic review reported according to PRISMA and registered in Prospero on 18 March 2024 [CRD42024518571]. The bibliographic databases, MEDLINE, CINAHL, and Scopus were searched from inception to 20 March 2024. Original quantitative studies assessing loneliness and/or social isolation of adults living with heart failure using a patient-reported instrument and written in English language were included. The Joanna Briggs Institute Critical Appraisal checklists were used to assess the quality of included studies. The results were presented narratively. Thirty studies (17 cohort studies, 9 cross-sectional studies, 2 RCTs, and 2 case control) with 529,665 participants (mean age ranged from 52 to 83 years, 57% were women) were included. The University of California Los Angeles Loneliness Scale was the most commonly used instrument to assess loneliness while composite measures of network size and frequency of social contacts were the most commonly used to assess social isolation in adults living with heart failure. Social isolation and loneliness exert deleterious effects on both mental and physical health, significantly diminishing life satisfaction. The improved use of social isolation and loneliness assessment instruments may contribute to more effective interventions, ultimately enabling care that may enhance the health outcomes and quality of life of adults living with heart failure.</p>","PeriodicalId":501706,"journal":{"name":"npj Cardiovascular Health","volume":"2 1","pages":"10"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11888987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143589119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Felipe Takaesu, Khalid Yasseen, Evan Yang, Hyun-Ji Park, John M. Kelly, Christopher K. Breuer, Michael E. Davis
{"title":"Transcriptomic analysis of circulating extracellular vesicles during the perioperative period of Fontan and Glenn surgery","authors":"Felipe Takaesu, Khalid Yasseen, Evan Yang, Hyun-Ji Park, John M. Kelly, Christopher K. Breuer, Michael E. Davis","doi":"10.1038/s44325-024-00039-1","DOIUrl":"10.1038/s44325-024-00039-1","url":null,"abstract":"Single-ventricle defects are treated with the Glenn and Fontan procedures, which offer lifesaving relief but result in lifelong complications. To address the lack of outcome predictors, we conducted an untargeted transcriptomic analysis to identify RNA biomarkers in serum and circulating sEVs from 25 Glenn or Fontan patients with three samples exclusively used for experimental assays. Unsupervised analysis revealed a distinction between pre-op and post-op samples in both surgical groups. Differential gene expression and pathway analysis showed enrichment for pro-angiogenic cargo in post-op sEVs compared to pre-op sEVs. Wound healing assays revealed post-op Fontan sEVs induce a stronger pro-angiogenic response than pre-op Fontan sEVs. A PLSR-guided approach revealed MAPK6, GLE1, hsa-miR-340-5p, and hsa-miR-199b-5p as key transcripts in the observed wound healing response. Lastly, EV-Origin revealed decreased secretion of sEV from cardiac tissue and increased secretion from brain tissue for both Fontan and Glenn samples. This work demonstrates the potential of sEV RNAs as biomarkers for patients with Fontan physiology, enabling quicker diagnosis for Fontan-associated complications.","PeriodicalId":501706,"journal":{"name":"npj Cardiovascular Health","volume":" ","pages":"1-12"},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s44325-024-00039-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Multi-channel masked autoencoder and comprehensive evaluations for reconstructing 12-lead ECG from arbitrary single-lead ECG","authors":"Jiarong Chen, Wanqing Wu, Tong Liu, Shenda Hong","doi":"10.1038/s44325-024-00036-4","DOIUrl":"10.1038/s44325-024-00036-4","url":null,"abstract":"Electrocardiogram (ECG) has emerged as a widely accepted diagnostic instrument for cardiovascular diseases (CVD). The standard clinical 12-lead ECG configuration causes considerable inconvenience and discomfort, while wearable devices offers a more practical alternative. To reduce information gap between 12-lead ECG and single-lead ECG, this study proposes a multi-channel masked autoencoder (MCMA) for reconstructing 12-Lead ECG from arbitrary single-lead ECG, and a comprehensive evaluation benchmark, ECGGenEval, encompass the signal-level, feature-level, and diagnostic-level evaluations. MCMA can achieve the state-of-the-art performance. In the signal-level evaluation, the mean square errors of 0.0175 and 0.0654, Pearson correlation coefficients of 0.7772 and 0.7287. In the feature-level evaluation, the average standard deviation of the mean heart rate across the generated 12-lead ECG is 1.0481, the coefficient of variation is 1.58%, and the range is 3.2874. In the diagnostic-level evaluation, the average F1-score with two generated 12-lead ECG from different single-lead ECG are 0.8233 and 0.8410.","PeriodicalId":501706,"journal":{"name":"npj Cardiovascular Health","volume":" ","pages":"1-13"},"PeriodicalIF":0.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s44325-024-00036-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142762902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Genetic and molecular underpinnings of atrial fibrillation","authors":"Mason E. Sweat, WIlliam T. Pu","doi":"10.1038/s44325-024-00035-5","DOIUrl":"10.1038/s44325-024-00035-5","url":null,"abstract":"Atrial fibrillation (AF) increases stroke and heart failure risks. This review examines genetic and molecular mechanisms underlying AF. We review genes linked to AF and mechanisms by which they alter AF risk. We highlight gene expression differences between atrial and ventricular cardiomyocytes, regulatory mechanisms responsible for these differences, and their contribution to AF. Understanding AF mechanisms through the lens of atrial gene regulation is crucial for developing targeted AF therapies.","PeriodicalId":501706,"journal":{"name":"npj Cardiovascular Health","volume":" ","pages":"1-17"},"PeriodicalIF":0.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s44325-024-00035-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142762895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Optimal facial regions for remote heart rate measurement during physical and cognitive activities","authors":"Shuo Li, Mohamed Elgendi, Carlo Menon","doi":"10.1038/s44325-024-00033-7","DOIUrl":"10.1038/s44325-024-00033-7","url":null,"abstract":"Remote photoplethysmography (rPPG) has gained prominence as a non-contact and real-time technology for heart rate monitoring. A critical factor in rPPG’s accuracy is the selection of regions of interest (ROI), as it can significantly influence prediction outcomes. Most studies typically use the forehead and cheeks as ROIs, but little research has explored other facial regions or how stable these ROIs are during physical movement and cognitive tasks. In this study, we analyzed 28 facial regions based on anatomical definitions using two mixed datasets derived from three public databases: LGI-PPGI, UBFC-rPPG, and UBFC-Phys. We applied rPPG algorithms such as orthogonal matrix image transformation (OMIT), plane-orthogonal-to-skin (POS), chrominance-based (CHROM), and local group invariance (LGI). Our findings show that the glabella, medial forehead, lateral forehead, malars, and upper nasal dorsum consistently perform well, with the glabella achieving the highest overall evaluation score. These results offer valuable insights for advancing remote heart rate monitoring technologies.","PeriodicalId":501706,"journal":{"name":"npj Cardiovascular Health","volume":" ","pages":"1-12"},"PeriodicalIF":0.0,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s44325-024-00033-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142737663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
David A. Zidar, Brigid M. Wilson, Sadeer G. Al-Kindi, David Sweet, Steven Juchnowski, Lauren Huntington, Carey Shive, Jürgen Bosch, Christopher King, Jonathan Karn, Mina K. Chung, Carl B. Gillombardo, Mohammad Karnib, Varun Sundaram, Sahil A. Parikh, Mukesh Jain, Douglas D. Gunzler, Jacek Skarbinski, W. H. Wilson Tang, Donald D. Anthony, Timothy A. Chan, Jarrod E. Dalton
{"title":"Pre-exposure immunohematologic features of heart failure associate with COVID-19 mortality","authors":"David A. Zidar, Brigid M. Wilson, Sadeer G. Al-Kindi, David Sweet, Steven Juchnowski, Lauren Huntington, Carey Shive, Jürgen Bosch, Christopher King, Jonathan Karn, Mina K. Chung, Carl B. Gillombardo, Mohammad Karnib, Varun Sundaram, Sahil A. Parikh, Mukesh Jain, Douglas D. Gunzler, Jacek Skarbinski, W. H. Wilson Tang, Donald D. Anthony, Timothy A. Chan, Jarrod E. Dalton","doi":"10.1038/s44325-024-00025-7","DOIUrl":"10.1038/s44325-024-00025-7","url":null,"abstract":"Chronic heart failure, like diabetes, is a pro-inflammatory cardiometabolic condition, but its association with immunodeficiency is less well established. We conducted a retrospective cohort study of US Veterans infected during the first wave of COVID-19 (n = 92,533) to identify relationships between comorbidities, pre-infection immunohematologic (IH) features (based on complete blood cell count parameters), and 60-day mortality. A biomarker sub-analysis of anti-SARS CoV2 antibodies and cytokine levels was also performed (n = 44). Heart failure was independently associated with higher COVID-19 mortality and with the specific IH alterations (especially relative anemia, anisocytosis, and lymphopenia) which themselves predicted non-survival or protracted inflammation. Over half the risk conferred by heart failure was mediated by its anticipatory IH features whereas diabetes risk was unrelated to its associated IH profile. These findings indicate that heart failure is associated with a COVID-19 immunodeficiency distinct from that of diabetes which correlates with antecedent erythrocyte and lymphocyte dyshomeostasis.","PeriodicalId":501706,"journal":{"name":"npj Cardiovascular Health","volume":" ","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s44325-024-00025-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142679986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}