Nguyen Yen Nhi Ngo, Chloé Davidson Villavaso, Chisom Joan Orakwue, William Zachary Rowalt, Madhur Roberts, Keith C. Ferdinand
{"title":"Lipoprotein(a) and coronary artery disease: The need for universal screening – A case-based review","authors":"Nguyen Yen Nhi Ngo, Chloé Davidson Villavaso, Chisom Joan Orakwue, William Zachary Rowalt, Madhur Roberts, Keith C. Ferdinand","doi":"10.1016/j.ahjo.2025.100560","DOIUrl":"10.1016/j.ahjo.2025.100560","url":null,"abstract":"<div><h3>Introduction</h3><div>Atherosclerosis cardiovascular disease (ASCVD), especially coronary artery disease (CAD), remains the leading cause of death worldwide, with several well-identified risk factors. This case report presents a premenopausal female with low calculated ASCVD risk, hypertension, elevated lipoprotein(a) [Lp(a)], and clinically significant CAD.</div></div><div><h3>Case report</h3><div>A 44-year-old premenopausal White female with controlled stage 2 hypertension, and overall low calculated 10-year ASCVD risk, was found to have severe CAD. She presented to the clinic with worsening chest discomfort during exertion and was diagnosed with a heavily calcified proximal left anterior descending artery stenosis, necessitating percutaneous coronary intervention.</div></div><div><h3>Discussion</h3><div>The global prevalence of elevated Lp(a) >50 mg/dL is around 1.43 billion. Elevated lipoprotein(a) is now recognized, based on the preponderance of the evidence, by several international scientific statements as an independent risk factor for ASCVD, including CAD. Nevertheless, the current 2018 American College of Cardiology (ACC) and American Heart Association (AHA) multi-society guideline on the Management of Blood Cholesterol only classifies Lp(a) as a risk enhancer. This recommendation, along with the lack of approved pharmacotherapy has contributed to limited testing in current United States clinical practice (<1 % for the general population). Furthermore, the inadequate assessment of Lp(a) may lead to an underestimation of ASCVD risk.</div></div><div><h3>Conclusion</h3><div>This case highlights the shortcomings of inadequate assessment of Lp(a) leading to the underestimation of cardiovascular risk. Accordingly, with multiple recent international scientific statements, clinicians should universally screen for elevated Lp(a). In the future, investigational therapies for lowering Lp(a) may be crucial for improving patient outcomes.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"56 ","pages":"Article 100560"},"PeriodicalIF":1.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144220871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Muhammad Ahmad Qureshi , Danyal Bakht , Omair Ahmed , Shahan Haseeb , Kartik Gupta , Omar Baqal , Maaz Amir , Khawar Ali , Mirza Muhammad Hadeed Khawar , Muqaddas Hussain , Luqman Munir , Hussein Othman
{"title":"Evaluating risk factors of embolism in patients with cardiac myxoma: A systematic review and meta-analysis","authors":"Muhammad Ahmad Qureshi , Danyal Bakht , Omair Ahmed , Shahan Haseeb , Kartik Gupta , Omar Baqal , Maaz Amir , Khawar Ali , Mirza Muhammad Hadeed Khawar , Muqaddas Hussain , Luqman Munir , Hussein Othman","doi":"10.1016/j.ahjo.2025.100559","DOIUrl":"10.1016/j.ahjo.2025.100559","url":null,"abstract":"<div><h3>Background</h3><div>Cardiac myxomas (CM), the most common primary cardiac tumors, can cause embolism in about 40 % of cases, making it crucial to identify risk factors for guiding clinical decisions.</div></div><div><h3>Objectives</h3><div>In this meta-analysis, we studied the risk factors associated with embolism among patients with cardiac myxomas.</div></div><div><h3>Methods</h3><div>A comprehensive search was conducted across PubMed, Embase, and Cochrane Library from their inception until May 2023. Statistical analyses were performed using Cochrane's RevMan 5.4 software. For each risk factor, the pooled odds ratio or mean difference was calculated along with the corresponding 95 % confidence interval.</div></div><div><h3>Results</h3><div>This meta-analysis incorporated 18 studies with 2601 patients, of whom 525 (20.1 %) experienced embolism. Significant risk factors included hypertension (<em>p</em> = 0.001), NYHA I/II (<em>p</em> = 0.03), irregular tumor surface (<em>p</em> < 0.01), hyperlipidemia (p < 0.01), coronary artery disease (<em>p</em> = 0.01), elevated mean platelet volume (<em>p</em> = 0.02), and high tumor mobility (p < 0.01), while female gender (p = 0.03) was linked to reduced risk. Smoking, atrial fibrillation, tumor size, age, BMI, diabetes, LVEF, and LAD were not significantly associated with embolism (<em>p</em> > 0.05).</div></div><div><h3>Conclusion</h3><div>This analysis is the first to highlight significant pooled outcomes for gender, hyperlipidemia, coronary artery disease, mean platelet volume, and tumor mobility. Patients with these risk factors may benefit from early evaluation and surgery to reduce embolism risk. Statistical analyses were performed using RevMan 5.4, with pooled odds ratios or mean differences calculated alongside 95 % confidence intervals.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"56 ","pages":"Article 100559"},"PeriodicalIF":1.3,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144253628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Potential role of gut microbiota in cardiac arrhythmias","authors":"Ramil Goel , Gurjit Singh , Carl J. Pepine","doi":"10.1016/j.ahjo.2025.100557","DOIUrl":"10.1016/j.ahjo.2025.100557","url":null,"abstract":"","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"55 ","pages":"Article 100557"},"PeriodicalIF":1.3,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144231958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Francis R. Joshi , Maria Petty , Yen Wing Ng , Hamish Elliott , Ross Anderson , Douglas Gordon , Rebecca Hanna , Robert Sykes , Shaun Leonard , Andrew Morrow , Dylan Tan , Anna Kamdar , Ramu Perumal , Jeffrey L. Creech , Peter Kellman , Paul Welsh , Alex McConnachie , Colin Berry
{"title":"Supersaturated oxygen therapy using radial artery access to prevent left ventricular remodeling after anterior ST-segment elevation myocardial infarction: a randomized, controlled trial","authors":"Francis R. Joshi , Maria Petty , Yen Wing Ng , Hamish Elliott , Ross Anderson , Douglas Gordon , Rebecca Hanna , Robert Sykes , Shaun Leonard , Andrew Morrow , Dylan Tan , Anna Kamdar , Ramu Perumal , Jeffrey L. Creech , Peter Kellman , Paul Welsh , Alex McConnachie , Colin Berry","doi":"10.1016/j.ahjo.2025.100556","DOIUrl":"10.1016/j.ahjo.2025.100556","url":null,"abstract":"<div><h3>Background</h3><div>Novel strategies to limit the size of infarction and prevent adverse remodeling and heart failure in patients following acute ST-segment elevation myocardial infarction (STEMI) are lacking. Supersaturated oxygen (SSO<sub>2</sub>) therapy is approved for patients presenting within 6 h of onset of anterior STEMI using femoral artery access. The feasibility of SSO<sub>2</sub> therapy via radial access is unknown. A more detailed understanding of the effect of therapy is needed.</div></div><div><h3>Objectives</h3><div>To assess the primary outcome, defined as the within-participant change in the plasma concentration of NT-proBNP measured at baseline, 24 h, 2–5 days and 3-months post-MI.</div></div><div><h3>Design</h3><div>Prospective, randomized, controlled, blinded, endpoint (mechanistic, PROBE) clinical trial.</div></div><div><h3>Randomized, controlled trial</h3><div>After primary PCI, eligible participants will be blinded and randomized 2:1 to either 1 h of SSO<sub>2</sub> therapy using radial artery access and intravenous glycoprotein IIbIIIa inhibitor therapy or a control (sham) procedure involving wrist manipulation in addition to standard care. The primary outcome is the within-participant change in the plasma concentration of NT-proBNP as detailed above. Secondary outcome assessments include coronary microcirculatory function, infarct size, microvascular obstruction, myocardial hemorrhage, left ventricular remodeling, myocardial blood flow, quality of life (EQ-5D-5L), Kansas City Cardiomyopathy Questionnaire (KCCQ) and the Duke Activity Status Index. Patient reported experience measures (PREMS) are an exploratory outcome. Health and economic outcomes will be assessed using electronic healthcare records.</div></div><div><h3>Value</h3><div>The study will test the feasibility of radial artery access, provide mechanistic data and inform a larger multicenter trial powered to detect treatment effects on clinical endpoints.</div><div><span><span>Clinicaltrials.gov</span><svg><path></path></svg></span>: <span><span>NCT06662890</span><svg><path></path></svg></span></div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"55 ","pages":"Article 100556"},"PeriodicalIF":1.3,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144178326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Arif Albulushi , Khaled El-Sharnouby , Kareem Soror , Noora Alhajri , Giuseppe Imperator
{"title":"GLP-1 receptor agonists and pulmonary hypertension in diabetes: A promising therapeutic strategy","authors":"Arif Albulushi , Khaled El-Sharnouby , Kareem Soror , Noora Alhajri , Giuseppe Imperator","doi":"10.1016/j.ahjo.2025.100555","DOIUrl":"10.1016/j.ahjo.2025.100555","url":null,"abstract":"<div><h3>Background</h3><div>Pulmonary hypertension (PH) is an emerging and underrecognized complication of diabetes mellitus, linked to adverse cardiopulmonary outcomes. Insulin resistance, inflammation, and endothelial dysfunction contribute to PH pathogenesis.</div></div><div><h3>Objective</h3><div>This review evaluates the emerging role of glucagon-like peptide-1 receptor agonists (GLP-1RAs) in mitigating PH risk among diabetic patients.</div></div><div><h3>Methods</h3><div>We synthesized data from preclinical and clinical studies, including large-scale observational cohorts, investigating GLP-1RAs' effects on pulmonary vasculature and hemodynamics.</div></div><div><h3>Results</h3><div>GLP-1RAs exhibit anti-inflammatory, vasodilatory, and endothelial-protective properties, with associated improvements in pulmonary artery pressure, vascular remodeling, and cardiopulmonary load. A Veterans Affairs cohort and meta-analyses suggest a reduced PH incidence among GLP-1RA users.</div></div><div><h3>Conclusion</h3><div>GLP-1RAs may represent a novel cardiopulmonary intervention in diabetes care. Prospective trials are needed to confirm their protective role against PH and define optimal integration into therapeutic strategies.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"55 ","pages":"Article 100555"},"PeriodicalIF":1.3,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144185755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Reproductive-associated risk factors and incident coronary heart disease in women: an umbrella review","authors":"Khadeeja Alnefaie , Jennifer R. Dungan","doi":"10.1016/j.ahjo.2025.100558","DOIUrl":"10.1016/j.ahjo.2025.100558","url":null,"abstract":"<div><h3>Background</h3><div>Reproductive risk factors influence women's risk of cardiovascular disease (CVD), particularly coronary heart disease (CHD). Despite growing evidence and recent guideline recommendations, their integration into cardiovascular risk screening and assessment remains limited. Evaluating the effect sizes of reproductive-associated risk factors along with temporal trends, homogeneity, and additive effects could provide critical insights to guide future research and inform evidence-based policies for CHD prevention in women.</div></div><div><h3>Methods</h3><div>This umbrella review synthesizes evidence from systematic reviews and meta-analyses examining reproductive-associated risk factors and their impact on incident coronary heart disease. A comprehensive search of PubMed and CINAHL databases was conducted for studies published between 2013 and 2024. Eligible articles were independently screened by two reviewers. Data were extracted using the Joanna Briggs Institute form and synthesized for effect sizes related to incident CHD. Prospective studies were used to assess temporality, and study quality was evaluated using the AMSTAR 2 tool. Forest plots were used for the effect size analysis based on comparative or time-to-event data.</div></div><div><h3>Results</h3><div>Of 902 articles, 29 met the inclusion criteria. Female reproductive risk factors from menarche to menopause across three categories (adverse pregnancy outcomes, reproductive endocrine disorders, and emerging reproductive risk factors) were associated with elevated CHD risk. Recurrent preeclampsia was identified as a significant risk factor, markedly increasing the risk of CHD. Additionally, cardiovascular events, including ischemic heart disease, were most frequent within the first decade postpartum in women with a history of gestational diabetes. Notably, none of the included studies evaluated the combined effects of multiple reproductive risk factors on CHD outcome.</div></div><div><h3>Conclusion</h3><div>Reproductive history is a critical factor in assessing CHD risk in women, with certain factors having temporal effects that correspond to heightened risk periods. Integrating these factors into screening tools, considering exposure and risk timing, may enable earlier intervention and improved outcomes.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"55 ","pages":"Article 100558"},"PeriodicalIF":1.3,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144185756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cardiogenic shock 2025: Understanding real world outcomes and contemporary practice to help guide improvements in care","authors":"Peter V. Johnston","doi":"10.1016/j.ahjo.2025.100553","DOIUrl":"10.1016/j.ahjo.2025.100553","url":null,"abstract":"","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"55 ","pages":"Article 100553"},"PeriodicalIF":1.3,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144231959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cristina Nunez-Pellot , Allison Akers , Sarah Običan , Mary Ashley Cain , Daniela R. Crousillat
{"title":"Lactation safety of cardiovascular medications","authors":"Cristina Nunez-Pellot , Allison Akers , Sarah Običan , Mary Ashley Cain , Daniela R. Crousillat","doi":"10.1016/j.ahjo.2025.100552","DOIUrl":"10.1016/j.ahjo.2025.100552","url":null,"abstract":"<div><div>Breastfeeding is the gold standard for infant feeding with well-established maternal, neonatal, and pediatric benefits. Patients with preexisting cardiovascular disease have lower breastfeeding rates than the general population. While little evidence exists regarding specific barriers to lactation in patients with preexisting cardiovascular disease, concerns regarding lactation safety and medication exposure in mothers with cardiovascular disease may be a cause for early breastfeeding cessation despite known health benefits. This literature review highlights the lactation safety of common cardiac medications. While some common cardiac medications may have limited safety data available, general pharmacokinetic principles of drug secretion in lactation can help to guide shared decision making in discussion with the patient. Enhancing provider knowledge regarding cardiac medication safety during breastfeeding may improve lactation outcomes in this population.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"55 ","pages":"Article 100552"},"PeriodicalIF":1.3,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jasmine N. Edghill , Evan Wasserman , Mary Ashley Cain , Daniela R. Crousillat , Ricardo Restrepo-Jaramillo
{"title":"The multidisciplinary management of pulmonary arterial hypertension patients in pregnancy and postpartum: A case series","authors":"Jasmine N. Edghill , Evan Wasserman , Mary Ashley Cain , Daniela R. Crousillat , Ricardo Restrepo-Jaramillo","doi":"10.1016/j.ahjo.2025.100551","DOIUrl":"10.1016/j.ahjo.2025.100551","url":null,"abstract":"<div><h3>Study objective</h3><div>Pregnancy has been contraindicated in the setting of pulmonary arterial hypertension (PAH) due to elevated maternal and fetal risk. We review our center's successful experience with pregnant PAH patients in this case series.</div></div><div><h3>Study design</h3><div>This is a retrospective case series.</div></div><div><h3>Participants</h3><div>Six patients with PAH with seven pregnancies delivered at Tampa General Hospital from 2014 to 2024.</div></div><div><h3>Interventions</h3><div>All cases involved a multidisciplinary team to optimize antenatal and intrapartum management. The REVEAL 2.0 risk assessment tool also guided treatment planning by determining risk status.</div></div><div><h3>Results</h3><div>Almost all of the patients in our study were diagnosed with PAH by right heart catheterization at our institution pre- or during pregnancy. All patients were either on a phosphodiesterase inhibitor or prostacyclin during their pregnancies. One mother was admitted at 34 weeks 1 day for decompensated heart failure without prior PAH treatment. All patients with outpatient follow-up had serial 6 min walk distances, brain natriuretic peptide levels, echocardiograms, and right heart catheterizations, and were able to achieve a low risk REVEAL 2.0 score during the pregnancy. All patient cases delivered via cesarean section with shared decision making and 5/7 cases were preterm. There was a 100 % maternal and fetal survival rate in our case series within the 1 year postpartum period.</div></div><div><h3>Conclusion</h3><div>Although pregnancy is a relative contraindication in patients with PAH, our case series demonstrates that a multidisciplinary approach to care at a specialized center for pulmonary vascular disease with close, personalized ante- and postnatal management can result in successful outcomes.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"55 ","pages":"Article 100551"},"PeriodicalIF":1.3,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143947288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ato Howard , Paulomi Gohel , Virginia Singla, Aditi Naniwadekar, Floyd Thoma, Suresh Mulukutla, Aditya Bhonsale, Krishna Kancharla, Andrew Voigt, Alaa Shalaby, N.A. Mark Estes III, Sandeep Jain, Samir Saba
{"title":"Cardiovascular resource utilization in patients with diastolic dysfunction: A retrospective cohort analysis","authors":"Ato Howard , Paulomi Gohel , Virginia Singla, Aditi Naniwadekar, Floyd Thoma, Suresh Mulukutla, Aditya Bhonsale, Krishna Kancharla, Andrew Voigt, Alaa Shalaby, N.A. Mark Estes III, Sandeep Jain, Samir Saba","doi":"10.1016/j.ahjo.2025.100550","DOIUrl":"10.1016/j.ahjo.2025.100550","url":null,"abstract":"<div><h3>Introduction</h3><div>Diastolic dysfunction (DD) is often linked to the development and persistence of atrial fibrillation (AF), but its impact on healthcare resource utilization (HCRU) in patients with or without AF is unclear.</div></div><div><h3>Methods</h3><div>Patients who received a transthoracic echocardiogram at our institution between 2010 and 2022 were included. DD was derived from the echocardiogram reports. HCRU included cardiac interventional, structural, surgical, and electrophysiology procedures, as well as diagnostic monitoring and imaging tests.</div></div><div><h3>Results</h3><div>A cohort of 157,043 patients (mean age 58 ± 18 years, 55 % women, 88 % White, 9 % with AF, 23 % with DD, LVEF 56 ± 8 %, BMI 30 ± 8 kg/m<sup>2</sup>) was retrospectively analyzed. The presence and severity of DD is associated with a proportional increase in HCRU, calculated as the mean annual number of cardiac procedures per year. For patients with no AF, the HRCU was 0.60 ± 1.02 in patients with no DD versus 0.93 ± 1.39 in those with any grade of DD (<em>p</em> < 0.001). Similar findings were seen in patients with AF (HCRU 1.08 ± 1.40 vs. 1.27 ± 1.64, in patients without versus with DD, <em>p</em> < 0.001). At lower grades of DD, the presence of AF is associated with higher HCRU, but this difference dissipates in patients with grade III DD (1.77 ± 2.37 vs. 1.67 ± 2.15, <em>p</em> = 0.42).</div></div><div><h3>Discussion</h3><div>DD is associated with higher HCRU in patients with or without AF.</div></div><div><h3>Conclusion</h3><div>DD significantly increases HCRU which is higher in the presence of AF. These data emphasize the real-world impact of DD on HCRU and highlight the need to prioritize DD diagnosis and treatment to improve patients' health and reduce cost.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"54 ","pages":"Article 100550"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143894936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}