2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T911,Early detection of risk of heart failure with reduced ejection fraction remains challenging in resource-limited settings due to limited access to echocardiography. Artificial intelligence electrocardiogram (AI-ECG) algorithms have demonstrated promise for identifying left ventricular systolic dysfunction (LVSD), but their feasibility in resource-constrained settings remains unknown. To determine the frequency of patients in Kenya with a high probability of LVSD by AI-ECG and assess AI-ECG algorithm performance against the gold standard of echocardiography. This was a cross-sectional study with enrollment from June to December 2024. Participants underwent baseline assessment and 12-lead ECG, and a subset completed echocardiography within 7 days. The echocardiography subset included participants from 3 prespecified risk strata: those with prior cardiovascular disease, those at high cardiovascular risk (Framingham Risk Score [FRS] ≥10%), and those at low risk (FRS <10%). The study took place at 8 outpatient health care facilities across Kenya. A total of 1444 patients 18 years and older seeking routine care were enrolled and completed paired echocardiogram. Exclusion criteria included inability to provide informed consent. Risk of LVSD was identified using a validated convolutional neural network AI-ECG algorithm (AiTiALVSD). Key outcomes were the diagnostic performance (sensitivity, specificity, and positive and negative predictive values) of the AI-ECG algorithm for detecting LVSD (LVEF <40%) when confirmed on echocardiography. Among 1444 participants (mean [SD] age, 59.0 [16.7] years; 907 [62.8%] female; 1118 [77.4%] at high risk), LVSD was identified in 204 (14.1%). The AI-ECG algorithm had a sensitivity of 95.6% (95% CI, 91.8-97.7), specificity of 79.4% (95% CI, 77.0-81.5), positive predictive value of 43.2% (95% CI, 38.7-47.9), negative predictive value of 99.1% (95% CI, 98.3-99.5), and area under the receiver operating characteristic curve (AUC) of 0.96 (95% CI, 0.95-0.97). Performance remained consistent across cardiovascular risk strata (AUC, 0.96-0.98). In this study, the AI-ECG algorithm demonstrated the potential clinical utility for screening of LVSD risk with high sensitivity and negative predictive value and may be particularly scalable in a resource-limited setting.31:Tdfa, Importance Early detection of risk of heart failure with reduced ejection fraction remains challenging in resource-limited settings due to limited access to echocardiography. Artificial intelligence electrocardiogram (AI-ECG) algorithms have demonstrated promise for identifying left ventricular systolic dysfunction (LVSD), but their feasibility in resource-constrained settings remains unknown. Objective To determine the frequency of patients in Kenya with a high probability of LVSD by AI-ECG and assess AI-ECG algorithm performance against the gold standard of echocardiography. Design, Setting, and Participants This was a cross-sectional study with enrollment from June to December 2024. Participants underwent baseline assessment and 12-lead ECG, and a subset completed echocardiography within 7 days. The echocardiography subset included participants from 3 prespecified risk strata: those with prior cardiovascular disease, those at high cardiovascular risk (Framingham Risk Score [FRS] ≥10%), and those at low risk (FRS &lt;10%). The study took place at 8 outpatient health care facilities across Kenya. A total of 1444 patients 18 years and older seeking routine care were enrolled and completed paired echocardiogram. Exclusion criteria included inability to provide informed consent. Exposure Risk of LVSD was identified using a validated convolutional neural network AI-ECG algorithm (AiTiALVSD). Main Outcomes and Measures Key outcomes were the diagnostic performance (sensitivity, specificity, and positive and negative predictive values) of the AI-ECG algorithm for detecting LVSD (LVEF &lt;40%) when confirmed on echocardiography. Results Among 1444 participants (mean [SD] age, 59.0 [16.7] years; 907 [62.8%] female; 1118 [77.4%] at high risk), LVSD was identified in 204 (14.1%). The AI-ECG algorithm had a sensitivity of 95.6% (95% CI, 91.8-97.7), specificity of 79.4% (95% CI, 77.0-81.5), positive predictive value of 43.2% (95% CI, 38.7-47.9), negative predictive value of 99.1% (95% CI, 98.3-99.5), and area under the receiver operating characteristic curve (AUC) of 0.96 (95% CI, 0.95-0.97). Performance remained consistent across cardiovascular risk strata (AUC, 0.96-0.98). Conclusions and Relevance In this study, the AI-ECG algorithm demonstrated the potential clinical utility for screening of LVSD risk with high sensitivity and negative predictive value and may be particularly scalable in a resource-limited setting. 32:T731,Cardiac involvement in systemic sclerosis (SSc) is a leading cause of death. We sought to investigate predictors of incident left ventricular systolic dysfunction (LVSD) and cardiac recovery in SSc. In total, 2,303 patients in the Johns Hopkins Scleroderma Center Research Registry and 13,209 echocardiograms were analyzed. We identified predictors associated with incident LVSD defined by transitions in left ventricular ejection fraction (EF) states (EF ≥50% declining to <50% and EF >35% dropping to ≤35% [severe LVSD]) by fitting multivariate logistic regression models with time-varying and invariant variables. Variables associated with cardiac recovery were identified by fitting multivariate logistic regression models using important variables identified from random forest analysis. Male sex, Black race, diffuse skin disease, higher modified Rodnan skin score (mRSS), echocardiographic evidence of pulmonary hypertension (PH), kidney disease, and atrial fibrillation (AFib) were associated with increased odds of incident LVSD (EF < 50%), whereas anticentromere and anti-topoisomerase-1 were protective. Male sex, higher mRSS, PH, skeletal myopathy, kidney disease, AFib, and anti-Ku antibodies were associated with higher odds of incident severe LVSD (EF ≤ 35%). For previous EF <50%, tendon friction rubs were associated with lower odds of cardiac recovery and anti-RNA polymerase III (anti-RNAP III) was associated with higher odds. For previous EF ≤35%, diabetes was associated with lower odds of recovering to EF >35%. Distinct demographic SSc-specific and cardiac characteristics are associated with increased risk of incident LVSD in SSc, with skeletal myopathy and anti-Ku antibodies being important risk factors for severe disease. Some patients improved, which was more likely in anti-RNAP III positive patients.33:T999, Objective Cardiac involvement in systemic sclerosis (SSc) is a leading cause of death. We sought to investigate predictors of incident left ventricular systolic dysfunction (LVSD) and cardiac recovery in SSc. Methods In total, 2,303 patients in the Johns Hopkins Scleroderma Center Research Registry and 13,209 echocardiograms were analyzed. We identified predictors associated with incident LVSD defined by transitions in left ventricular ejection fraction (EF) states (EF ≥50% declining to <50% and EF >35% dropping to ≤35% [severe LVSD]) by fitting multivariate logistic regression models with time‐varying and invariant variables. Variables associated with cardiac recovery were identified by fitting multivariate logistic regression models using important variables identified from random forest analysis. Results Male sex, Black race, diffuse skin disease, higher modified Rodnan skin score (mRSS), echocardiographic evidence of pulmonary hypertension (PH), kidney disease, and atrial fibrillation (AFib) were associated with increased odds of incident LVSD (EF < 50%), whereas anticentromere and anti–topoisomerase‐1 were protective. Male sex, higher mRSS, PH, skeletal myopathy, kidney disease, AFib, and anti‐Ku antibodies were associated with higher odds of incident severe LVSD (EF ≤ 35%). For previous EF <50%, tendon friction rubs were associated with lower odds of cardiac recovery and anti‐RNA polymerase III (anti–RNAP III) was associated with higher odds. For previous EF ≤35%, diabetes was associated with lower odds of recovering to EF >35%. Conclusion Distinct demographic SSc‐specific and cardiac characteristics are associated with increased risk of incident LVSD in SSc, with skeletal myopathy and anti‐Ku antibodies being important risk factors for severe disease. Some patients improved, which was more likely in anti–RNAP III positive patients. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Left Ventricular Systolic Dysfunction: condition Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Left Ventricular Systolic Dysfunction (condition). Clinician-written summaries and actionable practice insights. 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assumed to be consistent with devices used in the CHIP-BCIS3 trial (e.g., Impella), but this could not be confirmed from the provided text.","value_numeric":null},{"paper_doi":"10.1016/j.jacc.2026.06.041","tag_type":"warning","value":"This is a prespecified substudy of CHIP-BCIS3, not the primary trial report; generalizability is limited by the substudy sample size (n=97).","value_numeric":null}],"summaries":{"what_studied":"This prespecified substudy of the CHIP-BCIS3 RCT evaluated elective LV unloading with a microaxial flow pump (mAFP) vs. standard care in 97 patients with severe LV systolic dysfunction undergoing complex PCI, measuring hemodynamic instability and postprocedural myocardial stunning via pulmonary artery catheterization.","key_result":"mAFP reduced inotrope use (RR: 0.57; 95% CI: 0.34–0.97) but significantly increased loss of pulse pressure (LOPP; RR: 7.83; 95% CI: 2.53–24.24), which was itself linked to peri-procedural myocardial injury (OR: 3.00; 95% CI: 1.00–9.03); systolic BP reduction, cardiac index change, and PCWP change did not differ between groups.","limitations":"Small sample size (n=97 of 125 eligible); substudy design limits power for some endpoints; LOPP is a device-specific artifact of mAFP that may confound interpretation of hemodynamic instability.","practice_takeaway":"Elective mAFP use in complex PCI reduces inotrope requirements but does not prevent myocardial stunning and introduces LOPP, which is associated with myocardial injury — clinicians should weigh these trade-offs before routine prophylactic mAFP use."}},{"doi":"10.1161/str.0000000000000528","pmid":"42389837","title":"Management of Patients at Risk of Ischemic Stroke With Left Ventricular Systolic Dysfunction in the Absence of Intracardiac Thrombus: A Scientific Statement From the American Heart Association","journal_title":"Stroke","journal_issn":"0039-2499","published_at":"2026-07-02T00:00:00.000Z","url":"https://doi.org/10.1161/str.0000000000000528","source_score":29,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-10T13:25:37.255Z","updated_at":"2026-07-10T13:25:37.255Z","tags":[{"paper_doi":"10.1161/str.0000000000000528","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1161/str.0000000000000528","tag_type":"category","value":"Clinical Neurology","value_numeric":null},{"paper_doi":"10.1161/str.0000000000000528","tag_type":"condition","value":"Heart Failure with Reduced Ejection Fraction","value_numeric":null},{"paper_doi":"10.1161/str.0000000000000528","tag_type":"condition","value":"Ischemic Stroke","value_numeric":null},{"paper_doi":"10.1161/str.0000000000000528","tag_type":"condition","value":"Left Ventricular Systolic Dysfunction","value_numeric":null},{"paper_doi":"10.1161/str.0000000000000528","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1161/str.0000000000000528","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1161/str.0000000000000528","tag_type":"modality","value":"Anticoagulant","value_numeric":null},{"paper_doi":"10.1161/str.0000000000000528","tag_type":"modality","value":"Antiplatelet","value_numeric":null},{"paper_doi":"10.1161/str.0000000000000528","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1161/str.0000000000000528","tag_type":"study_design","value":"Scientific Statement / Systematic Review with Meta-Analysis","value_numeric":null},{"paper_doi":"10.1161/str.0000000000000528","tag_type":"warning","value":"No specific sample size (total N) was reported in the abstract; the tag has been omitted accordingly.","value_numeric":null},{"paper_doi":"10.1161/str.0000000000000528","tag_type":"warning","value":"Study design label reflects a hybrid AHA Scientific Statement combining narrative review and meta-analysis; it is not a standard RCT or purely observational study.","value_numeric":null},{"paper_doi":"10.1161/str.0000000000000528","tag_type":"warning","value":"The meta-analysis is based on secondary analyses of RCTs not originally designed to address this specific question, limiting causal inference and precision of effect estimates.","value_numeric":null},{"paper_doi":"10.1161/str.0000000000000528","tag_type":"warning","value":"The 'practice_changing' impact flag is applied cautiously — while this statement shifts guidance toward individualized anticoagulation for secondary prevention, it stops short of a blanket recommendation and emphasizes shared decision-making.","value_numeric":null}],"summaries":{"what_studied":"This AHA scientific statement evaluated the risk of incident and recurrent ischemic stroke in patients with LV systolic dysfunction (LVEF ≤40% or wall motion abnormality) without intracardiac thrombus, and compared anticoagulation vs. non-anticoagulation strategies for primary and secondary stroke prevention via narrative review and meta-analysis of secondary RCT analyses.","key_result":"Anticoagulation was associated with lower incident stroke risk in LV dysfunction without thrombus, but showed **no net benefit over non-anticoagulant strategies for primary prevention**. For secondary prevention (post-stroke), anticoagulation may reduce recurrent stroke risk with a net benefit compared to antiplatelet therapy.","limitations":"- Evidence is based on secondary analyses of RCTs, not trials designed primarily for this question.\n- No direct head-to-head RCT data specifically for stroke patients with LV dysfunction without thrombus.\n- Individualized risk-benefit balance is difficult to quantify given heterogeneity across included studies.","practice_takeaway":"For stroke patients with LV systolic dysfunction but no detected thrombus, anticoagulation may offer net benefit over antiplatelets for recurrent stroke prevention — consider shared decision-making with cardiology and neurology. Anticoagulation is **not** recommended for routine primary stroke prevention in this group based on current evidence."}},{"doi":"10.1161/cir.0000000000001450","pmid":"42339539","title":"Heart Failure Occurring in the Perinatal Period: A Scientific Statement From the American Heart Association","journal_title":"Circulation","journal_issn":"0009-7322","published_at":"2026-06-24T00:00:00.000Z","url":"https://doi.org/10.1161/cir.0000000000001450","source_score":19,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-01T13:27:22.482Z","updated_at":"2026-07-01T13:27:22.482Z","tags":[{"paper_doi":"10.1161/cir.0000000000001450","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1161/cir.0000000000001450","tag_type":"category","value":"Cardiac & Cardiovascular Systems","value_numeric":null},{"paper_doi":"10.1161/cir.0000000000001450","tag_type":"condition","value":"Cardiomyopathy","value_numeric":null},{"paper_doi":"10.1161/cir.0000000000001450","tag_type":"condition","value":"Left Ventricular Systolic Dysfunction","value_numeric":null},{"paper_doi":"10.1161/cir.0000000000001450","tag_type":"condition","value":"Perinatal Heart Failure","value_numeric":null},{"paper_doi":"10.1161/cir.0000000000001450","tag_type":"condition","value":"Peripartum Cardiomyopathy","value_numeric":null},{"paper_doi":"10.1161/cir.0000000000001450","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1161/cir.0000000000001450","tag_type":"level_of_evidence","value":"7","value_numeric":null},{"paper_doi":"10.1161/cir.0000000000001450","tag_type":"modality","value":"Heart Failure Pharmacotherapy","value_numeric":null},{"paper_doi":"10.1161/cir.0000000000001450","tag_type":"sex","value":"female","value_numeric":null},{"paper_doi":"10.1161/cir.0000000000001450","tag_type":"study_design","value":"Scientific Statement / Expert Consensus","value_numeric":null},{"paper_doi":"10.1161/cir.0000000000001450","tag_type":"warning","value":"No sample size applicable — this is a scientific statement, not a primary study.","value_numeric":null},{"paper_doi":"10.1161/cir.0000000000001450","tag_type":"warning","value":"Prevalence figure of 1–2% cited refers to the general adult US population, not confirmed perinatal-specific prevalence.","value_numeric":null},{"paper_doi":"10.1161/cir.0000000000001450","tag_type":"warning","value":"The impact_flag 'practice_changing' reflects the AHA endorsement and call for standardized definitions/screening, not a specific clinical trial result.","value_numeric":null}],"summaries":{"what_studied":"This AHA scientific statement evaluates heart failure with reduced and mildly reduced ejection fraction during pregnancy and the postpartum period, focusing on definitions, diagnostic challenges, treatment standards, screening tools, and maternal health equity across various cardiomyopathies.","key_result":"The true incidence of perinatal heart failure is unknown; prevalence of left ventricular systolic dysfunction may reach 1–2% in the general adult US population. Diagnostic delays are common due to symptom overlap with normal pregnancy physiology (dyspnea, edema, fatigue), contributing to adverse maternal outcomes.","limitations":"No primary data are generated — this is a consensus/expert statement. The true perinatal incidence and prevalence remain undefined. Pregnant and postpartum individuals are systematically underrepresented in heart failure trials, limiting the evidence base.","practice_takeaway":"Clinicians should maintain a low threshold for cardiac workup when pregnant or postpartum patients present with dyspnea, exercise intolerance, or edema, as these overlap with normal pregnancy changes and can mask heart failure. Standardized diagnostic criteria and early initiation of evidence-based therapies are needed to reduce adverse maternal outcomes."}},{"doi":"10.1136/bmjresp-2025-003815","pmid":"42134869","title":"Relationship between quantitative CT and cardiac function in patients with severe COPD exacerbations (ECOPD)","journal_title":"BMJ Open Respiratory Research","journal_issn":"2052-4439","published_at":"2026-05-14T00:00:00.000Z","url":"https://doi.org/10.1136/bmjresp-2025-003815","source_score":7,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-24T13:23:11.393Z","updated_at":"2026-05-24T13:23:11.393Z","tags":[{"paper_doi":"10.1136/bmjresp-2025-003815","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1136/bmjresp-2025-003815","tag_type":"category","value":"Respiratory System","value_numeric":null},{"paper_doi":"10.1136/bmjresp-2025-003815","tag_type":"condition","value":"Chronic Obstructive Pulmonary Disease","value_numeric":null},{"paper_doi":"10.1136/bmjresp-2025-003815","tag_type":"condition","value":"Coronary Artery Disease","value_numeric":null},{"paper_doi":"10.1136/bmjresp-2025-003815","tag_type":"condition","value":"Heart Failure","value_numeric":null},{"paper_doi":"10.1136/bmjresp-2025-003815","tag_type":"condition","value":"Left Ventricular Systolic Dysfunction","value_numeric":null},{"paper_doi":"10.1136/bmjresp-2025-003815","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1136/bmjresp-2025-003815","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1136/bmjresp-2025-003815","tag_type":"modality","value":"Quantitative Computed Tomography","value_numeric":null},{"paper_doi":"10.1136/bmjresp-2025-003815","tag_type":"sample_size","value":"n=56","value_numeric":56},{"paper_doi":"10.1136/bmjresp-2025-003815","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1136/bmjresp-2025-003815","tag_type":"study_design","value":"Prospective Cohort Study (sub-study of a Randomized Controlled Trial)","value_numeric":null},{"paper_doi":"10.1136/bmjresp-2025-003815","tag_type":"warning","value":"Funding from Chiesi Limited and Menarini Pharmaceutica is noted; authors declare no competing interests, but industry sponsorship warrants transparency.","value_numeric":null},{"paper_doi":"10.1136/bmjresp-2025-003815","tag_type":"warning","value":"Pi10 measured during acute exacerbation may partly reflect reversible airway oedema from cardiac decompensation, making causal direction between Pi10 and LVSD difficult to determine.","value_numeric":null},{"paper_doi":"10.1136/bmjresp-2025-003815","tag_type":"warning","value":"The 90-day mortality association with Pi10 is based on only 3 deaths and should be treated as hypothesis-generating only.","value_numeric":null},{"paper_doi":"10.1136/bmjresp-2025-003815","tag_type":"warning","value":"The study design is a sub-study of an RCT (SCATECOPD), but the qCT analysis itself is observational/cross-sectional — the RCT label should not imply a randomised intervention was tested for qCT utility.","value_numeric":null}],"summaries":{"what_studied":"This single-centre sub-study (SCATECOPD) evaluated whether quantitative CT (qCT) measures — airway wall thickness (Pi10), emphysema (Insp%950), and gas trapping (Exp%856) — obtained during hospitalisation for ECOPD correlate with cardiac function assessed by echocardiogram and CT coronary calcium score in 56 patients (mean age 72.5 years, mean FEV₁ 50.6% predicted).","key_result":"Pi10 was independently and negatively correlated with LVEF (β=−0.40, p=0.005 after full adjustment). Moderate-to-severe LVSD was found in 10.7% (8.9% newly diagnosed), HFpEF in 25.0% (23.2% new), right heart failure in 17.9% (14.3% new), and severe coronary artery disease (CACS ≥400) in 43.1%. Emphysema and gas trapping correlated strongly with FEV₁ but not significantly with cardiac dysfunction.","limitations":"- Small single-centre sample (n=56) limits generalisability; only 3 deaths at 90 days, making mortality associations exploratory at best.\n- qCT data were missing for subsets of patients (up to 12/56 for Exp%856) due to kernel incompatibility and motion artefact.\n- Pi10 during acute exacerbation may reflect transient airway oedema from cardiac decompensation rather than chronic structural disease, confounding causal interpretation.","practice_takeaway":"When a CT chest is already obtained during a COPD hospitalisation, an elevated Pi10 (airway wall thickness) may flag patients who warrant formal cardiac evaluation — particularly for undiagnosed left ventricular dysfunction. Clinicians should not use qCT as a substitute for echocardiography, but it could serve as a low-cost trigger for further workup."}},{"doi":"10.1001/jamacardio.2026.0908","pmid":"42090146","title":"Artificial Intelligence Electrocardiogram and Left Ventricular Systolic Dysfunction in Kenya","journal_title":"JAMA Cardiology","journal_issn":"2380-6583","published_at":"2026-05-06T00:00:00.000Z","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13150732/","source_score":40,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-05-11","doi":"10.1001/jamacardio.2026.0908","days":"7","issn":"2380-6583","rank":"7","field":"Clinical Medicine","score":"40","category":"Cardiac & Cardiovascular Systems","categories":["Cardiac & Cardiovascular Systems"],"_categories":["Cardiac & Cardiovascular Systems"]},"pubmed":{"doi":"10.1001/jamacardio.2026.0908","title":"Artificial Intelligence Electrocardiogram and Left Ventricular Systolic Dysfunction in Kenya.","journal":"JAMA cardiology","methods":"","results":"Among 1444 participants (mean [SD] age, 59.0 [16.7] years; 907 [62.8%] female; 1118 [77.4%] at high risk), LVSD was identified in 204 (14.1%). The AI-ECG algorithm had a sensitivity of 95.6% (95% CI, 91.8-97.7), specificity of 79.4% (95% CI, 77.0-81.5), positive predictive value of 43.2% (95% CI, 38.7-47.9), negative predictive value of 99.1% (95% CI, 98.3-99.5), and area under the receiver operating characteristic curve (AUC) of 0.96 (95% CI, 0.95-0.97). 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confirmed.","value_numeric":null},{"paper_doi":"10.1001/jamacardio.2026.0908","tag_type":"warning","value":"The full text was not accessible; summary is based solely on the abstract and results section provided. Some methodological details (e.g., ECG acquisition protocol, algorithm training data origin) could not be verified.","value_numeric":null},{"paper_doi":"10.1001/jamacardio.2026.0908","tag_type":"warning","value":"The 'practice_changing' impact flag is applied cautiously — while results are compelling, external validation in other low-resource settings is needed before broad implementation.","value_numeric":null}],"summaries":{"what_studied":"A cross-sectional study (June–December 2024) evaluated an AI-ECG algorithm (AiTiA LVSD) for detecting left ventricular systolic dysfunction (LVEF <40%) against echocardiography as the gold standard in 1,444 adult outpatients across 8 facilities in Kenya, stratified by prior cardiovascular disease, high CVD risk (FRS ≥10%), and low risk (FRS <10%).","key_result":"LVSD was found in 204 of 1,444 participants (14.1%). The AI-ECG achieved sensitivity 95.6%, specificity 79.4%, PPV 43.2%, NPV 99.1%, and AUC 0.96 (95% CI, 0.95–0.97), with consistent performance across all cardiovascular risk strata (AUC 0.96–0.98).","limitations":"- Cross-sectional design limits causal or longitudinal inference.\n- Study enrolled patients seeking routine care at outpatient facilities, which may not represent the general Kenyan population.\n- Low PPV (43.2%) means most AI-positive screens still require confirmatory echocardiography, which remains a resource constraint.","practice_takeaway":"The AI-ECG algorithm's very high sensitivity (95.6%) and NPV (99.1%) make it a strong rule-out tool for LVSD in resource-limited settings where echocardiography is scarce. Clinicians can use a negative AI-ECG result to confidently defer echocardiography, reserving limited imaging for screen-positive patients."}},{"doi":"10.1161/jaha.125.045994","pmid":"42037447","title":"Mavacamten in Obstructive Hypertrophic Cardiomyopathy: National Insights on Access and Safety Profile From Real‐World Data","journal_title":"Journal of the American Heart Association","journal_issn":"2047-9980","published_at":"2026-04-27T00:00:00.000Z","url":"https://doi.org/10.1161/jaha.125.045994","source_score":9,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-07T13:26:46.320Z","updated_at":"2026-06-07T13:26:46.320Z","tags":[{"paper_doi":"10.1161/jaha.125.045994","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1161/jaha.125.045994","tag_type":"brand","value":"Camzyos","value_numeric":null},{"paper_doi":"10.1161/jaha.125.045994","tag_type":"category","value":"Cardiac & Cardiovascular Systems","value_numeric":null},{"paper_doi":"10.1161/jaha.125.045994","tag_type":"condition","value":"Acute Heart Failure","value_numeric":null},{"paper_doi":"10.1161/jaha.125.045994","tag_type":"condition","value":"Atrial Fibrillation","value_numeric":null},{"paper_doi":"10.1161/jaha.125.045994","tag_type":"condition","value":"Left Ventricular Systolic Dysfunction","value_numeric":null},{"paper_doi":"10.1161/jaha.125.045994","tag_type":"condition","value":"Obstructive Hypertrophic Cardiomyopathy","value_numeric":null},{"paper_doi":"10.1161/jaha.125.045994","tag_type":"generic","value":"mavacamten","value_numeric":null},{"paper_doi":"10.1161/jaha.125.045994","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1161/jaha.125.045994","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1161/jaha.125.045994","tag_type":"modality","value":"Cardiac Myosin Inhibitor","value_numeric":null},{"paper_doi":"10.1161/jaha.125.045994","tag_type":"sample_size","value":"n=15145","value_numeric":15145},{"paper_doi":"10.1161/jaha.125.045994","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1161/jaha.125.045994","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1161/jaha.125.045994","tag_type":"warning","value":"Age distribution of the study population is not explicitly reported; the 'adult' age group tag is inferred from the clinical context of HCM management.","value_numeric":null},{"paper_doi":"10.1161/jaha.125.045994","tag_type":"warning","value":"Outcome follow-up duration is not explicitly stated in the abstract; the full observation window spans 2011–2023 but individual patient follow-up times may vary.","value_numeric":null},{"paper_doi":"10.1161/jaha.125.045994","tag_type":"warning","value":"The 1:3 propensity-score matching is weighted (not strictly 1:3 raw), so the effective control group size equals 502, not 1,475 unique patients — clinical interpretation should account for this weighting.","value_numeric":null}],"summaries":{"what_studied":"This observational multicenter study used TriNetX real-world data (2011–2023) to compare 502 propensity-matched obstructive HCM patients treated with mavacamten versus 502 matched controls (1:3 weighted), evaluating prescription access patterns and outcomes including acute heart failure, systolic dysfunction, cardiovascular hospitalization, new-onset AF, and all-cause mortality.","key_result":"Only 3.5% (509/15,145) of eligible patients received mavacamten; Black patients were 55% less likely to receive it than White patients (OR 0.45, 95% CI 0.33–0.63). Mavacamten patients with baseline AF (28% of recipients) had markedly worse outcomes: acute heart failure 7.8% vs. 3.6%, systolic dysfunction 12.8% vs. 6.4%, cardiovascular hospitalization 27.7% vs. 4.2%, and mortality 5% vs. 0% compared to those without AF.","limitations":"- Retrospective database design limits causal inference and may have unmeasured confounders.\n- TriNetX captures only patients within participating health systems, potentially missing those seen at safety-net or non-academic centers.\n- Drug dosing, echocardiographic parameters (e.g., LVEF at time of events), and socioeconomic variables are not granularly available in this dataset.","practice_takeaway":"Clinicians should be aware of a significant racial disparity in mavacamten access and take proactive steps to ensure equitable prescribing. Patients with preexisting AF starting mavacamten warrant heightened monitoring given substantially higher rates of heart failure, systolic dysfunction, hospitalization, and mortality."}},{"doi":"10.1161/circulationaha.126.079859","pmid":"41910411","title":"Role of Atrial Pacing Support in Cardiac Resynchronization Therapy: A Noninferiority Randomized Trial","journal_title":"Circulation","journal_issn":"0009-7322","published_at":"2026-03-30T00:00:00.000Z","url":"https://doi.org/10.1161/circulationaha.126.079859","source_score":16,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-10T14:24:27.564Z","updated_at":"2026-06-10T14:24:27.564Z","tags":[{"paper_doi":"10.1161/circulationaha.126.079859","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1161/circulationaha.126.079859","tag_type":"category","value":"Cardiac & Cardiovascular Systems","value_numeric":null},{"paper_doi":"10.1161/circulationaha.126.079859","tag_type":"condition","value":"Heart Failure","value_numeric":null},{"paper_doi":"10.1161/circulationaha.126.079859","tag_type":"condition","value":"Left Ventricular Systolic Dysfunction","value_numeric":null},{"paper_doi":"10.1161/circulationaha.126.079859","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1161/circulationaha.126.079859","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1161/circulationaha.126.079859","tag_type":"modality","value":"Cardiac Resynchronization Therapy","value_numeric":null},{"paper_doi":"10.1161/circulationaha.126.079859","tag_type":"modality","value":"Implantable Cardioverter-Defibrillator","value_numeric":null},{"paper_doi":"10.1161/circulationaha.126.079859","tag_type":"sample_size","value":"n=636","value_numeric":636},{"paper_doi":"10.1161/circulationaha.126.079859","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1161/circulationaha.126.079859","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1161/circulationaha.126.079859","tag_type":"warning","value":"CRT-DX devices used were exclusively Biotronik; the trial was funded by unrestricted grants from Biotronik, and two authors are Biotronik employees — potential industry bias should be noted.","value_numeric":null},{"paper_doi":"10.1161/circulationaha.126.079859","tag_type":"warning","value":"Generalizability is limited: single-country (Italy), predominantly White European population; race/ethnicity not systematically collected.","value_numeric":null},{"paper_doi":"10.1161/circulationaha.126.079859","tag_type":"warning","value":"The noninferiority margin (relative risk 1.20) was prespecified but observed event rates were lower than assumed (13.1–15.6% vs projected 17–20%), so the trial was marginally powered and noninferiority P-values were borderline significant.","value_numeric":null}],"summaries":{"what_studied":"This multicenter randomized noninferiority trial (CRT-NEXT) compared a 2-lead CRT-DX system (atrial sensing only, no pacing; n=317 ITT) versus conventional 3-lead CRT-D (atrial sensing + pacing; n=308 ITT) in 636 patients without sinus node dysfunction over a primary follow-up of 12 months (median overall follow-up 2.4 years) at 23 Italian centers.","key_result":"CRT-DX was noninferior to CRT-D for the 1-year composite of all-cause mortality, cardiovascular hospitalization, and lead-related complications (13.1% vs 15.6%; HR 0.82, 95% CI 0.54–1.25; noninferiority P=0.039 per-protocol, P=0.044 ITT). Atrial lead complications were significantly fewer with CRT-DX (1.3% vs 4.2%; P=0.040). Reverse remodeling rates (77.5% vs 76.3%; P=0.83) and 6-minute walk distance (404 vs 398 m; P=0.62) were equivalent. Only 1 CRT-DX patient (0.3%) needed a standard atrial lead upgrade over 2.4 years.","limitations":"- Trial conducted exclusively at Italian centers with predominantly White European patients, limiting generalizability.\n- Underpowered to detect differences in rare individual end points (e.g., specific lead failure modes, arrhythmic events) or subgroup interactions (e.g., ischemic cardiomyopathy, AF history).\n- Patients with NYHA class IV and permanent atrial fibrillation were excluded, so results apply only to a defined subset of CRT candidates.","practice_takeaway":"For CRT-D candidates without sinus node dysfunction, a 2-lead CRT-DX system (atrial sensing, no pacing) is a safe alternative to conventional 3-lead CRT-D — it shortens procedure time (~14%), cuts atrial lead complications 3-fold, and does not compromise clinical or echocardiographic outcomes. Routine atrial pacing appears unnecessary in this population."}},{"doi":"10.1002/art.43408","pmid":"41084328","title":"Identification of Risk Factors for Incident Left Ventricular Systolic Dysfunction and Predictors of Cardiac Recovery in Patients With Systemic Sclerosis","journal_title":"Arthritis & Rheumatology","journal_issn":"2326-5191","published_at":"2025-10-14T00:00:00.000Z","url":"https://doi.org/10.1002/art.43408","source_score":4,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2026-01-05","doi":"10.1002/art.43408","days":"14","issn":"2326-5191","rank":"6","field":"Clinical Medicine","score":"4","category":"Rheumatology","categories":["Rheumatology"],"_categories":["Rheumatology"]},"pubmed":{"doi":"10.1002/art.43408","title":"Identification of Risk Factors for Incident Left Ventricular Systolic Dysfunction and Predictors of Cardiac Recovery in Patients With Systemic Sclerosis.","journal":"Arthritis & rheumatology (Hoboken, N.J.)","methods":"","results":"Male sex, Black race, diffuse skin disease, higher modified Rodnan skin score (mRSS), echocardiographic evidence of pulmonary hypertension (PH), kidney disease, and atrial fibrillation (AFib) were associated with increased odds of incident LVSD (EF < 50%), whereas anticentromere and anti-topoisomerase-1 were protective. Male sex, higher mRSS, PH, skeletal myopathy, kidney disease, AFib, and anti-Ku antibodies were associated with higher odds of incident severe LVSD (EF ≤ 35%). For previous EF <50%, tendon friction rubs were associated with lower odds of cardiac recovery and anti-RNA polymerase III (anti-RNAP III) was associated with higher odds. For previous EF ≤35%, diabetes was associated with lower odds of recovering to EF >35%.","abstract":"$32","keywords":[],"pubmed_id":"41084328","conclusions":"Distinct demographic SSc-specific and cardiac characteristics are associated with increased risk of incident LVSD in SSc, with skeletal myopathy and anti-Ku antibodies being important risk factors for severe disease. Some patients improved, which was more likely in anti-RNAP III positive patients.","publication_date":"2025-10-14T00:00:00"},"crossref":{"DOI":"10.1002/art.43408","URL":"https://doi.org/10.1002/art.43408","ISSN":["2326-5191","2326-5205"],"link":[{"URL":"https://acrjournals.onlinelibrary.wiley.com/doi/pdf/10.1002/art.43408","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["Identification of Risk Factors for Incident Left Ventricular Systolic Dysfunction and Predictors of Cardiac Recovery in Patients With Systemic Sclerosis"],"author":[{"given":"Ji Soo","family":"Kim","sequence":"first","affiliation":[{"name":"Division of Rheumatology Johns Hopkins University School of Medicine Baltimore Maryland"},{"name":"Department of Biostatistics Johns Hopkins Bloomberg School of Public Health Baltimore Maryland"}]},{"given":"Rachel S.","family":"Wallwork","sequence":"additional","affiliation":[{"name":"Division of Rheumatology Johns Hopkins University School of Medicine Baltimore Maryland"}]},{"given":"Carrie L.","family":"Richardson","sequence":"additional","affiliation":[{"name":"Division of Rheumatology Northwestern University Chicago Chicago Illinois"}]},{"given":"Adrianne","family":"Woods","sequence":"additional","affiliation":[{"name":"Division of Rheumatology Johns Hopkins University School of Medicine Baltimore Maryland"}]},{"given":"Monica","family":"Mukherjee","sequence":"additional","affiliation":[{"name":"Division of Cardiology Johns Hopkins University Baltimore Maryland"}]},{"given":"Steven","family":"Hsu","sequence":"additional","affiliation":[{"name":"Division of Cardiology Johns Hopkins University Baltimore Maryland"}]},{"given":"Julie J.","family":"Paik","sequence":"additional","affiliation":[{"name":"Division of Rheumatology Johns Hopkins University School of Medicine Baltimore Maryland"}]},{"given":"Christopher A.","family":"Mecoli","sequence":"additional","affiliation":[{"name":"Division of Rheumatology Johns Hopkins University School of Medicine Baltimore Maryland"}]},{"given":"Laura K.","family":"Hummers","sequence":"additional","affiliation":[{"name":"Division of Rheumatology Johns Hopkins University School of Medicine Baltimore Maryland"}]},{"given":"Fredrick M.","family":"Wigley","sequence":"additional","affiliation":[{"name":"Division of Rheumatology Johns Hopkins University School of Medicine Baltimore Maryland"}]},{"given":"Scott L.","family":"Zeger","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Johns Hopkins Bloomberg School of Public Health Baltimore Maryland"}]},{"given":"Ami A.","family":"Shah","sequence":"additional","affiliation":[{"name":"Division of Rheumatology Johns Hopkins University School of Medicine Baltimore Maryland"}]}],"funder":[{"id":[{"id":"10.13039/100000005","id-type":"DOI","asserted-by":"publisher"}],"DOI":"10.13039/100000005","name":"U.S. Department of Defense","award":["PR231648"],"award-info":[{"award-number":["PR231648"]}],"doi-asserted-by":"publisher"},{"id":[{"id":"10.13039/100006260","id-type":"DOI","asserted-by":"publisher"}],"DOI":"10.13039/100006260","name":"Rheumatology Research Foundation","doi-asserted-by":"publisher"},{"id":[{"id":"10.13039/100001845","id-type":"DOI","asserted-by":"publisher"}],"DOI":"10.13039/100001845","name":"Scleroderma Research Foundation","doi-asserted-by":"publisher"},{"id":[{"id":"10.13039/100029250","id-type":"DOI","asserted-by":"publisher"}],"DOI":"10.13039/100029250","name":"Donald B. and Dorothy L. 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Patients With Systemic Sclerosis","updated":"2026-01-10T04:46:20+00:00","published_date":"2025-10-14","best_oa_location":null}},"created_at":"2026-01-15T20:51:27.064Z","updated_at":"2026-01-17T09:03:27.421Z","tags":[{"paper_doi":"10.1002/art.43408","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1002/art.43408","tag_type":"condition","value":"Left Ventricular Systolic Dysfunction","value_numeric":null},{"paper_doi":"10.1002/art.43408","tag_type":"condition","value":"Systemic Sclerosis","value_numeric":null},{"paper_doi":"10.1002/art.43408","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1002/art.43408","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1002/art.43408","tag_type":"sample_size","value":"n=2,303","value_numeric":2303},{"paper_doi":"10.1002/art.43408","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/art.43408","tag_type":"study_design","value":"Cohort","value_numeric":null},{"paper_doi":"10.1002/art.43408","tag_type":"warning","value":"Effect sizes and event rates are not provided in the abstract.","value_numeric":null},{"paper_doi":"10.1002/art.43408","tag_type":"warning","value":"Observational registry data; causality cannot be inferred.","value_numeric":null}],"summaries":{"what_studied":"A large single-center registry analysis (2,303 systemic sclerosis patients; 13,209 echocardiograms) evaluated predictors of incident left ventricular systolic dysfunction (EF <50% and EF ≤35%) and predictors of recovery among those with prior dysfunction using multivariable models.","key_result":"Higher odds of incident EF <50% were linked to male sex, Black race, diffuse skin disease, higher mRSS, echocardiographic pulmonary hypertension, kidney disease, and atrial fibrillation; anticentromere and anti–topoisomerase-1 antibodies were protective. For severe EF ≤35%, male sex, higher mRSS, pulmonary hypertension, skeletal myopathy, kidney disease, atrial fibrillation, and anti-Ku antibodies increased risk. Recovery from EF <50% was less likely with tendon friction rubs and more likely with anti–RNA polymerase III; among EF ≤35%, diabetes reduced odds of recovery to >35%.","practice_takeaway":"In systemic sclerosis, consider closer cardiac surveillance for patients with the identified risk factors (e.g., male, Black, diffuse disease, higher mRSS, PH, kidney disease, AFib, skeletal myopathy, anti-Ku). Recovery can occur; anti–RNA polymerase III positivity may signal better odds of improvement, while diabetes and tendon friction rubs may signal lower odds."}}],"initialOffset":8,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"condition","value":"Left Ventricular Systolic Dysfunction"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Conditions","href":"/hub/tag/condition"},{"name":"Left Ventricular Systolic Dysfunction"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"condition","hub_tag_value":"Left Ventricular Systolic Dysfunction"}}}]]

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