The cingulo-insular region is crucial for modulating cardiac activity. However, the distinct roles of its anatomic subdivisions in modulating sympathetic-parasympathetic balance remain poorly defined. We aimed to explore the distinct contributions of subdivisions within the cingulo-insular region to modulating cardio-autonomic balance.

Quantitative coronary plaque measures differ in prognostic value between women and men. It remains unclear whether cardiovascular risk increases proportionally with plaque extent in both sexes. We aimed to compare cardiovascular risk trajectories across quantitative coronary plaque measures in women and men with stable chest pain.

The optimal management of coronary artery disease in patients undergoing transcatheter aortic valve replacement (TAVR) remains unclear, and evidence supporting routine percutaneous coronary intervention (PCI) beforehand is limited. This study aimed to evaluate whether PCI before TAVR provides clinical benefit compared with conservative management in patients with significant coronary artery disease, using nationwide Swedish registry data.

Coronary artery disease (CAD) is a major contributor to cardiovascular morbidity (including myocardial infarction and heart failure) and mortality. Although the burden of CAD (number and degree of coronary artery stenosis) has been observationally linked to these outcomes, the causal contribution and independence from traditional cardiovascular risk factors have been poorly defined.

Moderate aortic stenosis (AS) poses a substantial risk for adverse outcomes, yet its prognostic determinants and cardiac remodeling markers remain underexplored. This study aimed to evaluate prognostic factors, including left atrial strain, and their predictive value for adverse cardiac events in patients with moderate AS.

The entrance of naive T cells into lymph nodes (LNs) is a crucial step for induction of heart transplant acceptance under costimulatory blockade. Specialized blood vessels within the LN known as high endothelial venules (HEVs) mediate this process. HEVs express a key glycoprotein containing 6-sulfo sialyl Lewis X, the binding site for L-selectin on the membrane of naive T cells. The proper formation of this carbohydrate requires sulfation by N-acetylglucosamine 6-O-sulfotransferases, particularly CHST4. Given the critical role of CHST4 in HEVs and transplant immunity, we aimed to develop a first-in-class antibody-drug conjugate (ADC) targeting the CHST4/HEV axis to deliver immunoregulatory molecules to LNs and promote long-term cardiac transplant survival.

The "2026 AHA/ACC/ACCP/ACEP/CHEST/SCAI/SHM/SIR/SVM/SVN Guideline for the Evaluation and Management of Acute Pulmonary Embolism in Adults" is a de novo guideline that provides comprehensive recommendations for the evaluation, management, and follow-up of adult patients (≥18 years of age) with acute pulmonary embolism (PE). A key feature of this guideline is the introduction of the AHA/ACC Acute Pulmonary Embolism Clinical Categories, which enhance the precision of severity classification, prognosis assessment, and evidence-based therapeutic decision-making.

There are limited data on the etiology, management, and outcomes of Society for Cardiovascular Angiography and Interventions (SCAI) B cardiogenic shock.

Atrial fibrillation (AF) is associated with substantial morbidity and mortality. We sought to investigate the predictive value of serum metabolomics for 5-year incident AF in the context of clinical and polygenic risk score (PRS) stratification tools.

Paravalvular leak (PVL) is a well-known complication of valve replacement, occurring in up to 10% of aortic and 17% of mitral prosthetic valves. Although many leaks are small and clinically insignificant, ≈1% to 5% of cases are associated with clinically relevant complications, such as heart failure symptoms and hemolytic anemia. Surgical reoperation is currently considered the first-line option; however, it encompasses high mortality and morbidity risks. In the past years, transcatheter PVL closure has proven to be highly effective when performed in experienced centers. Transcatheter PVL closure requires advanced imaging modalities, specialized materials, and techniques, reflecting the high complexity of the procedure. We review the complex nature of PVL, including its diagnostic workup and the available transcatheter treatment strategies, with a special focus on the treatment of mitral and aortic PVL using plugging devices.

Right ventricular (RV) failure is a principal determinant of morbidity and mortality in children with pulmonary hypertension, making accurate RV assessment a cornerstone of risk stratification and long-term management. Noninvasive imaging plays a central role in this evaluation; however, commonly used modalities, including 2- and 3-dimensional echocardiography and cardiac magnetic resonance imaging, each have distinct advantages and limitations in the pediatric population. Consequently, an integrated, multimodal imaging strategy is required. This review provides a contemporary, critical appraisal of the existing evidence and key knowledge gaps related to noninvasive multimodality imaging of the RV in pediatric pulmonary hypertension. The discussion is structured around fundamental aspects of RV physiology, including chamber size and mass, systolic function, diastolic function and stiffness, RV-left ventricle interactions, ventriculoarterial coupling, and exercise assessment. Echocardiography and cardiac magnetic resonance imaging are presented in parallel to highlight their complementary roles within a multimodality framework. Current prognostic thresholds in pediatric pulmonary hypertension imaging are largely supported by level of evidence C, underscoring persistent gaps that limit the development of definitive clinical recommendations and a unified approach. We propose a roadmap to guide future research efforts and collaborative initiatives among pediatric pulmonary hypertension and imaging specialists, emphasizing the role of professional networks in advancing the field.

Cardiovascular disease (CVD) prevalence is rising among younger women in the United States. Hypertensive disorders of pregnancy (HDP) are early indicators of cardiovascular risk, yet it remains unclear whether HDP independently increase CVD risk or reflect poor prepregnancy health. We aimed to quantify the association between HDP and incident CVD in a diverse, real-world population, with replication of findings across health systems.

Venous thromboembolism (VTE) is a leading cardiovascular disease, yet its etiology is incompletely understood. This study used large-scale, high-throughput aptamer-based proteomics to identify new circulating protein biomarkers and biological pathways for incident VTE.

Atrial septal defects (ASDs) are a prevalent type of congenital heart disease. Previous GWAS (Genome-Wide Association Studies) have identified common variants associated with ASDs, though their mechanisms remain unknown. We aimed to expand insights into the architecture of common variants associated with ASD risk and elucidate functional mechanisms.

With pulmonary hypertension (PH), a pulmonary artery wedge pressure (PAWP)>15 mm Hg is used to diagnose left heart dysfunction, but some patients with adjudicated group 1 PH demonstrate PAWP>15 mm Hg. The primary objective of the study was to evaluate group 1 PH with high PAWP>15 mm Hg.

Tissue-specific regulatory T cells (Tregs) accumulate in the heart after myocardial infarction (MI) and play a vital role in limiting inflammation and promoting tissue repair. However, the developmental trajectory of heart Tregs and the molecular cues that guide their recruitment to the heart remain poorly understood, impeding therapeutic strategies that leverage Treg-mediated cardiac protection.

Diagnosing cardiac amyloidosis (CA) on echocardiography can be challenging due to the imaging overlap between CA and more prevalent causes of a hypertrophic phenotype. This study sought to (1) evaluate the performance of artificial-intelligence (AI) derived measurements incorporated into the established multiparametric echocardiographic scoring system to detect CA; (2) develop and validate an AI-based deep-learning model for video-based detection of CA on echocardiography.

BCR-ABL (fusion between the Abelson [Abl] tyrosine kinase gene at chromosome 9 and the break point cluster [Bcr] gene at chromosome 22) tyrosine kinase inhibitors (TKIs) have been increasingly linked to pulmonary arterial hypertension (PAH) since 2009, although supporting evidence is limited. Our objective was to evaluate the risk of PAH associated with second- and third-generation BCR-ABL TKIs compared with imatinib in adults.

Obesity is an established risk factor for cardiovascular disease (CVD); however, the overall and sex-specific relationships across the full spectrum of body mass index (BMI), particularly severe obesity defined as class 2 (BMI 35 to <40.0 kg/m2) and class 3 (BMI ≥40 kg/m2), and long-term CVD outcomes remain incompletely described.

Calcified nodules (CNs) represent a high-risk coronary lesion phenotype associated with target lesion revascularization (TLR). Although rotational atherectomy (RA) is an established treatment for calcified lesions, its benefit for CNs remains unclear. This study aimed to evaluate the impact of RA on TLR and to identify specific morphological features on intravascular ultrasound that may influence its therapeutic effect for CNs.