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Defining Normal Ascending Aorta Size by Imaging

Two large biobank studies of the relationship between various imaging measurements of ascending aorta size normalized to several body size metrics have shown that ascending aorta area/height performs best for predicting adverse aortic events.

Total Steps vs. How You Get Them and the Risk of Cardiovascular Events

In a large U.K. Biobank study of subjects who performed a one-week determination of steps/day, those who achieved < 8,000 steps/day were categorized by the duration of their step acquisition periods and were followed for a mean of eight years. All-cause mortality and the development of cardiovascular disease (CVD) were greater in those with short step acquisition periods (< 5 minutes) as compared to those with longer periods (> 15 minutes). Thus, longer step acquisition bouts are more effective in reducing mortality and CVD in those with less-than-ideal total daily step counts.

Value of Natriuretic Peptide Measurements in HFpEF

A pooled analysis of four trials of drug therapy for heart failure with preserved ejection fraction (HFpEF) patients has shown that, although the risk of adverse outcomes is higher with increasing baseline N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, the effect is attenuated at higher body mass index levels, such that lower NT-proBNP cutoffs for risk-stratifying obese patients need to be developed.

Who Needs Antithrombotic Therapy After Atrial Fibrillation Ablation?

An international trial of rivaroxaban vs. low-dose aspirin started one year or more after successful atrial fibrillation catheter ablation has shown no significant differences in a composite outcome of stroke, systemic embolism, or covert cerebral emboli by head magnetic resonance imaging and no differences in major bleeding but shows an increase in clinically relevant minor bleeding with rivaroxaban.

CREST-2 Boosts Modern Medical Therapy for the Initial Treatment of Asymptomatic Carotid Stenosis

CREST-2 consisted of two parallel randomized trials in patients with ≥ 70% asymptomatic carotid stenosis, showing that intensive medical therapy alone produced very low stroke rates, with no significant additional benefit from carotid endarterectomy and a modest absolute risk reduction with carefully performed transfemoral carotid stenting over four years. These findings support intensive risk factor control as the default strategy and suggest reserving revascularization for highly selected patients at experienced centers.

Opportunistic Salpingectomy in Patients with High-Grade Serous Ovarian Carcinoma

Of 650 patients diagnosed with high-grade serous ovarian cancer between 2014 and 2021, 56.5% underwent a prior abdominal or pelvic surgery with opportunity to undergo risk-reducing opportunistic salpingectomy with a median time between ovarian cancer diagnosis and prior surgery of 30.0 years (interquartile range, 19.4 to 37.7 years).

Long-Term Outcomes of Peripartum Cardiomyopathy

A large, prospective, observational study from Israel of peripartum cardiomyopathy has shown that, in general, outcomes are favorable, with high rates of left ventricular function recovery that remain stable and with no mortality but also that show high rates of cardiovascular comorbidities during long-term follow-up.

Early vs. Late Catheter Ablation for Atrial Fibrillation in Older Patients

An observational study from China in older patients with persistent atrial fibrillation (AF) has shown that an earlier diagnosis to catheter ablation time of ≤ 12 months compared to > 12 months is associated with lower rates of AF recurrence and adverse cardiovascular outcomes.

Ablation vs. Drugs for Ventricular Tachycardia

A sub-analysis of the VANISH2 trial, which compared catheter ablation (CA) to antiarrhythmic drug therapy for the suppression of ventricular tachycardia (VT) in patients with ischemic cardiomyopathy has shown that in the sotalol therapy group, those randomized to CA less frequently experienced the VT-based composite endpoint. Conversely, in the amiodarone group, the primary endpoint was similar in the CA- and drug therapy-randomized patients, but amiodarone produced more adverse events.

Improved Major Arrhythmic Event Prediction in Non-Ischemic Cardiomyopathy

An international multicenter registry study of patients with non-ischemic cardiomyopathy without a history of major arrhythmic adverse cardiac events (MAACE) that compared a new cardiac magnetic resonance imaging score for predicting MAACE and consequently determining the need for a primary prevention implantable cardioverter defibrillator has found that this new score is superior to the standard left ventricular ejection fraction criterion.