Former NBA center Scot Pollard, who was admitted into the ICU last week as he awaits a large enough heart to support his 6-foot-11 body.

Obesity Care

Gastric Bypass Surgery’s Durable Hypertension Impact

The associations between obesity and hypertension are widely known, but a new JACC study reveals that weight-reducing gastric bypass surgery has a significant and lasting impact on patients’ need for antihypertensives.

The GATEWAY trial assigned 100 participants (76% women, 43.8 avg. age, 36.9 BMI) to receive Roux-en-Y gastric bypass and medical therapy or only receive medical therapy, finding that after five years…

• Far more gastric bypass patients cut their BP medication use by at least 30% (80.7% vs. 13.7%)
• Gastric bypass patients were taking far fewer different BP medications (0.8 vs. 2.97 meds)
• Nearly 20-times more bypass patients stopped taking any antihypertensive medication (46.9% vs. 2.4%)
• All gastric bypass patients eliminated their resistant hypertension (from 15.2% to 0%)

Despite these massive BP medication reductions, the gastric bypass group saw no significant difference in blood pressure, and 54.7% of them achieved BPs below 130/80 mm Hg (vs. 9% in the medical therapy group).

Although previous research into gastric bypass surgery’s impact on cardiometabolic comorbidities often focused on diabetes, the GATEWAY trial makes an excellent case for gastric bypass’ ability to control hypertension – even five years after the procedure. 

The Takeaway

The fact that the GATEWAY trial came out at the same time as another paper showing that people who took tirzepatide (Eli Lilly’s Zepbound weight loss drug) also saw major BP reductions further highlights how weight interventions like these can lead to major hypertension improvements.

Considering that 122 million Americans have high blood pressure, and hypertension drives a long list of negative outcomes and high-cost care, research like this could start to change the way payers and providers might perceive  these “costly” interventions.

Measuring True Cardiac Risk

How can AI help physicians “see” beyond conventional lipid profiles? Tune in to this on-demand webinar showcasing how Cleerly’s AI-QCT solution complements conventional approaches to evaluating heart disease risk factors, and improves coronary artery disease diagnosis and heart attack risk assessments.

Making the Leap to Outsource Post-Processing

Interested in how to outsource cardiac image post-processing, but not sure where to start? PIA walks you through how to assess and compare vendors, understand pricing models and payment options, and outline your requirements to identify vendors who meet your clinical needs. 

TeraRecon’s Structural Heart Enhancements

Detecting and addressing mitral valve and LAA conditions can be challenging. Check out TeraRecon’s Structural Heart white paper and discover how improving workflow and pretreatment planning can streamline these processes and potentially improve patient outcomes.

The Wire

• CCTA AI Impact: Results from the CERTAIN multicenter trial highlighted Cleerly’s ability to impact care. The researchers performed Cleerly AI analysis on 750 US-based patients’ CCTA exams, and had physicians interpret the exams with and without Cleerly AI. Compared to conventional CCTA assessments, Cleerly’s AI insights led to a change in diagnosis or management in the majority of patients (57.1%), impacting CAD-RADS scores and plaque burden (39.3% & 37.1%), reducing downstream testing (-37.1%), and driving statin initiation/increases (28.1%).

• NBA Player’s Transplant Challenge: Scot Pollard’s 6-foot-11 frame helped make him an NBA first-round pick and earned him an NBA championship ring with the 2008 Boston Celtics, but it’s now keeping him from finding a heart donor. After trying medications, ablation, and a pacemaker to treat a genetic heart condition, Pollard and his care team have decided that he needs a heart transplant. However, because it’s so hard to find a large/strong enough heart, he’s been admitted into the Vanderbilt ICU and will remain there until a suitable donor becomes available.

• Repatha’s Longer-Term Benefits: A new analysis of the FOURIER and FOURIER-OLE trials evaluating evolocumab (Amgen’s Repatha) shows that patients with and without multivessel disease (MVD) enjoy long-term benefits from the PCSK9i’s LDL-C reductions. Evolocumab reduced risk for major adverse CV events by 23% in those with MVD and by 11% without MVD. Repatha’s MACE reductions grew over the 2.2 year median follow up period, reaching 37%-38% and 23%-28%.

• Post-PCI Home Care: UC Davis Health is launching a post-PCI digital home care program, combining the C-NOW text-messaging platform and Clinii’s asynchronous monitoring tech to automate home care during the period between patients’ PCIs and their follow-up office visits. Around 200 monitored patients will be equipped with a weight scale, blood pressure kit, and a 4G hub that transmits data directly to their UCD clinical team, while the automated text messages will be used for proactive education and communication. 

• ML Model Shows Promise to Help STOP-RVF: Using data from a varied multicenter cohort, researchers developed an advanced right ventricular failure (RVF) prediction model that surpassed existing RVF risk scores. The machine learning-based STOP-RVF calculator exhibited a C statistic of 0.75 in the derivation cohort and 0.73 in validation (1.0 is perfect), showcasing its ability to more effectively guide HF therapies and aid in perioperative optimization to reduce RVF morbidity and mortality.

• Cardiac PET Provider Charged: The US Department of Justice has filed a complaint under the False Claims Act charging the former owner of a cardiac PET firm with violating the Stark anti-self-referral law. The DOJ alleges that Rick Nassenstein, former head of Cardiac Imaging of Illinois, paid referring cardiologists as if they were supervising PET scans when they were actually providing care to other patients or weren’t even on site. Cardiac Imaging already paid $85M to settle related kickback charges in 2023.

• PFA Boosts AFib Success: In a milestone study for AFib management, results from the ADVENT trial indicated a clear advantage for pulsed field ablation (PFA) over traditional thermal ablation in reducing pulmonary vein (PV) narrowing. PFA resulted in a mere 0.9% reduction in aggregate PV cross-sectional area, while thermal ablation led to a far more substantial 12% decrease. The ADVENT trial is the first RCT to directly compare the efficacy and safety of Boston Scientific’s FARAPULSE PFA System against thermal ablation.

• Biotronik Launches IMDS’ Micro Rx Catheter: Biotronik and IMDS expanded their PCI catheter distribution alliance, announcing that Biotronik will offer IMDS’ Micro Rx catheter in the US. The Micro Rx is developed to enhance guidewire support during PCI procedures, and is the fourth IMDS catheter that Biotronik has brought stateside.

• Hemodynamic Monitors Save HFrEF Lives: A new patient-level meta-analysis in JACC could spur more use of implantable hemodynamic heart monitors (IHMs) in HFrEF patients. In the meta-analysis of three studies (GUIDE-HF, CHAMPION and LAPTOP-HF) with a total of 1,350 HFrEF patients, hemodynamic-monitoring guided management reduced overall mortality by 25% and cut HF hospitalizations by 36%. 

• Rise in Medical Malpractice Verdicts: Medical malpractice cases are on the rise, with recent verdicts surpassing nine figures. A chilling new article in Medscape details the trend, citing statistics from TransRe showing 2023 set records for massive verdicts, including $120M in a New York case where a stroke was missed on a brain CT scan. A rollback of tort reform is cited as one reason for these rising verdicts, as well as anger at the healthcare system following the COVID-19 pandemic.

• PVI Add-On Fails with Persistent AFib: Mount Sinai data shows that the commonly-used posterior wall ablation (LAPW) add-on to pulmonary vein isolation (PVI) is ineffective in patients with persistent AFib. In a retrospective analysis of 547 persistent AFib patients undergoing pulsed field ablation, rates of freedom from atrial arrhythmias at one year were statistically similar for patients who underwent PVI alone and PVI/LAPW (73.1% and 66.4%), including propensity-matched cohorts. Major adverse event rates were also similar.

The Behavioral Science Behind Change Cardiology Hemo

When Change Healthcare set out to design its next-generation Cardiology Hemo monitoring system, they put behavior science at the heart of its product strategy. See how Change’s UX designers applied its behavioral science team’s findings to improve its Hemodynamics solution to help make physicians and technicians even more efficient.

Diagnosis Beyond the Hospital

It’s increasingly clear that healthcare is expanding beyond hospital walls, and recent evidence from Us2.ai suggests that AI-enabled cardiac ultrasound could help drive that expansion. Read these editorials by Izabella Uchmanowicz, RN, PhD and Prof. Blanche J Cupido, MBChB to see how Us2.ai-enabled and nurse-operated mobile ultrasound might both improve and expand heart failure diagnosis.

The Resource Wire

• HeartFlow FFRCT’s Real World Impact: See how HeartFlow FFRCT Analysis significantly improved NHS England’s patient outcomes and clinical efficiency in a massive real world implementation across 90k patients in this presentation by Newcastle University’s Professor Vijay Kunadian. 

• How to Identify and Treat More CVD Patients: Do you know how many patients with high CVD risks are in your chest CT archive? See how the Stanford Health Care System used Bunkerhill Health’s Incidental CAC algorithm to screen its previous non-gated chest CTs, identify patients with coronary calcium, and get them on statins.

• Reducing ECG Background Noise: Monebo’s Kinitec Rhythms ECG Algorithm separates true ECG signals from background noise, leading to more accurate diagnoses and improved operator efficiency. See for yourself how the algorithm measured up to a gold standard.

• Experience the future of learning: Medtronic Academy 2.0 is here! Unlock your ultimate destination for structural heart medical education with the newly redesigned Medtronic Academy 2.0. Gain access to expert-led courses, webinars, and a wealth of resources to stay ahead in cardiovascular care. Visit now!

• Streamline Your Cardiology Imaging Workflows: See how cardiologists and their teams can streamline imaging workflows to make their cardiovascular service line more efficient, cost-effective, and patient-centered, using Merge’s cardiology solutions.