Edward Livingston MD, Professor of Surgery at UCLA and Deputy Editor for Clinical Reviews and Education at JAMA.

AI is booming in cardiac imaging, and keeping a finger on the pulse of how to best implement it is critical to improving workflows and patient outcomes. Watch the latest episode of the Cardiac Wire Show with Dr. Thomas Semple and Kevin Lev to discover why TeraRecon is at the forefront of AI-enhanced imaging and what it means for the future of detection and diagnosis in cardiac care.

New automated software solutions are becoming available for analysis of arterial plaque, a major risk factor for heart disease. Hear clinicians discuss their real-world experiences with automated tools for plaque analysis in this joint Cardiac Wire & Imaging Wire webinar in partnership with Elucid.

Cardiovascular Disease

CV Polypills Could Prevent Millions of Deaths by 2050

A new JACC study revealed that broader adoption of single-pill combination therapies (aka polypills) containing multiple cardiovascular medications could significantly transform global health trends by 2050 and potentially lower the burden of future CVD.

• It’s already well established that polypill therapies consisting of a statin and one or more antihypertensive drugs can reduce rates of CVD.
• However, the use of polypills for preventing cardiovascular disease is low in many countries, both due to a lack of coordinated initiatives and resources.

To predict the benefits of polypills, researchers modeled two different implementation strategies, a targeted and a population level approach.

• The targeted approach focused on high-risk patients already receiving care but not optimized therapy, leading to 15% coverage by 2050.
• Meanwhile the population approach expanded potential patients to people over 55 with intermediate-high cardiovascular risk not yet receiving care, resulting in 35% coverage.

For the targeted approach, researchers found that it would translate into 29 million fewer deaths and 72 million fewer nonfatal cardiovascular events cumulatively over 2023-2050.

On the other hand, the broader population approach could lead to 51 million fewer deaths and 130 million fewer events over the same time.

• That’s an impact similar to eliminating tobacco smoking completely or achieving 80% antihypertensive therapy coverage
• Researchers also expect the greatest benefits to occur in South and East Asia Pacific regions due to their large populations and high CVD rate.

However, both approaches face serious barriers to implementation such as…

• Pharmaceutical industry reluctance due to questionable profitability with generic medications.
• Low manufacturer interest and a lack of government demand.
• Clinician resistance to simplified treatment approaches.

The Takeaway

It’s becoming pretty clear that polypills have serious potential to improve long-term CVD patient outcomes, and this study gives us a glimpse into a better future where they’re more widely implemented. What’s uncertain is whether or not the border pharmaceutical and public health decision-makers are willing to trade profits for better outcomes.

The Benefits of Outsourced Post-Processing

Using an outsourced cardiac image post-processing solution doesn’t have to mean sacrificing control of the results. Discover how PIA’s customizable post-processing workflow can help you get the most out of your images.

Heartbeats and EP Insights – How GE HealthCare Streamlines Cardiac Care

Are you stuck behind EP reporting backlogs? Take a break and join GE HealthCare for a 15-minute conversation with Dr. Nicholas Skipitaris of Northwell Health on how to simplify reporting, reduce delays and standardize workflows to scale best practices.

Identify and Treat Cardiovascular Disease

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The Wire

• CMS Proposes Renal Denervation Coverage: In a big win for hypertension patients, the CMS proposed covering renal denervation procedures for uncontrolled hypertension under its coverage with evidence development process. To qualify, patients must have blood pressure over 140/90 despite maximally tolerated medical therapy and lifestyle modifications for three months, with secondary causes evaluated. Meanwhile, care centers must have multidisciplinary hypertension programs with specialized staff to qualify. The proposal follows FDA approval of two systems in November 2023 from Medtronic and Recor.

• AstraZeneca Baxdrostat’s Early Results: Getting us closer to a new kind of BP pill, AstraZeneca’s BaxHTN Phase III trial demonstrated that its first-in-class aldosterone synthase inhibitor baxdrostat significantly reduced systolic blood pressure compared to placebo at 12 weeks when added to standard care. Both 2mg and 1mg doses showed statistically significant and clinically meaningful reductions in patients with uncontrolled or treatment-resistant hypertension. Also encouraging, the drug was well-tolerated with a favorable safety profile and met all secondary endpoints. 

• The First OTC Cuffless Monitor: Swiss optical BP monitoring company Aktiia received FDA 510(k) clearance for over-the-counter use of its cuffless blood pressure monitoring technology in the U.S. This makes the G0 Blood Pressure Monitoring System the first FDA-cleared cuffless blood pressure monitor available without prescription, and it will be available to American consumers in 2026 following successful deployment in Europe, where it’s been used by over 130,000 patients under the Hilo brand.

• CE Mark for a Unique Stent: W. L. Gore & Associates received CE Mark approval for expanded indication of its GORE VIABAHN VBX Balloon Expandable Endoprosthesis as a bridging stent device for both fenestrated and branched endovascular aortic aneurysm repair. This makes the GORE VIABAHN VBX the first bridging stent with dual indication for both of these complex procedures. The approval follows clinical studies that demonstrated high patency rates and freedom from complications at one year in patients who were treated with the device.

• Updated J&J Varipulse Approval: The FDA approved an updated irrigation flow rate for Johnson & Johnson MedTech’s Varipulse pulsed field ablation platform, which originally gained FDA approval in November 2024. This optimization aims to improve patient outcome consistency by implementing improvements based on clinical experience and user data. That’s pretty helpful considering the Varipulse platform has been used in over 10k PFA procedures worldwide with a neurovascular adverse event rate below 0.5%.

• Hypertension Starts Sooner in Women: A recent study suggests women could have a lower diagnostic threshold for hypertension than previously thought. Researchers performed a cross-sectional study on 1.4k women and found that among those with previous preeclampsia, BP levels above the female-specific threshold but below current diagnostic criteria significantly increased odds of left ventricular remodeling, diastolic dysfunction, and subclinical heart failure. As a result, the researchers suggest the female-specific BP threshold for hypertension starts at 133/81 mmHg, lower than current guidelines of 140/90 mmHg.

• Interventions for Adherence: Results from the TEAMLET study suggest that multicomponent interventions don’t improve patient medication adherence. The study’s 1.7k uncontrolled hypertension patients with low adherence were randomized to receive either an intervention consisting of team-based screening, clinical decision support, and provider-patient discussions or standard of care. While the intervention helped successfully identify nonadherent patients, it showed no improvement in medication adherence or blood pressure control compared to usual care at 12 months.

• Heartflow files for IPO: Cardiac AI developer Heartflow last week filed documents for an IPO that sources say should raise $100M for the company. Heartflow is perhaps the most successful AI firm in generating actual revenue for its solutions (as well as raising VC money), and SEC documents show the company’s sales grew 39% for the most recent quarter ($37.2M vs. $26.8M). But the firm’s net loss also expanded ($32.3 vs. $20.9M). Heartflow’s flagship products include FFRCT Analysis and Plaque Analysis.

• SGLT2is Lag in HF: New research published in JAMA suggests that SGLT2 inhibitors still aren’t a popular option for treating HF despite regulatory approval. Researchers conducted a retrospective cohort study of 756k HF patients and found that only 10.1% were prescribed SGLT2 inhibitors although usage increased from 4.6% in Q3 2019 to 16.2% in Q2 2023, with higher rates in reduced ejection fraction patients (28.5%) versus preserved/mildly reduced (12.8%).

• Better Understanding LMNA Cardiomyopathy: According to a recent JAMA study, the type and location of the mutation patients have in their LMNA gene could significantly impact the risks involved with LMNA cardiomyopathy. Researchers genetically profiled 718 patients with LMNA cardiomyopathy and found that truncating variants (shorter forms of the gene) increased malignant ventricular arrhythmia risk by 72% compared to missense variants (incorrect sequences of the gene), regardless of location. However, missense variants towards the end of the gene (exons 7-12) showed 65% lower arrhythmia risk and better HF outcomes.

• Cardiac MRI Detects Dangerous Scar Tissue: Cardiac MRI detected myocardial fibrosis in older male endurance athletes that was linked to irregular heart rhythms. U.K. researchers in the VENTOUX study scanned 106 male cyclists and triathletes over 50 with no symptoms, finding that 47% had signs of scarring in the left ventricle, 3% had sustained, potentially dangerous rapid heart rates, and 19% experienced shorter rapid heartbeats. Similar findings have occurred in patients with heart muscle disease, but discovering the association in athletes was unexpected.

AI Analysis of ATTR-CM

ATTR-CM is a progressive and fatal cardiomyopathy with a rising number of diagnoses and a highly variable clinical course. See how Us2.ai’s fully automated machine learning algorithm analyzes echocardiographic DICOM images without human interaction to improve tracking ATTR-CM progression and treatment responses.

Heartflow Roadmap Analysis For Efficient Care

As Coronary CT scan volumes increase, your entire reading team needs to deliver efficient and consistent reads. Good thing Heartflow’s Roadmap Analysis can help you maintain accuracy and increase CCTA read speeds by up to 25%, with even level 3 readers seeing real efficiency benefits.

Explore Vitrea Advanced Visualization

Discover Canon Medical Healthcare IT’s suite of advanced imaging workflows designed to increase efficiency in cardiovascular imaging, and facilitate the assessment, diagnosis, and treatment of cardiovascular diseases. These cutting-edge tools support the delivery of faster, more accurate care while integrating seamlessly into clinical workflow

The Resource Wire

• Redefining Percutaneous Coronary Intervention: Learn about the AGENT™ Drug-Coated Balloon from Boston Scientific and how this technology is expanding the treatment options for patients with in-stent restenosis in the U.S. Rx only. (Sponsored by Boston Scientific)

• Cracking the Code of ECG Analysis with Monebo’s AI Genetic Algorithm: How do you teach a computer to recognize the complex patterns in an ECG signal? Discover how Monebo found the answer by blending human expertise and a little evolutionary magic in this article that breaks down the advantages of genetic algorithms in ECG analysis.

• The All in One Cardiac Imaging Solution: Ready for an all-in-one solution that supports all of your MR and CT needs? See how Circle Cardiovascular Imaging’s cvi42 can streamline your core reading and reporting workflows within a single, customizable platform.

• The Hidden Costs of Delaying Cardiac MRI Adoption: Despite being the gold standard for functional cardiac imaging, many hospitals remain slow to adopt it. From missed revenue to lost patients, the impact goes far beyond the scan. Read about the real clinical and financial risks of falling behind.

• 5,600 Ways to Improve Your Cardiac Ultrasound Workflow: AI-powered measurements can enhance the way you acquire and interpret cardiac ultrasound. Learn how AI-powered ultrasound can help you overcome everyday limitations in echo. Read Siemens Healthineers’ white paper on how its AI software provides 5,600+ automated measurements to help improve workflow efficiency, consistency, and clinical confidence.

• A Solution for Your Entire Cardiology Service Line: The pace of change in healthcare can be dizzying, creating new and more complex challenges for cardiology departments to overcome. See how Merge Cardio and Merge Hemo can turn those challenges into opportunities for greater workflow efficiency and improved care.

• LVAD Therapy Receives 1A Recommendation for Inotrope-Dependent Patients: The U.S. joint societies of the AHA/ACC/HFSA have given LVAD therapy a 1A Recommendation for heart failure patients dependent on intravenous inotropes or who cannot be weaned from temporary mechanical circulatory support. As both the strongest class of recommendation and highest level of evidence, a 1A Recommendation indicates LVAD therapy is supported by strong data and the benefits far outweigh the risks.

The Industry Wire

1. Weight loss drugs could help women with hormonal disorders.
2. Fungal flora in our bodies could impact our brains.
3. Four people dead from flesh-eating bacteria in Florida.
4. Humana Medicare Advantage star ratings lawsuit dismissed.
5. Dexcom recalls 19 models of glucose monitoring receivers.
6. Wall Street fears an insurer meltdown is far from over.
7. Early filings suggest ACA premiums will spike in 2026.
8. Teladoc launches employee assistance program, leverages BetterHelp.
9. Trump admin to end Medicaid waivers for continuous enrollment.
10. Bankrupt Steward sues former CEO over alleged financial mismanagement.