Venk Murthy, MD, PhD on the results of a recent CJC study (covered below).

Every year, over 10 million chest CT scans are done in the U.S. alone, and among them, many asymptomatic patients with enlarged heart chambers are missed. In this Cardiac Wire Show interview, we talked to key opinion leaders about the new technologies becoming available to improve heart chamber screening, such as AutoChamber from HeartLung Technologies.

Cardiovascular Disease

The Impact of Physical Activity Before and After CV Events

A long-term analysis of the CARDIA study revealed that moderate-to-vigorous physical activity steadily declines from young adulthood through midlife, but patients destined to develop cardiovascular disease experience rapid activity decreases more than a decade before their first event.

• Studies have shown that moderate-to-vigorous physical activity (MVPA) is critical for both preventing and managing cardiovascular disease.
• To help stave off CVD, guidelines recommend 150 minutes per week of MVPA.
• However, previous research focused on short-term activity patterns rather than lifelong impact on cardiac events.

Collecting data over 37 years, researchers tracked ~3k participants from young adulthood to middle age and paired each individual with a matched control partner, finding that…

• Patients who eventually developed CVD, began decreasing their physical activity levels roughly 12 years before their cardiac events.
• Activity decline accelerated sharply within 2 years before their first cardiovascular event.
• Post-CVD, patients remained 78% more likely to maintain low activity levels compared to matched controls.
• Heart failure patients showed the steepest pre-event declines and consistently low post-event activity.

Researchers also identified striking demographic disparities that persisted throughout the entire study, even after adjusting for pre-CVD activity levels…

• Black women consistently reported the lowest MVPA levels across all age groups.
• Black women also faced the highest risk of low post-CVD activity (OR: 4.52).
• Black men experienced more sustained activity decline compared to other groups.

The Takeaway

This 37-year study reveals that CVD casts a long shadow, with physical activity decline beginning more than a decade before clinical events manifest. Even more sobering is the fact that post-CV-event activity gaps suggest traditional cardiac rehabilitation may not be enough for long-term recovery. In other words, don’t wait till it’s broken to fix it.

GLS Analysis of Us2.ai’s Fully-Automated Software

Ten years after the first head-to-head comparison of 2D echocardiography, the latest review suggests Us2.ai is among the easiest to use and integrate. Read the study to learn about how Us2.ai’s software requires zero operator input, operates without human intervention, and leads to high agreement with traditional semi-automated speckle- tracking software solutions.

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

Addressing Coronary Artery Disease

Learn how the AGENT™ Drug-Coated Balloon provides a new treatment option for in-stent restenosis in the U.S. Rx Only. (Sponsored by Boston Scientific)

The Wire

• Ultromics’ Series C: Ultromics raised $55M in Series C funding to scale its FDA-cleared AI technology that detects heart failure from routine echocardiograms. The EchoGo platform identifies hard-to-diagnose conditions like HFpEF and cardiac amyloidosis, improving HFpEF detection by 73.6% compared to standard methods. With up to 64% of heart failure cases going undiagnosed and costs projected to reach $70B by 2030, Ultromics’ Medicare-reimbursed solution addresses a critical diagnostic gap.

• Cardiosense’s CardioTag Cleared: Cardiosense received FDA 510(k) clearance for CardioTag, the first multimodal wearable sensor capturing ECG, PPG, and seismocardiogram signals simultaneously. The device measures cardiac mechanics and blood flow beyond traditional rhythm monitoring, accurately assessing cardiac timing intervals like left ventricular ejection time. Cardiosense plans to pair CardioTag with AI algorithms, including their FDA Breakthrough Device-designated pulmonary capillary wedge pressure algorithm that matches implantable sensor accuracy for advanced heart failure management across care settings.

• COVID or Flu in CV Outcomes: A new study in CJC suggests there might be a closer cardiovascular link between the flu and COVID-19 than previously thought. Researchers retrospectively studied 34k hospitalized patients and found similar rates of elevated cardiac biomarkers between both flu and COVID infections, such as troponin elevation (~40% of patients) and natriuretic peptides (72-82%). The study also uncovered that new clinical cardiac diagnoses were rare and similar between groups (for example, HF: ~2.5%, AFib: 3-5%).

• You Are What You Drink: Researchers now believe your refreshment of choice could significantly impact your CVD risk depending on how much sugar is in it. To test this, a recent study out of China developed a “healthy beverage score” (HBS) where coffee, tea, and low-fat milk led to higher scores while sugar-sweetened and artificially sweetened drinks led to lower ones. The study then examined ~9k adults’ beverage consumption patterns and found that participants with low HBS had increased CVD and all-cause mortality risks, regardless of age, sex, smoking status, and other factors.

• But You’re Not What You Smoke: In the same vein, another study found that smoking cannabis might not increase a person’s risk of CVD unlike previously thought. The study examined 4.2k veterans (ages 66-68) with coronary artery disease and found that those who reported smoking cannabis in the past 30 days showed no increased risk of cardiovascular death, stroke, or heart attack compared to those who didn’t over a 3.3 year follow-up (aHR: 0.87).

• Sulfonyureas Increase CV Risk: Adding to the complications between T2D and CVD, a recent JAMA study found that diabetes patients on metformin faced higher CVD risks while taking sulfonylureas compared to DPP4is. Researchers studied 48k T2D patients on metformin and found five-year MACE rates for patients taking DPP4 inhibitors were 8.1%, which was lower than sulfonylureas like glyburide (8.4%), glimepiride (8.6%), and glipizide (9.1%). Despite known cardiovascular concerns, glipizide remains widely used due to its low cost (~$50 annually).

• Post-TAVR Stroke Higher in Women: TAVR outcomes might be different between men and women, especially when it comes to stroke. A study of nearly 380k TAVR patients from 2016-2021 found that women had significantly higher stroke rates than men (2.31% vs 1.69%). The primary driver of this disparity was disabling strokes occurring in 1.61% of women versus 1.02% of men. Researchers suggest clinicians counsel female patients about heightened stroke risk and consider tailored strategies like embolic protection devices to improve outcomes.

• DNA Methylation Impacts CVD: Strengthening the association between genetics and CVD, a new Circulation study suggests DNA methylation could play a big role in CVD risk. Researchers analyzed DNA methylation patterns across 5 diverse cohorts using the AHA’s Life’s Essential 8 score and identified 609 methylation sites linked to cardiovascular health. The most important DNA sites were those that coded for inflammatory pathways leading to strong associations with stroke (29-fold) and ischemic heart disease (21-fold).

• How Old Are Your Veins? Researchers have developed an Aortic Vascular Age Index (AVAI) using 3D imaging to quantify vascular aging, revealing that the heart is directly impacted by how “old” our vasculature is. After creating the index, researchers studied 63k patients and found that early aortic aging was associated with adverse cardiac remodeling, including increased left ventricular mass and wall thickness. Beyond this, a patient’s AVAI showed high heritability (40%) with 54 genes identified, mostly involving fibrillin-1 and elastin genes.

• Junctophilin’s Role in Cardiac Remodeling: According to a Circulation study, there could be a specific membrane protein that is involved in fibrosis following MI. Using mice models, researchers uncovered that junctophilin-2 (Jph2) is the only junctophilin expressed in cardiac fibroblasts (CFs) and increases after myocardial infarction. Fibroblast-specific Jph2 mice showed worse cardiac remodeling post-MI, including decreased CF activation, enhanced proliferation, systolic dysfunction, and impaired angiogenesis. On the other hand, mice with Jph2-deficient CFs showed impaired activation, reduced extracellular matrix production, and decreased VEGF expression.

• Lp(a) Helps Predict ASCVD: Revisiting the debate around Lp(a)’s predictive abilities, a UK Biobank study suggests the molecule significantly predicts extracoronary ASCVD. Over 13.6 years of follow-up, patients with a higher Lp(a) concentration faced an increased risk of peripheral artery disease (HR 1.18 per 75 nmol/L) and carotid stenosis (HR 1.17). Among those with existing PAD, high Lp(a) also increased major adverse limb events by 57%.

Identify and Treat Cardiovascular Disease

Complex care pathways make getting patients to the next step a challenge. See how Tempus Next, an AI enabled care pathway platform, helps providers identify and reduce under treatment in cardiovascular disease by adding an intelligent layer onto their routinely generated EHR data.

An All-in-One Coronary Care Solution

See how HeartFlow ONE is transforming precision heart care as the first all-in-one CCTA pathway, combining FFRCT, stenosis, and plaque analysis in a single workflow.

PIA Medical Processes It All

Need an analysis like calcium scoring, strain or even FFR? PIA Medical began as a Core Lab and can handle creative cardiac research and clinical trials along with the full breadth of clinical analyses available today.

The Resource Wire

• Configure Your PCI Study: See for yourself how cardiac imagers use GE HealthCare’s Centricity Cardio Enterprise Universal Viewer to do their PCI studies, including configurable viewport setup and side-by-side comparisons.

• Assessing CAD with Circle CVI: Did you know that Circle CVI offers a suite of cardiac CT tools for the assessment of coronary artery disease? See how Circle combines heart function segmentation, automated plaque analysis, CAC scoring, reporting, and viewing in a single dedicated Cardiac CT package.

• Hope for advanced heart failure patients who do not respond to medical treatments: The HeartMate 3™ LVAD offers proven long-term, life-prolonging therapy for a patient population who otherwise would not be expected to survive beyond 1 year. Clinical outcomes for HeartMate 3 LVAD include >5 years median survival and 67% reduction in HRAE- related mortality.

• CMR Access Is Broken—Here’s How to Fix It​: Cardiac MRI is one of the most powerful tools for diagnosing heart disease, yet it’s still out of reach for many patients. Download Vista AI’s new infographic to see what’s holding CMR adoption back—and how AI and automation can help make gold-standard imaging more accessible than ever.

• Your Cardiology Data is Valuable. Put it To Work. See how one major Midwest health system’s decision to implement Merge Cardio transformed physician and staff workflows, improved data entry speed and accuracy, and increased cost savings.

• Monebo’s Approach to Cardiac Health Monitoring: The heart works day and night, so your cardiac monitoring software should too. Learn about how Monebo’s latest innovation superimposes long-term monitoring results onto a 24-hour circadian cycle scale, creating a comprehensive map of circadian variations.

• 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.

The Industry Wire

1. New T1D treatments could target the brain.
2. Major healthcare equipment firm on brink of failure.
3. UnitedHealth Group to replace CFO.
4. FDA requires labels to clarify opioid risks.
5. Trump admin to pilot 340B rebate model next year.
6. Cigna beats investor expectations on Evernorth growth.
7. >50% of healthcare orgs attacked with ransomware last year.
8. Trump admin also launches health data sharing initiative.
9. CMS finalizes 2.6% hospital pay bump for FY2026.
10. Medicaid cuts drive hospitals’ efficiency overhaul.