Anish Koka, MD, on the current physician shortage in the U.S.

ECG is emerging as a broad biomarker for cardiovascular health, not just for diagnosis, but for reflecting a patient’s true future risk. In the latest episode of the Cardiac Wire Show, we heard from AccurKardia’s Moin Hussaini and Dr. Matthew Segar, MD on how they’re leveraging AI to interpret ECGs for better aortic stenosis detection and prognosis.

Cardiovascular Disease

Genetic Risk Scores Improve CAD Detection

Coronary artery disease risk assessment might soon rely on genetic testing, following a UK Biobank analysis that suggests adding a CAD multi-gene risk score to conventional biomarkers significantly improves disease prediction and patient identification.

• Traditional CAD risk assessment uses biomarkers that fluctuate over time, while genetic scores capture inherited disease risk since birth.
• Currently, there are over one million genetic mutations that can lead to inherited CAD risk.

Examining genetic profiles, researchers followed 353k UK Biobank participants without baseline CAD for 11 years on average, and compared the predictive effects of adding a polygenic risk score (PRS) to a combo of three CV biomarkers (LDL-C, Lp(a), hs-CRP), finding substantial improvements…

• The predictive model’s discrimination significantly improved when CAD PRS was added to biomarkers (C-index: 0.739 vs. 0.754).
• The improvement was also similar when apoB replaced LDL-C (C-index: 0.740 vs. 0.754).
• Patients in the highest category for all three biomarkers showed 2x CAD risk (aHR: 2.15), but those also in the highest CAD PRS category faced nearly 4x higher risk (aHR: 3.71).
• CAD PRS alone showed stronger association than any single biomarker, with the highest PRS group facing 78% higher risk.
• Risk stratification also remained consistent across patient sex, suggesting universal applicability.

Since genetic risk is determined at birth and remains constant, using polygenic risk scores for CAD could enable early identification of high-risk patients before biomarker abnormalities even develop.

• Some institutions already use PRS in clinical risk assessment, but insurance coverage remains limited with tests costing $200-$250.
• It’s also worth noting that high genetic risk doesn’t doom a patient, since knowing earlier can enable preventive interventions before disease manifests.

The Takeaway

This study, like other genetic cardiology studies, reminds us that some people are at higher risk of heart disease no matter how they live their lives. The good news is, we have the technology to find out who these people are and with a disease like CAD, catching it sooner always leads to better outcomes.

Median Survival for HeartMate 3 LVAD Patients Exceeds 5 Years

Find out why for select transplant-eligible patients, the HeartMate 3 LVAD and heart transplant can be used as complementary therapies, resulting in net prolongation of life and even extending many patients’ lives 10+ years.

Vista AI Grows CMR Volume

Are your patients waiting weeks or months for cardiac MRIs? See Brigham and Women’s Hospital’s real-world results showing how Vista AI’s software for automated MRI scanning led to 50% more scan slots, without adding more scanners or staff.

Tempus Receives FDA 510(k) Clearance for Tempus ECG-Low EF

Tempus announces the expansion of its Tempus ECG-AI portfolio with Tempus ECG-Low EF, software intended for use to analyze 12-lead ECG recordings and detect signs associated with having a low left ventricular ejection fraction (LVEF less than or equal to 40%) in patients 40 years of age or older at risk of heart failure. It is not intended as a stand-alone diagnostic and positive results may suggest the need for further clinical evaluation. For Full Indications for Use, visit here.

The Wire

• Bodybuilding Increases SCD Risk: Another bodybuilder study suggests that while the sport may lead to impressive physiques, it isn’t good for the heart. Researchers followed 9.4k female competitive bodybuilders over 16 years, recording 32 deaths and finding that sudden cardiac death was the leading cause, significantly exceeding rates in other female athletic populations (10.47 per 100,000 athlete-years). While female bodybuilders showed lower mortality rates than males, those who competed professionally faced the highest mortality risk, likely due to steroid abuse.

• PET Predicts Heart Attack Recovery: PET can predict which patients might have poor functional recovery after an acute myocardial infarction. In a JNM study, researchers tested PET with 68-gallium-pentixafor, a radiotracer that detects expression of the CXCR4 inflammatory protein. Cardiac PET/CT scans of 49 heart attack patients found that the area of CXCR4 uptake predicted left ventricular ejection fraction, a sign of positive ventricular remodeling.

• High Heat = High CV Risk: Though it’s already known that high heat is bad for the heart, a new EJPC study out of China now quantifies the CV risk people face from overheating. The study analyzed 856k acute cardiovascular disease cases and found that extreme heat exposure increased CVD risk by 17% (cumulative relative risk 1.17), with peak effects four days post-exposure. Heat contributed to 3.2% of all CVD cases, while elderly individuals, rural populations, and those in temperate climates faced the highest risk.

• CareDx’s SHORE Registry: CareDx published findings from the SHORE registry in JACC: Heart Failure, demonstrating that its AlloSure Heart technology accurately identifies antibody-mediated rejection (AMR) in heart transplantation. The SHORE registry analyzed 2,240 patients, finding that AlloSure Heart (which measures donor-derived cell-free DNA) identified patients suffering from AMR with 92.8% specificity. CareDx combines AlloSure with AlloMap in its HeartCare product, to offer non-invasive tests that can potentially reduce unnecessary surveillance biopsies while improving post-cardiac transplant monitoring.

• Narcolepsy Meds and BP: Narcolepsy patients face higher CV risk, especially those with high blood pressure, but a recent AHA study suggests switching patients from high-sodium to low-sodium oxybate narcolepsy medication could lower this risk. The study examined 43 narcolepsy patients with elevated blood pressure who switched from high-sodium to low-sodium oxybate and found that after six weeks, patients showed significant reductions in both daily sodium intake (median decrease of 1,288 mg/day) and mean 24-hour ambulatory systolic blood pressure (4.1 mm Hg decrease).

• Immunexpress’ SeptiCyte Success: Immunexpress announced two studies that demonstrated how accurate its SeptiCyte RAPID technology is at differentiating sepsis from non-infectious inflammation in high-risk post-cardiac surgery patients. The first study showed elevated SeptiScores correlated with clinical severity in infective endocarditis patients, while negative results excluded infection complications. The second study achieved 100% negative predictive value for excluding infection in mesenteric ischemia patients, outperforming traditional biomarkers like procalcitonin and C-reactive protein.

• Semaglutide Protects the Heart: A new sub-analysis of Novo Nordisk’s SELECT trial suggests semaglutide’s CV benefits extend beyond simple body fat reduction. The subanalysis included 17.6k overweight/obese patients with cardiovascular disease without diabetes and found that semaglutide reduced MACE consistently across all baseline weight and waist circumference categories. While greater waist circumference reduction correlated with lower MACE risk, (approximately 33% of the benefit), the cardioprotective effects were largely independent of baseline body fat percentage and weight loss.

• Impella Class I Recall Confirmed: The FDA has doubled down on its Class I recall of Johnson & Johnson MedTech’s Automated Impella Controllers due to purge retainer failures causing cracks during disc insertion/removal. These failures can disrupt hemodynamic support, potentially causing pump stoppage and serious patient harm. Hospital inventory may continue being used while unused units should be returned for updates. This marks the fourth recent safety concern with these controllers, including previous recalls and cybersecurity issues, since Johnson & Johnson acquired Abiomed in 2022.

• Pre-Pregnancy Hyperlipidemia: A study presented at the ACC’s Cardio-Obstetrics conference suggests that pre-pregnancy hyperlipidemia significantly increases risks of obstetric complications and cardiovascular events within five years postpartum. Researchers analyzed over 10k women across the U.S., finding that women with hyperlipidemia prior to becoming pregnant faced elevated risks of arrhythmias, acute coronary syndrome, gestational diabetes, hypertensive disorders, and labor complications. Researchers recommend incorporating lipid screening into preconception care and closer monitoring during and after pregnancy.

• Ancora’s LV Restoration Tech: Ancora Heart announced two-year results from its early clinical studies that showed its AccuCinch Transcatheter Left Ventricular Restoration System maintained sustained reverse remodeling in heart failure patients. The analysis of 51 symptomatic HFrEF patients showed significant reductions in LV volume, improved EF (5.4%), enhanced QoL scores, and reduced HF hospitalizations compared to pre-implant rates. Following these results and FDA Breakthrough Device Designation, the company’s ongoing CORCINCH-HF pivotal trial is intended to support an upcoming FDA Premarket Approval submission.

• ASE Wants Better TEE CPT Codes: The ASE is proposing new interventional echocardiography CPT coding structures for structural heart procedures to help align payment with the difficulty of the modality. Currently, CPT code 93355 serves as a catch-all for transesophageal echo during transcatheter procedures. However, the ASE asserts that the single code doesn’t properly reflect the significant time and expertise required, with low RVUs failing to justify the resource allocation. To address this, the ASE plans to develop procedure-specific codes through the AMA’s RUC process.

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.

Monebo’s Customers Lead the Way

Monebo’s customers span across the globe, and range from local cardiac monitoring companies to major ECG OEMs. See what they all have in common, and how the Monebo monitoring advantage might help your business.

Changes in Heart Failure Management

Heart failure is a complex condition with high heart failure hospitalization and cardiovascular mortality rates, especially among patients with HFpEF and HFmrEF, for whom treatment options have been limited. Read how Bayer’s Dr. Alanna Morris-Simon discusses the changing treatment landscape and strategies for improving patient outcomes.

The Resource Wire

• Us2.ai’s AI HF Now Possible with Handheld Echo: The latest research shows Us2.ai’s software can take handheld echocardiography beyond its standard applications. Read this EHJ study about how swiftly and accurately Us2.ai’s HF detection software detects LVEF, closely matching expert human analysis of standard cart based echocardiograms.

• 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.

• 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.

• 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.

• Heartflow Plaque Analysis: Accurate CAD Assessment Now Covered Across the US: Heartflow’s Plaque Analysis is now reimbursable thanks to Medicare’s new coverage for AI-enabled plaque analysis of eligible patients with coronary artery disease.

• 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.

The Industry Wire

1. CMS calls back some employees for Medicare/ACA enrollments.
2. NewYork Presbyterian CEO to step down.
3. OpenEvidence nabs $200M in digital health funding.
4. What antidepressants do to the brain and body.
5. Measles spreading beyond Utah-Arizona outbreak epicenter.
6. Nearly 1/5 urinary tract infections linked to contaminated meat.
7. Senators show bipartisan support for reforming 340B.
8. Ballad Health sues UnitedHealth over Medicare Advantage claims denials.
9. Optum taps its second CFO in 6 months.
10. Elevance to penalize facilities for out-of-network providers.