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Fatty Hearts, OmniaSecure’s Approval, and ALARA+
March 26, 2026
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Together with
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“I wonder how much of medicine is driven by drugs. For example, why did they decide that LDL cholesterol is the main marker for heart disease, rather than triglycerides or insulin? After all, triglycerides and insulin are better markers of heart disease risk.”
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Dr. Ben Bikman’s much-criticized X post on what drives testing targets.
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ICYMI: If you missed Cardiac Wire’s latest webinar with Dr. Udo Hoffman, Dr. Brittany Weber, and Dr. Kashif Shaikh, you can now watch the full session on demand! Hosted by Cardiac Wire in partnership with Cleerly, we explored how AI-powered plaque analysis is different across unique patient populations. You can watch it on-demand here.
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We all know by now that too much body fat isn’t good for your heart, and new research suggests that the fat directly around your heart could play a role in your risk of coronary artery disease (CAD).
- Fat around the heart is also known as epicardial adipose tissue (EAT).
- While studies have looked at overall body fat burden as a clinical risk factor, none have tried to quantify the risk of a fatty heart until the PARADIGM registry.
Drawing data from PARADIGM, researchers followed 773 patients for eight years after they underwent serial CCTA imaging and categorized them into three EAT volume categories: low (≤ 77 cm3), moderate (77-113 cm3), and high (> 113 cm3).
- Nearly all patients (83.7%) saw their plaque volume progress, while a third of them developed new plaque after starting a zero.
- Progression of total plaque volume (including calcified and non-calcified) was consistently greater for the highest EAT volume category.
- Additionally, plaque progression rates (78.9% vs. 83.9% vs. 88.5%) increased across all three EAT categories.
There’s a serious caveat to these results though, since researchers determined that EAT volume measured with CCTA was not independently associated with major adverse cardiovascular events.
- Only when the fat volume readings were considered alongside a patient’s plaque progression data did it influence 10-year MACE risk predictions.
- However, high EAT volume was independently associated with CAD presence and progression.
So what does this mean for paying attention to fat around the heart?
- For one, it can still be a useful non-invasive biomarker for following statin and GLP-1 therapy impacts on the heart, since both can reduce EAT.
- Moreover, enlarged fat cells release proinflammatory cytokines that could contribute to localized inflammation of the heart tissue, ultimately contributing to heart disease.
- EAT could also eventually find a place among other CAD risk factors like cholesterol, Lp(a), and CAC.
The Takeaway
Fat around the heart isn’t random nor harmless, and while this study does suggest keeping an eye on it can provide some useful information, it’s still unclear how we’ll use that data for clinical decisions.
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Personalized Plaque Analysis Now With Medicare Coverage
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.
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The Power of AI in Cardiovascular Imaging
Cardiac labs are under more pressure than ever to deliver more with greater speed and precision. Hear from Tony Gallagher, Director of Noninvasive Cardiology at Baptist Health Lexington about how Siemens Healthineers’ ACUSON Origin is reshaping daily practice and transforming the future of echocardiography.
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How Vista AI Helps Solve the Technologist Shortage
Fewer than 2% of MRI scanners are routinely used for cardiac imaging—mainly due to a shortage of trained technologists amid rising demand. Vista AI addresses this challenge by automating CMR scanning, empowering technologists of all experience levels to deliver high-quality cardiac exams consistently and efficiently.
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- OmniaSecure Earns FDA Approval: Medtronic’s OmniaSecure received FDA approval, becoming the first defibrillation lead for left bundle branch area placement. This expansion supports Medtronic’s conduction system pacing (CSP) and LOT-CRT technologies, mimicking natural physiology to avoid pacing-induced cardiomyopathy. Validated by the LEADR LBBAP trial, this ultra-slim, lumenless lead could provide a reliable solution for adults and adolescents requiring both resynchronization and protection against sudden cardiac arrest.
- DASI’s TAVR Planning at CC: Cleveland Clinic and DASI Simulations partnered to enhance TAVR procedures using AI-driven predictive modeling. The PrecisionTAVI platform allows clinicians to simulate valve deployment, personalizing care by anticipating risks like coronary obstruction. The collaboration aims to evolve AI from a pre-procedural planning tool into a real-time execution resource, ensuring optimal lifetime management for structural heart patients.
- GLP-1s Post-MI: The “GLP-1 revolution” has officially moved into the acute care setting. An analysis of over 280k patients without diabetes showed that initiating tirzepatide (Zepbound/Mounjaro) within 14 days of a heart attack or stroke significantly improves two-year clinical outcomes. While the study found no difference in total MACE, patients on early tirzepatide therapy experienced a significantly lower risk of heart failure hospitalization, acute kidney injury, and recurrent ischemic stroke.
- DCD vs. DBD Hearts: Single-nuclei RNA sequencing of organ donor hearts suggests that there are distinct molecular differences in hearts donated after brain death (DBD) versus circulatory death (DCD). DCD hearts show significant ischemic stress and proinflammatory signaling, while DBD hearts have superior metabolic efficiency despite some endothelial inflammation. This means there could be specific cellular targets for therapies aimed at reducing preservation-induced injury and improving long-term graft longevity in heart transplantation.
- A New Infant Stent: Starlight Cardiovascular announced the world’s first implantation of its Lifeline Ductus Arteriosus Stent System in an 8-day-old baby at Cincinnati Children’s Hospital. The hospital’s cardiac team performed the procedure on an infant with a condition known as “double inlet left ventricle and pulmonary atresia,” using the purpose-built device to maintain pulmonary blood flow. The stent is designed specifically for infant ductal anatomy, offering improved flexibility and precision compared to adapted adult stents and is currently being studied under FDA IDE.
- CVAUSA’s Heartflow Integration: Cardiovascular Associates of America will deploy Heartflow’s AI diagnostic platform across its network of over 460 physicians to modernize its coronary artery disease workflow. By utilizing the Heartflow One platform (including FFRCT and Plaque Analysis) CVAUSA clinicians can generate personalized 3D digital models from non-invasive coronary CT scans to assess specific plaque composition and its impact on blood flow. This strategic rollout aims to provide more precise insights for the 1.3M patients CVAUSA serves annually.
- CCP’s Bedside AI Revolution: Cardiology Consultants of Philadelphia plans to integrate AISAP’s AI-enabled cardiac diagnostic platform across its independent cardiovascular practice. AISAP’s platform uses point-of-care ultrasound devices to provide automated assessments of valvular pathologies and heart failure metrics (like LVEF and ventricular dimensions) directly at the patient’s bedside. This rollout aims to create an “upstream triage” that allows clinicians to identify asymptomatic or early-stage heart disease in real-time while reducing reporting times.
- Africa’s Clinical Trial Gap: A systematic review of leading medical and cardiovascular journals from 2019 to 2024 revealed that African countries are severely underrepresented in randomized controlled trials (RCTs). The study found that only 3.9% of RCTs in top general medical journals and a staggering 0.6% in leading CV journals were conducted exclusively in Africa, with Central Africa seeing almost no representation and Africa-only trials focusing heavily on infectious diseases (75.9%).
- Cardiac Amyloidosis Partnership: Faster diagnosis of cardiac amyloidosis is the focus of a new partnership between Viz.ai and RNAi CA drug maker, Alnylam Pharmaceuticals. Viz.ai will develop an AI-based care pathway within its Viz Cardio Suite for identifying cardiac amyloidosis earlier that leverages echocardiography AI algorithms developed by Us2.ai. The combination will identify at-risk patients from echo exams, then enable confirmatory testing, patient referral, and track follow-up.
- Repeat CAC Scans Guide Cardiac Risk Assessment: More research confirms the value of repeat testing with CT-derived coronary artery calcium scans. In a new AJPC paper, researchers acquired CAC scores for 4.2k people from the CLARIFY study and followed them for almost six years. People with CAC scores of 0 at baseline had no increased risk of major adverse cardiovascular events, but those whose CAC scores increased faced nearly double the risk of MACE (HR = 1.96), an effect found across CAC severity levels.
- Stronger Fluoro Radiation Standards: As the U.S. government considers relaxing occupational radiation exposure standards, a coalition of cardiac and interventional medical groups is recommending that they be strengthened in one area, catheterization labs. A new report from the coalition recommends the adoption of ALARA+, an updated set of safety guidelines for fluoroscopy-guided procedures that includes better radiation protection technologies, real-time radiation monitoring, better radiation education and training, and stronger regulatory and accreditation standards.
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cvi42’s Real World Results
Consistency of measurements over time is of utmost importance for clinical interpretation and follow-up. Read about how cardiac imagers are using Circle Cardiovascular Imaging’s cvi42 platform to dramatically reduce manual segmentation by up to 60%.
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RoR in the Real World with Monebo and UNCG
Strenuous exercise can significantly reduce people’s heart relaxation reserve, putting them at risk without preliminary warning signs. Find out how Monebo’s new Reserve of Relaxation technology provides a crucial tool for anyone looking to enhance their physical performance without harm.
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How Us2.ai Improves CA Screening
Cardiac amyloidosis may not be as rare as previously thought, with early and accurate detection becoming increasingly critical for treatment. Read about how the AI-SCREEN-CA study implemented Us2.ai’s automated CA reporting and AI-based pattern recognition analysis, leading to better disease screening at scale.
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- Earlier Detection, Better Outcomes: When it comes to heart disease, early detection is crucial to a patient’s long-term health. Learn more about how Fujifilm helps clinicians achieve that with the Lisendo 880 cardiovascular ultrasound system’s unique solutions that detect early abnormalities seen in heart failure, while offering insight into cardiac functions and groundbreaking hemodynamic analysis.
- 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.
- Heart Failure Hospitalization Doubles Risk of Cardiovascular Death: 21% of patients with symptomatic heart failure escalate to hospitalization for heart failure or cardiovascular death, and 25% of those who experience hospitalization are readmitted due to heart failure within one year of discharge. Watch Bayer’s Dr. Alanna Morris-Simon discuss heart failure hospitalizations and when to assess care plans.
- Merge Hemo Ranks 2026 Best in KLAS: Merge Hemo ranked 2026 Best in KLAS for cardiology hemodynamics, marking the 14th year it’s been named a category leader. Find out more about why Merge’s strategy of a modular, unified imaging solutions portfolio continues to dominate the KLAS rankings, year in, year out.
- 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.
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