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Gut Microplastics in Your Heart, VNS Discontinued, and FDA News
June 1, 2026
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Together with
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“The story highlights the tension from having so much of our progress in cardiology dependent on profit from industry. This is not a statement against profit; clearly, profit motive has brought us many advances in modern medicine. I would not want to go back to the 1970s. But profit motive is not exactly congruent with scientific inquiry.”
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John Mandrola, MD on LivaNova’s VNS trial discontinuation.
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I talk to cardiologists pretty often and one thing is clear, data is everything when making decisions. So it was no surprise to me when I sat down to chat with Dr. Aditi Nayak about the annual Intermacs report and found out how it can help inform LVAD use in heart failure patients. You can watch our conversation here.
On another note, it’s been a while since we covered microplastics, and today’s top story provides some unsettling insights into one molecule in particular. Maybe paper straws ain’t so bad after all.
Thanks for reading, Vik
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Most microplastic research usually focuses on tissue build-up, but a new Circulation study suggests Bisphenol F (BPF) damages our heart muscle through an unexpected pathway in the gut.
- BPF was designed as a “safer” substitute for bisphenol A (BPA) and is widely used across plastic manufacturing.
- While no studies have explored BPF heart toxicity until now, we do know that the molecule is absorbed by the body through the digestive tract.
To determine if BPF causes harm, researchers first examined its prevalence in humans and then used germ-free mouse models and single-cell sequencing to map BPF’s path from ingestion to cardiac injury.
- BPF was detected in 90.5% of human urine samples (median concentration of 1.16 ng/μg creatinine).
- In mouse models, BPF exposure produced cardiomyocyte hypertrophy and cardiac dysfunction, but only in mice with intact gut microbiota, not in germ-free ones.
- Single-cell sequencing then found that the damage occurred directly in cardiomyocytes.
But if BPF is absorbed in the gut, how does it hurt the heart? The key mechanism is through microbial conversion.
- BPF stimulates intestinal epithelial cells to secrete an enzyme called Sat1, which converts BPF into a metabolite called N-acetylputrescine (NAP).
- NAP then damages the intestinal barrier and enters blood circulation to reach the heart.
- When absorbed by cardiomyocytes, NAP inhibits sugar breakdown, leading to hypertrophy.
Researchers compared this to real-world clinical data and found that patients with inflammatory bowel disease showed elevated serum NAP levels that positively correlated with cardiac injury markers.
- That means this pathway may already be active in humans with compromised gut barriers.
The study’s authors also uncovered a potential therapeutic angle for this damage through the gut microbiome.
- Giving mice Akkermansia muciniphila bacterial supplements reduced both cardiac and intestinal injuries by downregulating the Sat1-NAP axis.
- So the Sat1 pathway could be a possible intervention target, though we’re still far away from human testing.
The Takeaway
This study is an eye opener to the fact that microplastics enter and impact our bodies, especially our hearts, in unexpected ways. It’s also a good reminder to clinicians and patients alike that avoiding plastic ingestion is probably a good idea.
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State-of-the-Art Cardiac Monitoring at Scale
Cleared for 13 different heart rhythm interpretations, AccurKardia’s AccurECG 2.0 shortens the time from an arrhythmia incident to clinical intervention. Watch here to find out how AccurKardia and Specialized Medical are teaming up to bring the AccurECG 2.0 technology to clinicians across the U.S.
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CathWorks is now part of Medtronic.
The CathWorks FFRangio™ system is the new standard in coronary physiology. Learn more.
Source: Fearon WF, Jeremias A, Witberg G, et al. Angiography-Derived Fractional Flow Reserve to Guide PCI. NEJM 2026. doi: 10.1056/NEJMoa2600949
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Why Merge Hemo is the Cardiology Hemodynamics Leader
Thanks to feedback from its customers, Merge Hemo has been named the 2026 Best in KLAS for cardiology hemodynamics for the 14th time. Watch this on-demand virtual discussion to hear the factors behind their win and the latest innovations in hemodynamics.
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- VNS Trial Discontinued: A pivotal trial of LivaNova’s vagal nerve stimulation therapy for HFrEF patients was terminated early due to financial reasons rather than futility or efficacy. While the study’s primary endpoint of time to cardiovascular death or heart failure hospitalization was not met (HR 0.84), the device achieved 96.7% freedom from serious adverse events. Secondary endpoints including HF hospitalization and quality of life also showed favorable but inconclusive trends. Curiously, the safety board recommended the trial continue, only to be overruled by LivaNova.
- Artivion’s Arch Tech Investment: Cardiovascular medtech company, Artivion, finalized its acquisition of Israel-based Endospan for approximately $135M (up to $200M in milestone payments) for its aortic stent technology. At the center of the acquisition was Endospan’s Nexus Aortic Arch System, a branched endovascular stent graft which received FDA approval in April based on the NEXUS TRIOMPHE trial data showing positive one-year survival, disabling stroke, and reintervention outcomes.
- AliveCor and Diathrive’s Cardiometabolic Play: Diathrive Health and AliveCor partnered to deliver integrated cardiometabolic care by combining Diathrive’s diabetes management platform with AliveCor’s virtual cardiovascular care solutions. The partnership will focus initially on the employer market through coordinated sales, implementation, and member-engagement strategies for more unified chronic condition management. The duo believes the new initiative will help address the connection between T2D and CVD, which are often managed separately despite diabetic patients’ elevated cardiovascular risk.
- ACIST Pro Comes to America: Bracco’s ACIST Medical Systems subsidiary received FDA clearance and launched the ACIST Pro Diagnostic System in the U.S., a next-generation automated contrast delivery technology for image-guided cardiovascular procedures. ACIST Pro evolved from the earlier ACIST CVi system, and has demonstrated a 45ml lower average contrast dose, 30% CI-AKI reduction, and five minutes saved per case compared to manual injection. The system delivers precise, variable-rate contrast media and was originally launched in Japan in 2025 and European markets in February 2026.
- Poor Hemodynamics with Impella: A hemodynamic substudy of the CHIP-BCIS3 trial found that left ventricular unloading with J&J’s Impella CP during complex PCI reduced inotrope requirements but caused significant pulse pressure loss and myocardial injury. Despite improving cardiac output and reducing filling pressures as expected, Impella use showed an eightfold risk of pulse pressure loss across the study’s 97 patients and was associated with cardiovascular mortality. The device also didn’t reduce ischemic stunning compared to standard care.
- Impella Wins Infringement Case: In other Impella news, a U.S. District Court jury decided that Abiomed did not infringe patents held by Getinge’s subsidiary Maquet relating to intravascular heart pump technology. After months of hearings and deliberation, Abiomed’s (now J&J) Impella percutaneous ventricular assist device was found to not violate any of Maquet’s patents. The patent dispute was originally divided into two disputes and the second unrelated case is still in litigation.
- Coredio CSPE’s Big FDA Wins: Coredio received FDA Breakthrough Device Designation and acceptance into the Total Product Life Cycle Advisory Program for its Cardiac Performance Simulation Engine (CPSE). Coredio’s CSPE is a software-only platform for hemodynamic assessment using consumer smartwatches and blood pressure cuffs. The technology combines physics-based digital cardiovascular models with machine learning to noninvasively assess four key hemodynamic parameters: LVEDP, CVP, SVR, and cardiac index. This allows clinicians to monitor heart failure patients in home and office settings.
- Lowering LDL-C With Epigenetics: Getting us closer to genetic treatments in cardiology, Scribe Therapeutics reported positive preclinical data for STX-1150, its epigenetic silencing therapy for long-term LDL-C lowering. Per the study, STX-1150 achieved up to 90% PCSK9 reduction and 68% LDL-C lowering in non-human primates with a single dose and the lowest dose given maintained >50% LDL-C reduction for over 22 months. STX-1150 uses proprietary ELXR technology combining CRISPR with epigenetic mechanisms to silence PCSK9 transcription without permanently altering DNA.
- The CV Importance of Postpartum Care: A new ACC scientific statement suggests that postpartum care is a critical opportunity to improve cardiometabolic outcomes. The statement clarifies that women with cardiac conditions, hypertension, obesity, and adverse pregnancy outcomes including gestational diabetes and preeclampsia are at highest risk of cardiometabolic complications. That’s especially true considering that 60% of pregnancy-associated heart failure cases occur in the first two weeks postpartum and 40% of commercially insured patients skip postpartum visits within 8 weeks.
- Top Healthcare AI Failures: A brutal-yet-entertaining LinkedIn post from Dmitrii Gorbunov rounded up five of the biggest failures we’ve already seen from healthcare AI. The crown of shame went to Kaiser Permanente, which was fined $556M for using AI to add diagnostic codes to medical records without clinical confirmation, physician input, or audit trails. Dishonorable mentions included UnitedHealthcare (physician decision overrides), Cigna (one-second denials), Sharp (fabricated consent documents), and Doctronic (duped into recommending massive doses for opiates).
- Lantheus Mulls Takeover Bid: Radiopharmaceutical provider Lantheus is evaluating its options after getting a takeover offer from Curium Pharma. As first reported by Bloomberg, Curium offered to acquire Lantheus in an acquisition valuing the company at $7B. Lantheus is one of the largest suppliers of radiopharmaceuticals and major player in CV and echocardiography contrasts, although in January 2026 it sold its SPECT tracer business to SHINE.
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How AI Expands the Role of CMR Experts
If you’re an MRI technologist, AI could be the best thing that ever happened to your career. Read here to learn about the benefits of AI for CMR experts and how it can accelerate both your training and opportunities.
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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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Circle CVI’s CAD-RADS Rundown
Ever wondered how CAD-RADS enhances the communication of coronary artery disease findings from imaging studies? Check out this guide from Circle Cardiovascular Imaging about the evolution of CAD-RADS and how to incorporate it into your practice.
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- Why Competitors Benchmark Against Monebo’s ECG Algorithm: In the world of cardiac monitoring, it’s a big deal when your competitors use your technology as their benchmark for success. Learn why Monebo Technologies’ ECG analysis algorithm has been the “predicate device” of at least 13 other companies FDA 510(k) clearance regulatory filings and what this means for providers and their patients.
- Fujifilm’s Ultrasound for every Cardiovascular Ultrasound Environment: From academia to clinical diagnostics, versatility in cardiac ultrasound is essential. Discover why clinicians are choosing Fujifilm’s LISENDO 880 for exceptional image quality, comprehensive strain analysis, stress imaging, and innovative Virtual Contrast technology — all while delivering outstanding value.
- Staying ALERT with Tempus: Undertreatment and time to treatment of valvular heart disease are among the biggest challenges health systems face today, but Tempus’ AI-driven EHR notifications can change that. Read the results of Medtronic and Tempus’ ALERT trial which found that delivering data directly to providers resulted in a 40% relative increase in life-saving valve procedures.
- Harnessing the Power of AI to Improve Patient Care: Endeavor Health is one of the first healthcare providers in the Midwest to use AI in the echocardiography lab. Learn how they are harnessing echo AI’s tremendous potential to improve diagnoses in this report from Us2.ai.
- Heart failure places enormous strain on our healthcare systems and patients: There are 3.7 million US patients with HFpEF or HFmrEF, with prevalence only expected to rise. To learn more about the heart failure landscape and Bayer’s commitment to addressing patient unmet need, watch the video here.
- 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.
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