Ankylosing spondylitis (AS) is a chronic inflammatory arthritis affecting the spine, presenting a considerable morbidity risk. Although evidence consistently indicates an elevated risk of ischemic heart disease among AS patients, debates persist regarding the likelihood of these patients developing left ventricular dysfunction (LVD). Our investigation aimed to determine whether individuals with AS face a greater risk of LVD compared to the general population. To accomplish this, we identified studies exploring LVD in AS patients across five major databases and Google Scholar. Initially, 431 studies were identified, of which 30 met the inclusion criteria, collectively involving 2933 participants. Results show that AS patients had: (1) poorer Ejection Fraction (EF) [mean difference (MD): −0.92% (95% CI: −1.25 to −0.59)], (2) impaired Early (E) and Late (atrial—A) ventricular filling velocity (E/A) ratio [MD: −0.10 m/s (95% CI: −0.13 to −0.08)], (3) prolonged deceleration time (DT) [MD: 12.30 ms (95% CI: 9.23–15.36)] and, (4) a longer mean isovolumetric relaxation time (IVRT) [MD: 8.14 ms (95% CI: 6.58–9.70)] compared to controls. Though AS patients show increased risks of both systolic and diastolic LVD, we found no significant differences were observed in systolic blood pressure [MD: 0.32 mmHg (95% Confidence Interval (CI): −2.09 to 2.73)] or diastolic blood pressure [MD: 0.30 mmHg (95% CI: −0.40 to 1.01)] compared to the general population. This study reinforces AS patients' susceptibility to LVD without a notable difference in HTN risk.

Atrial fibrillation (AF) is a common and clinically significant complication in cancer patients, but data on its incidence and impact among multiple myeloma (MM) patients undergoing autologous stem cell transplantation (ASCT) remain limited. The aim of this study was to characterize the incidence, predictors, and prognostic implications of AF following ASCT in MM patients. A total of 801 MM patients who underwent ASCT between 2016 and 2022 were retrospectively analyzed. Pretransplantation evaluation included electrocardiography and echocardiography within 180 days of conditioning. Patients with AF at baseline were excluded. Post-transplantation AF was defined as electrocardiography-confirmed AF occurring after stem cell infusion. Over a median follow-up period of 36.2 months, 70 patients (8.7%) developed post-transplantation AF. The cumulative incidence was 5.5% at 90 days and 9.0% at 3 years, with a median onset of 13 days. Independent predictors included age >65 years (HR: 1.88; 95% CI: 1.16-3.07), prior paroxysmal AF (HR: 6.19; 95% CI: 3.63-10.5), and obesity (HR: 2.00; 95% CI: 1.10-3.63). Left atrial volume index >34 mL/m² (HR: 1.67; 95% CI: 0.99-2.80) and corrected QT interval >480 ms (HR: 1.69; 95% CI: 0.91-3.12) were associated with AF but not statistically significant after adjustment. Among patients without prior AF, corrected QT interval >480 ms remained a significant predictor. In multivariable analysis, post-transplantation AF conferred a 5-fold higher risk for all-cause mortality and a 4.5-fold higher risk for nonrelapse mortality. AF is a frequent and high-risk complication among MM patients undergoing ASCT. Routinely available clinical factors enable risk stratification, underscoring the importance of cardiovascular evaluation and vigilant post-transplantation monitoring in this vulnerable population.

Disparities in health care access persist in cardiovascular interventions. Coronary lithotripsy, a novel treatment for calcified coronary lesions, shows variability in utilization by sociodemographic factors. This study examines the impact of sex, race, income, and hospital characteristics on lithotripsy use in the United States. Using the 2021 Nationwide Inpatient Sample, patients undergoing percutaneous coronary intervention were identified. Lithotripsy was defined by the International Classification of Diseases-10th Revision codes. Multivariable logistic regression assessed the impact of sociodemographic factors, adjusting for comorbidities and hospital characteristics. Outcomes were compared using propensity score matching, with P < 0.05 considered significant. Of 261,260 percutaneous coronary intervention patients, 1,000 (0.38%) underwent lithotripsy. Adjusted analyses revealed that women were less likely to receive lithotripsy than men (adjusted OR [aOR]: 0.65; 95% CI: 0.53-0.79; P < 0.001). African American patients had lower odds of receiving lithotripsy than Whites (aOR: 0.66; 95% CI: 0.48-0.93; P = 0.016). Medicaid patients were less likely to receive lithotripsy (aOR: 0.20; 95% CI: 0.11-0.36; P < 0.001) compared to Medicare beneficiaries. Higher-income quartiles increased odds of receiving lithotripsy compared to lower quartiles (aOR: 1.38-1.6; P < 0.05). Regional disparities were noted, with lower use in the South (aOR: 0.66; 95% CI: 0.47-0.94; P = 0.022). Disparities in lithotripsy utilization persist, driven by sex, race, insurance status, income, and geographic region. These findings emphasize the need for targeted interventions to promote equitable access to advanced cardiovascular therapies. While some disparities may reflect differences in disease prevalence, persistent inequities in treatment allocation warrant further investigation.

Systemic sclerosis (SSc) is an autoimmune disorder causing immune dysregulation, leading to microvascular damage and fibrosis. Cardiovascular involvement begins with endothelial dysfunction and progresses to vasospasm, ischemia, and fibrosis, impairing cardiac function. Common manifestations include myocardial fibrosis, conduction abnormalities, heart failure, and valvular dysfunction, affecting 15–35% of patients and contributing to 27.2% of SSc-related deaths. High-risk factors include male gender, older disease onset, African American ethnicity, diffuse cutaneous SSc, and poor quality of life. Subclinical cardiac dysfunction is common but underdiagnosed, and cardiovascular complications worsen outcomes. Pulmonary arterial hypertension is a major cause of morbidity and mortality and requires early diagnosis and multidisciplinary management. Treatments include calcium channel blockers, phosphodiesterase inhibitors, endothelin receptor antagonists, and prostacyclin analogs. Imaging (echocardiography, cardiac MRI, stress tests) and biomarkers (troponin, NT-proBNP, endothelin-1) help in diagnosis and monitoring. Early recognition and comprehensive management improve patient outcomes.