Background and Objectives: Atrial fibrillation (AF) is one of the most common supraventricular arrhythmias in the adult population worldwide and it is frequently associated with heart failure (HF). The coexistence of these conditions increases morbidity, mortality and reduces quality of life in these patients. Therefore, it is important to delay the onset of AF in HF patients in order to avoid complications. The study aims to assess whether HF treatment influences AF onset. Materials and Methods: This retrospective observational study included 260 patients, 144 patients with heart failure treated with sodium–glucose cotransporter 2 inhibitors (SGLT2i) and 116 patients with heart failure without SGLT2i treatment (control group) hospitalized at least twice in the Cardiology Department of the “Pius Brinzeu” Emergency County Hospital between 2022 and 2024. Results: Treatment with SGLT2i was associated with a lower prevalence of atrial fibrillation in patients with heart failure. Conclusions: The study highlights the cardiovascular benefits of SGLT2 inhibitors and suggests a potential effect on the onset of AF in heart failure patients.

Background: Blood pressure variability (BPV) has emerged as an important clinical factor in acute ischemic stroke (AIS), with evidence linking excessive fluctuations in systolic blood pressure (SBP) to secondary brain injury. This study aimed to assess the association between SBP variability during the first week of hospitalization and the risk of early post-stroke complications, specifically hemorrhagic transformation and infarct growth. Methods: We conducted a prospective cohort study involving 138 AIS patients admitted to the Pius Brinzeu County Emergency Hospital, Timișoara, between November 2022 and December 2024. Systolic blood pressure (SBP) was assessed three times daily over a period of seven days, with variability determined as the standard deviation (SD) of the recorded values. Patients were categorized based on treatment modality (conservative versus intravenous thrombolysis), and complications were evaluated using repeated computed tomography (CT) imaging. Results: SBP variability was significantly higher in patients who developed hemorrhagic transformation (OR 3.64, 95% CI: 2.21–5.99, p < 0.001) or infarct growth (OR 1.80, 95% CI: 1.24–2.61, p = 0.001). A monotonic trend was observed across SBP variability categories, with complication rates increasing significantly with higher variability levels (p < 0.001 for hemorrhagic transformation; p = 0.001 for infarct growth). In multivariable models, SBP variability remained an independent predictor of hemorrhagic transformation in both the conservative group (OR 4.78, 95% CI: 2.07–37.14, p = 0.02) and thrombolysis group (OR 1.47, 95% CI: 1.13–2.08, p = 0.01), and was also associated with infarct growth in the thrombolysis group (OR 1.51, 95% CI: 1.13–2.25, p = 0.02). Conclusions: Medium-term SBP variability is an independent predictor of early ischemic and hemorrhagic complications following AIS, particularly in patients receiving thrombolysis. These findings support the need for targeted strategies to stabilize BP during the acute phase of stroke care.

Background and Objectives: Heart failure (HF) among patients with type 2 diabetes (T2DM) is linked to significant morbidity and mortality, despite the increased availability of new drug therapy. This study aims to investigate subclinical changes in patients with HF stage A (at risk for HF) and B (Pre-HF) and T2DM treated with oral semaglutide. Materials and Methods: In a prospective, observational, single-center study, 50 T2DM patients were assessed at baseline and one-year follow-up for changes in spectral Doppler, tissue Doppler, and speckle-tracking (2DST) and metabolic parameters. Results: Correlation and regression analyses identified predictors of Δ GLS. In correlation analysis, Δ GLS showed a negative correlation with Δ VAI (rho = −0.3, p = 0.02), Δ LAP (rho = −0.3, p = 0.04), Δ FPG (rho = −0.3, p = 0.009), Δ TG (rho = −0.4, p = 0.004), and Δ TyG (rho = −0.3, p = 0.02). In linear stepwise regression analysis, the most accurate model, with a p-value < 0.001, was M₃, explaining 70% of the variance in Δ GLS (adjusted R² = 0.7); this model included Δ FPG (beta −0.4, p = 0.001), Δ CRR (beta −1.3, p < 0.001), and Δ LDLc (beta 0.6, p = 0.01). Conclusions: These findings show that improved subclinical left ventricular systolic dysfunction is associated with improved glycemic control, visceral adiposity, and reduced insulin resistance, respectively, with improved lipid profiling.

Background and Objectives: Cardiac arrhythmias during the SARS-CoV-2 infection may occur due to the direct impact of the virus on the respiratory and cardiovascular systems, as well as through the broader effects of systemic inflammation, or a combination of both. Additional mechanisms include the proarrhythmic effects of COVID-19 pharmacotherapies, drug–drug interactions, and associated autonomic dysfunction. To improve future risk stratification and clinical management, it is essential to accurately assess the risk of arrhythmia in the context of severe infections, in order to develop diagnostic and therapeutic algorithms that support the fastest and safest possible interventions. Materials and Methods: This retrospective observational study included 151 patients diagnosed with COVID-19, who were hospitalized at the Cardiology Clinic of the Timisoara County Emergency Hospital between 2020 and 2022. Results: The most common arrhythmia observed was atrial fibrillation. Elevated inflammatory markers were associated with a higher risk of arrhythmias and increased mortality. Conclusions: The onset of sepsis, as indicated by the laboratory markers, was associated with increased incidence of arrhythmias and unfavorable outcome of the disease.

Background: Type 2 diabetes mellitus (T2DM) is associated with subclinical myocardial dysfunction, which may occur despite preserved left ventricular ejection fraction. Left ventricular global longitudinal strain (LV GLS) is a sensitive marker of early systolic impairment and may detect subtle changes in myocardial function before conventional echocardiographic parameters become abnormal. The effect of sodium-glucose cotransporter-2 inhibitors (SGLT2i) on LV GLS in adults with T2DM remains incompletely defined. Objective: To synthesize the available evidence on the effects of SGLT2i therapy on LV GLS or LV strain in adults with T2DM. Methods: Original full-text human studies evaluating SGLT2i therapy in adults with T2DM and reporting LV GLS or LV strain were included. LV GLS was assessed primarily by speckle-tracking echocardiography, while one study used cardiac magnetic resonance feature-tracking. Reviews, conference abstracts, protocols, animal-only studies, and studies without LV strain assessment were excluded. Risk of bias was assessed using RoB 2 for randomized studies and ROBINS-I for non-randomized studies. Results: Twenty-six studies involving more than 2300 participants were included. The studies evaluated dapagliflozin, empagliflozin, ertugliflozin, canagliflozin, or mixed SGLT2i regimens across heterogeneous clinical populations, including patients with preserved ejection fraction, pre-heart failure, diabetes-related cardiomyopathy, chronic heart failure, coronary artery disease, hypertension, non-alcoholic fatty liver disease, and cardio-oncology risk. Most observational and before–after studies reported favorable changes in LV GLS after SGLT2i therapy, whereas randomized and controlled studies showed more variable findings. Several studies also reported improvements in LV remodeling, diastolic function, left atrial function, myocardial work indices, NT-proBNP, cardiometabolic parameters, or epicardial adipose tissue thickness. However, the certainty of evidence was limited by methodological heterogeneity, differences in comparator groups, variable follow-up duration, non-standardized imaging protocols, and risk of bias, particularly in non-randomized and single-arm studies. Conclusions: SGLT2i therapy may be associated with favorable changes in LV GLS in adults with T2DM, suggesting a potential beneficial effect on subclinical left ventricular systolic function. However, current evidence does not definitively establish a consistent treatment effect across all populations. Larger randomized controlled trials with standardized strain imaging protocols, predefined LV GLS endpoints, and clinically relevant follow-up are needed to determine whether SGLT2i-related improvements in LV GLS reflect true myocardial benefit and translate into improved cardiovascular outcomes.

Background: Myocarditis is a challenging polymorphic disease with extensive variability in clinical presentation. The etiology of myocarditis often remains undetermined without an endomyocardial biopsy. Case presentation: A 25-year-old male with no prior cardiovascular history presented with acute severe retrosternal chest pain, dyspnea, fatigability, and diaphoresis, preceded by mild respiratory symptoms. Physical exam revealed stability, and ECG showed inferolateral ST-segment elevation. Laboratory tests indicated significant myocardial injury with elevated troponin and CK levels, alongside inflammatory markers. Coronary angiography excluded acute coronary syndrome, and cardiac MRI confirmed active myocarditis with characteristic late gadolinium enhancement and myocardial edema. The patient remained hemodynamically stable during hospitalization. Guideline-directed medical therapy was initiated, including a beta-blocker, an ACE inhibitor, and dapagliflozin as an SGLT2 inhibitor to support ventricular recovery and prevent remodeling. At one-month follow-up, the patient was asymptomatic with normalized biomarkers and unremarkable imaging, indicating clinical recovery. Conclusion: This case illustrates that acute myocarditis may lead to early cardiac dysfunction even in young individuals and highlights the potential benefit of adding an SGLT2 inhibitor to standard therapy to support recovery.