To evaluate the prognostic significance of the preprocedural albumin - bilirubin (ALBI) score on short- and long-term outcomes after transcatheter aortic valve implantation (TAVI). We retrospectively analyzed 737 consecutive patients who underwent TAVI. Patients were stratified into tertiles according to ALBI score. Baseline clinical, echocardiographic, laboratory features were compared across tertiles. The primary endpoint was long-term all-cause mortality; secondary endpoints included in-hospital mortality and major complications. Kaplan-Meier analysis assessed survival, and Cox-regression models evaluated predictors of long-term mortality after adjustment for conventional risk factors. Higher ALBI tertiles were associated with a greater comorbidity burden, worse ventricular function, and elevated biomarkers of inflammation and cardiac stress. In-hospital mortality increased across tertiles (5.3%, 7.3%, 11.8%). Long-term mortality also rose progressively (7.3%, 9.8%, 11.8%), with 60-month survival rates of approximately 90% (T1), 88% (T2), and 73% (T3). ALBI score independently predicted long-term mortality (HR 1.86, 95% CI 1.23-2.82), along with chronic kidney disease and lower TAPSE. Restricted cubic spline analysis demonstrated a near-linear association between ALBI and mortality risk. Preprocedural ALBI score is independently associated with both short and long-term mortality after TAVI and may reflect systemic vulnerability not captured by conventional risk models. Incorporating ALBI into preprocedural assessment could enhance risk stratification.

Right ventricular (RV) dysfunction is a critical yet often underrecognized determinant of prognosis in patients with advanced interstitial lung disease (ILD) undergoing lung transplant evaluation. The tricuspid annular plane systolic excursion to pulmonary arterial systolic pressure (TAPSE/PASP) ratio has emerged as a promising noninvasive echocardiographic surrogate of RV‐pulmonary arterial (RV‐PA) coupling, offering a dynamic estimate of RV function relative to afterload. In this single‐center retrospective cohort study, we assessed the prognostic association of the TAPSE/PASP ratio in 65 lung transplant candidates with advanced ILD. All patients underwent comprehensive transthoracic echocardiography and right heart catheterization as part of pre‐transplant evaluation. The primary endpoint was a composite of all‐cause mortality or lung transplantation. Over a median follow‐up of 24 months, 33 patients (50.8%) reached this endpoint. Receiver operating characteristic (ROC) curve analysis identified an optimal TAPSE/PASP cutoff value of 0.55 (AUC: 0.763, p < 0.001), with a sensitivity of 70% and specificity of 75% for predicting adverse outcomes. Patients with TAPSE/PAS p < 0.55 exhibited significantly worse transplant‐free survival (log‐rank p = 0.0057), more pronounced RV structural and functional impairment, and elevated pulmonary vascular resistance. In multivariable Cox regression analysis, TAPSE/PASP was the sole independent predictor of the primary outcome (HR: 0.09, p = 0.01). These findings suggest that the TAPSE/PASP ratio may constitute a feasible and reproducible noninvasive surrogate of RV–pulmonary arterial uncoupling and could facilitate the identification of high‐risk individuals among lung transplant candidates with advanced interstitial lung disease. However, in light of the retrospective and single‐center nature of this study, the results should be interpreted with caution as hypothesis‐generating, and further validation in large‐scale, prospective, multicenter cohorts is warranted.

Background: Acute coronary syndrome (ACS) remains a major cause of morbidity and mortality worldwide. Although obesity is a risk factor for ACS, decreased mortality has been shown in overweight individuals. This study aims to determine the association of body fat parameters such as body fat percentage (BFP), relative fat mass (RFM), and coronary thrombus burden with angiographic thrombotic grade in a series of patients presenting with ACS. Methods: Three hundred ninety patients who underwent percutaneous coronary intervention were enrolled in the study. BFP was calculated using the U.S. Navy formula. RFM index was calculated using gender, height, and waist circumference regardless of weight. Body mass index (BMI) is calculated as the weight in kilograms divided by the square of body length in meters (kg/m²). Two experienced interventional cardiologists reviewed coronary angiograms according to the TIMI thrombus scale. Patients were divided into groups according to thrombus classification and clinical status. Results: RFM, which is an anthropometric measurement parameter for obesity, was inversely related to thrombus burden in patients with ACS. There were no significant differences between ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) groups according to demographic, clinical characteristics, and coronary risk factors. Likewise, RFM, BFP, and BMI were comparable between the two groups. BFP and RFM were lower in patients with thrombus present STEMI group compared with no thrombus group. Thrombus presence was also compared in the NSTEMI group, and BMI, BFP, and RFM were lower in patients with thrombus present NSTEMI group. Conclusions: Our analysis demonstrated that RFM was better than BFP and BMI for predicting thrombus presence in patients with ACS.

Background: New-onset atrial fibrillation (NOAF) is a common complication after transcatheter aortic valve implantation (TAVI) and is associated with unfavorable clinical outcomes. Sodium–glucose cotransporter-2 (SGLT2) inhibitors may have antiarrhythmic effects, but their association with NOAF after TAVI remains uncertain. This study evaluated the relationship between SGLT2 inhibitor use and NOAF following TAVI. Methods: This retrospective observational study included 573 consecutive patients who underwent transfemoral TAVI between January 2020 and December 2025. Patients with prior atrial fibrillation or atrial flutter were excluded. NOAF was defined as any atrial fibrillation episode lasting ≥30 s during index hospitalization. A doubly robust inverse probability weighted logistic regression model was applied to reduce baseline imbalances and assess the association between SGLT2 inhibitor use and NOAF. Results: Overall, 169 patients received SGLT2 inhibitors, while 404 patients constituted the control group. NOAF occurred less frequently in the SGLT2 inhibitor group than in controls (11% vs. 19%, p = 0.041). In adjusted analysis, SGLT2 inhibitor use was independently associated with lower odds of NOAF (adjusted OR: 0.171, 95% CI: 0.076–0.381, p < 0.001). Older age and diabetes mellitus were associated with increased NOAF risk, whereas higher baseline left ventricular ejection fraction was associated with lower risk. Subgroup analysis indicated a possible interaction by diabetes status (P-interaction = 0.040), although this exploratory finding should be interpreted cautiously. Conclusions: SGLT2 inhibitor use was independently associated with lower odds of NOAF after TAVI. These findings should be interpreted as observational and hypothesis-generating and require confirmation in prospective randomized studies.

Background Left atrial (LA) remodeling and dysfunction are increasingly recognized as important contributors to outcomes in heart failure; however, their prognostic and functional relevance in advanced heart failure (AHF) remains insufficiently defined. This study evaluated the prognostic and functional significance of echocardiographic LA indices in AHF. Methods Between 2021 and 2023, 194 patients with left ventricular ejection fraction ≤ 25% were included. All patients were referred to our tertiary cardiovascular center for evaluation of advanced therapeutic options [left ventricular assist device (LVAD) or heart transplantation] and underwent echocardiography, right heart catheterization, and cardiopulmonary exercise testing (CPET). Kaplan-Meier and Cox regression analyses were used to assess the prognostic impact of LA strain and mechanical indices on the composite endpoint of all-cause death, LVAD implantation, or heart transplantation. Correlations with CPET parameters were examined to evaluate functional relevance. Results Patients with impaired LA reservoir strain (LASr < 8.35%) exhibited more advanced atrial remodeling, higher filling pressures, worse ventricular function, and reduced exercise capacity. During a median follow-up of 461 days, adverse outcomes occurred more frequently in the lower LASr group (35.1% vs. 14.4%, p = 0.002). Both LASr and LA minimum volume index (LAVImin) independently predicted the composite endpoint and provided incremental prognostic value. LASr, LA ejection fraction (LAEF), and LA expansion index (LAEI) showed positive associations with peak VO₂ (all p < 0.001), indicating an association between atrial mechanics and exercise performance. Conclusions In patients with AHF, LASr and LAVImin are independently associated with adverse clinical outcomes and reduced exercise tolerance. Incorporation of LA functional assessment into routine evaluation may help improve risk stratification and support clinical decision-making in this high-risk population.