A cardiac digital twin is a virtual replica of a patient-specific heart, mimicking its anatomy and physiology. A crucial step of building a cardiac digital twin is anatomical twinning, where the computational mesh of the digital twin is tailored to the patient-specific cardiac anatomy. In a number of studies, the effect of anatomical variation on clinically relevant functional measurements like electrocardiograms (ECGs) is investigated, using computational simulations. While such a simulation environment provides researchers with a carefully controlled ground truth, the impact of anatomical differences on functional measurements in real-world patients remains understudied. In this study, we develop a biventricular statistical shape model and use it to quantify the effect of biventricular anatomy on ECG-derived and demographic features, providing novel insights for the development of digital twins of cardiac electrophysiology. To this end, a dataset comprising high-resolution cardiac CT scans from 271 healthy individuals, including athletes, is utilized. Furthermore, a novel, universal, ventricular coordinate-based method is developed to establish lightweight shape correspondence. The performance of the shape model is rigorously established, focusing on its dimensionality reduction capabilities and the training data requirements. The most important variability in healthy ventricles captured by the model is their size, followed by their elongation. These anatomical factors are found to significantly correlate with ECG-derived and demographic features. Additionally, a comprehensive synthetic cohort is made available, featuring ready-to-use biventricular meshes with fiber structures and anatomical region annotations. These meshes are well-suited for electrophysiological simulations.

Myocardial infarction (MI) continues to pose a significant global healthcare burden despite advances in treatment options and their effectiveness. The incidence, prevalence, and mortality rates associated with MI are rising, emphasizing the need for improved therapeutic strategies. Traditional invasive surgical methods, aimed at recanalizing blood flow to the coronary arteries, have proven insufficient in fully addressing the complexities of MI. This ongoing challenge necessitates the exploration of novel approaches to enhance treatment efficacy and outcomes for MI patients.

One promising approach is the use of nanoparticle delivery systems for targeted therapy to the infarct site. When conventional methods fail to achieve adequate permeability and retention, nanoparticle strategies offer a potential solution. Functionalizing nanoparticles is a particularly effective technique, allowing these particles to conjugate with specific ligands. These ligands possess the intrinsic ability to selectively bind to receptors that are overexpressed or uniquely present at the infarct site, thereby conferring "smartness" to the nanoparticle constructs. This review delves into the various strategies employed in nanoparticle-ligand functionalization, highlighting the versatility and potential of these approaches. It provides a detailed cross section of several ligand classes, each with unique properties and binding affinities that make them suitable for targeted delivery in the context of MI. The focus is on identifying ligands that are either unique to the infarcted myocardium or significantly upregulated during MI, ensuring precise and efficient targeting of therapeutic agents.

In summary, while traditional surgical methods for restoring blood flow in MI patients remain important, they are not sufficient on their own. By leveraging the specificity of these ligands, nanoparticles can be directed precisely to the infarct site, enhancing the delivery and efficacy of therapeutic agents. This review underscores the need for continued research into nanoparticle-ligand functionalization strategies, aiming to improve outcomes for MI patients and reduce the global burden of this condition.

Normal circadian rhythms are essential for organisms to adapt to diurnal changes and maintain an optimal state of physiological function. Disturbances in circadian rhythms such as shift work and working at night increase the risk of cardiovascular disease. Myocardial infarction exhibits a marked circadian rhythm, usually peaking in the early morning. Krüppel-like factor 15 (KLF15), a transcription factor with a circadian rhythm, plays an important role in cardiac physiopathology. It has a protective effect against myocardial injury after myocardial infarction by regulating energy metabolism and inflammatory factors, among other pathways. Currently, the association between circadian rhythm, KLF15, and myocardial infarction is unclear, thus this paper reviews how circadian rhythm influences the role of KLF15 in myocardial infarction, aiming to reveal the association between circadian rhythm, KLF15, and myocardial infarction, and to explore the underlying mechanisms, to provide new theoretical insights and therapeutic strategies for the clinical treatment of myocardial infarction.

The differentiation of the Academic Research Consortium high bleeding risk (HBR) (ARC-HBR) criteria and those modified for Japanese patients (J-HBR) for predicting events following discharge in patients with acute coronary syndrome (ACS) has yet to be clarified. In this study, we compared the ARC-HBR and J-HBR criteria for predicting post-discharge bleeding and associated events in patients with ACS.

We retrospectively analyzed data from 889 patients with ACS discharged alive at two tertiary hospitals in Japan between August 2009 and July 2018. We identified patients with HBR using both sets of criteria. We compared the incidence of major bleeding/all-cause death within 2 years following discharge and performance metrics between each set of criteria, and explored the efficacy of combining both sets of criteria to stratify risk levels for the prediction of clinical events.

Eighty patients experienced major bleeding/all-cause death. In the ARC-HBR and J-HBR criteria, 51% and 65% of patients were categorized as HBR, respectively. Both sets of criteria effectively identified patients at a high risk of major bleeding/all-cause death. The ARC-HBR demonstrated a significantly higher area under the curve (AUC) for major bleeding and all-cause death combined (AUC [95% confidence interval]: 0.67 [0.64-0.69]) than that of the J-HBR (0.63 [0.60-0.66], P = 0.015). In each component, while the AUC for major bleeding was comparable between the two sets of criteria (0.61 [0.57-0.64] vs. 0.61 [0.57-0.63], P = 0.95), the ARC-HBR criteria showed a significantly higher AUC for all-cause death than the J-HBR criteria (0.67 [0.64-0.70] vs. 0.61 [0.59-0.64], P < 0.001). The combined use of both sets of criteria effectively stratified the risk for major bleeding/all-cause death (hazard ratio [95% confident interval]: 5.81 [2.79-12.07] in those positive for both sets of criteria, compared to those negative in both sets of criteria).

The ARC-HBR criteria demonstrated a greater discriminative capability for predicting major bleeding/all-cause mortality than the J-HBR criteria. For major bleeding alone, the discriminative ability of both sets of criteria was comparable.

Conventional micro-concave systems have been proposed as effective methods for facile cell spheroid formation, culture. However, these systems face challenges in terms of ease of cell transplantation and a low cell survival rate in ischemic disease. We present a novel open/close type hydrogel micro-concave patch (OC) designed for in situ 3D cell spheroid formation, culture, and a transplantable system utilizing a 3D printed mold. Open-type patches were fabricated with a rigid hydrogel, while closed-type patches were prepared with a combination of swellable soft hydrogel and rigid hydrogel. The open-type concave was intended for cell spheroid formation and subsequent transplantation into the ischemic region. Conversely, the close-type concave allowed released cytokines from cell spheroids, which were located inside the concave, to promote survival of transplanted cell spheroid. We hypothesized that transplant of open-type cell spheroids, combined with the release of paracrine factors from close-type cell spheroids, could enhance therapeutic outcomes in ischemic regions. The OC was prepared using different concentration ratios of swellable polyacrylamide (PAAM) hydrogel through 3D printed micropillar mold. Additionally, PAAM was characterized to enhance the compactness of close-type 3D cell spheroids. Transplantation of OC improved the therapeutic effect in a rat cardiac infarction model compared to open-type patches.

Cardiac injury, encompassing a spectrum of heart muscle damage, requires prompt and accurate diagnosis to improve patient outcomes. Early detection using cardiac biomarkers is vital for timely intervention and reducing mortality. This review highlights the role of high-sensitivity cardiac troponins (hs-cTns) in diagnosing cardiac injury. This article offers an overview of cardiac injury, including its causes, diagnostic challenges, and the evolution of biomarkers, up to the development and commercialization of "high-sensitivity" (hs-) cTns. The molecular structure of cardiac isoforms cTnI and cTnT, release kinetics, guidelines incorporation, diagnostic performance, and clinical application will be analyzed. It is concluded that the advent of hs-cTn assays has further expanded diagnostic capabilities by enabling the detection of low-level cTn elevations, which were previously undetectable using conventional methods. This enhanced sensitivity allows earlier identification of even minor cardiac injuries, facilitating prompt intervention and improving patient outcomes. However, this increased sensitivity also introduces interpretive challenges in understanding the nature of cardiac involvement, especially in distinguishing mild cTn elevations that may signify non-ischemic cardiac injury or be associated with other non-cardiac conditions.

Type 2 myocardial infarction occurs in the absence of atherothrombosis, due to myocardial oxygen supply or demand imbalance, often during another acute illness. It is common and associated with poor clinical outcomes. No randomized controlled trials are available to guide investigation or treatment.

The authors assessed the feasibility of implementing a complex intervention of investigation and treatment for coronary and structural heart disease in patients with type 2 myocardial infarction.

A pilot phase of a prospective randomized controlled trial was conducted. Process outcomes included the proportion of eligible patients approached, consented, and randomized. Adherence was defined as the number of recommended investigations and treatments administered at 90 days. Qualitative interviews explored reasons for participation and patient experience.

Between November 2022 and November 2023, 4,127 patients with increased cardiac troponin concentrations were screened across 3 sites, and 403 patients (10%) met inclusion criteria. One hundred and forty-three patients (35%) were eligible, 119 patients (83%) were approached, and 60 patients (42%, age 70 ± 10 years, 38% women) consented and randomized to the intervention (n = 28) or standard care (n = 32). Follow-up was complete in all participants. Adherence to recommendations was 90.7% (95% CI: 85.3%-96.1%). Patients highlighted variation in communication of the diagnosis and in trial investigation and management recommendations were potential barriers to participation.

It is feasible to recruit and randomize patients with type 2 myocardial infarction to a complex intervention targeting coronary or structural heart disease. A multicenter trial with an optimized intervention is now required to inform practice.

Pulse pressure (PP) is a recognized marker of cardiovascular risk in the general population. However, its role as an independent predictor of recurrent cardiovascular events following myocardial infarction (MI) and whether there are age-dependent differences in this relationship remains uncertain. We analyzed data from 4091 participants with a history of MI were enrolled in the Kailuan Study. Univariate and multivariable Cox models were used to analyze the associations between PP and primary outcome (composite cardiovascular events, a composite of all-cause death, nonfatal recurrent MI, nonfatal hospitalization for heart failure or nonfatal stroke) and secondary outcomes (each individual components of composite endpoint) after MI. Over a median follow-up of 7.8 years, 1610 composite cardiovascular events occurred. The mean baseline PP was 54.2 ± 16.1 mmHg. Compared with individuals in the first PP quartile, those in the fourth quartile had significantly greater risks of composite cardiovascular events (adjusted HR: 1.20; 95% CI: 1.03-1.41; p = 0.02) and recurrent MI (adjusted HR: 1.56; 95% CI: 1.03-2.36; p = 0.04). A linear, dose-response relationship was observed between PP and the risk of adverse cardiovascular outcomes (all p ≤ 0.02), except for stroke (p = 0.36). Subgroup analyses indicated that the association between PP and adverse outcomes was stronger among participants aged <60 years compared with older individuals. Elevated PP is an independent predictor of recurrent cardiovascular outcomes in post-MI patients, with particularly stronger associations observed in younger and middle-aged adults. Trial Registration: ChiCTR-TNRC-11001489.

The diagnostic criteria for Type 2 myocardial infarction identify a heterogeneous group of patients with variable outcomes and no clear treatment implications. We aimed to determine the implications of a new clinical classification for myocardial infarction with more objective diagnostic criteria using cardiac imaging.

In a prospective cohort study, patients with Type 2 myocardial infarction underwent coronary angiography and cardiac magnetic resonance imaging or echocardiography. The new classification was applied to identify (i) spontaneous myocardial infarction due to acute coronary pathology, (ii) secondary myocardial infarction precipitated by acute illness in the presence of obstructive coronary artery disease, a new regional wall motion abnormality, or infarct-pattern scarring, and (iii) no myocardial infarction in the absence of obstructive disease or new myocardial abnormality. In 100 patients (65 years, 43% women) with Type 2 myocardial infarction, the new classification identified 25 and 31 patients with spontaneous and secondary myocardial infarction, respectively, and 44 without myocardial infarction. Compared with patients without myocardial infarction, those with secondary myocardial infarction were older, had more risk factors, and had higher troponin concentrations (P < 0.05 for all). During a median follow-up of 4.4 years, death, myocardial infarction, or heart failure hospitalization was more common in secondary myocardial infarction compared with those without myocardial infarction [55% (17/31) vs. 16% (7/44), P < 0.001].

A new clinical classification of myocardial infarction informed by cardiac imaging would reduce the diagnosis of myocardial infarction in acute illness and identify those patients at highest risk who are most likely to benefit from treatment.

https://clinicaltrials.gov/ct2/show/NCT03338504.

Myocardial infarction (MI) is the leading cause of death and disability worldwide. It occurs when a thrombus forms after an atherosclerotic plaque bursts, obstructing blood flow to the heart. Prompt and accurate diagnosis is crucial for improving patient survival. Surface-enhanced Raman spectroscopy (SERS) offers quick response and excellent resolution for qualitative and quantitative analysis of body fluids, making it a valuable diagnostic tool. This study explores SERS for identifying proteins in blood serum samples from MI patients, focusing on cardiac Troponin I (cTnI), a key biomarker. Due to the small size and low concentration of cTnI, its SERS signal may be weak or absent. To address this, 30 kDa filtering devices are used to obtain filtrate portions of serum samples from cTnI-positive patients and healthy individuals. SERS spectral analysis of these filtrates identifies key SERS bands associated with biomolecular changes related to cTnI levels. Principal component analysis (PCA) effectively differentiates SERS spectra from healthy and MI-positive patients. Partial least squares regression (PLSR) quantifies cTnI levels based on SERS features, with a model showing R2 value of 0.79 and RMSEC of 1.37, validating its accuracy.

The soluble urokinase plasminogen activator receptor (SuPAR) is a biomarker of inflammation and immune activation that has been related with mortality in a vast spectrum of diseases in the elderly. Its prognostic value in preoperative evaluation for non-cardiac surgery has been promising. However, up to date there are no studies in high-risk patients undergoing hip fracture surgery. Therefore, we performed this prospective study aims to evaluate the prognostic value of SuPAR and other common clinical, echocardiographic, and blood biomarkers for the 1-year survival of high-risk hip fracture surgery patients.

We studied 46 patients with hip fracture that underwent hip fracture surgery from 2019 to 2024. There were 10 men and 36 women, over 65 years of age (mean, 85 ± 8 years) with at least one high-risk characteristic (dementia, chronic immobilization, age > 90 years). Upon admission, complete clinical and laboratory assessments, including electrocardiogram and cardiac ultrasonography, radiographs, and blood sampling, were conducted. Serum blood levels of SuPAR as well as natriuretic peptides and troponin I were measured. The Katz index of frailty was calculated. The patients were followed for 1 year after admission and hip fracture surgery. At that time, the patients or their relatives were contacted through telephone, and their 1-year survival was documented.

Overall, 25 (54.3%) patients were dead at 1-year examination. There was no significant difference in baseline values of SuPAR between patients dead or alive at follow-up (6.30 ng/dl [range, 4.95-7.05 ng/dl] vs. 6.25 ng/dl [4.25-9.05 ng/dl], respectively; p value = 0.767), and SuPAR has not been related to 1-year mortality (HR 0.802; 95% CI 0.248-2.595; p value = 0.712). The only univariate and multivariate predictors of survival were age (HR 1.098; 95% CI 1.003-1.181; p = 0.041) and Katz index ≤ 4 (HR 4.490; 95% CI 1.180-17.093; p = 0.028).

This study showed that SuPAR is not a predictive factor for 1-year mortality in high-risk patients undergoing hip fracture surgery. Older age and Katz index score ≤ 4 were the only independent predictors of 1-year mortality. Therefore, although no definite conclusion can be drawn from such a small number of patients, no trend in mortality for this measurement has been observed, suggesting SuPAR and similar biomarkers should not be considered in the evaluation of mortality in high-risk hip fracture patients.

ObjectiveThe study investigated the link between the homeostatic model assessment for insulin resistance (HOMA-IR) and myocardial infarction (MI) parameters, highlighting its role as a potential MI biomarker in Southern Saudi patients.MethodsThis cross-sectional study conducted from January to April 2021 at the Prince Faisal Bin Khalid Cardiac Center, Abha, Saudi Arabia, examined cardiovascular and diabetic biomarkers, including HOMA-IR, in MI patients and controls to assess insulin resistance (IR), risk, and diagnostic accuracy.ResultsMI patients showed significantly elevated HOMA-IR, leptin, resistin, body mass index (BMI), and glucose-complexed hemoglobin (HbA1c) levels compared with controls in both genders (p < 0.0001). HbA1c was strongly associated with HOMA-IR, whereas age, BMI, leptin, and resistin showed weak correlations. Elevated HOMA-IR increased MI risk and demonstrated high diagnostic accuracy.ConclusionsElevated HOMA-IR was identified as an early indicator of the onset of MI, whereas serum leptin and resistin levels exhibited a positive association with IR in patients with MI. Moreover, serum leptin, resistin, and elevated HOMA-IR may independently contribute to the risk of MI.

Cardiac metabolism relies on glycogen conversion by glycolysis. Glycolysis intersects fatty acid oxidation and often directs a signal crosstalk between redox metabolites. Myocardium with ischemia/reperfusion significantly diverts from normal metabolism. Prospectively, peroxisome lies central to metabolism and redox changes, but mechanisms underlying in ischemia/reperfusion remain undefined. This work aims at investigating the potential effects and mechanisms of Salvianolic acid B (Sal B) in cardioprotection through metabolic remodeling. Following experiments, we found that Sal B is absorbed in blood and rat hearts and its cardiac absorption prevents ischemia/reperfusion injury. Sal B cardioprotection relates to gluconeogenesis activation and peroxisomal redox remodeling. Gluconeogenesis compensates glycogen synthesis through upregulating pyruvate carboxylase (PC) and phosphoenolpyruvate carboxykinase. Gluconeogenic PC activity drives peroxisomal Pex2/Pex3 expressions and promotes the proliferation of peroxisome. Peroxisome quality control is enhanced with Pex5/Pex14/Pex13/Pex2 transcriptions. Nono, a non-POU domain-containing octamer-binding protein, promotes upregulation of gluconeogenic PC and peroxisomal gene transcripts through transcriptionally splicing their pre-RNAs at octamer duplex. Nono also controls the expression of SARM1/PARP1/sirtuin1 for catalyzing nicotinamide adenine dinucleotide (NAD+) consumption, leading to endurable redox capacities of peroxisome. Peroxisomal redox remodeling alters reactive oxygen species (ROS) and NAD+ contents, following which NAD+ affects cardiac accumulation of physiologically harmful glucocorticoid. In the tests of Sal B combinational treatments, results indicate ROS upregulation whereas NAD+ downregulation with glucocorticoid, ROS scavenging and glucocorticoid elimination with NAD+ precursor, and NAD+ promotion with ROS scavenger, respectively. This metabolite signal crosstalk alternatively antagonizes/agonizes Sal B cardioprotective functions on electrocardiographic output and infarction. Taken together, we reported a cardiac metabolism regulation with Sal B, capable of preventing myocardium from ischemia/reperfusion injury. The metabolite signal crosstalk was achieved by coupling reaction cascades between gluconeogenesis and peroxisomal redox remodeling.

Patients with acute myocardial infarction (AMI) complicating renal dysfunction (RD) are recognized as being at high risk. Although diabetes mellitus (DM) is a major cause of RD, the prognostic impact of coexisting DM on mortality in patients with AMI complicating RD is ill-defined. This study compared the prognostic impact of coexisting DM in patients with AMI complicating RD according to both age and sex.

A multicenter retrospective study was conducted on 2988 consecutive patients with AMI complicating RD (estimated glomerular filtration rate <60 mL/min per 1.73 m2). Multivariable Cox regression analysis was performed to investigate the effects of DM on in-hospital mortality.

Statistically significant interactions between age and DM and between sex and DM for in-hospital mortality were revealed in the entire cohort. Coexisting DM was identified as an independent risk factor for in-hospital mortality (hazard ratio [HR], 2.543) in young (aged <65 years), but not old (aged ≥65 years), patients. DM was identified as an independent risk factor (HR, 1.469) in male, but not female, patients. Kaplan-Meier survival curves showed that DM correlated with significantly low survival rates in patients that were young or male as compared to those who were old or female.

There were significant differences in the prognostic impact of DM on in-hospital mortality between young and old as well as male and female patients with AMI complicating RD. These results have implications for future research and the management of patients with DM, RD, and AMI comorbidities.

Myocardial ischemia/reperfusion injury (MIRI) is a significant challenge in the treatment of myocardial infarction, a leading cause of global mortality due to irreversible cardiac damage. Biomimetic nanodelivery systems offer promising therapeutic strategies to address MIRI. In this review, we comprehensively investigate the underlying pathophysiological mechanisms of MIRI and discuss recent advances in biomimetic nanodelivery systems including cell membrane-coated nanoparticles, exosomes, and nanoenzymes as innovative approaches for MIRI treatment. We emphasize the advantages and potential of biomimetic strategies in enhancing therapeutic efficacy, assess the preclinical effectiveness of these nanodelivery systems, and discuss the challenges associated with translating these approaches into clinical practice. This paper aims to provide new perspectives on biomimetic strategies for MIRI treatment, contributing to the development of effective drug delivery systems.

Myocardial infarctions (MIs) can occur in underlying obstructive coronary artery disease (MI-CAD) or in non-obstructive coronary arteries (MINOCA). The primary objectives of the study were to investigate the prevalence of MI-CAD and MINOCA in people with CAL, and to explore if CAL is an independent risk factor for MI-CAD and MINOCA. Secondary objectives were to explore these research questions stratified by sex and by smoking history.

Cross-sectional analysis of the population-based Swedish CArdioPulmonary bioImage Study (SCAPIS) of people aged 50-64 years. CAL was defined as a post-bronchodilator ratio of forced expiratory volume in one second and forced vital capacity below 0.70. MI-CAD was defined as a self-reported MI with coronary computed tomography angiography findings of previous revascularization or at least one significant coronary stenosis (>50%), and MINOCA as self-reported MI with no previous revascularization and no significant coronary stenosis.

In total, 1735 (8.3%) of 20,882 included participants had CAL. MI-CAD was more common than MINOCA both in people with (2.8 vs 0.6%) and without CAL (1.2 vs 0.3%). Compared with those without CAL, people with CAL had an almost doubled independent risk of both MI-CAD ([adjusted OR] 1.72; [95% CI] 1.22-2.42) and MINOCA (1.99; 1.02-3.86). In men, CAL was associated with increased risk of MINOCA (2.63; 1.23-5.64), and in women with increased risk for MI-CAD (3.43; 1.68-1.26).

Middle-aged people with CAL have an almost doubled risk of both MI-CAD and MINOCA, compared with people without CAL. In contrast to people without CAL, the risk of MINOCA is increased in men and the risk of MI-CAD is increased in women. In a clinical context, both MI types should be considered in CAL.

The aim of this study was to evaluate the midterm outcomes of secondary extension of frozen elephant trunk (FET) by means of thoracic endovascular aortic repair (TEVAR).

This single-center prospective study was conducted in a tertiary aortic center on consecutive patients having undergone TEVAR with an endograft covering most of the 10 cm FET module with 2 to 4 mm oversizing. All patients were monitored by computerized tomography angiography (CTA) at sixth month and yearly thereafter.

From January 2015 to July 2022, among 159 patients who received FET, 30 patients (18.8%) underwent a TEVAR procedure (13 for a thoracoabdominal aneurysm, 11 for a chronic aortic dissection and 6 for an emergency procedure). All connections were successfully achieved with 2 postoperative deaths (6.6%) and 1 paraplegia (3.3%). At a median follow-up of 21 months (interquartile range [IQR], 4.2-34.7), 5 patients (25%) required a fenestrated-branched endovascular aortic repair (F-BEVAR) extension followed by 4 patients with 5 reinterventions, 3 for a Type 3 endoleak due to disconnection between FET and TEVAR endograft, and 2 unrelated to the FET for a secondary Type 1C endoleak. All reinterventions were successful, without mortality or morbidity.

In this series, FET connection with a TEVAR endograft was effective with low postoperative morbidity but with a risk of aortic reintervention related to disconnection between the FET and TEVAR endograft. These results suggest the need for annual CTA monitoring with no time limit in patients following connection of the FET with a TEVAR endograft.

In this series of 30 patients, midterm outcomes of secondary extension of frozen elephant trunk (FET) by thoracic endovascular repair (TEVAR) showed 3 disconnections (10%) with a Type 3 endoleak between FET and TEVAR. These findings suggest the need for annual CTA monitoring with no time limit. But so far, only a few studies provide some information after one year while the risk of disconnection increases over time and becomes a concern after 3 years. This is the new message brought by our study.

An unhealthy diet is a major contributor to several noncommunicable diseases, including cardiovascular diseases, the leading cause of death worldwide. Additionally, our food system has significant impacts on the environment. The EAT-Lancet Commission has recommended a healthy diet that preserves global environmental resources.

This prospective study aimed to evaluate the associations between adherence to the EAT-Lancet diet and the incidence of cardiovascular events and all-cause mortality in a Swiss cohort.

We analyzed data from the CoLaus/PsyCoLaus cohort study (N = 3866). Dietary intake was assessed using a semiquantitative food frequency questionnaire. The EAT-Lancet adherence score was calculated based on the recommended intake and reference intervals of 12 food components, ranging from 0 to 39 points. Participants were categorized into low-, medium-, and high-adherence groups according to score tertiles. We used Cox Proportional Hazards regressions to assess the association among diet adherence, incident cardiovascular events, and all-cause mortality.

During a mean follow-up of 7.9 y (SD: ±2.0 y), 294 individuals (7.6%) from our initial sample experienced a first cardiovascular event, and 264 (6.8%) died. Compared with the low-adherence group, the adjusted hazard ratios for all-cause mortality were 0.88 (95% CI: 0.66, 1.17) and 0.70 (95% CI: 0.49, 0.98) for the medium-adherence and high-adherence groups, respectively (P-trend = 0.04). We observed no association between adherence groups and cardiovascular events.

In a Swiss cohort, high adherence to the EAT-Lancet diet is associated with a potential 30% lower risk of overall mortality. However, it is not associated with cardiovascular events.

Although mortality from myocardial infarction (MI) has declined worldwide due to advancements in emergency medical care and evidence-based pharmacological treatments, MI remains a significant contributor to global cardiovascular morbidity. This study aims to examine the risk factors associated with individuals who have experienced an MI in Türkiye.

Microdata obtained from the Türkiye Health Survey conducted by Turkish Statistical Institute in 2019 were used in this study. Binary logistic regression, Chi-Square, and CHAID analyses were conducted to identify the risk factors affecting MI.

The analysis identified several factors associated with an increased likelihood of MI, including hyperlipidemia, hypertension, diabetes, chronic disease status, male gender, older age, single marital status, lower education level, and unemployment. Marginal effects revealed that elevated hyperlipidemia levels increased the probability of MI by 4.6%, while the presence of hypertension, diabetes, or depression further heightened this risk. Additionally, individuals with chronic diseases lasting longer than six months were found to have a higher risk of MI. In contrast, factors such as being female, having higher education, being married, being employed, engaging in moderate physical activity, and moderate alcohol consumption were associated with a reduced risk of MI.

To prevent MI, emphasis should be placed on enhancing general education and health literacy. There should be a focus on increasing preventive public health education and practices to improve variables related to healthy lifestyle behaviours, such as diabetes, hypertension, and hyperlipidemia.

Polygonum plebeium, a member of the Polygonaceae family, is commonly known as small knotweed and has been traditionally used to treat various ailments, including cough, gastrointestinal disorders, respiratory infections, liver disease, inflammation, dysentery, eczema and ringworms, and other skin conditions. Many studies have suggested that plants belonging to this genus possess strong cardio-protective potentials. Rats were pre-treated with crude methanolic extract and other fractions at a dose of 500 mg/kg followed by administration of Isoproterenol hydrochloride after 24 h for 2 days. The cardioprotective effect was determined by investigating the levels of Biomarkers responsible for myocardial infarction (MI). Among all fractions Pp.CF (chloroform fraction) exhibited a significant cardioprotective effect by decreasing the levels of ALT, AST, CPK, and LDH to 74.56 ± 1.45, 95.78 ± 2.75, 156.73 ± 1.84, and 215.55 ± 5.33 IU/L in serum. The same fraction was tested for cardio-protective potential at a dose of 50, 100, and 250 mg/kg. Pp.CF at a dose of 250 mg/kg exhibited prominent effects and reduced levels of biomarkers responsible for MI. Further investigations confirmed that Pp.CF possesses antihyperlipidemic, membrane stabilizing, and thrombolytic potential which suggests P. plebeium an ideal candidate for natural product isolation which will be helpful in the management of cardiovascular problems.

The study 'Periodontitis and Its Relation to Coronary Artery Disease' (PAROKRANK) reported an association between periodontitis (PD) and the first myocardial infarction (MI). This follow-up study aims to test the hypothesis that those with PD-compared to periodontally healthy individuals-are at increased risk for cardiovascular (CV) events and death.

A total of 1587 participants (age <75 years; females 19%) had a dental examination including panoramic radiographs between 2010 and 2014. PD was categorized as healthy (≥80% alveolar bone height), mild/moderate (79%-66%) or severe (<66%). A composite CV event (first of all-cause death, non-fatal MI or stroke and hospitalization following to heart failure) was investigated during a mean follow-up period of 9.9 years (range 0.2-12.5 years). Participants were divided into two groups: those with and without PD. The primary event rate, stratified by periodontal status at baseline, was calculated using the Kaplan-Meier method and Cox regression.

The number of events was 187 in the 985 periodontally healthy participants (19%) and 174 in the 602 participants with PD (29%; p < 0.0001). Those with PD had a higher likelihood for a future event (hazard ratio [HR] = 1.26; 95% CI: 1.01-1.57; p = 0.038), following adjustment for age, smoking and diabetes.

The PAROKRANK follow-up revealed that CV events were more common among participants with PD, which supports the assumption that there might be a direct relation between PD and CV disease.

Type 2 diabetes (T2D) is often comorbid with cardiovascular diseases (CVDs). The direction of causation between T2D and CVD is difficult to determine; however, there may be a common underlying pathway attributable to shared genetic factors. We aimed to determine whether there is a shared genetic susceptibility to T2D and CVD. This study utilizes large-scale datasets from the UK Biobank (UKB) and DIAGRAM consortium to investigate the genetic association between T2D and CVD through phenotypic association analyses, linkage disequilibrium score (LDSC) analysis, and polygenic risk score (PRS) analysis. LDSC analysis demonstrates significant genetic associations between T2D and various CVD subtypes, including angina, heart failure (HF), myocardial infarction (MI), peripheral vascular disease (PVD), and stroke. Although the genetic association between T2D and atrial fibrillation (AF) was not significant, individuals in the high-T2D PRS group had a significantly increased risk of CVD. These findings suggest a common genetic basis and suggest that genetic susceptibility to T2D may be a potential predictor of CVD risk.

Background: Limited evidence exists regarding the association of chronic kidney disease (CKD) with long-term outcomes following percutaneous coronary intervention (PCI). We aimed to assess the association of CKD with 10-year outcome after PCI. Methods: This study included 5571 patients with coronary artery disease (CAD) undergoing PCI. Patients were categorized in groups according to the estimated glomerular filtration rate (eGFR) values: eGFR ≥ 90 mL/min/1.73 m2, (normal kidney function), 60 to <90 mL/min/1.73 m2 (mild kidney impairment), 30 to <60 mL/min/1.73 m2 (mild-to-moderate and moderate-to-severe kidney impairment) and <30 mL/min/1.73 m2 (severe kidney impairment). The primary endpoint was all-cause mortality at 10 years. Results: All-cause deaths occurred in 155 patients (86.3%) with eGFR < 30 mL/min/1.73 m2, 602 patients (59.1%) with eGFR 30 to <60 mL/min/1.73 m2, 775 patients (31.3%) with eGFR 60 to <90 mL/min/1.73 m2 and 220 patients (15.8%) with eGFR ≥ 90 mL/min/1.73 m2 (adjusted hazard ratio = 2.16, 95% confidence interval 1.84 to 2.54, p < 0.001, for 30 mL/min/1.73 m2 decrement in the eGFR). There were CKD-by-age (Pint < 0.001) and CKD-by-clinical presentation (Pint = 0.017) interactions showing a stronger association of CKD with mortality in younger patients and those presenting with acute coronary syndromes. The C statistic of the multivariable model for mortality increased from 0.748 [0.737-0.759] to 0.766 [0.755-0.777] (p < 0.001) after the inclusion of eGFR in the model. Conclusions: In patients with CAD undergoing PCI, CKD was associated with higher mortality at 10 years compared with patients with preserved renal function. The association between CKD and mortality was stronger in patients of younger age and those presenting with acute coronary syndromes.

The effect of methylprotodioscin (MPD), a steroidal saponin obtained from medicinal plants, on myocardial infarction (MI) remains elusive. In this study, HL-1 and AC16 cells were subjected to injury induced by hypoxic environment, and a mouse model of MI was established by ligating the left anterior descending. MPD significantly increased viabilities and proliferations, improved the stability of MMP, reduced ROS and inflammatory factor levels in hypoxia cardiomyocytes. Moreover, MPD significantly improved cardiac functions, increased the ventricular ejection fraction and short axis shortening rate of mice with MI, reduced the infarction area, alleviated oxidative stress and increased ATPase activities. Then, differentially expressed proteins (DEPs) were discovered and evaluated using tandem mass tag (TMT)-based proteomics and bioinformatics approaches. Compared with sham group, there were 420 DEPs in the cardiac tissue of MI group, likewise, 163 DEPs in MPD group were identified compared to MI group. By validating, the expression of COX6C was elevated in MI group and declined in MPD groups, consistent with the TMT-based proteomics results. Correspondingly, p-NF-κB expression was downregulated, while Nrf2 and SOD expressions were upregulated by MPD. Moreover, si-COX6C transfection blocked the regulatory effects of MPD on COX6C-mediated inflammation and oxidative stress in MI. Our findings indicate that MPD, a naturally occurring active ingredient, could effectively improve cardiac function. Its ability may result from regulating COX6C to reduce oxidative stress and suppress inflammation, suggesting that MPD is very attractive for the treatment of MI.

Background Arrhythmias are well-recognized complications of acute myocardial infarction (AMI) and are an important risk factor for mortality in both men and women across a wide age range. Aim This study aims to analyze the incidence of arrhythmia in patients with AMI with respect to age, gender distribution, and location of AMI and also to evaluate the prognostic factors of mortality in patients with AMI. Methods This prospective, observational, and cross-sectional study included 300 patients admitted within an hour of the presentation of AMI at a Super Speciality Hospital, MGMMC (Mahatma Gandhi Memorial Medical College), Indore, after fulfilling the inclusion criteria. Clinical features, elevated cardiac biomarkers, and an electrocardiogram guided the diagnosis of AMI and arrhythmia. Results Of the total of 300 patients, the majority were male, 280 (93.4%), with a mean age of 57.48 ± 13.48 years. Prevalent risk factors included obesity, 195 (65%); diabetes mellitus, 185 (61.66%); hypertension, 181 (60.33%); smoking, 114 (38%); alcohol consumption, 123 (41%); and hypercholesterolemia, 207 (69%). Among 152 patients with arrhythmia, obesity, ischemic heart disease, diabetes, hypertension, smoking, and alcohol were more prevalent compared to those without arrhythmia. The arrhythmia incidence was higher in 143 (51.07%) male patients. Out of 37 mortality cases, 29 were associated with arrhythmia. Mortality was highest in extensive anterior wall acute myocardial infarction (EAWMI), 14 (37.24%), and inferior wall myocardial infarction (IWMI), 13 (35.14%). Conclusion In conclusion, arrhythmia was prevalent in the age group of 45-54 years and among patients with EAWMI. Mortality was significantly associated with arrhythmia and was highest in elderly patients with EAWMI and IWMI. These findings underscore the importance of risk stratification and targeted management strategies.

Biomechanics-based patient-specific modeling is a promising approach that has proved invaluable for its clinical potential to assess the adversities caused by ischemic heart disease (IHD). In the present study, we propose a framework to find the passive material properties of the myocardium and the unloaded shape of cardiac ventricles simultaneously in patients diagnosed with ischemic cardiomyopathy (ICM). This was achieved by minimizing the difference between the simulated and the target end-diastolic pressure-volume relationships (EDPVRs) using black-box Bayesian optimization, based on the finite element analysis (FEA). End-diastolic (ED) biventricular geometry and the location of the ischemia were determined from cardiac magnetic resonance (CMR) imaging. We employed our pipeline to model the cardiac ventricles of three patients aged between 57 and 66 years, with and without the inclusion of valves. An excellent agreement between the simulated and the target EDPVRs has been reached. Our results revealed that the incorporation of valvular springs typically leads to lower hyperelastic parameters for both healthy and ischemic myocardium, as well as a higher fiber Green strain in the viable regions compared to models without valvular stiffness. Furthermore, the addition of valve-related effects did not result in significant changes in myofiber stress after optimization. We concluded that more accurate results could be obtained when cardiac valves were considered in modeling ventricles. The present novel and practical methodology paves the way for developing digital twins of ischemic cardiac ventricles, providing a non-invasive assessment for designing optimal personalized therapies in precision medicine.

Since the 1960s, cardiologists have adopted several binary classification systems for acute myocardial infarction (MI) that facilitated improved patient management. Conversely, for chronic stable manifestations of myocardial ischaemia, various classifications have emerged over time, often with conflicting terminology-e.g. 'stable coronary artery disease' (CAD), 'stable ischaemic heart disease', and 'chronic coronary syndromes' (CCS). While the 2019 European guidelines introduced CCS to impart symmetry with 'acute coronary syndromes' (ACS), the 2023 American guidelines endorsed the alternative term 'chronic coronary disease'. An unintended consequence of these competing classifications is perpetuation of the restrictive terms 'coronary' and 'disease', often connoting only a singular obstructive CAD mechanism. It is now important to advance a more broadly inclusive terminology for both obstructive and non-obstructive causes of angina and myocardial ischaemia that fosters conceptual clarity and unifies dyssynchronous nomenclatures across guidelines. We, therefore, propose a new binary classification of 'acute myocardial ischaemic syndromes' and 'non-acute myocardial ischaemic syndromes', which comprises both obstructive epicardial and non-obstructive pathogenetic mechanisms, including microvascular dysfunction, vasospastic disorders, and non-coronary causes. We herein retain accepted categories of ACS, ST-segment elevation MI, and non-ST-segment elevation MI, as important subsets for which revascularization is of proven clinical benefit, as well as new terms like ischaemia and MI with non-obstructive coronary arteries. Overall, such a more encompassing nomenclature better aligns, unifies, and harmonizes different pathophysiologic causes of myocardial ischaemia and should result in more refined diagnostic and therapeutic approaches targeted to the multiple pathobiological precipitants of angina pectoris, ischaemia and infarction.

Myocardial ischemia-reperfusion injury (MIRI) is a critical issue that arises when restoring blood flow after an ischemic event in the heart. Excessive reactive oxygen species (ROS) production during this process exacerbates cellular damage and impairs cardiac function. Recent therapeutic strategies have focused on leveraging the ROS microenvironment to design targeted drug delivery systems. ROS-responsive biomaterials have emerged as promising candidates, offering enhanced therapeutic efficacy with reduced systemic adverse effects. This review examines the mechanisms of ROS overproduction during myocardial ischemia-reperfusion and summarizes significant advancements in ROS-responsive biomaterials for MIRI treatment. We discuss various chemical strategies to impart ROS sensitivity to these materials, emphasizing ROS-induced solubility switches and degradation mechanisms. Additionally, we highlight various ROS-responsive therapeutic platforms, such as nanoparticles and hydrogels, and their unique advantages in drug delivery for MIRI. Preclinical studies demonstrating the efficacy of these materials in mitigating MIRI in animal models are reviewed, alongside their mechanisms of action and potential clinical implications. We also address the challenges and future prospects of translating these state of the art biomaterial-based therapeutics into clinical practice to improve MIRI management and cardiac outcomes. This review will provide valuable insights for researchers and clinicians working on novel therapeutic strategies for MIRI intervention.

Postoperative myocardial infarction (POMI) is associated with major surgeries and remains the leading cause of mortality and morbidity in people undergoing vascular surgery, with an incidence rate ranging from 5% to 20%. Preoperative coronary interventions, such as coronary artery bypass grafting (CABG) or percutaneous coronary interventions (PCI), may help prevent acute myocardial infarction in the perioperative period of major vascular surgery when used in addition to routine perioperative drugs (e.g. statins, angiotensin-converting enzyme inhibitors, and antiplatelet agents), CABG by creating new blood circulation routes that bypass the blockages in the coronary vessels, and PCI by opening up blocked blood vessels. There is currently uncertainty around the benefits and harms of preoperative coronary interventions.

To assess the effects of preoperative coronary interventions for preventing acute myocardial infarction in the perioperative period of major open vascular or endovascular surgery.

We searched the Cochrane Vascular Specialised Register, CENTRAL, MEDLINE Ovid, Embase Ovid, LILACS, and CINAHL EBSCO on 13 March 2023. We also searched the World Health Organization International Clinical Trials Registry Platform and ClinicalTrials.gov.

We included all randomised controlled trials (RCTs) or quasi-RCTs that compared the use of preoperative coronary interventions plus usual care versus usual care for preventing acute myocardial infarction during major open vascular or endovascular surgery. We included participants of any sex or any age undergoing major open vascular surgery, major endovascular surgery, or hybrid vascular surgery.

We used standard Cochrane methods. Our primary outcomes of interest were acute myocardial infarction, all-cause mortality, and adverse events resulting from preoperative coronary interventions. Our secondary outcomes were cardiovascular mortality, quality of life, vessel or graft secondary patency, and length of hospital stay. We reported perioperative and long-term outcomes (more than 30 days after intervention). We assessed the certainty of the evidence using the GRADE approach.

We included three RCTs (1144 participants). Participants were randomised to receive either preoperative coronary revascularisation with PCI or CABG plus usual care or only usual care before major vascular surgery. One trial enrolled participants if they had no apparent evidence of coronary artery disease. Another trial selected participants classified as high risk for coronary disease through preoperative clinical and laboratorial testing. We excluded one trial from the meta-analysis because participants from both the control and the intervention groups were eligible to undergo preoperative coronary revascularisation. We identified a high risk of performance bias in all included trials, with one trial displaying a high risk of other bias. However, the risk of bias was either low or unclear in other domains. We observed no difference between groups for perioperative acute myocardial infarction, but the evidence is very uncertain (risk ratio (RR) 0.28, 95% confidence interval (CI) 0.02 to 4.57; 2 trials, 888 participants; very low-certainty evidence). One trial showed a reduction in incidence of long-term (> 30 days) acute myocardial infarction in participants allocated to the preoperative coronary interventions plus usual care group, but the evidence was very uncertain (RR 0.09, 95% CI 0.03 to 0.28; 1 trial, 426 participants; very low-certainty evidence). There was little to no effect on all-cause mortality in the perioperative period when comparing the preoperative coronary intervention plus usual care group to usual care alone, but the evidence is very uncertain (RR 0.79, 95% CI 0.31 to 2.04; 2 trials, 888 participants; very low-certainty evidence). The evidence is very uncertain about the effect of preoperative coronary interventions on long-term (follow up: 2.7 to 6.2 years) all-cause mortality (RR 0.74, 95% CI 0.30 to 1.80; 2 trials, 888 participants; very low-certainty evidence). One study reported no adverse effects related to coronary angiography, whereas the other two studies reported five deaths due to revascularisations. There may be no effect on cardiovascular mortality when comparing preoperative coronary revascularisation plus usual care to usual care in the short term (RR 0.07, 95% CI 0.00 to 1.32; 1 trial, 426 participants; low-certainty evidence). Preoperative coronary interventions plus usual care in the short term may reduce length of hospital stay slightly when compared to usual care alone (mean difference -1.17 days, 95% CI -2.05 to -0.28; 1 trial, 462 participants; low-certainty evidence). We downgraded the certainty of the evidence due to concerns about risk of bias, imprecision, and inconsistency. None of the included trials reported on quality of life or vessel graft patency at either time point, and no study reported on adverse effects, cardiovascular mortality, or length of hospital stay at long-term follow-up.

Preoperative coronary interventions plus usual care may have little or no effect on preventing perioperative acute myocardial infarction and reducing perioperative all-cause mortality compared to usual care, but the evidence is very uncertain. Similarly, limited, very low-certainty evidence shows that preoperative coronary interventions may have little or no effect on reducing long-term all-cause mortality. There is very low-certainty evidence that preoperative coronary interventions plus usual care may prevent long-term myocardial infarction, and low-certainty evidence that they may reduce length of hospital stay slightly, but not cardiovascular mortality in the short term, when compared to usual care alone. Adverse effects of preoperative coronary interventions were poorly reported in trials. Quality of life and vessel or graft patency were not reported. We downgraded the certainty of the evidence most frequently for high risk of bias, inconsistency, or imprecision. None of the analysed trials provided significant data on subgroups of patients who could potentially experience more substantial benefits from preoperative coronary intervention (e.g. altered ventricular ejection fraction). There is a need for evidence from larger and homogeneous RCTs to provide adequate statistical power to assess the role of preoperative coronary interventions for preventing acute myocardial infarction in the perioperative period of major open vascular or endovascular surgery.

Myocardial infarction (MI), frequently referred to as a heart attack, happens when the blood supply to a region of the myocardium is reduced. It might be quiet or devastating, causing hemodynamic decline and rapid death. The most common cause of MI is coronary artery disease, which is the leading cause of mortality in the United States. Prolonged lack of oxygen can lead to myocardial cell loss and necrosis. Patients may report chest pain, pressure, and electrocardiogram alterations. Management of MI relies greatly on the interprofessional team. The purpose of this study was to determine the incidence of MI in Saudi Arabia. Between 2000 and 2024, English-language papers were gathered to demonstrate the prevalence of MI in Saudi Arabia. Overall, there were four articles. Surveys and studies of national databases were the most utilized methods (n=4). We found that heart attacks are a significant health issue in Saudi Arabia, with certain lifestyle choices and medical conditions increasing the risk. Heart attacks are a major health concern in Saudi Arabia. To lower the number of heart attacks, it's important for people to make healthier lifestyle choices.

Electrocardiogram (ECG) and measurement of plasma brain natriuretic peptides (BNP) are established markers of right ventricular dysfunction (RVD) in the setting of acute pulmonary embolism (PE) but their value at long-term follow-up is largely unknown. The purpose of this prospective study was to determine the prevalence of ECG abnormalities, describe levels of N-terminal proBNP (NT-proBNP), and establish their association with dyspnea at long-term follow-up after PE.

All Swedish patients diagnosed with acute PE in 2005 (n = 5793) were identified through the Swedish National Patient Registry. Surviving patients in 2007 (n = 3510) were invited to participate. Of these, 2105 subjects responded to a questionnaire about dyspnea and comorbidities. Subjects with dyspnea or risk factors for development of chronic thromboembolic pulmonary hypertension were included in the study in a secondary step, which involved collection of blood samples and ECG registration.

Altogether 49.3% had a completely normal ECG. The remaining participants had a variety of abnormalities, 7.2% had atrial fibrillation/flutter (AF). ECG with any sign of RVD was found in 7.2% of subjects. Right bundle branch block was the most common RVD sign with a prevalence of 6.4%. An abnormal ECG was associated with dyspnea. AF was associated with dyspnea, whereas ECG signs of RVD were not. 61.2% of subjects had NT-proBNP levels above clinical cut-off (>125 ng/L). The degree of dyspnea did not associate independently with NT-proBNP levels.

We conclude that the value of ECG and NT-proBNP in long term follow-up after PE lies mostly in differential diagnostics.

Ultimaster™, a third-generation sirolimus-eluting stent using biodegradable polymer, has been introduced to overcome long term adverse vascular events, such as restenosis or stent thrombosis. In the present study, we aimed to evaluate the 12-month clinical outcomes of Ultimaster™ stents in Korean patients with coronary artery disease.

This study is a multicenter, prospective, observational registry across 12 hospitals. To reflect real-world clinical evidence, non-selective subtypes of patients and lesions were included in this study. The study end point was target lesion failure (TLF) (the composite of cardiac death, target vessel myocardial infarction [MI], and target lesion revascularization [TLR]) at 12-month clinical follow up.

A total of 576 patients were enrolled between November 2016 and May 2021. Most of the patients were male (76.5%), with a mean age of 66.0±11.2 years. Among the included patients, 40.1% had diabetes mellitus (DM) and 67.9% had acute coronary syndrome (ACS). At 12 months, the incidence of TLF was 4.1%. The incidence of cardiac death was 1.5%, MI was 1.0%, TLR was 2.7%, and stent thrombosis was 0.6%. In subgroup analysis based on the presence of ACS, DM, hypertension, dyslipidemia, or bifurcation, there were no major differences in the incidence of the primary endpoint.

The present registry shows that Ultimaster™ stent is safe and effective for routine real-world clinical practice in non-selective Korean patients, having a low rate of adverse events at least up to 12 months.

Cardiopathy has become one of the predominant global causes of death. The timely identification of different types of heart diseases significantly diminishes mortality risk and enhances the efficacy of treatment. However, fast and efficient recognition necessitates continuous monitoring, encompassing not only specific clinical conditions but also diverse lifestyles. Consequently, an increasing number of studies are striving to automate and progress in the identification of different cardiopathies. Notably, the assessment of electrocardiograms (ECGs) is crucial, given that it serves as the initial diagnostic test for patients, proving to be both the simplest and the most cost-effective tool. This research employs a customized architecture of Convolutional Neural Network (CNN) to forecast heart diseases by analyzing the images of both three bands of electrodes and of each single electrode signal of the ECG derived from four distinct patient categories, representing three heart-related conditions as well as a spectrum of healthy controls. The analyses are conducted on a real dataset, providing noteworthy performance (recall greater than 80% for the majority of the considered diseases and sometimes even equal to 100%) as well as a certain degree of interpretability thanks to the understanding of the importance a band of electrodes or even a single ECG electrode can have in detecting a specific heart-related pathology.