UNASSIGNED: Use of healthcare wearable devices holds significant potential for improving the prevention and management of cardiovascular diseases (CVD). However, we have limited knowledge on the actual use of wearable devices by CVD patients and the key factors associated with their use. This study aims to assess wearable device use and willingness to share health data among CVD patients, while identifying socio-demographic, health, and technology-related factors associated with wearable technology use.
UNASSIGNED: Using a national survey of 933 CVD patients, we assess use of wearable healthcare devices (use, frequency of use and willingness to share health data from wearable with a provider), and a set of socio-demographic factors (age, gender, race, education and household income), health-related variables (general health, presence of comorbid conditions: diabetes and high blood pressure, attitude towards exercise) and technology self-efficacy using logistic regression.
UNASSIGNED: Of the 933 CVD patients, 18.34% reported using a healthcare wearable device in the prior 12 months. Of those, 41.92% indicated using it every day and another 19.76% indicated using it \'almost every day\'. 83.54% of wearable users indicated their willingness to share health data with their healthcare providers. Female CVD patients are more likely to use wearables compared to men (odds ratio (OR) = 1.65, 95% confidence interval (CI) = 1.04-2.63). The odds decrease with age, and are significantly high in patients with higher income levels. In comparison with non-Hispanic White, Hispanic (OR = 0.14, 95% CI = 0.03-0.70) and African Americans (OR = 0.17, 95% CI = 0.04-0.86) are less likely to use healthcare wearables. CVD patients who perceive their general health to be better (OR = 1.45, 95% CI = 1.11-1.89) and those who enjoy exercising (OR = 1.76, 95% CI = 1.22-2.55) are more likely to use wearables. CVD patients who use the internet for searching for medical information (OR = 2.10, 95% CI = 1.17-3.77) and those who use electronic means to make appointments with their providers (OR = 2.35, 95% CI = 1.48-3.74) are more inclined to use wearables.
UNASSIGNED: Addressing low wearable device usage among CVD patients requires targeted policy interventions to ensure equitable access. Variations in gender, age, race/ethnicity, and income levels emphasize the need for tailored strategies. Technological self-efficacy, positive health perceptions, and exercise enjoyment play significant roles in promoting wearable use. These insights should guide healthcare leaders in designing effective strategies for integrating wearables into cardiovascular care.

Chat Generative Pre-Trained Transformer (ChatGPT) is a chatbot based on a large language model that has gained public interest since its release in November 2022. This systematic review examines the current literature on the potential applications of ChatGPT in cardiology. A systematic literature search was conducted to retrieve all publications on ChatGPT in PubMed, Scopus, MedRxiv, and the Cochrane Library published on or before September 30, 2023. Search terms relating to ChatGPT and cardiology were used. Publications without relevance to ChatGPT and cardiology were excluded. The included publications were divided into cohorts. Cohort A examined ChatGPT\'s role in improving patient health literacy. Cohort B explored ChatGPT\'s role in clinical care. Cohort C examined ChatGPT\'s role in future literature and research. Cohort D included case reports that used ChatGPT. A total of 115 publications were found across all databases. Twenty-four publications met the inclusion criteria and were included in the review. Cohort A-C included a total of 14 records comprised of editorials/letters to the editor (29%), research letters/correspondence (21%), review papers (21%), observational studies (7%), research studies (7%), and short reports (7%). Cohort D included 10 case reports. No relevant systematic literature reviews, meta-analyses, or randomized controlled trials were identified in the search.  Based on this review of the literature, ChatGPT has the potential to enhance patient education, support clinicians providing clinical care, and enhance the development of future literature. However, further studies are needed to understand the potential applications of ChatGPT in cardiology and to address ethical concerns regarding the delivery of medical advice and the authoring of manuscripts.

This study evaluated the capabilities of the newly released ChatGPT-4V, a large language model with visual recognition abilities, in interpreting electrocardiogram waveforms and answering related multiple-choice questions for assisting with cardiovascular care.

Heart failure, a growing concern in the United States, significantly impacts both morbidity and mortality. Classified by ejection fraction, heart failure with preserved ejection fraction (HFpEF) now accounts for half of all cases and is steadily rising. Unlike its counterpart, heart failure with reduced ejection fraction (HFrEF), HFpEF lacks clear management guidelines. Recognizing this critical gap, we aim to review existing recommendations and formulate effective management strategies for HFpEF.

Cardiovascular diseases (CVD) are a major public health concern in the Caribbean. Cardiovascular care in the Caribbean revealed encouraging improvements but still less than expectations. This study aims to gain insight into CVD and identify gaps in cardiovascular care in the Caribbean compared to high-income countries. More specifically, this review reports on the epidemiology, CVD risk factors, management practices, and patient outcomes (quality of life (QOL) and mortality). A systematic review of peer-reviewed articles was conducted to assess the CVD of individuals in the Caribbean from 1959 to 2022.Using multiple search engines and keywords, a systematic review of relevant peer-reviewed CVD articles was conducted using the necessary inclusion and exclusion criteria. Relevant data of studies were classified by title, publication year, location, type and size of samples, and results. Further analysis grouped patients by epidemiological profile, CVD risk, management, and selected outcomes (quality of life and inpatient mortality).  From the initial review of 1,553 articles, 36 were analyzed from Trinidad and Tobago (20), Barbados (4), Jamaica (7), along with the Bahamas (2), British Virgin Islands (1), Bonaire (1), and one article from a Caribbean study. The social environment of fast food, sedentary jobs, and stress determinants are postulated to be precursors for an increase in CV risks. CVD in the Caribbean reveals a high prevalence of CV risks, suboptimal care, poor compliance, and high inpatient mortality compared with high-income countries. Greater efforts are required to improve CVD care at all stages, including in the social environment.

This review aims to explore the applications of digital technology in cardiovascular care across African countries. It highlights the opportunities and challenges associated with leveraging technology to enhance patient self-monitoring, remote patient-clinician interactions, telemedicine, clinician and patient education, and research facilitation. The purpose is to highlight how technology can transform cardiovascular care in Africa.
Recent findings indicate that the increasing penetration of mobile phones and internet connectivity in Africa offers a unique opportunity to improve cardiovascular care. Smartphone-based applications and text messaging services have been employed to promote self-monitoring and lifestyle management, although challenges related to smartphone ownership and digital literacy persist. Remote monitoring of patients by clinicians using home-based devices and wearables shows promise but requires greater accessibility and validation studies in African populations. Telemedicine diagnosis and management of cardiovascular conditions demonstrates significant potential but faces adoption challenges. Investing in targeted clinician and patient education on novel digital technology and devices as well as promoting technology-assisted research for participant recruitment and data collection can facilitate cardiovascular care advancements in Africa. Technology has the potential to revolutionize cardiovascular care in Africa by improving access, efficiency, and patient outcomes. However, barriers related to limited resources, supportive infrastructure, digital literacy, and access to devices must be addressed. Strategic actions, including investment in digital infrastructure, training programs, community collaboration, and policy advocacy, are crucial to ensuring equitable integration of digital health solutions.

The Nordic countries, including Denmark, Finland, Iceland, Norway, and Sweden have seen a steep decline in cardiovascular mortality in recent decades. They are among the most egalitarian countries by several measures, and all have universal, publicly funded welfare systems providing healthcare for all citizens. However, despite these seemingly ideal conditions, disparities in access to cardiovascular care and outcomes persist. To address this challenge, The Lancet Region Health-Europe convened experts from a broad range of countries to summarize the current state of knowledge on cardiovascular disease disparities across Europe. This Series Paper presents the main challenges in Nordic countries based on evidence from high-quality nationwide registries. Focusing on major cardiovascular health determinants, areas in need of improvement were identified. There is a need for addressing structural causes underlying these disparities, such as poverty and discrimination, but also to improve access to healthcare in deprived neighborhoods and to address underlying social determinants of health that may mitigate disparities in cardiovascular outcomes. Overall, while the Nordic countries have made great strides in promoting egalitarianism and providing universal healthcare, there is still much work to be done to ensure equitable access to care and improved cardiovascular outcomes for all members of society.

BACKGROUND: Standardized Mortality Ratios (SMRs) are case-mix adjusted mortality rates per hospital and are used to evaluate quality of care. However, acute care is increasingly organized on a regional level, with more severe patients admitted to specialized hospitals. We hypothesize that the current case-mix adjustment insufficiently captures differences in case-mix between non-specialized and specialized hospitals. We aim to improve the SMR by adding proxies of disease severity to the model and by calculating a regional SMR (RSMR) for acute cerebrovascular disease (CVD) and myocardial infarction (MI).
METHODS: We used data from the Dutch National Basic Registration of Hospital Care. We selected all admissions from 2016 to 2018. SMRs and RSMRs were calculated by dividing the observed in-hospital mortality by the expected in-hospital mortality. The expected in-hospital mortality was calculated using logistic regression with adjustment for age, sex, socioeconomic status, severity of main diagnosis, urgency of admission, Charlson comorbidity index, place of residence before admission, month/year of admission, and in-hospital mortality as outcome.
RESULTS: The IQR of hospital SMRs of CVD was 0.85-1.10, median 0.94, with higher SMRs for specialized hospitals (median 1.12, IQR 1.00-1.28, 71%-SMR > 1) than for non-specialized hospitals (median 0.92, IQR 0.82-1.07, 32%-SMR > 1). The IQR of RSMRs was 0.92-1.09, median 1.00. The IQR of hospital SMRs of MI was 0.76-1.14, median 0.98, with higher SMRs for specialized hospitals (median 1.00, IQR 0.89-1.25, 50%-SMR > 1 versus median 0.94, IQR 0.74-1.11, 44%-SMR > 1). The IQR of RSMRs was 0.90-1.08, median 1.00. Adjustment for proxies of disease severity mostly led to lower SMRs of specialized hospitals.
CONCLUSIONS: SMRs of acute regionally organized diseases do not only measure differences in quality of care between hospitals, but merely measure differences in case-mix between hospitals. Although the addition of proxies of disease severity improves the model to calculate SMRs, real disease severity scores would be preferred. However, such scores are not available in administrative data. As a consequence, the usefulness of the current SMR as quality indicator is very limited. RSMRs are potentially more useful, since they fit regional organization and might be a more valid representation of quality of care.

Knowledge translation (KT) is the exchange between knowledge producers and users to understand, synthesize, share, and apply evidence to accelerate the benefits of research to improve health and health systems. Knowledge translation practice (activities/strategies to move evidence into practice) and KT science (study of the methodology and approaches to promote the uptake of research) benefit from the use of conceptual thinking, the meaningful inclusion of patients, and the application of intersectionality. In spite of multiple barriers, there are opportunities to develop strong partnerships and evidence to drive an impactful research agenda and increase the uptake of cardiovascular research.

Background and Objectives: To estimate the association between admission functional outcomes and exposure to physiotherapy interventions with mortality rate in intensive care unit (ICU) inpatients with cardiovascular diseases and new coronavirus disease (COVID-19). Materials and Methods: Retrospective cohort including 100 ICU inpatients (mean (standard deviation), age 75 (16) years) split into COVID-19+ or COVID-19−. The association of in-ICU death with admission functional outcomes and physiotherapy interventions was investigated using univariable and multivariable regression models. Results: In total, 42 (42%) patients tested positive for COVID-19. In-ICU mortality rate was 37%, being higher for the COVID-19+ group (odds ratio, OR (95% CI): 3.15 (1.37−7.47), p = 0.008). In-ICU death was associated with lower admission ICU Mobility Scale score (0.81 (0.71−0.91), p = 0.001). Restricted mobility (24.90 (6.77−161.94), p < 0.001) and passive kinesiotherapy (30.67 (9.49−139.52), p < 0.001) were associated with in-ICU death, whereas active kinesiotherapy (0.13 (0.05−0.32), p < 0.001), standing (0.12 (0.05−0.30), p < 0.001), or walking (0.10 (0.03−0.27), p < 0.001) were associated with in-ICU discharge. Conclusions: In-ICU mortality was higher for inpatients with cardiovascular diseases who had COVID-19+, were exposed to invasive mechanical ventilation, or presented with low admission mobility scores. Restricted mobility or passive kinesiotherapy were associated with in-ICU death, whereas active mobilizations (kinesiotherapy, standing, or walking) were associated with in-ICU discharge in this population.