Cardiology Research Updates

The LOSE-AF randomized trial enrolled 118 patients aged 60–85 years with BMI ≥27 and persistent atrial fibrillation undergoing cardioversion, randomizing them to an 8-month low-calorie diet plus behavioral support (n=59) versus usual care (n=59). The intervention produced significant weight loss (baseline-adjusted mean difference −6.9 kg; 9.7% vs 3.1% weight reduction) but did not significantly change AF symptom severity at 8 months (between-group difference −0.9, 95% CI −3.3 to 1.4; P = .43) nor AF burden, cardiac imaging measures, blood pressure, lipid profile, or need for additional rhythm-control procedures, and no serious adverse events related to the trial were reported.

In 391,078 UK Biobank participants followed a median 13.35 years, incident arrhythmias (including AF, bradyarrhythmia/conduction block, and ventricular arrhythmia) were independently associated with increased risks of all-cause, vascular, and Alzheimer dementia, with a dose-response relationship for accumulated arrhythmia exposure driven largely by combined AF and brady/conduction disease. Concurrent AF with AV block/SND or BBB conferred higher dementia risk than either alone, pacemaker implantation related to lower risk compared with AVB/SND without pacing, and brain MRI showed arrhythmia-associated atrophy and white-matter injury.

Among 3,292 US Medicare beneficiaries aged >65 who received inpatient CAR-T therapy, 5.8% experienced major adverse cardiovascular events (MACE), most commonly acute heart failure (3.1%). Pre-existing atrial fibrillation/flutter, cardiomyopathy, and cerebrovascular disease were independently associated with MACE, which in turn was linked to markedly higher in-hospital mortality (aOR 16.9) and increased 1-year postdischarge mortality (adjusted HR 1.91).