Welcome to Cardiology Today – Recorded November 24, 2025. This episode summarizes 5 key cardiology studies on topics like high-sensitivity cardiac troponin and conduction system disease. Key takeaway: Hydroxychloroquine Cardiotoxicity: Fatal Conduction Disease.

Article Links:

Article 1: Association between Listing Hemodynamics and Heart Transplantation Waitlist Outcomes: an Analysis of the Scientific Registry of Transplant Recipients. (The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation)

Article 2: Validation of the European Society of Cardiology 0/1-hour algorithm for chest pain triage in Asian emergency departments: a multinational stepped-wedge cluster-randomised trial. (Heart (British Cardiac Society))

Article 3: Progressive Conduction System Disease in Hydroxychloroquine Cardiotoxicity: A Call for Early Vigilance. (The American journal of cardiology)

Article 4: Systemic and pulmonary congestion by ultrasound and prognosis in heart failure: A pooled cohort analysis. (International journal of cardiology)

Article 5: Acute type A aortic dissection following TAVI. (International journal of cardiology)

Full episode page: https://podcast.explainheart.com/podcast/hydroxychloroquine-cardiotoxicity-fatal-conduction-disease-11-24-25/

Journal: The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation

PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41276097

Summary: This analysis established specific associations between invasive hemodynamic measurements at the time of heart transplantation listing and subsequent waitlist outcomes. The study clarified how various hemodynamic profiles influence a patient’s risk of removal from the waitlist due to death or clinical deterioration. Utilizing data from the Scientific Registry of Transplant Recipients for adult candidates with statuses one through four and six, this research directly informs risk stratification and optimizes management for patients awaiting heart transplantation. These findings highlight the prognostic significance of pre-transplant hemodynamic assessment.

Journal: Heart (British Cardiac Society)

PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41276292

Summary: This multinational, stepped-wedge cluster-randomized trial established the safety and clinical utility of the European Society of Cardiology 0/1-hour high-sensitivity cardiac troponin algorithm for chest pain triage. The study validated this algorithm across multiple diverse Asian emergency department settings, addressing a critical need for rapid diagnosis and safe patient disposition. Previously showing promising performance in Western cohorts, this research demonstrated the algorithm’s effectiveness in new populations. These findings support implementing a standardized, efficient diagnostic pathway for chest pain patients in Asian emergency departments.

Journal: The American journal of cardiology

PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41276147

Summary: This report highlighted the underappreciated and lethal phenotype of progressive conduction system disease caused by hydroxychloroquine (H. C. Q.) cardiotoxicity. A 67-year-old female on chronic H. C. Q. developed progressive conduction abnormalities which led to cardiogenic shock and sudden death, despite initial stabilization with isolated atrial pacing. Autopsy findings confirmed extensive sinoatrial and atrioventricular nodal lysosomal toxicity and fibrosis, indicating irreversible cardiac damage. This case underscores the critical need for early vigilance in monitoring for progressive conduction system disease in patients treated with H. C. Q.

Journal: International journal of cardiology

PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41276189

Summary: This pooled cohort analysis confirmed that increasing congestion, both pulmonary detected by ultrasound and systemic quantified by inferior vena cava diameter, is associated with worse outcomes in patients with heart failure. The study involved five European cohorts of patients with heart failure, providing robust data on prognostic indicators. The primary outcome, a composite of hospitalization for heart failure and all-cause death, demonstrated the significant prognostic value of assessing both forms of congestion. This research provides a robust understanding of how different levels of fluid retention impact patient prognosis in heart failure.

Journal: International journal of cardiology

PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41276188

Summary: This retrospective analysis characterized the incidence, possible mechanisms, and management of acute type A aortic dissection following transcatheter aortic valve implantation (T. A. V. I.). The study confirmed this complication is rare but severe, frequently necessitating emergent cardiac surgery. Analyzing a large two-center cohort, the research provided crucial data that delineate the risks and optimal approaches for this potentially lethal post-T. A. V. I. complication. These findings help to better understand and manage this critical event in patients undergoing T. A. V. I.

Today’s date is November 24, 2025. Welcome to Cardiology Today. Here are the latest research findings.

Article number one. Association between Listing Hemodynamics and Heart Transplantation Waitlist Outcomes: an Analysis of the Scientific Registry of Transplant Recipients. This analysis established specific associations between invasive hemodynamic measurements at the time of heart transplantation listing and subsequent waitlist outcomes. The study clarified how various hemodynamic profiles influence a patient’s risk of removal from the waitlist due to death or clinical deterioration. Utilizing data from the Scientific Registry of Transplant Recipients for adult candidates with statuses one through four and six, this research directly informs risk stratification and optimizes management for patients awaiting heart transplantation. These findings highlight the prognostic significance of pre-transplant hemodynamic assessment.

Article number two. Validation of the European Society of Cardiology 0/1-hour algorithm for chest pain triage in Asian emergency departments: a multinational stepped-wedge cluster-randomised trial. This multinational, stepped-wedge cluster-randomized trial established the safety and clinical utility of the European Society of Cardiology 0/1-hour high-sensitivity cardiac troponin algorithm for chest pain triage. The study validated this algorithm across multiple diverse Asian emergency department settings, addressing a critical need for rapid diagnosis and safe patient disposition. Previously showing promising performance in Western cohorts, this research demonstrated the algorithm’s effectiveness in new populations. These findings support implementing a standardized, efficient diagnostic pathway for chest pain patients in Asian emergency departments.

Article number three. Progressive Conduction System Disease in Hydroxychloroquine Cardiotoxicity: A Call for Early Vigilance. This report highlighted the underappreciated and lethal phenotype of progressive conduction system disease caused by hydroxychloroquine (H. C. Q.) cardiotoxicity. A 67-year-old female on chronic H. C. Q. developed progressive conduction abnormalities which led to cardiogenic shock and sudden death, despite initial stabilization with isolated atrial pacing. Autopsy findings confirmed extensive sinoatrial and atrioventricular nodal lysosomal toxicity and fibrosis, indicating irreversible cardiac damage. This case underscores the critical need for early vigilance in monitoring for progressive conduction system disease in patients treated with H. C. Q.

Article number four. Systemic and pulmonary congestion by ultrasound and prognosis in heart failure: A pooled cohort analysis. This pooled cohort analysis confirmed that increasing congestion, both pulmonary detected by ultrasound and systemic quantified by inferior vena cava diameter, is associated with worse outcomes in patients with heart failure. The study involved five European cohorts of patients with heart failure, providing robust data on prognostic indicators. The primary outcome, a composite of hospitalization for heart failure and all-cause death, demonstrated the significant prognostic value of assessing both forms of congestion. This research provides a robust understanding of how different levels of fluid retention impact patient prognosis in heart failure.

Article number five. Acute type A aortic dissection following TAVI. This retrospective analysis characterized the incidence, possible mechanisms, and management of acute type A aortic dissection following transcatheter aortic valve implantation (T. A. V. I.). The study confirmed this complication is rare but severe, frequently necessitating emergent cardiac surgery. Analyzing a large two-center cohort, the research provided crucial data that delineate the risks and optimal approaches for this potentially lethal post-T. A. V. I. complication. These findings help to better understand and manage this critical event in patients undergoing T. A. V. I.

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high-sensitivity cardiac troponin, conduction system disease, prognosis, ultrasound, sinoatrial node toxicity, transcatheter aortic valve implantation, risk stratification, emergency department, invasive hemodynamics, Hydroxychloroquine cardiotoxicity, Heart failure, T. A. V. I. complications, Chest pain triage, cardiac surgery, systemic congestion, transplant candidate, Heart transplantation, waitlist outcomes, cardiogenic shock, Asian populations, aortic dissection management, Acute type A aortic dissection, inferior vena cava, E. S. C. 0/1-hour algorithm, sudden cardiac death, pulmonary congestion.

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