volume-11-issue-4-December-2025 – JCE – Journal of Cardiovascular Emergencies

Implementation of Artificial Intelligence for Predicting Atrial Fibrillation – A Review

Renáta Gerculy, Emanuel Blîndu, Theodora Benedek — Mon, 22 Dec 2025 10:37:40 +0000

ABSTRACT
Atrial fibrillation is the most common heart arrhythmia globally, leading to life-threatening complications, reduced quality of life, a high financial burden, and significant healthcare resource utilization. Artificial intelligence is increasingly being integrated into medicine, enhancing clinicians’ ability to screen for, diagnose, and treat various conditions. In recent years, artificial intelligence models have been successfully applied to predict atrial fibrillation by analyzing 12-lead electrocardiogram waveforms, imaging features derived from computed tomography, cardiac magnetic resonance imaging, and echocardiography, as well as other clinical risk factors. The aim of this study is to synthesize current evidence, highlight emerging trends, and identify future directions in this field.

Hypertensive Emergencies – Updated Insights into Guidelines, Mechanisms, and Emerging Challenges

Mon, 22 Dec 2025 10:35:27 +0000

ABSTRACT
Hypertensive emergencies are critical conditions characterized by severe blood pressure (BP) elevations causing acute target organ damage. Despite advancements in hypertension management, these emergencies remain a significant clinical challenge, affecting 1–2% of hypertensive patients and often arising from poor disease control. This review integrates updated guidelines, emerging evidence, and treatment strategies to optimize outcomes. Pathophysiological mechanisms, including failure of autoregulation and renin–angiotensin–aldosterone system activation, contribute to endothelial dysfunction and microvascular injury. Effective management requires rapid, yet cautious BP reduction to prevent further organ damage while preserving perfusion. Intravenous antihypertensive agents, such as labetalol and nicardipine, are emphasized for their safety and efficacy. Comparative studies highlight nicardipine’s superior efficacy in achieving rapid BP control, whereas labetalol offers versatility with fewer cardiac side effects. In specific scenarios, such as ischemic stroke or preeclampsia, treatment is tailored to underlying conditions, reflecting guideline recommendations. Long-term outcomes depend on sustained BP control and the prevention of hypertensive-mediated organ damage. Emerging biomarkers provide insights into disease progression and potential therapeutic targets. Despite progress, research gaps remain in precision medicine and healthcare equity. Future efforts should focus on personalizing treatment and integrating advanced diagnostics to reduce morbidity and mortality in hypertensive emergencies.

The Association of Coronary Artery Calcium Score with Heart Failure – a Literature Review

Mon, 22 Dec 2025 10:33:01 +0000

ABSTRACT
One of the main principles of cardiovascular disease prevention is early intervention. Heart failure represents an end stage of most cardiovascular diseases and is a consequence of persistent damage caused by conditions such as coronary artery disease, hypertension, or valvular heart disease. Since its introduction, the coronary artery calcium (CAC) score has proven to be a comprehensive, reproducible, and accessible measure to quantify atherosclerotic burden. This review aimed to assess the prognostic value of the CAC score in patients with heart failure and its association with heart failure-related mortality. We searched the PubMed, Web of Science, and Google Scholar databases for studies examining the relationship between the CAC score and heart failure. After an initial selection of 32 articles, 23 were deemed eligible for inclusion. Based on the findings of these studies, the CAC score can be considered a useful tool for assessing heart failure risk, either alone or in combination with other parameters, across diverse populations, thereby supporting earlier initiation of pharmacological therapy.

The Impact of Connective Tissue Disorders on Patients with Thoracic Aortic Pseudoaneurysms

Sandra Rečičárová, Michael Jonák, Ivan Netuka — Mon, 22 Dec 2025 10:30:15 +0000

ABSTRACT
Introduction: We sought to review the clinical presentation, etiologies, diagnostic methods, surgical techniques, and long-term outcomes of patients with thoracic aortic false aneurysms (TAFA) treated at our institution. Although connective tissue disorders (CTDs) are recognized risk factors for aortic aneurysms, their role in the development and management of false aneurysms is less well established. The aim of this study was to compare cohorts of patients with and without CTD. Methods: A total of 116 patients were diagnosed with a thoracic aortic pseudoaneurysm between January 1996 and August 2024 at our institute. Genetic screening confirmed a CTD in 18 patients. Follow-up was obtained for all patients through echocardiographic or computed tomography assessment. Results: In all cases, TAFA developed after prior cardiovascular surgery. In the CTD cohort, the most common initial diagnosis was aortic dissection (72%), and the most frequent primary operation was the Bentall procedure (88%). Ten patients with CTD were indicated for reintervention (surgical reoperation, endoluminal graft implantation, or occluder implantation). Conclusion: One-year survival was higher in patients without CTD (98%) than in those with CTD (89%); however, ten-year survival was higher in the CTD cohort (89% vs. 68%). After surgical reoperation, secondary TAFA recurrence was lower in patients without CTD (16% vs. 22%), although recurrence occurred sooner in this group. Operative mortality was 11.1% in patients with CTD and 5.1% in those without CTD.

Previous Cardiovascular and Cerebrovascular Events Increase Risk of Depression or Anxiety Disorder in Patients with Chronic Limb-Threatening Ischemia

Mon, 22 Dec 2025 10:27:23 +0000

ABSTRACT
Background: Chronic limb-threatening ischemia (CLTI), the most severe type of peripheral arterial disease (PAD), is characterized by rest pain, ischemic ulcers, or gangrene. It is associated with high rates of amputation, hospitalization, and mortality. Depression affects between 16% and 35% of patients with PAD, while anxiety disorders are present in approximately 24.4% to 29%. Aim of the study: This study aims to identify and analyze the risk factors associated with the presence of anxiety or depressive disorders in patients with CLTI. Material and Methods: In this monocentric, retrospective, observational study, all patients with CLTI admitted to the Vascular Surgery Clinic of the Târgu Mureș County Emergency Clinical Hospital from January 2020 to December 2023 were included. Demographic data, comorbidities, risk factors, and laboratory data were collected from the hospital’s electronic database. Additionally, cardiovascular events (history of myocardial infarction or angina pectoris) and cerebrovascular events (including stroke or transient ischemic attack) were documented, along with the presence of depression or anxiety disorders. Results: A total of 113 patients with CLTI were enrolled, with a mean age of 70.54 ± 8.96 years. Of the entire cohort, 14 patients (12.39%) were diagnosed with depression or anxiety disorder. Based on the presence of depression or anxiety disorder, no significant differences were observed concerning demographic data, comorbidities, and risk factors, except for cardiovascular events (35.71% vs. 11.11%; p = 0.013) and cerebrovascular events (64.29% vs. 12.12%; p < 0.001). Regarding laboratory findings, only blood urea nitrogen levels were higher in patients with depression or anxiety disorder (p = 0.023). In the univariate analysis, cardiovascular events (OR 4.44; p = 0.020) and cerebrovascular events (OR 13.05; p < 0.001) were linked to depression or anxiety. Conclusions: A history of cardiovascular and cerebrovascular events was strongly linked to an increased risk of depression or anxiety in patients with CLTI. This emphasizes the close connection between vascular disease and mental health, indicating that neurological and cardiac conditions might worsen psychological distress in this at-risk group.

Peripheral Vascular Access Complications After Percutaneous Procedures: A Single-Center Experience

Mon, 22 Dec 2025 10:22:30 +0000

ABSTRACT
Background: The Seldinger technique is a fundamental method for percutaneous vascular access in cardiovascular interventions, including extracorporeal membrane oxygenation, transcatheter aortic valve implantation, percutaneous coronary intervention, and coronary angiography. Despite its critical role in hemodynamic monitoring, drug delivery, and device placement, peripheral vascular access is associated with complications such as pseudoaneurysm, hematoma, arteriovenous fistula, thrombosis, and bleeding, which may adversely impact clinical outcomes. Aim of the Study: This study aimed to evaluate the incidence, risk factors, and management strategies of severe vascular complications requiring surgical intervention following peripheral vascular access in cardiovascular procedures. Materials and Methods: A retrospective analysis was conducted on 81 patients treated at the Emergency Institute for Cardiovascular Diseases and Transplantation Târgu Mureș between 2017 and 2024 for vascular complications after percutaneous interventions. From a total of 23,370 procedures, including 592 cases of transcatheter aortic valve implantation, 73 patients with femoral artery complications were analyzed. Demographic data, comorbidities, procedural history, complication type, and surgical management were recorded. Results: The cohort had a mean age of 65.7 ± 13.3 years; 60.2% were male, and 87.6% were over 50 years of age. Frequent comorbidities included cardiopathies (97.5%), anemia (67.1%), peripheral arterial disease (32.8%), and coagulopathies (28.7%). Previous vascular interventions were significantly associated with increased complication risk (p < 0.001). Pseudoaneurysm was the most prevalent complication (43.8%), followed by hematoma and arteriovenous fistula. Arterial suturing constituted the primary surgical management (67.1%). Conclusions: Femoral artery access in cardiovascular interventions carries a measurable risk of severe complications, particularly in older patients with comorbidities and prior vascular procedures. Pseudoaneurysm represents the most frequent adverse event. Optimal outcomes require meticulous patient selection, procedural planning, and early recognition of complications, supported by advanced imaging, closure devices, and prompt surgical intervention when necessary.