Twin Pregnancy: Heart Disease Raises Heart Failure Risk 10/25/25
Welcome to Cardiology Today â Recorded October 25, 2025. This episode summarizes 5 key cardiology studies on topics like chest pain and heart disease. Key takeaway: Twin Pregnancy: Heart Disease Raises Heart Failure Risk.
Article Links:
Article 1: A Novel IgG- and IgM-Cleaving Endopeptidase, IceMG, for Antibody-Mediated Rejection. (American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons)
Article 2: Erythropoietin prolongs graft survival in mice by counteracting trained immunity. (American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons)
Article 3: Added value of cardiac magnetic resonance to clinical diagnostic criteria in the diagnosis of pericarditis: a retrospective cohort study. (Heart (British Cardiac Society))
Article 4: Twin pregnancies in women with heart disease are complicated by high risk of heart failure: data from the EORP ROPAC Registry. (Heart (British Cardiac Society))
Article 5: Cardioversion of atrial fibrillation and flutter: Trends, outcomes, and rhythm management strategies over two decades. (Heart rhythm)
Full episode page: https://podcast.explainheart.com/podcast/twin-pregnancy-heart-disease-raises-heart-failure-risk-10-25-25/
đ Featured Articles
Article 1: A Novel IgG- and IgM-Cleaving Endopeptidase, IceMG, for Antibody-Mediated Rejection.
Journal: American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41135884
Summary: This study investigated IceMG, a novel recombinant endopeptidase designed to simultaneously cleave Immunoglobulin G and Immunoglobulin M, for its efficacy in antibody-mediated rejection. In rhesus macaques sensitized by sequential skin transplantations, a single intravenous dose of IceMG (2 milligrams per kilogram) significantly but transiently reduced total Immunoglobulin G and Immunoglobulin M levels. It also decreased allo- and xenoreactive Immunoglobulin G and Immunoglobulin M antibodies. These findings highlight IceMG’s potential as a therapeutic agent to temporarily clear harmful antibodies, offering a promising approach to improve outcomes in allo- and xenotransplantation by mitigating antibody-mediated rejection.
Article 2: Erythropoietin prolongs graft survival in mice by counteracting trained immunity.
Journal: American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41135883
Summary: This research explored erythropoietin’s immune-modulatory effects, specifically its impact on trained immunity and graft survival. C57BL/6 mice, receiving BALB/c cardiac allografts and treated with CpG (a trained immunity inducer), demonstrated accelerated rejection. However, treatment with erythropoietin, which binds to erythropoietin receptors on myeloid cells, effectively counteracted the epigenetic and metabolic reprogramming associated with trained immunity. This intervention resulted in a significant prolongation of cardiac allograft survival in the treated mice. The discovery suggests erythropoietin offers a novel therapeutic strategy to prevent transplant rejection by targeting trained immunity in macrophages, thereby improving long-term graft survival.
Article 3: Added value of cardiac magnetic resonance to clinical diagnostic criteria in the diagnosis of pericarditis: a retrospective cohort study.
Journal: Heart (British Cardiac Society)
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41136194
Summary: This retrospective cohort study evaluated the clinical utility of cardiac magnetic resonance in diagnosing pericarditis, particularly when traditional clinical criteria are transient or ambiguous. Consecutive patients referred for pericarditis evaluation by cardiac magnetic resonance between 2010 and 2024 at a tertiary hospital were screened. The study confirmed that while pericarditis is typically diagnosed clinically via symptoms like chest pain, pericardial rub, E.C.G. changes, and pericardial effusion, these findings can be transient. Cardiac magnetic resonance provides crucial added value by offering a more definitive diagnosis of pericardial inflammation or effusion. This enhances diagnostic accuracy and aids in guiding appropriate management for patients with challenging pericarditis presentations.
Article 4: Twin pregnancies in women with heart disease are complicated by high risk of heart failure: data from the EORP ROPAC Registry.
Journal: Heart (British Cardiac Society)
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41136193
Summary: This study, using data from the prospective global Registry Of Pregnancy And Cardiac disease (R.O.P.A.C.) from 2007-2018, tested the hypothesis that twin pregnancies in women with heart disease lead to higher rates of adverse cardiac events. Comparing 96 twin pregnancies to singleton pregnancies in women with heart disease, the research confirmed that cardiovascular adaptation is more pronounced in twin gestations. Women with pre-existing heart disease carrying twins faced a significantly higher rate of adverse cardiac events, particularly heart failure. These findings highlight the substantial hemodynamic burden of twin pregnancies in this vulnerable population and underscore the critical need for intensive cardiac monitoring and specialized care.
Article 5: Cardioversion of atrial fibrillation and flutter: Trends, outcomes, and rhythm management strategies over two decades.
Journal: Heart rhythm
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41135625
Summary: This study analyzed a large multi-institutional dataset spanning two decades to characterize temporal trends, outcomes, and rhythm management strategies surrounding direct current cardioversion for atrial fibrillation and atrial flutter. Researchers identified all direct current cardioversions performed for atrial fibrillation and atrial flutter between 2000 and 2024, assessing annual volumes and patient status (outpatient versus inpatient). The investigation revealed evolving patterns in the utilization, effectiveness, and patient profiles associated with direct current cardioversion over time. Understanding these trends and contemporary practices is crucial for optimizing rhythm management strategies, improving patient selection, and enhancing the safety and efficacy of cardioversion procedures in modern cardiology practice.
đ Transcript
Today’s date is October 25, 2025. Welcome to Cardiology Today. Here are the latest research findings.
Article number one. A Novel IgG- and IgM-Cleaving Endopeptidase, IceMG, for Antibody-Mediated Rejection. This study investigated IceMG, a novel recombinant endopeptidase designed to simultaneously cleave Immunoglobulin G and Immunoglobulin M, for its efficacy in antibody-mediated rejection. In rhesus macaques sensitized by sequential skin transplantations, a single intravenous dose of IceMG (2 milligrams per kilogram) significantly but transiently reduced total Immunoglobulin G and Immunoglobulin M levels. It also decreased allo- and xenoreactive Immunoglobulin G and Immunoglobulin M antibodies. These findings highlight IceMG’s potential as a therapeutic agent to temporarily clear harmful antibodies, offering a promising approach to improve outcomes in allo- and xenotransplantation by mitigating antibody-mediated rejection.
Article number two. Erythropoietin prolongs graft survival in mice by counteracting trained immunity. This research explored erythropoietin’s immune-modulatory effects, specifically its impact on trained immunity and graft survival. C57BL/6 mice, receiving BALB/c cardiac allografts and treated with CpG (a trained immunity inducer), demonstrated accelerated rejection. However, treatment with erythropoietin, which binds to erythropoietin receptors on myeloid cells, effectively counteracted the epigenetic and metabolic reprogramming associated with trained immunity. This intervention resulted in a significant prolongation of cardiac allograft survival in the treated mice. The discovery suggests erythropoietin offers a novel therapeutic strategy to prevent transplant rejection by targeting trained immunity in macrophages, thereby improving long-term graft survival.
Article number three. Added value of cardiac magnetic resonance to clinical diagnostic criteria in the diagnosis of pericarditis: a retrospective cohort study. This retrospective cohort study evaluated the clinical utility of cardiac magnetic resonance in diagnosing pericarditis, particularly when traditional clinical criteria are transient or ambiguous. Consecutive patients referred for pericarditis evaluation by cardiac magnetic resonance between 2010 and 2024 at a tertiary hospital were screened. The study confirmed that while pericarditis is typically diagnosed clinically via symptoms like chest pain, pericardial rub, E.C.G. changes, and pericardial effusion, these findings can be transient. Cardiac magnetic resonance provides crucial added value by offering a more definitive diagnosis of pericardial inflammation or effusion. This enhances diagnostic accuracy and aids in guiding appropriate management for patients with challenging pericarditis presentations.
Article number four. Twin pregnancies in women with heart disease are complicated by high risk of heart failure: data from the EORP ROPAC Registry. This study, using data from the prospective global Registry Of Pregnancy And Cardiac disease (R.O.P.A.C.) from 2007-2018, tested the hypothesis that twin pregnancies in women with heart disease lead to higher rates of adverse cardiac events. Comparing 96 twin pregnancies to singleton pregnancies in women with heart disease, the research confirmed that cardiovascular adaptation is more pronounced in twin gestations. Women with pre-existing heart disease carrying twins faced a significantly higher rate of adverse cardiac events, particularly heart failure. These findings highlight the substantial hemodynamic burden of twin pregnancies in this vulnerable population and underscore the critical need for intensive cardiac monitoring and specialized care.
Article number five. Cardioversion of atrial fibrillation and flutter: Trends, outcomes, and rhythm management strategies over two decades. This study analyzed a large multi-institutional dataset spanning two decades to characterize temporal trends, outcomes, and rhythm management strategies surrounding direct current cardioversion for atrial fibrillation and atrial flutter. Researchers identified all direct current cardioversions performed for atrial fibrillation and atrial flutter between 2000 and 2024, assessing annual volumes and patient status (outpatient versus inpatient). The investigation revealed evolving patterns in the utilization, effectiveness, and patient profiles associated with direct current cardioversion over time. Understanding these trends and contemporary practices is crucial for optimizing rhythm management strategies, improving patient selection, and enhancing the safety and efficacy of cardioversion procedures in modern cardiology practice.
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đ Keywords
chest pain, heart disease, epigenetic reprogramming, rhythm management, endopeptidase, pericarditis, cardiac allograft, atrial fibrillation, diagnostic criteria, heart failure, antibody-mediated rejection, atrial flutter, immunoglobulin G, direct current cardioversion, trained immunity, procedural outcomes, erythropoietin, IceMG, E.C.G., macrophages, twin pregnancy, immunoglobulin M, cardiac magnetic resonance, pericardial effusion, temporal trends, cardiovascular adaptation, transplantation, adverse cardiac events, graft survival, R.O.P.A.C. Registry.
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Concise summaries of cardiovascular research for professionals.
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