Hearts, Volume 6, Issue 4 (December 2025) – 2 articles

Background: Heart failure (HF) is common and deadly, affecting over 60 million people worldwide, and it remains a leading cause of hospitalization and post-discharge death. One-year mortality after an acute decompensated HF (ADHF) admission often approaches 40%. Prognostic models are critical for stratifying mortality risk in heart failure (HF) patients. This study compared the performance of the MAGGIC and BCN Bio-HF models in predicting 1-year and 3-year all-cause mortality (ACM) in patients discharged after acute decompensated HF (ADHF). Methods: A retrospective analysis was conducted on 229 patients hospitalized for ADHF at the Clinical University Hospital of Zaragoza. The required variables were extracted from medical records, and ACM risks were calculated using web-based tools. Calibration, discrimination (AUC), and Kaplan–Meier survival analysis and calibration curves assessed risk stratification and alignment with observed outcomes. Reclassification metrics (Net Reclassification Index [NRI], Integrated Discrimination Improvement [IDI]) were used to compare the models’ predictive performances. Results: Both of the models demonstrated robust discrimination for 1-year ACM (AUC: MAGGIC = 0.738, BCN Bio-HF = 0.769) but showed lower performance for 3-year predictions. Calibration was poor, with both models exhibiting significant risk underestimation at the individual level. MAGGIC achieved higher sensitivity (1-year: 0.911; 3-year: 0.685), favoring high-risk patient identification, whereas BCN Bio-HF offered superior specificity (1-year: 0.679; 3-year: 0.746) and a positive prediction value, reducing false positives. BCN Bio-HF showed a significant 12.7% reclassification improvement for 1-year mortality prediction. Conclusions: BCN Bio-HF did not outperform MAGGIC in our cohort. MAGGIC is preferable for the initial high-risk patient identification, requiring more intense short-term follow-up, while BCN Bio-HF’s higher specificity is best-suited to avoid overtreatment. Altogether, the clinical utility of both models was limited in our cohort by severe miscalibration, which may render adequate risk stratification difficult. Full article

Background: Balloon aortic valvuloplasty is a procedure for treating aortic stenosis, as well as being a preliminary step before transcatheter aortic valve implantation. Balloon aortic valvuloplasty requires inserting a balloon catheter into the aortic valve and repeatedly inflating it to widen the narrowed valve. With a wide range of equipment, operators rely on manufacturer data to guide the balloon use during surgery. However, such data can have variations of up to 10%, which can affect the procedures’ efficacy. Methods: In this paper, we report a bench-top proof-of-concept, automated, non-contact optical system that combines a linear delta robot (ROMI) equipped with a bright-field microscopy system, image stitching, and passive autofocusing algorithms to measure the diameters of aortic valvuloplasty balloons inflated using clinically relevant pressures. The system also introduces a laser projection system, enabling the use of passive autofocus algorithms to allow measuring transparent balloons. We evaluate three balloon brands (TRUE Dilatation, Edwards, and Z-MED II) across commonly used sizes and compare the measured diameters with vendor specifications. The developed system allows us to systematically determine the balloons’ diameters with submillimeter-level accuracy. Results: The experimental data shows that the TRUE Dilatation balloon presented the smallest deviations from the manufacturers’ data, even though the 22 and 24 mm balloons exceeded the 1% tolerance by +2.26% (over-inflation) and −1.56% (under-inflation), respectively. The Edwards Lifesciences and Z-MED II balloons presented inflation diameter variations ranging from −5.97% to + 8.81%, which led to a deviation of the specified balloon diameter of 1.76 mm. The standard error value obtained within our measurements revealed that the balloon diameters were consistent despite multiple inflations and were also resilient to repeated inflations up to the rated burst pressure. Conclusions: These results demonstrate the potential of the system presented herein to be adapted for in situ, contactless pre-operative balloon assessment in clinical settings. Full article