CONGRATULATIONS HEART, LUNG AND CIRCULATION  CELEBRATING 35 YEARS!

The Official Journal of The Cardiac Society of Australia and New Zealand and The Australian and New Zealand Society for Cardiac and Thoracic Surgeons

May 2026 Issue Out Now 2026. Volume 35 Issue 5 p595-708, e67-e80

Essential reading for cardiologists, cardiothoracic surgeons, intensivists, nurses, scientists, allied health and all clinicians committed to advancing cardiovascular medicine. The May issue of Heart Lung and Circulation delivers more research that bridges cutting-edge technology with real-world clinical practice, whilst addressing critical gaps in cardiovascular care delivery.

 

Review Spotlight: Machine learning has emerged as a transformative force in cardiovascular medicine, yet a critical knowledge gap persists between data scientists developing these tools and clinicians tasked with implementing them. In this issue, Sritharan and coworkers address this divide with timely precision, grounding abstract concepts into clinical reality through cardiovascular-specific applications, from atrial fibrillation detection algorithms to heart failure readmission models.

As ML tools proliferate across cardiovascular medicine, we face critical questions extending beyond methodology: How do we ensure equitable implementation across resource-constrained institutions? How do we prevent algorithmic bias from perpetuating healthcare disparities, particularly regarding sex-based and racial differences in cardiovascular disease? How do we detect and respond to performance drift as clinical practice evolves? How do we build governance frameworks that protect patients whilst enabling innovation? This work underscores the necessity of genuine collaboration between clinicians and data scientists, not as passive consumers of outputs, but as essential partners shaping model development from inception. As the frontier accelerates, it is crucial that we ensure ML tools enhance rather than replace clinical judgment, whilst maintaining transparency, equity, and efficacy.

Other highlights include:

Lipoprotein(a): Closing the Testing Gap

  • Prevalence Study: Eccleston et al. reveal current testing patterns for lipoprotein(a) across a large Australian cardiology network, exposing potential underdiagnosis in atherosclerotic cardiovascular disease.
  • Trend Analysis: Bachmeier and colleagues document a decade of lipoprotein(a) ordering patterns, providing essential data on how testing practices have evolved, or stagnated, across Queensland and Australia.

Catheter-based Therapies:

  • Ventricular Tachycardia Ablation: So et al. characterise substrate features and outcomes in heart failure patients, with novel insights into the papillary muscle's role.
  • TAVI Outcomes: The TAVI-NOR study (Wasim et al. ) illuminates sex-based disparities in long-term survival following transcatheter aortic valve implantation, critical data for personalised risk stratification.

Mechanical Support and Perioperative Care:

  • Escalation Therapy: Wang and colleagues challenge current practice by demonstrating that escalation from intra-aortic balloon pump to extracorporeal membrane oxygenation may worsen outcomes in cardiogenic shock.
  • SGLT2 Inhibitors: Ruste et al. investigate preoperative exposure to sodium-glucose cotransporter-2 inhibitors and acute kidney injury risk, timely guidance for perioperative optimisation.

Surgical Outcomes and Quality of Life

  • Diabetes's impact on graft patency and proximal stenosis progression (Siderakis et al.)
  • Fatigue as a pivotal determinant of quality of life in valve disease (Pons et al.)—a qualitative study addressing the patient experience often overlooked in quantitative metrics
  • Optimal transannular patch sizing for tetralogy of Fallot repair (Shikata et al.)

Health Equity in Focus

Two studies confront disparities head-on:

Takotsubo Cardiomyopathy: Agrawal and colleagues expose racial and sex disparities in patients with inflammatory bowel disease—highlighting intersectional vulnerabilities in cardiovascular care.

Telehealth Access: Fakes et al. document barriers to remote cardiology care in regional areas, revealing infrastructure and equity challenges that persist despite technological advances.