{"title":"Assessment of Coronary Microvascular Dysfunction in Patients with Systemic Vasculitis.","authors":"Shihab Sarwar, Faisal Ahmed, Yoshito Kadoya, Ramtin Hakimjavadi, Kevin Emery Boczar","doi":"10.1007/s11886-025-02231-w","DOIUrl":"https://doi.org/10.1007/s11886-025-02231-w","url":null,"abstract":"<p><strong>Introduction: </strong>Coronary microvascular dysfunction (CMD) is characterized by impaired coronary blood flow in the absence of obstructive coronary artery disease. CMD primarily involves the microvasculature, leading to myocardial ischemia, angina, and increased cardiovascular risk. Systemic vasculitides (e.g., giant cell arteritis, antineutrophil cytoplasmic antibody-associated vasculitis, and Takayasu arteritis) are a group of autoimmune conditions known to affect the vasculature through inflammation of the blood vessels that have been associated with more prevalent and severe CMD. Although systemic inflammation likely plays a role in the increased risk of cardiovascular events, the underlying pathogenesis is not well understood.</p><p><strong>Purpose of review: </strong>Invasive and non-invasive techniques for assessing coronary microvascular function have been developed to assess for blood flow and coronary flow reserve (CFR), defined as the ratio of the maximum achievable blood flow during stress to the resting blood flow. The purpose of this review is to further explore the relationship between vasculitis and CMD as well as the techniques available for assessing this association.</p><p><strong>Recent findings: </strong>Studies have shown that CMD is significantly more prevalent in patients with systemic vasculitis compared to the general population. Moreover, in the absence of significant atherosclerotic burden, patients with vasculitis have a lower CFR than controls, indicating more severely impaired coronary vasomotor function. This suggests that systemic inflammation itself is a factor in driving coronary vasomotor abnormalities and CMD development. CMD contributes to cardiovascular morbidity in patients with systemic vasculitis, underscoring the need for early recognition and management. Further studies are needed to determine whether therapies targeting the reduction of systemic inflammation can lead to improved coronary microvascular function and cardiovascular outcomes.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"81"},"PeriodicalIF":3.1,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Racial and Ethnic Disparities in Cardio-Oncology Care.","authors":"Olayiwola Bolaji, Michelle N Johnson","doi":"10.1007/s11886-025-02229-4","DOIUrl":"https://doi.org/10.1007/s11886-025-02229-4","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review examines racial, ethnic, and socioeconomic disparities in cardio-oncology care, evaluating current evidence and proposing evidence-based strategies to address inequities in cardiovascular care for cancer patients.</p><p><strong>Recent findings: </strong>Significant disparities exist in cardio-oncology outcomes and access across populations. Racial and ethnic minoritized groups face higher cardiovascular mortality and increased cardiotoxicity risks during cancer treatment. These populations also preset with more advanced-stage cancer diagnoses and increased burden of cardiovascular risk factors. Social vulnerability indices strongly correlate with worse outcomes, while geographic location and environmental factors create additional risks. Rural populations particularly struggle with access to specialized care and clinical trials. Multiple factors contribute to disparities in cardio-oncology, including social determinants of health, disproportionate burden of cardiovascular risk factors, barriers to access, and environmental exposures. Key solutions include expanding access to subspecialty care, creation of collaborations between academic centers and community hospitals, particularly those in underserved communities, enhancing community engagement and public health education, improving clinical trial representation, increasing workforce diversity, and enhancing cultural competency. These findings emphasize the need for systematic healthcare delivery changes and resource allocation to achieve equitable cardio-oncology care for all populations.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"82"},"PeriodicalIF":3.1,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aditi Kothari, John Paul Aparece, Raul Del Toro Mijares
{"title":"Cardiovascular Risk Associated with the Treatment of Attention-Deficit/Hyperactivity Disorder in Adults.","authors":"Aditi Kothari, John Paul Aparece, Raul Del Toro Mijares","doi":"10.1007/s11886-025-02223-w","DOIUrl":"https://doi.org/10.1007/s11886-025-02223-w","url":null,"abstract":"<p><strong>Purpose of review: </strong>The increasing prevalence of attention deficit hyperactivity disorder (ADHD) makes it important to study the cardiovascular implications of this disease and the drugs used to treat it. As more patients are diagnosed with ADHD across the world and these medications are prescribed more, it is imperative to understand the cardiovascular risk profile associated with these medications. This narrative review will highlight the importance of considering cardiovascular risk factors inherent to ADHD and the medications currently used to treat it.</p><p><strong>Recent findings: </strong>Chronic sympathetic activation as caused by ADHD therapies has numerous effects on the cardiovascular system including an increase in blood pressure and heart rate. These changes could potentially lead to heart failure, arrythmias or even sudden cardiac death. While a few studies that have shown no correlation between ADHD medications and cardiovascular effects, current guidelines recommend a thorough assessment prior to initiating treatment and periodic monitoring during treatment.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"80"},"PeriodicalIF":3.1,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Saisnigdha Allaparthi, Amanda Bode, Christan Bury, Amanda R Vest
{"title":"Nutrition Optimization Among Critically Ill Patients in the Cardiac Intensive Care Unit.","authors":"Saisnigdha Allaparthi, Amanda Bode, Christan Bury, Amanda R Vest","doi":"10.1007/s11886-025-02208-9","DOIUrl":"10.1007/s11886-025-02208-9","url":null,"abstract":"<p><strong>Purpose of review: </strong>Many critical care clinicians are unfamiliar with management principals or recent studies that guide nutritional optimization of patients in the cardiac intensive care unit (CICU). The goal of this review is to describe the prevalence of malnutrition in the CICU, the frameworks for malnutrition diagnosis and assessment of skeletal muscle wasting, and the potential clinical consequences of improper feeding practices.</p><p><strong>Recent findings: </strong>Malnutrition is common and has been linked to poor outcomes across various CICU patient populations. Several nutritional randomized controlled trials have refined best practices around the timing of enteral nutrition and the selection of protein intake targets in the intensive care setting. A hypocaloric, rather than normocaloric, feeding regimen usually preferred during the early phase of critical illness, and it is important to await adequate gut perfusion before uptitrating enteral feeds. There is an evolving evidence base that defines current practice in CICU nutritional management, albeit with multiple knowledge gaps warranting further study.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"79"},"PeriodicalIF":3.1,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anthony M Hachem, Aditya Desai, Noah Beinart, Keila C Ostos-Mendoza, Ana Sofia Lopez Rodriguez, Regina Diaz de Leon Derby, Sara Ebrahimi, Nicolas L Palaskas
{"title":"Updates in Diagnosis and Treatment of Immune Checkpoint Inhibitor Myocarditis.","authors":"Anthony M Hachem, Aditya Desai, Noah Beinart, Keila C Ostos-Mendoza, Ana Sofia Lopez Rodriguez, Regina Diaz de Leon Derby, Sara Ebrahimi, Nicolas L Palaskas","doi":"10.1007/s11886-025-02232-9","DOIUrl":"10.1007/s11886-025-02232-9","url":null,"abstract":"<p><strong>Purpose of review: </strong>To provide an update on the literature regarding diagnosis and management of immune checkpoint inhibitor myocarditis.</p><p><strong>Recent findings: </strong>The diagnosis of immune checkpoint inhibitor myocarditis has evolved to include more reliance on performing endomyocardial biopsy to clarify the diagnosis in selected cases. Additionally, there is recognition of a spectrum of disease both clinically and on endomyocardial biopsy suggesting that there is a range of severity from mild to fulminant. The treatment of immune checkpoint inhibitor myocarditis is shifting towards increased use of additional immunosuppressive medications as steroid sparing agents. There are increased studies including two randomized controlled trials evaluating abatacept in the treatment of immune checkpoint inhibitor myocarditis. This review summarizes the latest literature regarding diagnosis and management of immune checkpoint inhibitor myocarditis and provides our experience and approach to this rare but potentially fatal condition.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"78"},"PeriodicalIF":3.1,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Samuel F Sears, Elizabeth W Jordan, Zeba Hashmath, Maeve M Sargeant, John Catanzaro, Rajasekhar Nekkanti, Ghanshyam Shantha
{"title":"Leadless Pacemakers: The \"Leading Edge\" of Quality of Life in Cardic Electrophysiology.","authors":"Samuel F Sears, Elizabeth W Jordan, Zeba Hashmath, Maeve M Sargeant, John Catanzaro, Rajasekhar Nekkanti, Ghanshyam Shantha","doi":"10.1007/s11886-025-02228-5","DOIUrl":"10.1007/s11886-025-02228-5","url":null,"abstract":"<p><strong>Purpose of the review: </strong>Permanent pacemakers (PPMs) are common cardiac implantable devices indicated for patients with bradycardia or tachycardia. Currently, PPMs include both transvenous pacemakers (TV-PM) and leadless pacemakers (L-PM). This paper reviews the existing data on L-PM technology including: a) medical aspects and indications, b) patient experience and quality of life (QOL) outcome studies, and c) recommendations for optimizing patient QOL through enhanced knowledge and shared decision-making.</p><p><strong>Recent findings: </strong>This review includes the seven papers that report on patient-reported outcomes (PRO) in leadless pacemakers and indicate that QOL is as good, if not better, than TV-PM. Existing evidence from descriptive statistics suggests that patients with L-PM report high levels of patient acceptance and satisfaction with esthetic appearance (96%), recovery (91%), and level of physical activity (74%). Leadless pacemakers provide an attractive alternative for the indicated potential patient. The evidence demonstrates the benefits of L-PM such as a minimal implant and lack of leads. Recommendations for future research indicate that electrophysiology-specific metrics are essential and control for the common co-morbidities in the PM population are needed.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"77"},"PeriodicalIF":3.1,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11958420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohammed Ayyad, Maram Albandak, Dhir Gala, Basel Alqeeq, Muath Baniowda, Johann Pally, Joseph Allencherril
{"title":"Reevaluating STEMI: The Utility of the Occlusive Myocardial Infarction Classification to Enhance Management of Acute Coronary Syndromes.","authors":"Mohammed Ayyad, Maram Albandak, Dhir Gala, Basel Alqeeq, Muath Baniowda, Johann Pally, Joseph Allencherril","doi":"10.1007/s11886-025-02217-8","DOIUrl":"10.1007/s11886-025-02217-8","url":null,"abstract":"<p><strong>Background: </strong>The current classification of acute myocardial infarction (AMI) into ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI) has limitations in identifying patients with acute coronary occlusion (ACO) who do not exhibit classic ST-elevation. Emerging evidence suggests that a reclassification to \"Occlusive Myocardial Infarction\" (OMI) may enhance diagnostic accuracy and therapeutic interventions.</p><p><strong>Methods: </strong>A comprehensive review of the literature was conducted, focusing on the pathophysiology, electrocardiographic (EKG) patterns, and management of ACO. The utility of the OMI paradigm was evaluated against the traditional STEMI/NSTEMI framework, with a particular emphasis on atypical EKG findings and their role in guiding early intervention.</p><p><strong>Results: </strong>Traditional STEMI criteria fail to identify ACO in approximately 30% of NSTEMI patients, leading to delayed reperfusion and increased mortality. The OMI framework demonstrates improved sensitivity (78.1% vs. 43.6% for STEMI criteria) for detecting ACO by incorporating subtle EKG changes, including hyperacute T-waves, de Winter T-waves, and posterior infarction patterns. OMI-guided management facilitates timely diagnosis and intervention, potentially reducing adverse outcomes. Emerging artificial intelligence (AI) tools further enhance EKG interpretation and clinical decision-making.</p><p><strong>Conclusions: </strong>Transitioning to the OMI paradigm addresses critical gaps in the STEMI/NSTEMI framework by emphasizing the identification of ACO irrespective of ST-segment elevation. This approach could significantly improve patient outcomes by reducing delays in reperfusion therapy. Future randomized trials are needed to validate the OMI paradigm and optimize its implementation in clinical practice.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"75"},"PeriodicalIF":3.1,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11950105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Viral Infection and Connexin Dysfunction in the Heart.","authors":"Chelsea M Phillips, James W Smyth","doi":"10.1007/s11886-025-02227-6","DOIUrl":"10.1007/s11886-025-02227-6","url":null,"abstract":"<p><strong>Purpose of review: </strong>Gap junctions, comprising connexin proteins, enable the direct intercellular electrical coupling of cardiomyocytes, and disruption of this process is arrhythmogenic. In addition, gap junctions effect metabolic coupling and of relevance to this review, propagate host antiviral immune responses. Accordingly, connexins have emerged as viral targets during infection. This review summarizes current knowledge regarding contributions of inflammation vs virally encoded factors in driving alterations to cardiac gap junction function.</p><p><strong>Recent findings: </strong>In addition to host immune-mediated effects on cardiac electrophysiology and gap junctions in myocarditis, there is now increasing appreciation for virally encoded factors targeting connexin function in acute/active infection. We now know diverse viral species have independently evolved to directly target connexin function during infection. Understanding both the direct and indirect effects of viral infection on cardiac gap junctions is critical to inform treatment strategies and development of novel therapeutics for acute infection as a distinct disease process from chronic myocarditis.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"76"},"PeriodicalIF":3.1,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11950093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
John F Mulvey, Emily L Meyer, Mikkel Skjoldan Svenningsen, Alicia Lundby
{"title":"Integrating -Omic Technologies across Modality, Space, and Time to Decipher Remodeling in Cardiac Disease.","authors":"John F Mulvey, Emily L Meyer, Mikkel Skjoldan Svenningsen, Alicia Lundby","doi":"10.1007/s11886-025-02226-7","DOIUrl":"10.1007/s11886-025-02226-7","url":null,"abstract":"<p><strong>Purpose of review: </strong>Despite significant efforts to understand pathophysiological processes underlying cardiac diseases, the molecular causes for the most part remain unresolved. Rapid advancements in -omics technologies, and their application in cardiac research, offer new insight into cardiac remodeling in disease states. This review aims to provide an accessible overview of recent advances in omics approaches for studying cardiac remodeling, catering to readers without extensive prior expertise.</p><p><strong>Recent findings: </strong>We provide a methodologically focused overview of current methods for performing transcriptomics and proteomics, including their extensions for single-cell and spatial measurements. We discuss approaches to integrate data across modalities, resolutions and time. Key recent applications within the cardiac field are highlighted. Each -omics modality can provide insight, yet each existing experimental method has technical or conceptual limitations. Integrating data across multiple modalities can leverage strengths and mitigate weaknesses, ultimately enhancing our understanding of cardiac pathophysiology.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"74"},"PeriodicalIF":3.1,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11928419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jacqueline Levene, Alyssa Chang, Anisha Reddy, Alisse Hauspurg, Esa M Davis, Malamo Countouris
{"title":"The Role of Race in Pregnancy, Hypertension, and Long-Term Outcomes.","authors":"Jacqueline Levene, Alyssa Chang, Anisha Reddy, Alisse Hauspurg, Esa M Davis, Malamo Countouris","doi":"10.1007/s11886-025-02224-9","DOIUrl":"https://doi.org/10.1007/s11886-025-02224-9","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review aims to discuss racial and ethnic differences in the prevalence of hypertensive disorders of pregnancy (HDP), disparities in peripartum and postpartum outcomes, and strategies to improve health equity.</p><p><strong>Recent findings: </strong>Racial disparities in HDP are significant contributors to maternal morbidity and mortality. The prevalence of preeclampsia has increased over the last 20 years, with the highest prevalence among non-Hispanic Black, non-Hispanic American Indian and Alaska Native individuals. Black birthing individuals are at increased risk for cardiovascular-related morbidity and mortality, particularly from complications of HDP. Factors such as social determinants of health and systemic racism have a significant impact on disparities in maternal and fetal outcomes related to HDP. System changes and provider implicit bias training can help address systemic racism. Interventions aimed at improving access to care, such as telehealth and home blood pressure monitoring, as well as incorporating health system navigators that provide peripartum and postpartum support can improve outcomes and promote health equity.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"71"},"PeriodicalIF":3.1,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}