Current Cardiology Reports最新文献

{"title":"Echocardiographic Evaluation of the Post-Heart Transplant Patient.","authors":"Aris Karatasakis, Omid Kiamanesh, Richard K Cheng, James N Kirkpatrick, David M Dudzinski","doi":"10.1007/s11886-024-02169-5","DOIUrl":"https://doi.org/10.1007/s11886-024-02169-5","url":null,"abstract":"<p><strong>Purpose of review: </strong>Significant practice variability exists with respect to the role and frequency of echocardiography after heart transplantation. We sought to illustrate key studies relating to the utility and diagnostic accuracy of echocardiography for the post-heart transplant patient.</p><p><strong>Recent findings: </strong>Several echocardiographic parameters correlate with acute heart transplant rejection, but there is enough heterogeneity between study results or in diagnostic accuracy, such that it precludes parameter use in isolation to rule out rejection. Newer techniques such as strain echocardiography may have better sensitivity. Similarly, resting and stress echocardiography can be combined with modern techniques such as myocardial contrast echocardiography to diagnose and prognosticate cardiac allograft vasculopathy, but studies have again demonstrated variable accuracy. Echocardiography remains an accessible tool in the evaluation and management of patients after heart transplantation. This modality can guide clinical judgment with real-time data and several fairly sensitive parameters for the detection of rejection, cardiac allograft vasculopathy, and other abnormalities. Often, auxiliary diagnostic modalities need to be combined to optimize diagnostic accuracy.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"63"},"PeriodicalIF":3.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514994","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":"Novel F-18-labeled Tracers of Sympathetic Function for Improved Risk Stratification and Clinical Outcomes.","authors":"Fatema Tuj Zohora, Matthew A Nazari, Albert J Sinusas","doi":"10.1007/s11886-025-02197-9","DOIUrl":"https://doi.org/10.1007/s11886-025-02197-9","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review summarizes the role of the novel ¹⁸F-labeled positron emission tomography (PET) sympathetic radiotracers for risk stratification in patients with ischemic heart disease. PET tracers have demonstrated prognostic value by characterizing myocardial sympathetic nerve density and by extension the extent of myocardial sympathetic denervation. The unique features of these PET radiotracers are discussed in relation to clinical application.</p><p><strong>Recent findings: </strong>Absolute quantification of sympathetic denervation has been possible with ¹⁸F-labeled PET tracers which outperform low ejection fraction (<35%) in predicting sudden cardiac death (SCD) and allow for more optimal risk stratification in patients with heart failure. This underscores their utility in selecting patients for preventable strategies with implantable cardioverter defibrillators (ICD). Appropriate candidate selection for ICD placement is a major priority as at present 80% of patients that die from SCD do not receive an ICD (potentially preventable mortality) while only 1 in 8 patients with an ICD receive a life-saving shock. Furthermore, 1 in 3 patients with ICDs receive inappropriate shocks. Thus, there is a pressing need to more appropriately select and exclude patients who will and will not benefit from ICD placement, respectively, as both suffer poor outcomes. Despite the clear prognostic benefit offered by prior PET sympathetic radiotracers in imaging myocardial sympathetic denervation, their short half-lives necessitated costly onsite cyclotron synthesis obviating their pragmatic clinical use. ¹⁸F-labeled radiotracers have a longer half-life allowing centralized synthesis and transport to their point of use. As such, ¹⁸F-labeled sympathetic radiotracers define an innovation and may offer a more affordable and clinically practical approach for evaluation of risk in patients with cardiovascular disease. ¹⁸F-labeled sympathetic radiotracers are currently available for evaluation and risk stratification of patients with ischemic heart disease and heart failure. These radiotracers may offer a more practical approach for selection of ICD placement and consequent prevention of SCD; a major, yet unmet need, in heart failure patients and those that suffer SCD at large. However, further development and clinical testing of these ¹⁸F-labeled sympathetic radiotracers is required.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"61"},"PeriodicalIF":3.1,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499573","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":"Surgical Techniques for Mitral Valve Repair: A Review for the Non-Cardiac Surgeon.","authors":"Hanghang Wang, James S Gammie","doi":"10.1007/s11886-025-02213-y","DOIUrl":"https://doi.org/10.1007/s11886-025-02213-y","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review provides an overview of surgical techniques for mitral valve repair, emphasizing advancements in artificial cordal repair, annuloplasty, and resectional approaches. It aims to equip non-cardiac surgeons with insights into the principles and strategies that underpin successful valve repair, encouraging broader application in clinical practice.</p><p><strong>Recent findings: </strong>Innovations in mitral valve repair, including the adoption of artificial neochordae and advancements in annuloplasty devices, have continued to improve repair durability. Intraoperative tools, such as transesophageal echocardiography, remain essential for optimizing outcomes. Nonetheless, significant variability persists in repair rates across regions and surgeons, highlighting opportunities for improvement. Mitral valve repair remains the gold standard for managing degenerative mitral regurgitation, with proven benefits in survival and long-term outcomes. As techniques become more reproducible and accessible, expanding repair expertise and improving national repair rates could significantly improve patient outcomes.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"60"},"PeriodicalIF":3.1,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482456","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":"Anti-inflammatory Therapies for Ischemic Heart Disease.","authors":"Tillmann Muhs, Senka Ljubojevic-Holzer, Susanne Sattler","doi":"10.1007/s11886-025-02211-0","DOIUrl":"10.1007/s11886-025-02211-0","url":null,"abstract":"<p><strong>Purpose of review: </strong>The inclusion of immunomodulatory strategies as supportive therapies in ischemic heart disease (IHD) has garnered significant support over recent years. Several such approaches appear to be unified through their ultimate target, the NLRP3 inflammasome. This review presents a brief update on immunomodulatory strategies in the continuum of conditions constituting ischemic heart disease and emphasising on the seemingly unifying mechanism of NLRP3 activation as well as modulation across these conditions.</p><p><strong>Recent findings: </strong>The NLRP3 inflammasome is a multiprotein complex assembled upon inflammatory stimulation, causing the release of pro-inflammatory cytokines and initiating pyroptosis. The NLRP3 pathway is relevant in inflammatory signalling of cardiac immune cells as well as non-immune cells in the myocardium, including cardiomyocytes, fibroblasts and endothelial cells. In addition to a focus on clinical outcome and efficacy trials of targeting NLRP3-related pathways, the potential connection between immunomodulation in cardiology and the NLRP3 pathway is currently being explored in preclinical trials. Colchicine, cytokine-based approaches and SGLT2 inhibitors have emerged as promising agents. However, the conditions comprising IHD including atherosclerosis, coronary artery disease (CAD), myocardial infarction (MI) and ischemic cardiomyopathy/heart failure (iCMP/HF) are not equally amenable to immunomodulation with the respective drugs. Atherosclerosis, coronary artery disease and ischemic cardiomyopathy are affected by chronic inflammation, but the immunomodulatory approach to acute inflammation in the post-MI setting remains a pharmacological challenge, as detrimental and regenerative effects of myocardial inflammation are initiated in unison. The NLRP3 inflammasome lies at the center of cell mediated inflammation in IHD. Recent trial evidence has highlighted anti-inflammatory effects of colchicine, interleukin-based therapy as well as SGLT2i in IHD and that the respective drugs modulate the NLRP3 inflammasome.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"57"},"PeriodicalIF":3.1,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11839821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448437","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":"Artificial Intelligence Applications in Cardio-Oncology: A Comprehensive Review.","authors":"Avirup Guha, Viraj Shah, Tarek Nahle, Shivam Singh, Harikrishnan Hyma Kunhiraman, Fathima Shehnaz, Priyanshu Nain, Omar M Makram, Morteza Mahmoudi, Sadeer Al-Kindi, Anant Madabhushi, Rakesh Shiradkar, Hisham Daoud","doi":"10.1007/s11886-025-02215-w","DOIUrl":"https://doi.org/10.1007/s11886-025-02215-w","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review explores the role of artificial intelligence (AI) in cardio-oncology, focusing on its latest application across problems in diagnosis, prognosis, risk stratification, and management of cardiovascular (CV) complications in cancer patients. It also highlights multi-omics analysis, explainable AI, and real-time decision-making, while addressing challenges like data heterogeneity and ethical concerns.</p><p><strong>Recent findings: </strong>AI can advance cardio-oncology by leveraging imaging, electronic health records (EHRs), electrocardiograms (ECG), and multi-omics data for early cardiotoxicity detection, stratification and long-term risk prediction. Novel AI-ECG models and imaging techniques improve diagnostic accuracy, while multi-omics analysis identifies biomarkers for personalized treatment. However, significant barriers, including data heterogeneity, lack of transparency, and regulatory challenges, hinder widespread adoption. AI significantly enhances early detection and intervention in cardio-oncology. Future efforts should address the impact of AI technologies on clinical outcomes, and ethical challenges, to enable broader clinical adoption and improve patient care.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"56"},"PeriodicalIF":3.1,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448492","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":"Fluoroscopy-free Transcatheter Atrial Septal Defect Closure: A Simplified Approach.","authors":"Naychi Lwin, Piia Suursalmi, Sophia Yong, Saleha Kabir, Matthew I Jones, Alexandra Savis, Shakeel A Qureshi, Eric Rosenthal","doi":"10.1007/s11886-024-02177-5","DOIUrl":"10.1007/s11886-024-02177-5","url":null,"abstract":"<p><strong>Purpose of review: </strong>To provide an overview of fluoroscopy-free transcatheter atrial septal defect (ASD) closure and introduce a simplified approach that avoids pulmonary vein instrumentation.</p><p><strong>Recent findings: </strong>Since the first reported fluoroscopy-free ASD closure 24 years ago, only a few small series have described this technique. We present a simplified and less cumbersome approach to encourage wider adoption of the fluoroscopy-free method to suitable ASD anatomy.</p><p><strong>Results: </strong>Fluoroscopy free ASD closure was performed in 9 patients using the conventional technique (Group 1) and 23 patients using our simplified approach of direct placement of the device into the defect (Group 2). Median age and weight were 28 years, 53 kg in Group 1 (range: 5-52 years, 22-88 kg) and 36 years, 66 kg in Group 2 (range: 4-76 years, 16-115 kg). Devices were successfully implanted in all patients, with a median device size of 21 mm (Group 1: 9-36 mm, Group 2: 10-33 mm). Procedural time was 47 min for Group 1 and 35 min for Group 2 (p = 0.09). Length of hospital stay was similar in both groups. There were no acute or long-term complications and no need for reintervention. Transcatheter ASD closure without the use of fluoroscopy using the simplified approach is safe and effective, offers a shorter procedure duration and minimises instrumentation within the left atrium and pulmonary veins. Patient selection is key and with greater experience, this procedure may be applicable to a wider selection of ASD anatomy.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"59"},"PeriodicalIF":3.1,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11839779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448493","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":"Angiographic Anatomy of the Left Coronary Veins: Beyond Conventional Cardiac Resynchronization Therapy.","authors":"Iulia-Georgiana Zehan, Csilla-Andrea Eötvös, Mădălina Patricia Moldovan, Mihai-Gabriel Andrei, Călina-Patricia Șchiop-Țentea, Roxana Daiana Lazar, Adriana Daniela Sârb, Giorgia Coșeriu, Teodora Avram, Adela Șerban, Gabriel Gușetu, Larisa Diana Mocan-Hognogi, Roxana Chiorescu, Sorin Pop, Edwin Kevin Heist, Dan Blendea","doi":"10.1007/s11886-025-02204-z","DOIUrl":"10.1007/s11886-025-02204-z","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review aims to synthesize current knowledge on the angiographic anatomy of the coronary sinus and its tributaries veins, with focus on venous branches other than classical ones used in cardiac resynchronization therapy. It also presents common anatomical aspects that could impact the clinical outcome.</p><p><strong>Recent findings: </strong>Recent advancements in the electrophysiology field, like epicardial arrhythmia mapping and ablation through coronary sinus or cardiac pacing from atypical veins requires a detailed angiographic assessment of cardiac veins. There is an increased interest for the veins coursing in the left ventricular summit (LVS) area and could potentially provide a pathway to reach the LVS arrhythmogenic foci. However, there is no consensus regarding the nomenclature and classification of these veins. This review could offer a better understanding of the coronary sinus and its tributary veins distribution, dimensions and relationship with nearby structures that could help the development of new ablation and pacing tools and strategies, with higher success rates.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"58"},"PeriodicalIF":3.1,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11839802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448281","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":"Point-of-Care Ultrasonography in the Critical Care Unit: An Update.","authors":"Keith Guevarra, Yonatan Greenstein","doi":"10.1007/s11886-024-02187-3","DOIUrl":"10.1007/s11886-024-02187-3","url":null,"abstract":"<p><strong>Purpose of review: </strong>This article outlines updates in point of care ultrasonography.</p><p><strong>Recent findings: </strong>Improving diagnostic accuracy and image quality is continuing to evolve in Point-of-care ultrasonography (POCUS). This include incorporating Artificial Intelligence (AI) and use of other modalities such as Doppler in lung ultrasonography. Transesophageal echocardiography is an emerging option when imaging is difficult to obtain via transthoracic echocardiography. POCUS is becoming instrumental when used during cardiac arrest. Ultrasound (VExUS) Grading System is a promising measurement to assess a patient's volume status. Given the multiple advantages of POCUS usage, competency in POCUS became a requirement of Critical Care fellowship training. POCUS is an important diagnostic modality and guide to medical management. New technological advances such as AI, can serve as a guide to enhance image quality and help accurately obtain quantitative assessments. POCUS has a major role during cardiac arrest and advanced cardiac life support. The clinical utility of POCUS was further substantiated during the COVID-19 pandemic. The Accreditation Council for Graduate Medical Education (ACGME) requires critical care programs to include competency in POCUS as part of their training.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"54"},"PeriodicalIF":3.1,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425133","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":"Life's Essential 8 and Cardiovascular Disease in Breast Cancer Survivors.","authors":"Kamari C Ositelu, Tejasvi Peesay, Carol Garcia, Nausheen Akhter","doi":"10.1007/s11886-025-02216-9","DOIUrl":"https://doi.org/10.1007/s11886-025-02216-9","url":null,"abstract":"<p><strong>Purpose of review: </strong>To explore the role of optimal cardiovascular health as defined by the Life's Essential 8 in breast cancer survivors.</p><p><strong>Recent findings: </strong>Optimal cardiovascular health may be associated with decreased cancer mortality. Breast cancer survivors may derive additional benefit from obtaining ideal cardiovascular health as defined by the Life's Essential 8. Certain components of the Life's Essential 8 may impact cardiovascular risk but also cancer mortality, and risk for cancer therapy related cardiac dysfunction. Continued physical activity, avoidance of smoking, and control of lipids and blood pressure are beneficial in breast cancer survivors. More study is needed to define the role of anti-hyperglycemic agents, BMI, and sleep on CVD risk in breast cancer survivors. The Life's Essential 8 can be a tool to inform clinicians regarding a breast cancer survivor's disease risk and to identify potential areas of improvement.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"55"},"PeriodicalIF":3.1,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425132","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":"From Mechanisms to Management: Tackling In-Stent Restenosis in the Drug-Eluting Stent Era.","authors":"Luigi Spadafora, Rossella Quarta, Giovanni Martino, Letizia Romano, Francesco Greco, Antonio Curcio, Tommaso Gori, Carmen Spaccarotella, Ciro Indolfi, Alberto Polimeni","doi":"10.1007/s11886-025-02193-z","DOIUrl":"10.1007/s11886-025-02193-z","url":null,"abstract":"<p><strong>Purpose of review: </strong>Drug-eluting stent (DES) technology has greatly enhanced the safety and effectiveness of percutaneous coronary interventions (PCI). The aim of the present paper is to provide a comprehensive review of in-stent restenosis (ISR), focusing on the contemporary DES era, including its incidence, mechanisms, and imaging characterization.</p><p><strong>Recent findings: </strong>Despite the widespread use of DES and numerous improvements, recent clinical data indicate that ISR still occurs in 5-10% of PCI procedures, posing a considerable public health issue. The incidence, morphology, and clinical implications of ISR are determined by a complex interplay of several factors: the patient, stent, procedure, and vessel and lesion-related factors. Advancements in intracoronary imaging have provided greater insight into its patterns and underlying causes. Over time, treatment strategies have evolved, and current guidelines recommend an individualized approach using intracoronary imaging to characterize ISR's underlying substrate.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"53"},"PeriodicalIF":3.1,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11814036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390291","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}