Current Cardiology Reports最新文献

{"title":"Cardiovascular Outcomes After Acute Coronary Syndrome in Persons Living with HIV: A Scoping Review.","authors":"David Iskhakov, Julie N Deleger, Jorge Plutzky, Virginia A Triant, Emily P Hyle","doi":"10.1007/s11886-024-02186-4","DOIUrl":"https://doi.org/10.1007/s11886-024-02186-4","url":null,"abstract":"<p><strong>Purpose of review: </strong>Over the past twenty-five years, a growing body of research has investigated outcomes after an acute coronary syndrome (ACS) event in persons with HIV (PWH). In this scoping review, we assessed the published literature on outcomes after a prior ACS event in PWH compared to persons without HIV (PWoH) in the US and Europe.</p><p><strong>Recent findings: </strong>Of 27 studies of secondary prevention of cardiovascular disease, 15 studies found a greater incidence of recurrent ACS, heart failure, in-stent thrombosis, revascularization, restenosis, and mortality in PWH after a prior ACS event compared to PWoH. PWH were more likely to present with STEMI, less likely to receive percutaneous coronary intervention, and more likely to exhibit an active inflammatory state. The remaining 12 studies found no significant difference in outcomes after a prior ACS event. PWH may face an increased risk of adverse outcomes after ACS that differ in presentation and management compared with PWoH. Larger observational studies are needed to assess outcomes after a prior ACS event in PWH compared to PWoH and improve clinical management.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"84"},"PeriodicalIF":3.1,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11999250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957405","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":"⁶⁸Ga-FAPI-04 PET/CT for the Assessment of Light-Chain Cardiac Amyloidosis: A Promising Risk- Stratification Imaging Modality.","authors":"Yaqi Zheng, Yanlin Wang, Xiaoli Zhang","doi":"10.1007/s11886-025-02230-x","DOIUrl":"https://doi.org/10.1007/s11886-025-02230-x","url":null,"abstract":"<p><strong>Purpose of review: </strong>The diagnosis of light-chain cardiac amyloidosis (AL-CA) is often delayed owing to nonspecific clinical symptoms and comorbidities, making early detection and risk stratification essential for early intervention. Activated cardiac fibroblasts play a vital role in cardiac remodeling and cardiac damage progression, leading to heart failure. Emerging imaging modalities visualize fibroblast activation protein (FAP) as a marker of activated fibroblasts, enabling non-invasive and accurate measurement of cardiac remodeling for risk stratification. This review summarizes the status of diagnosis and treatment, pathogenic basis of AL-CA, and positron emission tomography (PET) imaging to assess the potential of gallium 68 (⁶⁸Ga)-labeled FAP inhibitor 04 (⁶⁸Ga-FAPI-04) for AL-CA diagnosis and treatment.</p><p><strong>Recent findings: </strong>⁶⁸Ga-FAPI-04 PET/computed tomography (CT) can detect myocardial fibroblast activation in patients with AL-CA, with significant uptake observed in most patients. The degree of activation correlates with cardiac function, morphology, and serum markers, suggesting its utility in prognostic assessments. ⁶⁸Ga-FAPI-04 PET/CT may enable more robust risk stratification and prognostic assessment than that via ¹⁸F-florbetapir PET/CT, underscoring the significance of cardiac fibroblast activation in predicting the outcomes of patients with AL-CA. ⁶⁸Ga-FAPI-04 PET/CT has emerged as a promising tool for diagnosing AL-CA, offering insights into the molecular characteristics of the disease and aiding in clinical decision-making. Existing findings suggest the potential of ⁶⁸Ga-FAPI-04 PET/CT for enhancing myocardial fibrosis management in AL-CA. Future multicenter trials are warranted to validate these findings and explore the integration of ⁶⁸Ga-FAPI-04 PET/CT with other imaging modalities to improve the diagnosis and prognostic prediction of patients with AL-CA.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"83"},"PeriodicalIF":3.1,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956718","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":"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":"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":"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}

{"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":"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}

{"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}

{"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}

{"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}

{"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}