Current Cardiology Reports最新文献

{"title":"Coronary Inflammation and Cardiovascular Events in Patients Without Obstructive Coronary Artery Disease.","authors":"Jia Ling Diau, Richard A Lange","doi":"10.1007/s11886-025-02221-y","DOIUrl":"10.1007/s11886-025-02221-y","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review evaluates the role of vascular inflammation in patients who develop myocardial infarction with non-obstructive coronary arteries (MINOCA). It also introduces pericoronary adipose tissue (PCAT) and epicardial adipose tissue (EAT) as possible biomarkers for risk prediction in patients with non-obstructive coronary artery disease (CAD).</p><p><strong>Recent findings: </strong>PCAT and EAT contribute to the development and progression of coronary artery inflammation and plaque vulnerability. Coronary computed tomography angiography (CCTA) can detect localized areas of inflammation through changes in the attenuation values of PCAT and EAT. Attenuation values can be further integrated with traditional risk factors using artificial intelligence to generate risk scores that significantly enhance prognostic accuracy in patients with and without obstructive coronary artery disease. Assessing PCAT and EAT inflammation via CCTA and AI-driven risk algorithms enable precise risk prediction of MINOCA and major adverse coronary events (MACE) in patients with non-obstructive CAD.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"68"},"PeriodicalIF":3.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11889004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572419","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":"Venous Insufficiency: Endovascular and Surgical Treatment.","authors":"Abdullah Khan, Ahmed A Sorour, George E Anton, Sean P Lyden, Lee Kirksey","doi":"10.1007/s11886-024-02155-x","DOIUrl":"10.1007/s11886-024-02155-x","url":null,"abstract":"<p><strong>Purpose of review: </strong>Venous insufficiency (VI) is a is a common and debilitating disease that can present with a wide range of manifestations ranging from telangiectasias to venous ulceration. The chapter explores various endovascular and open-surgical modalities used for VI, their technique, patient selection, outcomes, complications, and comparison with other modalities.</p><p><strong>Recent findings: </strong>The use of non-thermal and non-tumescent ablation techniques are found to have a better quality of life scores; however, the primary closure rates are inferior to thermal ablation techniques. A wide range of treatment modalities are available, ranging from conservative management, endovascular techniques and open-surgical options. Each intervention has its unique benefits, limitations, and potential complications. The management approach for VI is not one-fits-all, and must be meticulously tailored to each patient, carefully considering their disease severity, anatomy, quality of life, and expectations, for an effective treatment.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"67"},"PeriodicalIF":3.1,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11885322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566439","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":"Race, Genetics, and Social Determinants of Health in Transthyretin Cardiac Amyloidosis: A Literature Review and Call to Action.","authors":"Gracia Fahed, Briana N Collins, Nixuan Cai, John Isaiah Jimenez, Hiroki Kitakata, Jesus E Pino Moreno, Kevin M Alexander","doi":"10.1007/s11886-025-02220-z","DOIUrl":"10.1007/s11886-025-02220-z","url":null,"abstract":"<p><strong>Purpose of review: </strong>Recent evidence suggests that transthyretin cardiac amyloidosis (ATTR-CM) is significantly more common than once believed, yet it remains frequently under- and mis-diagnosed. With effective treatments now available, early and accurate diagnosis has become critical for better patient outcomes. Understanding the interplay between genetics, race, and social determinants of health (SDOH) in influencing both ATTR-CM diagnosis and management is essential for bridging the current gaps.</p><p><strong>Recent findings: </strong>Our analysis reveals multiple barriers affecting ATTR-CM care. Specifically, we discuss how clinician awareness, regional differences in clinical practice, and limited access to health care and specialty centers contribute to diagnostic delays. Additionally, we identify several management obstacles, such as inadequate diversity in clinical trials, high cost of available treatments, and limited ancillary resources. We examine these challenges in detail and provide practical solutions to address them. While disparities in heart failure outcomes have been well-documented, those specific to ATTR-CM remain underrepresented in the literature. This review establishes a structured approach to understanding how biological, structural and SDOH-related disparities impact ATTR-CM diagnosis and management while offering concrete strategies to overcome these challenges. We emphasize the need for enhanced SDOH identification and advocate for coordinated, multidisciplinary efforts to improve ATTR-CM patient outcomes.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"66"},"PeriodicalIF":3.1,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556194","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":"Management of Stable Coronary Artery Disease and Acute Coronary Syndrome in Patients with Cancer.","authors":"Shubh Desai, Moez Karim Aziz, Konstantinos Marmagkiolis, Mehmet Cilingiroglu, Cezar Iliescu, Leslie A Ynalvez","doi":"10.1007/s11886-025-02214-x","DOIUrl":"10.1007/s11886-025-02214-x","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review examines the current evidence and management strategies for stable coronary artery disease (CAD) and acute coronary syndrome (ACS) in patients with cancer. We outline the unique challenges, optimal treatment approaches, and outcomes in this growing population.</p><p><strong>Recent findings: </strong>First-line medications for CAD management are consistently underutilized in cancer patients despite serving as standard of care. As a corollary, medical optimization in CAD management in general is less likely to occur in patients with cancer. Early invasive strategies in ACS show improved survival, yet cancer patients receive percutaneous coronary intervention less frequently than non-cancer patients. Optimization of medical management should be prioritized in stable CAD; revascularization with PCI is first line for most patients presenting with ACS. Modification of risk factors contributing to both CAD and cancer is of utmost importance. Cancer survivors should receive vigilant, long-term monitoring for the development of signs of CAD.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"65"},"PeriodicalIF":3.1,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540350","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":"Echocardiography and Heart Failure: An Echocardiographic Decision Aid for the Diagnosis and Management of Cardiomyopathies.","authors":"Ashley Pender, Jessica Lewis-Owona, Abdulmojeed Ekiyoyo, Marcus Stoddard","doi":"10.1007/s11886-025-02194-y","DOIUrl":"10.1007/s11886-025-02194-y","url":null,"abstract":"<p><strong>Purpose of review: </strong>The purpose of this review is to highlight the utility of echocardiography in the diagnosis and management of cardiomyopathies.</p><p><strong>Recent findings: </strong>Echocardiographic parameters function synergistically to guide decision-making ranging from early detection of disease and screening to risk stratification of complex disease. The collective wealth of information available from 2D/3D assessment, Doppler, diastology and strain makes echocardiography an invaluable decision aid.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"64"},"PeriodicalIF":3.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11870920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522878","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":"Sociodemographic Disparities in Obtaining Cardiac MRI: Black, White, and Shades of Gray.","authors":"Ololade Akingbade, Elizabeth Cabrera, Varun Subashchandran, Ryan Yang, Neal Shah, Hena Patel, Jeremy A Slivnick","doi":"10.1007/s11886-025-02219-6","DOIUrl":"10.1007/s11886-025-02219-6","url":null,"abstract":"<p><strong>Purpose of review: </strong>Despite growing recommendations for CMR utilization in heart disease evaluation, access remains limited by geography and socioeconomic status. In this review we discuss the role of CMR in addressing health disparities, review barriers to CMR access, and finally propose solutions to increasing CMR testing globally and in the U.S.</p><p><strong>Recent findings: </strong>CMR testing is higher prevalence in academic and urban centers in the Northeast and Midwest and remains sparser in Southern and rural areas which face a high burden of cardiovascular mortality. Globally, CMR is also limited in low- and middle-income countries. Barriers to CMR access include bias in physician referrals based on race, patient income, insurance status, language barriers, health literacy, and disparities in the multimodal cardiovascular imaging workforce. A multimodal approach involving policy makers, hospital systems, cardiologists, and health care personnel is essential to improving national and global barriers to accessing CMR.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"62"},"PeriodicalIF":3.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514995","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":"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":"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":"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":"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}