Aditi G M Patel, Pengyang Li, Narotham Badrish, Aditya Kesari, Keyur B Shah
{"title":"Transthyretin Cardiac Amyloidosis: Current and Emerging Therapies.","authors":"Aditi G M Patel, Pengyang Li, Narotham Badrish, Aditya Kesari, Keyur B Shah","doi":"10.1007/s11886-024-02172-w","DOIUrl":"10.1007/s11886-024-02172-w","url":null,"abstract":"<p><strong>Purpose of review: </strong>In this article, we describe current and newer TTR stabilizers, TTR silencers which include small interfering RNA agents (siRNA), antisense oligonucleotides (ASO) and CRISPR-Cas9 gene editing, and TTR depleters, which investigates the use of monoclonal antibodies to remove amyloid fibril deposits for patients with advanced disease.</p><p><strong>Recent findings: </strong>Once thought to be a rare and fatal condition, increased recognition, improved non-invasive diagnostic tools, and the explosive development of novel therapies, has transformed the landscape of transthyretin amyloid cardiomyopathy (ATTR-CM). Advances in cardiac imaging with respect to echocardiography, cardiac magnetic resonance imaging (CMR), and radionuclide bone scintigraphy has increased the diagnosis of ATTR-CM over the last twenty years. Ongoing clinical trials are evaluating several novel therapies at several mechanistic targets in the transthyretin (TTR) amyloidogenesis cascade, including the recently published findings from the study of vutrisiran, a siRNA agent. Our review provides a comprehensive summary of current and emerging therapies for ATTR-CM. While these are promising, disease-modifying treatments, reaching vulnerable populations early in the disease course should be a focus for future studies and interventions.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"33"},"PeriodicalIF":3.1,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11754378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001564","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":"Echocardiographic Updates in the Assessment of Cardiomyopathy.","authors":"Baoqiong Liu, Kandarp Suthar, Christine M Gerula","doi":"10.1007/s11886-024-02159-7","DOIUrl":"10.1007/s11886-024-02159-7","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review aims to provide an updated overview of the role of echocardiography in the assessment of cardiomyopathies, highlighting recent findings and technological advancements.</p><p><strong>Recent findings: </strong>Over the past few years, significant advancements in echocardiographic techniques have improved diagnostic accuracy and provided important prognostic value in the assessment of cardiomyopathies. Cardiomyopathy is a group of diseases affecting the heart muscle. Echocardiography, a non-invasive imaging modality provides crucial information on cardiac structure, function, and hemodynamics. Recent advancements, including strain imaging, speckle-tracking, and 3D echocardiography enhance the precision of structural and functional assessments, while artificial intelligence integration improves diagnostic accuracy and workflow efficiency. These advancements not only refine diagnostic capabilities but also provide prognostic insights and facilitate better patient outcomes.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"34"},"PeriodicalIF":3.1,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11754376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001632","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}
Davide Fabbricatore, Katarzyna Malaczynska-Rajpold
{"title":"Vascular Access and Closure Management for Electrophysiological Interventions: Small Interventions Big Impact.","authors":"Davide Fabbricatore, Katarzyna Malaczynska-Rajpold","doi":"10.1007/s11886-024-02156-w","DOIUrl":"10.1007/s11886-024-02156-w","url":null,"abstract":"<p><strong>Purpose of the review: </strong>This review examines the role of vascular access and closure management in cardiac electrophysiology (EP) procedures, emphasising their impact on patient outcomes and safety. It synthesises current evidence and highlights advancements, challenges, and opportunities in this critical area of EP practice.</p><p><strong>Recent findings: </strong>Ultrasound-guided vascular access has significantly reduced complications and improved success rates compared to traditional methods. Vascular closure devices (VCDs) enable faster recovery and same-day discharge, becoming superior alternatives to manual compression. The \"4P framework\"- Plan, Prepare, Puncture, Protect- offers a structured approach to optimising vascular access. Alternative techniques, such as transhepatic and jugular access, are feasible in complex cases, though large-scale evidence is limited. Vascular access management is essential for EP procedures, demanding adequate planning and execution. While advancements in imaging and closure techniques enhance outcomes, further research is needed to standardise practices and evaluate long-term results. A personalised, systematic approach ensures optimal procedural success and patient care.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"35"},"PeriodicalIF":3.1,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001565","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":"Molecular Regulation of Cardiomyocyte Maturation.","authors":"Bhavana Shewale, Tasneem Ebrahim, Arushi Samal, Nicole Dubois","doi":"10.1007/s11886-024-02189-1","DOIUrl":"10.1007/s11886-024-02189-1","url":null,"abstract":"<p><strong>Purpose of the review: </strong>This review aims to discuss the process of cardiomyocyte maturation, with a focus on the underlying molecular mechanisms required to form a fully functional heart. We examine both long-standing concepts associated with cardiac maturation and recent developments, and the overall complexity of molecularly integrating all the processes that lead to a mature heart.</p><p><strong>Recent findings: </strong>Cardiac maturation, defined here as the sequential changes that occurring before the heart reaches full maturity, has been a subject of investigation for decades. Recently, there has been a renewed, highly focused interest in this process, driven by clinically motivated research areas where enhancing maturation may lead to improved therapeutic opportunities. These include using pluripotent stem cell models for cell therapy and disease modeling, as well as recent advancements in adult cardiac regeneration approaches. We highlight key processes underlying maturation of the heart, including cellular and organ growth, and electrophysiological, metabolic, and contractile maturation. We further discuss how these processes integrate and interact to contribute to the overall complexity of the developing heart. Finally, we emphasize the transformative potential for translating relevant maturation concepts to emerging models of heart disease and regeneration.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"32"},"PeriodicalIF":3.1,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001639","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":"Key Concepts in Machine Learning and Clinical Applications in the Cardiac Intensive Care Unit.","authors":"Dhruv Sarma, Aniket S Rali, Jacob C Jentzer","doi":"10.1007/s11886-024-02149-9","DOIUrl":"10.1007/s11886-024-02149-9","url":null,"abstract":"<p><strong>Purpose of review: </strong>Artificial Intelligence (AI) technology will significantly alter critical care cardiology, from our understanding of diseases to the way in which we communicate with patients and colleagues. We summarize the potential applications of AI in the cardiac intensive care unit (CICU) by reviewing current evidence, future developments and possible challenges.</p><p><strong>Recent findings: </strong>Machine Learning (ML) methods have been leveraged to improve interpretation and discover novel uses for diagnostic tests such as the ECG and echocardiograms. ML-based dynamic risk stratification and prognostication may help optimize triaging and CICU discharge procedures. Latent class analysis and K-means clustering may reveal underlying disease sub-phenotypes within heterogeneous conditions such as cardiogenic shock and decompensated heart failure. AI technology may help enhance routine clinical care, facilitate medical education and training, and unlock individualized therapies for patients in the CICU. However, robust regulation and improved clinician understanding of AI is essential to overcome important practical and ethical challenges.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"30"},"PeriodicalIF":3.1,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001635","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":"Blood Pressure Control and Incident Left-Ventricular Conduction Disease.","authors":"Emilie K Frimodt-Møller, Gregory M Marcus","doi":"10.1007/s11886-025-02196-w","DOIUrl":"10.1007/s11886-025-02196-w","url":null,"abstract":"<p><strong>Purpose of review: </strong>Cardiac conduction disease, a harbinger of pacemaker implantation, heart failure, and death, is commonly regarded as immutable. However, emerging research suggests it may be a target for upstream prevention strategies such as blood pressure management. This review summarizes recent evidence regarding blood pressure control and the development of conduction disease.</p><p><strong>Recent findings: </strong>Recent observational studies link hypertension to both prevalent and incident conduction disease. In randomized trials, intensive blood pressure control among hypertensive individuals reduced the incidence of left-ventricular conduction abnormalities in the form of fascicular- and left bundle branch blocks, while treatment with lisinopril independent of blood pressure control appeared to reduce conduction disease risk. Understanding factors that influence conduction system disease development may help inform novel primary prevention strategies. Recent evidence suggests that treatment of hypertension may play a key role in the prevention of conduction disease.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"29"},"PeriodicalIF":3.1,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001619","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}
Lakshmi Kattamuri, Shivangini Duggal, John Paul Aparece, Shrilekha Sairam
{"title":"Cardiovascular Risk Factor and Atherosclerosis in Rheumatoid Arthritis (RA).","authors":"Lakshmi Kattamuri, Shivangini Duggal, John Paul Aparece, Shrilekha Sairam","doi":"10.1007/s11886-025-02198-8","DOIUrl":"10.1007/s11886-025-02198-8","url":null,"abstract":"<p><strong>Purpose of review: </strong>To highlight advancements in managing traditional and rheumatoid arthritis (RA) specific risk factors and the impact of RA treatments on cardiovascular outcomes.</p><p><strong>Recent findings: </strong>Advancements in rheumatoid arthritis management have paralleled declining trends in cardiovascular disease risks. Biomarkers like CRP, Lipoprotein(a), Apolipoprotein B 100, and imaging tools such as coronary artery calcium scoring enhance cardiovascular risk stratification, particularly in intermediate-risk RA patients. While effective RA treatments, have demonstrated substantial cardiovascular benefits, subclass differences were noted in high-risk patients. Increased risk of cardiovascular disease is driven by chronic inflammation, altered lipid metabolism, and traditional risk factors. Effective RA treatment significantly lowers cardiovascular events. Standard treatment of hypertension, diabetes and hypercholesterolemia are effective and lowers RA disease activity and inflammatory markers. While RA is considered a risk enhancing state in calculating CV risk scores, currently there exists no RA disease -specific blood pressure, blood sugar or lipid targets.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"31"},"PeriodicalIF":3.1,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001621","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}
Johannes Bernhard, Lukas Galli, Walter S Speidl, Konstantin A Krychtiuk
{"title":"Cardiovascular Risk Reduction in Metabolic Dysfunction-Associated Steatotic Liver Disease and Metabolic Dysfunction-Associated Steatohepatitis.","authors":"Johannes Bernhard, Lukas Galli, Walter S Speidl, Konstantin A Krychtiuk","doi":"10.1007/s11886-024-02185-5","DOIUrl":"10.1007/s11886-024-02185-5","url":null,"abstract":"<p><strong>Purpose of review: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease, characterized by hepatic steatosis with at least one cardiometabolic risk factor. Patients with MASLD are at increased risk for the occurrence of cardiovascular events. Within this review article, we aimed to provide an update on the pathophysiology of MASLD, its interplay with cardiovascular disease, and current treatment strategies.</p><p><strong>Recent findings: </strong>Given their high burden of cardiovascular comorbidities, patients with MASLD or MASH should undergo regular cardiovascular risk assessment using established risk models. In the absence of liver-specific therapies, therapeutic strategies should focus on improving cardiometabolic risk factors. Patients require a multimodal and multi-stakeholder treatment approach, including optimization of lifestyle, dysglycemia, obesity, and dyslipidemia. Statin treatment represents a safe and effective but often underused therapy in the management of at-risk patients with MASLD and MASH. Novel promising approaches include the use of GLP-1 receptor agonists, especially in, but not limited to, patients with cardiovascular disease and obesity. Patients with MASLD and MASH are at high cardiovascular risk requiring a multi-modal therapeutic approach including regular cardiovascular risk assessment, as well as lifestyle and pharmacological interventions. Statin therapy represents an inexpensive, safe and effective therapy across the spectrum of non-alcohol related steatotic liver diseases without major safety concerns. More prospective, randomized trials in patients with MASLD and MASH are needed.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"28"},"PeriodicalIF":3.1,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11742736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001626","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":"Measurement of Blood Pressure in Children and Adolescents Outside the Office for the Diagnosis of Hypertension.","authors":"James T Nugent","doi":"10.1007/s11886-024-02178-4","DOIUrl":"10.1007/s11886-024-02178-4","url":null,"abstract":"<p><strong>Purpose of review: </strong>To review the benefits of ambulatory blood pressure monitoring and home blood pressure monitoring in children and to discuss implementation of guideline-recommended ambulatory blood pressure monitoring.</p><p><strong>Recent findings: </strong>Compared with office blood pressure, ambulatory blood pressure monitoring and home blood pressure monitoring provide superior accuracy, reproducibility, and stronger associations with target organ damage although future work is needed to determine the utility of home blood pressure monitoring to predict hypertension status on ambulatory blood pressure monitoring. Due to the benefits of out-of-office blood pressure measurement, ambulatory blood pressure monitoring has been recommended to confirm the diagnosis of hypertension in children and adolescents since publication of the 2017 American Academy of Pediatrics clinical practice guidelines on hypertension. However, access to ambulatory blood pressure monitoring remains limited to the subspecialty setting and novel care pathways are needed to improve guideline-concordant use of ambulatory blood pressure monitoring. Nocturnal home blood pressure monitoring may be a practical alternative when ambulatory blood pressure monitoring is not available.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"27"},"PeriodicalIF":3.1,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001638","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 Therapies for Right Ventricular Failure.","authors":"Bibhuti B Das","doi":"10.1007/s11886-024-02157-9","DOIUrl":"10.1007/s11886-024-02157-9","url":null,"abstract":"<p><strong>Purpose of review: </strong>Traditionally viewed as a passive player in circulation, the right ventricle (RV) has become a pivotal force in hemodynamics. RV failure (RVF) is a recognized complication of primary cardiac and pulmonary vascular disorders and is associated with a poor prognosis. Unlike treatments for left ventricular failure (LVF), strategies such as adrenoceptor signaling inhibition and renin-angiotensin system modulation have shown limited success in RVF. This review aims to reassure about the progress in RVF treatment by exploring the potential of contemporary therapies for heart failure, including angiotensin receptor and neprilysin inhibitors, sodium-glucose co-transporter 2 inhibitors, and soluble guanylate cyclase stimulators, which may be beneficial for treating RV failure, particularly when associated with left heart failure. Additionally, it examines novel therapies currently in the pipeline.</p><p><strong>Recent findings: </strong>Over the past decade, a new wave of RVF therapies has emerged, both pharmacological and device-centered. Novel pharmacological interventions targeting metabolism, calcium homeostasis, oxidative stress, extracellular matrix remodeling, endothelial function, and inflammation have shown significant promise in preclinical studies. There is also a burgeoning interest in the potential of epigenetic modifications as therapeutic targets for RVF. Undoubtedly, a deeper understanding of the mechanisms underlying RV failure, both with and without pulmonary hypertension, is urgently needed. This knowledge is not just a theoretical pursuit, but a crucial step that could lead to the development of pharmacological and cell-based therapeutic options that directly target the RV and pulmonary vasculature, aligning with the principles of precision medicine.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"26"},"PeriodicalIF":3.1,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001562","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}