Current Cardiology Reports最新文献

{"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}

{"title":"Navigating the Waves of Critical Care Echocardiography: Unveiling its Role, Advantages, and Pitfalls in the Cardiac Intensive Care Unit.","authors":"Ashley Darlington, Dustin Hillerson, Brad Ternus, Sunil Mankad","doi":"10.1007/s11886-024-02176-6","DOIUrl":"10.1007/s11886-024-02176-6","url":null,"abstract":"<p><strong>Purpose of review: </strong>Critical Care Echocardiography (CCE) is now established as an important tool in the intensive care unit (ICU). This paper aims to examine the expanding role of cardiovascular ultrasound in the ICU, focusing on its applications, benefits, and challenges, while highlighting recent advancements shaping the future of critical care echocardiography.</p><p><strong>Recent findings: </strong>Non-invasive echocardiographic measurement of hemodynamic parameters including stroke volume, cardiac output, left ventricular filling pressures, and pulmonary pressures have been well-validated against invasive measurements. Myocardial perfusion can also be evaluated using ultrasound enhancing agent techniques to further risk-stratify patients with chest pain. Echocardiography enables clinicians to visualize cardiac anatomy and physiology directly at the bedside, providing immediate feedback in rapidly changing clinical situations. Assessment of stroke volume, cardiac output, and left ventricular filling pressures can be readily measured at the bedside and correspond with clinical outcomes including mortality. Measurement of central venous pressure and pulmonary pressures may guide clinical decisions in fluid management and mechanical ventilation strategies. Lastly, myocardial perfusion imaging can supplement the 2D echocardiographic evaluation to further risk-stratify patients presenting with chest pain.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"25"},"PeriodicalIF":3.1,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001647","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":"Closing the Gap: Digital Innovations to Address Hypertension Disparities.","authors":"Bassel M Shanab, Allison E Gaffey, Lee Schwamm, Matthew Zawalich, Daniel F Sarpong, Rafael Pérez-Escamilla, Jocelyn Dorney, Charlotte Cooperman, Ryan Schafer, Heather S Lipkind, Yuan Lu, Oyere K Onuma, Erica S Spatz","doi":"10.1007/s11886-024-02171-x","DOIUrl":"10.1007/s11886-024-02171-x","url":null,"abstract":"<p><strong>Purpose of review: </strong>Significant inequities persist in hypertension detection and control, with minoritized populations disproportionately experiencing organ damage and premature death due to uncontrolled hypertension. Remote blood pressure monitoring combined with telehealth visits (RBPM) is proving to be an effective strategy for controlling hypertension. Yet there are challenges related to technology adoption, patient engagement and social determinants of health (SDoH), contributing to disparities in patient outcomes. This review summarizes the evidence to date for RBPM, focusing on the potential to advance health equity in blood pressure control and the existing levers for largescale implementation.</p><p><strong>Recent findings: </strong>Several studies demonstrate the promise of RBPM programs to address health disparities through: (1) the use of cellular-enabled blood pressure machines that do not require internet access or smart devices to connect readings into the medical record; (2) emphasis on home blood pressure monitoring to illuminate the daily factors that influence blood pressure control, thereby increasing patient empowerment; (3) adoption of standardized algorithms for hypertension management; and (4) integration of services to address SDoH. Multidisciplinary, non-physician care teams that include nurses, pharmacists, and community health workers are integral to this model. However, most studies have not embraced all aspects of RBPM, and implementation is challenging as current payment models do not support the digital components of RBPM or a diverse workforce of hypertension providers.</p><p><strong>Conclusion: </strong>To address hypertension disparities, RBPM programs need to integrate digital technology that is accessible to all users as well as multidisciplinary care teams that attend to the medical and social needs of populations experiencing health inequities.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"23"},"PeriodicalIF":3.1,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983026","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":"Atrial FDG Uptake: Etiologies, Clinical Significance, and Implications.","authors":"Julie Lanctôt-Bédard, Hassan Bachir Melhem, Francois Harel, Matthieu Pelletier-Galarneau","doi":"10.1007/s11886-024-02166-8","DOIUrl":"10.1007/s11886-024-02166-8","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review aims to explore the clinical significance of atrial fluorodeoxyglucose (FDG) uptake observed in positron emission tomography (PET) scans, focusing on its association with atrial fibrillation (AF), cardiac sarcoidosis, and myocarditis. We discuss the implications of atrial uptake for patient management and prognosis.</p><p><strong>Recent findings: </strong>Recent studies have demonstrated that atrial FDG uptake is frequently present in patients with AF, particularly those with persistent AF, and is linked to increased risks of stroke and poorer outcomes after ablation. In cardiac sarcoidosis, atrial uptake correlates with inflammation and an elevated risk of AF. Additionally, non-granulomatous myocarditis has been associated with localized atrial FDG uptake, necessitating careful differentiation from other causes. : Atrial FDG uptake reflects underlying pathological processes such as inflammation, which can significantly impact patient management and outcomes across various cardiovascular diseases. Recognizing these findings can facilitate early intervention, improve prognosis, and support the development of clear guidelines for clinical practice, emphasizing the need for continued research in this area.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"22"},"PeriodicalIF":3.1,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983023","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":"Primary Graft Dysfunction after Heart Transplantation: Current Evidence and Implications for Clinical Practice.","authors":"Elena I Gavrila, Jonathan S Dowell, Ananya Gorrai, Christopher Wrobel, Nicholas Hendren, E Ashley Hardin, Yasbanoo Moayedi, Natalie Tapaskar, Matthias Peltz, Maryjane Farr, Lauren K Truby","doi":"10.1007/s11886-024-02153-z","DOIUrl":"10.1007/s11886-024-02153-z","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review summarizes the current literature on primary graft dysfunction highlighting the current definition, reviewing epidemiology, and describing donor, recipient, and perioperative risk factors in the contemporary era.</p><p><strong>Recent findings: </strong>PGD, in its most severe form, complicates 8% of heart transplants and portends a 1-year mortality of close to 40%. PGD is multifactorial and heterogeneous with contributions from donor and recipient risk as well as organ recovery and preservation modalities. Biomarkers may enhance risk stratification and lend insight into the underlying mechanism of PGD. Temperature-controlled storage and hypothermic oxygenation perfusion systems, in particular, may have significant potential to mitigate PGD risk. PGD is a devastating early complication of heart transplantation that is both complex and multifactorial. Despite its incidence and impact the underlying biology of PGD remains poorly understood. Future studies mechanistic studies are needed to address the underlying pathophysiology of PGD to develop targeted prophylactic and/or therapeutic interventions.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"24"},"PeriodicalIF":3.1,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983031","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":"Promotion of Cardiometabolic Health: A Personal Journey.","authors":"Jean-Pierre Després","doi":"10.1007/s11886-024-02165-9","DOIUrl":"10.1007/s11886-024-02165-9","url":null,"abstract":"<p><p>PURPOSE OF REVIEW: Narrative review of the author's main contributions to the field of cardiovascular health spanning four decades, with a focus on findings related to 1- the pathophysiology of obesity, insulin resistance, type 2 diabetes and cardiovascular disease, and 2- the management/prevention of these conditions. Particular attention is given to the importance of regular physical activity. RECENT FINDINGS: Because behaviors and their physiological consequences are still not measured in clinical practice, it is proposed to systematically assess and target \"lifestyle vital signs\" (waist circumference, cardiorespiratory fitness, food-based diet quality and level of leisure-time physical activity) in primary care. However, cardiometabolic health of the population will not be substantially improved until our living and economic conditions are permissive to the adoption of healthy behaviors. Closing the gap between primary care and public health should be a priority to address the socioeconomic determinants of cardiometabolic health.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"20"},"PeriodicalIF":3.1,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977948","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":"Multi-Modality Imaging in Cardio-Rheumatology.","authors":"Vasiliki Vartela, Alessia Pepe, Ioannis Fragos, Sophie I Mavrogeni","doi":"10.1007/s11886-024-02160-0","DOIUrl":"10.1007/s11886-024-02160-0","url":null,"abstract":"<p><strong>Purpose of review: </strong>Our purpose was to discuss the advantages and disadvantages of various noninvasive imaging modalities in the evaluation of cardiovascular disease (CVD) in patients with autoimmune rheumatic diseases (ARDs). The detailed knowledge of imaging modalities will facilitate the diagnosis and follow up of CVD in ARDs.</p><p><strong>Recent findings: </strong>Autoimmune Rheumatic Diseases (ARDs) are characterized by alterations in immunoregulatory system of the body. Although there is great progress in anti-rheumatic treatment, ARD patients are still at a higher risk for reduced life expectancy, compared with the general population, which is mainly due to the high incidence of CVD. Cardiovascular imaging holds the promise of early, noninvasive diagnosis and follow up of these patients. Echocardiography (echo), a cost effective, widely available imaging modality, can provide valuable early information about CVD in ARDs and motivate the use of more sophisticated investigations, if needed. Single Photon Emission tomography (SPECT) gives information about myocardial perfusion, while positron emission tomography (PET) gives information about both myocardial perfusion and inflammation with better spatial resolution and less radiation but at a higher financial cost, compared to SPECT. Computed Tomography Coronary Angiography (CTCA) is a reliable tool to rule out the presence of coronary artery disease, which has high incidence in ARD population. Lastly, Cardiovascular Magnetic Resonance (CMR) can perform function and tissue characterization evaluation in the same scan without using radiation and represents the ideal tool for serial evaluation of ARD patients. Lastly, molecular imaging holds the promise for individualized treatment in various ARDs. Cardiovascular imaging is the modern \"stethoscope\" of the clinicians and therefore they should be familiar with pro and contra of these modalities in order to achieve the best diagnostic and therapeutic target in ARD patients.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"21"},"PeriodicalIF":3.1,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977945","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":"Metabolic Dysfunction Associated-Steatotic Liver Disease (MASLD) and Cardiovascular Risk: Embrace All Facets of the Disease.","authors":"Niki Katsiki, Genovefa Kolovou, Michal Vrablik","doi":"10.1007/s11886-024-02181-9","DOIUrl":"10.1007/s11886-024-02181-9","url":null,"abstract":"<p><strong>Purpose of review: </strong>In recent years, the terms \"metabolic associated fatty liver disease-MAFLD\" and \"metabolic dysfunction-associated steatotic liver disease-MASLD\" were introduced to improve the encapsulation of metabolic dysregulation in this patient population, as well as to avoid the negative/stigmatizing terms \"non-alcoholic\" and \"fatty\".</p><p><strong>Recent findings: </strong>There is evidence suggesting links between MASLD and coronary heart disease (CHD), heart failure (HF), atrial fibrillation (AF), stroke, peripheral artery disease (PAD) and chronic kidney disease (CKD), although the data for HF, AF, stroke and PAD are scarcer. Physicians should consider the associations between MASLD and CV diseases in their daily practice. Based on this knowledge and current guidelines, they should also assess and manage CV risk/co-morbidities in such patients. It is important to further investigate the impact of MASLD on CV outcomes, a knowledge that will help to elucidate the clinical implications of this \"novel\" liver entity.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"27 1","pages":"19"},"PeriodicalIF":3.1,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969852","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}