Current Cardiology Reviews最新文献

{"title":"Coronary Artery Calcium Screening: A Narrative Review and Guide to Preventive Strategies.","authors":"Mohammadmoein Dehesh, Reihanehsadat Hosseini","doi":"10.2174/011573403X491898261006113636","DOIUrl":"https://doi.org/10.2174/011573403X491898261006113636","url":null,"abstract":"<p><p>Coronary Artery Calcium (CAC) scoring has become a central tool for detecting subclinical atherosclerosis and refining cardiovascular risk assessment, particularly in individuals with intermediate or atypical risk profiles. Traditional risk models such as the ASCVD Pooled Cohort Equations remain foundational but have important limitations, especially in younger adults and those with nontraditional risk patterns. CAC scoring provides direct visualization of atherosclerotic burden and can outperform serum biomarkers in predicting cardiovascular events. Recent cohort data suggest that CAC can be detected decades earlier than current guideline thresholds imply, and that early CAC presence and progression carry significant prognostic value, although evidence to support routine screening below current guideline-recommended age thresholds remains investigational rather than established practice. With advances in imaging technology and expanding population-based evidence, CAC scoring is evolving from a decision aid into an increasingly central tool in preventive cardiology, one whose benefits must be weighed against radiation exposure, incidental findings, overdiagnosis, and cost. This review summarizes current evidence on the biology of coronary calcification, available imaging techniques, CAC scoring systems, and the clinical application and limitations of CAC in primary prevention of cardiovascular diseases and situates guideline-endorsed uses of CAC alongside areas that remain hypothesis-generating.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endothelial Dysfunction and Inflammatory Pathways in Heart Failure - Role of suPAR and sVCAM-1 as Novel Biomarkers.","authors":"Gunanidhi Sakthivel, Vijayakumar Thangavel Mahalingam, Suryaprakash Sabapathi","doi":"10.2174/011573403X522286260923132142","DOIUrl":"https://doi.org/10.2174/011573403X522286260923132142","url":null,"abstract":"<p><strong>Introduction: </strong>Heart failure (HF) is a multifactorial clinical syndrome characterised by myocardial remodelling, endothelial dysfunction, and chronic inflammation. Emerging evidence highlights the role of inflammatory and endothelial biomarkers, particularly soluble urokinase plasminogen activator receptor (suPAR) and soluble vascular cell adhesion molecule-1 (sVCAM-1), in improving our understanding and management of HF.</p><p><strong>Methods: </strong>A narrative review of the literature was conducted to evaluate the biological significance, clinical utility, and prognostic relevance of suPAR and sVCAM-1 in HF. Given the heterogeneity of study designs, HF phenotypes, and clinical outcomes, the available evidence was critically synthesised to provide an integrated overview of these biomarkers.</p><p><strong>Results: </strong>Endothelial dysfunction and persistent inflammation were identified as key contributors to the pathogenesis of HF. Elevated suPAR levels are associated with immune activation, myocardial remodelling, renal dysfunction, increased rehospitalisation, and mortality. Similarly, increased sVCAM-1 concentrations reflect endothelial activation and vascular inflammation and are linked to adverse cardiac remodelling and poor clinical outcomes. Both biomarkers have potential value in early diagnosis, risk stratification, and therapeutic monitoring, particularly in patients with heart failure with preserved ejection fraction (HFpEF).</p><p><strong>Discussion: </strong>suPAR and sVCAM-1 provide complementary information beyond that of conventional natriuretic peptides by capturing the inflammatory and endothelial mechanisms involved in HF progression. The incorporation of these markers into multi-marker strategies may improve risk assessment and support personalised treatment approaches.</p><p><strong>Conclusion: </strong>suPAR and sVCAM-1 are promising biomarkers for enhancing diagnosis, prognostic assessment, and therapeutic monitoring in HF. Further multicentre prospective studies are needed to validate their clinical utility and establish their roles in precision heart failure management.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardio-Hepatic Syndrome in Iron Overload: A Scenario Beyond Alcohol and Metabolic Dysfunction.","authors":"Yuri Gerasimenko, Svetlana Tarasenko, Olga Tarasova, Svetlana Rachina, Nina Rozina, Diana Popandopulo, Georgy Zayratyants, Dmitriy Bykov, Maria Poltavskaya, Anzhela Soloveva","doi":"10.2174/011573403X516185260914073314","DOIUrl":"https://doi.org/10.2174/011573403X516185260914073314","url":null,"abstract":"<p><p>Liver disease and heart failure have interconnected pathophysiology and frequently coexist within the common framework of systemic metabolic disorder, as a result of alcohol overuse, or as a consequence of one organ's failure precipitating the other, in the form of congestive hepatopathy or, conversely, cirrhotic cardiomyopathy. Iron overload represents a less common but potentially devastating cardio-hepatic phenotype that may be missed when liver dysfunction, diabetes, arrhythmia, and heart failure are attributed prematurely to more prevalent causes. In this narrative mini-review, illustrated by an autopsy-confirmed case of fatal multiorgan iron overload, we aim (i) to raise clinical suspicion of iron overload among cardiologists, (ii) to address the wide spectrum of differential diagnoses to consider when liver disorder and heart failure coexist, and (iii) to emphasize the need for correct interpretation of iron indices and targeted management to improve patient outcomes.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149036750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic Hypertension in Pregnancy: Risk Stratification, Management Strategies and Long-term Maternal-Fetal Outcomes.","authors":"Sofia Lopes-Pereira, Luís Guedes-Martins","doi":"10.2174/011573403X512215260909111132","DOIUrl":"https://doi.org/10.2174/011573403X512215260909111132","url":null,"abstract":"<p><strong>Introduction/objectives: </strong>Chronic hypertension in pregnancy is increasingly prevalent and is associated with substantial maternal and fetal morbidity, including superimposed preeclampsia, placental abruption, fetal growth restriction, preterm birth and long-term cardiovascular disease. This review summarizes evidence on pathophysiology, risk stratification, management and outcomes in pregnancies complicated by chronic hypertension.</p><p><strong>Methods: </strong>A systematic literature search was conducted in PubMed in September 2025 using MeSH terms related to hypertension, pregnancy, risk assessment, antihypertensive therapy and pregnancy outcomes. Studies published in English between 2000 and 2025 were included. The review followed the PRISMA 2020 guidelines and a qualitative synthesis was performed.</p><p><strong>Results: </strong>A total of 141 studies were included. Chronic hypertension confers a 5-fold increased risk of pre-eclampsia and is associated with adverse maternal and perinatal outcomes through impaired cardiovascular adaptation, endothelial dysfunction and abnormal placentation. Evidence showed that targeting blood pressure below 140/90 mmHg reduced severe hypertension without increasing fetal growth restriction. First-trimester screening combining maternal characteristics, uterine artery doppler and angiogenic biomarkers improved pre-eclampsia prediction. Low-dose aspirin reduced risk, although effectiveness varied.</p><p><strong>Discussion: </strong>Uncertainties remain regarding optimal blood pressure targets, aspirin efficacy in chronic hypertension, and integration of angiogenic biomarkers into routine risk stratification. The sFlt-1/PlGF ratio showed value for short-term pre-eclampsia prediction but performed poorly as a standalone predictor of adverse outcomes. Remote monitoring showed promise for postpartum management, yet long-term cardiovascular benefits require confirmation.</p><p><strong>Conclusions: </strong>Chronic hypertension requires individualized multidisciplinary care from preconception through the postpartum period. Pregnancy acts as an early marker of future cardiovascular risk, underscoring the need for structured long-term follow-up and integration of obstetric and cardiovascular care.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149036776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac Implantable Electronic Devices Management in Older Adults ≥75 Years Old: From Underrepresentation in Clinical Trials to Overrepresentation in Contemporary Clinical Practice.","authors":"Matthew F Yuyun, Jacob Joseph, Scott Kinlay, Adelqui O Peralta, Peter S Hoffmeister, Jagmeet P Singh, J Michael Gaziano, Ariela R Orkaby","doi":"10.2174/011573403X485322260904063323","DOIUrl":"https://doi.org/10.2174/011573403X485322260904063323","url":null,"abstract":"<p><p>Cardiac Implantable Electronic Devices (CIEDs), ranging from Permanent Pacemakers (PPMs) for bradycardia, Implantable Cardioverter-Defibrillators (ICDs), to Cardiac Resynchronization Therapy (CRT) with Pacing (CRT-P) or Defibrillation (CRT-D), have been shown to significantly improve morbidity and mortality across a variety of clinical scenarios. The burden of cardiovascular disease and the indications for CIED implantation increase with age. These trends are becoming increasingly apparent with rising life expectancy, necessitating evidencebased therapeutic interventions for older adult patients. However, older adults, particularly those aged ≥75 years, were either markedly underrepresented or excluded from major Randomized Controlled Trials (RCTs) evaluating CIED, in which the mean participant age was predominantly in the 60s. Consequently, there has been a tendency to extrapolate the findings of these trials in subsequent guideline recommendations and consensus statements to older adults despite the lack of clear, adequately tested evidence regarding the benefits and risks of such recommendations in this population. As a result, real-world observational studies, in which older adults are often overrepresented, have largely been relied upon to characterize the efficacy and safety of CIED implantation. Complications associated with CIED implantation and long-term outcomes are generally worse in older adults than in younger patients, particularly among those with premature biological aging, increased frailty, and/or a high burden of comorbidities. Nevertheless, uncertainty remains regarding the balance of benefits and risks associated with certain invasive cardiac device therapies in older adults. This narrative review critically summarizes the current evidence regarding the efficacy and safety of CIEDs in adults aged ≥75 years compared with those aged <75 years.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149036833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung Density: A Computed Tomography Marker for Severity in Pulmonary Hypertension of Various Etiologies.","authors":"Serhii Progonov, Olena Torbas, Bogdan Batsak","doi":"10.2174/011573403X475339260903094116","DOIUrl":"https://doi.org/10.2174/011573403X475339260903094116","url":null,"abstract":"<p><strong>Introduction: </strong>To investigate the capabilities of CT markers for assessing the severity of PH and to compare them with PFT and gas exchange parameters.</p><p><strong>Methods: </strong>This single-center study evaluated 90 consecutive Pulmonary Hypertension (PH) patients across five diagnostic subgroups (idiopathic, connective tissue disease, congenital heart disease, left heart disease, and chronic thromboembolic). Baseline diagnostics included comprehensive clinical, functional, and invasive right heart catheterization. Automated non-contrast chest CT densitometry via the Siemens Syngo.via (VB80B) workstation extracted volumetric parenchymal metrics: Mean Lung Density (MLD), Percentile 75, and High Attenuation Volume (HAV). Statistical robustness was verified using 1000-resample percentile bootstrap simulations, followed by multi-parameter ROC analysis to determine the diagnostic accuracy of CT-AI metrics in identifying severe pulmonary vascular resistance (PVR > 5 Wood units).</p><p><strong>Results: </strong>In bootstrap-validated multivariable regression models, right atrium area emerged as an independent predictor for both MLD (β = 2.02, 95% CI: 0.21-3.83, p = 0.030) and Percentile 75 (β = 2.19, 95% CI: 0.21-4.17, p = 0.031), while forced vital capacity independently predicted High Attenuation Volume (HAV; β = -0.031, 95% CI: -0.053- -0.009, p = 0.007). ROC curve analysis demonstrated modest but consistent diagnostic performance of non-contrast CT-AI metrics in discriminating severe PVR (>5 Wood units), led by MLD (AUC = 0.686, 95% CI: 0.511-0.860; candidate threshold > -785 HU) and closely mirrored by Percentile 75 (AUC = 0.680) and HAV (AUC = 0.680).</p><p><strong>Discussion: </strong>The established associations between AI-driven lung density, right atrial remodeling, and spirometric volumes reflect descriptive cross-sectional associations that may parallel underlying macro-structural changes. Furthermore, automated density profiling provides an objective, observer-independent tool to capture mosaic parenchymal alterations, serving strictly as an exploratory adjunct for preliminary phenotype characterization.</p><p><strong>Conclusion: </strong>Automated non-contrast CT-AI densitometric metrics consistently discriminate severe PVR (>5 Wood units), led by MLD (AUC = 0.686; threshold -785HU), serving as potential exploratory screening indicators that reflect underlying cardiopulmonary alterations. They do not replace established clinical tools but offer potential value for opportunistic screening, warranting further prospective multi-center and prognostic validation.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obstructive Sleep Apnea as a Driver of Venous Congestion, Cardio-Renal Dysfunction, and Cardiac Conduction Disease: A Comprehensive Review.","authors":"Sidhartha Gautam Senapati, Satya Priya Paritala, Srija Sirineni, Abhinav Vulisha, Debabrata Mukherjee","doi":"10.2174/011573403X502569260902101501","DOIUrl":"https://doi.org/10.2174/011573403X502569260902101501","url":null,"abstract":"<p><strong>Introduction: </strong>Obstructive sleep apnea (OSA) represents one of the significant systemic diseases with considerable cardiovascular and renal consequences. Along with the wellknown links of OSA with hypertension and metabolic disorders, growing data have been found that indicate the connection between OSA and redistribution of fluids, venous congestion, heart failure, kidney problems, and cardiac arrhythmias via several mechanisms.</p><p><strong>Methods: </strong>For this narrative review, a search was performed using PubMed, Scopus, and Google Scholar to find English-language papers published between January 2000 and January 2026 to obtain articles on obstructive sleep apnea (OSA), intermittent hypoxia, venous congestion, cardiorenal dysfunction, sympathetic activation, oxidative stress, inflammation, arrhythmias, and continuous positive airway pressure (CPAP), among others. Clinical studies, scientific statements, systematic reviews, and mechanistically relevant experimental studies were narratively synthesized.</p><p><strong>Results: </strong>Obstructive episodes occurring recurrently in the upper airway cause hypoxemia, sympathetic responses on arousals, and marked negative intrathoracic pressure. Such physiologic changes can trigger the activation of the sympathetic and renin-angiotensin-aldosterone systems, thus causing sodium retention, fluid shift, and an increased workload for the heart. Intermittent hypoxia also triggers an oxidative-inflammatory response, even through NLRP3 inflammasomedependent pathways in animal models.</p><p><strong>Discussion: </strong>Activation of the sympathetic nervous system, intermittent hypoxemia, inflammation, and mechanical stress secondary to increased pressure are some of the components of a complex network of mechanisms that could potentially link OSA to venous congestion, as well as cardiorenal and electrophysiological dysfunction. However, many molecular pathways have not yet been shown to have clinical relevance.</p><p><strong>Conclusion: </strong>The existence of obstructive sleep apnea (OSA) needs to be taken into consideration when thinking about possible causes of venous congestion, in addition to cardiorenal disease and dysrhythmias. Recognition and treatment can lead to improved cardiovascular outcomes, but more research is needed to understand the clinical implications.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149011968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ischemic Conditioning in ST-Elevation Myocardial Infarction: A Systematic Review of Randomized Controlled Trials.","authors":"Muhammad Fadil, Andriany Qanitha, Eryati Darwin, Hirowati Ali, Doni Firman, Abdul Hakim Alkatiri","doi":"10.2174/011573403X463044260901064703","DOIUrl":"https://doi.org/10.2174/011573403X463044260901064703","url":null,"abstract":"<p><strong>Introduction: </strong>Despite recent developments in the treatment of ST-Elevation Myocardial Infarction (STEMI), there has been an increase in cases of post-infarction heart failure, even though there has been a decrease in mortality rates. A feasible process, such as ischemic conditioning, has been found to possess cardioprotective effects.</p><p><strong>Methods: </strong>A systematic review was conducted following PRISMA guidelines. Articles related to the study objective were identified through a search of the PubMed, ScienceDirect, and Cochrane databases. Randomized Controlled Trials (RCTs) published between 2015 and 2025 that assessed ischemic conditioning in STEMI patients were included.</p><p><strong>Results: </strong>The aggregate of the RCTs showed heterogeneous findings on the effectiveness of ischemic conditioning. The co-primary outcomes were myocardial infarct size and clinical outcomes, including Acute Kidney Injury (AKI) or Contrast-Induced Nephropathy (CIN), Major Adverse Cardiovascular Events (MACE), malignant arrhythmias, and heart failure. Other outcomes, including global longitudinal strain, Left Ventricular Ejection Fraction (LVEF), Myocardial Blush Grade (MBG), platelet reactivity, and cardioprotective biomarkers, were also evaluated. Overall, while several trials suggested potential cardioprotective effects, a substantial proportion reported neutral findings.</p><p><strong>Discussion: </strong>These discrepancies in clinical trial outcomes reflect the complexity of successfully applying ischemic conditioning in clinical settings. Various factors, such as timing, sample size, device protocols, and individual differences, may be responsible for the discrepancies observed in clinical trials. Additionally, evolving reperfusion strategies and concurrent therapies may diminish or modify the measurable impact of conditioning interventions. Standardization and determination of susceptibility subsets are, therefore, crucial priorities.</p><p><strong>Conclusions: </strong>Ischemic conditioning appears to confer beneficial effects on several surrogate markers, including cardioprotective biomarkers, malignant arrhythmias, MBG, and platelet reactivity. However, evidence regarding hard clinical outcomes remains variable and does not demonstrate a convincing clinical benefit. Large-scale trials with a clear design are warranted to further clarify its role in patients with STEMI, particularly in selected populations that may derive the greatest benefit. (PROSPERO CRD420251239059).</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Glycemic Control: Multi-pathway Cardioprotective Mechanisms of Selective Na+/glucose Co-transporter 2 Inhibitors with Emerging Implications for Atrial Fibrillation.","authors":"Fadia Mayyas, Zaid Tashtoush","doi":"10.2174/011573403X495026260829090437","DOIUrl":"https://doi.org/10.2174/011573403X495026260829090437","url":null,"abstract":"<p><strong>Introduction: </strong>Atrial fibrillation (AF) is the most common form of cardiac arrhythmia and is associated with electrocardiographic changes resulting from several complex mechanisms. While management of AF relies mainly on ion channel blockers and beta blockers for cardioversion and control of ventricular rate, many patients remain symptomatic despite the use of optimal therapy, highlighting the need for new upstream drug therapies to further improve management.</p><p><strong>Methods: </strong>In this narrative review, we summarize and discuss key findings related to the use of selective sodium-glucose co-transporter 2 inhibitors (SGLT2i) in heart failure (HF) and their potential role in AF and the mechanisms underlying their beneficial effects. Recent landmark trials and relevant mechanistic studies were reviewed.</p><p><strong>Results: </strong>Recent growing evidence suggests a cardioprotective role for SGLT2i, especially in patients with diabetes and HF with reduced (HFrEF) or preserved ejection fraction (HFpEF). At the molecular level, SGLT2i attenuate cardiac inflammation, oxidative stress, and fibrosis. In HFrEF and HFpEF patients, SGLT2i reduce the risk of HF hospitalization and cardiovascular (CV) mortality.</p><p><strong>Discussion: </strong>SGLT2i may provide potential anti-arrhythmic benefits in both ventricular and atrial arrhythmias. However, it remains unclear whether these potential effects on AF and other types of arrhythmias are secondary to improved HF outcomes or result from direct effects on the myocardium. In patients with cardiac arrhythmia, SGLT2i may favorably influence cardiac structural/ electrical remodeling, oxidative stress, inflammation, and metabolic pathways.</p><p><strong>Conclusion: </strong>Therapeutic approaches aiming at reducing AF burden using SGLT2i may be beneficial, potentially extending beyond patients with HF or diabetes.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Impedance-Guided Fluid Therapy on Treatment Outcomes of Patients with Heart Failure: A Systematic Review and Meta-Analysis.","authors":"Yichi Liu, Yuting Xie, Shuangshuang Du, Jingming Zheng, Yutong Qiu, Weixi Liu, Jiayi Liu, Min Mao","doi":"10.2174/011573403X493832260820062705","DOIUrl":"https://doi.org/10.2174/011573403X493832260820062705","url":null,"abstract":"<p><strong>Introduction: </strong>Traditional volumetric assessment methods have limitations in the management of HF. The clinical value of impedance-guided monitoring (including bioelectrical impedance analysis [BIA], lung/thoracic impedance [LI], or intrathoracic impedance monitoring [IIM]) for quantifying extracellular fluid status remains controversial. This study aims to systematically evaluate the effect of impedance-guided fluid management on rehospitalization rates, mortality, and other outcomes in patients with HF.</p><p><strong>Methods: </strong>PubMed, Embase, and Web of Science were searched from inception to May 31, 2025, for randomized controlled trials (RCTs) comparing impedance-guided fluid therapy with standard care in patients with HF. This review was conducted in accordance with the PRISMA guidelines.</p><p><strong>Results: </strong>A total of 4 RCTs or secondary analyses of RCTs involving 650 patients with HF (impedance- guided group: 326 cases) were included. The risk of rehospitalization for HF was reduced without statistical significance in the impedance-guided group (OR: 0.73, 95% CI: 0.22- 2.48), while the risk of mortality for HF demonstrated a statistically significant reduction (OR: 0.33, 95% CI: 0.20-0.56), though these findings should be interpreted with caution given the limited number of included studies. The impedance-guided group demonstrated positive trends in reducing the incidence of acute kidney injury (AKI), lowering N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels and improving quality of life. These outcomes were not subjected to analysis due to data heterogeneity.</p><p><strong>Discussion: </strong>This meta-analysis suggests that impedance-guided fluid management did not demonstrate a statistically significant reduction in HF rehospitalization in the pooled analysis, though a consistent directional trend was observed. However, the statistics about HF-related mortality among patients with HF showed that impedance-guided fluid therapy potentially provided a tool for more precise volume management. Also, these findings are based on a limited number of studies with methodological heterogeneity.</p><p><strong>Conclusion: </strong>Impedance-guided fluid management may represent a potential adjunct for reducing rehospitalization in patients with HF. Given the methodological heterogeneity and small number of included studies in this research, future large-scale, high-quality RCTs are needed to confirm these results in clinical practice.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}