Expert Review of Cardiovascular Therapy最新文献

{"title":"Exercise stress cardiac magnetic resonance imaging in cardiac patients.","authors":"Egidie Uwase, Maxime Caru, Ariane Levesque, Chloe Sholler, Julia McAlexander, Philippe Dodin, Daniel Curnier, Delphine Périé","doi":"10.1080/14779072.2026.2634020","DOIUrl":"10.1080/14779072.2026.2634020","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiac magnetic resonance imaging testing protocols used in combination with exercise (Ex-CMR) facilitate the characterization of the heart by differentiating between normal cardiac remodeling and pathological cardiac remodeling. Studies have reported challenges when using Ex-CMR, limiting its clinical use. Hence, this review provides an overview of existing Ex-CMR studies focusing on cardiac remodeling in cardiac patients.</p><p><strong>Methods: </strong>This scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. A total of 24 studies were included in this review.</p><p><strong>Results: </strong>A total of 538 patients (265 males and 200 females) underwent an Ex-CMR procedure. Ex-CMR testing protocols included cycle ergometer (<i>N</i>=20), isometric handgrip exercise (<i>N</i>=3) and stepper ergometer (<i>N</i>=1). Exercise-induced cardiovascular responses were evaluated in both the left and right ventricles. This review reports the advantages and limitations of Ex-CMR testing.</p><p><strong>Conclusions: </strong>This scoping review identified existing Ex-CMR protocols that assess cardiovascular responses among cardiac patients, highlighting their advantages and limitations. Both cycle ergometer and isometric handgrip protocols have been used to induce cardiovascular responses in cardiac patients. Nevertheless, it appears that developing an effective Ex-CMR protocol is necessary and may improve early detection of abnormal cardiovascular responses in cardiac patients.</p><p><strong>Registration: </strong>This study was registered as a protocol as 'Exercise stress cardiac magnetic resonance imaging in the assessment of induced cardiovascular responses in cardiac patients: a scoping review protocol' (https://journals.lww.com/jbisrir/fulltext/2023/09000/exercise_stress_cardiac_magnetic_resonance_imaging.10.aspx) with the protocol prospectively registered with the Open Science Framework (https://osf.io/hvn75/overview?view_only = f6cf8fc2112e498d89c39639dbce70d1).</p>","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"207-234"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146212445","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":"How can we best utilize atherosclerotic burden as a predictor of vascular outcomes in atrial fibrillation patients?","authors":"Nicola Mumoli, Stefania Marengo, Francesco Cei","doi":"10.1080/14779072.2025.2604576","DOIUrl":"10.1080/14779072.2025.2604576","url":null,"abstract":"","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"1-4"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145741670","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":"How coronary plaque morphology affects fractional flow reserve: clinical evidence from intravascular imaging studies.","authors":"Kota Murai, Yu Kataoka, Satoshi Honda, Masashi Fujino, Shuichi Yoneda, Kazuhiro Nakao, Kensuke Takagi, Fumiyuki Otsuka, Yasuhide Asaumi, Teruo Noguchi","doi":"10.1080/14779072.2025.2603971","DOIUrl":"10.1080/14779072.2025.2603971","url":null,"abstract":"<p><strong>Introduction: </strong>Fractional flow reserve (FFR) is widely used to assess the functional significance of coronary artery disease (CAD). However, the severity of anatomical stenosis does not always correspond with the extent of myocardial ischemia. This discordance highlights the limitations of angiographic assessment alone and underscores the need for more comprehensive evaluation strategies. Recent advances in intravascular imaging have provided deeper insights into the contribution of plaque itself to myocardial ischemia. A PubMed search was conducted for relevant studies published up to May 2025.</p><p><strong>Areas covered: </strong>This review summarizes current evidence on the relationship between intravascular imaging-derived plaque characteristics and FFR. Key features examined include plaque burden, lipidic and calcified plaques, and plaque microstructures. Of these, large plaque burden and lipid-rich plaque characteristics show the most consistent associations with reduced FFR. Mechanistic explanations such as impaired vasodilatory capacity and localized endothelial dysfunction are also explored.</p><p><strong>Expert opinion: </strong>Plaque morphology contributes important diagnostic and prognostic information beyond luminal narrowing. Integrating morphological imaging with physiological assessment is expected to improve clinical decision-making and management of CAD. Future research should focus on validating integrated imaging-physiology strategies to personalize treatment and improve outcomes in patients with CAD.</p>","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"37-56"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145767513","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":"Can vascular biomarkers be used in hypertension management to improve cardiovascular outcomes?","authors":"Tomoyuki Kabutoya","doi":"10.1080/14779072.2025.2609599","DOIUrl":"10.1080/14779072.2025.2609599","url":null,"abstract":"<p><strong>Introduction: </strong>The association between vascular biomarkers as indices of atherosclerosis and cardiovascular events has been widely reported. Measurement of vascular biomarkers has been used for risk stratification and prognostic prediction in hypertensive patients and has been included in various hypertension guidelines.</p><p><strong>Areas covered: </strong>This article describes the evidence for various vascular biomarkers in hypertension practice, their interpretation in guidelines and future perspectives.</p><p><strong>Expert opinion: </strong>Regarding the risk stratification of physiological vascular tests in hypertensive patients, while some hypertension guidelines provide cutoff values for physiological tests, the reference values for blood biomarkers are not clearly defined. Future evidence on the contribution of vascular biomarker measurements to improve outcome in hypertensive patients is expected, including the establishment of appropriate cutoff values based on large studies of blood biomarkers and future evidence on cardio-ankle vascular index.</p>","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"15-20"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145818565","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":"Management of acute cardiovascular consequences of sleep disorders: clinical implications for improved patient outcomes.","authors":"Ritu Prakash Chandra Tated, Darshilkumar Maheta, Saptak Mankad, Bhanu Maturi, Siddharth Pravin Agrawal, Valbona Biba, Archi Dhamelia, Jaykumar Oza, Wilbert S Aronow","doi":"10.1080/14779072.2026.2614600","DOIUrl":"10.1080/14779072.2026.2614600","url":null,"abstract":"<p><strong>Introduction: </strong>Sleep disorders such as insomnia, restless legs syndrome (RLS) and sleep disordered breathing such as obstructive sleep apnea (OSA) and central sleep apnea (CSA) are increasingly recognized as independent risk factors for acute cardiovascular events.</p><p><strong>Areas covered: </strong>This review highlights the key mechanisms linking sleep disorders to acute cardiovascular events, including autonomic dysregulation, intermittent hypoxia, systemic inflammation, and endothelial dysfunction. These contribute to arrhythmias, acute coronary syndromes, heart failure exacerbations, and strokes. OSA stands out due to its strong association with cardiovascular risk through repetitive hypoxia and sympathetic activation. Treatment options like CPAP, ASV, and phrenic nerve stimulation show benefits, though long-term cardiovascular outcomes are still being studied. Despite growing evidence, sleep disorders remain underdiagnosed in cardiac patients, underscoring the need for improved screening and management.</p><p><strong>Expert opinion: </strong>Integrating sleep evaluations into routine cardiovascular care could help reduce acute events and improve outcomes. Increased screening, better awareness among clinicians, and accessible treatment pathways are essential. Further longitudinal research is needed to confirm causal links and assess the sustained cardiovascular benefits of managing sleep disorders, especially in high-risk groups.</p>","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"115-121"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145932837","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":"Strategic targeting of mitochondria in ischemic heart disease: mechanisms and emerging therapies.","authors":"Gino A Kurian, Eren Rose Gino","doi":"10.1080/14779072.2026.2637751","DOIUrl":"10.1080/14779072.2026.2637751","url":null,"abstract":"<p><strong>Introduction: </strong>Ischemic heart disease (IHD) remains a leading cause of global morbidity and mortality. Mitochondrial dysfunction is central to ischemia - reperfusion injury, contributing to bioenergetic failure, oxidative stress, calcium overload, and impaired adaptive responses, making mitochondria an important therapeutic target.</p><p><strong>Areas covered: </strong>This review integrates mechanistic and translational evidence linking mitochondrial dysfunction, structural injury, and adaptive-response failure in IHD. Key pathways discussed include reverse electron transport - driven reactive oxygen species generation, mitochondrial permeability transition pore activation, disrupted fusion - fission dynamics, mitophagy imbalance, and proteostasis collapse. Emerging therapeutic strategies such as mitochondria-targeted antioxidants, cardiolipin-stabilizing peptides, metabolic modulators, mitochondrial transplantation, and genome-directed approaches are evaluated alongside diagnostic innovations, including circulating mitochondrial DNA, mitomiRs, and molecular imaging. A structured literature search was conducted using PubMed/MEDLINE, Scopus, and Web of Science for English-language studies published between January 2000 and March 2025.</p><p><strong>Expert opinion: </strong>Precision targeting of mitochondrial injury and adaptive failure offers stage-specific therapeutic opportunities in IHD; however, successful translation requires biomarker-guided stratification, optimized delivery systems, and temporally aligned clinical trial design.</p>","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"185-205"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147283187","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":"Ivabradine in acute myocardial infarction: a systematic review and meta-analysis of randomized controlled trials.","authors":"Chia Siang Kow, Abdullah Faiz Zaihan, Syed Shahzad Hasan, Kaeshaelya Thiruchelvam","doi":"10.1080/14779072.2026.2618040","DOIUrl":"10.1080/14779072.2026.2618040","url":null,"abstract":"<p><strong>Introduction: </strong>While effective in stable angina and chronic heart failure, ivabradine's role in acute myocardial infarction (AMI) is less clear. We assessed the effects of ivabradine versus placebo or standard care on all-cause mortality, major adverse cardiovascular events (MACE) and heart failure in AMI patients.</p><p><strong>Methods: </strong>We systematically searched six databases through April 2025 for randomized controlled trials (RCTs) comparing ivabradine to control therapy in AMI. Primary outcomes included all-cause mortality, MACE, and heart failure incidence. Random-effects meta-analysis was conducted, with sensitivity analyses using the IVhet model. Risk of bias was assessed using the Cochrane RoB 2.0 tool, and publication bias was explored via funnel plots.</p><p><strong>Results: </strong>Fifteen RCTs involving 2220 patients (ivabradine: 1126; control: 1094) were included. Ivabradine did not significantly reduce all-cause mortality (OR 0.66, 95% CI: 0.38-1.16), though the trend favored treatment. It significantly reduced MACE (OR 0.49, 95% CI: 0.30-0.82; I² = 12%) and heart failure events (OR 0.60, 95% CI: 0.40-0.90). Subgroup analysis indicated greater benefit when combined with beta-blockers. Sensitivity analyses confirmed these findings.</p><p><strong>Conclusion: </strong>Ivabradine may reduce cardiovascular complications post-AMI, particularly MACE and heart failure, and may serve as a useful adjunct to standard therapy. Further large-scale trials are warranted.</p><p><strong>Registration: </strong>This systematic review and meta-analysis was registered on PROSPERO (CRD420251054716).</p>","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"123-135"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145988847","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":"Evaluating catheter usage for atrial fibrillation ablation: improving rates of efficacy and safety.","authors":"Sara Poggi, Assunta Iuliano, Giorgio Spiniello, Antonio De Simone, Francesco Solimene, Giuseppe Stabile","doi":"10.1080/14779072.2025.2603970","DOIUrl":"10.1080/14779072.2025.2603970","url":null,"abstract":"<p><strong>Introduction: </strong>Pulmonary vein (PV) isolation remains the cornerstone of atrial fibrillation (AF) catheter ablation. While the single-tip radiofrequency-based PV isolation in conjunction with a 3D mapping system was for many years considered to be the 'gold standard,' the strategy of PV isolation has evolved tremendously in the recent years.</p><p><strong>Area covered: </strong>This review explores the latest energy source and catheter technologies developed in order to improve the efficiency, safety, and persistence of acute success over the long-term follow-up in patients undergoing PV isolation for AF ablation. Relevant articles were searched in PubMed, Scopus, and Cochrane databases up to August 2025.</p><p><strong>Expert opinion: </strong>Radiofrequency remains a milestone, especially in the field of the point-by-point ablation manner. The introduction of the temperature-controlled ablation catheters allows ablation with higher power settings compared to standard power-controlled ablation, resulting in high acute and one-year success rate with a low incidence of complications. Similar results have been reported with both cryoballoon ablation system, with shorter procedural time and longer fluoroscopy time. Pulsed field ablation is a novel ablation modality, largely nonthermal, aiming at creating transmural, durable ablation lesions while reducing the risk of collateral damage.</p>","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"29-36"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145741725","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":"Secretoneurin as a novel cardiovascular biomarker and potential therapeutic strategy.","authors":"Anett H Ottesen, Helge Røsjø, Torbjørn Omland","doi":"10.1080/14779072.2025.2604574","DOIUrl":"10.1080/14779072.2025.2604574","url":null,"abstract":"<p><strong>Introduction: </strong>Secretoneurin (SN) is a prognostic biomarker in cardiovascular disease (CVD), and circulating SN concentrations have been associated with clinical outcomes in various cohort of CVDs. SN reflects other cellular pathways than established CV biomarkers, and SN provides incremental prognostic information to established CV risk indices. SN has been found to have several beneficial properties and SN could have potential as a future therapeutic strategy in CVD.</p><p><strong>Areas covered: </strong>This review discusses SN as a novel cardiovascular biomarker and a potential therapeutic strategy in cardiovascular medicine. The authors have considered relevant papers identified by PubMed.</p><p><strong>Expert opinion: </strong>SN is a prognostic biomarker in CVD, and unraveling the underlying pathophysiology of SN will be important to advance SN as a biomarker and potential future therapy in CVD. The future for SN as a biomarker and therapy is attractive and could be of future clinical relevance.</p>","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"21-27"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145741737","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":"Management of new-onset postoperative atrial fibrillation after coronary artery bypass grafting.","authors":"Florian E M Herrmann, Anders Jeppsson, Amar Taha","doi":"10.1080/14779072.2025.2610389","DOIUrl":"10.1080/14779072.2025.2610389","url":null,"abstract":"<p><strong>Introduction: </strong>New-onset postoperative atrial fibrillation (POAF) is the most common arrhythmia after coronary artery bypass grafting (CABG). Traditionally regarded as a benign and self-limiting event, more recent evidence highlights its association with prolonged hospitalization, increased healthcare utilization, and a heightened risk of stroke, recurrent atrial fibrillation, and heart failure. Understanding its significance is essential for patient care and long-term outcomes. PubMed was searched using terms related to POAF and CABG, supplemented by the review of relevant guidelines and key publications.</p><p><strong>Areas covered: </strong>This narrative review summarizes recent evidence on the epidemiology, pathophysiology, prophylaxis, and treatment of POAF after CABG. Evidence for pharmacological prophylaxis (e.g. amiodarone, beta-blockers) and surgical strategies (e.g. posterior pericardiotomy, atrial pacing) is summarized, along with current approaches for acute management and stroke prevention. The literature reveals significant heterogeneity in treatment strategies, particularly regarding anticoagulation, with emerging trials expected to refine clinical practice.</p><p><strong>Expert opinion: </strong>Current evidence suggests that POAF functions more as an indicator of underlying patient vulnerability than as a direct driver of adverse outcomes. Clinically, management must balance arrhythmia control, stroke and bleeding risk, and individualized anticoagulation decisions. Research efforts should prioritize robust risk stratification tools and randomized evidence to guide tailored therapy.</p>","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"81-92"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145827264","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}