Future cardiologyPub Date : 2025-04-01Epub Date: 2025-03-10DOI: 10.1080/14796678.2025.2477421
Mohammad Reza Movahed, Austin Mineer, Mehrtash Hashemzadeh
{"title":"Partial obesity paradox regarding mortality in patients hospitalized with diastolic or systolic heart failure.","authors":"Mohammad Reza Movahed, Austin Mineer, Mehrtash Hashemzadeh","doi":"10.1080/14796678.2025.2477421","DOIUrl":"10.1080/14796678.2025.2477421","url":null,"abstract":"<p><strong>Introduction: </strong>A phenomenon known as the obesity paradox has been reported in patients with heart failure (HF). The goal of this study is to characterize this observation in systolic (SHF) and diastolic (DHF) HF.</p><p><strong>Methods and results: </strong>We used the National Inpatient Sample (NIS) database for 2016-2020. We evaluated mortality based on body weight. A total of 7,364,023 with SHF and 10,064,223 with DHF were found in the NIS database. All-cause inpatient mortality was lowest in overweight followed by obesity and morbid obesity, whereas mortality was highest in cachexia for SHF and DHF (mortality: overweight 2.56%, obese 3.12%, morbidly obese 3.70%, normal weight 5.60%, and cachexia 15.22%; <i>p</i> < 0.001) and DHF patients (mortality: overweight 2.08%, obese 2.43%, morbidly obese 2.93%, normal weight 4.58%, and cachexia 14.25%; <i>p</i> < 0.001). This relationship remains similar after multivariate analysis (SHF patients: overweight OR: 0.49 (0.41-0.58), obesity OR: 0.64 (0.62-0.66), morbid obesity OR: 0.85 (0.83-0.88), and cachexia OR: 2.78 (2.67-2.90); <i>p</i> < 0.001; DHF patients: overweight OR: 0.47 (0.40-0.56), obesity OR: 0.61 (0.59-0.63), morbid obesity OR: 0.83 (0.81-0.85), and cachexia OR: 3.09 (2.96-3.23); <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>All-cause inpatient mortality in SHF and DHF is lowest in overweight populations followed by obese and morbidly obese populations, whereas cachexia has the highest mortality.</p>","PeriodicalId":12589,"journal":{"name":"Future cardiology","volume":" ","pages":"283-290"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11980452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Future cardiologyPub Date : 2025-04-01Epub Date: 2025-03-21DOI: 10.1080/14796678.2025.2479970
Athanasios J Manolis, Peter Collins, José López-Sendón
{"title":"Diagnosing and treating stable angina: a contemporary approach for practicing physicians.","authors":"Athanasios J Manolis, Peter Collins, José López-Sendón","doi":"10.1080/14796678.2025.2479970","DOIUrl":"10.1080/14796678.2025.2479970","url":null,"abstract":"<p><p>Longer life expectancy and advancements in coronary artery disease management have improved life expectancy and survival, increasing the prevalence of chronic coronary syndromes (CCS). Angina is a common symptom in patients with CCS but remains underdiagnosed and undertreated. Contemporary guidelines provide detailed information on diagnosing and treating angina based on evidence and expert consensus; however, their extensive nature may hinder uptake by non-specialists. This review presents a practical approach to diagnosing stable angina, followed by the three pillars of CCS management: 1) healthy lifestyle including appropriate exercise, diet, and avoiding toxic habits; 2) optimal medical therapy, including treatment recommended to prevent cardiovascular events and drugs for the control of myocardial ischemia and angina tailored to the patient's comorbidities; and 3) myocardial revascularization when indicated. This approach may be useful for practicing physicians but is not intended to substitute more detailed and authoritative documents. Checklists are proposed to help focus patient-physician interactions and make follow-up visits more efficient. This approach seeks to increase the proportion of correct angina diagnoses and patients receiving evidence-based treatments, emphasizing the importance of patient education, managing residual angina, and reducing cardiovascular risk. We include reference to the recently published 2024 ESC guidelines on chronic coronary syndromes.</p>","PeriodicalId":12589,"journal":{"name":"Future cardiology","volume":" ","pages":"291-303"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11980508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Future cardiologyPub Date : 2025-04-01Epub Date: 2025-03-28DOI: 10.1080/14796678.2025.2481731
Ting-Yu Lin, Young-Fong Siew, Tse-Min Lu
{"title":"OCT-Guided covered stent implantation for acquired coronary aneurysm after bioresorbable vascular scaffold: case report.","authors":"Ting-Yu Lin, Young-Fong Siew, Tse-Min Lu","doi":"10.1080/14796678.2025.2481731","DOIUrl":"10.1080/14796678.2025.2481731","url":null,"abstract":"<p><p>Coronary artery aneurysm (CAA) formation following bioresorbable vascular scaffold (BVS) implantation is a rare but serious complication with no clear treatment guidelines. We report the case of a 56-year-old man with coronary artery disease (CAD) and a chronic total occlusion (CTO) in the left anterior descending artery (LAD) underwent full revascularization with BVS in 2016. Seven years later, he experienced recurrent angina, and angiography revealed 80% stenosis in the proximal LAD and a large coronary aneurysm in the middle LAD. Optical coherence tomography (OCT) confirmed a 5.88 mm aneurysm, which was treated with a PK Papyrus covered stent, while the proximal LAD stenosis was addressed with a Resolute Onyx drug-eluting stent (DES). After six months of standard dual antiplatelet therapy (DAPT) followed by three months of single antiplatelet therapy (SAPT), the patient developed in-stent restenosis (ISR) in the covered stent. This was successfully treated with high-pressure balloon angioplasty and a drug-eluting balloon (DEB). At the nine-month follow-up, the patient remained symptom-free. This case highlights the utility of OCT in evaluating CAAs and guiding covered stent deployment, while prolonged DAPT may help reduce the risk of very late stent thrombosis and future ischemic events, though further studies are needed.</p>","PeriodicalId":12589,"journal":{"name":"Future cardiology","volume":" ","pages":"269-273"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11980444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Future cardiologyPub Date : 2025-04-01Epub Date: 2025-03-21DOI: 10.1080/14796678.2025.2482369
Sriram Sunil Kumar, Sanjana Nagraj, Nathaniel Abittan, Ayelet Beilin, Sharanya Kaushik, Sophie Madlena Starosta, Mark Guelfguat
{"title":"Through the gap: a case series on managing Type B aortic dissection with multiple lumens and tears.","authors":"Sriram Sunil Kumar, Sanjana Nagraj, Nathaniel Abittan, Ayelet Beilin, Sharanya Kaushik, Sophie Madlena Starosta, Mark Guelfguat","doi":"10.1080/14796678.2025.2482369","DOIUrl":"10.1080/14796678.2025.2482369","url":null,"abstract":"<p><p>Aortic dissections are classified as Stanford Type A and B based on site of intimal dissection. Management of Type B dissections is guided by risk stratification. Complicated and high-risk Type B aortic dissections are managed either using endovascular or open surgical repair. Uncomplicated Type B dissections are managed medically. The role of the patency of the false lumen and the presence of reentry tears in the dissecting membrane are still contested. Here, we describe two cases of descending aortic dissections with varying anatomical features in the setting of cocaine use and uncontrolled hypertension. The first case uniquely had a triple lumen dissection with two true lumens, while the second case had two distal tears. Both patients initially had signs of reduced end organ perfusion that resolved with control of comorbid conditions. After multidisciplinary discussions, the decision was made to continue with anti-impulse treatment. Due to the radiological and biochemical absence of evidence of end organ injury even while visceral organs were supplied by the false lumen, our multidisciplinary team preferred conservative management with anti-impulse therapy. This serves as a demonstration of individualized management of Type B aortic dissection in patients with multiple comorbidities using carefully analyzed radiographic and biochemical evidence.</p>","PeriodicalId":12589,"journal":{"name":"Future cardiology","volume":" ","pages":"275-282"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11980449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Future cardiologyPub Date : 2025-04-01Epub Date: 2025-03-09DOI: 10.1080/14796678.2025.2476313
Helge Haarmann, Besir Hasan, Nibras Soubh, Eva Rasenack, Simon Schlögl, Markus Zabel, Leonard Bergau
{"title":"First experience with a new tool for automatic mapping of fragmented signals in a case report of cardioneuroablation.","authors":"Helge Haarmann, Besir Hasan, Nibras Soubh, Eva Rasenack, Simon Schlögl, Markus Zabel, Leonard Bergau","doi":"10.1080/14796678.2025.2476313","DOIUrl":"10.1080/14796678.2025.2476313","url":null,"abstract":"<p><p>Cardioneuroablation is a treatment option for patients with recurrent vasovagal syncope (VVS). Ablation targets of parasympathetic ganglionated plexi (GP) adjacent to the right and left atrial walls and distal endocardial inputs of these GP can be identified both by their anatomical localization and by intracardiac mapping of fragmented electrogram signals. In this case of a successful cardioneuroablation of a 22-year-old patient suffering from recurrent VVS, a new algorithm for automatic mapping of fragmented signals (CARTO Elevate Module, Biosense Webster) was used to identify areas of GP. In this first experience, automatic tags of fragmented signals were matching well with anatomically guided ablation points. This new tool for automatic identification of fragmented signals may facilitate and improve cardioneuroablation procedures.</p>","PeriodicalId":12589,"journal":{"name":"Future cardiology","volume":" ","pages":"265-268"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11980472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Future cardiologyPub Date : 2025-04-01Epub Date: 2025-03-07DOI: 10.1080/14796678.2025.2476351
Maisha Maliha, Vikyath Satish, Kuan Yu Chi, Amrin Kharawala, Sanjana Nagraj, Tinatin Saralidze, Nathaniel Abittan, Natalia Nazarenko, Gal Rubinstein, Riya Patel, Seth I Sokol, Robert T Faillaice, Leonidas Palaiodimos
{"title":"Introducing the use of AngioVac in nonbacterial thrombotic endocarditis: a systematic review.","authors":"Maisha Maliha, Vikyath Satish, Kuan Yu Chi, Amrin Kharawala, Sanjana Nagraj, Tinatin Saralidze, Nathaniel Abittan, Natalia Nazarenko, Gal Rubinstein, Riya Patel, Seth I Sokol, Robert T Faillaice, Leonidas Palaiodimos","doi":"10.1080/14796678.2025.2476351","DOIUrl":"10.1080/14796678.2025.2476351","url":null,"abstract":"<p><strong>Introduction: </strong>Nonbacterial thrombotic endocarditis (NBTE) involves vegetations on heart valves without active bloodstream infection. The AngioVac device, a vacuum-based aspiration system commonly used for infective endocarditis, has potential in managing NBTE, particularly in patients unsuitable for surgery. This study systematically reviews the literature to evaluate AngioVac's effectiveness in reducing vegetations in NBTE.</p><p><strong>Methods: </strong>A systematic literature review was conducted using PubMed, Embase, Cochrane, and Web of Science databases through February 2024. Primary outcome was procedural success, defined as a ≥ 50% reduction in vegetation size on transesophageal echocardiogram. Secondary outcomes included in-hospital mortality, hospital stay length, and procedural complications.</p><p><strong>Results: </strong>Out of 38 identified articles, 4 case reports met inclusion criteria. Patients were male with a median age of 60 years, and NBTE was associated with conditions such as lung adenocarcinoma, end-stage renal disease, and antiphospholipid syndrome. The mitral valve was the most commonly affected site. AngioVac achieved 100% procedural success, with no complications or in-hospital mortality. The average hospital stay was 2 days. Follow-up revealed one patient alive at 2 months, one deceased at 3 months and no data for two patients.</p><p><strong>Conclusion: </strong>AngioVac is a promising tool for safely reducing vegetations in NBTE, especially for high-risk surgical candidates.The study design and protocol are registered with PROSPERO International Prospective Register of Systematic Reviews (registration number CRD42024505295).</p>","PeriodicalId":12589,"journal":{"name":"Future cardiology","volume":" ","pages":"305-313"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11980514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Future cardiologyPub Date : 2025-04-01Epub Date: 2025-03-05DOI: 10.1080/14796678.2025.2472551
Venugopal Menon, Alexandra Hall
{"title":"Acute aortic regurgitation: a call for urgent intervention.","authors":"Venugopal Menon, Alexandra Hall","doi":"10.1080/14796678.2025.2472551","DOIUrl":"10.1080/14796678.2025.2472551","url":null,"abstract":"","PeriodicalId":12589,"journal":{"name":"Future cardiology","volume":" ","pages":"257-259"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11980511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Treatment options for heart failure in individuals with overweight or obesity: a review.","authors":"Athina Nasoufidou, Panagiotis Stachteas, Paschalis Karakasis, Christos Kofos, Efstratios Karagiannidis, Aleksandra Klisic, Djordje S Popovic, Theocharis Koufakis, Nikolaos Fragakis, Dimitrios Patoulias","doi":"10.1080/14796678.2025.2479378","DOIUrl":"10.1080/14796678.2025.2479378","url":null,"abstract":"<p><p>Obesity and heart failure are interlaced global epidemics, each contributing to significant morbidity and mortality. Obesity is not only a risk-factor for heart failure, but also complicates its management, by distinctive pathophysiological mechanisms and cumulative comorbidities, requiring tailored treatment plan. To present current treatment options for heart failure in individuals with overweight/obesity, emphasizing available pharmacological therapies, non-pharmacological strategies, and the management of related comorbidities. We conducted a comprehensive literature review regarding the results of heart failure treatments in individuals with overweight/obesity, including cornerstone interventions as well as emerging therapeutic options. Specific drug classes, including angiotensin receptor-neprilysin inhibitors, mineralocorticoid receptor antagonists, and sodium-glucose cotransporter-2 inhibitors, have demonstrated consistent efficacy in heart failure irrespective of body mass index, while diuretics remain a key for fluid management. Glucagon-like peptide-1 receptor agonists have shown promising results in improving relevant outcomes and warrant further research. Non-pharmacological approaches, including weight-loss strategies and lifestyle modifications, have shown to improve symptoms, exercise tolerance and quality of life. Managing heart failure in individuals with overweight/obesity requires a multidisciplinary, individualized approach integrating pharmacological and non-pharmacological options. Emerging therapies and preventive strategies arise to address the unique challenges in this population and provide improved outcomes.</p>","PeriodicalId":12589,"journal":{"name":"Future cardiology","volume":" ","pages":"315-329"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11980494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Future cardiologyPub Date : 2025-03-01Epub Date: 2025-02-28DOI: 10.1080/14796678.2025.2472590
Bryan Tornabene, David Waldron, Hannah Short, Nicholas Duca
{"title":"An unexpected battle with peripartum cardiomyopathy: a case report.","authors":"Bryan Tornabene, David Waldron, Hannah Short, Nicholas Duca","doi":"10.1080/14796678.2025.2472590","DOIUrl":"10.1080/14796678.2025.2472590","url":null,"abstract":"<p><p>Peripartum cardiomyopathy (PPCM) is a rare cardiomyopathy marked by systolic dysfunction that presents in late pregnancy or the early postpartum period with an ejection fraction (EF) of less than 45%. Diagnosing PPCM often presents a diagnostic dilemma due to its nonspecific clinical presentation, which usually resembles physiological changes of pregnancy or peripartum pulmonary embolism. Echocardiography is frequently used as a diagnostic modality of choice with management following the GDMT guidelines and delivery. This case presents a 23-year-old patient with a delayed diagnosis of PPCM, followed by a discussion of goal-directed medical therapy (GDMT) and the benefits of early diagnosis and treatment. Common pitfalls in diagnosing PPCM are introduced to encourage clinicians to consider PPCM during late pregnancy. Currently, a new clinical trial is underway investigating the efficacy of dopamine agonists in conjunction with GDMT for treatment of peripartum cardiomyopathy.</p>","PeriodicalId":12589,"journal":{"name":"Future cardiology","volume":" ","pages":"223-227"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11901409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}