Trends in Cardiovascular Medicine最新文献

{"title":"Single pill combination therapy for hypertension: New evidence and new challenges: Combination Therapy for Hypertension.","authors":"Martin Rosas-Peralta, Giuseppe Mancia, Miguel Camafort, Héctor Galván-Oseguera, Carlos M Ferrario, Luis Alcocer, Ernesto Cardona-Muñoz, Humberto Álvarez-López, Silvia Palomo-Piñón, Adolfo Chávez-Mendoza, Enrique Díaz-Díaz, José M Enciso-Muñoz","doi":"10.1016/j.tcm.2025.06.004","DOIUrl":"10.1016/j.tcm.2025.06.004","url":null,"abstract":"<p><p>Hypertension (HTN) continues to be one of the most important risk factors for major cardiovascular events and mortality. The global prevalence of hypertension is approximately 30% among adults over 20 years old. Cardiovascular risk stratification is crucial to determine the most appropriate pharmacological therapeutic strategy for hypertensive patients. Despite the many scales to stratify risk, none is perfect and represents weighted mathematical models to determine risk at 10 years. Reports have identified numerous limitations, and the challenge persists. A practical way to determine CV risk is the clinical approach based on 1) the number of risk factors, 2) the degree of elevation of blood pressure, 3) the presence of target organ damage/DM/CKD, and 4) a history of major cardiovascular events. Currently, it is recommended to start with dual therapy in a single pill (either ACE inhibitors or ARB2 + dihydropyridine calcium channel blockers or thiazide/thiazide-like diuretic); however, many patients could need to start with triple therapy (low or standard doses) if they belong to the high- or very high-risk group with elevation grade 2 or 3 of blood pressure. This article discusses this topic and establishes some practical recommendations for the physician of first contact.</p>","PeriodicalId":51199,"journal":{"name":"Trends in Cardiovascular Medicine","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Calcium modification techniques.","authors":"James Cotton, Lampson Fan","doi":"10.1016/j.tcm.2025.06.006","DOIUrl":"10.1016/j.tcm.2025.06.006","url":null,"abstract":"","PeriodicalId":51199,"journal":{"name":"Trends in Cardiovascular Medicine","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single pill combination therapy for hypertension management: Clinical benefits and considerations.","authors":"Keisuke Narita","doi":"10.1016/j.tcm.2025.06.007","DOIUrl":"10.1016/j.tcm.2025.06.007","url":null,"abstract":"","PeriodicalId":51199,"journal":{"name":"Trends in Cardiovascular Medicine","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute myocardial infarction in patients without standard modifiable risk factors -A state-of-the-art review.","authors":"Dimitrios V Moysidis, Andreas S Papazoglou, Vasileios Anastasiou, Stylianos Daios, Efstratios Karagiannidis, Barbara Fyntanidou, Vasileios Kamperidis, Matthaios Didagelos, George Giannakoulas, Antonios Ziakas, Georgios Giannopoulos, Vassilios Vassilikos","doi":"10.1016/j.tcm.2025.06.005","DOIUrl":"10.1016/j.tcm.2025.06.005","url":null,"abstract":"<p><p>Acute myocardial infarction (AMI) in patients without standard modifiable risk factors (SMuRFs) is an increasingly recognized clinical entity. Traditionally, AMI has been closely associated with SMuRFs: hypertension, diabetes, dyslipidemia, and smoking. However, a subset of patients experience AMI without any of these established risk factors, posing diagnostic and therapeutic challenges. The true prevalence of AMI in SMuRF-less patients remains unclear, and the pathogenesis of coronary artery disease in these individuals is poorly understood. Current evidence suggests that unique mechanisms, including genetic predispositions and epigenetic modifications, inflammation, mental health and other non-traditional risk factors may contribute, though these remain to be clearly defined. Furthermore, the outcomes of SMuRF-less AMI present heterogeneity. In this review, we aim to examine the available literature on the underlying pathogenesis, potential causes of AMI in SMuRF-less patients, and their short- and long-term clinical outcomes compared to AMI patients with traditional risk factors. This knowledge could contribute to developing tailored treatment strategies and improving outcomes for this patient group.</p>","PeriodicalId":51199,"journal":{"name":"Trends in Cardiovascular Medicine","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ventricular arrhythmias and older women.","authors":"Nanette K Wenger","doi":"10.1016/j.tcm.2025.06.003","DOIUrl":"10.1016/j.tcm.2025.06.003","url":null,"abstract":"","PeriodicalId":51199,"journal":{"name":"Trends in Cardiovascular Medicine","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Etiology-specific survival and reoperation trends following surgical mitral valve repair and replacement: A meta-analysis of reconstructed time-to-event data.","authors":"Mohammed Al-Tawil, Serge Sicouri, Yoshiyuki Yamashita, Basel Ramlawi","doi":"10.1016/j.tcm.2025.06.002","DOIUrl":"10.1016/j.tcm.2025.06.002","url":null,"abstract":"<p><p>Current American and European guidelines recommend mitral valve repair (MVr) over replacement (MVR) whenever feasible. However, these recommendations are primarily based on data from patients with degenerative mitral regurgitation (DMR), whereas evidence supporting MVr in other etiologies, such as infective endocarditis (IE) or ischemic mitral regurgitation (IMR), remains less conclusive. We systematically searched for and identified studies published after 2000 that compared MVr and MVR in patients with specific mitral valve disease etiologies, including DMR, IE, IMR, and rheumatic heart disease (RHD). A total of 61 records (10 DMR, 21 IE, 18 IMR, and 12 RHD) of 59 studies published between 2005 and 2024, were included. MVr consistently demonstrated superior survival compared to MVR in DMR and IE patients. Parametric time-varying hazard ratios revealed a sustained survival benefit of MVr in DMR and IE, whereas in IMR and RHD, the survival advantage was transient-lasting only up to six months and 2.7 years postoperatively, respectively-after which survival hazards between MVr and MVR became comparable. This was further corroborated by the results of a two-year landmark and the propensity-matched subgroup analyses. In DMR, MVr was associated with lower reoperation rates compared to MVR; however, in IE, IMR, and RHD, MVr was associated with significantly higher reoperation rates compared to MVR. Our study supports current guidelines favoring MVr over MVR, demonstrating sustained survival benefits in DMR. In IE-specific MR, MVr also showed consistent benefits over MVR, demonstrating that MVr should be prioritized when feasible. However, in IMR and RHD, there was no notable survival advantage of MVr over MVR, with higher reoperation rates observed with MVr. These findings highlight the need for etiology-specific and individualized surgical planning.</p>","PeriodicalId":51199,"journal":{"name":"Trends in Cardiovascular Medicine","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammasome and ventricular arrhythmogenesis: Pathogenic interplay and potential targets on the horizon.","authors":"Maria Lucia Narducci, Cristina Conte, Alessandro Telesca, Giovanna Liuzzo, Massimo Imazio","doi":"10.1016/j.tcm.2025.05.006","DOIUrl":"10.1016/j.tcm.2025.05.006","url":null,"abstract":"<p><p>Life-threatening ventricular arrhythmias (VAs) pose a significant challenge in clinical management due to their impact on mortality, particularly the risk of sudden cardiac death, which remains a concern despite the use of only partially effective anti-arrhythmic drugs and repeated catheterablation. There is also a need for more precise risk stratification tools for implantable cardioverter defibrillators (ICD). Sustained ventricular tachycardia (VT) most commonly occurs in patients with a history of myocardial infarction (MI) or non ischemic cardiomyopathy characterized by fibrotic ventricular scars, which can be identified as areas of late gadolinium enhancement (LGE) through cardiac magnetic resonance or as low-voltage areas via three-dimensional electroanatomic mapping. Both the presence and extent of cardiac fibrosis are linked to ventricular arrhythmogenesis and the risk of sudden death. Fibrosis contributes to VAs for several reasons; primarily, it causes structural remodelling that alters the myocardial architecture and promotes reentry circuits. On this regard, increasing evidence highlights the role of inflammation mediated by the NLR family pyrin domain containing 3 (NLRP3) inflammasome as a key factor in scar development, cardiac electrical instability, and disease progression. Secondly, systemic and local sympathetic hyperactivity significantly contribute to electrical instability. The interplay between inflammation, cardiac fibrosis and sympathetic hyperactivity has been neglected for a long time. However, a deep insight in the pathogenesis of VAs is warranted in order to develop new and tailored pharmacological strategies. Therefore, the NLRP3 inflammasome pathway, autonomic imbalance, and early stage of myocardial fibrosis may represent promising therapeutic targets for mitigating adverse ventricular remodeling and the burden of VAs. On this basis of multiple evidence, inflammation plays a role of trigger in a hypothetical Coumel's triangle of arrhythmogenesis for the pathogenesis of VAs, where the ventricular substrate is represented by cardiac fibrosis, and the favoring modulating factor is provided by sympathetic hyperactivity.</p>","PeriodicalId":51199,"journal":{"name":"Trends in Cardiovascular Medicine","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial commentary: Finerenone as an additional therapeutic strategy in heart failure.","authors":"Bianca Larroux, Aldo Bonaventura","doi":"10.1016/j.tcm.2025.06.001","DOIUrl":"10.1016/j.tcm.2025.06.001","url":null,"abstract":"","PeriodicalId":51199,"journal":{"name":"Trends in Cardiovascular Medicine","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac neuromodulation to treat ventricular arrhythmias.","authors":"Saori Asada, Hiroshi Morita","doi":"10.1016/j.tcm.2025.05.007","DOIUrl":"10.1016/j.tcm.2025.05.007","url":null,"abstract":"","PeriodicalId":51199,"journal":{"name":"Trends in Cardiovascular Medicine","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The cardiorespiratory fitness gap.","authors":"Barbara Cifra, Robert M Hamilton","doi":"10.1016/j.tcm.2025.05.004","DOIUrl":"10.1016/j.tcm.2025.05.004","url":null,"abstract":"","PeriodicalId":51199,"journal":{"name":"Trends in Cardiovascular Medicine","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}