Aneel S. Maini, Mansi Maini, Tayo Addo, Vivek Koshti, Thomas Koshy, James A. de Lemos, Angela Price, Dharam J. Kumbhani
{"title":"The current state and future of renal denervation: A review","authors":"Aneel S. Maini, Mansi Maini, Tayo Addo, Vivek Koshti, Thomas Koshy, James A. de Lemos, Angela Price, Dharam J. Kumbhani","doi":"10.1016/j.tcm.2024.08.005","DOIUrl":"10.1016/j.tcm.2024.08.005","url":null,"abstract":"<div><div>Renal denervation as an option for difficult to treat hypertension has been a concept for several decades, with recent U.S. FDA approval of new, minimally invasive devices. However, while renal denervation has the potential to improve hypertension management, several challenges require consideration prior to widespread adoption. The effect relative to sham control is modest, and generally similar to addition of a single blood pressure lowering medication. It is possible that with additional technique refinement greater effects may be possible. Key factors to consider beyond the direction, strengths, and limitations of the renal denervation technologies themselves, are an understanding of patient groups that derive greatest benefit and phenotypes or biomarkers that predict greater response. This review provides an update on these challenges in addition to the current state and future of renal denervation within the context of hypertension management and treatment.</div></div>","PeriodicalId":51199,"journal":{"name":"Trends in Cardiovascular Medicine","volume":"35 2","pages":"Pages 96-104"},"PeriodicalIF":7.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114539","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":"Cardiovascular-liver-metabolic health: Time to integrate liver assessment into cardiology practice?","authors":"Luan C V Lima, Lubna Al-Sharif, Matheus Souza","doi":"10.1016/j.tcm.2025.01.003","DOIUrl":"10.1016/j.tcm.2025.01.003","url":null,"abstract":"","PeriodicalId":51199,"journal":{"name":"Trends in Cardiovascular Medicine","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048636","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}
Panteleimon E Papakonstantinou, José Miguel Rivera-Caravaca, Mauro Chiarito, Hanne Ehrlinder, Panayiotis Iliakis, Aleksandra Gąsecka, Giulio Francesco Romiti, William A E Parker, Gregory Y H Lip
{"title":"Atrial fibrillation versus atrial myopathy in thrombogenesis: Two sides of the same coin?","authors":"Panteleimon E Papakonstantinou, José Miguel Rivera-Caravaca, Mauro Chiarito, Hanne Ehrlinder, Panayiotis Iliakis, Aleksandra Gąsecka, Giulio Francesco Romiti, William A E Parker, Gregory Y H Lip","doi":"10.1016/j.tcm.2025.01.002","DOIUrl":"10.1016/j.tcm.2025.01.002","url":null,"abstract":"<p><p>Atrial fibrillation (AF) and atrial myopathy are recognized contributors to cardiovascular morbidity, particularly ischemic stroke. AF poses an elevated risk of thrombogenesis due to irregular heart rhythm leading to blood stasis and clot formation. Atrial myopathy, marked by structural and functional alterations in the atria, is emerging as a crucial factor influencing thromboembolic events, independently of AF. This narrative review article provides an overview of the interwoven relationship between AF and atrial myopathy in thrombogenesis, focusing on the epidemiology, risk factors, and clinical implications of these two entities. The discussion encompasses the association between AF burden and stroke risk, evaluating current evidence and guidelines for anticoagulant therapy. Additionally, it explores the role of atrial myopathy in the pathogenesis of thromboembolic events, emphasizing the patient's clinical profile assessed by the CHA<sub>2</sub>DS<sub>2</sub>-VASc score. The manuscript provides insights into ongoing trials and future perspectives, discussing potential advancements in antithrombotic therapy, fibrin clot dynamics, and anti-inflammatory strategies. This comprehensive review challenges the conventional perception of AF as a sole cause of stroke, urging a holistic approach to risk assessment of thrombogenesis and management in the high-risk population that AF patients constitute.</p>","PeriodicalId":51199,"journal":{"name":"Trends in Cardiovascular Medicine","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043317","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}
Antonis A Manolis, Theodora A Manolis, Apostolos Vouliotis, Antonis S Manolis
{"title":"Metabolic Dysfunction-Associated Steatotic Liver Disease and the Cardiovascular System.","authors":"Antonis A Manolis, Theodora A Manolis, Apostolos Vouliotis, Antonis S Manolis","doi":"10.1016/j.tcm.2025.01.001","DOIUrl":"https://doi.org/10.1016/j.tcm.2025.01.001","url":null,"abstract":"<p><p>Metabolic dysfunction-associated steatotic liver disease (MASLD), previously termed nonalcoholic fatty-liver disease, is an important and rising health issue with a link with atherosclerotic cardiovascular (CV) disease (CVD), affecting ∼25-30% of the adults in the general population; in patients with diabetes, its prevalence culminates to ∼70%; its evolutive form, nonalcoholic steatohepatitis, is estimated to be the main cause of liver transplantation in the future. MASLD is a multisystem disease that affects, besides the liver, extra-hepatic organs and regulatory pathways; it raises the risk of type 2 diabetes mellitus (T2D), CVD, and chronic kidney disease; the disease may also progress to hepatocellular carcinoma. Its diagnosis requires hepatic steatosis and at least one cardiometabolic risk factor and the exclusion of both significant alcohol consumption and other competing causes of chronic liver disease. Beyond CV events, associated metabolic comorbidities comprise obesity (∼50%), T2D (∼20%), hyperlipidemia (∼70%), hypertension (∼40%), and metabolic syndrome (∼40%). Among the various clinical events, CV events mostly determine prognosis as they are the leading cause of death in these patients. Regarding management, statins exert beneficial effects in improving liver injury; silybin, derived from Silybum marianum, has some protective effects; lifestyle modification, such as weight loss, dietary changes, physical exercise, and abstention from alcohol use combined with optimal management of comorbidities are most helpful. Bariatric surgery may be an option in persons with MASLD and obesity. Adults with non-cirrhotic MASLD and significant liver fibrosis may be candidates for targeted treatment with resmetirom, which has histological efficacy on steatohepatitis and fibrosis with an acceptable safety and tolerability profile, whereas, no MASLD-targeted pharmacotherapy can be beneficial in the cirrhotic stage, whereby other measures may include metabolic drugs, nutritional counseling, surveillance for portal hypertension and hepatocellular carcinoma, and finally, liver transplantation in decompensated cirrhosis.</p>","PeriodicalId":51199,"journal":{"name":"Trends in Cardiovascular Medicine","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029875","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":"Takotsubo syndrome: Be happy, then worry?","authors":"J D Horowitz, A M Kucia, T H Nguyen","doi":"10.1016/j.tcm.2024.12.012","DOIUrl":"https://doi.org/10.1016/j.tcm.2024.12.012","url":null,"abstract":"","PeriodicalId":51199,"journal":{"name":"Trends in Cardiovascular Medicine","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973187","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":"Exploring the complex interplay between alcohol consumption and cardiovascular health: Mechanisms, evidence, and future directions.","authors":"Dae-In Lee, Sunwon Kim, Dong Oh Kang","doi":"10.1016/j.tcm.2024.12.011","DOIUrl":"10.1016/j.tcm.2024.12.011","url":null,"abstract":"<p><p>This review article explores the intricate relationship between alcohol consumption and cardiovascular health, underscoring on both clinical outcomes and underlying pathophysiological mechanisms. It examines the complex dose-response relationships for various cardiovascular disease (CVD) subtypes, including coronary heart disease, stroke, and atrial fibrillation, while categorizing pathophysiological mechanisms into three conceptual areas: primary initiating factors, secondary transmission pathways, and end-organ effects. Although mild-to-moderate alcohol consumption may confer some benefits for cardiovascular health and certain CVD subtypes, growing evidence highlights the importance of lifestyle modifications to reduce alcohol intake, particularly among heavy drinkers. This review provides a comprehensive overview of current knowledge, emphasizes the need for future research with robust methodologies, and advocates for incorporating updated scientific evidence into personalized approaches within international cardiovascular and national guidelines.</p>","PeriodicalId":51199,"journal":{"name":"Trends in Cardiovascular Medicine","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933466","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":"Thromboembolic risk and oral anticoagulation in subclinical atrial fibrillation","authors":"Felix K. Wegner, Lars Eckardt","doi":"10.1016/j.tcm.2024.04.001","DOIUrl":"10.1016/j.tcm.2024.04.001","url":null,"abstract":"<div><div>Availability of devices capable of continuous rhythm monitoring such as smartwatches, implantable loop recorders, or pacemakers/defibrillators is continuously increasing. Importantly, device detected “subclinical” atrial fibrillation seems to convey a significantly lower risk of thromboembolism than “clinical” atrial fibrillation verified by a conventional ECG recording. While current guidelines indicate a possible role of oral anticoagulation in selected high-risk patients with subclinical AF, recent trials show an ambiguous risk/benefit relationship of anticoagulation in this setting. The present review therefore summarizes current data on the role of oral anticoagulation in subclinical AF, aims at aiding in the decision process of anticoagulation, and illustrates current gaps in evidence regarding subclinical AF.</div></div>","PeriodicalId":51199,"journal":{"name":"Trends in Cardiovascular Medicine","volume":"35 1","pages":"Pages 1-7"},"PeriodicalIF":7.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140776030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jeffrey Shi Kai Chan , Raymond Ngai Chiu Chan , Yan Hiu Athena Lee , Danish Iltaf Satti , Edward Christopher Dee , Kenrick Ng , Alexandru Achim , Chi Fai Ng , Tong Liu , Gareth D K Matthews , Gary Tse , Vassilios S Vassiliou
{"title":"Cardiovascular health of patients with cancer: Challenges abound","authors":"Jeffrey Shi Kai Chan , Raymond Ngai Chiu Chan , Yan Hiu Athena Lee , Danish Iltaf Satti , Edward Christopher Dee , Kenrick Ng , Alexandru Achim , Chi Fai Ng , Tong Liu , Gareth D K Matthews , Gary Tse , Vassilios S Vassiliou","doi":"10.1016/j.tcm.2024.04.004","DOIUrl":"10.1016/j.tcm.2024.04.004","url":null,"abstract":"<div><div>Patients with cancer have elevated cardiovascular risks compared to those without cancer. As cancer incidence increases and cancer-related mortality decreases, cardiovascular diseases in patients with a history of cancer will become increasingly important. This in turn is reflected by the exponentially increasing amount of cardio-oncology research in recent years. This narrative review aims to summarize the key existing literature in several main areas of cardio-oncology, including the epidemiology, natural history, prevention, management, and determinants of the cardiovascular health of patients with cancer, and identify relevant gaps in evidence for further research.</div></div>","PeriodicalId":51199,"journal":{"name":"Trends in Cardiovascular Medicine","volume":"35 1","pages":"Pages 24-31"},"PeriodicalIF":7.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140788752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Editorial commentary: How to build an actionable narrative for cardio-oncology","authors":"Mark T. Nolan , Doan T.M. Ngo , Aaron L. Sverdlov","doi":"10.1016/j.tcm.2024.06.001","DOIUrl":"10.1016/j.tcm.2024.06.001","url":null,"abstract":"","PeriodicalId":51199,"journal":{"name":"Trends in Cardiovascular Medicine","volume":"35 1","pages":"Pages 32-33"},"PeriodicalIF":7.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141477930","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 role of genetic testing in management and prognosis of individuals with inherited cardiomyopathies","authors":"Sophie Hespe , Belinda Gray , Rajesh Puranik , Stacey Peters , Joanna Sweeting , Jodie Ingles","doi":"10.1016/j.tcm.2024.06.002","DOIUrl":"10.1016/j.tcm.2024.06.002","url":null,"abstract":"<div><div>Inherited cardiomyopathies are a heterogeneous group of heart muscle conditions where disease classification has traditionally been based on clinical characteristics. However, this does not always align with genotype. While there are well described challenges of genetic testing, understanding the role of genotype in patient management is increasingly required. We take a gene-by-gene approach, reviewing current evidence for the role of genetic testing in guiding prognosis and management of individuals with inherited cardiomyopathies. In particular, focusing on causal variants in genes definitively associated with arrhythmogenic cardiomyopathy, dilated cardiomyopathy, and hypertrophic cardiomyopathy. This review identifies genotype-specific disease sub-groups with strong evidence supporting the use of genetics in clinical management and highlights that at present, the spectrum of clinical utility is not reflected in current guidelines. Of 13 guideline or expert consensus statements for management of cardiomyopathies, there are seven gene-specific therapeutic recommendations that have been published from four documents. Understanding how genotype influences phenotype provides evidence for the role of genetic testing for prognostic and therapeutic purposes, moving us closer to precision-medicine based care.</div></div>","PeriodicalId":51199,"journal":{"name":"Trends in Cardiovascular Medicine","volume":"35 1","pages":"Pages 34-44"},"PeriodicalIF":7.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617558","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}