Current Opinion in Cardiology最新文献

When is imaging needed to assess the response to treatment in cardiac amyloidosis. 什么时候需要影像学来评估对心脏淀粉样变性治疗的反应。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-05-22 DOI: 10.1097/HCO.0000000000001236

Shantanu P Sengupta, Prayag Kini

引用次数: 0

Revascularization in chronic coronary syndrome: shifts in clinical practice guidelines. 慢性冠脉综合征的血运重建术：临床实践指南的变化。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-05-15 DOI: 10.1097/HCO.0000000000001234

Maria Servito, Weiang Yan, Jenny Namkoong, Dominique Vervoort, Stephen E Fremes

{"title":"Revascularization in chronic coronary syndrome: shifts in clinical practice guidelines.","authors":"Maria Servito, Weiang Yan, Jenny Namkoong, Dominique Vervoort, Stephen E Fremes","doi":"10.1097/HCO.0000000000001234","DOIUrl":"https://doi.org/10.1097/HCO.0000000000001234","url":null,"abstract":"Purpose of review: The optimal revascularization strategy for chronic coronary syndrome (CCS) is rapidly evolving due to emerging evidence and technological advancements. This review will discuss the guidelines for the management of CCS, examining how they align with and respond to recent high-quality studies. We will also discuss the evolution of the guidelines and highlight key differences.Recent findings: While broad consensus exists between the most recent European and American guidelines, notable differences exist in the management of multivessel disease with preserved ejection fraction and left main disease. The role of the Heart Teams has become increasingly vital particularly when the guidelines do not fit the clinical scenarios, and the evidence is controversial.Summary: Determining the optimal management strategy for patients with CCS requires careful consideration of anatomic complexity, comorbidities, and individual patient preferences. While advances in percutaneous coronary intervention (PCI) and medical therapy have been widely discussed, it is equally important to contextualize these with emerging innovations in surgical revascularization. Techniques such as multiple arterial grafting and minimally invasive surgical approaches represent significant progress in coronary artery bypass surgery. Randomized trials that compare state-of-the-art percutaneous and surgical revascularization techniques are thus needed.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Anabolic-androgenic steroids among recreational athletes and cardiovascular risk. 休闲运动员中的合成代谢雄激素类固醇与心血管风险。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-05-15 DOI: 10.1097/HCO.0000000000001235

Sean Meagher, Michael S Irwig, Prashant Rao

{"title":"Anabolic-androgenic steroids among recreational athletes and cardiovascular risk.","authors":"Sean Meagher, Michael S Irwig, Prashant Rao","doi":"10.1097/HCO.0000000000001235","DOIUrl":"https://doi.org/10.1097/HCO.0000000000001235","url":null,"abstract":"Purpose of review: The use of androgenic anabolic steroids (AAS) is rising, particularly among recreational athletes. This review addresses growing concerns about the underrecognized cardiovascular and multiorgan consequences of chronic AAS exposure with a focus on noncompetitive populations.Recent findings: It is well documented that AAS use enhances muscle mass and strength, but at the cost of multisystem toxicity including endocrine disruption, hepatotoxicity, and mood disorders. Emerging evidence highlights the profound cardiovascular impact of AAS use, including elevated blood pressure, adverse lipid profiles, accelerated atherosclerosis, subclinical cardiomyopathy, and increased risk of myocardial infarction and sudden cardiac death. Structural and functional cardiac abnormalities such as left ventricular hypertrophy, ventricular dysfunction, and arterial stiffness have been reported, with some changes persisting after cessation.Summary: AAS use carries multisystem risks with evidence for adverse cardiovascular remodeling and atherogenesis. Clinicians caring for athletes using AAS should recognize patterns of AAS use and provide risk stratification, monitoring, and tapering strategies. Future research should prioritize long-term outcomes, sex-specific effects, and multidisciplinary approaches to care.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Neurodevelopmental outcomes in congenital heart disease: modifiable and nonmodifiable substrates. 先天性心脏病的神经发育结局：可改变和不可改变的基础。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-05-14 DOI: 10.1097/HCO.0000000000001218

Kelly Wolfe, Shabnam Peyvandi

{"title":"Neurodevelopmental outcomes in congenital heart disease: modifiable and nonmodifiable substrates.","authors":"Kelly Wolfe, Shabnam Peyvandi","doi":"10.1097/HCO.0000000000001218","DOIUrl":"https://doi.org/10.1097/HCO.0000000000001218","url":null,"abstract":"Purpose of review: Neurodevelopmental impairments are the most common comorbidity among children, adolescents, and adults with congenital heart disease (CHD). Despite significant advances in operative and perioperative care resulting in increased survival, neurodevelopmental impairments remain prevalent in this population. Neurodevelopmental impairments, though subtle, can have a major impact on quality of life, attainment of independence and societal contribution. In this review, we summarize current knowledge on neurodevelopmental outcomes in the CHD population, including neuroimaging findings, known risk factors and opportunities to optimize outcomes.Recent findings: Several risk factors have been identified contributing to neurodevelopmental impairments across the lifespan. These include risk factors originating in the prenatal period and new risk factors that are acquired in adulthood. The risk factors encompass several categories, including genetic abnormalities, aberrant cardiovascular physiology, environmental factors, social determinants of health and mental health. Many risk factors can be considered modifiable, though large multicenter studies identifying the most salient risk factors for neurodevelopmental impairment are lacking.Summary: In this review, we identify potentially modifiable risk factors for neurodevelopmental impairment in the CHD population that can be studies in future neuroprotective clinical trials.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hypertension after solid-organ transplantation: special considerations for management. 实体器官移植后高血压：处理的特殊考虑。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-05-06 DOI: 10.1097/HCO.0000000000001230

Jason Feliberti, Amit Alam, Christopher Maulion

{"title":"Hypertension after solid-organ transplantation: special considerations for management.","authors":"Jason Feliberti, Amit Alam, Christopher Maulion","doi":"10.1097/HCO.0000000000001230","DOIUrl":"https://doi.org/10.1097/HCO.0000000000001230","url":null,"abstract":"Purpose of review: Hypertension is one of the most common comorbidities affecting patients after solid organ transplantation. Here we review the mechanisms leading to hypertension, along with common practices in terms of medical management. Glucagon-like peptide-1 receptor (GLP-1R) agonists, baroreflex therapy, and renal denervation are common interventions utilized prior to heart transplant. Special considerations for their management throughout the perioperative and postoperative period are covered here.Recent findings: Most common medical management includes utilization of calcium channel blockers, followed by angiotensin-converting enzyme inhibitors and angiotensin receptor blockers. GLP-1R agonists have shown significant benefit in recent cardiovascular outcome trials. Preoperative management centers around risks associated with slowed gastric emptying, while reinitiation after heart transplant must take into consideration initiation and tolerance of immunosuppressive therapies. Baroreflex activation therapy has been approved for therapy of heart failure, with many patients proceeding to heart transplant. The device is frequently deactivated after transplantation, with little published experience regarding reinitiation of therapy after heart transplant. There is renewed interest in renal denervation as a treatment for refractory hypertension. The incidence of hypertension after heart transplant in those patients that have undergone previous renal denervation remains unknown, however there is limited experience with its use after renal transplant.Summary: Further studies are required to elucidate optimal medical management of hypertension following heart transplantation. GLP-1R agonists, baroreflex activation therapy, and renal denervation are emerging therapies prior to transplant that require further investigation.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pulmonary hypertension in 2025: next steps? 2025年肺动脉高压：下一步？

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-05-02 DOI: 10.1097/HCO.0000000000001228

Kinjal Parikh

引用次数: 0

Ultrasound-Based assessment of systemic congestion in pulmonary hypertension. 肺动脉高压全身性充血的超声评估。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-05-02 DOI: 10.1097/HCO.0000000000001227

Pei-Lun Lee, Laura Marcela Romero Acero, Michele Nanna

{"title":"Ultrasound-Based assessment of systemic congestion in pulmonary hypertension.","authors":"Pei-Lun Lee, Laura Marcela Romero Acero, Michele Nanna","doi":"10.1097/HCO.0000000000001227","DOIUrl":"https://doi.org/10.1097/HCO.0000000000001227","url":null,"abstract":"Purpose of review: Systemic congestion is a common manifestation in pulmonary hypertension (PH) associated with morbidity and mortality. Its extent can be difficult to define and is usually determined by subjective medical history and physical examinations, leading to delay in decision-making. We conducted a literature review to collect evidence on imaging tools aimed at detecting and defining severity of venous congestion in PH.Recent findings: We discussed pathophysiology and outlined a structured approach in the management of venous congestion. Point-of-care ultrasound becomes more accessible and aids in gauging the severity of systemic congestion. Venous excess ultrasound (VExUS) grading system analyzes the inferior vena cava, hepatic vein, portal vein, and intrarenal vein and provides a comprehensive assessment of systemic congestion. Nonetheless, almost all available studies were performed in unselected populations, and data on PH is scarce. Herein, we discuss the imaging methods proposed in systemic congestion as they apply to PH.Summary: VExUS offers fast, convenient assessment of volume status. Despite the promising data on VExUS, it should be emphasized that ultrasound should be placed in the context of a comprehensive evaluation and should not replace basic examination. Further research is needed to establish its role in PH and verify its clinical utility in guiding fluid management.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hypertension in chronic kidney disease and future heart failure. 高血压在慢性肾脏疾病和未来的心力衰竭。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-05-01 Epub Date: 2025-02-10 DOI: 10.1097/HCO.0000000000001206

Michel Burnier

{"title":"Hypertension in chronic kidney disease and future heart failure.","authors":"Michel Burnier","doi":"10.1097/HCO.0000000000001206","DOIUrl":"10.1097/HCO.0000000000001206","url":null,"abstract":"Purpose of review: Hypertension and chronic kidney diseases (CKDs) are known risk factors for the development or worsening of heart failure. In last years, several new therapeutic approaches for the management of people with diabetic and nondiabetic CKD and hypertension have been investigated. In this brief review, the most recent findings regarding the ability of SGLT-2 inhibitors and nonsteroidal mineralocorticoid receptor antagonists (nsMRA) and GLP-1 receptor agonists to prevent heart failure in patients with hypertension and CKD will be discussed.Recent findings: In the last 3 years, several large clinical trials involving very large numbers of CKD patients have been published showing that these new therapeutic approaches significantly reduce the risk of heart failure events and hospitalizations in patients with diabetic and nondiabetic nephropathies and hypertension as well as in patients with heart failure without nephropathy. Moreover, these drugs retard the progression of CKD towards end-stage kidney disease.Summary: These observations already have a major impact on the management of people with hypertension and CKD. SGLT-2 inhibitors are now recommended as first-line therapy in people with diabetes, CKD and heart failure. The use of nsMRA is increasing and could replace spironolactone over time in heart failure as well as in early CKD stages.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"158-163"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cardiac phenotypes in LMNA mutations. LMNA突变中的心脏表型。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-05-01 Epub Date: 2025-02-17 DOI: 10.1097/HCO.0000000000001209

Leila Rouhi

{"title":"Cardiac phenotypes in LMNA mutations.","authors":"Leila Rouhi","doi":"10.1097/HCO.0000000000001209","DOIUrl":"10.1097/HCO.0000000000001209","url":null,"abstract":"Purpose of review: This review highlights the diverse cardiac manifestations of LMNA mutations, focusing on their underlying molecular mechanisms and clinical implications. As LMNA mutations are implicated in cardiomyopathies, such as dilated cardiomyopathy (DCM), arrhythmogenic cardiomyopathy (ARVC), and conduction system diseases, understanding these phenotypes is critical for advancing diagnosis and management strategies.Recent findings: Recent studies reveal that LMNA mutations disrupt nuclear envelope stability, activating the DNA damage response (DDR) and compromising chromatin organization and mechanotransduction. Mouse models have elucidated pathways linking LMNA dysfunction to fibrosis, arrhythmias, and myocardial remodeling. Emerging evidence demonstrates that fibroblasts play a crucial role in cardiac phenotypes. Advances in genetic screening have also underscored the importance of early identification and risk stratification, particularly for arrhythmias and sudden cardiac death.Summary: The diverse spectrum of LMNA-related cardiac phenotypes, from isolated conduction defects to severe DCM and ARVC, underscores the necessity of personalized care strategies. Bridging insights from molecular studies and clinical research paves the way for targeted therapies to slow disease progression and improve patient outcomes. Future efforts should prioritize translational research on molecular mechanisms with potential in mouse models, alongside a deeper exploration of genotype-phenotype correlations, to refine and implement effective therapeutic interventions.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"131-138"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Genetics, manifestations, and management of catecholaminergic polymorphic ventricular tachycardia. 儿茶酚胺能多形性室性心动过速的遗传学、表现和管理。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-05-01 Epub Date: 2025-01-20 DOI: 10.1097/HCO.0000000000001202

Shubh Desai, Oliver M Moore, Xander H T Wehrens

{"title":"Genetics, manifestations, and management of catecholaminergic polymorphic ventricular tachycardia.","authors":"Shubh Desai, Oliver M Moore, Xander H T Wehrens","doi":"10.1097/HCO.0000000000001202","DOIUrl":"10.1097/HCO.0000000000001202","url":null,"abstract":"Purpose of review: Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a devastating heritable channelopathy that can lead to sudden cardiac death in children and young adults. This review aims to explore genetics, the cardiac and extracardiac manifestations of mutations associated with CPVT, and the challenges involved with managing phenotypically variable variants.Recent findings: The understanding of the genetics and mechanisms of CPVT continues to grow with recent discoveries including alternative splicing of cardiac TRDN and calmodulin gene variants. Additionally, there is an increasing recognition of the extra-cardiac manifestations such as epilepsy, neurodevelopmental delay, and glucose homeostasis abnormalities in RyR2 variant carriers. Advances in precision medicine, including the development of iPSC-derived cardiomyocytes, are valuable models for developing targeted therapeutics.Summary: CPVT remains a complex disorder with cardiac and neurological manifestations impacting management. Early genetic testing and personalized treatment, including beta-blockers, flecainide, and ICDs, is important in improving outcomes. Ongoing research into the mechanism of each mutation will help in developing more effective, personalized therapeutics.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"150-157"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0