Current Opinion in Cardiology最新文献

Broadening the applicability of coronary surgery from minimally invasive approaches to the modern treatment of ventricular septal rupture. 拓宽冠状动脉手术从微创入路到室间隔破裂现代治疗的适用性。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-11-01 Epub Date: 2025-10-02 DOI: 10.1097/HCO.0000000000001257

Marc Ruel, Subodh Verma

引用次数: 0

Symptoms, coronary artery disease and percutaneous coronary intervention: connecting the dots. 症状，冠状动脉疾病和经皮冠状动脉介入治疗：连接点。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-11-01 Epub Date: 2025-09-10 DOI: 10.1097/HCO.0000000000001246

Shayna Chotai, Kayla Chiew, Rasha Al-Lamee

{"title":"Symptoms, coronary artery disease and percutaneous coronary intervention: connecting the dots.","authors":"Shayna Chotai, Kayla Chiew, Rasha Al-Lamee","doi":"10.1097/HCO.0000000000001246","DOIUrl":"10.1097/HCO.0000000000001246","url":null,"abstract":"Purpose of review: Symptom relief is now recognized as the primary remit of percutaneous coronary intervention (PCI) in patients with stable coronary artery disease. The relationship between the nature of angina symptoms and the likelihood of successful symptom relief from PCI had not been systematically studied until recently.Recent findings: The ORBITA-2 symptom-stratified analysis found that while the severity and nature of symptoms were poorly associated with the severity of coronary disease, the nature of the symptoms powerfully predicted the efficacy of PCI in relieving angina. Specifically, patients with typical or \"Rose angina\" were most likely to benefit from PCI, while those with atypical symptoms were less likely to see significant improvement beyond placebo. Furthermore, the ORBITA-STAR study demonstrated that patients whose angina symptoms closely matched those induced by balloon occlusion at the site of a coronary stenosis were significantly more likely to experience symptom relief from PCI.Summary: Symptom analysis offers a powerful tool for predicting the efficacy of PCI. Misattributing noncardiac symptoms as angina often results in ineffective intervention, highlighting the critical importance of accurate and thoughtful symptom assessment, particularly in identifying typical angina. The persistent challenge of residual angina despite technically successful PCI reflects not a failure of the intervention itself, but a shortcoming in diagnostic precision to identify those who will benefit. Future research should focus on refining clinical predictors to better guide the selection of patients most likely to benefit from revascularization.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"417-423"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145014473","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

The clinical utility of assessing coronary vasomotor dysfunction in angina with nonobstructive coronary artery. 非阻塞性冠状动脉心绞痛患者冠状动脉血管舒缩功能障碍评估的临床应用。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-11-01 Epub Date: 2025-08-13 DOI: 10.1097/HCO.0000000000001248

Kai Nogami, Lilach O Lerman, Amir Lerman

{"title":"The clinical utility of assessing coronary vasomotor dysfunction in angina with nonobstructive coronary artery.","authors":"Kai Nogami, Lilach O Lerman, Amir Lerman","doi":"10.1097/HCO.0000000000001248","DOIUrl":"10.1097/HCO.0000000000001248","url":null,"abstract":"Purpose of review: This paper reviews the current understanding of coronary vascular dysfunction (CVDys) in patients with angina and no obstructive coronary artery disease (ANOCA), based on recent findings from a comprehensive, large-scale study. It also discusses potential future directions for research and clinical practice.Recent findings: CVDys involves enhanced vasoconstriction or impaired vasodilation caused by endothelium-dependent and/or -independent dysfunction in the epicardial or microvascular coronary arteries. It is classified into four subtypes based on anatomical location and underlying mechanisms, and can be assessed using coronary reactivity testing (CRT). Previous studies have evaluated their prognostic implications separately or in limited populations.A recent study assessed all subtypes within a single ANOCA cohort and confirmed that endothelium-dependent epicardial dysfunction and both types of microvascular dysfunction are associated with worse prognosis. Moreover, it demonstrated that microvascular function - both endothelium-dependent and -independent - serves as an independent prognostic factor for major adverse cardiovascular events. These findings emphasize the value of CRT-based comprehensive evaluation for risk stratification.Summary: While evidence regarding the prognostic impact of CVDys has become increasingly robust, effective treatment strategies remain undefined. Future efforts should focus on developing CRT-guided interventions targeting coronary dysfunction, with the goal of improving clinical outcomes.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"440-447"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979038","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

Complete revascularization with percutaneous coronary intervention for acute coronary syndromes presenting with multivessel disease. 经皮冠状动脉介入治疗以多血管疾病为表现的急性冠状动脉综合征的完全血运重建术

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-11-01 Epub Date: 2025-08-22 DOI: 10.1097/HCO.0000000000001250

Rohin K Reddy, Hannah Bernstein, James P Howard, Yousif Ahmad

{"title":"Complete revascularization with percutaneous coronary intervention for acute coronary syndromes presenting with multivessel disease.","authors":"Rohin K Reddy, Hannah Bernstein, James P Howard, Yousif Ahmad","doi":"10.1097/HCO.0000000000001250","DOIUrl":"10.1097/HCO.0000000000001250","url":null,"abstract":"Purpose of review: Complete revascularization (CR) by percutaneous coronary intervention (PCI) in acute coronary syndromes with multivessel coronary artery disease (CAD) was previously contraindicated in the absence of cardiogenic shock or high-risk ischemia. Over the last decade, CR has been a focus of recent clinical investigation and practice evolution due to high-quality evidence supporting hard cardiovascular outcome benefit, contributing to a reversal in international guidelines. This review provides concise syntheses of contemporary and emerging randomized evidence underpinning current strategies and unresolved questions regarding patient selection, timing of CR and guidance modalities for the identification and treatment of nonculprit lesions.Recent findings: The randomized evidence base supporting CR with PCI for acute coronary syndromes (ACS) and multivessel CAD has increased recently with large-scale trials comparing immediate versus staged CR and physiology-guided versus angiography-guided CR, including reports of longer-term comparative outcomes. Enough events have recently accrued to enable demonstration of all-cause mortality benefits with CR.Summary: Contemporary randomized data increasingly support CR with PCI in haemodynamically stable patients. However, ACS type, timing of intervention and method of evaluation still necessitate individualized shared clinical decision-making, and further trials are required to validate the optimal PCI strategies by which to achieve CR in the correct populations.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"410-416"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979658","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

The role of high-risk plaque in refining cardiovascular event prediction. 高危斑块在改善心血管事件预测中的作用。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-11-01 Epub Date: 2025-08-20 DOI: 10.1097/HCO.0000000000001249

Daisuke Kinoshita, Masafumi Watanabe, Ik-Kyung Jang

{"title":"The role of high-risk plaque in refining cardiovascular event prediction.","authors":"Daisuke Kinoshita, Masafumi Watanabe, Ik-Kyung Jang","doi":"10.1097/HCO.0000000000001249","DOIUrl":"10.1097/HCO.0000000000001249","url":null,"abstract":"Purpose of review: High-risk plaque (HRP) features are commonly observed in patients with acute coronary syndromes (ACS); however, their individual predictive value remains limited. This review explores the importance of integrating anatomical and physiological assessments to enhance risk stratification and optimize therapeutic decision-making.Recent findings: Studies have indicated that combining HRP evaluation with hemodynamic assessment significantly improves prognostic accuracy, particularly in guiding revascularization strategies. Although the interaction between HRP and inflammatory biomarkers remains incompletely understood, specific plaque characteristics, such as positive remodeling, have demonstrated consistent associations with lesion-specific inflammation. Furthermore, emerging evidence suggests that hemodynamic stress plays a crucial role in plaque progression and disruption, reinforcing the need for a more comprehensive approach.Summary: A refined strategy that incorporates plaque burden, functional significance, and vascular inflammation is promising for improving cardiovascular risk prediction. By integrating these elements, HRP assessment may improve patient outcomes by optimizing preventive interventions and mitigating the progression of atherosclerotic disease.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"432-439"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979059","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

Advanced cardiovascular imaging in immune-mediated inflammatory diseases: redefining ischemic heart disease risk. 免疫介导的炎症性疾病的高级心血管成像：重新定义缺血性心脏病的风险

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-11-01 Epub Date: 2025-09-24 DOI: 10.1097/HCO.0000000000001254

Jonathan A Aun, Camila V Blair, Ron Blankstein, Brittany N Weber

引用次数: 0

Completed and ongoing trials in minimally invasive cardiac surgery coronary surgery. 完成和正在进行的微创心脏手术冠状动脉手术试验。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-11-01 Epub Date: 2025-08-11 DOI: 10.1097/HCO.0000000000001244

Marko T Boskovski, Elaine E Tseng

{"title":"Completed and ongoing trials in minimally invasive cardiac surgery coronary surgery.","authors":"Marko T Boskovski, Elaine E Tseng","doi":"10.1097/HCO.0000000000001244","DOIUrl":"10.1097/HCO.0000000000001244","url":null,"abstract":"Purpose of review: Minimally invasive cardiac surgery (MICS) coronary artery bypass grafting (CABG), first established two decades ago, offers multivessel revascularization via a small left anterior thoracotomy and without the need for cardiopulmonary bypass, potentially leading to lower complication rates and faster recovery. However, adoption of MICS CABG has been slow, in part due to lack of randomized trial data. Here, we review important retrospective studies, as well as ongoing and completed MICS CABG trials.Recent findings: The majority of studies remain single-center observational studies demonstrating that MICS CABG yields comparable perioperative morbidity and mortality to conventional CABG, with excellent angiographic graft patency, comparable long-term outcomes and faster recovery times. There are two ongoing randomized controlled trials, the MIST and MICS-CABG PRPP trials, both comparing quality of life and recovery in the early postoperative period between patients undergoing MICS CABG versus sternotomy CABG.Summary: The MIST and MICS-CABG PRPP trials will for the first time provide prospective, randomized data on the benefits of MICS CABG. However, both trials involve highly experienced MICS CABG surgeons. As such, the findings will likely not be generalizable to the general cardiac surgery community and MICS CABG will remain a boutique operation offered in highly specialized centers.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"406-409"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979717","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

Postmyocardial infarction ventricular septal rupture: optimizing surgical timing and repair. 心肌梗死后室间隔破裂：优化手术时机和修复。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-11-01 Epub Date: 2025-09-18 DOI: 10.1097/HCO.0000000000001256

Daniel Goubran, Hugo Issa, Nadia Clarizia, Vincent Chan, Marc Ruel

{"title":"Postmyocardial infarction ventricular septal rupture: optimizing surgical timing and repair.","authors":"Daniel Goubran, Hugo Issa, Nadia Clarizia, Vincent Chan, Marc Ruel","doi":"10.1097/HCO.0000000000001256","DOIUrl":"10.1097/HCO.0000000000001256","url":null,"abstract":"Purpose of review: This review summarizes the most recent literature regarding the surgical management of postmyocardial infarction (MI) ventricular septal rupture and the optimal timing and performance of the operation.Recent findings: There are conflicting data surrounding the optimal timing of surgical intervention for post-MI ventricular septal rupture. Patients often present in hemodynamic compromise which limits the ability to delay their intervention. A lack of randomized control trials mandates reliance on retrospective cohort studies that have a selection bias in favor of delayed surgery due to unstable patients requiring emergent intervention. Similarly, mechanical circulatory support may be associated with poorer outcomes in part due to selection bias. There is a trend towards better prognosis in patients with lower preoperative lactate and lower vasopressor requirements.Summary: A diagnosis of a post-MI ventricular septal rupture carries a poor prognosis. Without surgical intervention, the likelihood of 1-year survival is very low. Percutaneous treatment options have limited success, and the gold standard remains surgical intervention. Surgical timing is often dictated by patients being hemodynamically unstable and requiring emergent surgery. When a patient can have delayed intervention, there is a trend towards better outcomes. Optimized hemodynamics, metabolic parameters, and initial medical management are associated with improved outcomes. Mechanical circulatory support is of benefit in sicker patients if it can assist with preoperative optimization.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"395-398"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132792","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

Ischemic events after coronary artery bypass grafting: when to treat interventionally, medically or surgically? 冠状动脉搭桥术后缺血事件：什么时候介入治疗，药物治疗还是手术治疗？

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-11-01 Epub Date: 2025-08-01 DOI: 10.1097/HCO.0000000000001245

Hannah M Bernstein, Rohin K Reddy, Marko Boskovski, Yousif Ahmad

{"title":"Ischemic events after coronary artery bypass grafting: when to treat interventionally, medically or surgically?","authors":"Hannah M Bernstein, Rohin K Reddy, Marko Boskovski, Yousif Ahmad","doi":"10.1097/HCO.0000000000001245","DOIUrl":"10.1097/HCO.0000000000001245","url":null,"abstract":"Purpose of review: All revascularization modalities in patients with prior coronary artery bypass grafting (CABG) have been shown to have higher rates of procedural complications and worse outcomes compared to patients without prior CABG. However, patients' clinical presentations often necessitate revascularization. This review outlines the different treatment options for patients with prior CABG presenting with ischemia depending on clinical presentation, focusing on the advantages and challenges of different techniques and emerging evidence.Recent findings: While still high risk, recent studies have shown improvement in outcomes in both surgical and interventional revascularization options in post-CABG patients. Redo CABG, still recommended in patients with left anterior descending disease and an available internal mammary conduit, has had improved outcomes over the past two decades. Percutaneous coronary intervention (PCI) is preferred in most cases, with native-vessel PCI generally preferred over vein-graft PCI when feasible. Bypassed arteries often have high rates of chronic total occlusions, and the vein grafts themselves can be useful in retrograde approaches.Summary: Revascularization in patients with prior CABG remains high risk and should be reserved for high-risk ischemia or symptoms refractory to medical management. The choice of intervention is often dictated by the clinical presentation and coronary anatomy, with specific techniques available to improve both native-vessel and saphenous vein graft PCI success rates.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"399-405"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796199","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

Left ventricular function recovery in Takotsubo syndrome, clinical and pathophysiological insights: a state-of-the-art review. Takotsubo综合征的左心室功能恢复，临床和病理生理学见解：最新的回顾。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-11-01 Epub Date: 2025-08-22 DOI: 10.1097/HCO.0000000000001247

Ravi Vazirani, Iván J Núñez-Gil

{"title":"Left ventricular function recovery in Takotsubo syndrome, clinical and pathophysiological insights: a state-of-the-art review.","authors":"Ravi Vazirani, Iván J Núñez-Gil","doi":"10.1097/HCO.0000000000001247","DOIUrl":"10.1097/HCO.0000000000001247","url":null,"abstract":"Purpose of review: Early (<10 days) recovery of the left ventricular ejection fraction (LVEF) in Takotsubo syndrome (TTS) has been associated with better short- and long-term clinical outcomes compared to delayed recovery (>10 days). This review aims to comprehensively address the literature regarding its clinical implications, the pathological basis underlying a chronic inflammatory heart failure phenotype; as well as the potential pharmacological and nonpharmacological therapies that might aid in LVEF recovery and improve clinical outcomes in TTS.Recent findings: We describe the clinical findings of the two large studies addressing this topic, derived from ongoing prospective registries (RETAKO and InterTAK) in which inflammatory biomarkers are the strongest independently associated factor with late left ventricular (LV) recovery (>10 days). This is in line with the previous studies suggesting a chronic inflammatory phenotype with elevated inflammatory biomarkers (e.g. interleukin-6) that persists even 5 months after the index event and long-lasting myocardial energetic impairment >1 year after the TTS episode.Summary: Late LV recovery in TTS is linked to a worse short- and long-term prognosis, identifying these patients for closer monitoring might be clinically relevant for the early detection of complications. Mechanistical research needs to be undertaken to elucidate the cellular and molecular pathways implicated in late LV recovery, this could aid in the selection of pharmacological and nonpharmacological therapies to aid LV recovery.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"459-464"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978890","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