Current Opinion in Cardiology最新文献_第2页

Statin-Associated muscle symptoms and vitamin D supplementation. 他汀类药物相关肌肉症状和维生素D补充

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-07-01 Epub Date: 2025-04-24 DOI: 10.1097/HCO.0000000000001222

Kahtan Fadah, Adriana Mares, Richard A Lange

{"title":"Statin-Associated muscle symptoms and vitamin D supplementation.","authors":"Kahtan Fadah, Adriana Mares, Richard A Lange","doi":"10.1097/HCO.0000000000001222","DOIUrl":"10.1097/HCO.0000000000001222","url":null,"abstract":"Purpose of review: Statin medications play a pivotal role in the primary and secondary prevention and management of cardiovascular disease due to their potent lipid-lowering and anti-inflammatory effects. Nevertheless, the clinical application of statins is often hampered by statin-associated muscle symptoms (SAMS), which deter patient adherence and treatment efficacy considerably. SAMS currently affects 10-20% of statin users, thus understanding potential mitigation strategies is crucial. This review focuses on the role of vitamin D in mitigating SAMS, given the growing interest in vitamin D deficiency as a potentially modifiable risk factor.Recent findings: Despite observational suggestions linking vitamin D deficiency to heightened SAMS risk, recent studies have yielded conflicting results on the role of vitamin D supplementation in preventing SAMS. Some studies report an improvement in statin tolerance following vitamin D repletion. However, recent large-scale clinical trials, particularly the Vitamin D and Omega-3 trial (VITAL) report no significant benefit of vitamin D supplementation in preventing SAMS or reducing statin discontinuation rates, regardless of baseline vitamin D levels.Summary: Observational data provides evidence for the use of vitamin D supplementation in SAMS management, however conflicting evidence in recent clinical trials do not support its routine use for preventing or treating SAMS. To explore alternative strategies in improving statin tolerance and adherence, this discourse aims to elucidate the current understanding the complex mechanisms underlying SAMS, the influence of serum vitamin D levels, and the implications for clinical management.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"215-220"},"PeriodicalIF":2.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12147742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782028","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

Managing acute supraventricular tachycardia and the role of intravenous sotalol. 急性室上性心动过速的治疗及静脉索他洛尔的作用。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-07-01 Epub Date: 2025-04-09 DOI: 10.1097/HCO.0000000000001223

Mitchell I Cohen, Robert Przybylski

{"title":"Managing acute supraventricular tachycardia and the role of intravenous sotalol.","authors":"Mitchell I Cohen, Robert Przybylski","doi":"10.1097/HCO.0000000000001223","DOIUrl":"10.1097/HCO.0000000000001223","url":null,"abstract":"Purpose of review: The initial approach to stable supraventricular tachycardia (SVT) in children is either adenosine or vagal maneuvers. While automatic tachycardias do not respond to such an approach, even reentrant arrythmias will fail to terminate with adenosine or vagal maneuvers. Little consensus exists on the ideal second line antiarrhythmic medication for stable SVT. This article reviews the current approach to stable SVT and early pediatric studies using intravenous (i.v.) sotalol.Recent findings: The development of i.v. sotalol has spawned enthusiasm for a novel antiarrhythmic for refractory reentrant SVT and other automatic atrial tachycardias. Retrospective pediatric multicenter studies have shown an excellent conversion (50-90%) of refractory SVT with a single dose of i.v. sotalol; generally, over 30 min. Cautioned should be exercised using i.v. sotalol in patients with ventricular dysfunction and dose adjustments need to be made based on creatinine clearance. In addition, i.v. sotalol has shown promising early results in slowing the ventricular rate in postoperative junctional ectopic tachycardia faster than i.v. amiodarone.Summary: Intravenous sotalol has shown promising results in refractory pediatric SVT. Protocol driven dosing with the help of hospital pharmacists should be established before i.v. sotalol is prescribed. Future prospective studies especially in postoperative patients, neonates and patients with congenital heart disease are needed.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"290-297"},"PeriodicalIF":2.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059068","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 vein stenosis: future optimism. 肺静脉狭窄：未来乐观。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-07-01 Epub Date: 2025-04-09 DOI: 10.1097/HCO.0000000000001217

Patcharapong Suntharos, Marin Satawiriya, Lourdes R Prieto

{"title":"Pulmonary vein stenosis: future optimism.","authors":"Patcharapong Suntharos, Marin Satawiriya, Lourdes R Prieto","doi":"10.1097/HCO.0000000000001217","DOIUrl":"10.1097/HCO.0000000000001217","url":null,"abstract":"Purpose of review: Pulmonary vein stenosis (PVS) is a rare disease with high morbidity and mortality. Prevention of restenosis remains challenging. This review will highlight recent advances in therapy that are beginning to show a survival benefit.Recent findings: Intervention for multivessel pediatric PVS may be surgical or transcatheter, both with high restenosis rates. At a threshold upstream diameter of 7 mm, the risk of restenosis decreases. Close vigilance and frequent reinterventions, typically transcatheter, are now accepted practice to maintain vein patency and achieve upstream growth. Suppressive agents targeting the exuberant myofibroblastic proliferation characteristic of PVS, specifically sirolimus, delivered locally on the surface of balloons and stents, and as adjunct systemic therapy, have been shown to increase survival and decrease reinterventions. Newer surgical techniques focused on shortening and straightening the vein to optimize flow dynamics, coupled with hybrid intraoperative stent placement in selected cases, also show a survival benefit.Adult-onset PVS, most commonly a complication of pulmonary vein isolation, now occurs rarely, and generally responds to transcatheter intervention. Further advances in ablation techniques aim to eliminate this complication.Summary: An aggressive approach of frequent reinterventions is a necessary strategy rather than treatment failure. More granular understanding of the mechanisms underlying PVS leading to novel muti-pronged anatomic and suppressive therapy are yielding improved survival.Multispecialty PVS teams at the institutional level and multiinstitutional collaboration, now possible via the PVS registry, are crucial to optimal care and future progress.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"298-304"},"PeriodicalIF":2.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058462","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

Anesthetic management in patients with long QT and Brugada syndromes. 长QT期综合征和Brugada综合征患者的麻醉处理。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-07-01 Epub Date: 2025-04-09 DOI: 10.1097/HCO.0000000000001220

Jordan A Cohen, Joseph Dayan

{"title":"Anesthetic management in patients with long QT and Brugada syndromes.","authors":"Jordan A Cohen, Joseph Dayan","doi":"10.1097/HCO.0000000000001220","DOIUrl":"10.1097/HCO.0000000000001220","url":null,"abstract":"Purpose of review: Both long QT and Brugada syndrome are inherited arrhythmic conditions that can predispose patients to life-threatening ventricular arrhythmias. Managing the anesthesia for patients with either long QT or Brugada syndrome necessitates an understanding of potential drug-drug interactions with the underlying channelopathy. This review illustrates contemporary insight into managing such patients for the anesthesiologist.Recent findings: Long QT, due to disorder of potassium or sodium ion channels, is associated with prolonged repolarization of the action potential phase. Medications that prolong the action potential should be avoided. In patients with long QT syndrome, each drug administered should be carefully reviewed to be certain it does not prolong the QT interval. Brugada syndrome is a result of a pathogenic sodium channel that results in potential ventricular arrhythmias. Medications that exacerbate the electrocardiographic changes of Brugada should be avoided.Summary: Anesthesiologists need to be aware of proper management in children with known or suspected long QT or Brugada pathologies as well as the potential poly-pharmaceutical impact that exists on cardiac ion channels.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"275-281"},"PeriodicalIF":2.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059217","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 management in patients with advanced chronic kidney disease with and without dialysis. 晚期慢性肾病伴和不伴透析患者的高血压管理。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-07-01 Epub Date: 2025-04-03 DOI: 10.1097/HCO.0000000000001221

Maria L Gonzalez Suarez, Jose Arriola-Montenegro, Leticia Rolón

{"title":"Hypertension management in patients with advanced chronic kidney disease with and without dialysis.","authors":"Maria L Gonzalez Suarez, Jose Arriola-Montenegro, Leticia Rolón","doi":"10.1097/HCO.0000000000001221","DOIUrl":"10.1097/HCO.0000000000001221","url":null,"abstract":"Purpose of review: Hypertension is a common comorbidity in patients with advanced chronic kidney disease (CKD) and end-stage kidney disease (ESKD) on dialysis, contributing significantly to cardiovascular disease and increased mortality. Managing hypertension in this population is complex due to the frequent occurrence of resistant hypertension. This review highlights the recent updates in hypertension management for these patients, especially considering new guidelines and therapeutic options.Recent findings: Recent literature emphasizes updated KDIGO guidelines, which have lowered blood pressure targets to decrease cardiovascular risks in patients with advanced CKD and ESKD. First-line therapies include diuretics, angiotensin converting enzyme inhibitors, and angiotensin II receptor blockers. New pharmacological treatments, such as sodium-glucose cotransporter-2 (SGLT2) inhibitors, endothelin receptor antagonists, RNA interference therapeutics, and aldosterone synthase inhibitors, offer promising options for resistant hypertension. Additionally, lifestyle modifications, including a low-salt diet and aerobic exercise, and volume control through ultrafiltration in dialysis patients, are crucial for blood pressure management.Summary: The findings suggest that individualized treatment strategies, incorporating both pharmacologic and nonpharmacologic approaches, are essential for optimizing blood pressure control in patients with advanced CKD and ESKD. These strategies can improve cardiovascular outcomes and enhance patient quality of life, with important implications for clinical practice.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"199-205"},"PeriodicalIF":2.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782025","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

Impact of glucagon-like peptide-1 receptor agonists on hypertension management: a narrative review. 胰高血糖素样肽-1受体激动剂对高血压治疗的影响：叙述性综述。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-07-01 Epub Date: 2025-04-11 DOI: 10.1097/HCO.0000000000001225

Diana De Oliveira-Gomes, Adhvithi Pingili, Sara Inglis, Stacy A Mandras, Juan F Loro-Ferrer, Adrian daSilva-deAbreu

{"title":"Impact of glucagon-like peptide-1 receptor agonists on hypertension management: a narrative review.","authors":"Diana De Oliveira-Gomes, Adhvithi Pingili, Sara Inglis, Stacy A Mandras, Juan F Loro-Ferrer, Adrian daSilva-deAbreu","doi":"10.1097/HCO.0000000000001225","DOIUrl":"10.1097/HCO.0000000000001225","url":null,"abstract":"Purpose of review: The increasing prevalence of hypertension, alongside the growing use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) for conditions beyond type 2 diabetes, underscores the need for understanding if there is a role for these medications in blood pressure management. This review addresses the timely opportunity to assess how GLP-1 RAs could influence blood pressure control, potentially broadening therapeutic strategies for cardiovascular risk management.Recent findings: Emerging literature indicates that GLP-1 RAs influence blood pressure through various mechanisms, such as sympathetic nervous modulation, vasodilation, and diuretic effects. Clinical trials demonstrate modest yet statistically significant reductions in systolic blood pressure (SBP), with less consistent effects on diastolic blood pressure (DBP). The advent of dual GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) receptor agonists presents enhanced possibilities for managing hypertension.Summary: The implications of these findings suggest that GLP-1 RAs have potential as adjunctive therapies for hypertension, especially in patients already receiving these agents for other cardiometabolic conditions. The blood pressure-lowering effects, often independent of weight loss or glucose control, warrant further investigation to determine their precise role within hypertension treatment algorithms and encourage integration into clinical practice.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"185-192"},"PeriodicalIF":2.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057588","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 : 2025-07-01 Epub Date: 2025-05-14 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":"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":"221-229"},"PeriodicalIF":2.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12264803/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hypertension in atherosclerotic cardiovascular disease: insights into epidemiology, management strategies, and outcomes. 动脉粥样硬化性心血管疾病中的高血压：流行病学、管理策略和结果的见解

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-07-01 Epub Date: 2025-04-23 DOI: 10.1097/HCO.0000000000001226

Prerna Gupta, Julia A Bast, Alexander C Razavi, Mario Enrico Canonico, Anum Shahzad, Muhammad Naeem, Marc P Bonaca, Laurence S Sperling, Raymundo A Quintana

{"title":"Hypertension in atherosclerotic cardiovascular disease: insights into epidemiology, management strategies, and outcomes.","authors":"Prerna Gupta, Julia A Bast, Alexander C Razavi, Mario Enrico Canonico, Anum Shahzad, Muhammad Naeem, Marc P Bonaca, Laurence S Sperling, Raymundo A Quintana","doi":"10.1097/HCO.0000000000001226","DOIUrl":"10.1097/HCO.0000000000001226","url":null,"abstract":"Purpose of review: To provide a comprehensive review of hypertension among patients with atherosclerotic vascular disease. Although there is significant alignment in treatment goals and strategies, blood pressure targets and therapies differ among atherosclerosis in varying vascular territories. Hypertension is a prominent risk factor for the development and amplification of atherosclerosis, as well as the cause of significant downstream morbidity and mortality.Recent findings: Hypertension is the greatest contributor to population attributable cardiovascular risk. Hypertension accelerates the development of atherosclerotic cardiovascular disease (ASCVD), and treatment of hypertension is a central tenet to managing ASCVD. Patients with ASCVD often merit a multidisciplinary approach, require multiple specialists and medications, and may suffer from additional consequences of therapy due to multimorbidity. Significant arterial stenoses may lead to unintended consequences of antihypertensive therapy. Further, there have been recent advances in the interventional management of hypertension, including techniques like renal denervation.Summary: In recent years, there have been significant changes in management guidelines of hypertension and peripheral arterial disease, new evidence in coronary artery disease, and simultaneously there's been an evolution in interventional management of hypertension, such as renal denervation. We provide an update on hypertension treatment in atherosclerotic disease among different vascular beds.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"206-212"},"PeriodicalIF":2.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058397","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: diagnostic aspects-what is the role of imaging? 肺动脉高压：诊断方面——影像学的作用是什么？

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-06-27 DOI: 10.1097/HCO.0000000000001241

Hyeon-Ju Ali, Ashrith Guha

{"title":"Pulmonary hypertension: diagnostic aspects-what is the role of imaging?","authors":"Hyeon-Ju Ali, Ashrith Guha","doi":"10.1097/HCO.0000000000001241","DOIUrl":"https://doi.org/10.1097/HCO.0000000000001241","url":null,"abstract":"Purpose of review: The role of imaging in diagnosis of pulmonary hypertension is multifaceted, spanning from estimation of pulmonary arterial pressures, understanding pulmonary artery-right ventricular interaction, and identification of the cause. The purpose of this review is to provide a comprehensive overview of multimodality imaging in evaluation of pulmonary hypertension as well as the novel applications of imaging techniques that have improved our detection and understanding of pulmonary hypertension.Recent findings: There are diverse imaging modalities available for comprehensive assessment of pulmonary hypertension that are expanding with new tracers (e.g., hyperpolarized xenon gas, 129Xe) and imaging techniques (C-arm cone-bean computed tomography). Artificial intelligence applications may improve efficiency and accuracy of screening for pulmonary hypertension as well as further characterize pulmonary vasculopathies using computed tomography of the chest. In the face of increasing imaging options, a \"value-based imaging\" approach should be adopted to reduce unnecessary burden on the patient and the healthcare system without compromising the accuracy and completeness of diagnostic assessment.Summary: Future studies are needed to optimize use of multimodality imaging and artificial intelligence in comprehensive evaluation of patients with pulmonary hypertension.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546264","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

Desmoplakin cardiomyopathy: recent updates in natural history and management. Desmoplakin心肌病：自然史和治疗的最新进展。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-06-27 DOI: 10.1097/HCO.0000000000001240

Lily Hoffman-Andrews, Olivia G Anderson, Anjali Tiku Owens

引用次数: 0