Current Opinion in Cardiology最新文献_第2页

A practical review of stress perfusion cardiac magnetic resonance imaging for the management of coronary artery disease. 心脏磁共振成像在冠状动脉疾病治疗中的应用综述。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-11-01 Epub Date: 2025-10-02 DOI: 10.1097/HCO.0000000000001259

Raymond Y Kwong, Bobak Heydari, Benedikt Bernhard

{"title":"A practical review of stress perfusion cardiac magnetic resonance imaging for the management of coronary artery disease.","authors":"Raymond Y Kwong, Bobak Heydari, Benedikt Bernhard","doi":"10.1097/HCO.0000000000001259","DOIUrl":"https://doi.org/10.1097/HCO.0000000000001259","url":null,"abstract":"Purpose of review: Stress perfusion cardiac magnetic resonance imaging (CMR) has gained increasing adoption across North America and Europe for the evaluation of symptomatic suspected or established ischemic heart disease (IHD).Recent findings: Over the past decade, stress perfusion CMR has demonstrated excellent diagnostic and prognostic performance, particularly in patients at intermediate or high risk of IHD or with established coronary artery disease (CAD). After the landmark ISCHEMIA trial, stress CMR may play an important role in selecting patients for invasive management strategies and determination of revascularization technique. Artificial intelligence has streamlined CMR scanning techniques and in-line automation of quantitative pixelated perfusion maps. Quantitative stress CMR can evaluate absolute myocardial blood flow and perfusion reserve that improves risk stratification and detection of coronary microvascular disease (CMD). CMD detection may assist clinicians with diagnosis of chest pain in patients without obstructive CAD and improve prognostication and detection of pathophysiological mechanisms in a variety of cardiomyopathies.Summary: Quantitative stress perfusion CMR will play an important clinical role in evaluating patients at risk of IHD and cardiomyopathy with iterative cost and time efficiency owing to continued integration of artificial intelligence techniques. More widespread adoption will likely improve cost effective cardiac care and reduce adverse clinical outcomes.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":"40 6","pages":"448-458"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193897","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

Invasive treatment strategies in the ESC guidelines developed in collaboration with EACTS for the management of chronic coronary syndrome: implications for contemporary clinical practice. 与EACTS合作制定的ESC指南中的侵入性治疗策略用于慢性冠状动脉综合征的管理：对当代临床实践的影响。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-11-01 Epub Date: 2025-09-03 DOI: 10.1097/HCO.0000000000001253

Milan Milojevic, Slobodan Micovic, Petar Otasevic

{"title":"Invasive treatment strategies in the ESC guidelines developed in collaboration with EACTS for the management of chronic coronary syndrome: implications for contemporary clinical practice.","authors":"Milan Milojevic, Slobodan Micovic, Petar Otasevic","doi":"10.1097/HCO.0000000000001253","DOIUrl":"10.1097/HCO.0000000000001253","url":null,"abstract":"Purpose of review: To critically appraise the 2024 ESC Guidelines for chronic coronary syndrome (CCS), developed in collaboration with EACTS, emphasizing invasive-treatment recommendations, their underlying rationale and key areas requiring further clarification for clinical implementation.Recent findings: The document formally incorporates indications for myocardial revascularization and the criteria for choosing between percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) into the single CCS guideline framework. It calls for Heart-Team decisions whenever CABG and PCI are equally recommended and introduces modality-specific criteria based on anatomical complexity, SYNTAX score, and clinically relevant comorbidities. CABG remains the preferred strategy for anatomically complex disease, including left main and multivessel involvement, especially when PCI cannot achieve equivalent completeness of revascularization or in patients with comorbidities associated with a favorable prognosis (e.g., diabetes mellitus, heart failure). PCI is recommended for less complex lesions in which comparable completeness is feasible for patients whose primary goal is symptom relief or those at high surgical risk. Apart from patient selection, the document provides limited procedural detail, offers limited guidance on secondary prevention measures, and lacks explicit recommendations on the optimal timing of intervention.Summary: The 2024 guideline re-establishes a unified, multidisciplinary European approach to the management of CCS, reaffirming the prognostic value of guideline-directed revascularization and the central role of the Heart Team in selecting the optimal strategy. Supplementary documents are required to fill procedural, secondary prevention and implementation gaps.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"382-389"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978853","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

Teaching minimally invasive coronary artery bypass grafting: a structured framework for well tolerated adoption and training. 微创冠状动脉旁路移植术的教学：一个良好耐受的采用和培训的结构化框架。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-11-01 Epub Date: 2025-09-24 DOI: 10.1097/HCO.0000000000001252

Ziyab K Sarfaraz, Qasim Al Abri, Mahesh Ramchandani

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 : 2025-09-25 DOI: 10.1097/HCO.0000000000001254

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

引用次数: 0

Teaching minimally invasive coronary artery bypass grafting: a structured framework for well tolerated adoption and training. 微创冠状动脉旁路移植术的教学：一个良好耐受的采用和培训的结构化框架。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-09-25 DOI: 10.1097/HCO.0000000000001252

Ziyab K Sarfaraz, Qasim Al Abri, Mahesh Ramchandani

引用次数: 0

Recent advances in cardiac imaging: emerging use of three-dimensional visualization for analyzing complex cardiovascular anatomy. 心脏成像的最新进展：三维可视化用于分析复杂的心血管解剖。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-09-25 DOI: 10.1097/HCO.0000000000001260

Kenichi Kamiya, Yukihiro Nagatani, Susumu Nakata, Ryuta Seguchi, Subodh Verma

{"title":"Recent advances in cardiac imaging: emerging use of three-dimensional visualization for analyzing complex cardiovascular anatomy.","authors":"Kenichi Kamiya, Yukihiro Nagatani, Susumu Nakata, Ryuta Seguchi, Subodh Verma","doi":"10.1097/HCO.0000000000001260","DOIUrl":"https://doi.org/10.1097/HCO.0000000000001260","url":null,"abstract":"Purpose of review: Technical progress in noninvasive medical imaging continues to enhance diagnosis and intervention, with three-dimensional (3D) imaging emerging as a significant advancement over traditional methods. While 3D visualization is widely used to evaluate a living heart, precise measurement from such images remains challenging. This review describes a new technique named isosurface geometric measurement on volume-rendered images (IMVR), which facilitates accurate 3D measurement of complex cardiovascular anatomy.Recent findings: Direct volume rendering provides clear visualization and tissue identification, but the lack of exact spatial boundaries inherently makes measurement of any anatomical feature difficult. However, by superimposing a surface-rendered polygonal mesh (representing isosurface geometry) onto a variably transparent volume image of the heart, IMVR enables significantly easier and more accurate 3D measurement. This technique demonstrates versatility across various cardiovascular, anatomical, and clinical applications, including preinterventional assessment and planning for structural heart diseases, notably expanding 3D imaging's utility toward precision medicine and personalized treatment.Summary: This review article summarizes recent advances in cardiac imaging, highlighting an efficient IMVR technique, which combines volume-rendered images with superimposed surface-rendered image to facilitate accurate 3D measurements of cardiac anatomical features.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139451","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

Adding the patient perspective: the necessity of patient reported outcomes in cardiac surgery clinical trials. 增加患者视角：心脏手术临床试验中患者报告结果的必要性

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-09-01 Epub Date: 2025-06-23 DOI: 10.1097/HCO.0000000000001239

Alexander C Gregg, Ruth Masterson Creber, John A Spertus, Gregg W Stone, Mario F Gaudino

{"title":"Adding the patient perspective: the necessity of patient reported outcomes in cardiac surgery clinical trials.","authors":"Alexander C Gregg, Ruth Masterson Creber, John A Spertus, Gregg W Stone, Mario F Gaudino","doi":"10.1097/HCO.0000000000001239","DOIUrl":"10.1097/HCO.0000000000001239","url":null,"abstract":"Purpose of review: This review highlights the growing importance of patient reported outcomes (PROs) in cardiac surgery trials. Cardiac surgery trials have traditionally focused on cardiovascular events such as survival, stroke or myocardial infarction. However, as surgical outcomes have continued to improve, incorporating the patient's perspective through PROs has become increasingly critical. Incorporating PROs as key study outcomes provides essential patient data, while also overcoming the methodological limitations of classic composite endpoints.Recent findings: Continued advancements in cardiac surgery have significantly reduced classic endpoint differentials, making it challenging to evaluate interventions with their use alone. PROs offer more granular details on the effects of surgical interventions compared to classic clinical events and are widely used in other medical fields. More recently, cardiac surgery trials have begun successfully implementing PROs, though there is need for greater utilization across the discipline.Summary: The integration of PROs into cardiac surgery trials allows for better understanding of the impact of surgical interventions on patients' daily lives. While barriers exist, efforts to develop and standardize PRO measures promise to enhance the relevance of cardiac surgery clinical trials and ultimately improve patient care.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"350-356"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12221202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546262","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

Management of difficult coronary anatomy during transcatheter aortic valve implantation: what are the key issues? 经导管主动脉瓣植入术中冠状动脉解剖困难的处理：关键问题是什么？

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-09-01 Epub Date: 2025-04-24 DOI: 10.1097/HCO.0000000000001229

Takayuki Onishi, Gilbert H L Tang

{"title":"Management of difficult coronary anatomy during transcatheter aortic valve implantation: what are the key issues?","authors":"Takayuki Onishi, Gilbert H L Tang","doi":"10.1097/HCO.0000000000001229","DOIUrl":"10.1097/HCO.0000000000001229","url":null,"abstract":"Purpose of review: Predicting and preventing coronary obstruction in transcatheter aortic valve replacement (TAVR) is crucial due to its high mortality risk.Recent findings: In native TAVR, predicting coronary obstruction requires assessing aortic cusp height, coronary artery height, valve-to-coronary distance, and leaflet calcium volume. The VIVID classification has been proposed for evaluating the risk of coronary obstruction in TAVR for failed bioprosthetic surgical valves. After TAVR with the Sapien 3 valve, the feasibility of redo TAVR and coronary access decreases with a shallower implantation of the initial Sapien 3. In redo TAVR of Sapien 3 within an Evolut valve, positioning the Sapien 3 outflow at node 4 improves redo TAVR feasibility and coronary accessibility compared to positioning at nodes 5 or 6. For valve sizing in redo TAVR with Sapien 3, in-vivo CT sizing results in smaller valve sizes than bench sizing, reducing coronary risk and improving redo TAVR feasibility. Leaflet modification and coronary stenting techniques and a dedicated leaflet-splitting device have been proposed to maintain coronary perfusion in high-risk cases.Summary: Coronary preservation in high-risk TAVR remains a significant challenge, requiring further research into preprocedural planning and leaflet modification strategies.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"367-374"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018374","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 : 2025-09-01 Epub 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":"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, 129 Xe) 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":"311-318"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","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

The role of imaging in risk assessment for pulmonary arterial hypertension. 影像学在肺动脉高压风险评估中的作用。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-09-01 Epub Date: 2025-06-25 DOI: 10.1097/HCO.0000000000001238

Divya Verma, Rodolfo A Estrada, Sandeep Sahay

{"title":"The role of imaging in risk assessment for pulmonary arterial hypertension.","authors":"Divya Verma, Rodolfo A Estrada, Sandeep Sahay","doi":"10.1097/HCO.0000000000001238","DOIUrl":"10.1097/HCO.0000000000001238","url":null,"abstract":"Purpose of review: There are several multifactorial risk assessment tools used to predict mortality in patients with pulmonary arterial hypertension (PAH). These tools are also used to guide clinical decision-making including changes in therapy and referrals for transplantation. While the prominent driver of morbidity and mortality in PAH is right ventricular failure, most available risk assessment tools do not include parameters specific to right ventricular structure or function. Several cardiac imaging parameters are known to be associated with survival and may enhance the predictive ability of existing risk scores.Recent findings: This review compiles the existing literature surrounding the improved predictive power of existing risk assessment tools when combined with echocardiographic and cardiac magnetic resonance imaging findings. The review also discusses scenarios in which imaging findings may influence clinical decision making outside of risk scores.Summary: Decision making in PAH is complex and multifaceted. Cardiac imaging is an important component in the management of PAH and should be considered carefully and in conjunction with existing risk assessment tools.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"327-334"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12337924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487205","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