Current Opinion in Cardiology最新文献_第3页

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 : 2025-06-24 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":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-24","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

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 : 2025-06-23 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":"https://doi.org/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":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

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

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

Mitigating heart failure risk in patients with diabetes and chronic kidney disease. 减轻糖尿病和慢性肾脏疾病患者心力衰竭的风险。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-05-01 Epub Date: 2025-02-12 DOI: 10.1097/HCO.0000000000001208

Nicholas S Kowalczyk, Megan Prochaska

{"title":"Mitigating heart failure risk in patients with diabetes and chronic kidney disease.","authors":"Nicholas S Kowalczyk, Megan Prochaska","doi":"10.1097/HCO.0000000000001208","DOIUrl":"10.1097/HCO.0000000000001208","url":null,"abstract":"Purpose of review: Patients with chronic kidney disease and diabetes are at high risk of cardiovascular disease, including heart failure. Risk mitigation requires a comprehensive approach with lifestyle modifications, blood pressure management, renin-angiotensin blockade, and sodium-glucose cotransporter 2 inhibitors. Recent trials have shown that nonsteroidal mineralocorticoid receptor antagonists (ns-MRA) and glucagon-like peptide 1 receptor agonists (GLP-1 RA) should also be components of this approach. This review will discuss the comprehensive approach to mitigating risk in these high-risk patients and highlight the recent trials of ns-MRAs and GLP-1 RA.Recent findings: In recent years, large, randomized controlled trials of ns-MRA and GLP-1 RA have shown benefit in kidney and cardiovascular outcomes for patients with chronic kidney disease and diabetes.Summary: The substantial benefits and overall favorable safety profiles for ns-MRA and GLP-1 RA in patients with chronic kidney disease and diabetes demonstrate that these medications should be considered as a part of a comprehensive approach to cardiovascular risk reduction in this high-risk population. Future studies should consider different combination therapies and guide how and when to initiate these therapies.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"178-183"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494928","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

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

Editorial introductions. 编辑介绍。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-05-01 Epub Date: 2025-04-03 DOI: 10.1097/HCO.0000000000001213

引用次数: 0