Current Opinion in Cardiology最新文献_第4页

RNA modifications in heart failure: current insights and future directions. 心力衰竭中的RNA修饰：当前的见解和未来的方向。

IF 1.9 4区医学

Current Opinion in Cardiology Pub Date : 2026-07-01 Epub Date: 2026-04-07 DOI: 10.1097/HCO.0000000000001293

Manisha Deogharia

{"title":"RNA modifications in heart failure: current insights and future directions.","authors":"Manisha Deogharia","doi":"10.1097/HCO.0000000000001293","DOIUrl":"10.1097/HCO.0000000000001293","url":null,"abstract":"Purpose of review: Gene expression is regulated at multiple levels beyond genetic and epigenetic modifications of DNA. Even when DNA is accurately transcribed into RNA, transcript abundance often does not correlate with protein levels, underscoring the importance of posttranscriptional regulation. Chemical modifications of RNA occur in both coding and noncoding RNAs and add an additional layer of gene control. More than 170 distinct RNA modifications have been identified across different RNAs in all domains of life. Although the abundant modifications have been investigated, their roles in cardiac biology and heart failure remain incompletely defined. This review discusses the current knowledge of both well characterized and understudied RNA modifications in the heart.Recent findings: Recent studies highlight context-dependent roles of N6-methyladenosine (m 6 A), 5-methylcytosine (m 5 C), N4-acetylcytidine (ac 4 C), and adenosine-to-inosine (A-to-I) RNA editing in the heart are discussed in this review.Summary: RNA modifications constitute a critical regulatory layer that complements transcriptional control and facilitates rapid adaptation to cardiac stress. Dysregulation of m 6 A, m 5 C, and A-to-I editing contributes to pathological remodeling and disease progression. However, most RNA modifications remain unexplored in heart failure. Enzymes that write, erase, or read these marks represent promising targets for precision therapeutic strategies.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"360-368"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789918","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

Role of nicotinamide adenine dinucleotide in cardiovascular disease. 烟酰胺腺嘌呤二核苷酸在心血管疾病中的作用。

IF 1.9 4区医学

Current Opinion in Cardiology Pub Date : 2026-07-01 Epub Date: 2026-04-02 DOI: 10.1097/HCO.0000000000001292

Janani Prasanna, Ravikumar Manickam, Srinivas M Tipparaju

{"title":"Role of nicotinamide adenine dinucleotide in cardiovascular disease.","authors":"Janani Prasanna, Ravikumar Manickam, Srinivas M Tipparaju","doi":"10.1097/HCO.0000000000001292","DOIUrl":"10.1097/HCO.0000000000001292","url":null,"abstract":"Purpose of review: The nicotinamide adenine dinucleotide (NAD + ) is an important redox cofactor that plays a major role in energy metabolism. This review provides an overview of the current understanding of NAD + in cardiovascular diseases.Recent findings: Activation of the rate-limiting enzyme nicotinamide phosphoribosyltransferase (NAMPT), a key component of the NAD + salvage pathway, is emerging as an alternative method to replenish the cycling NAD + pools and to alleviate the cardiovascular pathophysiology driven by NAD + depletion. The NAD + -dependent sirtuins play an important role in cellular metabolism and integrate the circadian signaling of clock controlled Nampt oscillation and thereby NAD + synthesis.Summary: An imbalance in the NAD + /NADH ratio caused by NAD + depletion is implicated in various diseases, including metabolic disease, aging, and cancer. The cellular NAD + content is decreased in cardiovascular diseases and heart failure. Lack of NAD + in cardiomyocytes leads to mitochondrial dysfunction, increased reactive oxygen species (ROS) production and cell death. The supplementation of NAD + and its precursors such as nicotinic acid (NA), nicotinamide (NAM), nicotinamide mononucleotide (NMN), and nicotinamide riboside (NR) are currently being evaluated in clinical trials. This review mainly focuses on the role of NAD + in cardiovascular diseases and therapeutics.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"369-376"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789948","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

Revisiting the role of beta blockers in the management of hypertension. 重新审视-受体阻滞剂在高血压治疗中的作用。

IF 1.9 4区医学

Current Opinion in Cardiology Pub Date : 2026-07-01 Epub Date: 2026-05-03 DOI: 10.1097/HCO.0000000000001303

Takeshi Fujiwara, Kazuomi Kario

{"title":"Revisiting the role of beta blockers in the management of hypertension.","authors":"Takeshi Fujiwara, Kazuomi Kario","doi":"10.1097/HCO.0000000000001303","DOIUrl":"10.1097/HCO.0000000000001303","url":null,"abstract":"Purpose of review: Although beta blockers have a long history in hypertension management, their first-line role remains controversial after early-2000 s trials raised concerns about inferior stroke prevention with traditional beta-blocker based regimens. This review re-examines the role of beta blockers in contemporary hypertension care by integrating mechanistic insights, phenotype-oriented considerations, and recent clinical evidence.Recent findings: Recent randomized controlled trials in acute myocardial infarction suggest that beta blocker depends on patient selection and left ventricular ejection function, arguing against routine use. Advances in out-of-office blood pressure (BP) assessment have enabled identification of clinically relevant phenotypes - including BP variability, morning BP surge, and nocturnal hypertension - that are closely linked to sympathetic overactivity and elevated heart rate. These associated pathophysiological abnormalities provide a mechanistic rationale for targeted beta-blocker use. Moreover, beta blockers are a heterogeneous drug class; β 1 -selective and vasodilatory agents exhibit distinct hemodynamic effects, including on central hemodynamics.Summary: Beta blockers should not be viewed as universally applicable antihypertensive agents; instead, they are best positioned as phenotype-oriented therapies for selected patients with heightened sympathetic activity, specific BP phenotypes, or coexisting cardiovascular disease. Contemporary evidence supports an individualized approach that moves beyond legacy beta-blocker-based regimens toward selective beta-blocker use in modern cardiovascular care.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"227-235"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823644","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

From sleep disorders to social determinants - risk predictors for cardiovascular diseases beyond low density lipoprotein cholesterol. 从睡眠障碍到社会决定因素——低密度脂蛋白胆固醇以外心血管疾病的风险预测因素。

IF 1.9 4区医学

Current Opinion in Cardiology Pub Date : 2026-07-01 Epub Date: 2026-06-04 DOI: 10.1097/HCO.0000000000001314

Debabrata Mukherjee, Dimitri P Mikhailidis

引用次数: 0

CRP/hs-CRP lowering by statins and other drugs used to treat dyslipidemia. 他汀类药物和其他用于治疗血脂异常的药物降低CRP/hs-CRP。

IF 1.9 4区医学

Current Opinion in Cardiology Pub Date : 2026-07-01 Epub Date: 2026-05-14 DOI: 10.1097/HCO.0000000000001307

Aditi Kothari, Nain Dadhania, Joel Jacob, John Paul Aparece

{"title":"CRP/hs-CRP lowering by statins and other drugs used to treat dyslipidemia.","authors":"Aditi Kothari, Nain Dadhania, Joel Jacob, John Paul Aparece","doi":"10.1097/HCO.0000000000001307","DOIUrl":"10.1097/HCO.0000000000001307","url":null,"abstract":"Purpose of review: Atherosclerosis is recognized as a chronic inflammatory disease, with high-sensitivity C-reactive protein (hs-CRP) serving as a biomarker of cardiovascular risk that persists despite optimal control of traditional risk factors. Landmark trials, like JUPITER (Justification for the Use of Statins in Prevention) and PROVE-IT (Pravastatin or Atorvastatin Evaluation and Infection Therapy), demonstrate the effect of lipid-lowering medications on inflammation. This can have further implications for comprehensive cardiovascular risk reduction.Recent findings: Statins lower hs-CRP alongside low-density lipoprotein cholesterol (LDL-C), with greater effects from high-intensity regimens. Nonstatin medications have variable effects; for example, the addition of ezetimibe to statin therapy enhances hs-CRP reduction. Bempedoic acid exerts direct anti-inflammatory effects, producing significant hs-CRP lowering. Omega-3 fatty acids also demonstrate favorable effects on inflammatory markers. However, fibrates offer only marginal benefits, and PCSK9 inhibitors (Proprotein Convertase Subtilisin/Kexin type 9) have minimal impact. Residual inflammatory risk persists despite LDL-C control, supporting dual-target strategies.Summary: The evidence supports therapeutic strategies targeting both lipid and inflammatory pathways, with hs-CRP serving as a complementary marker to refine cardiovascular risk stratification and guide treatment intensification in primary and secondary prevention. Future studies should evaluate inflammation-targeted adjunctive therapies to address discordance between lipid control and residual inflammatory risk.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"298-303"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147935566","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

Sodium reduction and salt substitutes: impact on blood pressure and recurrent stroke. 减少钠和盐替代品：对血压和复发性中风的影响。

IF 1.9 4区医学

Current Opinion in Cardiology Pub Date : 2026-07-01 Epub Date: 2026-04-27 DOI: 10.1097/HCO.0000000000001300

Priya Patel, Biff F Palmer, Richard A Lange

引用次数: 0

Fetal MRI for cardiopulmonary anomalies: what the pediatric cardiologist and surgeon need to know. 心肺异常的胎儿MRI：儿科心脏病专家和外科医生需要知道的。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2026-07-01 Epub Date: 2026-05-07 DOI: 10.1097/HCO.0000000000001301

Simon E Dadoun, Sonam Mokha, Soheil Kooraki, Yalda Afshar

{"title":"Fetal MRI for cardiopulmonary anomalies: what the pediatric cardiologist and surgeon need to know.","authors":"Simon E Dadoun, Sonam Mokha, Soheil Kooraki, Yalda Afshar","doi":"10.1097/HCO.0000000000001301","DOIUrl":"10.1097/HCO.0000000000001301","url":null,"abstract":"Purpose of review: Advances in fetal cardiac magnetic resonance imaging (CMR) have expanded its role as an adjunct to expert fetal echocardiography in the prenatal evaluation of complex cardiopulmonary anomalies. This review outlines an evidence-based framework for integrating fetal CMR when it provides diagnostic or prognostic information that can informs counseling, delivery planning, or postnatal management.Recent findings: Fetal CMR offers high-resolution, multiplanar imaging with superior soft-tissue contrast and wide field of view, enabling improved assessment of cardiopulmonary structures where echocardiography is limited by technical or physiologic factors, or when expert echocardiography raises clinically relevant questions. MRI enables improved delineation of aortic arch and pulmonary venous anatomy, characterization of pulmonary parenchymal changes, and quantify lung and ventricular volumetry without relying on geometric assumptions. Emerging flow-based techniques allow evaluation of fetal hemodynamics and cardiovascular physiology beyond static imaging. These technologies provide diagnostic and prognostic information in select, often critical, congenital heart diseases.Summary: Fetal cardiac CMR serves as a complementary modality to expert echocardiography when applied selectively to address clinically meaningful diagnostic or prognostic questions. However, limited availability, technical complexity, and the need for specialized expertise currently constrain widespread adoption. Continued technical refinement and outcome-based validation are required before fetal CMR can be routinely integrated into clinical practice.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"328-335"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846732","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

Beyond the 2025 guidelines: tailoring hypertension management to the underlying pathogenic pathway in the age of precision medicine. 超越2025年指南：精准医学时代根据潜在致病途径调整高血压管理。

IF 1.9 4区医学

Current Opinion in Cardiology Pub Date : 2026-07-01 Epub Date: 2026-03-30 DOI: 10.1097/HCO.0000000000001295

Omar Al Dhaybi, Deepak L Bhatt

{"title":"Beyond the 2025 guidelines: tailoring hypertension management to the underlying pathogenic pathway in the age of precision medicine.","authors":"Omar Al Dhaybi, Deepak L Bhatt","doi":"10.1097/HCO.0000000000001295","DOIUrl":"10.1097/HCO.0000000000001295","url":null,"abstract":"Purpose of review: Hypertension is the most common chronic disease in developed countries, with a prevalence exceeding 25-30% of adults. The updated hypertension guidelines define evidence-based blood pressure targets and provide clinicians with a framework for achieving them. Examining the underlying hypertension phenotypes provides a complementary approach to the management of hypertension.Recent findings: Rather than a one-size fits all approach, a more directed hypertension management involves tailoring therapy toward the predominant pathophysiologic mechanism or \"Phenotype\" responsible for blood pressure elevation, rather than adhering to a uniform, stepwise treatment algorithm. Such an approach allows clinicians to tailor therapy to the key biological drivers of hypertension in the individual patient. It is important to note that these pathways overlap and are not isolated, while oftentimes, one single phenotype is the predominant over the others. This article examines these distinct phenotypes, outlining their key characteristics and the best therapeutic approaches for each.Summary: Our ability to delineate hypertension phenotypes through biomedical, genetic and clinical testing is advancing rapidly, and precision medicine innovations are reshaping hypertension care with a level of specific and clinical insights that were not previously attainable, paving the way for the refinement of future hypertension guidelines.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"220-226"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147583168","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 2026: building the future by realizing the past. 2026年的高血压：实现过去，创造未来。

IF 1.9 4区医学

Current Opinion in Cardiology Pub Date : 2026-07-01 Epub Date: 2026-06-04 DOI: 10.1097/HCO.0000000000001297

Omar Al Dhaybi, Deepak L Bhatt

引用次数: 0

Managing and predicting electrical and mechanical failure in the systemic right ventricle. 管理和预测系统性右心室的电气和机械故障。

IF 1.9 4区医学

Current Opinion in Cardiology Pub Date : 2026-07-01 Epub Date: 2026-05-08 DOI: 10.1097/HCO.0000000000001308

Stephanie Fuentes Rojas, Paul Khairy

{"title":"Managing and predicting electrical and mechanical failure in the systemic right ventricle.","authors":"Stephanie Fuentes Rojas, Paul Khairy","doi":"10.1097/HCO.0000000000001308","DOIUrl":"10.1097/HCO.0000000000001308","url":null,"abstract":"Purpose of review: Adults with congenital heart disease increasingly survive into later adulthood, exposing the long-term limitations of a morphologic right ventricle supporting the systemic circulation. Heart failure and arrhythmias are common, frequently coexist, and represent leading causes of morbidity and mortality in this population. This review examines the mechanisms linking systemic right ventricular dysfunction and arrhythmogenesis and their implications for contemporary management.Recent findings: Recent literature highlights that chronic systemic loading of the right ventricle promotes maladaptive structural, electrical, and inflammatory remodeling, creating a substrate for atrial and ventricular arrhythmias. Conversely, arrhythmias exacerbate systemic right ventricular dysfunction through loss of atrioventricular synchrony, tachycardia-mediated impairment, dyssynchrony, and hypoxemia, mechanisms to which systemic right ventricular physiologies are particularly susceptible. Advances in catheter ablation, device therapy, cardiac resynchronization, and conduction system pacing have expanded therapeutic options, although evidence guiding patient selection and timing remains limited.Summary: Failure of the systemic right ventricle and arrhythmias are tightly interwoven processes that evolve over time. Integrating mechanistic insights with longitudinal imaging, electrophysiologic phenotyping, and individualized risk assessment may improve arrhythmia management, refine device strategies, and support more personalized approaches to preserving systemic right ventricular function.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"312-319"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846658","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