Current Opinion in Cardiology最新文献_第7页

Treatment options to break the cycle of recurrent pericarditis. 治疗方案打破心包炎复发循环。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-03-01 Epub Date: 2025-01-10 DOI: 10.1097/HCO.0000000000001201

Ajit B Raisinghani, Sushil Allen Luis

{"title":"Treatment options to break the cycle of recurrent pericarditis.","authors":"Ajit B Raisinghani, Sushil Allen Luis","doi":"10.1097/HCO.0000000000001201","DOIUrl":"10.1097/HCO.0000000000001201","url":null,"abstract":"Purpose of review: This review provides a contemporary, evidence-based update on the pathophysiological mechanisms and rapidly evolving therapeutic options for recurrent pericarditis.Recent findings: Recent studies have elucidated the pathogenesis of recurrent pericarditis, identifying autoinflammation as a key mechanism and interleukin-1 (IL-1) as a central modulator of the inflammatory cascade. Multiple clinical trials have investigated novel therapeutic approaches, particularly focusing on IL-1 inhibition. The recent FDA approval of IL-1 pathway blockade for recurrent pericarditis has revolutionized treatment, offering patients significantly improved quality of life and symptom management.Summary: The enhanced understanding of the autoinflammatory nature of recurrent pericarditis, coupled with groundbreaking advances in targeted therapies, has transformed the treatment landscape for affected patients. The emergence of IL-1 inhibitors as an effective therapeutic option promises substantial improvements in clinical outcomes and patient well being. Clinicians must familiarize themselves with these new treatments, their efficacy, and potential limitations to optimize patient care and guide therapeutic decision-making in this challenging condition.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"107-114"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016858","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

Promoting gender diversity and ergonomic equity in the cardiac surgery operating room. 促进心脏外科手术室的性别多样性和人体工程学公平。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-03-01 Epub Date: 2024-12-26 DOI: 10.1097/HCO.0000000000001195

Eslem Altin, Hamnah Majeed, Raj Verma, Ema Paterson, Bobby Yanagawa

{"title":"Promoting gender diversity and ergonomic equity in the cardiac surgery operating room.","authors":"Eslem Altin, Hamnah Majeed, Raj Verma, Ema Paterson, Bobby Yanagawa","doi":"10.1097/HCO.0000000000001195","DOIUrl":"10.1097/HCO.0000000000001195","url":null,"abstract":"Purpose of review: The operating room (OR) infrastructure and equipment such as gloves, were historically designed at a time when most surgeons were male. Today, there are increasing numbers of females in the OR and we should ensure that there is not a disproportionate risk of ergonomic stress and risk of work-related injuries. This review provides a perspective on the representation of female cardiac surgeons globally and examines the unique ergonomic challenges they may face.Recent findings: Female cardiac surgeons represent approximately 17% of practitioners in our sample of cardiac surgery centers, underscoring significant underrepresentation. Female cardiac surgeons report higher incidences of work-related musculoskeletal injuries and ergonomic challenges compared to their male colleagues. This could negatively impact their physical health and performance. Studies further highlight the inadequacy of standardized surgical tools and workstations in accommodating sex-specific anthropometry, contributing to the disproportionate strain experienced by female surgeons.Summary: To mitigate gender disparities in cardiac surgery, there is a need to optimize OR infrastructure and surgical instrumentation to accommodate sex-based anatomical differences. Implementing ergonomic solutions, such as adjustable workstations and gender-specific surgical tools, could reduce musculoskeletal injuries and improve overall surgeon performance. Addressing these disparities represents a critical step toward fostering an equitable and inclusive surgical workforce, enhancing both the health and career longevity of female cardiac surgeons.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"91-97"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923668","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

Robotic mitral valve surgery: evolving history, techniques, and training paths. 机器人二尖瓣手术：发展历史、技术和训练路径。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-03-01 Epub Date: 2025-01-09 DOI: 10.1097/HCO.0000000000001194

Irsa Hasan, Andrea Amabile, Derrick Y Tam

引用次数: 0

Cardiovascular disease in South Asian immigrants facing adverse socioeconomic circumstances: challenges and opportunities for enhanced management. 面临不利社会经济环境的南亚移民的心血管疾病：加强管理的挑战和机遇。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-01-01 Epub Date: 2024-12-05 DOI: 10.1097/HCO.0000000000001187

Carolina C Pappalettere, Marc Llagostera, Joan Vime-Jubany, Miguel Cainzos-Achirica

{"title":"Cardiovascular disease in South Asian immigrants facing adverse socioeconomic circumstances: challenges and opportunities for enhanced management.","authors":"Carolina C Pappalettere, Marc Llagostera, Joan Vime-Jubany, Miguel Cainzos-Achirica","doi":"10.1097/HCO.0000000000001187","DOIUrl":"10.1097/HCO.0000000000001187","url":null,"abstract":"Purpose of review: To describe the challenges that health professionals often face when attempting to provide optimal primary and secondary prevention care of atherosclerotic cardiovascular disease (ASCVD) to South Asian immigrant patients who face adverse socioeconomic factors, such as many of the South Asian men and women who live in Catalonia, and to present a number of constructive approaches that can help minimize those barriers.Recent findings: The challenges include limited health literacy, frequent language barriers, cultural factors that limit the relevance of standard lifestyle advice, financial barriers, limited access to preventive care, racism, and other barriers. Approaches that can help minimize them and enhance the quality of secondary cardiovascular preventive care in this group include empathy, using support from cultural mediators, enhanced proficiency using readily available translation programs, approaches that minimize financial barriers and simplify treatment regimes, and provision of more culturally competent lifestyle advice, among others.Summary: We hope that the notions included in this review will help physicians and healthcare system managers around the world become more aware and culturally competent when treating South Asian patients with ASCVD. The ongoing Pul-Cat and other studies will illuminate the most effective steps moving forward.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":"40 1","pages":"42-49"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781943","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

Electrographic flow mapping of atrial fibrillation. 心房颤动的电子血流图。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-01-01 Epub Date: 2024-10-29 DOI: 10.1097/HCO.0000000000001182

Steven Castellano, Melissa H Kong

{"title":"Electrographic flow mapping of atrial fibrillation.","authors":"Steven Castellano, Melissa H Kong","doi":"10.1097/HCO.0000000000001182","DOIUrl":"10.1097/HCO.0000000000001182","url":null,"abstract":"Purpose of review: A low ceiling of efficacy exists for the treatment of persistent atrial fibrillation via pulmonary vein isolation without adjunctive ablations, which is likely because they do not target an individual patient's specific underlying disease mechanisms. Electrographic flow (EGF) mapping is the first system that reliably displays wavefront propagation through the atria. It is a promising tool for localizing sources of atrial fibrillation, guiding targeted ablation, and visualizing conduction through the atrial substrate.Recent findings: We describe EGF mapping with emphasis on contemporary studies examining map reproducibility and use cases in the preclinical and clinical environment. Animal experiments demonstrated that maps were interpretable across increasingly complex rhythms with pacing during spontaneously persistent atrial fibrillation reliably simulating EGF sources. The FLOW-AF randomized controlled trial showed that source ablation improved outcomes and that EGF map properties may be used to phenotype patients based on their atrial fibrillation mechanisms and recurrence likelihoods.Summary: Targeted ablation strategies balance the risks of insufficiently ablating atrial fibrillation triggers with exacerbating disease through additional scar formation. EGF mapping leverages spatiotemporal relationships in voltage to localize sources and quantify substrate health. Further research is needed to optimize phenotyping and treatment efforts.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"8-14"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11623381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373618","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 : 2025-01-01 Epub Date: 2024-12-05 DOI: 10.1097/HCO.0000000000001191

引用次数: 0

Ablation options for sub-epicardially located ventricular substrates responsible for ventricular tachycardia: where is it all headed? 心外膜下心室基质导致室速的消融方案：何去何从？

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-01-01 Epub Date: 2024-10-09 DOI: 10.1097/HCO.0000000000001184

Jason S Sperling, Pasquale Santangeli

{"title":"Ablation options for sub-epicardially located ventricular substrates responsible for ventricular tachycardia: where is it all headed?","authors":"Jason S Sperling, Pasquale Santangeli","doi":"10.1097/HCO.0000000000001184","DOIUrl":"10.1097/HCO.0000000000001184","url":null,"abstract":"Purpose of review: Patients with nonischemic and ischemic cardiomyopathy (NICM and ICM) exhibit re-entrant tachycardias related to scar tissue in subepicardial, in addition to typical subendocardial locations. Control of ventricular arrhythmias related to these targets has remained elusive despite advances in mapping and ablation technology.Recent findings: Percutaneous epicardial ablation is the standard after failed endocardial ventricular ablation, but recurrence rates are disappointing. Pulsed-field energy has been associated with coronary artery spasm and therefore may be less suitable for epicardial ablation. Commercially available energy sources, including pulsed-field, have limited depths of myocardial penetration when applied epicardially. Lateral volumetric thermal spreading of ablation injury is associated with decreasing depth of ablation and is difficult to control. A new cryoablation technology based on liquid helium and developed specifically for epicardial work may be able to overcome these limitations.Summary: Ablation strategies that can improve lesion formation in subepicardial ventricular myocardium may improve outcomes of ablation in nonsubendocardial NICM and ICM targets.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"1-7"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481402","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

Coronary artery injury in pulsed field ablation. 脉冲场消融对冠状动脉的损伤。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-01-01 Epub Date: 2024-09-23 DOI: 10.1097/HCO.0000000000001181

Satoshi Higuchi, Edward P Gerstenfeld

{"title":"Coronary artery injury in pulsed field ablation.","authors":"Satoshi Higuchi, Edward P Gerstenfeld","doi":"10.1097/HCO.0000000000001181","DOIUrl":"https://doi.org/10.1097/HCO.0000000000001181","url":null,"abstract":"Purpose of review: Although pulsed field ablation (PFA) has emerged as an innovative nonthermal catheter ablation modality, recent reports raise concerns about its potential impact on nearby coronary arteries. This review provides a comprehensive overview of the current understanding and future directions regarding the effects of PFA on or near coronary arteries.Recent findings: Clinical studies have demonstrated the risks of acute transient vasospasm after delivery of PFA, especially with ablation of structures in proximity to the coronary arteries, such as the cavotricuspid and mitral isthmuses. The clinical incidence has been reported to be approximately 0.14%, according to the largest multicenter registry. Nitroglycerin pretreatment has been demonstrated to mitigate vasospastic events. However, early preclinical models indicate that chronic neointimal hyperplasia, tunica media fibrosis and mild coronary artery narrowing may occur, suggesting long-term coronary injury after delivering PFA near coronary arteries.Summary: Despite reducing collateral tissue damage compared with thermal methods, PFA near coronary arteries may require careful procedural planning and proactive use of nitroglycerin to reduce coronary vasospasm. Further research is essential to elucidate the mechanisms underlying PFA-induced coronary spasm, optimize catheter design and placement, and assess the long-term coronary health implications.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":"40 1","pages":"22-30"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781944","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

Rethinking atherosclerotic cardiovascular disease prevention in the era of expanding therapies: could plaque stabilization reduce the need for lifelong treatments and polypharmacy? 在疗法不断扩展的时代重新思考动脉粥样硬化性心血管疾病的预防：稳定斑块能否减少对终身治疗和多种药物的需求？

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-01-01 Epub Date: 2024-10-16 DOI: 10.1097/HCO.0000000000001188

Kathrine Bruun, Martin Bødtker Mortensen

{"title":"Rethinking atherosclerotic cardiovascular disease prevention in the era of expanding therapies: could plaque stabilization reduce the need for lifelong treatments and polypharmacy?","authors":"Kathrine Bruun, Martin Bødtker Mortensen","doi":"10.1097/HCO.0000000000001188","DOIUrl":"10.1097/HCO.0000000000001188","url":null,"abstract":"Purpose of review: This review examines current evidence on pharmacologically induced plaque stabilization in the context of a growing range of new therapies. It explores the potential for a paradigm shift in atherosclerotic cardiovascular disease (ASCVD) prevention, where treatments may not need to be lifelong to achieve lasting benefits.Recent findings: Since 2015, over 14 novel therapies have been introduced, each shown to reduce ASCVD risk when added to standard care with statins and aspirin. More than 80% of ischemic heart disease patients are now eligible for one or more of these treatments, increasing the risk of polypharmacy, treatment burden, and adverse side effects. As more therapies become available, this challenge is expected to grow. Many of these treatments have demonstrated plaque regression and stabilization, as evidenced by both intravascular ultrasound and computed tomography angiography, which likely explains much of their efficacy.Summary: The increasing number of novel therapies presents challenges in preventing ASCVD without leading to lifelong polypharmacy and increased patient burden. Since many of these drugs act through plaque stabilization, a new approach may be feasible - using these treatments for shorter durations to induce plaque regression, followed by less intensive maintenance therapies to preserve stability. This approach warrants further investigation in future studies.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"50-55"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481403","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 management of new-onset atrial fibrillation in critical illness: an update on current therapeutic options. 危重病人新发心房颤动的管理：当前治疗方案的最新进展。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-01-01 Epub Date: 2024-10-09 DOI: 10.1097/HCO.0000000000001186

Zhe Wang, Jiang Li, Yihong Sun

{"title":"The management of new-onset atrial fibrillation in critical illness: an update on current therapeutic options.","authors":"Zhe Wang, Jiang Li, Yihong Sun","doi":"10.1097/HCO.0000000000001186","DOIUrl":"10.1097/HCO.0000000000001186","url":null,"abstract":"Purpose of review: New-onset atrial fibrillation (NOAF) is the most prevalent arrhythmia among critically ill patients, correlating with heightened morbidity and mortality rates. Current evidence for managing NOAF in this patient population is limited.Recent findings: Numerous meta-analyses have been conducted to assess the efficacy of atrial fibrillation treatments in acute settings, including rate or rhythm control strategies, anticoagulation, and intensive care interventions. The employment of β-blockers for rate control appears to confer greater benefits in critically ill patients. However, the advantage of anticoagulation remains ambiguous because of bleeding risks, which is partly attributed to the scarcity of evidence in the complex context of critical illness. Approximately one-third of patients with transient atrial fibrillation face recurrence within a year. Therefore, vigilant posthospitalization follow-up and monitoring should be considered for high-risk patients to detect atrial fibrillation recurrence. Long-term anticoagulation strategies should be tailored to individual patient profiles, weighing the risks of thromboembolism.Summary: Factors predicting atrial fibrillation recurrence include age, the burden of atrial fibrillation, and atrial size. There are significant knowledge gaps concerning NOAF in critically ill patients, highlighting the need for further research, particularly randomized clinical trials.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"31-36"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481404","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