Expert Rev Cardiovasc Ther [JOURNAL]
Sun
200 papers
Effects of mineralocorticoid receptor antagonists on cardiometabolic profile and liver health in individuals with increased cardiometabolic risk: a systematic review and meta-analysis of randomized controlled trials.
Dias J, Leite AR, Godinho T … +4 more , Correia-Chaves J, Borges-Canha M, Leite-Moreira A, Neves JS
Expert Rev Cardiovasc Ther · 2026 · PMID 41702409 · Publisher ↗
INTRODUCTION: Recent studies link overactivation of mineralocorticoid receptors to insulin resistance, inflammation, and metabolic dysfunction-associated steatotic liver disease. We aimed to assess the effects of mineral...
INTRODUCTION: Recent studies link overactivation of mineralocorticoid receptors to insulin resistance, inflammation, and metabolic dysfunction-associated steatotic liver disease. We aimed to assess the effects of mineralocorticoid receptor antagonists (MRAs) on liver steatosis, fibrosis, inflammation, and cardiometabolic risk. METHODS: We conducted a systematic review and meta-analysis including placebo-controlled randomized controlled trials (RCTs) assessing MRAs' effects. A random-effects meta-analysis assessed MRAs effects on anthropometry, lipid profile, inflammatory parameters, and glucose metabolism. Outcomes were presented as mean differences (MD) with 95% confidence intervals (95% CI). Twenty-six studies were included and seventeen were meta-analyzed. MRAs studied included spironolactone, eplerenone, canrenone, apararenone, and finerenone. Most studies included participants with diabetes, metabolic syndrome, obesity, heart failure, or hypertension. RESULTS: In the meta-analysis, we found a mild but significant decrease in body weight (MD = -1.27, 95% CI [-2.54, -0.01]) and a trend for higher HbA1c (MD = 0.13, 95% CI [-0.01, 0.27]) with MRAs. There was a trend toward a decrease in C-reactive protein levels (MD = -0.99, 95% CI [-2.22, 0.24]) with MRAs. RCTs on liver function and structure showed no differences compared to placebo. CONCLUSIONS: MRAs appear to have a mild impact on metabolic and inflammatory parameters in patients with increased cardiometabolic risk. However, more RCTs on MRAs' cardiometabolic impact are needed. REGISTRATION: This study was registered with PROSPERO (CRD42025632202).
Technological advancements for improving preoperative assessment and precision in cardiovascular surgery.
Galyfos G, Chamzin A, Theodorou A … +3 more , Sigala F, Filis K, Theodorou D
Expert Rev Cardiovasc Ther · 2026 · PMID 41701924 · Publisher ↗
INTRODUCTION: Cardiovascular surgery, including cardiac surgery and complex endovascular procedure, needs careful preoperative planning as well as intraoperative precision to improve outcomes and ameliorate complications...
INTRODUCTION: Cardiovascular surgery, including cardiac surgery and complex endovascular procedure, needs careful preoperative planning as well as intraoperative precision to improve outcomes and ameliorate complications. During the last decades, several technological advancements have been made that could improve preoperative assessment, design of the surgical procedure, risk prediction as well as surgical precision. AREAS COVERED: Several areas of technological advancements referring to cardiovascular surgery are discussed in this review. Data have been collected using the Pubmed, Scopus, and Google Scholar databases. We report advancements regarding the utilization of artificial intelligence in preoperative assessment and risk prediction. We also report on advancements made in intraoperative imaging including holographic and fusion imaging techniques. Furthermore, operating techniques such as the use of novel endovascular tools or robotic surgery are also discussed. Finally, other novel technologies, such as three-dimentional (3D) printing, is also presented. EXPERT OPINION: In the next 5 years, technological advancements in cardiovascular surgery will be definitely improved and more broadly used. Although these advancements are associated with a very high cost and a longer learning curve, the associated healthcare cost benefit is evident. Due to bioethical reasons, this progress will need to be contained and controlled by humans.
Exercise stress cardiac magnetic resonance imaging in cardiac patients.
Uwase E, Caru M, Levesque A … +5 more , Sholler C, McAlexander J, Dodin P, Curnier D, Périé D
Expert Rev Cardiovasc Ther · 2026 · PMID 41701481 · Publisher ↗
INTRODUCTION: Cardiac magnetic resonance imaging testing protocols used in combination with exercise (Ex-CMR) facilitate the characterization of the heart by differentiating between normal cardiac remodeling and patholog...
INTRODUCTION: Cardiac magnetic resonance imaging testing protocols used in combination with exercise (Ex-CMR) facilitate the characterization of the heart by differentiating between normal cardiac remodeling and pathological cardiac remodeling. Studies have reported challenges when using Ex-CMR, limiting its clinical use. Hence, this review provides an overview of existing Ex-CMR studies focusing on cardiac remodeling in cardiac patients. METHODS: This scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. A total of 24 studies were included in this review. RESULTS: A total of 538 patients (265 males and 200 females) underwent an Ex-CMR procedure. Ex-CMR testing protocols included cycle ergometer (=20), isometric handgrip exercise (=3) and stepper ergometer (=1). Exercise-induced cardiovascular responses were evaluated in both the left and right ventricles. This review reports the advantages and limitations of Ex-CMR testing. CONCLUSIONS: This scoping review identified existing Ex-CMR protocols that assess cardiovascular responses among cardiac patients, highlighting their advantages and limitations. Both cycle ergometer and isometric handgrip protocols have been used to induce cardiovascular responses in cardiac patients. Nevertheless, it appears that developing an effective Ex-CMR protocol is necessary and may improve early detection of abnormal cardiovascular responses in cardiac patients. REGISTRATION: This study was registered as a protocol as 'Exercise stress cardiac magnetic resonance imaging in the assessment of induced cardiovascular responses in cardiac patients: a scoping review protocol' (https://journals.lww.com/jbisrir/fulltext/2023/09000/exercise_stress_cardiac_magnetic_resonance_imaging.10.aspx) with the protocol prospectively registered with the Open Science Framework (https://osf.io/hvn75/overview?view_only = f6cf8fc2112e498d89c39639dbce70d1).
Temporal trends of cardiac implantable electronic devices (CIED) implantation in the Brazilian Public Health System: a 12-year real-world data study.
Marcolino MAZ, Antonini Ribeiro R, Polanczyk CA
Expert Rev Cardiovasc Ther · 2026 Feb · PMID 41641808 · Publisher ↗
BACKGROUND: Population aging, cardiovascular disease burden, and evolving clinical practices may influence procedure rates, key to health policy planning. This study aimed to describe cardiac implantable electronic devic...
BACKGROUND: Population aging, cardiovascular disease burden, and evolving clinical practices may influence procedure rates, key to health policy planning. This study aimed to describe cardiac implantable electronic devices (CIED) implantation trends in the Brazilian Universal Health System (SUS) over 12 years. RESEARCH DESIGN AND METHODS: Ecological study using open data on hospital claims (2008-2019) for permanent pacemaker (PM), implantable cardioverter-defibrillator (ICD), and cardiac resynchronization therapy with pacemaker (CRT-P) or defibrillator (CRT-D) implants. Annual percent changes (APC) with 95% confidence interval (CI) were estimated by linear regression of the logarithm of age and sex standardized implantation rates per million (MM) population (Brazil 2019 population). RESULTS: In total, 216,927 CIED implants were analyzed. Annual implant volume rose from 14,466 to 20,726 (+43.3%). Nonetheless, the standardized rate declined from 108.9 to 98.2/MM (-9.8%), with an APC of -1.2% (95%CI -1.7% to -0.7%). PM and ICD rates were stable, but CRT trends diverged (CRT-D increasing, CRT-P decreasing). Regional analyses showed negative trends for PM and CRT-P, and heterogeneous ICD/CRT-D patterns. CONCLUSIONS: Despite increasing volume, standardized CIED implantation rates declined in SUS, especially for PM and CRT-P. Divergent regional trends highlight the need for targeted health policies to ensure equitable access to advanced CIED therapies.
Trends and forecasting of mortality associated with obstructive sleep apnea and hypertension among older adults in the United States (1999-2035).
Umar M, Shah SS, Hafeez S … +7 more , Baig MMA, Amin A, Zafar A, Hidayat A, Naz I, Patel K, Sattar Y
Expert Rev Cardiovasc Ther · 2026 · PMID 41615151 · Publisher ↗
BACKGROUND: Obstructive sleep apnea (OSA) and hypertension (HTN) frequently coexist and are associated with increased cardiovascular morbidity and mortality in the United States. RESEARCH DESIGN AND METHODS: Mortality da...
BACKGROUND: Obstructive sleep apnea (OSA) and hypertension (HTN) frequently coexist and are associated with increased cardiovascular morbidity and mortality in the United States. RESEARCH DESIGN AND METHODS: Mortality data from 1999-2023 were obtained from the CDC WONDER Multiple Causes of Death database. Deaths were identified when ICD-10 codes for OSA (G47.3) and HTN (I10-I15) were listed as underlying or contributing causes of death. Age-adjusted mortality rates (AAMRs) were calculated and stratified by demographic and geographic factors. Temporal trends were evaluated using Joinpoint regression, and mortality was forecasted using Poisson regression model. RESULTS: A total of 107,514 deaths were associated with OSA and HTN between 1999 and 2023. AAMRs increased from 0.4 in 1999 to 12.4 in 2023, with higher rates observed among males, adults aged ≥75 years, NH-White individuals, rural populations, and residents of the Midwest. Among states, West Virginia had the highest AAMR. Forecasting models project continued increases in overall mortality, with AAMRs reaching 55.38 by 2035. CONCLUSIONS: Mortality associated with OSA and HTN has increased substantially over the past two decades, disproportionately affecting older adults, males, and rural populations. Forecasted trends highlight the need for targeted prevention, early diagnosis, and improved access to effective therapies.
Ensuring long-term arrhythmia freedom: what are the options for long-standing persistent atrial fibrillation?
Kotoulas SC, Doundoulakis I, Tsiachris D … +8 more , Pannone L, Botis M, Poulimenos LS, Chiotis S, Kordalis A, Chierchia GB, de Asmundis C, Tsioufis C
Expert Rev Cardiovasc Ther · 2026 · PMID 41603043 · Publisher ↗
INTRODUCTION: Long-standing persistent atrial fibrillation (LSPAF) is among the most challenging arrhythmia phenotypes to manage, due to extensive atrial remodeling, fibrosis, and the presence of complex non-pulmonary ve...
INTRODUCTION: Long-standing persistent atrial fibrillation (LSPAF) is among the most challenging arrhythmia phenotypes to manage, due to extensive atrial remodeling, fibrosis, and the presence of complex non-pulmonary vein substrates and triggers. Conventional antiarrhythmic drug (AAD) therapy provides limited efficacy and is constrained by short- and long-term toxicity. Catheter ablation (CA) remains the cornerstone of rhythm control but offers modest single-procedure success. AREAS COVERED: This review examines current treatment strategies for LSPAF, including pharmacologic rhythm control, CA, and hybrid surgical - endocardial approaches. Evidence from major clinical trials and meta-analyses is summarized, highlighting the limitations of pulmonary vein isolation (PVI) as a stand-alone therapy and the role of adjunctive strategies. The article also discusses novel approaches, including pulsed field ablation (PFA), fibrosis-guided mapping, and insights from recent international guidelines. EXPERT OPINION: CA remains the most effective rhythm-control strategy for LSPAF, but durable arrhythmia-free survival often requires repeat or hybrid procedures. Hybrid ablation should be considered, particularly in patients with advanced atrial remodeling. Emerging technologies, including PFA, offer the potential for improved outcomes. Future progress will depend on dedicated LSPAF trials with standardized endpoints, long-term follow-up, and broader patient representation to refine selection, optimize lesion sets, and establish the role of next-generation technologies.
Contemporary implantable cardiac device trials for sudden cardiac death and future guidelines: how can we shape the future?
Fastenrath F, Sattler K, Duerschmied D … +3 more , Lewandowski M, Akin I, Kuschyk J
Expert Rev Cardiovasc Ther · 2026 · PMID 41569233 · Publisher ↗
INTRODUCTION: Sudden cardiac death (SCD) remains a major cause of mortality despite substantial progress in heart failure management and arrhythmia prevention. Current implantable cardioverter-defibrillator (ICD) guideli...
INTRODUCTION: Sudden cardiac death (SCD) remains a major cause of mortality despite substantial progress in heart failure management and arrhythmia prevention. Current implantable cardioverter-defibrillator (ICD) guideline recommendations, mainly based on left ventricular ejection fraction (LVEF), are largely derived from historical trials and may no longer reflect contemporary patient populations or therapies. AREAS COVERED: This review critically appraises the historical and contemporary ICD evidence base with particular attention to evolving background therapy, competing risks of non-arrhythmic death, device technology, and modern risk stratification strategies. ICD trials cited in major international guidelines were reviewed and supplemented by a targeted PubMed literature search using ICD-related keywords, including relevant publications through September 2025. We emphasize emerging tools such as cardiac magnetic-resonance-imaging, genomics, artificial intelligence, remote monitoring data, and modular cardiac rhythm management systems. EXPERT OPINION: We propose a future ICD trial framework grounded in multimodal risk assessment, competing-risk-adjusted endpoints, pragmatic and adaptive trial designs, and device-specific evaluation pathways. We further outline how future guidelines may evolve to incorporate enriched patient phenotyping, precision risk prediction, and personalized device selection. Together, these developments signal a paradigm shift toward an individualized, digitally supported, and modular approach to SCD prevention in the next decade.
Alternatives to right ventricular pacing in patients with atrioventricular block: can we prevent pacing-induced cardiomyopathy?
Dogan M, Canpolat U
Expert Rev Cardiovasc Ther · 2026 · PMID 41568415 · Publisher ↗
INTRODUCTION: Right ventricular apical pacing (RVAP) has been a standard treatment for patients experiencing symptomatic advanced atrioventricular (AV) block. However, due to electrical and subsequent mechanical dyssynch...
INTRODUCTION: Right ventricular apical pacing (RVAP) has been a standard treatment for patients experiencing symptomatic advanced atrioventricular (AV) block. However, due to electrical and subsequent mechanical dyssynchrony, RVAP might lead to pacing-induced cardiomyopathy (PICM). Various predisposing risk factors for PICM have been identified. AREAS COVERED: This review, based on a literature search of PubMed and Scopus databases (up to April 2025), focuses on alternative pacing strategies, including conduction system pacing (CSP) and biventricular pacing (BiVP), to reduce PICM. EXPERT OPINION: Implementing pacing strategies that encourage physiological ventricular activation, like CSP and BiVP, can greatly diminish the risk of PICM in patients with AV block. Implementing alternative pacing strategies necessitates careful patient selection and consideration of individual anatomical and clinical factors. A team-based approach should be utilized to identify the most suitable pacing method for each patient, with the goal of optimizing cardiac function and reducing the risk of PICM.
Ivabradine in acute myocardial infarction: a systematic review and meta-analysis of randomized controlled trials.
Kow CS, Zaihan AF, Hasan SS … +1 more , Thiruchelvam K
Expert Rev Cardiovasc Ther · 2026 · PMID 41537857 · Publisher ↗
INTRODUCTION: While effective in stable angina and chronic heart failure, ivabradine's role in acute myocardial infarction (AMI) is less clear. We assessed the effects of ivabradine versus placebo or standard care on all...
INTRODUCTION: While effective in stable angina and chronic heart failure, ivabradine's role in acute myocardial infarction (AMI) is less clear. We assessed the effects of ivabradine versus placebo or standard care on all-cause mortality, major adverse cardiovascular events (MACE) and heart failure in AMI patients. METHODS: We systematically searched six databases through April 2025 for randomized controlled trials (RCTs) comparing ivabradine to control therapy in AMI. Primary outcomes included all-cause mortality, MACE, and heart failure incidence. Random-effects meta-analysis was conducted, with sensitivity analyses using the IVhet model. Risk of bias was assessed using the Cochrane RoB 2.0 tool, and publication bias was explored via funnel plots. RESULTS: Fifteen RCTs involving 2220 patients (ivabradine: 1126; control: 1094) were included. Ivabradine did not significantly reduce all-cause mortality (OR 0.66, 95% CI: 0.38-1.16), though the trend favored treatment. It significantly reduced MACE (OR 0.49, 95% CI: 0.30-0.82; I = 12%) and heart failure events (OR 0.60, 95% CI: 0.40-0.90). Subgroup analysis indicated greater benefit when combined with beta-blockers. Sensitivity analyses confirmed these findings. CONCLUSION: Ivabradine may reduce cardiovascular complications post-AMI, particularly MACE and heart failure, and may serve as a useful adjunct to standard therapy. Further large-scale trials are warranted. REGISTRATION: This systematic review and meta-analysis was registered on PROSPERO (CRD420251054716).
Management of acute cardiovascular consequences of sleep disorders: clinical implications for improved patient outcomes.
Tated RPC, Maheta D, Mankad S … +6 more , Maturi B, Agrawal SP, Biba V, Dhamelia A, Oza J, Aronow WS
Expert Rev Cardiovasc Ther · 2026 · PMID 41504280 · Publisher ↗
INTRODUCTION: Sleep disorders such as insomnia, restless legs syndrome (RLS) and sleep disordered breathing such as obstructive sleep apnea (OSA) and central sleep apnea (CSA) are increasingly recognized as independent r...
INTRODUCTION: Sleep disorders such as insomnia, restless legs syndrome (RLS) and sleep disordered breathing such as obstructive sleep apnea (OSA) and central sleep apnea (CSA) are increasingly recognized as independent risk factors for acute cardiovascular events. AREAS COVERED: This review highlights the key mechanisms linking sleep disorders to acute cardiovascular events, including autonomic dysregulation, intermittent hypoxia, systemic inflammation, and endothelial dysfunction. These contribute to arrhythmias, acute coronary syndromes, heart failure exacerbations, and strokes. OSA stands out due to its strong association with cardiovascular risk through repetitive hypoxia and sympathetic activation. Treatment options like CPAP, ASV, and phrenic nerve stimulation show benefits, though long-term cardiovascular outcomes are still being studied. Despite growing evidence, sleep disorders remain underdiagnosed in cardiac patients, underscoring the need for improved screening and management. EXPERT OPINION: Integrating sleep evaluations into routine cardiovascular care could help reduce acute events and improve outcomes. Increased screening, better awareness among clinicians, and accessible treatment pathways are essential. Further longitudinal research is needed to confirm causal links and assess the sustained cardiovascular benefits of managing sleep disorders, especially in high-risk groups.
Management of new-onset postoperative atrial fibrillation after coronary artery bypass grafting.
Herrmann FEM, Jeppsson A, Taha A
Expert Rev Cardiovasc Ther · 2026 · PMID 41447343 · Publisher ↗
INTRODUCTION: New-onset postoperative atrial fibrillation (POAF) is the most common arrhythmia after coronary artery bypass grafting (CABG). Traditionally regarded as a benign and self-limiting event, more recent evidenc...
INTRODUCTION: New-onset postoperative atrial fibrillation (POAF) is the most common arrhythmia after coronary artery bypass grafting (CABG). Traditionally regarded as a benign and self-limiting event, more recent evidence highlights its association with prolonged hospitalization, increased healthcare utilization, and a heightened risk of stroke, recurrent atrial fibrillation, and heart failure. Understanding its significance is essential for patient care and long-term outcomes. PubMed was searched using terms related to POAF and CABG, supplemented by the review of relevant guidelines and key publications. AREAS COVERED: This narrative review summarizes recent evidence on the epidemiology, pathophysiology, prophylaxis, and treatment of POAF after CABG. Evidence for pharmacological prophylaxis (e.g. amiodarone, beta-blockers) and surgical strategies (e.g. posterior pericardiotomy, atrial pacing) is summarized, along with current approaches for acute management and stroke prevention. The literature reveals significant heterogeneity in treatment strategies, particularly regarding anticoagulation, with emerging trials expected to refine clinical practice. EXPERT OPINION: Current evidence suggests that POAF functions more as an indicator of underlying patient vulnerability than as a direct driver of adverse outcomes. Clinically, management must balance arrhythmia control, stroke and bleeding risk, and individualized anticoagulation decisions. Research efforts should prioritize robust risk stratification tools and randomized evidence to guide tailored therapy.
Can vascular biomarkers be used in hypertension management to improve cardiovascular outcomes?
Kabutoya T
Expert Rev Cardiovasc Ther · 2026 Jan · PMID 41436724 · Publisher ↗
INTRODUCTION: The association between vascular biomarkers as indices of atherosclerosis and cardiovascular events has been widely reported. Measurement of vascular biomarkers has been used for risk stratification and pro...
INTRODUCTION: The association between vascular biomarkers as indices of atherosclerosis and cardiovascular events has been widely reported. Measurement of vascular biomarkers has been used for risk stratification and prognostic prediction in hypertensive patients and has been included in various hypertension guidelines. AREAS COVERED: This article describes the evidence for various vascular biomarkers in hypertension practice, their interpretation in guidelines and future perspectives. EXPERT OPINION: Regarding the risk stratification of physiological vascular tests in hypertensive patients, while some hypertension guidelines provide cutoff values for physiological tests, the reference values for blood biomarkers are not clearly defined. Future evidence on the contribution of vascular biomarker measurements to improve outcome in hypertensive patients is expected, including the establishment of appropriate cutoff values based on large studies of blood biomarkers and future evidence on cardio-ankle vascular index.
How coronary plaque morphology affects fractional flow reserve: clinical evidence from intravascular imaging studies.
Murai K, Kataoka Y, Honda S … +7 more , Fujino M, Yoneda S, Nakao K, Takagi K, Otsuka F, Asaumi Y, Noguchi T
Expert Rev Cardiovasc Ther · 2026 Jan · PMID 41403090 · Publisher ↗
INTRODUCTION: Fractional flow reserve (FFR) is widely used to assess the functional significance of coronary artery disease (CAD). However, the severity of anatomical stenosis does not always correspond with the extent o...
INTRODUCTION: Fractional flow reserve (FFR) is widely used to assess the functional significance of coronary artery disease (CAD). However, the severity of anatomical stenosis does not always correspond with the extent of myocardial ischemia. This discordance highlights the limitations of angiographic assessment alone and underscores the need for more comprehensive evaluation strategies. Recent advances in intravascular imaging have provided deeper insights into the contribution of plaque itself to myocardial ischemia. A PubMed search was conducted for relevant studies published up to May 2025. AREAS COVERED: This review summarizes current evidence on the relationship between intravascular imaging-derived plaque characteristics and FFR. Key features examined include plaque burden, lipidic and calcified plaques, and plaque microstructures. Of these, large plaque burden and lipid-rich plaque characteristics show the most consistent associations with reduced FFR. Mechanistic explanations such as impaired vasodilatory capacity and localized endothelial dysfunction are also explored. EXPERT OPINION: Plaque morphology contributes important diagnostic and prognostic information beyond luminal narrowing. Integrating morphological imaging with physiological assessment is expected to improve clinical decision-making and management of CAD. Future research should focus on validating integrated imaging-physiology strategies to personalize treatment and improve outcomes in patients with CAD.
Prioritizing surgical ablation for atrial fibrillation during coronary artery bypass grafting: new evidence, old debate.
Erez E, Squiers JJ, Dorton CW … +5 more , Banwait J, Gasparini A, Mack M, DiMaio JM, Schaffer JM
Expert Rev Cardiovasc Ther · 2026 Jan · PMID 41388766 · Publisher ↗
INTRODUCTION: Atrial fibrillation (AF) affects 10-20% of patients undergoing coronary artery bypass grafting (CABG) and is associated with increased postoperative morbidity and mortality. Although studies support the saf...
INTRODUCTION: Atrial fibrillation (AF) affects 10-20% of patients undergoing coronary artery bypass grafting (CABG) and is associated with increased postoperative morbidity and mortality. Although studies support the safety and effectiveness of surgical ablation (SA), and guidelines recommend its use during CABG for patients with preexisting AF, clinical adoption remains limited. AREAS COVERED: In this review, we outline current guideline recommendations, evaluate the evidence base, highlight recent analyses, and examine persistent barriers to the adoption of SA during CABG, informed by studies identified through searches of PubMed and Google Scholar. EXPERT OPINION: Small randomized studies demonstrate that SA restores sinus rhythm following CABG, while observational studies suggest rhythm restoration improves survival and reduces thromboembolic events. Recent national database analyses have lent further support, finding an association between SA and long-term survival. Analytic approaches included analysis by treatment type using propensity-score risk adjustment and, more recently, using surgeon frequency of SA as an instrumental variable. However, concerns about unmeasured confounding, sparse rhythm follow-up, and limited lesion-set granularity undermine confidence and contribute to underuse. A randomized trial comparing long-term outcomes between pulmonary vein isolation, left atrial, and bi-atrial lesion sets is critically needed to guide optimal implementation of SA during CABG.
Secretoneurin as a novel cardiovascular biomarker and potential therapeutic strategy.
Ottesen AH, Røsjø H, Omland T
Expert Rev Cardiovasc Ther · 2026 Jan · PMID 41388621 · Publisher ↗
INTRODUCTION: Secretoneurin (SN) is a prognostic biomarker in cardiovascular disease (CVD), and circulating SN concentrations have been associated with clinical outcomes in various cohort of CVDs. SN reflects other cellu...
INTRODUCTION: Secretoneurin (SN) is a prognostic biomarker in cardiovascular disease (CVD), and circulating SN concentrations have been associated with clinical outcomes in various cohort of CVDs. SN reflects other cellular pathways than established CV biomarkers, and SN provides incremental prognostic information to established CV risk indices. SN has been found to have several beneficial properties and SN could have potential as a future therapeutic strategy in CVD. AREAS COVERED: This review discusses SN as a novel cardiovascular biomarker and a potential therapeutic strategy in cardiovascular medicine. The authors have considered relevant papers identified by PubMed. EXPERT OPINION: SN is a prognostic biomarker in CVD, and unraveling the underlying pathophysiology of SN will be important to advance SN as a biomarker and potential future therapy in CVD. The future for SN as a biomarker and therapy is attractive and could be of future clinical relevance.
How can we best utilize atherosclerotic burden as a predictor of vascular outcomes in atrial fibrillation patients?
Mumoli N, Marengo S, Cei F
Expert Rev Cardiovasc Ther · 2026 Jan · PMID 41388610 · Publisher ↗
Abstract loading — click title to view on PubMed.
Evaluating catheter usage for atrial fibrillation ablation: improving rates of efficacy and safety.
Poggi S, Iuliano A, Spiniello G … +3 more , De Simone A, Solimene F, Stabile G
Expert Rev Cardiovasc Ther · 2026 Jan · PMID 41384352 · Publisher ↗
INTRODUCTION: Pulmonary vein (PV) isolation remains the cornerstone of atrial fibrillation (AF) catheter ablation. While the single-tip radiofrequency-based PV isolation in conjunction with a 3D mapping system was for ma...
INTRODUCTION: Pulmonary vein (PV) isolation remains the cornerstone of atrial fibrillation (AF) catheter ablation. While the single-tip radiofrequency-based PV isolation in conjunction with a 3D mapping system was for many years considered to be the 'gold standard,' the strategy of PV isolation has evolved tremendously in the recent years. AREA COVERED: This review explores the latest energy source and catheter technologies developed in order to improve the efficiency, safety, and persistence of acute success over the long-term follow-up in patients undergoing PV isolation for AF ablation. Relevant articles were searched in PubMed, Scopus, and Cochrane databases up to August 2025. EXPERT OPINION: Radiofrequency remains a milestone, especially in the field of the point-by-point ablation manner. The introduction of the temperature-controlled ablation catheters allows ablation with higher power settings compared to standard power-controlled ablation, resulting in high acute and one-year success rate with a low incidence of complications. Similar results have been reported with both cryoballoon ablation system, with shorter procedural time and longer fluoroscopy time. Pulsed field ablation is a novel ablation modality, largely nonthermal, aiming at creating transmural, durable ablation lesions while reducing the risk of collateral damage.
Coronary artery bypass grafting versus percutaneous coronary intervention outcomes among patients with acute coronary syndrome and unprotected left main coronary artery disease: a meta-analysis with a reconstructed time-to-event analysis.
Elbahloul MA, Gadelmawla AF, Ali AHG … +6 more , Awad AK, Elazab A, Mansour A, Mohamed AN, Sarhan H, Elgendy IY
Expert Rev Cardiovasc Ther · 2026 Jan · PMID 41379597 · Publisher ↗
INTRODUCTION: Patients with an unprotected left main coronary artery (ULMCA) presenting with acute coronary syndrome (ACS) were underrepresented in randomized trials. We aimed to compare the outcomes of coronary artery b...
INTRODUCTION: Patients with an unprotected left main coronary artery (ULMCA) presenting with acute coronary syndrome (ACS) were underrepresented in randomized trials. We aimed to compare the outcomes of coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) in these patients. METHODS: Electronic databases were searched for studies comparing CABG vs PCI for patients with ULMCA presenting with ACS. The primary outcome was all-cause mortality. The outcomes were reported using a risk ratio (RR) and 95% confidence interval (CI) using random-effect model. RESULTS: A total of 7 studies with 4033 patients were included. There was no difference in the incidence of all-cause mortality between CABG and PCI. CABG was associated with a trend toward a higher incidence of stroke in short-term, but with lower rates of lower target vessel revascularization, and target lesion revascularization during long-term follow-up. CONCLUSIONS: CABG and PCI were associated with comparable long-term mortality among patients with ULMCA who presented with ACS. However, CABG was associated with a lower incidence of MI and revascularization but a trend toward a higher incidence of stroke. These findings could help with informed decision-making among patients with ULMCA presenting with ACS. REGISTRATION: The protocol was registered on PROSPERO (CRD420251034578).
Diagnosis and treatment of coronary artery disease in patients with chronic kidney disease.
Dod R, Yadav H, Jovin IS
Expert Rev Cardiovasc Ther · 2025 Dec · PMID 41320798 · Publisher ↗
INTRODUCTION: Patients with chronic kidney disease (CKD) have a significantly elevated risk of coronary artery disease. The relationship between CAD and CKD is multifaceted involving complex physiological mechanisms that...
INTRODUCTION: Patients with chronic kidney disease (CKD) have a significantly elevated risk of coronary artery disease. The relationship between CAD and CKD is multifaceted involving complex physiological mechanisms that result in increased inflammation, oxidative stress, and lipid abnormalities. Medical therapy and interventions in these comorbid conditions are highly complex, as they must ideally address both cardiovascular risk reduction and renal protection. AREAS COVERED: This literature review provides an overview of the epidemiology, unique pathophysiology, clinical presentation, and management of CAD in patients with CKD. We searched PubMed and Web of Science databases from inception to November 2025 to gather evidence-based recommendations regarding CAD in CKD. We also discuss the challenges of medical and revascularization therapy that arise in patients with concurrent CAD and CKD, including providing insight into outcome differences in percutaneous coronary intervention compared to coronary artery bypass grafting. EXPERT OPINION: CAD in CKD remains sub-optimally treated due to provider hesitancy, poor risk stratification tools, and limited dedicated trials. New medical therapies show potential. Future advances may include CKD-specific CAD calculators, contrast-free imaging, artificial intelligence driven treatment models, and expanded guideline-based use, though real-world implementation will require overcoming cost and education barriers.
Use of sodium-glucose cotransporter 2 inhibitor in heart failure: a real-world study.
Valladales-Restrepo LF, Torrente-López D, Bedoya-Toro CM … +3 more , Lerma-Barco MF, Franco-Carvajal AS, Machado-Alba JE
Expert Rev Cardiovasc Ther · 2025 Dec · PMID 41319251 · Publisher ↗
BACKGROUND: The aim was to determine the use of Sodium - Glucose Cotransporter-2 Inhibitors (SGLT2i) in patients with heart failure with and without diabetes mellitus in Colombia. RESEARCH DESIGN AND METHODS: The use of...
BACKGROUND: The aim was to determine the use of Sodium - Glucose Cotransporter-2 Inhibitors (SGLT2i) in patients with heart failure with and without diabetes mellitus in Colombia. RESEARCH DESIGN AND METHODS: The use of SGLT2i in patients with heart failure, followed for one year was evaluated. The patterns of use, indications, adherence and persistence of SGLT2i were analyzed. Descriptive and multivariate analyses were performed. RESULTS: A total of 500 patients were selected, with a mean age of 70.8 ± 12.8 years and 53.0% men; 57.2% started management with dapagliflozin. SGLT2i were most frequently used for heart failure with a reduced ejection fraction (HFrEF) and New York Heart Association classification of II or III (41.0%). The drug adherence rate was 80.9 ± 16.4%, and 71.8% of the patients reported persistent SGLT2i use for one year. Hospitalizations were less common during SGLT2i treatment than in the previous year (12.2% vs. 24.4%; < 0.001). Having a Charlson Comorbidity Index ≥3 increased the probability of persistence of SGLT2i use at one year (Odds Ratio:4.56; 95%-Confidence Interval:1.46-14.27). CONCLUSIONS: SGLT2i use predominates in patients with HFrEF and in those with a high comorbidity burden. Adherence and persistence were similar to or even better than those reported in other real-world evidence studies.
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