PURPOSE OF REVIEW: Leadless pacemakers (LPMs) are an established alternative to transvenous pacing systems for the treatment of bradyarrhythmias. This review outlines the evolution of LPMs, summarizes available safety an...PURPOSE OF REVIEW: Leadless pacemakers (LPMs) are an established alternative to transvenous pacing systems for the treatment of bradyarrhythmias. This review outlines the evolution of LPMs, summarizes available safety and efficacy data, and highlights future development for leadless systems and the challenges that lie ahead. RECENT FINDINGS: Data from prospective cohort studies, large patient registries, and meta-analyses demonstrate high implantation success rates and fewer long-term complications with LPMs when compared to transvenous systems. Recent advances in leadless systems include dual-chamber devices capable of atrial and ventricular synchronous pacing and LPMs integrated with subcutaneous defibrillators. Future directions for leadless systems include leadless cardiac resynchronization therapy and leadless conduction system pacing. However, unresolved issues remain, including management of device end of life. LPMs are transforming cardiac pacing by reducing complications frequently observed with transvenous systems. Continued technological refinement and long-term clinical evaluation will guide broader adoption and optimize outcomes.
Rossi R, Nouri A, Akman Z
… +3 more, Arya Nezhad S, Damluji AA, Nanna MG
Curr Cardiol Rep
· 2025 Dec · PMID 41400788
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PURPOSE OF REVIEW: This review will evaluate current data on broadly used lipid lowering agents in relation to cognition in older adults and highlight key findings and research gaps to guide clinical practice and future...PURPOSE OF REVIEW: This review will evaluate current data on broadly used lipid lowering agents in relation to cognition in older adults and highlight key findings and research gaps to guide clinical practice and future guidelines. RECENT FINDINGS: Evidence from observational studies and randomized controlled trials indicate no significant association between statin use and cognitive decline, with some data suggesting potential protective effects. While there is insufficient data on inclisaran’s effect on cognition, monoclonal antibodies PCSK9 inhibitors, ezetimibe and bempedoic acid appear neurocognitively safe. Current literature does not conclusively elucidate the association between lipid-lowering therapies and cognitive outcomes in older adults, though existing data, particularly for statins, largely suggest neutral or potentially protective effects. Clinicians should continue prescribing LLT to eligible patients, and future research should prioritize long-term studies that incorporate cognitive outcomes in a diverse group of older adults to guide individualized care.
BACKGROUND: Multi-society expert consensus statements on catheter-based left atrial appendage occlusion (LAAO) suggest transesophageal echocardiography (TEE) or cardiac computed tomography angiography (CCTA) for pre-proc...BACKGROUND: Multi-society expert consensus statements on catheter-based left atrial appendage occlusion (LAAO) suggest transesophageal echocardiography (TEE) or cardiac computed tomography angiography (CCTA) for pre-procedural planning. However, evidence comparing the outcomes of adding CCTA to TEE on procedural success is limited. OBJECTIVE: Perform a systematic review and meta-analysis to determine the impact of adding CCTA to TEE for pre-procedural planning in patients undergoing LAAO. METHODS: We systematically searched Cochrane, Embase, and Medline for observational studies and randomized controlled trials (RCTs) comparing the addition of CCTA vs. TEE alone. The primary endpoint was procedural success. Risk ratios (RRs) with 95% confidence intervals (CIs) were pooled across studies using a random-effects model. RESULTS: Systematic review identified four studies for meta-analysis, three RCTs and one observational study, including a total of 824 patients, of whom 496 (60.2%) underwent additional CCTA. In the pooled analysis, procedural success was higher with added CCTA (RR 1.10; 95% CI 1.01-1.19; p = 0.022; I²=52%). A subgroup analysis of only RCTs confirmed these findings with a slightly higher magnitude of effect and lower heterogeneity (RR 1.15; 95% CI: 1.06-1.25; I = 0%).
Alebna PL, Martey S, Mehta A
… +2 more, Lavie CJ, Carbone S
Curr Cardiol Rep
· 2025 Dec · PMID 41400711
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PURPOSE OF REVIEW: While excess adiposity is a known risk factor for incident heart failure ( HF), once the condition is established, observational data suggest that increased body mass index (BMI) may confer a survival...PURPOSE OF REVIEW: While excess adiposity is a known risk factor for incident heart failure ( HF), once the condition is established, observational data suggest that increased body mass index (BMI) may confer a survival advantage. This paradox has emphasized the underlying roles of cardiorespiratory fitness (CRF), and body composition, particularly lean mass (LM), in influencing clinical outcomes. RECENT FINDINGS: In this review, we explore the multifaceted nature of the obesity paradox in HF, with a focus on emerging anti-obesity incretin-mimetic therapies, such as glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and dual GLP-1/glucose-dependent insulinotropic polypeptide (GIP) receptor agonists. These agents have demonstrated remarkable efficacy in weight reduction and favorable cardiovascular profiles in patients with HF with preserved ejection fraction (EF), yet their use in other HF populations, such as HF with reduced EF, raises important clinical questions and the urgent need for future research. Concerns include the potential for LM loss, implications for sarcopenic obesity, and the uncertain impact of weight loss on outcomes in patients who may not benefit from weight loss. We also highlight the need to assess therapeutic outcomes beyond BMI, incorporating measures of CRF, such as peak oxygen consumption (VO₂ peak), quality of life, and functional capacity, using tools such as the 6-minute walk test. Barriers to implementation, including cost, provider hesitation, insurance restrictions, and patient level challenges are also reviewed. Finally, we call for future research using contemporary cohorts and advanced phenotyping to reevaluate the obesity paradox in the context of modern pharmacologic interventions. As obesity treatment continues to evolve, a patient-centered, individualized approach that integrates body composition, functional status, and comorbid conditions will be essential in optimizing care for individuals with HF.
PURPOSE OF REVIEW: This review examines the impact of incretin-based therapies and related incretin therapies on skeletal muscle health during pharmacologic weight loss. It explores the extent to which lean mass reductio...PURPOSE OF REVIEW: This review examines the impact of incretin-based therapies and related incretin therapies on skeletal muscle health during pharmacologic weight loss. It explores the extent to which lean mass reduction contributes to total weight loss and highlights strategies to preserve muscle as a determinant of cardiovascular resilience. RECENT FINDINGS: Emerging data indicate that 25-40% of incretin-based therapies-induced weight loss derives from loss of lean mass, with skeletal muscle being a key component. Although incretin-based therapies may improve the quality of skeletal muscle by reducing muscle fat infiltration, its function and strength remain underexplored. Exercise, adequate protein intake, and creatine supplementation mitigate these effects, whereas novel adjuncts such as myostatin/activin inhibitors and selective androgen receptor modulators show promise in early trials. Preserving muscle during incretin-based pharmacotherapy weight reduction is key to sustain long-term metabolic and cardiovascular benefits. Future trials should assess body composition, functional outcomes, and integrate muscle-preserving co-therapies into obesity management.
PURPOSE OF REVIEW: This review summarizes the emerging role of ultra-low temperature cryoablation (ULTC) in ventricular tachycardia (VT) ablation. It outlines the limitations of conventional techniques such as radiofrequ...PURPOSE OF REVIEW: This review summarizes the emerging role of ultra-low temperature cryoablation (ULTC) in ventricular tachycardia (VT) ablation. It outlines the limitations of conventional techniques such as radiofrequency (RF) ablation and explores the current clinical data supporting ULTC's deeper lesion formation, safety, and efficacy. RECENT FINDINGS: ULTC delivers cryothermal energy at -140 to -150 °C via a specialized catheter in a freeze-thaw-freeze sequence, achieving lesion depths ≥ 10 mm. Clinical studies report > 90% acute success, > 60% VT-free survival, and > 80% freedom from implantable cardioverter defibrillator (ICD) shocks at 6 months, with sustained effectiveness at 1-year follow-up. The approach is effective across both ischemic and non-ischemic cardiomyopathy without the need for adjunctive interventions. Ongoing preclinical work with augmented ULTC systems shows encouraging results. ULTC offers a promising new strategy in VT ablation by creating durable, transmural lesions. Further randomized trials are warranted to confirm its long-term clinical benefits and safety.
Lin JP, Marelli A, Liu A
… +6 more, Guo L, Desalvo J, Hile D, Roeder M, Aboulhosn J, Daniels CJ
Curr Cardiol Rep
· 2025 Dec · PMID 41335270
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PURPOSE OF THE REVIEW: To understand the growth of the adults with congenital heart disease (ACHD) population and ACHD work force needs in the United States, and to consider solutions to provide access for this populatio...PURPOSE OF THE REVIEW: To understand the growth of the adults with congenital heart disease (ACHD) population and ACHD work force needs in the United States, and to consider solutions to provide access for this population. RECENT FINDINGS: The ACHD population is growing rapidly and is outpacing current efforts to improve access and delivery of ACHD care. Achieving adequate access for the ACHD population will require a multipronged approach, including training more ACHD cardiologists and advanced practice providers, expanding use of telehealth, increasing collaboration between larger tertiary ACHD care centers and smaller ACHD clinics and cardiology practices, and reimagining care models and pay structures.
Curr Cardiol Rep
· 2025 Dec · PMID 41329236
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PURPOSE OF REVIEW: To summarize and provide insight into the role of exercise rehabilitation for heart failure, cardiomyopathies and associated conditions. We provide an overview of the evolution of exercise training fro...PURPOSE OF REVIEW: To summarize and provide insight into the role of exercise rehabilitation for heart failure, cardiomyopathies and associated conditions. We provide an overview of the evolution of exercise training from “bed rest” to current guidelines and highlight emerging approaches. RECENT FINDINGS: Exercise training appears to be safe and provide benefits for patients with heart failure. Emerging evidence also suggests potential benefit in hypertrophic cardiomyopathy as well as angina with non-obstructive coronary arteries, though more data are needed for widespread implementation. Given appropriate precautions and clinical assessments, exercise is a unifying therapy across most heart failure conditions regardless of ejection fraction. Exercise training appears to be safe, and beneficial in terms of improvements in functional capacity and health-related quality of life. Larger controlled trials are needed to better examine the impact of exercise on hard clinical endpoints such as HF hospitalizations (likely beneficial) and cardiovascular mortality.
Angriman F, Bortolotti F, Perotto M
… +7 more, Artioli R, Radesich C, Paldino A, Collesi C, Zacchigna S, Sinagra G, Dal Ferro M
Curr Cardiol Rep
· 2025 Dec · PMID 41329234
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PURPOSE OF REVIEW: Titin-related cardiomyopathy (TTN CMP) is the most prevalent genetic cause of dilated cardiomyopathy (DCM), yet its clinical variability and incomplete penetrance challenge risk stratification and ther...PURPOSE OF REVIEW: Titin-related cardiomyopathy (TTN CMP) is the most prevalent genetic cause of dilated cardiomyopathy (DCM), yet its clinical variability and incomplete penetrance challenge risk stratification and therapeutic management. This review aims to summarize recent insights into the genetic, molecular, and clinical aspects of TTN-CMP, emphasizing its heterogeneity and the implications for diagnosis, prognosis, and treatment. RECENT FINDINGS: TTN truncating variants (TTNtv) are associated with DCM but are also present in asymptomatic individuals, complicating their interpretation. Emerging evidence suggests that both haploinsufficiency and toxic gain-of-function mechanisms may underlie disease expression, influenced by variant location and expression. Patient-derived iPSC models and advanced imaging studies have elucidated pathophysiological mechanisms and highlighted promising therapeutic targets. Clinically, TTN-CMP shows relatively high rates of left ventricular reverse remodeling and variable arrhythmic burden, with male sex and environmental stressors influencing outcomes. TTN-CMP spans a broad phenotypic spectrum, ranging from asymptomatic carriers to end-stage heart failure. While standard heart failure therapies are often effective, precision management remains limited. Improved clinical, genetics and molecular understanding, together with novel experimental models, provide promising new tools for precise disease assessment and targeted therapeutic interventions.
Panichella G, Garofalo M, Ragagnin M
… +6 more, Fanizzi AI, Zampieri M, Del Franco A, Cappelli F, Pieroni M, Olivotto I
Curr Cardiol Rep
· 2025 Dec · PMID 41324783
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PURPOSE OF REVIEW: This review aims to provide a comprehensive overview of mavacamten in the management of obstructive hypertrophic cardiomyopathy (oHCM), from its molecular mechanism of action to clinical trial outcomes...PURPOSE OF REVIEW: This review aims to provide a comprehensive overview of mavacamten in the management of obstructive hypertrophic cardiomyopathy (oHCM), from its molecular mechanism of action to clinical trial outcomes and real-world application. It explores the efficacy, safety, and practical considerations of mavacamten use, while highlighting evolving indications and future directions. RECENT FINDINGS: Randomized trials have shown that mavacamten significantly reduces left ventricular outflow tract gradients, improves symptoms and exercise capacity, and induces structural reverse remodeling with a favorable safety profile. Real-world data confirm these benefits in broader patient populations. Pharmacogenetic variability, titration protocols, and cost-effectiveness analyses have further refined its clinical use. Mavacamten represents a paradigm shift in oHCM treatment by targeting disease at its sarcomeric origin. Its integration into routine care is expanding, supported by real-world evidence. Ongoing studies will clarify its role in non-obstructive HCM, heart failure with preserved ejection fraction, pediatric populations, and early-stage disease.
PURPOSE OF THE REVIEW: Epicardial adipose tissue (EAT), the visceral fat of the heart, is highly inflammatory fat depot with pro-inflammatory transcriptome and proteosome. EAT contributes to the development and progressi...PURPOSE OF THE REVIEW: Epicardial adipose tissue (EAT), the visceral fat of the heart, is highly inflammatory fat depot with pro-inflammatory transcriptome and proteosome. EAT contributes to the development and progression of coronary artery disease (CAD) and atrial fibrillation (AF) through multifactorial inflammatory pathways. However, the paradigm linking EAT inflammation and cardiovascular risk was recently reevaluated. RECENT FINDINGS: EAT inflammation may be also necessary process for adipose tissue remodeling and expansion to accommodate excess lipids. EAT inflammation may be also considered an adaptive response of adipose tissue to the effects of glucagon-like peptide-1 receptor (GLP-1Rs) and glucose-dependent insulinotropic polypeptide (GIP) analogs. The presence of GLP-1 (GLP-1R) and GIP receptors (GIP-R) suggest direct interaction of these agents with EAT. EAT GLP-1R and GIP-R activation can induce a beneficial balance between increased adipogenesis and reduced ectopic fat accumulation. Cardiovascular effects of liraglutide, semaglutide and tirzepatide can be mediated by EAT inflammation.
PURPOSE OF REVIEW: Accurate, timely quantification of cardiac function is central to the diagnosis, management, and monitoring of cardiovascular disease. This review synthesizes recent advances in artificial intelligence...PURPOSE OF REVIEW: Accurate, timely quantification of cardiac function is central to the diagnosis, management, and monitoring of cardiovascular disease. This review synthesizes recent advances in artificial intelligence (AI) applications across the major data modalities used in cardiovascular medicine, spanning electrocardiography (ECG), echocardiography, cardiac CT/MRI, and clinical text in electronic health records (EHR). RECENT FINDINGS: State-of-the-art deep learning algorithms now enable highly accurate assessment of cardiac disease across a range of modalities. These models excel in detecting subclinical cardiovascular disease, occult disease etiologies, and ventricular dysfunction that may elude conventional interpretation. Recent randomized controlled trials demonstrate that AI models can match or even outperform clinicians in identifying myocardial infarction from ECGs, occult atrial fibrillation from sinus rhythm ECGs, and in quantifying left ventricular ejection fraction from echocardiography. Concurrently, the emergence of foundation models and multimodal architectures is accelerating label-efficient learning, enabling automated report generation, and facilitating scalable population-level screening across diverse clinical settings. AI is poised to transition from proof-of-concept to indispensable clinical partner in cardiology. Robust multicenter validation, open-source code transparency, and prospective trials are essential to confirm generalizability and to quantify patient-level benefit. As foundation models mature and multimodal learning becomes routine, AI will enable scalable screening, precision phenotyping, and more equitable cardiovascular care-particularly in resource-limited settings-while allowing clinicians to refocus on patient-centered practice.
PURPOSE OF REVIEW: To provide clinicians with a concise introduction of microplastics potential role as a cardiovascular risk factor. RECENT FINDINGS: Microplastics have been identified in human cardiovascular tissues. I...PURPOSE OF REVIEW: To provide clinicians with a concise introduction of microplastics potential role as a cardiovascular risk factor. RECENT FINDINGS: Microplastics have been identified in human cardiovascular tissues. In vitro and animal-based studies associate microplastics presence with increased oxidative stress, endothelial dysfunction, platelet aggregation disruption, and low-grade inflammation. Small human studies report associations between intraplaque or circulating microplastics and cardiovascular outcomes. However, these signals are associative, method-dependent, and vulnerable to exposure misclassification, co-pollutant confounding, contamination, and heterogeneous analytics. Microplastics are pervasive and biologically plausible as a cardiovascular risk factor, supported by growing in-vitro evidence and incipient human association studies. Cohesive population-level measures to curb MP pollution should be embedded within policies addressing broader environmental cardiovascular risk factors. For clinicians, it remains premature to recommend personal-level mitigation strategies, and MPs are best regarded as an emerging exposure within the patient's exposome that warrants awareness and further rigorous studies.
Curr Cardiol Rep
· 2025 Nov · PMID 41307777
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PURPOSE OF REVIEW: To summarize the key features of vulnerable plaques identified by intracoronary and non-invasive imaging and explore how anti-atherosclerotic therapies contribute to plaque regression and stabilization...PURPOSE OF REVIEW: To summarize the key features of vulnerable plaques identified by intracoronary and non-invasive imaging and explore how anti-atherosclerotic therapies contribute to plaque regression and stabilization. RECENT FINDINGS: Compared with high-dose statin therapy, intensive lipid-lowering with proprotein convertase subtilisin/kexin type 9 inhibitors achieves lower low-density lipoprotein cholesterol (LDL-C) levels and results in greater plaque regression and fibrous cap thickening. Recent data suggest that preventive intervention for functionally non-significant but high-risk plaques may reduce clinical events, and this strategy is now being further evaluated in randomized controlled trials. Detecting and treating vulnerable plaques is essential for improving the prognosis of patients with coronary artery disease. The extent of plaque volume reduction and fibrous cap thickening appears closely associated with on-treatment LDL-C levels. Anti-inflammatory therapies may provide additional stabilizing effects. Preventive treatment of high-risk, non-obstructive lesions and the use of non-invasive imaging to identify vulnerable plaques and high-risk individuals are promising strategies warranting further research.
Gunsaulus M, Aldrich J, Carrillo SA
… +4 more, Kelly J, Salah R, Blais B, Salavitabar A
Curr Cardiol Rep
· 2025 Nov · PMID 41307776
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PURPOSE OF REVIEW: This review examines the growing role of extended reality (XR) (including virtual, augmented, and mixed reality) in the care of patients with congenital heart disease (CHD), with a focus on its use in...PURPOSE OF REVIEW: This review examines the growing role of extended reality (XR) (including virtual, augmented, and mixed reality) in the care of patients with congenital heart disease (CHD), with a focus on its use in patient education, trainee instruction, and procedural planning. RECENT FINDINGS: XR has demonstrated early success in improving patient and family understanding, enhancing trainee comprehension of cardiac anatomy, and aiding in surgical and transcatheter procedural planning for patients with complex cardiac anatomy. Studies demonstrate that XR improves visualization of 3D spatial relationships, increases confidence amongst providers and learners, and facilitates more informed preprocedural decision-making. XR addresses longstanding limitations of 2D imaging by providing interactive, patient-specific 3D environments. While most studies in this area are small and exploratory, they consistently underscore the clinical and educational value of XR in CHD care. XR is well-positioned to become a powerful tool across the continuum of CHD management.
Nair P, Dai M, Patel DA
… +2 more, Pearlman K, Shah SD
Curr Cardiol Rep
· 2025 Nov · PMID 41307773
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PURPOSE OF REVIEW: This paper examines how digital health technologies can either reduce or exacerbate disparities in cardiovascular disease outcomes. It explores the role of the digital divide defined as a multifactoria...PURPOSE OF REVIEW: This paper examines how digital health technologies can either reduce or exacerbate disparities in cardiovascular disease outcomes. It explores the role of the digital divide defined as a multifactorial phenomenon encompassing unequal access to internet connectivity, digital devices, and digital literacy, often driven by socioeconomic status, geography, age, education, language, and disability in shaping access to telehealth, remote monitoring, and patient engagement tools, with a focus on strategies for equitable implementation. RECENT FINDINGS: Digital health interventions have improved patient outcomes by enhancing accessibility and adherence to care. However, challenges such as limited technology access, low digital literacy, and systemic biases contribute to persistent disparities, particularly among marginalized populations. Emerging strategies, including community-based digital literacy programs, policy reforms, and inclusive design approaches, show promise in addressing these gaps. While digital health has the potential to bridge gaps in cardiovascular care, ensuring equity requires intentional design and policy interventions. Addressing barriers to access and digital literacy is critical to maximizing the benefits of these innovations for all patient populations.
Trankle CR, Pillai A, Krayem H
… +3 more, Shah KB, Ellenbogen KA, Hundley WG
Curr Cardiol Rep
· 2025 Nov · PMID 41307768
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PURPOSE OF REVIEW: To summarize the recent literature examining the degree of overlap among atrial fibrillation (AF), heart failure (HF), and left atrial (LA) dysfunction, the prognostic relevance of finding a second con...PURPOSE OF REVIEW: To summarize the recent literature examining the degree of overlap among atrial fibrillation (AF), heart failure (HF), and left atrial (LA) dysfunction, the prognostic relevance of finding a second condition in one of the other disease states, and the treatment effects for one condition on the secondary entities. RECENT FINDINGS: If one condition (AF, HF, or LA dysfunction) is present, there are very high prevalences of a second condition demonstrated across several cohorts. Additionally, the presence of a second condition consistently has a negative impact on prognosis. Treatment effects for AF or HF tend to show bidirectional benefit, whereas data is limited toward impacts on LA dysfunction. Patients with AF, HF, or LA dysfunction often have more than one of these conditions (either clinically manifest or occult), which may influence prognosis. Established treatment pathways for AF or HF tend to show benefits in the second condition, whereas there is limited data to determine effects on LA dysfunction, or whether LA dysfunction may be directly targeted for therapy.
Cavallo D, Bergamaschi L, Angeli F
… +31 more, Armillotta M, Di Iuorio O, Ryabenko K, Asta C, Suma N, Ciarlantini M, Fedele D, Canton L, Amicone S, Belà R, Bavuso LL, Salerno J, Alvarez MC, Basile M, Maida A, Manaresi T, Vasumini N, Di Leo M, Tuttolomondo D, Carletti R, Dall'Ara G, Gardini E, De Vita M, Gaibazzi N, Guglielmo M, Pavon AG, Ciliberti G, Squeri A, Facchini G, Pontone G, Pizzi C
Curr Cardiol Rep
· 2025 Nov · PMID 41307636
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PURPOSE OF REVIEW: The diagnostic, therapeutic, and prognostic management of patients with suspected acute coronary syndrome (ACS) is a major challenge for clinicians in both emergency and outpatient settings. While clea...PURPOSE OF REVIEW: The diagnostic, therapeutic, and prognostic management of patients with suspected acute coronary syndrome (ACS) is a major challenge for clinicians in both emergency and outpatient settings. While clear-cut cases of acute myocardial infarction typically require immediate invasive coronary angiography (ICA), more nuanced and complex presentations require careful selection of the most appropriate diagnostic tests to determine the underlying cause of symptoms. This narrative review aims to delineate specific scenarios in which non-invasive multimodal imaging techniques-such as transthoracic echocardiography (TTE), coronary computed tomography angiography (CCTA), cardiac magnetic resonance (CMR), and nuclear imaging-are appropriate and optimal in the setting of ACS. RECENT FINDINGS: In the initial assessment of a patient with suspected ACS, TTE is essential to identify regional wall motion abnormalities (RWMA) with a typical "coronary pattern". In recent years, the use of speckle tracking echocardiography has been shown to increase diagnostic sensitivity in this setting, particularly in patients without overt RWMA. Stress echocardiography also holds diagnostic value in specific low-risk ACS settings. Moreover, in this patient population, CCTA has demonstrated a very high negative predictive value (NPV) across multiple trials, effectively reducing the number of unnecessary ICA. Recently, this technique has been enhanced by the ability to perform qualitative analysis of atherosclerotic plaque, allowing the identification of high-risk features associated with instability and rupture, and thus with ACS. Finally, CMR enables myocardial tissue characterization, which is essential in the diagnostic work-up of myocardial infarction with non-obstructive coronary arteries (MINOCA) and also serves as an effective gatekeeper in suspected non-ST elevation myocardial infarction (NSTEMI) through the exclusion of mimickers such as myocarditis, thereby reducing the number of useless ICA. Moreover, CMR is supported by substantial evidence regarding its prognostic value in ACS patients. When available, myocardial perfusion imaging, using single photon emission tomography or positron emission tomography, has a valuable role in patients with suspected ACS and non-diagnostic ECG and biomarkers; in fact, it can detect inducible ischemia and prior infarction with a high NPV supporting safe discharge and reducing unnecessary admissions. We aim to point out the role of non-invasive multimodal imaging in patients with confirmed or suspected ACS. By analyzing the available evidence and current guidelines, it's clear that these imaging techniques are especially useful in cases of low pre-test ACS probability, low-risk NSTEMI, in ruling out alternative diagnoses, and in specific diagnostic work-up such as MINOCA. In clinical practice, our goal is to provide practical recommendations for the clinicians on when and how to apply non-invasive imaging to reduce the number of ICA in order to minimize redundant, costly, and invasive diagnostic procedures that carry an inherent risk of complications.
Arockiam AD, Rosenzveig A, Sorathia S
… +13 more, Khurana R, Agrawal A, Haroun E, Issa R, Gurram A, Alamer M, Dong T, El Roumi J, Majid M, Rodriguez L, Popovic ZB, Griffin BP, Wang TKM
Curr Cardiol Rep
· 2025 Nov · PMID 41307634
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PURPOSE OF REVIEW: This review aims to provide a comprehensive contemporary overview regarding the clinical perspectives, multi-modality imaging evaluation, treatments and outcomes of subaortic stenosis (SAS). RECENT FIN...PURPOSE OF REVIEW: This review aims to provide a comprehensive contemporary overview regarding the clinical perspectives, multi-modality imaging evaluation, treatments and outcomes of subaortic stenosis (SAS). RECENT FINDINGS: SAS remains an important condition making up a significant minority of patients with progressive fixed left ventricular ouflow tract obstruction. Echocardiography remains the first-line imaging modality to diagnose SAS, evaluate severity of obstruction along with cardiac chamber and valvular function. Transesophageal echocardiography, cardiac computed tomography and cardiac magnetic resonance have adjunctive roles to help delineate SAS anatomy, functional implications and pre-operative planning. A variety of surgical techniques have been developed for SAS with significant obstruction often with symptoms, with excellent contemporary outcomes, though recurrence rates remain significant particularly in younger patients and those with complex anatomical features that may need repeat surgeries. Multi-disciplinary approach to management is necessary to improve clinical outcomes, including multi-modality imaging for diagnosis, risk stratification, treatment guidance and close surveillance, along with meticulous surgery by experienced surgeons, are necessary to improve clinical outcomes for SAS.
Maciorowska M, Zhang L, Tokhi B
… +2 more, Biso S, Khalique OK
Curr Cardiol Rep
· 2025 Nov · PMID 41307612
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PURPOSE OF REVIEW: Mitral regurgitation is a common and heterogeneous valve disease, with its prevalence increasing due to aging populations. This review aims to provide a comprehensive overview of the roles of transthor...PURPOSE OF REVIEW: Mitral regurgitation is a common and heterogeneous valve disease, with its prevalence increasing due to aging populations. This review aims to provide a comprehensive overview of the roles of transthoracic (TTE) and transesophageal echocardiography (TEE) in the evaluation of mitral regurgitation (MR). RECENT FINDINGS: MR encompasses a spectrum of pathologies, ranging from degenerative leaflet prolapse to functional regurgitation caused by left ventricular remodeling. Accurate assessment of regurgitation is challenging and requires a multiparametric, comprehensive approach. TTE remains the primary imaging modality used to evaluate mitral valve structure, determine the severity of regurgitation, and related hemodynamic effects. TEE provides higher-resolution imaging for more detailed anatomical assessment, particularly valuable in surgical planning and transcatheter mitral procedures. The introduction of 3D echocardiography has further improved mitral valve imaging, allowing accurate preprocedural assessment and real-time guidance during structural interventions. Both TTE and TEE play essential and complementary roles in the thorough evaluation of MR. A multiparametric approach ensures accurate characterization of the regurgitation severity.