Current Cardiology Reports[JOURNAL]
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200 papers
Life Course Approach to Familial Hypercholesterolemia.
Miname MH, Castanhel FD, Mizuta MH … +1 more , Santos RD
Curr Cardiol Rep · 2025 Nov · PMID 41307594 · Publisher ↗
PURPOSE OF THE REVIEW: To describe recent advances in knowledge of familial hypercholesterolemia (FH). RECENT FINDINGS: There has been a significant advance in understanding the natural history, risk stratification, and...
PURPOSE OF THE REVIEW: To describe recent advances in knowledge of familial hypercholesterolemia (FH). RECENT FINDINGS: There has been a significant advance in understanding the natural history, risk stratification, and therapy of FH. Heterozygous FH affects approximately 1 in every 310 individuals worldwide and is associated with an increased risk of premature atherosclerotic cardiovascular disease (ASCVD). Early diagnosis is crucial and relies on clinical criteria and/or genetic testing. Timely initiation of treatment in childhood is imperative, as cumulative exposure to elevated LDL-cholesterol is directly correlated with the onset and progression of ASCVD. Several ASCVD risk prediction models have been developed specifically for adults with FH. Coronary artery calcium scoring is a valuable adjunct to cardiovascular risk stratification in this population. Pharmacological management of FH typically involves statins and ezetimibe, as well as PCSK9 inhibitors. In the elderly, therapeutic strategies must account for age-related factors, such as frailty and comorbidities.
Variabiliy in Prescribing Patterns of Wearable Cardiac Defibrillators: Current Data, Guidelines, Challenges, and Controversies.
Guglieri M, Lenormand T, Bodin A … +2 more , Bisson A, Fauchier L
Curr Cardiol Rep · 2025 Nov · PMID 41307590 · Publisher ↗
PURPOSE OF REVIEW: Wearable cardioverter-defibrillators (WCDs) offer a non-invasive, temporary safeguard against sudden cardiac death in patients with transient high-risk conditions, but real-world prescribing is highly...
PURPOSE OF REVIEW: Wearable cardioverter-defibrillators (WCDs) offer a non-invasive, temporary safeguard against sudden cardiac death in patients with transient high-risk conditions, but real-world prescribing is highly variable due to inconsistent evidence of benefit. This review examines current WCD evidence and guideline recommendations, highlighting recent clinical findings, international guideline discrepancies, health economic data, and controversies underlying heterogeneous prescribing practices. RECENT FINDINGS: Observational studies and meta-analyses show that WCDs effectively terminate malignant arrhythmias and that arrhythmic death during WCD use is rare (~ 0.7% over 3 months). Approximately 5% of patients receive appropriate WCD shocks within 3 months. However, the VEST randomized trial did not demonstrate a significant reduction in arrhythmic mortality, likely due in part to low patient adherence (median 18 h/day). Post-hoc analyses of VEST suggested potential mortality reduction with better compliance. Reflecting the evidence gap, U.S. guidelines (2017) granted WCD a Class IIa/IIb role in several transient high-risk scenarios, whereas recent European guidelines (2021–2022) are more restrictive after VEST’s neutral results. Modeling studies indicate WCD use can be cost-effective in select high-risk populations, but the device’s high cost ($3,734/month; ~$223k per shock) raises concerns for broader use. WCD prescribing remains highly heterogeneous worldwide due to divergent guidelines, uncertain mortality benefit, and variable patient selection. While WCDs are generally safe and can bridge patients during reversible risk periods, definitive survival benefit is unproven. Ongoing debates about appropriate patient selection and cost-effectiveness underscore the need for further trials and unified guidance. In the meantime, health policy should encourage prudent, case-by-case use of WCDs focused on those most likely to benefit.
The Effects of Energy Drinks on the Cardiovascular System: A Systematic Review.
Mandato J, Kola R, Tyson T … +2 more , Laffin L, Bales R
Curr Cardiol Rep · 2025 Nov · PMID 41236610 · Full text
INTRODUCTION: Energy drinks are widely marketed to enhance alertness and performance, making them a rapidly growing industry valued at $73.99 billion. These beverages typically contain caffeine and other stimulants, but...
INTRODUCTION: Energy drinks are widely marketed to enhance alertness and performance, making them a rapidly growing industry valued at $73.99 billion. These beverages typically contain caffeine and other stimulants, but their consumption has raised concerns about potential cardiovascular risks, including arrhythmias, tachycardia, and hypertension, particularly among young adults. While moderate caffeine intake may offer health benefits, excessive consumption of energy drinks has been linked to increased cardiovascular risks. This systematic review aims to explore the cardiovascular effects of energy drink consumption, identify knowledge gaps, and guide clinicians in making recommendations. METHODS: A comprehensive literature search was conducted across multiple databases, including CENTRAL, CINAHL, MEDLINE, PubMed, and others. Studies were screened for those involving energy drink consumption and cardiovascular outcomes such as heart rate, blood pressure, and ECG changes. After screening abstracts, full-text articles were reviewed based on inclusion criteria: participants aged 13+, energy drink consumption, and relevant cardiovascular endpoints. RESULTS: A total of 1,444 references were screened, resulting in 37 studies with 1,597 participants (mean age 22.6). Red Bull and Monster were the most studied brands. Results showed significant cardiovascular effects, including increased heart rate (60.9%), systolic blood pressure (53.8%), diastolic blood pressure (61.5%), and QTc interval prolongation (63.2%). Other ECG changes, such as PR interval and T-wave alterations, were observed in 57.9% of studies. CONCLUSION: This review highlights the cardiovascular risks of energy drinks, including increased heart rate, blood pressure, and QTc prolongation. Future research should focus on at-risk groups and long-term effects.
Alteration of Essential Cell Function by Ultrasound-Targeted Microbubble Cavitation.
Paranjape AN, Chen X, Villanueva FS
Curr Cardiol Rep · 2025 Nov · PMID 41236581 · Publisher ↗
PURPOSE OF REVIEW: Ultrasound-targeted microbubble cavitation (UTMC) has emerged as a transformative non-invasive technology in diagnostic imaging, therapy, and targeted gene and drug delivery. As UTMC advances toward cl...
PURPOSE OF REVIEW: Ultrasound-targeted microbubble cavitation (UTMC) has emerged as a transformative non-invasive technology in diagnostic imaging, therapy, and targeted gene and drug delivery. As UTMC advances toward clinical translation, understanding its impact on fundamental cellular functions is essential. RECENT FINDINGS: Recent studies on UTMC have provided insights into its effects on biological processes. These include transient membrane opening and resealing (sonoporation), calcium ion (Ca) influx, generation of free radicals, nitric oxide synthesis, cytoskeletal remodeling, inter-endothelial gap formation, gene expression changes, and neuroinflammation. This review explores the mechanisms underlying UTMC, with a focus on ultrasound-targeted microbubble cavitation and its bioeffects on cellular function. We examine the molecular processes induced by cavitation, including sonoporation and Ca influx, and highlight their effects on key biological processes.
Echocardiographic Evaluation of Pulmonary Hypertension: A Contemporary Review of the American Society of Echocardiography (ASE) Guidelines and Emerging Modalities.
Lu J, Zinzuwadia A, Sullivan J … +4 more , Pérez-López P, Abovich A, Mukherjee M, Grapsa J
Curr Cardiol Rep · 2025 Oct · PMID 41144074 · Publisher ↗
PURPOSE OF REVIEW: This review summarizes current 2D and 3D echocardiographic techniques for evaluating right heart structure and function in pulmonary hypertension (PH), emphasizing their diagnostic, prognostic, and mon...
PURPOSE OF REVIEW: This review summarizes current 2D and 3D echocardiographic techniques for evaluating right heart structure and function in pulmonary hypertension (PH), emphasizing their diagnostic, prognostic, and monitoring roles. It also highlights the emerging role of myocardial strain imaging and right atrial (RA) assessment in comprehensive right heart evaluation. RECENT FINDINGS: Recent guidelines support a multiparametric echocardiographic approach, integrating structural, functional, and hemodynamic parameters to characterize right ventricular (RV) remodeling in PH. Advanced modalities such as 3D echocardiography and speckle-tracking strain imaging enhance evaluation of RV and RA function and may enable earlier detection of dysfunction and improved risk stratification. Established 2D echocardiographic guidelines provide a strong foundation for PH assessment. Incorporating 3D RV imaging and RA/RV strain builds on these standards, improving diagnostic precision and clinical relevance. Standardization and broader adoption of these tools will be essential to optimize patient outcomes and support future PH research.
Cardiac Contractility Modulation: a Novel Adjunctive Therapy for Heart Failure Patients Undergoing Treatment with Implantable Cardioverter Defibrillators.
Ju Y, Wang MJ, Ji Y … +3 more , Tang J, Wang Z, Zhao Q
Curr Cardiol Rep · 2025 Oct · PMID 41138025 · Publisher ↗
PURPOSE OF REVIEW: This paper aims to clarify the mechanism of action of Cardiac Contractility Modulation in heart failure treatment, synthesize key clinical evidence supporting the combination of Cardiac Contractility M...
PURPOSE OF REVIEW: This paper aims to clarify the mechanism of action of Cardiac Contractility Modulation in heart failure treatment, synthesize key clinical evidence supporting the combination of Cardiac Contractility Modulation and implantable cardioverter-defibrillators for managing heart failure with reduced ejection fraction, and explore potential challenges and future applications pertaining to this combined therapy. RECENT FINDINGS: Recent studies indicate that cardiac contractility modulation therapy improves ventricular function without elevating myocardial oxygen consumption, promotes recovery of diastolic and systolic function, augments myocardial contractility, and exhibits substantial efficacy in drug-refractory chronic heart failure. Additionally, cardiac contractility modulation markedly improves left ventricular function, reduces hospitalization frequency, and enhances quality of life in patients with heart failure with reduced ejection fraction and a QRS duration of 120-149 ms. It may also serve as a pivotal strategy to arrest progression of heart failure with preserved ejection fraction. Combining implantable cardioverter-defibrillators with cardiac contractility modulation addresses a critical gap in the clinical management of patients with heart failure with reduced ejection fraction. These individuals meet criteria for left ventricular assist devices but are ineligible for cardiac resynchronization therapy and fail to derive long-term survival benefits from implantable cardioverter-defibrillator monotherapy. This review demonstrates that combining cardiac contractility modulation and implantable cardioverter-defibrillators shows potential for improving outcomes in specific populations with heart failure with reduced ejection fraction by addressing limitations of single-therapy approaches. A key implication is that this combined strategy may offer a valuable therapeutic option for patients underserved by current guidelines. However, further rigorous clinical investigations are needed to fully establish its long-term efficacy, safety, and optimal patient selection criteria. These findings highlight the need for future research to refine the application of this combined therapy and expand its evidence base, which may inform future treatment guidelines for heart failure with reduced ejection fraction.
The Weight of Comorbidities in the Specific Treatment of ATTR-Related Amyloid Cardiomyopathy.
Cantone A, Dicorato MM, Porcari A
Curr Cardiol Rep · 2025 Oct · PMID 41138000 · Full text
PURPOSE OF REVIEW: This review aims to provide an updated overview of the clinical management of heart failure and comorbidities in transthyretin amyloid cardiomyopathy (ATTR-CM). We sought to address key unanswered ques...
PURPOSE OF REVIEW: This review aims to provide an updated overview of the clinical management of heart failure and comorbidities in transthyretin amyloid cardiomyopathy (ATTR-CM). We sought to address key unanswered questions and current uncertainties regarding treatment response, prognosis, and optimization of care in this complex population. RECENT FINDINGS: Once considered rare, ATTR-CM is now increasingly recognized due to greater awareness and the possibility of non-invasive diagnosis. Patients are often identified at earlier stages, with lower mortality than historically observed. Disease-modifying therapies with proven efficacy in randomized trials are now available, yet many patients experience disease progression. In real-world practice, ATTR-CM patients are typically older and have multiple cardiac and extracardiac comorbidities, often representing exclusion criteria of clinical trials, which may influence treatment response and efficacy. Modern management of ATTR-CM should integrate heart failure treatment with tailored approaches to comorbidity care. Earlier diagnosis, real-world evidence, and strategies for patients outside trial populations will be essential to improve prognosis and guide future research.
Optimal Approach in Staged Chronic Total Occlusion Percutaneous Coronary Intervention.
Jalli S, Strepkos D, Alexandrou M … +11 more , Mutlu D, Carvalho PEP, Kladou E, Ser OS, Singh Sara JD, Mastrodemos O, Rangan BV, Voudris K, Burke MN, Sandoval Y, Brilakis ES
Curr Cardiol Rep · 2025 Oct · PMID 41129066 · Publisher ↗
PURPOSE OF REVIEW: To discuss the optimal timing of staged chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in patients presenting with acute coronary syndromes (ACS), multiple CTOs and after a CTO...
PURPOSE OF REVIEW: To discuss the optimal timing of staged chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in patients presenting with acute coronary syndromes (ACS), multiple CTOs and after a CTO modification procedure. RECENT FINDINGS: In patients with acute coronary syndromes CTO PCI should be performed as part of a complete revascularization strategy within a few weeks or months from the initial presentation. In patients who undergo CTO modification procedures, such as subintimal tracking and re-entry (STAR) earlier re-intervention (within 1-2 months) is better than later re-intervention. Staged intervention is preferred in most patients who need PCI of more than one CTO to minimize the risk of complications. The optimal timing of CTO intervention as part of a complete revascularization strategy remains unknown, as does the optimal timing of repeat intervention after a CTO modification procedure, though earlier is likely better than later in both cases. PCI of more than one CTO in the same patient should also be staged for safety reasons.
Risks and Prognostic Implications of Pericardial Disease and Atrial Fibrillation after Cardiac Surgery.
El Harake L, Al-Kazaz M, Cremer PC
Curr Cardiol Rep · 2025 Oct · PMID 41129045 · Publisher ↗
PURPOSE OF REVIEW: Postoperative atrial fibrillation (POAF) and post pericardiotomy syndrome (PPS) are among the most common complications following cardiac surgery. This review explores their incidence, clinical feature...
PURPOSE OF REVIEW: Postoperative atrial fibrillation (POAF) and post pericardiotomy syndrome (PPS) are among the most common complications following cardiac surgery. This review explores their incidence, clinical features, risk factors, and shared inflammatory mechanisms. It also examines prevention and management strategies, with a focus on the relationship between PPS and POAF and remaining gaps in understanding. RECENT FINDINGS: Pericardial inflammation and innate immune activation are central to the development of both POAF and PPS. Surgical trauma initiates cascades involving cytokines, oxidative stress, and atrial remodeling. PPS has been associated with a higher risk of atrial fibrillation in the early postoperative period. Although current prediction models do not provide optimal discrimination, several preventive strategies, including preoperative medications and surgical options, have been shown to reduce the risk of these complications. However, varying definitions and diagnostic criteria limit comparability across studies, and long-term data are scarce. POAF and PPS are associated with significant morbidity, including longer hospital stays, readmissions, and cardiovascular complications. Identifying high-risk patients is essential to guide early interventions. The overlap in pathophysiology suggests PPS may trigger POAF, but causality remains unconfirmed. Future research should focus on clarifying their relationship, assessing the durability of preventive strategies, and establishing standardized diagnostic criteria to reduce heterogeneity and improve clinical decision-making.
Left Atrial Coupling Index for the Prediction of Atrial Fibrillation and Heart Failure: Current Evidence and Clinical Implications.
Gegenava T, Pio SM, Nieman K
Curr Cardiol Rep · 2025 Oct · PMID 41129030 · Publisher ↗
PURPOSE OF REVIEW: The aim of this review paper is to explore the clinical utility of left atrial coupling indices—LACI-v/m (volumetric/mechanical) and LACI-av (atrioventricular volumetric)—as emerging predictors of atri...
PURPOSE OF REVIEW: The aim of this review paper is to explore the clinical utility of left atrial coupling indices—LACI-v/m (volumetric/mechanical) and LACI-av (atrioventricular volumetric)—as emerging predictors of atrial fibrillation (AF) and heart failure (HF). It emphasizes their relevance in the context of diastolic dysfunction and left heart remodeling. RECENT FINDINGS: LACI-v/m, calculated by dividing indexed left atrial volume by a′ velocity, has been independently associated with incident AF and HF across diverse populations. LACI-av, defined as the ratio of left atrium (LA) to left ventricular (LV) end-diastolic volumes, is applicable in AF and has demonstrated predictive value for AF, HF, and mortality using echocardiography, cardiac MRI, and CT. A meta-analysis confirmed a significant association between elevated LACI and AF risk. Given the interdependence of LA and LV function, both LACI-v/m and LACI-av enhance cardiovascular risk stratification by integrating left atrial structure and function. Future prospective studies are needed to validate standardized thresholds and guide LACI-based management strategies.
The Ross Procedure: Historical Context, Modern Outcomes, and the Road Ahead.
Eidson C, Well A, Turek J … +2 more , Mery CM, Beckerman Z
Curr Cardiol Rep · 2025 Oct · PMID 41129025 · Full text
PURPOSE OF REVIEW: There remains no single perfect aortic valve replacement option in patients with aortic valve disease. In this manuscript, we will discuss the modern role of the Ross Procedure in children and adults w...
PURPOSE OF REVIEW: There remains no single perfect aortic valve replacement option in patients with aortic valve disease. In this manuscript, we will discuss the modern role of the Ross Procedure in children and adults with aortic valve disease. RECENT FINDINGS: Currently, the Ross procedure is the only established operation that allows replacement of the aortic valve with living, growing tissue. Use of the Ross procedure for aortic valve replacement has waxed and waned in recent decades. However, in recent years, with reports from long-term data series, interest has been redirected at the Ross procedure due to its excellent durability and freedom from long-term valvular morbidity and mortality. In patients requiring aortic valve replacement, the Ross procedure offers excellent short- and long-term outcomes and can be tailored to specific pathologies and the needs of individual patients. In this patient population, it is the only intervention that restores life expectancy to that of the general population. The Ross procedure remains a superb intervention for the treatment of aortic valve disease in children and adults in the modern era and should be heavily considered as an option when aortic valve replacement is required.
Interplay between Elevated Bile Acids and Reduced Vitamin D Levels in Fontan Circulation: A Double-Edged Sword.
Shah AH, Ravandi A, Dhingra S … +4 more , Aliani M, Sivakumar K, Krasuski RA, Ramakrishnan S
Curr Cardiol Rep · 2025 Oct · PMID 41128958 · Publisher ↗
PURPOSE OF REVIEW: The Fontan procedure, a palliative surgery for single-ventricle congenital heart disease, often leads to multisystem complications. Elevated bile acids and reduced vitamin D3 levels, frequently observe...
PURPOSE OF REVIEW: The Fontan procedure, a palliative surgery for single-ventricle congenital heart disease, often leads to multisystem complications. Elevated bile acids and reduced vitamin D3 levels, frequently observed in this population, may share a harmful bidirectional relationship. This review examines their interplay and therapeutic relevance. RECENT FINDINGS: Fontan-associated liver disease and potential gut dysbiosis contribute to altered bile acid metabolism, with elevated circulating secondary bile acids impairing cardiovascular, hepatic, musculoskeletal, and immune functions. Recent evidence suggests that bile acid accumulation hinders vitamin D absorption and metabolism. In turn, vitamin D deficiency exacerbates systemic inflammation and fibrosis while reducing bile acid detoxification via diminished vitamin D receptor signaling. The dysregulation of bile acid and vitamin D pathways may create a vicious cycle driving Fontan-associated multisystem dysfunction. Interventions targeting this axis-such as vitamin D supplementation and bile acid modulation-may offer novel strategies to mitigate organ injury and improve long-term outcomes in this high-risk population.
Human iPSC-Based in Vitro Cardiovascular Tissue Models for Drug Screening Applications.
Anand S, Chen G, Khanna A … +1 more , Huang NF
Curr Cardiol Rep · 2025 Oct · PMID 41128948 · Full text
PURPOSE OF REVIEW: To provide an overview of human induced pluripotent stem cell (hiPSC)-derived cardiovascular lineages and describe their impact on drug testing in vitro. RECENT FINDINGS: hiPSCs have garnered tremendou...
PURPOSE OF REVIEW: To provide an overview of human induced pluripotent stem cell (hiPSC)-derived cardiovascular lineages and describe their impact on drug testing in vitro. RECENT FINDINGS: hiPSCs have garnered tremendous interest over the last decade due to their potential for unlimited proliferation and differentiation into cardiovascular lineages. Technologies using tissue engineering, 3D bioprinting, and organ-on-a-chip platforms composed of hiPSC derivatives can produce cardiovascular tissue mimetics that enhance drug screening applications. hiPSC-derived cardiovascular lineages advance drug screening efforts by using autologous cells that are more therapeutically relevant. Established approaches to reproducibly generate hiPSC-derived cardiovascular lineages and their subsequent organization into 3D constructs more accurately mimic the physiological organization of cardiac tissue, leading to improved identification of potential drug targets for therapeutic testing.
Associations Between Positive Affect and Heart Rate Variability: A Systematic Review.
Schneider M, Rominger C, Schwerdtfeger AR
Curr Cardiol Rep · 2025 Oct · PMID 41128836 · Full text
PURPOSE OF REVIEW: The relationship between positive affect (PA) and heart rate variability (HRV) has attracted considerable interest due to its potential implications for emotion regulation and cardiovascular health. Th...
PURPOSE OF REVIEW: The relationship between positive affect (PA) and heart rate variability (HRV) has attracted considerable interest due to its potential implications for emotion regulation and cardiovascular health. This systematic review synthesizes current literature on the association between PA and HRV, considering resting-state, stress-reactivity and recovery contexts, as well as variations in PA conceptualization. RECENT FINDINGS: A total of 36 studies (N = 5501) were included, spanning experimental, ambulatory, cross-sectional, and mixed designs. Elevated PA was most often associated with higher vagally mediated HRV, measured as RMSSD or high-frequency (HF) power, but results varied by context. Resting-state and trait-like PA measures showed the most consistent positive associations. In stress-induction paradigms, effects depended on the stress phase and arousal level of PA, with RMSSD emerging as a more consistent index than other HRV metrics. In real-life settings, aggregated activated PA was linked to higher RMSSD, while momentary activated PA was linked to lower RMSSD, suggesting short-term allostatic adjustments. Findings for other HRV metrics, such as LF/HF ratio, LF-HRV, and SDNN, were mixed. Overall, this review highlights the complex interplay between PA and cardiac autonomic regulation and provides directions for future research, which should aim for greater methodological consistency and clarify the temporal dynamics of the PA-HRV relationship.
Autonomic Imbalance in Cardiomyopathy and Heart Failure: From Neurobiology to Precision Neuromodulation.
Talishinsky A, Ajijola OA, Khalsa SS
Curr Cardiol Rep · 2025 Oct · PMID 41117884 · Full text
PURPOSE OF THE REVIEW: This review provides a framework for understanding autonomic neural regulation of cardiac function and dysfunction, highlighting the anatomical and functional organization of the autonomic nervous...
PURPOSE OF THE REVIEW: This review provides a framework for understanding autonomic neural regulation of cardiac function and dysfunction, highlighting the anatomical and functional organization of the autonomic nervous system, from intrinsic cardiac neurons to central cortical control centers. We review pathways leading to autonomic dysregulation in heart failure (HF) and cardiomyopathy (CMY), and we discuss the potential for precision neuromodulation informed by biomarkers and neuroimaging. RECENT FINDINGS: We synthesize emerging insights into the molecular, inflammatory, and psychological mechanisms contributing to autonomic dysregulation in HF, and examine the clinical implications of impaired reflex arcs and persistent neurohormonal activation. Recent advances in neuromodulation, including vagus nerve stimulation, baroreflex activation therapy, spinal cord stimulation, cardiac sympathetic denervation and cortical neuromodulation demonstrate the potential to restore autonomic balance and improve HF outcomes. Autonomic imbalance, characterized by sympathetic overactivation and parasympathetic withdrawal, is a hallmark of HF and CMY, contributing to disease progression and adverse outcomes. While traditional pharmacotherapies target downstream neurohormonal pathways, neuromodulation offers the opportunity to intervene upstream, directly at pathophysiological nexus points. Ultimately, a shift toward personalized, circuit-specific neuromodulation strategies may offer new opportunities for treating autonomic dysregulation in HF and CMY.
Occupational Risk Factors for Cardiovascular Disease: A Comprehensive Review.
Jeon SY, Lee CY, Lee YH … +5 more , Kim H, Kim J, Cho SK, Noh HS, Kang MY
Curr Cardiol Rep · 2025 Oct · PMID 41116135 · Publisher ↗
PURPOSE OF REVIEW: Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality worldwide, with occupational factors emerging as significant yet modifiable risk factors. This comprehensive review evalu...
PURPOSE OF REVIEW: Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality worldwide, with occupational factors emerging as significant yet modifiable risk factors. This comprehensive review evaluates the association between various occupational exposures-including job stress, long working hours, shift work, physical activity at work, and exposure to hazardous substances-and CVD risk. Using the GRADE framework, we assessed the strength of evidence for each risk factor. RECENT FINDINGS: Job stress, long working hours, night shift work, and carbon monoxide exposure demonstrated moderate evidence linking them to increased CVD risk, while occupational noise, air pollutants, and extreme temperatures had limited evidence. Physical activity at work and exposure to toxic metals showed inconclusive findings due to inconsistencies and indirectness in study populations. This review suggests that evaluating occupational exposures is essential for the early identification and management of individuals at elevated cardiovascular risk, and emphasizes that workplace interventions and health policies should prioritize reducing specific risk factors-such as job stress, long working hours, and hazardous exposures-to prevent CVD at both individual and population levels.
The Emerging Role of Lithotripsy in Structural Heart Interventions.
Fang JX, Lai LKL, Giustino G … +9 more , Khan JM, Engel Gonzalez P, O'Neill BP, Frisoli TM, Lee JC, Jabri A, Wang DD, O'Neill WW, Villablanca PA
Curr Cardiol Rep · 2025 Oct · PMID 41085773 · Full text
PURPOSE OF REVIEW: Lithotripsy, first applied to treating nephrolithiasis, has an evolving role in cardiovascular disease, including intravascular treatment of calcified coronary and peripheral artery disease. Its role i...
PURPOSE OF REVIEW: Lithotripsy, first applied to treating nephrolithiasis, has an evolving role in cardiovascular disease, including intravascular treatment of calcified coronary and peripheral artery disease. Its role is expanding to the management of valvular and structural heart disease. This narrative review provides an overview of the emerging role of lithotripsy in various valvular and structural heart interventions. RECENT FINDINGS: We have conducted a comprehensive literature review of all publications on lithotripsy in structural heart interventions found in PubMed and Google Scholar. We have also included a series of case examples of lithotripsy in structural heart interventions from a tertiary referral center in the United States (Henry Ford Health, Michigan). Lithotripsy has been used to facilitate large-bore access in both transfemoral and alternative access procedures, to treat valvular stenosis of mitral and aortic valves, manage paravalvular leak closure, aid transcatheter electrosurgery, and manage endovascular, congenital, and structural electrophysiology procedures. While a nationwide registry is available for large-bore access facilitation, the current data on valvular stenosis is limited to a single-center registry. Data on most other applications is restricted to case reports and case series and is subject to publication bias. Only two studies have been published on ex vivo and translational models. Lithotripsy is increasingly used off-label in structural heart interventions, with early clinical successes being reported. Translational research and bench-testing models are necessary to determine the optimal energy transfer conditions for valvular and annular lithotripsy. Multi-center studies and randomized controlled trials are needed to assess the efficacy of these novel procedures.
The Role of Pericardial Fat in Cardiometabolic Disease: Emerging Evidence and Therapeutic Potential.
Shahrori Z, Chedid El Helou M, Sallam S … +2 more , Iacobellis G, Neeland IJ
Curr Cardiol Rep · 2025 Oct · PMID 41071445 · Publisher ↗
PURPOSE OF REVIEW: This review explores the unique anatomy and pathophysiology of pericardial fat (including both epicardial adipose tissue [EAT] and paracardial fat), its clinical significance, and its potential role as...
PURPOSE OF REVIEW: This review explores the unique anatomy and pathophysiology of pericardial fat (including both epicardial adipose tissue [EAT] and paracardial fat), its clinical significance, and its potential role as a therapeutic target. It addresses key questions regarding the contribution of EAT to cardiometabolic conditions such as coronary artery disease, heart failure, atrial fibrillation, and ventricular arrhythmias, and explores interventions that reduce EAT to possibly improve cardiovascular outcomes. RECENT FINDINGS: Recent studies have established EAT as a metabolically active, pro-inflammatory fat depot directly affecting the myocardium and coronary arteries. Imaging and metabolomic studies have advanced the assessment of EAT burden. Clinical evidence supports lifestyle modification, pharmacologic therapies including GLP-1 RA and SGLT2i, and bariatric surgery to effectively reduce EAT volume. Emerging data link EAT reduction with improved cardiac function and arrhythmia risk, although causality remains unclear. EAT is a modifiable cardiometabolic risk factor associated with adverse outcomes in coronary artery disease, heart failure, atrial fibrillation, and ventricular arrhythmias. Targeting EAT through cardiometabolic risk reduction strategies may improve prognosis. Future research should focus on determining whether reducing EAT directly improves clinical outcomes.
Cardiomyopathy in Older Adults.
O'Neill DE, Forman DE
Curr Cardiol Rep · 2025 Oct · PMID 41066002 · Publisher ↗
PURPOSE OF REVIEW: Cardiomyopathy is a disorder of the myocardium, in which structural and functional abnormalities of the heart muscle result in mechanical and/or electrical cardiac dysfunction. Aging increases suscepti...
PURPOSE OF REVIEW: Cardiomyopathy is a disorder of the myocardium, in which structural and functional abnormalities of the heart muscle result in mechanical and/or electrical cardiac dysfunction. Aging increases susceptibility to molecular damage and related risks of cardiomyopathy, often in combination with other chronic diseases and geriatric syndromes (e.g., frailty, sarcopenia). With the rapidly growing population of older adults, awareness of the most prevalent cardiomyopathies in this population provides important insight to optimize prevention and treatment. RECENT FINDINGS: Hypertrophic, restrictive and dilated cardiomyopathies are highly prevalent in older adults. Furthermore, coronary artery disease, hypertension and valve disease increase with aging, and often lead to myocardial abnormalities that have many similar features to cardiomyopathy that are important to clarify. This review provides important age-related perspectives regarding pathophysiology, diagnosis, management and prevention. Aging is associated with inflammation and oxidative stress that can lead to molecular damage and vulnerability to many chronic diseases, including various cardiomyopathies. However, development is not inevitable. Prevention via lifestyle modification is paramount, with novel gerotherapeutic options targeting biologic hallmarks of aging under investigation. This increases the potential to improve the lifespan and healthspan of older adults.
SCN5A Cardiomyopathy: from Ion Channel Dysfunction To Clinical Disease.
Heymans ABM, Bianchi L, Volders PGA … +2 more , van der Crabben SN, Verdonschot JAJ
Curr Cardiol Rep · 2025 Oct · PMID 41065902 · Full text
PURPOSE OF REVIEW: Although SCN5A variants are an established cause of arrhythmia and conduction disease, their association with dilated cardiomyopathy (DCM) is less studied. This review summarizes recent insights into S...
PURPOSE OF REVIEW: Although SCN5A variants are an established cause of arrhythmia and conduction disease, their association with dilated cardiomyopathy (DCM) is less studied. This review summarizes recent insights into SCN5A-related cardiomyopathy, focusing on genotype-phenotype correlations, overlap with arrhythmia, and implications for management. RECENT FINDINGS: Both gain- and loss-of-function SCN5A variants are associated with cardiomyopathy, found in 0.5-0.9% of DCM cases. Presentation ranges from isolated DCM to overlap phenotypes, in both pediatric and adult patients. High variability and intrafamilial heterogeneity suggest pleiotropic effects and variable penetrance. High prevalence of arrhythmias and conduction disease suggests the DCM phenotype may be mediated by electrical disturbances. However, functional studies and cases without prior arrhythmia suggest SCN5A variants may directly contribute to structural myocardial changes. SCN5A-related cardiomyopathy is a rare disorder at the intersection of structural and electrical heart disease. Genotype-informed strategies, including arrhythmia management, and early cascade genetic screening are clinically relevant. Further research should address SCN5A-specific risk management in DCM patients.
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