Current Opinion In Cardiology[JOURNAL]
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200 papers
Fetal MRI for cardiopulmonary anomalies: what the pediatric cardiologist and surgeon need to know.
Dadoun SE, Mokha S, Kooraki S … +1 more , Afshar Y
Curr Opin Cardiol · 2026 Jul · PMID 42093267 · Publisher ↗
PURPOSE OF REVIEW: Advances in fetal cardiac magnetic resonance imaging (CMR) have expanded its role as an adjunct to expert fetal echocardiography in the prenatal evaluation of complex cardiopulmonary anomalies. This re...
PURPOSE OF REVIEW: Advances in fetal cardiac magnetic resonance imaging (CMR) have expanded its role as an adjunct to expert fetal echocardiography in the prenatal evaluation of complex cardiopulmonary anomalies. This review outlines an evidence-based framework for integrating fetal CMR when it provides diagnostic or prognostic information that can informs counseling, delivery planning, or postnatal management. RECENT FINDINGS: Fetal CMR offers high-resolution, multiplanar imaging with superior soft-tissue contrast and wide field of view, enabling improved assessment of cardiopulmonary structures where echocardiography is limited by technical or physiologic factors, or when expert echocardiography raises clinically relevant questions. MRI enables improved delineation of aortic arch and pulmonary venous anatomy, characterization of pulmonary parenchymal changes, and quantify lung and ventricular volumetry without relying on geometric assumptions. Emerging flow-based techniques allow evaluation of fetal hemodynamics and cardiovascular physiology beyond static imaging. These technologies provide diagnostic and prognostic information in select, often critical, congenital heart diseases. SUMMARY: Fetal cardiac CMR serves as a complementary modality to expert echocardiography when applied selectively to address clinically meaningful diagnostic or prognostic questions. However, limited availability, technical complexity, and the need for specialized expertise currently constrain widespread adoption. Continued technical refinement and outcome-based validation are required before fetal CMR can be routinely integrated into clinical practice.
Discontinuation of statin therapy - an updated review.
Orfanos E, Byun JH, Daskalopoulou SS
Curr Opin Cardiol · 2026 Jul · PMID 42093246 · Publisher ↗
PURPOSE OF REVIEW: This narrative review aims to provide an updated synthesis of the recent epidemiology, clinical determinants, and consequences of statin discontinuation. RECENT FINDINGS: Cardiovascular disease (CVD) r...
PURPOSE OF REVIEW: This narrative review aims to provide an updated synthesis of the recent epidemiology, clinical determinants, and consequences of statin discontinuation. RECENT FINDINGS: Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality worldwide, with elevated low-density lipoprotein cholesterol (LDL-C) representing a key modifiable risk factor. Statins are first-line lipid-lowering agents that reduce major adverse cardiovascular events, cardiovascular mortality, and all-cause mortality. Despite their efficacy, statin discontinuation and suboptimal adherence remain common. Discontinuation rates within the first-year range widely (0.8-70.5%), with higher rates observed in primary prevention populations. Factors associated with discontinuation include male sex, non-White ethnicity, smoking, and lack of insurance, whereas secondary prevention is consistently associated with better persistence. Interestingly, polypharmacy demonstrated conflicting associations across studies. Overall, approximately 40% of patients fail to achieve optimal adherence. Discontinuation is consistently associated with increased cardiovascular events, hospitalizations, and all-cause mortality. SUMMARY: Statin discontinuation and poor adherence remain major barriers to effective cardiovascular risk reduction. Addressing patient-, clinician-, and system-level determinants is essential to improve long-term adherence and clinical outcomes.
Interventional procedures in congenital heart disease for atrio-ventricular valves: future possibility or fools dream.
Linnane N, Kenny D
Curr Opin Cardiol · 2026 Jul · PMID 42083498 · Publisher ↗
PURPOSE OF REVIEW: Transcatheter options for atrioventricular valve disease have skyrocketed in recent years and this review aims to outline current available technologies and how they have been used to date in congenita...
PURPOSE OF REVIEW: Transcatheter options for atrioventricular valve disease have skyrocketed in recent years and this review aims to outline current available technologies and how they have been used to date in congenital heart disease patients. RECENT FINDINGS: Transcatheter edge to edge repair is the best described technology to date with most reports being limited to case series. The limitation of its widespread use is largely imaging based with a steep learning curve from the imaging standpoint most likely limiting its widespread use in stand-alone paediatric hospitals where a lot of adult congenital interventions take place. Valve in valve tricuspid valve replacement has been well described with off label use of balloon expandable valves but further additional technologies; transcatheter annuloplasty, transcatheter mitral valve in valve or valve in ring and native transcatheter valve replacement have limited reports in the congenital field. SUMMARY: As the newer transcatheter options for atrioventricular valve disease become more ubiquitous in acquired cardiovascular disease attention will turn more to congenital patients. Collaboration with adult acquired structural interventionalists and imaging cardiologists will be the key which unlocks these technologies in the future for congenital patients.
Revisiting the role of beta blockers in the management of hypertension.
Fujiwara T, Kario K
Curr Opin Cardiol · 2026 Jul · PMID 42070984 · Publisher ↗
PURPOSE OF REVIEW: Although beta blockers have a long history in hypertension management, their first-line role remains controversial after early-2000 s trials raised concerns about inferior stroke prevention with tradit...
PURPOSE OF REVIEW: Although beta blockers have a long history in hypertension management, their first-line role remains controversial after early-2000 s trials raised concerns about inferior stroke prevention with traditional beta-blocker based regimens. This review re-examines the role of beta blockers in contemporary hypertension care by integrating mechanistic insights, phenotype-oriented considerations, and recent clinical evidence. RECENT FINDINGS: Recent randomized controlled trials in acute myocardial infarction suggest that beta blocker depends on patient selection and left ventricular ejection function, arguing against routine use. Advances in out-of-office blood pressure (BP) assessment have enabled identification of clinically relevant phenotypes - including BP variability, morning BP surge, and nocturnal hypertension - that are closely linked to sympathetic overactivity and elevated heart rate. These associated pathophysiological abnormalities provide a mechanistic rationale for targeted beta-blocker use. Moreover, beta blockers are a heterogeneous drug class; β 1 -selective and vasodilatory agents exhibit distinct hemodynamic effects, including on central hemodynamics. SUMMARY: Beta blockers should not be viewed as universally applicable antihypertensive agents; instead, they are best positioned as phenotype-oriented therapies for selected patients with heightened sympathetic activity, specific BP phenotypes, or coexisting cardiovascular disease. Contemporary evidence supports an individualized approach that moves beyond legacy beta-blocker-based regimens toward selective beta-blocker use in modern cardiovascular care.
RNA modifications in heart failure: current insights and future directions.
Deogharia M
Curr Opin Cardiol · 2026 Jul · PMID 42047244 · Publisher ↗
PURPOSE OF REVIEW: Gene expression is regulated at multiple levels beyond genetic and epigenetic modifications of DNA. Even when DNA is accurately transcribed into RNA, transcript abundance often does not correlate with...
PURPOSE OF REVIEW: Gene expression is regulated at multiple levels beyond genetic and epigenetic modifications of DNA. Even when DNA is accurately transcribed into RNA, transcript abundance often does not correlate with protein levels, underscoring the importance of posttranscriptional regulation. Chemical modifications of RNA occur in both coding and noncoding RNAs and add an additional layer of gene control. More than 170 distinct RNA modifications have been identified across different RNAs in all domains of life. Although the abundant modifications have been investigated, their roles in cardiac biology and heart failure remain incompletely defined. This review discusses the current knowledge of both well characterized and understudied RNA modifications in the heart. RECENT FINDINGS: Recent studies highlight context-dependent roles of N6-methyladenosine (m 6 A), 5-methylcytosine (m 5 C), N4-acetylcytidine (ac 4 C), and adenosine-to-inosine (A-to-I) RNA editing in the heart are discussed in this review. SUMMARY: RNA modifications constitute a critical regulatory layer that complements transcriptional control and facilitates rapid adaptation to cardiac stress. Dysregulation of m 6 A, m 5 C, and A-to-I editing contributes to pathological remodeling and disease progression. However, most RNA modifications remain unexplored in heart failure. Enzymes that write, erase, or read these marks represent promising targets for precision therapeutic strategies.
Role of nicotinamide adenine dinucleotide in cardiovascular disease.
Prasanna J, Manickam R, Tipparaju SM
Curr Opin Cardiol · 2026 Jul · PMID 42047243 · Publisher ↗
PURPOSE OF REVIEW: The nicotinamide adenine dinucleotide (NAD + ) is an important redox cofactor that plays a major role in energy metabolism. This review provides an overview of the current understanding of NAD + in car...
PURPOSE OF REVIEW: The nicotinamide adenine dinucleotide (NAD + ) is an important redox cofactor that plays a major role in energy metabolism. This review provides an overview of the current understanding of NAD + in cardiovascular diseases. RECENT FINDINGS: Activation of the rate-limiting enzyme nicotinamide phosphoribosyltransferase (NAMPT), a key component of the NAD + salvage pathway, is emerging as an alternative method to replenish the cycling NAD + pools and to alleviate the cardiovascular pathophysiology driven by NAD + depletion. The NAD + -dependent sirtuins play an important role in cellular metabolism and integrate the circadian signaling of clock controlled Nampt oscillation and thereby NAD + synthesis. SUMMARY: An imbalance in the NAD + /NADH ratio caused by NAD + depletion is implicated in various diseases, including metabolic disease, aging, and cancer. The cellular NAD + content is decreased in cardiovascular diseases and heart failure. Lack of NAD + in cardiomyocytes leads to mitochondrial dysfunction, increased reactive oxygen species (ROS) production and cell death. The supplementation of NAD + and its precursors such as nicotinic acid (NA), nicotinamide (NAM), nicotinamide mononucleotide (NMN), and nicotinamide riboside (NR) are currently being evaluated in clinical trials. This review mainly focuses on the role of NAD + in cardiovascular diseases and therapeutics.
Impact of social determinants of health on cardiovascular health.
Porras-Perez E, Perez-Martinez P, Yubero-Serrano EM
Curr Opin Cardiol · 2026 Jul · PMID 42047242 · Publisher ↗
PURPOSE OF REVIEW: Cardiovascular diseases remain the leading cause of global morbidity and mortality. Strategies centered on individual risk factors have been insufficient to reduce population-level cardiovascular burde...
PURPOSE OF REVIEW: Cardiovascular diseases remain the leading cause of global morbidity and mortality. Strategies centered on individual risk factors have been insufficient to reduce population-level cardiovascular burden or to address persistent health inequities. This review is timely given the increasing emphasis on cardiovascular health (CVH) metrics, particularly the American Heart Association (AHA) Life's Essential 8 (LE8), and the growing recognition of social determinants of health (SDOH) as fundamental drivers of cardiovascular outcomes. RECENT FINDINGS: CVH, as defined by AHA frameworks, remains suboptimal across populations being a strong predictor of cardiovascular and all-cause mortality. Emerging evidence highlights food insecurity and other adverse SDOH as major contributors of poor CVH, acting primarily through modifiable behavioral domains such as diet, physical activity, nicotine exposure, and sleep. LE8 mediates a substantial proportion of the link between social disadvantages and adverse cardiovascular outcomes, underscoring its potential utility as both risk assessment and intervention framework. SUMMARY: Collectively, current evidence supports a paradigm shift in cardiovascular prevention strategies that integrate CVH metrics with SDOH. LE8 provides a practical and scalable framework to assess CVH and target modifiable pathways linking social disadvantages to CVD. Future research and interventions should adopt multilevel, equity-focused, and life-course-oriented approaches to effectively reduce cardiovascular morbidity and mortality.
Renal denervation: from establishing effectiveness to measuring success.
Lee HH, Krawisz AK, Secemsky EA
Curr Opin Cardiol · 2026 Jul · PMID 42047236 · Publisher ↗
PURPOSE OF REVIEW: Renal denervation has emerged as a new therapeutic option for blood pressure (BP) control and is now incorporated into contemporary hypertension guidelines. Here, we review the evolution of evidence fo...
PURPOSE OF REVIEW: Renal denervation has emerged as a new therapeutic option for blood pressure (BP) control and is now incorporated into contemporary hypertension guidelines. Here, we review the evolution of evidence for renal denervation, approaches to assessing treatment response, and emerging technological developments. RECENT FINDINGS: Early non-sham-controlled trials of renal denervation showed substantial reductions in BP, whereas the first sham-controlled trial, SYMPLICITY HTN-3, yielded neutral findings. To address its limitations, subsequent trials incorporated key design modifications - including strict restriction of changes in background antihypertensive medications, procedural standardization, and separate conduct of trials in "on-medication" and "off-medication" cohorts - and have since consistently demonstrated the efficacy of renal denervation. In these studies, efficacy was assessed primarily by reductions in systolic BP, with additional measures including reductions in diastolic BP and antihypertensive medication burden. Alternative ablative mechanisms (e.g., alcohol-mediated neurolysis) are currently under investigation, along with multi-organ denervation approaches aimed at augmenting BP reduction while providing additional metabolic benefits. SUMMARY: Evidence supporting renal denervation has continued to accumulate, demonstrating consistent BP reductions. The field is evolving, with new approaches using alternative ablative mechanisms or targeting multi-organ sympathetic pathways on the horizon.
Sodium reduction and salt substitutes: impact on blood pressure and recurrent stroke.
Patel P, Palmer BF, Lange RA
Curr Opin Cardiol · 2026 Jul · PMID 42047235 · Full text
PURPOSE OF REVIEW: The health effects of dietary sodium and dietary potassium intake in mitigating blood pressure (BP) are a focus of research. This review summarizes recent findings of these health effects and the effec...
PURPOSE OF REVIEW: The health effects of dietary sodium and dietary potassium intake in mitigating blood pressure (BP) are a focus of research. This review summarizes recent findings of these health effects and the effectiveness of potassium-enriched salt substitutes on the risk for and recurrence of cardiovascular events. RECENT FINDINGS: Salt substitution is an emerging sodium reduction strategy that may prove to be more beneficial in lowering BP and reducing risk for recurrent stroke compared with alternative low-sodium diets. However, careful consideration is required for patients with impaired renal function or on specific renal physiology-modulating pharmacotherapies. SUMMARY: Low sodium substitutes have proven to be more efficacious and practical in lowering BP and preventing stroke or recurrence of stroke than alternative low-sodium diets. This salt reduction strategy holds promising value in reducing the risk for cardiovascular disease.
Novel approaches to cardiac rehabilitation among patients with cardiovascular disease: current and future states.
Schwab G, Vigen R
Curr Opin Cardiol · 2026 May · PMID 41912336 · Publisher ↗
PURPOSE OF REVIEW: Novel approaches to cardiac rehabilitation delivery, the integration of emerging exercise modalities, and the extension of cardiac rehabilitation principles to additional disease states have the potent...
PURPOSE OF REVIEW: Novel approaches to cardiac rehabilitation delivery, the integration of emerging exercise modalities, and the extension of cardiac rehabilitation principles to additional disease states have the potential to improve care for patients with established and evolving indications. This review summarizes recent advances in hybrid and home-based cardiac rehabilitation, digital and behavioral technologies, innovative exercise strategies, and the application of cardiac rehabilitation to broader patient populations. RECENT FINDINGS: Technology-enabled cardiac rehabilitation models - including hybrid delivery, remote monitoring, wearables, gamification, and behavioral-economic nudges - demonstrate promise in improving participation, adherence, and engagement. Concurrently, newer exercise modalities offer more personalized and physiologically targeted programs. Evidence supports expanding cardiac rehabilitation to additional clinical populations, including individuals with heart failure with preserved ejection fraction and cardio-oncology, and demonstrates meaningful benefits in older and frail adults, with improvements in exercise capacity, symptoms, and quality of life. SUMMARY: Advances in digital health, behavioral science, and exercise physiology are increasingly reshaping cardiac rehabilitation, moving beyond traditional, center-based models toward more flexible, patient-centered, and data-enabled approaches to cardiovascular care. Further research is needed to refine implementation, evaluate long-term outcomes, and ensure equitable access. Integrating novel exercise modalities with technology-enabled and behavioral approaches may help modernize cardiac rehabilitation and extend its therapeutic reach.
Targeting genomic instability to attenuate age-dependent cardiovascular disease.
Marian AJ
Curr Opin Cardiol · 2026 May · PMID 41912335 · Publisher ↗
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Liver lesions in Fontan-associated liver disease: current challenges and future directions.
Singh P, Nair A, Emamaullee JA
Curr Opin Cardiol · 2026 Jul · PMID 41911494 · Publisher ↗
PURPOSE OF REVIEW: Hepatic lesions develop in nearly half of the Fontan population, yet clinicians lack tools to distinguish benign lesions from malignancy, including hepatocellular carcinoma (HCC). Standard Liver Imagin...
PURPOSE OF REVIEW: Hepatic lesions develop in nearly half of the Fontan population, yet clinicians lack tools to distinguish benign lesions from malignancy, including hepatocellular carcinoma (HCC). Standard Liver Imaging Reporting and Data System (LI-RADS) criteria are not applicable to Fontan-associated liver disease (FALD). To address this critical diagnostic gap, risk-stratified surveillance approaches have been proposed. RECENT FINDINGS: We review the spectrum of hepatic lesions in FALD, emphasizing the diagnostic challenge in distinguishing benign from malignant nodules. Noninvasive fibrosis assessment, including transient elastography, is discussed for risk stratification, though liver biopsy remains the only reliable tool for characterizing suspicious lesions. HCC in FALD demonstrates distinct features and carries poor prognosis primarily due to presentation with advanced disease. Despite treatment modalities, outcomes remain suboptimal, with most therapies limited by cardiac comorbidities, abnormal hemodynamics, and advanced FALD. SUMMARY: The optimal surveillance and diagnostic strategy for hepatic lesions in patients with FALD remains undefined. Multimodal assessment, multidisciplinary care, and a low threshold for biopsy are essential. Liver biopsy remains the only reliable method for characterizing suspicious lesions and staging fibrosis severity in the context of FALD. FALD-specific diagnostic criteria and evidence-based surveillance protocols are urgently needed to guide early detection and improve outcomes.
Beyond the 2025 guidelines: tailoring hypertension management to the underlying pathogenic pathway in the age of precision medicine.
Al Dhaybi O, Bhatt DL
Curr Opin Cardiol · 2026 Jul · PMID 41911492 · Publisher ↗
PURPOSE OF REVIEW: Hypertension is the most common chronic disease in developed countries, with a prevalence exceeding 25-30% of adults. The updated hypertension guidelines define evidence-based blood pressure targets an...
PURPOSE OF REVIEW: Hypertension is the most common chronic disease in developed countries, with a prevalence exceeding 25-30% of adults. The updated hypertension guidelines define evidence-based blood pressure targets and provide clinicians with a framework for achieving them. Examining the underlying hypertension phenotypes provides a complementary approach to the management of hypertension. RECENT FINDINGS: Rather than a one-size fits all approach, a more directed hypertension management involves tailoring therapy toward the predominant pathophysiologic mechanism or "Phenotype" responsible for blood pressure elevation, rather than adhering to a uniform, stepwise treatment algorithm. Such an approach allows clinicians to tailor therapy to the key biological drivers of hypertension in the individual patient. It is important to note that these pathways overlap and are not isolated, while oftentimes, one single phenotype is the predominant over the others. This article examines these distinct phenotypes, outlining their key characteristics and the best therapeutic approaches for each. SUMMARY: Our ability to delineate hypertension phenotypes through biomedical, genetic and clinical testing is advancing rapidly, and precision medicine innovations are reshaping hypertension care with a level of specific and clinical insights that were not previously attainable, paving the way for the refinement of future hypertension guidelines.
Genetic factors contributing to atherosclerosis.
Raddatz MA, Allayee H, Lusis AJ
Curr Opin Cardiol · 2026 May · PMID 41883225 · Full text
PURPOSE OF REVIEW: Atherosclerosis is a highly complex and heterogeneous disease characterized by inflammation and lipid accumulation in the arterial wall. Genetic studies to identify loci and genes predisposing to the d...
PURPOSE OF REVIEW: Atherosclerosis is a highly complex and heterogeneous disease characterized by inflammation and lipid accumulation in the arterial wall. Genetic studies to identify loci and genes predisposing to the disease have now been carried out in large human cohorts and the underlying pathways have been studied in animal models, primarily mice. This review summarizes recent findings relating to genetic contributions to the disease and implications for diagnosis and treatment. RECENT FINDINGS: Recent discoveries of genes contributing to all aspects of atherosclerosis and related diseases, including inflammation, lipid levels and oxidation, clonal hematopoiesis, hypertension, cardiac function, and aortic stenosis, are discussed. Altogether, several hundred contributing genes have been identified, and these are enabling a better understanding of the important pathways involved. These findings have also led to the development of improved diagnostic methods, including overall risk evaluation, and the identification of new therapeutic targets. SUMMARY: Genetics is proving to be a powerful approach to dissecting atherosclerosis. Genetic studies promise to revolutionize the diagnosis and treatment of the disease.
Aldosterone synthase inhibition in hypertension: an evolving therapeutic strategy.
Alkhatib R, Hatab T, Laffin LJ
Curr Opin Cardiol · 2026 Jul · PMID 41883217 · Publisher ↗
PURPOSE OF REVIEW: Despite widespread use of renin-angiotensin-aldosterone system blockade, resistant and uncontrolled hypertension remain common, highlighting the need for novel therapeutic strategies. Growing recogniti...
PURPOSE OF REVIEW: Despite widespread use of renin-angiotensin-aldosterone system blockade, resistant and uncontrolled hypertension remain common, highlighting the need for novel therapeutic strategies. Growing recognition of aldosterone excess as a central driver of vascular, cardiac, and kidney injury has renewed interest in targeting this pathway. Recent advances in highly-selective aldosterone synthase inhibition (ASI) suggest this is a clinically viable approach. RECENT FINDINGS: ASIs, including baxdrostat and lorundrostat, demonstrate consistent blood pressure reductions of approximately 8-12 mmHg when administered in addition to standard antihypertensive therapy across phase 2 and phase 3 trials. These drugs may overcome limitations of mineralocorticoid receptor antagonists by suppressing aldosterone production upstream, mitigating aldosterone escape, and reducing adverse effects. There may also be benefits among patients with chronic kidney disease, primary aldosteronism, and heart failure with preserved ejection fraction, supporting a broader cardiorenal role. SUMMARY: Aldosterone synthase inhibition represents an advance in hypertension therapeutics. If ongoing and future outcome-driven trials confirm cardiovascular and renal benefit, ASIs may reshape treatment algorithms, complement existing renin-angiotensin-aldosterone-based strategies, and enable more precise targeting of aldosterone-mediated disease.
Cardiometabolic vulnerability in cardio-oncology: mechanistic links, clinical implications, and emerging preventive strategies.
Kim J, Muquith M, Huang L … +1 more , Chandra A
Curr Opin Cardiol · 2026 May · PMID 41841682 · Publisher ↗
PURPOSE OF REVIEW: Cardiovascular disease is a leading cause of morbidity and mortality among patients with cancer, yet individual risk is highly heterogeneous. This review examines cardiometabolic vulnerability as a uni...
PURPOSE OF REVIEW: Cardiovascular disease is a leading cause of morbidity and mortality among patients with cancer, yet individual risk is highly heterogeneous. This review examines cardiometabolic vulnerability as a unifying framework linking baseline cardiometabolic risk factors with cancer therapy-related cardiovascular injury and discusses emerging pharmacologic and lifestyle interventions for cardiovascular risk mitigation. RECENT FINDINGS: Epidemiologic and mechanistic studies demonstrate that obesity, insulin resistance, dyslipidemia, and hypertension, often exacerbated by cancer therapies, amplify systemic inflammation, neurohormonal activation, endothelial dysfunction, and metabolic inflexibility. These disturbances interact with specific anticancer treatments, including anthracyclines, HER2-targeted agents, VEGF pathway inhibitors, endocrine therapies, and immune checkpoint inhibitors, increasing susceptibility to diverse cardiovascular toxicities. Emerging evidence supports multimodal preventive strategies integrating pharmacologic interventions targeting neurohormonal, metabolic, and inflammatory pathways with lifestyle modifications, though optimal approaches require further validation in cancer populations. SUMMARY: Cardiometabolic vulnerability provides a framework to understand heterogeneous cardiovascular risk in cancer patients. Integrating cardiometabolic profiling with therapy-specific risk assessment may improve prevention strategies in cardio-oncology. Continued research is needed to refine risk stratification and inform personalized approaches for this growing population.
2025 ESC/EACTS valvular heart disease guidelines: key updates and surgical implications for cardiac surgeons.
Patel SK, Elsherbini A, Hassan SMA … +3 more , Verma R, White C, Chu MWA
Curr Opin Cardiol · 2026 May · PMID 41841672 · Publisher ↗
PURPOSE OF REVIEW: The 2025 ESC/EACTS Guidelines for valvular heart disease introduce substantial changes in timing and modality of intervention, making a focused appraisal of their surgical implications highly relevant...
PURPOSE OF REVIEW: The 2025 ESC/EACTS Guidelines for valvular heart disease introduce substantial changes in timing and modality of intervention, making a focused appraisal of their surgical implications highly relevant for contemporary cardiac practice. RECENT FINDINGS: The guidelines formalize imaging-based staging of cardiac damage, lower thresholds for intervention in aortic stenosis and primary mitral regurgitation, and refine age- and risk-stratified allocation of surgery vs. transcatheter therapies across aortic, mitral, and tricuspid disease. They expand indications for transcatheter aortic valve implantation, mitral and tricuspid transcatheter edge-to-edge repair, and transcatheter valve replacement in carefully selected high-risk patients, while strengthening the role of durable surgical valve repair, complex aortic and multivalve procedures, and lifetime valve management strategies. Organizationally, they define and emphasize the importance of Heart Valve Centres and volume-outcome relationships. SUMMARY: These guideline recommendations reflect upon contemporary evidence to support thoughtful decision making, encourage earlier intervention, and reinforce the central role of cardiac surgery and cardiology partnerships in achieving best patient outcomes through Heart Valve Centres. Cardiac surgeons should continue advance excellence in valve repair and reconstructive surgery and embrace the complementary role of transcatheter valve therapies.
Exercise training for the prevention and treatment of cardiometabolic disease.
Kong S, Foulkes S, Peters AE
Curr Opin Cardiol · 2026 May · PMID 41841647 · Publisher ↗
PURPOSE OF REVIEW: The aim of this study is to provide an updated overview on exercise training as an optimal strategy for preventing and treating cardiometabolic complications. RECENT FINDINGS: Physical inactivity is re...
PURPOSE OF REVIEW: The aim of this study is to provide an updated overview on exercise training as an optimal strategy for preventing and treating cardiometabolic complications. RECENT FINDINGS: Physical inactivity is recognized as one of the most significant, modifiable risk factors for cardiovascular disease (CVD), the leading cause of mortality worldwide. Despite well established guidelines, nearly one-third of adults fail to meet recommended activity levels. Physical inactivity is associated with increased risk of CVD and cardiometabolic complications including coronary artery disease, heart failure, hypertension, stroke, obesity, type 2 diabetes, and dyslipidemia. Home exercise prescriptions and supervised exercise training programs including aerobic ± resistance training have been shown to modify risk and treat cardiometabolic disease. This includes positive effects on glycemic control, obesity, stroke, hypertension, heart failure, and primary and secondary prevention of atherosclerotic CVD. The cardioprotective effects of exercise training programs appear to be multifactorial, mediated through specific structural and functional cardiovascular adaptations, and systemic effects including improved lipid metabolism, enhanced mitochondrial efficiency, and attenuation of systemic inflammation. SUMMARY: In this review, we summarize recent evidence for various exercise training programs in preventing and managing cardiometabolic disease and explore the physiologic mechanisms underlying their cardiovascular benefits.
The impact of sleep on heart health: contemporary research and medical practice.
Drakopanagiotakis F, Gouveri E, Steiropoulos P … +1 more , Papanas N
Curr Opin Cardiol · 2026 Jul · PMID 41841645 · Publisher ↗
PURPOSE OF REVIEW: This review discusses current research (between July 2024 and January 2026) on sleep disorders and cardiovascular disease, highlighting underlying biological processes, clinical outcomes, and therapeut...
PURPOSE OF REVIEW: This review discusses current research (between July 2024 and January 2026) on sleep disorders and cardiovascular disease, highlighting underlying biological processes, clinical outcomes, and therapeutic strategies. RECENT FINDINGS: More than a billion adults worldwide are affected by sleep disorders that significantly increase heart disease risk. Obstructive sleep apnoea (OSA) is increasingly recognised as an independent predictor of major cardiovascular complications, with nocturnal hypoxaemia emerging as a critical marker for risk stratification. Continuous positive airway pressure (CPAP) may decrease cardiovascular complications in selected high-risk patients with OSA. In addition, irregular sleep patterns and insufficient sleep duration are associated with arrhythmias and cardiac failure. Sleep disruption contributes to adverse cardiac remodelling through mechanisms involving oxidative stress and autonomic dysfunction. Genetic studies further support a direct causal relationship between OSA and coronary heart disease. Sleep has been added by the American Heart Association to its Life's Essential 8 framework, emphasising its role in cardiovascular health. SUMMARY: Sleep disorders represent a modifiable cardiovascular risk factor that warrants systematic assessment and targeted management. Optimal sleep health encompasses sufficient duration, appropriate timing, and regularity. Treatment of sleep disorders-particularly OSA with CPAP therapy in carefully selected high-risk populations-can confer cardiovascular benefits.
Weight loss as the optimal cardiometabolic management strategy for preventing and treating heart failure.
Costa TA, Vest AR, Harrington J
Curr Opin Cardiol · 2026 May · PMID 41802118 · Publisher ↗
PURPOSE OF REVIEW: To synthesize current evidence supporting intentional weight reduction as a cardiometabolic strategy for treating and preventing heart failure (HF) across the ejection-fraction spectrum, examine the in...
PURPOSE OF REVIEW: To synthesize current evidence supporting intentional weight reduction as a cardiometabolic strategy for treating and preventing heart failure (HF) across the ejection-fraction spectrum, examine the influence of baseline obesity on treatment effects of established HF therapies, and highlight key knowledge gaps and future research directions. RECENT FINDINGS: Visceral adipose tissue, central obesity, and dysfunctional adipose mass are linked to the development and progression of HF with preserved ejection fraction (HFpEF). Recent trials show that incretin-based therapies (semaglutide, tirzepatide) improve exercise capacity, symptoms, and quality of life in HFpEF, and potentially reduce HF events. Patients with higher degrees of obesity may derive greater benefit from incretin-based therapies and other guideline-directed therapies, including mineralocorticoid receptor antagonists (MRA), sodium-glucose transport 2 (SGLT2) inhibitors, and angiotensin receptor-neprilysin inhibitor (ARNI). While observational studies suggest intentional weight loss may lower HF risk, randomized trials of antiobesity medications have yet to further clarify this potential benefit. SUMMARY: Weight loss is currently recommended as an optimal strategy for individuals with obesity and HFpEF, given consistent benefits for exercise capacity, functional status, and quality of life, with a potential for reducing clinical events. Intentional weight loss impact in HFrEF and its role in primary HF prevention remains uncertain. Large, well designed cardiovascular outcome trials of intentional weight-loss interventions in populations with obesity and HF, or obesity and elevated HF risk, are needed to establish clinical efficacy and better define individuals who benefit from those interventions across the spectrum of ejection fraction.
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