Current Opinion In Cardiology[JOURNAL]
Sun
200 papers
Applications of genetic testing in cardiovascular disease.
Smirnova A, Urtis M, Arbustini E
Curr Opin Cardiol · 2026 May · PMID 41735041 · Publisher ↗
PURPOSE OF REVIEW: The identification of the genetic basis of an increasing number of cardiovascular diseases (CVDs) has substantially expanded the clinical demand for genetic testing. This review summarizes the major gr...
PURPOSE OF REVIEW: The identification of the genetic basis of an increasing number of cardiovascular diseases (CVDs) has substantially expanded the clinical demand for genetic testing. This review summarizes the major groups of genetic CVDs, the current testing strategies, the limitations of available approaches, and future perspectives for improving diagnostic accuracy. RECENT FINDINGS: Growing awareness of genetic CVD has stimulated comprehensive clinical phenotyping, family screening, and the integration of advanced imaging, functional studies, and pathological investigations. This has enabled an unprecedented incorporation of genetics into clinical cardiology, representing one of the most transformative developments in the field. This evolution is occurring within multidisciplinary frameworks, generating a high demand for expertise and technological innovation. SUMMARY: Mendelian CVDs include cardiomyopathies, arrhythmias, arteriopathies, primary calcific CVD, pulmonary hypertension, hereditary hemorrhagic telangiectasia, monogenic vasculitides, autoinflammatory disorders, syndromic cardiovascular tumors, and metabolic diseases (hypercholesterolemia and MODY). Mendelian CVDs are complemented by maternally-inherited mitochondrial diseases, characterized by heterogeneous, often syndromic phenotypes with frequent cardiovascular involvement. The genetic testing landscape is rapidly expanding, aiming to provide comprehensive and simplified "all-in-one" solutions while improving accessibility and sustainability. Key challenges remain related to technological limitations, result interpretation, and test completeness, representing major priorities for future development in cardiovascular genetics.
Sutureless aortic valves: timing, technique, and evidence.
Patel SK, Hassan SMA, Dhingra NK … +2 more , Verma R, Cohen G
Curr Opin Cardiol · 2026 May · PMID 41701009 · Publisher ↗
PURPOSE OF REVIEW: This review synthesizes contemporary evidence for sutureless aortic valve replacement (SuAVR). It focuses on indications, imaging-guided sizing, operative technique, outcomes, and complications to clar...
PURPOSE OF REVIEW: This review synthesizes contemporary evidence for sutureless aortic valve replacement (SuAVR). It focuses on indications, imaging-guided sizing, operative technique, outcomes, and complications to clarify where SuAVR meaningfully complements or substitutes conventional surgical aortic valve replacement and transcatheter aortic valve implantation. RECENT FINDINGS: Modern studies show SuAVR consistently shortens cardiopulmonary bypass and cross-clamp times by 25-50%, produces low discharge gradients and larger effective orifice areas, and is particularly advantageous in elderly patients, small annuli, redo operations, and concomitant procedures. Routine multidetector-row computed tomography perimeter sizing and meticulous annular decalcification have reduced clinically relevant paravalvular leak to low single digits, whereas higher implantation and conservative ballooning have lowered permanent pacemaker implantation rates toward single digits. Mid-term durability is encouraging, with 95-97% freedom from structural valve deterioration and 94-97% freedom from reintervention at 5 years. Conduction-system injury, transient thrombocytopenia, and residual pacemaker risk remain the principal trade-offs. SUMMARY: With Heart-Team selection and standardized computed tomography-first workflows and implant technique, SuAVR is a valuable surgical option that expands minimally invasive and complex surgical candidacy. Definitive adoption requires randomized long-term comparisons and standardized pacemaker-avoidance protocols.
Current opinion in cardiology, epigenetics of heart failure.
El-Osta A
Curr Opin Cardiol · 2026 May · PMID 41701005 · Publisher ↗
PURPOSE OF REVIEW: Heart failure is not simply a pump that has grown tired; it is a tissue that adapts and then, too often, becomes locked into its adaptations. This review examines how epigenetic regulation - chromatin...
PURPOSE OF REVIEW: Heart failure is not simply a pump that has grown tired; it is a tissue that adapts and then, too often, becomes locked into its adaptations. This review examines how epigenetic regulation - chromatin accessibility, histone modifications, DNA methylation and hydroxymethylation, and the reader complexes that interpret these marks - converts transient stress into durable transcriptional programs. We focus on the mechanisms by which the failing heart acquires regulatory "memory," and on the chromatin control nodes that are emerging as actionable targets for therapy and for biomarker development. RECENT FINDINGS: Three lines of evidence are reshaping the field. First, the failing-heart transcriptome is increasingly governed by a tractable set of chromatin control points: acetylation balance [histone deacetylases (HDACs) versus histone acetyltransferases (HATs) such as p300/CREB-binding protein (CBP)] and acetyl-lysine readers [bromodomain and extraterminal (BET) proteins, including bromodomain-containing protein 4 (BRD4)] that amplify hypertrophic, inflammatory, and profibrotic programs. Second, the adult human myocardium is not epigenetically inert: reproducible disease-associated methylation signatures and regulatory shifts are detectable across cardiomyopathy and ischemic heart failure, with early signals that some features may move with physiologic recovery. Third, acute stress phenotypes are being reframed as chromatin-state problems: Takotsubo syndrome compresses stress-to-dysfunction into days, and emerging mechanistic work supports an acetylation/deacetylation axis as a tractable regulatory lever in Takotsubo-like injury. SUMMARY: Epigenetics provides a mechanistic account of why cardiac injury can outlast its trigger and a rational route to intervention by targeting reader complexes, writer-eraser balance, and remodeler-mediated enhancer control. The translational mandate is precision: define causal regulatory nodes by cell type and disease phase and develop biomarkers that distinguish hemodynamic improvement from molecular reset.
Advancing gene and base editing for cardiovascular disease: overcoming barriers in delivery, precision and safety.
Kim TK, Hinson JT
Curr Opin Cardiol · 2026 May · PMID 41665042 · Publisher ↗
PURPOSE OF REVIEW: Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality despite major advances in pharmacological, devices, and surgical care. Gene editing technologies have introduced a transf...
PURPOSE OF REVIEW: Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality despite major advances in pharmacological, devices, and surgical care. Gene editing technologies have introduced a transformative approach to correct pathogenic variants and modulate disease pathways. This review highlights recent progress in editing technologies that are currently or may soon be applied to address cardiovascular disorders, summarizes recent preclinical and clinical studies that demonstrate improved precision and efficacy, and examines technical and translational challenges that must be overcome for broader clinical application. RECENT FINDINGS: We summarize preclinical advances, including refined target selection, improved delivery strategies, and enhanced therapeutic efficiency. We highlight emerging technologies that aim to overcome longstanding constraints such as limited vector cargo capacity, protospacer-adjacent motif (PAM) incompatibility, chromatin accessibility, suboptimal editing efficiency, and off-target activity. We also summarize the increasing clinical experience with in-vivo editing - particularly using lipid nanoparticle (LNP) and adeno-associated virus (AAV)-based platforms - that has also revealed important safety considerations, including vector immunogenicity, systemic inflammation, and organ-specific toxicities. SUMMARY: Despite rapid progress, successful clinical translation of gene and base editing for CVD continues to hinge on two central challenges: efficient and precise delivery and mitigation of immunogenicity and toxicity from both delivery vectors and gene-editing enzymes. Although next-generation editors and targeted delivery systems have expanded the scope of feasible cardiovascular applications, overcoming these biological barriers remains the critical step toward achieving well tolerated, durable, one-time genomic therapies. Continued innovation in vector engineering, tissue-selective delivery, and immunologic risk mitigation will be essential for advancing editing technologies into cardiovascular care.
Tumours of the heart valves.
Dhingra NK, Lee G, Cusimano RJ
Curr Opin Cardiol · 2026 Mar · PMID 41576418 · Publisher ↗
PURPOSE OF REVIEW: Tumours involving cardiac valves pose complex diagnostic and therapeutic challenges. In this review, we use three theoretical cases as a foundation to explore diagnostic workup, therapeutic interventio...
PURPOSE OF REVIEW: Tumours involving cardiac valves pose complex diagnostic and therapeutic challenges. In this review, we use three theoretical cases as a foundation to explore diagnostic workup, therapeutic interventions, and follow-up for both benign and malignant tumours of the heart valves. RECENT FINDINGS: While the differential for valvular masses is broad, the most common valvular tumours are benign. Multimodal imaging, usually beginning with echocardiography, and tissue sampling where feasible, are the core tenants of diagnostic workup. Highly mobile lesions on a stalk that are isolated to the valve are likely to be papillary fibroelastomas. However, malignancy should be considered in cases of immobile lesions with unclear boundaries. Based on available data, left sided benign tumours involving valves should be excised promptly given the safety and efficacy of operative approaches and the risk of embolization. For suspected malignancy, biopsy should be organized and a centre of excellence should be consulted. Given that recurrence is possible for benign lesions, and is effectively certain for malignant lesions, a lifelong follow-up plan is crucial. SUMMARY: Current treatment paradigms for valvular tumours described herein are based entirely from anecdotal and retrospective data. Future standardization and optimization of treatment protocols depend on the systematic gathering of long-term prospective data.
Don't forget about mechanical valves!!!
Magruder JT, Kim SA, Thourani VH
Curr Opin Cardiol · 2026 Mar · PMID 41491624 · Publisher ↗
PURPOSE OF REVIEW: Mechanical prosthetic heart valves have been implanted for decades, but have seen declining utilization in modern cardiac surgery. We aim to explore recent literature on the risks and benefits of mecha...
PURPOSE OF REVIEW: Mechanical prosthetic heart valves have been implanted for decades, but have seen declining utilization in modern cardiac surgery. We aim to explore recent literature on the risks and benefits of mechanical prostheses. RECENT FINDINGS: The desire of patients to avoid anticoagulation and good performance of bioprosthetic valves appears to have driven a decline in the percentage of mechanical valve use, with mechanical valves now accounting for <20% of aortic and mitral prosthetic implants. However, modern mechanical valves exhibit excellent hemodynamics and durability. Modern bioprosthetic surgical valves are durable, but still experience structural valve deterioration (SVD), especially in younger patients. Transcatheter aortic valve replacement (TAVR) valves are a special case of bioprostheses in which long-term valve durability remains unclear, but presumably will have similar SVD rates to surgical bioprostheses. The true durability of TAVR-in-surgical aortic valve replacement (SAVR) remains unproven and the promise of this for younger patients is without significant data. Moreover, though bleeding risks due to anticoagulation are real and warfarin alternatives elusive, lower INR targets for mechanical valves may be a safe and promising approach. In keeping with the data on the tradeoffs of SVD and anticoagulation, multiple well conducted retrospective studies have confirmed age cutoffs below which patients have a mortality benefit from mechanical valves. SUMMARY: Mechanical valves are associated with improved survival in younger patients with excellent hemodynamics and may be underutilized.
Innovations in robotic aortic valve surgery.
Darehzereshki A, Wei L, Badhwar V
Curr Opin Cardiol · 2026 Mar · PMID 41461016 · Publisher ↗
PURPOSE OF REVIEW: This review explores the contemporary minimally invasive strategies in management of aortic valve disease, highlighting the innovative advancements in robotic approaches, particularly right transaxilla...
PURPOSE OF REVIEW: This review explores the contemporary minimally invasive strategies in management of aortic valve disease, highlighting the innovative advancements in robotic approaches, particularly right transaxillary robotic aortic valve replacement (RAVR). RECENT FINDINGS: Over the past two decades, there has been increasing interest by patients and providers for less invasive alternatives to conventional sternotomy for treatment of aortic valve disease. Such strategies include transcatheter and minimally invasive surgical approaches such as mini-sternotomy, right anterior thoracotomy and robotic-assisted techniques. A major milestone was achieved in January 2020 with the introduction of RAVR, utilizing the established right transaxillary lateral 3 cm mini-thoracotomy platform commonly used for robotic mitral surgery. SUMMARY: RAVR provides a nonsternotomy, rib-sparing surgical option that offers the longitudinal benefits of conventional surgical aortic valve replacement (SAVR). As transcatheter aortic valve replacement (TAVR) expands into nonprohibitive risk populations, RAVR may provide similar minimally invasive advantages yet with the added benefit of comprehensive therapy to include concomitant procedures, particularly in low and intermediate surgical risk patients. Importantly, RAVR has facilitated a transformative advance in cardiac surgery, providing a platform for nearly all cardiac surgery with progressive complexity.
Sex differences in postoperative outcomes for infective endocarditis.
Greek A, Patel SK, Hassan SMA … +3 more , Saleh Y, Goveas C, Yanagawa B
Curr Opin Cardiol · 2026 Mar · PMID 41355294 · Publisher ↗
PURPOSE OF REVIEW: Infective endocarditis (IE) remains a prevalent and high-risk condition despite advances in cardiac care. Increasing attention has been directed toward sex-based differences in physiological presentati...
PURPOSE OF REVIEW: Infective endocarditis (IE) remains a prevalent and high-risk condition despite advances in cardiac care. Increasing attention has been directed toward sex-based differences in physiological presentation, disease progression, and surgical management. This review synthesizes evidence on sex-specific differences in IE, with an emphasis on diagnosis, risk factors, disease manifestations, medical management, surgical intervention, and postoperative outcomes. RECENT FINDINGS: While the incidence of IE is more than twice as high in men, women consistently experience worse outcomes. Women present at an older age, with greater comorbidity burden and greater delays in surgical referral. Postoperatively, women are at higher risk of complications - including embolic events, extended ventilation time, and intensive care unit stays - and have significantly higher short-term mortality. Long-term survival is comparable between sexes, suggesting disparities largely influence short-term outcomes. SUMMARY: Awareness of sex-specific differences in risk factors, clinical presentation, intervention bias, complications, and outcomes of IE is essential for optimizing management and equitable care. Further research into sex-based pathophysiology, comorbidity management, and tailored perioperative strategies is critical to advancing patient-centered treatment and optimizing clinical outcomes.
Editorial: arrhythmia issue in Current Opinion in Cardiology.
Ha ACT, Su W
Curr Opin Cardiol · 2026 Jan · PMID 41343250 · Publisher ↗
Abstract loading — click title to view on PubMed.
Advances in echocardiography for cardiac amyloidosis and restrictive cardiomyopathies.
Kafil TS, Canova TJ, Wang TKM … +1 more , Klein AL
Curr Opin Cardiol · 2026 Jan · PMID 41236415 · Publisher ↗
PURPOSE OF REVIEW: Cardiac amyloidosis is an infiltrative cardiomyopathy with characteristic echocardiographic findings. Echocardiography is the initial imaging test to identify restrictive cardiomyopathies, and timely d...
PURPOSE OF REVIEW: Cardiac amyloidosis is an infiltrative cardiomyopathy with characteristic echocardiographic findings. Echocardiography is the initial imaging test to identify restrictive cardiomyopathies, and timely diagnosis is important for treatment and prognosis. This review outlines key echocardiographic "red flags," structural and functional findings, and emerging diagnostic tools that enhance early recognition and monitoring of cardiac amyloidosis. RECENT FINDINGS: Classic echocardiographic red flags for cardiac amyloidosis include increased ventricular wall thickness, biatrial enlargement, pericardial effusion, and a granular myocardial appearance. Tissue Doppler imaging shows reduced mitral annular velocities, while advanced disease presents with restrictive filling patterns. Global longitudinal strain with apical sparing is a hallmark finding that distinguishes cardiac amyloidosis from other cardiomyopathies. Left atrial strain has been proposed as a prognostic marker for thromboembolism in cardiac amyloidosis. Evidence shows variability in strain measurements across different vendors, which is an important consideration when comparing results between institutions in both research and clinical practice. Echocardiography can be used in conjunction with multimodal imaging techniques in order to monitor disease progression. SUMMARY: Echocardiography is the initial diagnostic test of choice and several findings can suggest cardiac amyloidosis. Advances in echocardiographic techniques have enabled earlier detection of cardiac involvement and now play a central role in both diagnosis and ongoing treatment monitoring.
Assessment of cardiac autonomic function: from bench to bedside.
Chakraborty P, Nair GKK, Po SS
Curr Opin Cardiol · 2026 Jan · PMID 41208141 · Publisher ↗
PURPOSE OF REVIEW: Cardiac autonomic dysfunction plays a crucial role in the pathogenesis of common cardiovascular diseases. The review discusses current and emerging techniques in the evaluation of cardiac autonomic ton...
PURPOSE OF REVIEW: Cardiac autonomic dysfunction plays a crucial role in the pathogenesis of common cardiovascular diseases. The review discusses current and emerging techniques in the evaluation of cardiac autonomic tone. RECENT FINDINGS: Assessment techniques include invasive nerve recordings, neurochemical staining, serum biomarkers, advanced imaging, and autonomic reflex testing. Noninvasive modalities such as heart rate variability and skin sympathetic nerve activity have improved clinical feasibility. Novel radiotracers and serum-based assays are emerging to map neurotransmitter dynamics and receptor activity with greater precision. SUMMARY: No single method captures the full spectrum of autonomic function. A multimodal approach, integrating structural, functional, and molecular tools, offers a more comprehensive evaluation. Future strategies combining imaging, transcriptomics, and biomarkers may enable earlier detection and guide personalized neuromodulation therapies in cardiovascular care.
Percutaneous left atrial appendage closure for stroke prevention in atrial fibrillation: who should receive it in current clinical practice?
d'Entremont MA, Healy JS, Jolly SS
Curr Opin Cardiol · 2026 Jan · PMID 41185460 · Publisher ↗
PURPOSE OF REVIEW: Although oral anticoagulation (OAC) remains the cornerstone therapy for stroke prevention in atrial fibrillation, several limitations, such as noncompliance and bleeding, limit its effectiveness. Percu...
PURPOSE OF REVIEW: Although oral anticoagulation (OAC) remains the cornerstone therapy for stroke prevention in atrial fibrillation, several limitations, such as noncompliance and bleeding, limit its effectiveness. Percutaneous left atrial appendage closure (pLAAC) has emerged as a promising therapy. We will review current and potential indications for pLAAC and knowledge gaps. RECENT FINDINGS: Current guidelines recommend pLAAC for patients who have atrial fibrillation at moderate to high risk of stroke with a high risk of bleeding or who have a contraindication for OAC. pLAAC is being investigated as a potential therapeutic option for the following patient populations: end-stage renal disease, after atrial fibrillation ablation, and in combination with OAC in patients with a high risk of breakthrough stroke or in patients with prior stroke on OAC. The Left Atrial Appendage Occlusion Study IV (LAAOS-IV) ( n = 4000) is a randomized trial that will determine the role of pLAAC and OAC compared to OAC alone in preventing ischemic stroke or systemic embolism. SUMMARY: pLAAC has a growing role in patients with atrial fibrillation with moderate to high stroke risk and contraindication to OAC. Multiple randomized trials are currently underway in different patient populations, which may expand the role of pLAAC.
Mapping and ablation of intramural premature ventricular complexes: state-of-the-art review.
Das SK, Lee G, Anderson RD
Curr Opin Cardiol · 2026 Jan · PMID 41175107 · Publisher ↗
PURPOSE OF REVIEW: Despite significant technological progress over the last decade, the optimal strategy for mapping and ablating intramural premature ventricular complexes (PVCs) remains elusive, with suboptimal success...
PURPOSE OF REVIEW: Despite significant technological progress over the last decade, the optimal strategy for mapping and ablating intramural premature ventricular complexes (PVCs) remains elusive, with suboptimal success rates. RECENT FINDINGS: Recent studies have highlighted the limitations of traditional activation mapping and pointed towards newer indices for accurately localizing the site of origin (SOO) of intramural PVCs. Emerging technologies - including bipolar ablation, intramyocardial needle ablation, and pulsed field ablation - have demonstrated early promise in improving lesion depth and transmurality, potentially overcoming the constraints of conventional radiofrequency ablation. SUMMARY: Intramural PVCs are challenging for the electrophysiologist. While definitive strategies remain to be validated in large-scale, randomized studies, a pragmatic and systematic mapping approach, coupled with judicious use of conventional and emerging technologies, allows the electrophysiologist to circumvent the current limitations and achieve optimal outcomes in this challenging subset of ventricular arrhythmias. This review provides a contemporary overview and outlines a stepwise approach for managing intramural PVCs.
Risk stratification for sudden death in congenital heart disease: bridging evidence, uncertainty, and individual decision-making.
Khairy P, Fuentes Rojas S, Hermann Honfo S
Curr Opin Cardiol · 2026 Jan · PMID 41086267 · Publisher ↗
PURPOSE OF REVIEW: Sudden cardiac death (SCD) remains a feared and difficult-to-predict outcome in patients with congenital heart disease (CHD). This review examines the latest evidence in risk stratification, with a foc...
PURPOSE OF REVIEW: Sudden cardiac death (SCD) remains a feared and difficult-to-predict outcome in patients with congenital heart disease (CHD). This review examines the latest evidence in risk stratification, with a focus on limitations of existing models and the mechanistic and statistical complexities that hinder individualized decision-making. RECENT FINDINGS: New multivariable risk scores for repaired tetralogy of Fallot and systemic right ventricle have improved prognostic resolution. Artificial intelligence-enabled ECG algorithms have shown promise in early identification of high-risk individuals with repaired tetralogy of Fallot. In parallel, three-dimensional cardiac magnetic resonance imaging has been leveraged to delineate arrhythmogenic isthmuses, enhancing substrate-guided interventions. While these tools enhance risk estimation, they require validation specific to the prediction of shockable terminal rhythms, improved interpretability, and integration into individualized decision frameworks. SUMMARY: SCD risk prediction in CHD is evolving toward a multimodal, individualized approach that emphasizes probabilistic reasoning, shared decision-making, and epistemic humility. Although new models and technologies offer incremental gains, they do not eliminate the uncertainty inherent in predicting rare events. The application of population-based tools to individual patients must be interpreted cautiously, recognizing that SCD represents a final common pathway for diverse pathophysiological processes, and that decisions about ICD implantation entail complex trade-offs.
Obesity and hypertension new insights in management.
Catalfamo VJ, Koos A, Tutor AW … +1 more , Lavie CJ
Curr Opin Cardiol · 2026 Jan · PMID 41076726 · Publisher ↗
PURPOSE OF REVIEW: Obesity-associated hypertension is a pressing and ever-growing public health concern. The prevalence of obesity has increased four-fold over the four preceding decades, with concomitantly rising rates...
PURPOSE OF REVIEW: Obesity-associated hypertension is a pressing and ever-growing public health concern. The prevalence of obesity has increased four-fold over the four preceding decades, with concomitantly rising rates of hypertension not far behind. Importantly, the interplay between these conditions exacerbates cardiovascular disease (CVD) risk, and optimal management strategies remain an evolving challenge. This review synthesizes recent advancements in understanding obesity-associated hypertension pathophysiology and explores emerging therapeutic options, highlighting their relevance in shaping future clinical practice. RECENT FINDINGS: Emerging research into understanding obesity-associated hypertension has identified mechanisms, including dysregulated hormonal signaling, increased sympathetic activity, and enhanced inflammation as the key processes underlying obesity-associated hypertension development. With respect to management, new dietary interventions are poised to overtake traditional strategies as the ideal approach to achieving sustained weight loss for obesity-associated hypertension patients. Additionally, while conventional antihypertensive medications highlight the mainstay of standard pharmacotherapy, recent studies highlight the efficacy of diabetic agents and other novel therapies, which have the potential to further shape obesity-associated hypertension management guidelines. SUMMARY: As an emphasis on precision medicine underscores contemporary research into obesity-associated hypertension management, targeted treatment strategies are emerging as promising alternatives for reducing CVD burden and improving patient outcomes. Ultimately, further research is necessary to continue to refine treatment guidelines and explore the full potential of evolving interventions.
Postoperative atrial fibrillation after cardiac surgery: what is new?
Lee JG, Ha ACT
Curr Opin Cardiol · 2026 Jan · PMID 41066142 · Publisher ↗
PURPOSE OF REVIEW: Since postoperative atrial fibrillation (POAF) after cardiac surgery remains a common clinical problem and is associated with adverse clinical outcomes, considerable research efforts are spent to bette...
PURPOSE OF REVIEW: Since postoperative atrial fibrillation (POAF) after cardiac surgery remains a common clinical problem and is associated with adverse clinical outcomes, considerable research efforts are spent to better understand and inform its management. This review highlights recent studies on this topic. RECENT FINDINGS: A PubMed review of published research on POAF after cardiac surgery over the past two years was conducted. Papers were selected on the basis of their potential value to enhance clinical practice. This search yielded studies which have advanced our understanding on the incidence of late-onset POAF after cardiac surgery and its predictive factors. This information may be useful for clinicians on the optimal timing for atrial fibrillation detection after cardiac surgery. Due to a lack of dedicated randomized trial data, the optimal stroke prevention approach remains uncertain in this patient population. SUMMARY: POAF after cardiac surgery is an active area of research. Recent studies have provided additional insights on the risk of late-onset atrial fibrillation (>3 months) after cardiac surgery. This information may help clinicians identify patients who are more likely to experience recurrent atrial fibrillation after cardiac surgery. Ongoing randomized trials will help clarify the optimal stroke prevention strategy in this patient population.
A practical review of stress perfusion cardiac magnetic resonance imaging for the management of coronary artery disease.
Kwong RY, Heydari B, Bernhard B
Curr Opin Cardiol · 2025 Nov · PMID 41025335 · Publisher ↗
PURPOSE OF REVIEW: Stress perfusion cardiac magnetic resonance imaging (CMR) has gained increasing adoption across North America and Europe for the evaluation of symptomatic suspected or established ischemic heart diseas...
PURPOSE OF REVIEW: Stress perfusion cardiac magnetic resonance imaging (CMR) has gained increasing adoption across North America and Europe for the evaluation of symptomatic suspected or established ischemic heart disease (IHD). RECENT FINDINGS: Over the past decade, stress perfusion CMR has demonstrated excellent diagnostic and prognostic performance, particularly in patients at intermediate or high risk of IHD or with established coronary artery disease (CAD). After the landmark ISCHEMIA trial, stress CMR may play an important role in selecting patients for invasive management strategies and determination of revascularization technique. Artificial intelligence has streamlined CMR scanning techniques and in-line automation of quantitative pixelated perfusion maps. Quantitative stress CMR can evaluate absolute myocardial blood flow and perfusion reserve that improves risk stratification and detection of coronary microvascular disease (CMD). CMD detection may assist clinicians with diagnosis of chest pain in patients without obstructive CAD and improve prognostication and detection of pathophysiological mechanisms in a variety of cardiomyopathies. SUMMARY: Quantitative stress perfusion CMR will play an important clinical role in evaluating patients at risk of IHD and cardiomyopathy with iterative cost and time efficiency owing to continued integration of artificial intelligence techniques. More widespread adoption will likely improve cost effective cardiac care and reduce adverse clinical outcomes.
Advanced cardiovascular imaging in immune-mediated inflammatory diseases: redefining ischemic heart disease risk.
Aun JA, Blair CV, Blankstein R … +1 more , Weber BN
Curr Opin Cardiol · 2025 Nov · PMID 41025334 · Publisher ↗
PURPOSE OF REVIEW: Immune-mediated inflammatory diseases (IMIDs) such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), psoriasis (PsO), and systemic sclerosis (SSc) are associated with significantly incr...
PURPOSE OF REVIEW: Immune-mediated inflammatory diseases (IMIDs) such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), psoriasis (PsO), and systemic sclerosis (SSc) are associated with significantly increased risk of ischemic heart disease (IHD), driven by chronic inflammation, and often compounded by undertreated traditional cardiovascular risk factors. Conventional risk scores frequently underestimate this burden. RECENT FINDINGS: Advanced cardiovascular imaging techniques, such as coronary CT angiography (CCTA), cardiac magnetic resonance (CMR), and nuclear imaging techniques, offer enhanced detection of subclinical atherosclerosis, myocardial inflammation, and coronary microvascular dysfunction. SUMMARY: This review highlights the role of imaging tools in improving risk stratification and guiding personalized care, while underscoring the need for ongoing research to validate their clinical utility and ensure equitable implementation.
Teaching minimally invasive coronary artery bypass grafting: a structured framework for well tolerated adoption and training.
Sarfaraz ZK, Abri QA, Ramchandani M
Curr Opin Cardiol · 2025 Nov · PMID 41025333 · Publisher ↗
PURPOSE OF REVIEW: Minimally invasive coronary artery bypass grafting (MICS CABG) offers the benefits of surgical revascularization without sternotomy but remains underutilized due to technical demands and a lack of stru...
PURPOSE OF REVIEW: Minimally invasive coronary artery bypass grafting (MICS CABG) offers the benefits of surgical revascularization without sternotomy but remains underutilized due to technical demands and a lack of structured training. This review outlines a stepwise framework for safe adoption. RECENT FINDINGS: Studies and real-world experience confirm that off-pump CAB (OPCAB) proficiency, systematic technical progression, and mentorship in high-volume centers are essential for safe learning. Recent training innovations and simulator-based techniques improve outcomes and reduce complications during the learning curve. SUMMARY: Wider adoption of MICS CABG hinges on structured training rooted in OPCAB, technical sequencing, and surgical mentorship. Programs emphasizing patient safety, proper case selection, and skill development can expand access to minimally invasive coronary surgery.
Broadening the applicability of coronary surgery from minimally invasive approaches to the modern treatment of ventricular septal rupture.
Ruel M, Verma S
Curr Opin Cardiol · 2025 Nov · PMID 41025332 · Publisher ↗
Abstract loading — click title to view on PubMed.
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