Current Opinion In Cardiology[JOURNAL]
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200 papers
Recent advances in cardiac imaging: emerging use of three-dimensional visualization for analyzing complex cardiovascular anatomy.
Kamiya K, Nagatani Y, Nakata S … +2 more , Seguchi R, Verma S
Curr Opin Cardiol · 2026 Mar · PMID 40996043 · Publisher ↗
PURPOSE OF REVIEW: Technical progress in noninvasive medical imaging continues to enhance diagnosis and intervention, with three-dimensional (3D) imaging emerging as a significant advancement over traditional methods. Wh...
PURPOSE OF REVIEW: Technical progress in noninvasive medical imaging continues to enhance diagnosis and intervention, with three-dimensional (3D) imaging emerging as a significant advancement over traditional methods. While 3D visualization is widely used to evaluate a living heart, precise measurement from such images remains challenging. This review describes a new technique named isosurface geometric measurement on volume-rendered images (IMVR), which facilitates accurate 3D measurement of complex cardiovascular anatomy. RECENT FINDINGS: Direct volume rendering provides clear visualization and tissue identification, but the lack of exact spatial boundaries inherently makes measurement of any anatomical feature difficult. However, by superimposing a surface-rendered polygonal mesh (representing isosurface geometry) onto a variably transparent volume image of the heart, IMVR enables significantly easier and more accurate 3D measurement. This technique demonstrates versatility across various cardiovascular, anatomical, and clinical applications, including preinterventional assessment and planning for structural heart diseases, notably expanding 3D imaging's utility toward precision medicine and personalized treatment. SUMMARY: This review article summarizes recent advances in cardiac imaging, highlighting an efficient IMVR technique, which combines volume-rendered images with superimposed surface-rendered image to facilitate accurate 3D measurements of cardiac anatomical features.
Postmyocardial infarction ventricular septal rupture: optimizing surgical timing and repair.
Goubran D, Issa H, Clarizia N … +2 more , Chan V, Ruel M
Curr Opin Cardiol · 2025 Nov · PMID 40986486 · Publisher ↗
PURPOSE OF REVIEW: This review summarizes the most recent literature regarding the surgical management of postmyocardial infarction (MI) ventricular septal rupture and the optimal timing and performance of the operation....
PURPOSE OF REVIEW: This review summarizes the most recent literature regarding the surgical management of postmyocardial infarction (MI) ventricular septal rupture and the optimal timing and performance of the operation. RECENT FINDINGS: There are conflicting data surrounding the optimal timing of surgical intervention for post-MI ventricular septal rupture. Patients often present in hemodynamic compromise which limits the ability to delay their intervention. A lack of randomized control trials mandates reliance on retrospective cohort studies that have a selection bias in favor of delayed surgery due to unstable patients requiring emergent intervention. Similarly, mechanical circulatory support may be associated with poorer outcomes in part due to selection bias. There is a trend towards better prognosis in patients with lower preoperative lactate and lower vasopressor requirements. SUMMARY: A diagnosis of a post-MI ventricular septal rupture carries a poor prognosis. Without surgical intervention, the likelihood of 1-year survival is very low. Percutaneous treatment options have limited success, and the gold standard remains surgical intervention. Surgical timing is often dictated by patients being hemodynamically unstable and requiring emergent surgery. When a patient can have delayed intervention, there is a trend towards better outcomes. Optimized hemodynamics, metabolic parameters, and initial medical management are associated with improved outcomes. Mechanical circulatory support is of benefit in sicker patients if it can assist with preoperative optimization.
Symptoms, coronary artery disease and percutaneous coronary intervention: connecting the dots.
Chotai S, Chiew K, Al-Lamee R
Curr Opin Cardiol · 2025 Nov · PMID 40920179 · Full text
PURPOSE OF REVIEW: Symptom relief is now recognized as the primary remit of percutaneous coronary intervention (PCI) in patients with stable coronary artery disease. The relationship between the nature of angina symptoms...
PURPOSE OF REVIEW: Symptom relief is now recognized as the primary remit of percutaneous coronary intervention (PCI) in patients with stable coronary artery disease. The relationship between the nature of angina symptoms and the likelihood of successful symptom relief from PCI had not been systematically studied until recently. RECENT FINDINGS: The ORBITA-2 symptom-stratified analysis found that while the severity and nature of symptoms were poorly associated with the severity of coronary disease, the nature of the symptoms powerfully predicted the efficacy of PCI in relieving angina. Specifically, patients with typical or "Rose angina" were most likely to benefit from PCI, while those with atypical symptoms were less likely to see significant improvement beyond placebo. Furthermore, the ORBITA-STAR study demonstrated that patients whose angina symptoms closely matched those induced by balloon occlusion at the site of a coronary stenosis were significantly more likely to experience symptom relief from PCI. SUMMARY: Symptom analysis offers a powerful tool for predicting the efficacy of PCI. Misattributing noncardiac symptoms as angina often results in ineffective intervention, highlighting the critical importance of accurate and thoughtful symptom assessment, particularly in identifying typical angina. The persistent challenge of residual angina despite technically successful PCI reflects not a failure of the intervention itself, but a shortcoming in diagnostic precision to identify those who will benefit. Future research should focus on refining clinical predictors to better guide the selection of patients most likely to benefit from revascularization.
Complete revascularization with percutaneous coronary intervention for acute coronary syndromes presenting with multivessel disease.
Reddy RK, Bernstein H, Howard JP … +1 more , Ahmad Y
Curr Opin Cardiol · 2025 Nov · PMID 40900649 · Full text
PURPOSE OF REVIEW: Complete revascularization (CR) by percutaneous coronary intervention (PCI) in acute coronary syndromes with multivessel coronary artery disease (CAD) was previously contraindicated in the absence of c...
PURPOSE OF REVIEW: Complete revascularization (CR) by percutaneous coronary intervention (PCI) in acute coronary syndromes with multivessel coronary artery disease (CAD) was previously contraindicated in the absence of cardiogenic shock or high-risk ischemia. Over the last decade, CR has been a focus of recent clinical investigation and practice evolution due to high-quality evidence supporting hard cardiovascular outcome benefit, contributing to a reversal in international guidelines. This review provides concise syntheses of contemporary and emerging randomized evidence underpinning current strategies and unresolved questions regarding patient selection, timing of CR and guidance modalities for the identification and treatment of nonculprit lesions. RECENT FINDINGS: The randomized evidence base supporting CR with PCI for acute coronary syndromes (ACS) and multivessel CAD has increased recently with large-scale trials comparing immediate versus staged CR and physiology-guided versus angiography-guided CR, including reports of longer-term comparative outcomes. Enough events have recently accrued to enable demonstration of all-cause mortality benefits with CR. SUMMARY: Contemporary randomized data increasingly support CR with PCI in haemodynamically stable patients. However, ACS type, timing of intervention and method of evaluation still necessitate individualized shared clinical decision-making, and further trials are required to validate the optimal PCI strategies by which to achieve CR in the correct populations.
Patient selection in robotic mitral valve surgery.
Gillinov M, Malas T, Rabbani M … +1 more , Wierup P
Curr Opin Cardiol · 2026 Mar · PMID 40900647 · Full text
PURPOSE OF REVIEW: National databases reveal increased application of the surgical robot to facilitate mitral valve repair. Single-center and multiinstitutional studies confirm that excellent results are achievable with...
PURPOSE OF REVIEW: National databases reveal increased application of the surgical robot to facilitate mitral valve repair. Single-center and multiinstitutional studies confirm that excellent results are achievable with robotic mitral valve repair. However, not all patients with degenerative mitral valve disease are appropriate candidates for robotic mitral valve repair. RECENT FINDINGS: With increased experience, surgeons have successfully applied the surgical robot to perform mitral valve repair in conjunction with concomitant procedures. Concurrently, selection criteria have expanded, enabling more patients to enjoy the benefits of a less invasive approach. A small group of patient-related and anatomic factors are best managed via a standard sternal approach. SUMMARY: Approaching 15% of all mitral valve repairs for degenerative disease, robotic mitral valve repair has reached an inflection point in its growth. Well tolerated application of this technology requires understanding of both its advantages and its limitations.
Invasive treatment strategies in the ESC guidelines developed in collaboration with EACTS for the management of chronic coronary syndrome: implications for contemporary clinical practice.
Milojevic M, Micovic S, Otasevic P
Curr Opin Cardiol · 2025 Nov · PMID 40900620 · Publisher ↗
PURPOSE OF REVIEW: To critically appraise the 2024 ESC Guidelines for chronic coronary syndrome (CCS), developed in collaboration with EACTS, emphasizing invasive-treatment recommendations, their underlying rationale and...
PURPOSE OF REVIEW: To critically appraise the 2024 ESC Guidelines for chronic coronary syndrome (CCS), developed in collaboration with EACTS, emphasizing invasive-treatment recommendations, their underlying rationale and key areas requiring further clarification for clinical implementation. RECENT FINDINGS: The document formally incorporates indications for myocardial revascularization and the criteria for choosing between percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) into the single CCS guideline framework. It calls for Heart-Team decisions whenever CABG and PCI are equally recommended and introduces modality-specific criteria based on anatomical complexity, SYNTAX score, and clinically relevant comorbidities. CABG remains the preferred strategy for anatomically complex disease, including left main and multivessel involvement, especially when PCI cannot achieve equivalent completeness of revascularization or in patients with comorbidities associated with a favorable prognosis (e.g., diabetes mellitus, heart failure). PCI is recommended for less complex lesions in which comparable completeness is feasible for patients whose primary goal is symptom relief or those at high surgical risk. Apart from patient selection, the document provides limited procedural detail, offers limited guidance on secondary prevention measures, and lacks explicit recommendations on the optimal timing of intervention. SUMMARY: The 2024 guideline re-establishes a unified, multidisciplinary European approach to the management of CCS, reaffirming the prognostic value of guideline-directed revascularization and the central role of the Heart Team in selecting the optimal strategy. Supplementary documents are required to fill procedural, secondary prevention and implementation gaps.
The role of high-risk plaque in refining cardiovascular event prediction.
Kinoshita D, Watanabe M, Jang IK
Curr Opin Cardiol · 2025 Nov · PMID 40900612 · Publisher ↗
PURPOSE OF REVIEW: High-risk plaque (HRP) features are commonly observed in patients with acute coronary syndromes (ACS); however, their individual predictive value remains limited. This review explores the importance of...
PURPOSE OF REVIEW: High-risk plaque (HRP) features are commonly observed in patients with acute coronary syndromes (ACS); however, their individual predictive value remains limited. This review explores the importance of integrating anatomical and physiological assessments to enhance risk stratification and optimize therapeutic decision-making. RECENT FINDINGS: Studies have indicated that combining HRP evaluation with hemodynamic assessment significantly improves prognostic accuracy, particularly in guiding revascularization strategies. Although the interaction between HRP and inflammatory biomarkers remains incompletely understood, specific plaque characteristics, such as positive remodeling, have demonstrated consistent associations with lesion-specific inflammation. Furthermore, emerging evidence suggests that hemodynamic stress plays a crucial role in plaque progression and disruption, reinforcing the need for a more comprehensive approach. SUMMARY: A refined strategy that incorporates plaque burden, functional significance, and vascular inflammation is promising for improving cardiovascular risk prediction. By integrating these elements, HRP assessment may improve patient outcomes by optimizing preventive interventions and mitigating the progression of atherosclerotic disease.
Left ventricular function recovery in Takotsubo syndrome, clinical and pathophysiological insights: a state-of-the-art review.
Vazirani R, Núñez-Gil IJ
Curr Opin Cardiol · 2025 Nov · PMID 40900430 · Publisher ↗
PURPOSE OF REVIEW: Early (<10 days) recovery of the left ventricular ejection fraction (LVEF) in Takotsubo syndrome (TTS) has been associated with better short- and long-term clinical outcomes compared to delayed recover...
PURPOSE OF REVIEW: Early (<10 days) recovery of the left ventricular ejection fraction (LVEF) in Takotsubo syndrome (TTS) has been associated with better short- and long-term clinical outcomes compared to delayed recovery (>10 days). This review aims to comprehensively address the literature regarding its clinical implications, the pathological basis underlying a chronic inflammatory heart failure phenotype; as well as the potential pharmacological and nonpharmacological therapies that might aid in LVEF recovery and improve clinical outcomes in TTS. RECENT FINDINGS: We describe the clinical findings of the two large studies addressing this topic, derived from ongoing prospective registries (RETAKO and InterTAK) in which inflammatory biomarkers are the strongest independently associated factor with late left ventricular (LV) recovery (>10 days). This is in line with the previous studies suggesting a chronic inflammatory phenotype with elevated inflammatory biomarkers (e.g. interleukin-6) that persists even 5 months after the index event and long-lasting myocardial energetic impairment >1 year after the TTS episode. SUMMARY: Late LV recovery in TTS is linked to a worse short- and long-term prognosis, identifying these patients for closer monitoring might be clinically relevant for the early detection of complications. Mechanistical research needs to be undertaken to elucidate the cellular and molecular pathways implicated in late LV recovery, this could aid in the selection of pharmacological and nonpharmacological therapies to aid LV recovery.
The clinical utility of assessing coronary vasomotor dysfunction in angina with nonobstructive coronary artery.
Nogami K, Lerman LO, Lerman A
Curr Opin Cardiol · 2025 Nov · PMID 40889163 · Full text
PURPOSE OF REVIEW: This paper reviews the current understanding of coronary vascular dysfunction (CVDys) in patients with angina and no obstructive coronary artery disease (ANOCA), based on recent findings from a compreh...
PURPOSE OF REVIEW: This paper reviews the current understanding of coronary vascular dysfunction (CVDys) in patients with angina and no obstructive coronary artery disease (ANOCA), based on recent findings from a comprehensive, large-scale study. It also discusses potential future directions for research and clinical practice. RECENT FINDINGS: CVDys involves enhanced vasoconstriction or impaired vasodilation caused by endothelium-dependent and/or -independent dysfunction in the epicardial or microvascular coronary arteries. It is classified into four subtypes based on anatomical location and underlying mechanisms, and can be assessed using coronary reactivity testing (CRT). Previous studies have evaluated their prognostic implications separately or in limited populations.A recent study assessed all subtypes within a single ANOCA cohort and confirmed that endothelium-dependent epicardial dysfunction and both types of microvascular dysfunction are associated with worse prognosis. Moreover, it demonstrated that microvascular function - both endothelium-dependent and -independent - serves as an independent prognostic factor for major adverse cardiovascular events. These findings emphasize the value of CRT-based comprehensive evaluation for risk stratification. SUMMARY: While evidence regarding the prognostic impact of CVDys has become increasingly robust, effective treatment strategies remain undefined. Future efforts should focus on developing CRT-guided interventions targeting coronary dysfunction, with the goal of improving clinical outcomes.
Completed and ongoing trials in minimally invasive cardiac surgery coronary surgery.
Boskovski MT, Tseng EE
Curr Opin Cardiol · 2025 Nov · PMID 40889158 · Publisher ↗
PURPOSE OF REVIEW: Minimally invasive cardiac surgery (MICS) coronary artery bypass grafting (CABG), first established two decades ago, offers multivessel revascularization via a small left anterior thoracotomy and witho...
PURPOSE OF REVIEW: Minimally invasive cardiac surgery (MICS) coronary artery bypass grafting (CABG), first established two decades ago, offers multivessel revascularization via a small left anterior thoracotomy and without the need for cardiopulmonary bypass, potentially leading to lower complication rates and faster recovery. However, adoption of MICS CABG has been slow, in part due to lack of randomized trial data. Here, we review important retrospective studies, as well as ongoing and completed MICS CABG trials. RECENT FINDINGS: The majority of studies remain single-center observational studies demonstrating that MICS CABG yields comparable perioperative morbidity and mortality to conventional CABG, with excellent angiographic graft patency, comparable long-term outcomes and faster recovery times. There are two ongoing randomized controlled trials, the MIST and MICS-CABG PRPP trials, both comparing quality of life and recovery in the early postoperative period between patients undergoing MICS CABG versus sternotomy CABG. SUMMARY: The MIST and MICS-CABG PRPP trials will for the first time provide prospective, randomized data on the benefits of MICS CABG. However, both trials involve highly experienced MICS CABG surgeons. As such, the findings will likely not be generalizable to the general cardiac surgery community and MICS CABG will remain a boutique operation offered in highly specialized centers.
The role of artificial intelligence in early detection and intervention of coronary artery disease.
Butt FR, Chu MWA, Nedadur R
Curr Opin Cardiol · 2025 Sep · PMID 40772528 · Publisher ↗
PURPOSE OF REVIEW: The diagnosis and management of coronary artery disease (CAD) involves complex delivery of care. Artificial intelligence (AI) proves to be a timely solution to challenges with diagnostics and timely an...
PURPOSE OF REVIEW: The diagnosis and management of coronary artery disease (CAD) involves complex delivery of care. Artificial intelligence (AI) proves to be a timely solution to challenges with diagnostics and timely and appropriate, quality of care. RECENT FINDINGS: Artificial intelligence has the capacity to improve care for patients with CAD at every step of the way including diagnosis, medical management, in the cath lab and operating room, and even at home. Integration of multiple data sources increases the utility of the individual data sources and can also improve the overall prediction accuracy compared to single dataset predictions. Applications in the cath lab and operating room involve augmented reality and rely on hardware improvements to deliver advanced analytics. User interphases have seen significant growth to operationalize the analytics and placing information in front of physicians and patients to improve accessibility. SUMMARY: AI can revolutionize the way in which we deliver care to patients with CAD by improving access, enhancing diagnosis and treatment, and empowering patients to remain engaged in their health. Initiatives should be directed with a clinical goal in mind while respecting data privacy and protection procedures and accounting for the ethical responsibilities we have toward our patients and society.
Ischemic events after coronary artery bypass grafting: when to treat interventionally, medically or surgically?
Bernstein HM, Reddy RK, Boskovski M … +1 more , Ahmad Y
Curr Opin Cardiol · 2025 Nov · PMID 40768291 · Publisher ↗
PURPOSE OF REVIEW: All revascularization modalities in patients with prior coronary artery bypass grafting (CABG) have been shown to have higher rates of procedural complications and worse outcomes compared to patients w...
PURPOSE OF REVIEW: All revascularization modalities in patients with prior coronary artery bypass grafting (CABG) have been shown to have higher rates of procedural complications and worse outcomes compared to patients without prior CABG. However, patients' clinical presentations often necessitate revascularization. This review outlines the different treatment options for patients with prior CABG presenting with ischemia depending on clinical presentation, focusing on the advantages and challenges of different techniques and emerging evidence. RECENT FINDINGS: While still high risk, recent studies have shown improvement in outcomes in both surgical and interventional revascularization options in post-CABG patients. Redo CABG, still recommended in patients with left anterior descending disease and an available internal mammary conduit, has had improved outcomes over the past two decades. Percutaneous coronary intervention (PCI) is preferred in most cases, with native-vessel PCI generally preferred over vein-graft PCI when feasible. Bypassed arteries often have high rates of chronic total occlusions, and the vein grafts themselves can be useful in retrograde approaches. SUMMARY: Revascularization in patients with prior CABG remains high risk and should be reserved for high-risk ischemia or symptoms refractory to medical management. The choice of intervention is often dictated by the clinical presentation and coronary anatomy, with specific techniques available to improve both native-vessel and saphenous vein graft PCI success rates.
Desmoplakin cardiomyopathy: recent updates in natural history and management.
Hoffman-Andrews L, Anderson OG, Owens AT
Curr Opin Cardiol · 2025 Sep · PMID 40600431 · Publisher ↗
PURPOSE OF REVIEW: Cardiomyopathy caused by pathogenic variants in the desmoplakin gene has recently emerged as an entity distinct from other genetic cardiomyopathies. This review summarizes recent literature, including...
PURPOSE OF REVIEW: Cardiomyopathy caused by pathogenic variants in the desmoplakin gene has recently emerged as an entity distinct from other genetic cardiomyopathies. This review summarizes recent literature, including the first large cohort studies of this disease, that have begun to characterize its natural history and specific management challenges. RECENT FINDINGS: Desmoplakin cardiomyopathy may be characterized by episodic "hot phases", cutaneous findings, and a high risk of sudden cardiac death. Gene-specific risk factors for sudden cardiac death have begun to be elucidated. SUMMARY: Genetic testing in arrhythmogenic cardiomyopathy and recurrent myocarditis can identify patients with desmoplakin variants who may have a unique phenotype that requires gene-specific management. More research is needed in this population to further guide treatment, counseling, and risk stratification.
Pulmonary hypertension: diagnostic aspects-what is the role of imaging?
Ali HJ, Guha A
Curr Opin Cardiol · 2025 Sep · PMID 40600429 · Publisher ↗
PURPOSE OF REVIEW: The role of imaging in diagnosis of pulmonary hypertension is multifaceted, spanning from estimation of pulmonary arterial pressures, understanding pulmonary artery-right ventricular interaction, and i...
PURPOSE OF REVIEW: The role of imaging in diagnosis of pulmonary hypertension is multifaceted, spanning from estimation of pulmonary arterial pressures, understanding pulmonary artery-right ventricular interaction, and identification of the cause. The purpose of this review is to provide a comprehensive overview of multimodality imaging in evaluation of pulmonary hypertension as well as the novel applications of imaging techniques that have improved our detection and understanding of pulmonary hypertension. RECENT FINDINGS: There are diverse imaging modalities available for comprehensive assessment of pulmonary hypertension that are expanding with new tracers (e.g., hyperpolarized xenon gas, 129 Xe) and imaging techniques (C-arm cone-bean computed tomography). Artificial intelligence applications may improve efficiency and accuracy of screening for pulmonary hypertension as well as further characterize pulmonary vasculopathies using computed tomography of the chest. In the face of increasing imaging options, a "value-based imaging" approach should be adopted to reduce unnecessary burden on the patient and the healthcare system without compromising the accuracy and completeness of diagnostic assessment. SUMMARY: Future studies are needed to optimize use of multimodality imaging and artificial intelligence in comprehensive evaluation of patients with pulmonary hypertension.
Adding the patient perspective: the necessity of patient reported outcomes in cardiac surgery clinical trials.
Gregg AC, Masterson Creber R, Spertus JA … +2 more , Stone GW, Gaudino MF
Curr Opin Cardiol · 2025 Sep · PMID 40591401 · Full text
PURPOSE OF REVIEW: This review highlights the growing importance of patient reported outcomes (PROs) in cardiac surgery trials. Cardiac surgery trials have traditionally focused on cardiovascular events such as survival,...
PURPOSE OF REVIEW: This review highlights the growing importance of patient reported outcomes (PROs) in cardiac surgery trials. Cardiac surgery trials have traditionally focused on cardiovascular events such as survival, stroke or myocardial infarction. However, as surgical outcomes have continued to improve, incorporating the patient's perspective through PROs has become increasingly critical. Incorporating PROs as key study outcomes provides essential patient data, while also overcoming the methodological limitations of classic composite endpoints. RECENT FINDINGS: Continued advancements in cardiac surgery have significantly reduced classic endpoint differentials, making it challenging to evaluate interventions with their use alone. PROs offer more granular details on the effects of surgical interventions compared to classic clinical events and are widely used in other medical fields. More recently, cardiac surgery trials have begun successfully implementing PROs, though there is need for greater utilization across the discipline. SUMMARY: The integration of PROs into cardiac surgery trials allows for better understanding of the impact of surgical interventions on patients' daily lives. While barriers exist, efforts to develop and standardize PRO measures promise to enhance the relevance of cardiac surgery clinical trials and ultimately improve patient care.
The role of imaging in risk assessment for pulmonary arterial hypertension.
Verma D, Estrada RA, Sahay S
Curr Opin Cardiol · 2025 Sep · PMID 40557914 · Full text
PURPOSE OF REVIEW: There are several multifactorial risk assessment tools used to predict mortality in patients with pulmonary arterial hypertension (PAH). These tools are also used to guide clinical decision-making incl...
PURPOSE OF REVIEW: There are several multifactorial risk assessment tools used to predict mortality in patients with pulmonary arterial hypertension (PAH). These tools are also used to guide clinical decision-making including changes in therapy and referrals for transplantation. While the prominent driver of morbidity and mortality in PAH is right ventricular failure, most available risk assessment tools do not include parameters specific to right ventricular structure or function. Several cardiac imaging parameters are known to be associated with survival and may enhance the predictive ability of existing risk scores. RECENT FINDINGS: This review compiles the existing literature surrounding the improved predictive power of existing risk assessment tools when combined with echocardiographic and cardiac magnetic resonance imaging findings. The review also discusses scenarios in which imaging findings may influence clinical decision making outside of risk scores. SUMMARY: Decision making in PAH is complex and multifaceted. Cardiac imaging is an important component in the management of PAH and should be considered carefully and in conjunction with existing risk assessment tools.
From C-reactive protein to climate change: risk predictors for cardiovascular diseases beyond low-density lipoprotein cholesterol.
Mukherjee D, Mikhailidis DP
Curr Opin Cardiol · 2025 Jul · PMID 40470842 · Publisher ↗
Abstract loading — click title to view on PubMed.
When is imaging needed to assess the response to treatment in cardiac amyloidosis.
Sengupta SP, Kini P
Curr Opin Cardiol · 2025 Sep · PMID 40401634 · Publisher ↗
PURPOSE OF REVIEW: Cardiac amyloidosis is characterized by systolic and diastolic abnormalities due to deposition of amyloid fibril within the myocardial extracellular space. Technological advances in multimodality cardi...
PURPOSE OF REVIEW: Cardiac amyloidosis is characterized by systolic and diastolic abnormalities due to deposition of amyloid fibril within the myocardial extracellular space. Technological advances in multimodality cardiac imaging now helps in accurate diagnosis and prognosis of this disease. With technological advances in imaging, it is now easier to follow up these patients whether they are getting response to therapy. RECENT FINDINGS: Left ventricular global longitudinal strain assessment is an important noninvasive tool to track response to treatment in cardiac amyloidosis patient. SUMMARY: Present era has shown the importance of using multimodality imaging to understand the pathophysiology of this disease which has been supplemented by both imaging and blood biomarkers. These help in prognosticating the disease burden and to assess treatment response. Future research is now focused on the use of artificial intelligence and precision medicine to detect of changes earlier in the course of treatment.
Anabolic-androgenic steroids among recreational athletes and cardiovascular risk.
Meagher S, Irwig MS, Rao P
Curr Opin Cardiol · 2025 Jul · PMID 40401476 · Full text
PURPOSE OF REVIEW: The use of androgenic anabolic steroids (AAS) is rising, particularly among recreational athletes. This review addresses growing concerns about the underrecognized cardiovascular and multiorgan consequ...
PURPOSE OF REVIEW: The use of androgenic anabolic steroids (AAS) is rising, particularly among recreational athletes. This review addresses growing concerns about the underrecognized cardiovascular and multiorgan consequences of chronic AAS exposure with a focus on noncompetitive populations. RECENT FINDINGS: It is well documented that AAS use enhances muscle mass and strength, but at the cost of multisystem toxicity including endocrine disruption, hepatotoxicity, and mood disorders. Emerging evidence highlights the profound cardiovascular impact of AAS use, including elevated blood pressure, adverse lipid profiles, accelerated atherosclerosis, subclinical cardiomyopathy, and increased risk of myocardial infarction and sudden cardiac death. Structural and functional cardiac abnormalities such as left ventricular hypertrophy, ventricular dysfunction, and arterial stiffness have been reported, with some changes persisting after cessation. SUMMARY: AAS use carries multisystem risks with evidence for adverse cardiovascular remodeling and atherogenesis. Clinicians caring for athletes using AAS should recognize patterns of AAS use and provide risk stratification, monitoring, and tapering strategies. Future research should prioritize long-term outcomes, sex-specific effects, and multidisciplinary approaches to care.
Revascularization in chronic coronary syndrome: shifts in clinical practice guidelines.
Servito M, Yan W, Namkoong J … +2 more , Vervoort D, Fremes SE
Curr Opin Cardiol · 2025 Sep · PMID 40401463 · Publisher ↗
PURPOSE OF REVIEW: The optimal revascularization strategy for chronic coronary syndrome (CCS) is rapidly evolving due to emerging evidence and technological advancements. This review will discuss the guidelines for the m...
PURPOSE OF REVIEW: The optimal revascularization strategy for chronic coronary syndrome (CCS) is rapidly evolving due to emerging evidence and technological advancements. This review will discuss the guidelines for the management of CCS, examining how they align with and respond to recent high-quality studies. We will also discuss the evolution of the guidelines and highlight key differences. RECENT FINDINGS: While broad consensus exists between the most recent European and American guidelines, notable differences exist in the management of multivessel disease with preserved ejection fraction and left main disease. The role of the Heart Teams has become increasingly vital particularly when the guidelines do not fit the clinical scenarios, and the evidence is controversial. SUMMARY: Determining the optimal management strategy for patients with CCS requires careful consideration of anatomic complexity, comorbidities, and individual patient preferences. While advances in percutaneous coronary intervention (PCI) and medical therapy have been widely discussed, it is equally important to contextualize these with emerging innovations in surgical revascularization. Techniques such as multiple arterial grafting and minimally invasive surgical approaches represent significant progress in coronary artery bypass surgery. Randomized trials that compare state-of-the-art percutaneous and surgical revascularization techniques are thus needed.
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