Current Opinion In Cardiology[JOURNAL]
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200 papers
Neurodevelopmental outcomes in congenital heart disease: modifiable and nonmodifiable substrates.
Wolfe K, Peyvandi S
Curr Opin Cardiol · 2025 Jul · PMID 40401446 · Full text
PURPOSE OF REVIEW: Neurodevelopmental impairments are the most common comorbidity among children, adolescents, and adults with congenital heart disease (CHD). Despite significant advances in operative and perioperative c...
PURPOSE OF REVIEW: Neurodevelopmental impairments are the most common comorbidity among children, adolescents, and adults with congenital heart disease (CHD). Despite significant advances in operative and perioperative care resulting in increased survival, neurodevelopmental impairments remain prevalent in this population. Neurodevelopmental impairments, though subtle, can have a major impact on quality of life, attainment of independence and societal contribution. In this review, we summarize current knowledge on neurodevelopmental outcomes in the CHD population, including neuroimaging findings, known risk factors and opportunities to optimize outcomes. RECENT FINDINGS: Several risk factors have been identified contributing to neurodevelopmental impairments across the lifespan. These include risk factors originating in the prenatal period and new risk factors that are acquired in adulthood. The risk factors encompass several categories, including genetic abnormalities, aberrant cardiovascular physiology, environmental factors, social determinants of health and mental health. Many risk factors can be considered modifiable, though large multicenter studies identifying the most salient risk factors for neurodevelopmental impairment are lacking. SUMMARY: In this review, we identify potentially modifiable risk factors for neurodevelopmental impairment in the CHD population that can be studies in future neuroprotective clinical trials.
Pulmonary hypertension in 2025: next steps?
Parikh K
Curr Opin Cardiol · 2025 Jul · PMID 40401433 · Publisher ↗
PURPOSE OF REVIEW: To review recent updates in pediatric pulmonary hypertension with a special focus on recent recommendations from the World Symposium of Pulmonary Hypertension (WSPH). RECENT FINDINGS: The third pediatr...
PURPOSE OF REVIEW: To review recent updates in pediatric pulmonary hypertension with a special focus on recent recommendations from the World Symposium of Pulmonary Hypertension (WSPH). RECENT FINDINGS: The third pediatric specific WSPH report highlights updated recommendations for pediatric pulmonary hypertension classification, risk stratification, and management approaches, with special focus on an emerging cohort of pulmonary hypertension relating to bronchopulmonary dysplasia, in the premature population. SUMMARY: Based on real-world data and expert opinion, the newest iteration of the WSPH report encourages recommendations that optimize detection and management of pediatric pulmonary hypertension, with the ultimate goal of enhancing quality of life and long-term prognosis.
Ultrasound-Based assessment of systemic congestion in pulmonary hypertension.
Lee PL, Acero LMR, Nanna M
Curr Opin Cardiol · 2025 Sep · PMID 40401432 · Publisher ↗
PURPOSE OF REVIEW: Systemic congestion is a common manifestation in pulmonary hypertension (PH) associated with morbidity and mortality. Its extent can be difficult to define and is usually determined by subjective medic...
PURPOSE OF REVIEW: Systemic congestion is a common manifestation in pulmonary hypertension (PH) associated with morbidity and mortality. Its extent can be difficult to define and is usually determined by subjective medical history and physical examinations, leading to delay in decision-making. We conducted a literature review to collect evidence on imaging tools aimed at detecting and defining severity of venous congestion in PH. RECENT FINDINGS: We discussed pathophysiology and outlined a structured approach in the management of venous congestion. Point-of-care ultrasound becomes more accessible and aids in gauging the severity of systemic congestion. Venous excess ultrasound (VExUS) grading system analyzes the inferior vena cava, hepatic vein, portal vein, and intrarenal vein and provides a comprehensive assessment of systemic congestion. Nonetheless, almost all available studies were performed in unselected populations, and data on PH is scarce. Herein, we discuss the imaging methods proposed in systemic congestion as they apply to PH. SUMMARY: VExUS offers fast, convenient assessment of volume status. Despite the promising data on VExUS, it should be emphasized that ultrasound should be placed in the context of a comprehensive evaluation and should not replace basic examination. Further research is needed to establish its role in PH and verify its clinical utility in guiding fluid management.
Hypertension after solid-organ transplantation: special considerations for management.
Feliberti J, Alam A, Maulion C
Curr Opin Cardiol · 2025 Jul · PMID 40401425 · Publisher ↗
PURPOSE OF REVIEW: Hypertension is one of the most common comorbidities affecting patients after solid organ transplantation. Here we review the mechanisms leading to hypertension, along with common practices in terms of...
PURPOSE OF REVIEW: Hypertension is one of the most common comorbidities affecting patients after solid organ transplantation. Here we review the mechanisms leading to hypertension, along with common practices in terms of medical management. Glucagon-like peptide-1 receptor (GLP-1R) agonists, baroreflex therapy, and renal denervation are common interventions utilized prior to heart transplant. Special considerations for their management throughout the perioperative and postoperative period are covered here. RECENT FINDINGS: Most common medical management includes utilization of calcium channel blockers, followed by angiotensin-converting enzyme inhibitors and angiotensin receptor blockers. GLP-1R agonists have shown significant benefit in recent cardiovascular outcome trials. Preoperative management centers around risks associated with slowed gastric emptying, while reinitiation after heart transplant must take into consideration initiation and tolerance of immunosuppressive therapies. Baroreflex activation therapy has been approved for therapy of heart failure, with many patients proceeding to heart transplant. The device is frequently deactivated after transplantation, with little published experience regarding reinitiation of therapy after heart transplant. There is renewed interest in renal denervation as a treatment for refractory hypertension. The incidence of hypertension after heart transplant in those patients that have undergone previous renal denervation remains unknown, however there is limited experience with its use after renal transplant. SUMMARY: Further studies are required to elucidate optimal medical management of hypertension following heart transplantation. GLP-1R agonists, baroreflex activation therapy, and renal denervation are emerging therapies prior to transplant that require further investigation.
Management of difficult coronary anatomy during transcatheter aortic valve implantation: what are the key issues?
Onishi T, Tang GHL
Curr Opin Cardiol · 2025 Sep · PMID 40305236 · Publisher ↗
PURPOSE OF REVIEW: Predicting and preventing coronary obstruction in transcatheter aortic valve replacement (TAVR) is crucial due to its high mortality risk. RECENT FINDINGS: In native TAVR, predicting coronary obstructi...
PURPOSE OF REVIEW: Predicting and preventing coronary obstruction in transcatheter aortic valve replacement (TAVR) is crucial due to its high mortality risk. RECENT FINDINGS: In native TAVR, predicting coronary obstruction requires assessing aortic cusp height, coronary artery height, valve-to-coronary distance, and leaflet calcium volume. The VIVID classification has been proposed for evaluating the risk of coronary obstruction in TAVR for failed bioprosthetic surgical valves. After TAVR with the Sapien 3 valve, the feasibility of redo TAVR and coronary access decreases with a shallower implantation of the initial Sapien 3. In redo TAVR of Sapien 3 within an Evolut valve, positioning the Sapien 3 outflow at node 4 improves redo TAVR feasibility and coronary accessibility compared to positioning at nodes 5 or 6. For valve sizing in redo TAVR with Sapien 3, in-vivo CT sizing results in smaller valve sizes than bench sizing, reducing coronary risk and improving redo TAVR feasibility. Leaflet modification and coronary stenting techniques and a dedicated leaflet-splitting device have been proposed to maintain coronary perfusion in high-risk cases. SUMMARY: Coronary preservation in high-risk TAVR remains a significant challenge, requiring further research into preprocedural planning and leaflet modification strategies.
The burden of innovation in the pediatric heart center.
Torzone A, Birely A
Curr Opin Cardiol · 2025 Jul · PMID 40305185 · Publisher ↗
PURPOSE OF REVIEW: The purpose of this review is to elucidate the growing complexity involved in providing pediatric cardiac care in the contemporary era of innovation. Aiming to highlight the phenomenon of chronic criti...
PURPOSE OF REVIEW: The purpose of this review is to elucidate the growing complexity involved in providing pediatric cardiac care in the contemporary era of innovation. Aiming to highlight the phenomenon of chronic critical illness in a pediatric heart center, this review outlines the burdens placed on those caring for these uniquely challenging patients and poses considerations for alleviating those burdens. RECENT FINDINGS: As care advancements drive improved survival for children with heart disease, heart centers face a growing population of chronically critically ill patients with high resource utilization and uncertain trajectories. Preterm infants, single ventricles, and complex heart failure patients require significant interventions and expertise. Their lengthy courses challenge care delivery systems and resources, in addition to placing significant emotional and cognitive burdens on the multidisciplinary teams. SUMMARY: The growing population of chronically critically ill cardiac patients are some of the most challenging both at the system level and on the team members. While undertaking innovative therapies, we must recognize that survival as an outcome cannot be separated from associated costs of achieving that outcome; the resultant burdens of innovation cannot be ignored. Heart centers must take a proactive stance in optimizing care for children with prolonged illness while also addressing the needs of those who care for them.
Hypertension in atherosclerotic cardiovascular disease: insights into epidemiology, management strategies, and outcomes.
Gupta P, Bast JA, Razavi AC … +6 more , Canonico ME, Shahzad A, Naeem M, Bonaca MP, Sperling LS, Quintana RA
Curr Opin Cardiol · 2025 Jul · PMID 40305167 · Publisher ↗
PURPOSE OF REVIEW: To provide a comprehensive review of hypertension among patients with atherosclerotic vascular disease. Although there is significant alignment in treatment goals and strategies, blood pressure targets...
PURPOSE OF REVIEW: To provide a comprehensive review of hypertension among patients with atherosclerotic vascular disease. Although there is significant alignment in treatment goals and strategies, blood pressure targets and therapies differ among atherosclerosis in varying vascular territories. Hypertension is a prominent risk factor for the development and amplification of atherosclerosis, as well as the cause of significant downstream morbidity and mortality. RECENT FINDINGS: Hypertension is the greatest contributor to population attributable cardiovascular risk. Hypertension accelerates the development of atherosclerotic cardiovascular disease (ASCVD), and treatment of hypertension is a central tenet to managing ASCVD. Patients with ASCVD often merit a multidisciplinary approach, require multiple specialists and medications, and may suffer from additional consequences of therapy due to multimorbidity. Significant arterial stenoses may lead to unintended consequences of antihypertensive therapy. Further, there have been recent advances in the interventional management of hypertension, including techniques like renal denervation. SUMMARY: In recent years, there have been significant changes in management guidelines of hypertension and peripheral arterial disease, new evidence in coronary artery disease, and simultaneously there's been an evolution in interventional management of hypertension, such as renal denervation. We provide an update on hypertension treatment in atherosclerotic disease among different vascular beds.
Impact of glucagon-like peptide-1 receptor agonists on hypertension management: a narrative review.
De Oliveira-Gomes D, Pingili A, Inglis S … +3 more , Mandras SA, Loro-Ferrer JF, daSilva-deAbreu A
Curr Opin Cardiol · 2025 Jul · PMID 40305149 · Publisher ↗
PURPOSE OF REVIEW: The increasing prevalence of hypertension, alongside the growing use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) for conditions beyond type 2 diabetes, underscores the need for understandi...
PURPOSE OF REVIEW: The increasing prevalence of hypertension, alongside the growing use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) for conditions beyond type 2 diabetes, underscores the need for understanding if there is a role for these medications in blood pressure management. This review addresses the timely opportunity to assess how GLP-1 RAs could influence blood pressure control, potentially broadening therapeutic strategies for cardiovascular risk management. RECENT FINDINGS: Emerging literature indicates that GLP-1 RAs influence blood pressure through various mechanisms, such as sympathetic nervous modulation, vasodilation, and diuretic effects. Clinical trials demonstrate modest yet statistically significant reductions in systolic blood pressure (SBP), with less consistent effects on diastolic blood pressure (DBP). The advent of dual GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) receptor agonists presents enhanced possibilities for managing hypertension. SUMMARY: The implications of these findings suggest that GLP-1 RAs have potential as adjunctive therapies for hypertension, especially in patients already receiving these agents for other cardiometabolic conditions. The blood pressure-lowering effects, often independent of weight loss or glucose control, warrant further investigation to determine their precise role within hypertension treatment algorithms and encourage integration into clinical practice.
Pulmonary vein stenosis: future optimism.
Suntharos P, Satawiriya M, Prieto LR
Curr Opin Cardiol · 2025 Jul · PMID 40305143 · Publisher ↗
PURPOSE OF REVIEW: Pulmonary vein stenosis (PVS) is a rare disease with high morbidity and mortality. Prevention of restenosis remains challenging. This review will highlight recent advances in therapy that are beginning...
PURPOSE OF REVIEW: Pulmonary vein stenosis (PVS) is a rare disease with high morbidity and mortality. Prevention of restenosis remains challenging. This review will highlight recent advances in therapy that are beginning to show a survival benefit. RECENT FINDINGS: Intervention for multivessel pediatric PVS may be surgical or transcatheter, both with high restenosis rates. At a threshold upstream diameter of 7 mm, the risk of restenosis decreases. Close vigilance and frequent reinterventions, typically transcatheter, are now accepted practice to maintain vein patency and achieve upstream growth. Suppressive agents targeting the exuberant myofibroblastic proliferation characteristic of PVS, specifically sirolimus, delivered locally on the surface of balloons and stents, and as adjunct systemic therapy, have been shown to increase survival and decrease reinterventions. Newer surgical techniques focused on shortening and straightening the vein to optimize flow dynamics, coupled with hybrid intraoperative stent placement in selected cases, also show a survival benefit.Adult-onset PVS, most commonly a complication of pulmonary vein isolation, now occurs rarely, and generally responds to transcatheter intervention. Further advances in ablation techniques aim to eliminate this complication. SUMMARY: An aggressive approach of frequent reinterventions is a necessary strategy rather than treatment failure. More granular understanding of the mechanisms underlying PVS leading to novel muti-pronged anatomic and suppressive therapy are yielding improved survival.Multispecialty PVS teams at the institutional level and multiinstitutional collaboration, now possible via the PVS registry, are crucial to optimal care and future progress.
Anesthetic management in patients with long QT and Brugada syndromes.
Cohen JA, Dayan J
Curr Opin Cardiol · 2025 Jul · PMID 40305108 · Publisher ↗
PURPOSE OF REVIEW: Both long QT and Brugada syndrome are inherited arrhythmic conditions that can predispose patients to life-threatening ventricular arrhythmias. Managing the anesthesia for patients with either long QT...
PURPOSE OF REVIEW: Both long QT and Brugada syndrome are inherited arrhythmic conditions that can predispose patients to life-threatening ventricular arrhythmias. Managing the anesthesia for patients with either long QT or Brugada syndrome necessitates an understanding of potential drug-drug interactions with the underlying channelopathy. This review illustrates contemporary insight into managing such patients for the anesthesiologist. RECENT FINDINGS: Long QT, due to disorder of potassium or sodium ion channels, is associated with prolonged repolarization of the action potential phase. Medications that prolong the action potential should be avoided. In patients with long QT syndrome, each drug administered should be carefully reviewed to be certain it does not prolong the QT interval. Brugada syndrome is a result of a pathogenic sodium channel that results in potential ventricular arrhythmias. Medications that exacerbate the electrocardiographic changes of Brugada should be avoided. SUMMARY: Anesthesiologists need to be aware of proper management in children with known or suspected long QT or Brugada pathologies as well as the potential poly-pharmaceutical impact that exists on cardiac ion channels.
Managing acute supraventricular tachycardia and the role of intravenous sotalol.
Cohen MI, Przybylski R
Curr Opin Cardiol · 2025 Jul · PMID 40305094 · Publisher ↗
PURPOSE OF REVIEW: The initial approach to stable supraventricular tachycardia (SVT) in children is either adenosine or vagal maneuvers. While automatic tachycardias do not respond to such an approach, even reentrant arr...
PURPOSE OF REVIEW: The initial approach to stable supraventricular tachycardia (SVT) in children is either adenosine or vagal maneuvers. While automatic tachycardias do not respond to such an approach, even reentrant arrythmias will fail to terminate with adenosine or vagal maneuvers. Little consensus exists on the ideal second line antiarrhythmic medication for stable SVT. This article reviews the current approach to stable SVT and early pediatric studies using intravenous (i.v.) sotalol. RECENT FINDINGS: The development of i.v. sotalol has spawned enthusiasm for a novel antiarrhythmic for refractory reentrant SVT and other automatic atrial tachycardias. Retrospective pediatric multicenter studies have shown an excellent conversion (50-90%) of refractory SVT with a single dose of i.v. sotalol; generally, over 30 min. Cautioned should be exercised using i.v. sotalol in patients with ventricular dysfunction and dose adjustments need to be made based on creatinine clearance. In addition, i.v. sotalol has shown promising early results in slowing the ventricular rate in postoperative junctional ectopic tachycardia faster than i.v. amiodarone. SUMMARY: Intravenous sotalol has shown promising results in refractory pediatric SVT. Protocol driven dosing with the help of hospital pharmacists should be established before i.v. sotalol is prescribed. Future prospective studies especially in postoperative patients, neonates and patients with congenital heart disease are needed.
Hypertension management in patients with advanced chronic kidney disease with and without dialysis.
Gonzalez Suarez ML, Arriola-Montenegro J, Rolón L
Curr Opin Cardiol · 2025 Jul · PMID 40183393 · Publisher ↗
PURPOSE OF REVIEW: Hypertension is a common comorbidity in patients with advanced chronic kidney disease (CKD) and end-stage kidney disease (ESKD) on dialysis, contributing significantly to cardiovascular disease and inc...
PURPOSE OF REVIEW: Hypertension is a common comorbidity in patients with advanced chronic kidney disease (CKD) and end-stage kidney disease (ESKD) on dialysis, contributing significantly to cardiovascular disease and increased mortality. Managing hypertension in this population is complex due to the frequent occurrence of resistant hypertension. This review highlights the recent updates in hypertension management for these patients, especially considering new guidelines and therapeutic options. RECENT FINDINGS: Recent literature emphasizes updated KDIGO guidelines, which have lowered blood pressure targets to decrease cardiovascular risks in patients with advanced CKD and ESKD. First-line therapies include diuretics, angiotensin converting enzyme inhibitors, and angiotensin II receptor blockers. New pharmacological treatments, such as sodium-glucose cotransporter-2 (SGLT2) inhibitors, endothelin receptor antagonists, RNA interference therapeutics, and aldosterone synthase inhibitors, offer promising options for resistant hypertension. Additionally, lifestyle modifications, including a low-salt diet and aerobic exercise, and volume control through ultrafiltration in dialysis patients, are crucial for blood pressure management. SUMMARY: The findings suggest that individualized treatment strategies, incorporating both pharmacologic and nonpharmacologic approaches, are essential for optimizing blood pressure control in patients with advanced CKD and ESKD. These strategies can improve cardiovascular outcomes and enhance patient quality of life, with important implications for clinical practice.
Statin-Associated muscle symptoms and vitamin D supplementation.
Fadah K, Mares A, Lange RA
Curr Opin Cardiol · 2025 Jul · PMID 40183368 · Full text
PURPOSE OF REVIEW: Statin medications play a pivotal role in the primary and secondary prevention and management of cardiovascular disease due to their potent lipid-lowering and anti-inflammatory effects. Nevertheless, t...
PURPOSE OF REVIEW: Statin medications play a pivotal role in the primary and secondary prevention and management of cardiovascular disease due to their potent lipid-lowering and anti-inflammatory effects. Nevertheless, the clinical application of statins is often hampered by statin-associated muscle symptoms (SAMS), which deter patient adherence and treatment efficacy considerably. SAMS currently affects 10-20% of statin users, thus understanding potential mitigation strategies is crucial. This review focuses on the role of vitamin D in mitigating SAMS, given the growing interest in vitamin D deficiency as a potentially modifiable risk factor. RECENT FINDINGS: Despite observational suggestions linking vitamin D deficiency to heightened SAMS risk, recent studies have yielded conflicting results on the role of vitamin D supplementation in preventing SAMS. Some studies report an improvement in statin tolerance following vitamin D repletion. However, recent large-scale clinical trials, particularly the Vitamin D and Omega-3 trial (VITAL) report no significant benefit of vitamin D supplementation in preventing SAMS or reducing statin discontinuation rates, regardless of baseline vitamin D levels. SUMMARY: Observational data provides evidence for the use of vitamin D supplementation in SAMS management, however conflicting evidence in recent clinical trials do not support its routine use for preventing or treating SAMS. To explore alternative strategies in improving statin tolerance and adherence, this discourse aims to elucidate the current understanding the complex mechanisms underlying SAMS, the influence of serum vitamin D levels, and the implications for clinical management.
Phenotypic diversity of the LMNA mutations.
Marian AJ
Curr Opin Cardiol · 2025 May · PMID 40178405 · Full text
Abstract loading — click title to view on PubMed.
A farewell editorial.
Roberts R
Curr Opin Cardiol · 2025 May · PMID 40178404 · Publisher ↗
Abstract loading — click title to view on PubMed.
Developing a professional and career identity: it's a journey to enjoy.
Checchia PA
Curr Opin Cardiol · 2025 Jul · PMID 40172131 · Publisher ↗
PURPOSE OF REVIEW: Developing a professional identity in medicine is a crucial journey for healthcare professionals, as it encapsulates the blending of personal values, skills, knowledge, and the ethos of the medical pro...
PURPOSE OF REVIEW: Developing a professional identity in medicine is a crucial journey for healthcare professionals, as it encapsulates the blending of personal values, skills, knowledge, and the ethos of the medical profession. To examine the pathway towards developing a professional identity, we must define precisely what that represents. RECENT FINDINGS: The journey to develop both a professional identity and an academic career presence has long been the focus of educators and mentors. The idea of teaching a student how to develop a professional identity has not always been seen as the role of medical training. SUMMARY: The effort committed to developing an identity and a career should be satisfying.Throughout a long career, job satisfaction waxes and wanes. Having a diverse portfolio of interests and commitments allows for the backfill of motivation. Ultimately building a professional identity and career within cardiac critical care is a journey. There is never an end, but rather a progression and evolution.
Role of coronary artery calcification detection in tailoring patient care, personalized risk assessment, and prevention of future cardiac events.
Kankaria R, Gami A, Patel J
Curr Opin Cardiol · 2025 Jul · PMID 40072518 · Publisher ↗
PURPOSE OF REVIEW: We review the utility of coronary artery calcium (CAC) scoring in personalized risk assessment and initiation of cardiovascular disease risk modifying therapy. RECENT FINDINGS: Many populations - inclu...
PURPOSE OF REVIEW: We review the utility of coronary artery calcium (CAC) scoring in personalized risk assessment and initiation of cardiovascular disease risk modifying therapy. RECENT FINDINGS: Many populations - including South Asians, patients with cancer, patients with human immunodeficiency virus (HIV), younger patients, and elderly patients - were not included during the conception of the current risk stratification tools. CAC scoring may allow clinicians to risk-stratify these individuals and help initiate preventive therapy in higher risk populations. Furthermore, CAC scoring may be able to be integrated into current imaging practices to allow for more ubiquitous and equitable screening practices. SUMMARY: CAC scoring is an additional, objective metric that may allow for nuanced and personalized risk assessment of future atherosclerotic cardiovascular disease (ASCVD) events.
Elevated C-reactive protein and cardiovascular risk.
Chia JE, Ang SP
Curr Opin Cardiol · 2025 Jul · PMID 40014057 · Publisher ↗
PURPOSE OF REVIEW: This review critically examines the evolving role of C-reactive protein (CRP) in cardiovascular disease (CVD), addressing its pathogenesis and relationship with various CVDs including coronary artery d...
PURPOSE OF REVIEW: This review critically examines the evolving role of C-reactive protein (CRP) in cardiovascular disease (CVD), addressing its pathogenesis and relationship with various CVDs including coronary artery disease (CAD), heart failure, and atrial fibrillation. RECENT FINDINGS: CRP is mechanistically implicated in endothelial dysfunction, oxidative stress, and plaque destabilization. Recent studies demonstrate that lipid-lowering agents (statins, bempedoic acid) and anti-inflammatory therapies (canakinumab, colchicine) reduce CRP levels and improve outcomes in CAD. In heart failure, elevated CRP predicts adverse events, though evidence on phenotypes varies, and novel therapies (glucagon-like peptide-1 agonists, sodium-glucose cotransporter-2 inhibitors) lower CRP independently of weight loss. For atrial fibrillation, CRP correlates with postoperative incidence and recurrence postablation, though data remain inconsistent. Guidelines offer differing opinion with the American College of Cardiology and the American Heart Association (ACC/AHA) guidelines cautiously endorsing CRP for risk stratification in intermediate-risk individuals, while European guidelines advise against its routine use for primary prevention, reflecting unresolved questions about CRP's additive value. SUMMARY: CRP remains a pivotal inflammation biomarker in CVD, yet its causal role and clinical applicability require clarification. While CRP-guided therapies show promise, discrepancies in guidelines highlight the need for robust trials to determine whether targeting CRP directly improves outcomes. Future research should focus on CRP's pathophysiological mechanisms and validate its utility in personalized CVD management.
Hypertension in chronic kidney disease and future heart failure.
Burnier M
Curr Opin Cardiol · 2025 May · PMID 39998630 · Publisher ↗
PURPOSE OF REVIEW: Hypertension and chronic kidney diseases (CKDs) are known risk factors for the development or worsening of heart failure. In last years, several new therapeutic approaches for the management of people...
PURPOSE OF REVIEW: Hypertension and chronic kidney diseases (CKDs) are known risk factors for the development or worsening of heart failure. In last years, several new therapeutic approaches for the management of people with diabetic and nondiabetic CKD and hypertension have been investigated. In this brief review, the most recent findings regarding the ability of SGLT-2 inhibitors and nonsteroidal mineralocorticoid receptor antagonists (nsMRA) and GLP-1 receptor agonists to prevent heart failure in patients with hypertension and CKD will be discussed. RECENT FINDINGS: In the last 3 years, several large clinical trials involving very large numbers of CKD patients have been published showing that these new therapeutic approaches significantly reduce the risk of heart failure events and hospitalizations in patients with diabetic and nondiabetic nephropathies and hypertension as well as in patients with heart failure without nephropathy. Moreover, these drugs retard the progression of CKD towards end-stage kidney disease. SUMMARY: These observations already have a major impact on the management of people with hypertension and CKD. SGLT-2 inhibitors are now recommended as first-line therapy in people with diabetes, CKD and heart failure. The use of nsMRA is increasing and could replace spironolactone over time in heart failure as well as in early CKD stages.
Cardiac phenotypes in LMNA mutations.
Rouhi L
Curr Opin Cardiol · 2025 May · PMID 39998502 · Full text
PURPOSE OF REVIEW: This review highlights the diverse cardiac manifestations of LMNA mutations, focusing on their underlying molecular mechanisms and clinical implications. As LMNA mutations are implicated in cardiomyopa...
PURPOSE OF REVIEW: This review highlights the diverse cardiac manifestations of LMNA mutations, focusing on their underlying molecular mechanisms and clinical implications. As LMNA mutations are implicated in cardiomyopathies, such as dilated cardiomyopathy (DCM), arrhythmogenic cardiomyopathy (ARVC), and conduction system diseases, understanding these phenotypes is critical for advancing diagnosis and management strategies. RECENT FINDINGS: Recent studies reveal that LMNA mutations disrupt nuclear envelope stability, activating the DNA damage response (DDR) and compromising chromatin organization and mechanotransduction. Mouse models have elucidated pathways linking LMNA dysfunction to fibrosis, arrhythmias, and myocardial remodeling. Emerging evidence demonstrates that fibroblasts play a crucial role in cardiac phenotypes. Advances in genetic screening have also underscored the importance of early identification and risk stratification, particularly for arrhythmias and sudden cardiac death. SUMMARY: The diverse spectrum of LMNA-related cardiac phenotypes, from isolated conduction defects to severe DCM and ARVC, underscores the necessity of personalized care strategies. Bridging insights from molecular studies and clinical research paves the way for targeted therapies to slow disease progression and improve patient outcomes. Future efforts should prioritize translational research on molecular mechanisms with potential in mouse models, alongside a deeper exploration of genotype-phenotype correlations, to refine and implement effective therapeutic interventions.
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