Current Opinion In Cardiology[JOURNAL]
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200 papers
An integrative approach to patient selection for mitral transcatheter edge-to-edge repair in secondary mitral regurgitation.
Brusosa M, Flores-Umanzor E, Horlick E
Curr Opin Cardiol · 2026 Jul · PMID 42394523 · Publisher ↗
PURPOSE OF REVIEW: Secondary mitral regurgitation (SMR) remains a major contributor to symptoms and hospitalizations in heart failure, despite guideline-directed medical therapy (GDMT). This review synthesizes current ev...
PURPOSE OF REVIEW: Secondary mitral regurgitation (SMR) remains a major contributor to symptoms and hospitalizations in heart failure, despite guideline-directed medical therapy (GDMT). This review synthesizes current evidence and proposes a structured framework for identifying patients most likely to benefit from mitral transcatheter edge-to-edge repair (M-TEER), integrating data from randomized clinical trials, proportionality concepts, and multimodality imaging. RECENT FINDINGS: Divergent results in MITRA-FR and COAPT mainly reflect differences in echocardiographic selection and left-ventricular remodeling, which means SMR severity should be judged relative to ventricular size and regurgitant burden. Contemporary trials such as RESHAPE-HF2 and MATTERHORN broaden the evidence and support M-TEER in selected patients and as a safer alternative to surgery in some operable cohorts. Beyond effective regurgitant orifice area, regurgitant volume and regurgitant fraction better capture MR load. Cardiac magnetic resonance refines quantification when echocardiography is discordant or limited. Right-ventricular dysfunction and pulmonary vascular involvement are key modifiers of prognosis and expected benefit. SUMMARY: Optimal candidate selection requires a structured, integrative evaluation: confirm clinically meaningful SMR despite GDMT, ensure anatomic suitability, quantify severity with a multiparametric echo approach supplemented by CMR when indicated, and incorporate ventricular-atrial-pulmonary coupling. This physiology-based strategy moves beyond single thresholds to identify patients most likely to achieve meaningful clinical benefit.
Rebooting blood vessel repair: implications of the SEMA-VR CardioLink-15 trial.
Verma R, Verma M, Park B … +4 more , Teoh H, Quan A, Connelly KA, Hess DA
Curr Opin Cardiol · 2026 Jul · PMID 42388102 · Publisher ↗
PURPOSE OF REVIEW: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) reduce major adverse cardiovascular events (MACE), heart failure, and mortality through undetermined mechanisms independent of glycemic control. Thi...
PURPOSE OF REVIEW: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) reduce major adverse cardiovascular events (MACE), heart failure, and mortality through undetermined mechanisms independent of glycemic control. This review examines emerging evidence that GLP-1RAs overcome vascular regenerative cell exhaustion (VRCE), a pathological depletion of bone marrow-derived progenitor cells that mediate vessel repair. RECENT FINDINGS: VRCE, the progressive loss of circulating progenitor cells that mediate vessel regeneration, has recently emerged as an underappreciated driver of MACE risk in individuals living with type 2 diabetes (T2D), obesity or atherosclerotic cardiovascular disease. In a recent randomized translational trial of semaglutide vs. usual care, SEMA-VR CardioLink-15 provided the direct evidence that 6-month semaglutide administration could reverse VRCE profile associated with longstanding cardiometabolic disease (34.8% increase in VR myeloid progenitor cells, 66.2% expansion of endothelial precursor cells). Semaglutide additionally reduced circulating granulocyte content and suppressed pro-inflammatory TNF and interleukin family cytokines in sera. SUMMARY: GLP-1RAs can restore bone marrow progenitor cell output towards a more vessel regenerative profile. Reversal of VRCE may partially explain early event curve separation in cardiovascular outcome trials with multiple GLP-1RAs. Therefore, circulating VR cell content could serve as a measure of compromised vascular regenerative capacity and elevated cardiovascular disease risk.
Advancements in wearable technology for heart failure patients.
Perlman G, Leroux J, Sharma A
Curr Opin Cardiol · 2026 Jul · PMID 42388093 · Publisher ↗
PURPOSE OF REVIEW: While pharmacologic and device therapies have improved heart failure care in recent decades, age-adjusted rehospitalization rates remain largely stable. While the adoption of many implanted devices sho...
PURPOSE OF REVIEW: While pharmacologic and device therapies have improved heart failure care in recent decades, age-adjusted rehospitalization rates remain largely stable. While the adoption of many implanted devices shown to reduce heart failure hospitalizations has been slow due to their invasive nature and limited insurance coverage, wearable devices such as smartwatches are noninvasive and increasingly accessible for the general population. In this review, we discuss novel developments in clinical applications of wearable devices for heart failure. RECENT FINDINGS: While no wearable is currently recommended for heart failure monitoring or screening, recent studies have shown promising preliminary results that suggest wearables may be used to screen for prevalent heart failure, monitor congestion levels, predict acute exacerbation events, and evaluate response to interventions. We highlight research on smartwatch-based prediction of acute exacerbations and screening for heart failure, and patch-based pulmonary capillary wedge pressure estimation. SUMMARY: This review aims to serve as a primer for healthcare providers and researchers on advances for use of wearable devices in patients with heart failure. If properly validated and implemented, wearables offer potential to improve quality of life and self-efficacy of patients with heart failure while reducing their hospitalization risk.
Minimally invasive approaches to coronary artery bypass grafting: techniques, current evidence, and future directions.
Hassan SMA, Maatallah M, Patel S … +2 more , Verma M, Davierwala P
Curr Opin Cardiol · 2026 Jun · PMID 42301235 · Publisher ↗
PURPOSE OF REVIEW: Conventional coronary artery bypass grafting (CABG) is most commonly performed via median sternotomy, an approach that can be associated with postoperative pain, sternal wound complications, and prolon...
PURPOSE OF REVIEW: Conventional coronary artery bypass grafting (CABG) is most commonly performed via median sternotomy, an approach that can be associated with postoperative pain, sternal wound complications, and prolonged recovery. Over the past two decades, multiple minimally invasive coronary surgery strategies have been developed, offering sternotomy-sparing alternatives that may reduce surgical trauma and accelerate recovery in appropriately selected patients. This review summarizes contemporary minimally invasive strategies, focusing on their procedural steps, patient selection, clinical outcomes, and evolving role in contemporary coronary revascularization. RECENT FINDINGS: Contemporary techniques include minimally invasive direct coronary artery bypass (MIDCAB), endoscopic/robotic-assisted coronary artery bypass, totally endoscopic coronary artery bypass (TECAB), and hybrid coronary revascularization (HCR), which combines CABG with percutaneous coronary intervention (PCI). Available evidence, largely from observational series and experienced centers, supports favorable graft patency and recovery profiles; however, comparative long-term data remain limited for multivessel and robotic approaches. Owing to their inherent technical complexity, steep learning curves, and high costs of robotic platforms, widespread adoption of MI-CABG has remained limited. SUMMARY: MI-CABG offers an important sternotomy-sparing option for selected patients with coronary artery disease. Wider adoption will depend on careful patient selection, structured training, multidisciplinary Heart Team decision-making, and stronger comparative evidence defining which patients benefit most.
Advances in artificial intelligence for the evaluation of mitral regurgitation.
Sanchez AA, Sadeghpour A, Asch FM
Curr Opin Cardiol · 2026 Jun · PMID 42301221 · Publisher ↗
PURPOSE OF REVIEW: The diagnostic evaluation of mitral regurgitation (MR) is complex, time-intensive, and prone to significant interobserver variability. This review examines the current evidence on artificial intelligen...
PURPOSE OF REVIEW: The diagnostic evaluation of mitral regurgitation (MR) is complex, time-intensive, and prone to significant interobserver variability. This review examines the current evidence on artificial intelligence (AI) applications across the full MR diagnostic pathway, from pre-imaging screening to advanced multimodality imaging, and explores future directions for clinical integration. RECENT FINDINGS: AI-enabled digital stethoscopes and deep learning-based electrocardiographic models provide scalable upstream strategies for early detection and population-level risk stratification, although they currently function as enrichment tools rather than standalone diagnostics. In echocardiography, AI has demonstrated strong performance for automated valve segmentation, Doppler analysis, severity grading, and phenotypic classification. In cardiac magnetic resonance, AI enables automated valve tracking, ventricular segmentation, and tissue characterization, although dedicated algorithms for direct MR quantification remain under development. Beyond automation, AI-driven approaches have identified clinically meaningful phenotypes linking valvular dysfunction and cardiac remodeling with myocardial fibrosis and increased cardiovascular risk. SUMMARY: AI holds significant promise to improve reproducibility, consistency, and clinical integration of MR assessment. Widespread implementation, however, requires prospective validation, standardized acquisition protocols, improved model interpretability and, most importantly, proper regulations driven by a culture of safety.
Role of nutritional interventions to reduce cardiometabolic disease burden in the community.
López-Arana S, Rincón-Cervera MÁ, Pereyra-González I
Curr Opin Cardiol · 2026 Jun · PMID 42267498 · Publisher ↗
PURPOSE OF REVIEW: Cardiovascular disease (CVD) is the leading global cause of death and disability, with most disability-adjusted life-years linked to modifiable risk factors. Nutrition is a scalable intervention that i...
PURPOSE OF REVIEW: Cardiovascular disease (CVD) is the leading global cause of death and disability, with most disability-adjusted life-years linked to modifiable risk factors. Nutrition is a scalable intervention that influences multiple cardiometabolic pathways. This review is timely because recent scientific statements and global policy frameworks highlight the need to prioritize dietary strategies in community settings to reduce CVD burden and promote equity. RECENT FINDINGS: Community-based nutritional interventions in urban settings, neighborhoods and workplaces effectively reach underserved populations by leveraging trust and cultural relevance. Dietary patterns such as the Mediterranean and DASH diets have demonstrated improvements in blood pressure, lipid profiles, and inflammation. New approaches, including intermittent fasting and the EAT-Lancet reference diet, broaden prevention options. Policy actions such as taxes, nutrition labeling, and healthier procurement standards are recognized by the WHO as cost-effective measures. SUMMARY: Community-based nutritional interventions reduce cardiometabolic risk and promote equity. Strategies include fiscal policies, healthier food environments, education, digital tools, and "Food Is Medicine" programs. Their success relies on cultural adaptation and stakeholder engagement. Evidence supports their capacity to shift norms, improve diets, and sustain long-term reductions in CVD burden.
Artificial intelligence for right ventricular assessment: current evidence and future directions.
Tan X, Fowler J, Li M … +1 more , Guha A
Curr Opin Cardiol · 2026 Jun · PMID 42267489 · Publisher ↗
PURPOSE OF REVIEW: Right ventricular size and function are vital to risk stratification in pulmonary hypertension, valvular disease, and congenital heart disease, yet right ventricular assessment remains technically dema...
PURPOSE OF REVIEW: Right ventricular size and function are vital to risk stratification in pulmonary hypertension, valvular disease, and congenital heart disease, yet right ventricular assessment remains technically demanding and subject to interpreter variability. This review aims to synthesize the rapidly expanding evidence on the application of artificial intelligence to RV structural and functional assessment across echocardiography, cardiac magnetic resonance (CMR), and computed tomography. RECENT FINDINGS: Artificial intelligence has demonstrated accuracy approaching interobserver variability for automated right ventricular segmentation and chamber quantification across imaging modalities. Functional applications include artificial intelligence derived fractional area change, tricuspid annular plane systolic excursion, free-wall strain, and ejection fraction estimation compared against CMR. Emerging applications address right ventricular-pulmonary artery coupling and hemodynamic phenotyping through afterload-aware, physiology-centered models. SUMMARY: Current artificial intelligence tools can standardize and accelerate established right ventricular measurements, with the strongest performance in echocardiographic segmentation, annular tracking, and ejection fraction surrogates. Translation into clinical practice will require robust external validation across disease phenotypes, hybrid artificial intelligence workflows that loop in humans, and prospective studies that display measurable impact on clinical efficiency and patient outcomes.
Coronary physiology and intravascular imaging in surgical and percutaneous revascularization.
Elsherbini A, Patel SK, Marvasti TB … +5 more , Verma M, Hassan SMA, Tam DY, Fremes S, Yau TM
Curr Opin Cardiol · 2026 Jun · PMID 42267487 · Publisher ↗
PURPOSE OF REVIEW: Coronary angiography remains the principal imaging modality guiding coronary revascularization, but it provides only an anatomic representation of disease and does not reliably identify lesion-specific...
PURPOSE OF REVIEW: Coronary angiography remains the principal imaging modality guiding coronary revascularization, but it provides only an anatomic representation of disease and does not reliably identify lesion-specific ischemia. This review summarizes contemporary evidence on coronary physiology and intravascular imaging in percutaneous and surgical revascularization. RECENT FINDINGS: Physiology-guided percutaneous coronary intervention (PCI) improves clinical outcomes by refining lesion selection and supporting safe deferral of nonflow-limiting stenoses. Fractional flow reserve and instantaneous wave-free ratio are supported by long-term randomized data, while angiography-derived quantitative flow ratio has shown favorable outcomes compared with angiography-guided PCI, although equivalence to pressure-wire-based strategies remains unsettled. In parallel, intravascular ultrasound and optical coherence tomography enhance procedural optimization by improving stent sizing, expansion, and detection of mechanical complications, with the strongest benefit observed in anatomically complex lesions. Postprocedural physiologic testing frequently reveals residual ischemia despite acceptable angiographic results. In coronary bypass surgery, physiologic assessment may refine target selection and clarify mechanisms of competitive flow, and postoperative quantitative flow ratio has been explored in assessing functional completeness; however, consistent improvement in clinical outcomes has not been demonstrated. SUMMARY: Current evidence strongly supports integration of coronary physiology and intravascular imaging in PCI, whereas their role in coronary artery bypass grafting remains investigational.
From sleep disorders to social determinants - risk predictors for cardiovascular diseases beyond low density lipoprotein cholesterol.
Mukherjee D, Mikhailidis DP
Curr Opin Cardiol · 2026 Jul · PMID 42241575 · Publisher ↗
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Hypertension in 2026: building the future by realizing the past.
Al Dhaybi O, Bhatt DL
Curr Opin Cardiol · 2026 Jul · PMID 42241574 · Publisher ↗
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Cardioneuroablation for children with syncope.
Cohen MI, Cohen JA
Curr Opin Cardiol · 2026 Jul · PMID 42186407 · Publisher ↗
PURPOSE OF REVIEW: Children with recurrent syncope with prolonged pauses who have failed traditional therapies may be candidates for a cardioneuroablation as an alternative to pacemaker implantation. This article reviews...
PURPOSE OF REVIEW: Children with recurrent syncope with prolonged pauses who have failed traditional therapies may be candidates for a cardioneuroablation as an alternative to pacemaker implantation. This article reviews cardioneuroablation in the pediatric population. RECENT FINDINGS: Cardioneuroablation has been used in adults for cardioinhibitory syncope for more than 2 decades with promising results. Despite the heterogenous patient population and variation in technical approaches to the procedure, between 85 and 90% of patients have a significant reduction in syncope and improvement in quality of life. While the data in children is limited, reports have shown similar success. Catheter ablation of ganglionated plexuses can be performed by ablating in the right or left atrium or both. The long-term effects in disrupting the sympathovagal imbalance remains unknown. SUMMARY: Cardioneuroablation may be an option for select children with cardioinhibitory syncope who have failed standard medical approaches. Early results of vagal ablation in children have been promising. Future long-term registries following cardioneuroablation is needed.
Transcatheter pulmonary valve replacement: what we know, what we still want to know.
Nageotte SJ, Berman DP, Sullivan PM
Curr Opin Cardiol · 2026 Jul · PMID 42186401 · Publisher ↗
PURPOSE OF REVIEW: Transcatheter pulmonary valve replacement (TPVR) has transformed the management of patients with congenital heart disease (CHD) with dysfunctional pulmonary outflow tracts. Technological advancements h...
PURPOSE OF REVIEW: Transcatheter pulmonary valve replacement (TPVR) has transformed the management of patients with congenital heart disease (CHD) with dysfunctional pulmonary outflow tracts. Technological advancements have expanded the number of patients eligible for this minimally invasive alternative to surgical valve replacement. With the introduction of larger self-expanding valves and adaptive prestenting systems, TPVR has become accessible to patients with complex anatomies, including those with native right ventricular outflow tract (RVOT) disease. RECENT FINDINGS: Recent studies have demonstrated the excellent clinical outcomes of TPVR thus far, while also acknowledging the occurrence of rare complications. Crucial questions guiding the future of TPVR management include: timing to refer for TPVR, how to optimize valve durability, enhance preprocedural screening with advanced imaging and electrophysiology studies, and improve hemodynamic monitoring. SUMMARY: These advancements underscore TPVR's adaptability and efficacy, offering new solutions for complex cases and improving outcomes. Future research should focus on optimizing patient selection and intervention timing, as well as addressing long-term durability and complications.
Too high and too loose: dysautonomia and the hypertensive paradox in hypermobility disorders.
Johnson JW, Mirro I, Kontorovich AR
Curr Opin Cardiol · 2026 Jul · PMID 42186391 · Publisher ↗
PURPOSE OF REVIEW: Hypertension in hypermobile Ehlers-Danlos syndrome (hEDS) and hypermobility spectrum disorders (HSD) represents an increasingly recognized but poorly understood clinical phenomenon. This review address...
PURPOSE OF REVIEW: Hypertension in hypermobile Ehlers-Danlos syndrome (hEDS) and hypermobility spectrum disorders (HSD) represents an increasingly recognized but poorly understood clinical phenomenon. This review addresses the unique pathophysiology, diagnostic considerations, and management challenges of hypertension occurring in the context of dysautonomia - a comorbidity affecting up to 70% of patients with hEDS/HSD. RECENT FINDINGS: Emerging evidence identifies distinct hypertensive endotypes in hEDS/HSD, including hyperadrenergic dysautonomia, paroxysmal hypertension, cervicogenic hypertension, and nocturnal/supine hypertension. Pathophysiologic mechanisms involve connective tissue laxity, altered baroreflex function, small fiber neuropathy, and mast cell activation. Standard antihypertensive therapies may paradoxically worsen symptoms by exacerbating orthostatic intolerance, while targeted approaches using alpha-blockers and central sympatholytics show promise in hyperadrenergic phenotypes. SUMMARY: Management of hypertension in hEDS/HSD requires adaptation of standard guidelines to accommodate dysautonomia-specific considerations, including withdrawal of provocative medications, avoidance of volume-depleting agents, and phenotype-directed pharmacotherapy. Long-term cardiovascular outcomes remain poorly defined, highlighting critical research gaps and the need for evidence-based consensus guidelines tailored to this unique patient population.
Superficial intercostal plane blocks for post-sternotomy pain control rationale and design for the EPOCH CardioLink-10 randomized clinical trial.
Dhingra NK, Dennis F, Hassan SMA … +33 more , Quan A, Teoh H, Chin K, Ricci MJ, Tran JD, Li J, Verma R, de Vasconcelos Papa F, Lee Y, Chang AP, Igualada J, Morales JF, Ghiringhelli JP, Derry KL, George T, Mazine A, Rotstein OD, Adams C, Cook RC, Hassan A, Nagpal AD, Yau TM, Spence JD, Sutherland K, Martinka PM, Noss CD, Dougherty JL, de Jager P, Gregory AJ, Arora RC, Verma S, Alli A, Mazer CD
Curr Opin Cardiol · 2026 May · PMID 42186387 · Publisher ↗
PURPOSE OF THE TRIAL: Inadequate pain control following cardiac surgery remains a significant clinical and socioeconomic burden. Superficial parasternal intercostal plane (SPIP) blocks are not widely utilized for reducin...
PURPOSE OF THE TRIAL: Inadequate pain control following cardiac surgery remains a significant clinical and socioeconomic burden. Superficial parasternal intercostal plane (SPIP) blocks are not widely utilized for reducing pain and opioid consumption post-cardiac surgery because the available evidence is weak and inconsistent. METHODS: The double-blind, placebo-controlled, multicenter EPOCH CardioLink-10 trial was designed to evaluate how continuous bilateral SPIP blocks affect opioid consumption and recovery-related endpoints among individuals who have undergone cardiac surgery via median sternotomy. Participants from four Canadian sites are randomized to receive either 0.2% ropivacaine or placebo (0.9% sodium chloride) for 48-h following bilateral catheter insertion into the SPIP. The primary outcome is cumulative postoperative opioid use (morphine milligram equivalents) up to 72-hours post-catheter insertion. Secondary endpoints include median pain scores and the incidence of delirium over the 72-hours post-catheter insertion; cumulative postoperative opioid use up to hospital discharge; and participant-reported quality of recovery 24-96 h post-surgery. SUMMARY: EPOCH CardioLink-10 is to date the largest randomized controlled trial to evaluate an Enhanced Recovery After Surgery (ERAS) intervention among individuals who are recuperating from cardiac surgery with median sternotomy. Its overarching goal is to obtain robust data to improve clinical care and inform on post-cardiac surgery pain management guidelines.
Heart failure in adults with congenital heart disease: the role of sodium-glucose cotransporter 2 inhibitors.
Savvidi M, Riesgo Gil F, Brida M
Curr Opin Cardiol · 2026 Jul · PMID 42143619 · Publisher ↗
PURPOSE OF REVIEW: Heart failure (HF) is the leading cause of morbidity and mortality in adults with congenital heart disease (ACHD), yet evidence-based pharmacological options remain limited. Sodium-glucose cotransporte...
PURPOSE OF REVIEW: Heart failure (HF) is the leading cause of morbidity and mortality in adults with congenital heart disease (ACHD), yet evidence-based pharmacological options remain limited. Sodium-glucose cotransporter 2 inhibitors (SGLT2I) have demonstrated robust benefits across the heart failure spectrum in acquired cardiovascular disease. This review is summarizing emerging data on the use of SGLT2I in ACHD, a population characterized by unique pathophysiology and unmet therapeutic needs. RECENT FINDINGS: Recent literature, predominantly comprising case reports, retrospective cohorts, and small prospective studies, suggests that SGLT2I are generally safe and well tolerated in adult congenital heart disease heart failure (ACHD-HF). Across heterogeneous ACHD populations, including those with a systemic right ventricle (SRV) and Fontan circulation, SGLT2I use has been associated with improvements in natriuretic peptides, functional status, exercise capacity, and reductions in HF hospitalizations. Early data support favourable safety and low discontinuation rates. SUMMARY: The use of SGLT2I in ACHD-HF is feasible, well tolerated and with potential clinical benefit. Further ACHD-specific randomized clinical trials to define efficacy, optimal patient selection, and long-term outcomes are warranted.
CRP/hs-CRP lowering by statins and other drugs used to treat dyslipidemia.
Kothari A, Dadhania N, Jacob J … +1 more , Aparece JP
Curr Opin Cardiol · 2026 Jul · PMID 42130325 · Publisher ↗
PURPOSE OF REVIEW: Atherosclerosis is recognized as a chronic inflammatory disease, with high-sensitivity C-reactive protein (hs-CRP) serving as a biomarker of cardiovascular risk that persists despite optimal control of...
PURPOSE OF REVIEW: Atherosclerosis is recognized as a chronic inflammatory disease, with high-sensitivity C-reactive protein (hs-CRP) serving as a biomarker of cardiovascular risk that persists despite optimal control of traditional risk factors. Landmark trials, like JUPITER (Justification for the Use of Statins in Prevention) and PROVE-IT (Pravastatin or Atorvastatin Evaluation and Infection Therapy), demonstrate the effect of lipid-lowering medications on inflammation. This can have further implications for comprehensive cardiovascular risk reduction. RECENT FINDINGS: Statins lower hs-CRP alongside low-density lipoprotein cholesterol (LDL-C), with greater effects from high-intensity regimens. Nonstatin medications have variable effects; for example, the addition of ezetimibe to statin therapy enhances hs-CRP reduction. Bempedoic acid exerts direct anti-inflammatory effects, producing significant hs-CRP lowering. Omega-3 fatty acids also demonstrate favorable effects on inflammatory markers. However, fibrates offer only marginal benefits, and PCSK9 inhibitors (Proprotein Convertase Subtilisin/Kexin type 9) have minimal impact. Residual inflammatory risk persists despite LDL-C control, supporting dual-target strategies. SUMMARY: The evidence supports therapeutic strategies targeting both lipid and inflammatory pathways, with hs-CRP serving as a complementary marker to refine cardiovascular risk stratification and guide treatment intensification in primary and secondary prevention. Future studies should evaluate inflammation-targeted adjunctive therapies to address discordance between lipid control and residual inflammatory risk.
Artificial intelligence for left ventricular strain.
Grenne B, Østvik A, Dalen H … +1 more , Løvstakken L
Curr Opin Cardiol · 2026 May · PMID 42130319 · Publisher ↗
PURPOSE OF REVIEW: To review recent advances in artificial intelligence (AI) for left ventricular (LV) strain echocardiography, with emphasis on studies published during the preceding 18 months, and to assess current evi...
PURPOSE OF REVIEW: To review recent advances in artificial intelligence (AI) for left ventricular (LV) strain echocardiography, with emphasis on studies published during the preceding 18 months, and to assess current evidence for measurement performance, workflow integration, emerging AI-based approaches, disease-specific applications and barriers to widespread clinical adoption. RECENT FINDINGS: The most mature evidence relates to automated global longitudinal strain (GLS) measurement, where recent studies show high feasibility, improved reproducibility and reduced operator dependence compared with conventional analysis. AI-based tools have also moved beyond retrospective post-processing towards real-time acquisition support and workflow integration, with evidence of shorter analysis time and more standardized image acquisition. Emerging approaches suggest a shift from single-task GLS automation towards multitask and phenotyping-oriented models in which strain is integrated with broader echocardiographic interpretation. Disease-specific applications are most studied in acute ischaemic heart disease and cardio-oncology, where AI-based strain has shown promise for risk stratification, surveillance and clinical triage. However, agreement with conventional methods remains imperfect and varies substantially across models, decision thresholds are uncertain, and prospective evidence for improved clinical outcomes is still limited. SUMMARY: AI for LV strain is evolving from single-task automated measurement towards broader support for reproducibility, workflow integration and clinical interpretation. Current priorities are robust external validation, transparent reporting of feasibility and unsuccessful analyses, and prospective evaluation of clinical utility and workflow impact in routine practice, with clinician oversight as a critical component of safe implementation.
Optimizing conduits and intraoperative graft quality in coronary artery bypass graft surgery.
Majeed H, Pelletier M
Curr Opin Cardiol · 2026 May · PMID 42130305 · Publisher ↗
PURPOSE OF REVIEW: Optimization of conduits and intraoperative graft assessment remain central determinants of long-term success in coronary artery bypass grafting (CABG). This review is timely, given the recent publicat...
PURPOSE OF REVIEW: Optimization of conduits and intraoperative graft assessment remain central determinants of long-term success in coronary artery bypass grafting (CABG). This review is timely, given the recent publication of randomized data refining conduit selection, harvesting strategies, and modalities for physiologic graft verification. RECENT FINDINGS: Over the past year, accumulating randomized and registry-based evidence has strengthened support for multi-arterial revascularization, while clarifying the risks and benefits of certain arterial grafting and associated techniques. Parallel investigations have emphasized atraumatic great saphenous vein (GSV) harvesting and no-touch techniques, to mitigate endothelial injury and enhance patency. Intraoperative graft assessment has increasingly shifted toward routine use of objective physiologic tools, particularly transit-time flow measurement (TTFM) with adjunctive Doppler/ultrasound or fluorescence angiography, and emerging data refining quantitative thresholds and quality benchmarks. SUMMARY: Contemporary evidence underscores that durable surgical revascularization depends on integrated biologic, technical, and physiologic optimization. Standardizing conduit selection, minimizing conduit injury, and adopting routine intraoperative graft assessment may reduce early technical failure and improve long-term graft performance. Ongoing trials and implementation research will determine how best to translate these advances into consistent, high-quality CABG practice.
Resistant hypertension, hyperaldosteronism, and the emerging understanding of hypercortisolism.
Einhorn D, Mende C, Auchus RJ
Curr Opin Cardiol · 2026 Jul · PMID 42124528 · Full text
PURPOSE OF REVIEW: This article reviews the evolving landscape and high prevalence of hyperaldosteronism and hypercortisolism, two previously under-recognized disorders for which cardiologists should have a high index of...
PURPOSE OF REVIEW: This article reviews the evolving landscape and high prevalence of hyperaldosteronism and hypercortisolism, two previously under-recognized disorders for which cardiologists should have a high index of suspicion when managing patients with resistant hypertension. RECENT FINDINGS: Resistant hypertension is estimated to occur in approximately 10-20% of people with hypertension, or 10 million people in the United States, and is associated with substantially increased cardiovascular morbidity and mortality. Hyperaldosteronism, previously considered a rare disease, has been shown to be a relatively common cause of hypertension and is a multisystem disease associated with a significantly higher risk of multiple comorbid conditions, including resistant hypertension. Likewise, endogenous hypercortisolism, once considered a rare disease, is now known to have a higher prevalence than previously estimated and is associated with a wide spectrum of clinical and biochemical presentations, including resistant hypertension, that result from prolonged exposure to excess cortisol activity. However, despite the prevalence and negative clinical consequences of hyperaldosteronism and hypercortisolism, screening rates remain low. SUMMARY: Cardiologists are well positioned to provide timely screening for both hyperaldosteronism and hypercortisolism. To optimize clinical outcomes, patients with these endocrine causes of resistant hypertension require aldosterone-directed and/or cortisol-directed therapy in addition to therapy for hypertension.
Managing and predicting electrical and mechanical failure in the systemic right ventricle.
Rojas SF, Khairy P
Curr Opin Cardiol · 2026 Jul · PMID 42100847 · Publisher ↗
PURPOSE OF REVIEW: Adults with congenital heart disease increasingly survive into later adulthood, exposing the long-term limitations of a morphologic right ventricle supporting the systemic circulation. Heart failure an...
PURPOSE OF REVIEW: Adults with congenital heart disease increasingly survive into later adulthood, exposing the long-term limitations of a morphologic right ventricle supporting the systemic circulation. Heart failure and arrhythmias are common, frequently coexist, and represent leading causes of morbidity and mortality in this population. This review examines the mechanisms linking systemic right ventricular dysfunction and arrhythmogenesis and their implications for contemporary management. RECENT FINDINGS: Recent literature highlights that chronic systemic loading of the right ventricle promotes maladaptive structural, electrical, and inflammatory remodeling, creating a substrate for atrial and ventricular arrhythmias. Conversely, arrhythmias exacerbate systemic right ventricular dysfunction through loss of atrioventricular synchrony, tachycardia-mediated impairment, dyssynchrony, and hypoxemia, mechanisms to which systemic right ventricular physiologies are particularly susceptible. Advances in catheter ablation, device therapy, cardiac resynchronization, and conduction system pacing have expanded therapeutic options, although evidence guiding patient selection and timing remains limited. SUMMARY: Failure of the systemic right ventricle and arrhythmias are tightly interwoven processes that evolve over time. Integrating mechanistic insights with longitudinal imaging, electrophysiologic phenotyping, and individualized risk assessment may improve arrhythmia management, refine device strategies, and support more personalized approaches to preserving systemic right ventricular function.
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