Current Cardiology Reports最新文献

Purpose of review: As the obesity epidemic expands, the alarming acceleration of youth obesity represents a critical global health concern. This timely analysis explores the underlying biological and socio-environmental drivers of childhood obesity and evaluates its role in the growing incidence of cardiometabolic disease. Moreover, this review aims to identify the limitations of existing preventive health systems and examine intervention strategies designed to mitigate the escalating burdens imposed by pediatric obesity.

Recent findings: Contemporary research seeks to characterize distinct youth obesity phenotypes and to distinguish measurable markers of adiposity in early life that are implicated in the progression of cardiometabolic dysfunction. Recognizing the deficiencies of modern exercise education curricula, studies evaluating the implementation of school-based health interventions have demonstrated significant improvements in body composition and metabolic profiles among children and adolescents. The long-term health and societal consequences posed by rising pediatric obesity constitute one of the greatest population health challenges of our time. Future research should prioritize uncovering additional genetic and epigenetic determinants of youth obesity and emphasize the equitable delivery of early, accessible, and sustainable school-based health promotion programs to reverse the global trajectory of obesity-related cardiometabolic disease.

Purpose of review: Takotsubo syndrome (TTS), also known as stress-induced cardiomyopathy, is an acute and transient form of myocardial dysfunction that predominantly affects postmenopausal women after emotional or physical stress. Although initially considered benign, growing evidence demonstrates that TTS carries substantial morbidity, recurrence, and mortality risks. This review aims to summarize current knowledge on the pathophysiology of TTS with a focus on inflammation, to explore the interplay between stress and myocardial injury, and to discuss the diagnostic and prognostic value of multimodality imaging together with emerging therapeutic approaches, providing a comprehensive framework for clinical practice and future research.

Recent findings: The pathophysiology of TTS is multifactorial, involving sympathetic hyperactivation with catecholamine excess, microvascular dysfunction, epicardial coronary spasm, intracellular calcium overload, and myocardial stunning. Increasing evidence supports a central role of inflammation, including activation of the NLRP3 inflammasome, release of cytokines such as IL-1β, IL-6, and TNF-α, oxidative stress, and macrophage polarization, ultimately leading to myocardial injury, fibrosis, and adverse ventricular remodelling. Multimodality imaging, comprising echocardiography, cardiac magnetic resonance, and nuclear techniques, enables early identification of functional and structural abnormalities, exclusion of differential diagnoses such as acute coronary syndromes or myocarditis, and prognostic assessment. TTS represents a complex stress-related cardiomyopathy with overlapping neurohormonal, inflammatory, and microvascular mechanisms. Current management remains largely supportive, focused on heart failure therapy, anticoagulation when indicated, and hemodynamic stabilization. Novel therapies targeting inflammatory and sympathetic pathways are under investigation and may change the future management of this condition. Understanding the interplay between stress, inflammation, and myocardial injury offers new opportunities for pathophysiology-driven treatment strategies and improved patient outcomes.

Purpose of the review: Metabolic disorders represent a growing epidemiological and clinical challenge, associated with worsening prognosis of cardiovascular disease. These conditions cluster in patients with heart failure and cardiomyopathies, limiting therapeutic options. Although cardiomyopathies contribute substantially to the burden of heart failure, the impact of metabolic disorders on their progression remains underexplored. This review explores the complex cardiorenal and metabolic dimensions of cardiomyopathies, focusing on pathophysiological mechanisms, therapeutic innovations, and future organizational models.

Recent findings: Metabolic disorders likely modulate genotype-phenotype expression, aggravate myocardial dysfunction, and accelerate disease progression through converging molecular mechanisms and pathways leading to energetic imbalance, inflammation and fibrosis. Novel therapies act on these pathways favouring microscopic and macroscopic reverse remodelling. A holistic and multidisciplinary approach is required to select appropriate therapies, improve disease progression and quality of life of these patients. Cardiomyopathies exemplify the complexity of heart failure, where genetic and metabolic dysfunctions coexist and act as both triggers and amplifiers of myocardial damage. DCM, HCM, HCM phenocopies and ARVC all present the burden of metabolic disorders and some of them benefit from novel therapies. SGLT2i, GLP1-RA, and non-steroidal MRA represent the forefront of a new therapeutic era, aiming at pleiotropic targets beyond neurohormonal blockade. Integrated care models will reshape disease management and improve patients' outcomes. Future research should investigate on metabolic disorders prevalence in cardiomyopathies and better characterize molecular pathways and phenotypic profiles that mostly benefit from novel therapies.

Purpose of review: The bioresorbable vascular scaffold (BVS) is a promising technology with clear theoretical benefits. Large randomized controlled trials (RCTs) of the early generation of this technology, however, demonstrated issues translating these benefits from the abstract into the clinical realm. This review covers the outcomes beginning with the first-generation scaffolds and provides updates on advances made with newer technologies and evolved approaches to platform delivery.

Recent findings: Pooled individual patient data from the ABSORB studies with 5-year follow-up was published in early 2025, showing higher event rates in the BVS group driven by events in the first three years of follow-up. Events after three years were the same or lower compared to traditional metallic drug-eluting stents (DES). BVS technology is not yet ready for clinical primetime. However, there is need for improved scaffold technology and new BVS will again need to be tested against metallic DES in large-scale RCTs with long-term follow-up.