Current Cardiology Reports最新文献

Purpose of review: This review summarizes recent evidence linking experiences of discrimination and anticipated discrimination with cardiovascular health outcomes.

Recent findings: Experiences of discrimination were consistently associated with increased risk of nicotine exposure, poor sleep health, obesity, diabetes, hypertension, and subclinical cardiovascular disease. Evidence is mixed for cardiovascular disease diagnoses and cardiovascular mortality. Although research is limited, anticipated discrimination is an independent risk factor for poor sleep health and subclinical cardiovascular disease. Key methodological limitations included the limited use of gold-standard objective measures of health behaviors and well-validated self-report measures, inadequate consideration of intersectionality, and lack of robust examinations of psychological, behavioral, and physiological mechanisms linking discrimination with cardiovascular health outcomes. There is substantial evidence linking experiences of discrimination with cardiovascular outcomes. Yet, before translating these findings into clinical practice, more rigorous studies are needed to address methodological limitations and uncover mechanisms by which discrimination influences cardiovascular health. There is a need for studies to inform the development of evidence-based interventions focused on reducing the influence of discrimination-related stressors on cardiovascular health outcomes. Findings have important implications for future work to advance cardiovascular health equity.

Purpose of review: Our goal of this review is to describe the current evidence and future applications of virtual reality (VR) from echocardiographic acquired images to enhance diagnostic accuracy and improve the visualization of cardiac structures by providing immersive 3-dimensional (3D) environments for better interpretation, communication between healthcare providers, families and trainees.

Recent findings: Virtual reality is a powerful tool for education, procedural planning and simulation. Using readily available echocardiographic images for this purpose is feasible, effective and safe. This document highlights the increasing role of VR in procedural planning, education, and intraprocedural guidance using three-dimensional echocardiography (3DE). Key advancements include the development of smaller 3D transthoracic and pediatric transesophageal probes with better temporal resolution, which enable enhanced imaging for preoperative planning. VR allows surgeons to visualize dynamic 3D cardiac models created from echocardiographic or Computed Tomography (CT) data, enabling better pre-surgical rehearsal, device selection, and landing zone visualization. It also provides immersive training tools for echocardiographers and offers potential for intraprocedural guidance in interventions such as atrial septal defect closures. These developments underscore the growing synergy between VR and 3DE for refining diagnosis and procedural strategies.

Purpose of review: To provide an overview of the predictive value of A Body Shape Index (ABSI) for the risk of cardiovascular events.

Recent findings: ABSI has been reported to have an association with development of cardiovascular diseases, and its usefulness for predicting major cardiovascular events including cardiovascular mortality, nonfatal coronary syndrome and nonfatal stroke has been investigated. The formula for ABSI includes waist circumference, which is not included in the conventional calculation of body mass index (BMI), along with BMI and height. High ABSI is independently associated with a high incidence of cardiovascular events. ABSI with specific cutoff values can be a useful tool for cardiovascular risk stratification by detecting the presence of abdominal obesity and it can be used for evaluation of the risk of cardiovascular events. Nonetheless, other factors such as race, gender, age, and physical, environmental and socioeconomic purviews also need be taken into consideration.

Purpose of review: This review discusses the transformative potential of artificial intelligence (AI) in ischemic heart disease (IHD) prevention. It explores advancements of AI in predictive modeling, biomarker discovery, and cardiovascular imaging. Finally, considerations for clinical integration of AI into preventive cardiology workflows are reviewed.

Recent findings: AI-driven tools, including machine learning (ML) models, have greatly enhanced IHD risk prediction by integrating multimodal data from clinical sources, patient-generated inputs, biomarkers, and imaging. Applications in these various data sources have demonstrated superior diagnostic accuracy compared to traditional methods. However, ensuring algorithm fairness, mitigating biases, enhancing explainability, and addressing ethical concerns remain critical for successful deployment. Emerging technologies like federated learning and explainable AI are fostering more robust, scalable, and equitable adoption. AI holds promise in reshaping preventive cardiology workflows, offering more precise risk assessment and personalized care. Addressing barriers related to equity, transparency, and stakeholder engagement is key for seamless clinical integration and sustainable, lasting improvements in cardiovascular care.

Purpose of review: What is the pathophysiology and clinical findings as well as management of patients presenting with INOCA/MINOCA (Ischemia/Myocardial Infarction with Non-Obstructive Coronary Arteries).

Recent findings: INOCA/MINOCA has a complex pathophysiology. In this review article, we aim to summarize the complex pathophysiology and clinical diagnosis, and review the current management options.

Purpose of review: We aim to summarize the available literature guiding tailored sedation practices for specific conditions encountered in the Cardiovascular Intensive Care Unit (CICU).

Recent findings: Data specific for the CICU population is lacking. Preclinical data and observational studies guide sedation approaches for specific pathologies that we have used to generate a guideline for sedative choice for various scenarios. We discuss the challenges associated with extubation and highlight the importance of spontaneous breathing trials and role of non invasive ventilation. Understanding the underlying pathology and the effects of sedation and positive pressure ventilation is the base to guide induction and sedation management for patients in the CICU. There is a pressing need for further research to generate high quality clinical data to improve sedation techniques in the CICU.

Purpose of review: To provide a contemporary update on the American Society of Echocardiography's ImageGuideEcho Registry and present a case study of an individual institution's experience with enrollment.

Recent findings: Technical innovation in clinical echocardiography has expanded the impact of echocardiography in cardiovascular care and provides new opportunities to leverage clinical data to inform quality improvement initiatives and research. The ImageGuideEcho Registry is the first echocardiography-specific imaging registry in the United States and provides a data infrastructure for quality improvement and multicenter research. The ImageGuideEcho Registry continues to grow, offering a window into echocardiography care across the United States in a variety of practice settings. This early experience highlights its value, opportunities, and ongoing challenges. Continued innovation, such as the addition of primary images, will further add to the substantial value of the registry.

Purpose of review: This review aims to explore how a diagnosis of LMNA-related cardiomyopathy (LMNA-CM) informs clinical management, focusing on the prevention and management of its complications, through practical clinical strategies.

Recent findings: Longitudinal studies have enhanced our understanding of the natural history of LMNA-CM including its arrhythmic and non-arrhythmic complications. A LMNA specific ventricular arrhythmia risk prediction strategy has been integrated into clinical practice guidelines. Although less robust, observational studies are shaping gene-specific strategies for mitigating other complications including atrioventricular block, atrial fibrillation and cardiomyopathy, while novel therapies have been evaluated in clinical trials. LMNA-CM follows an aggressive yet generally stereotyped course. Early recognition of anticipated complications allows for more effective prevention and management in both symptomatic and asymptomatic patients.

Purpose of the review: Takotsubo syndrome (TTS) is a transient form of left ventricular dysfunction, typically affecting post-menopausal females, often preceded by emotional or physical stressful events that act as triggers. Initially believed to be a rare and benign condition for its reversible nature, TTS has recently emerged as a complex multifaceted clinical entity, with heterogenous clinical presentations and a non-negligible risk of serious in-hospital complications, including acute heart failure, arrhythmias and death.

Recent findings: Emerging pathophysiological hypotheses, ranging from microvascular dysfunction to systemic inflammation, offer new insights into the underlying mechanisms of TTS. Moreover, increasing awareness of potential complications during the acute phase of the disease underscores its significant prognostic implications and emphasizes the need for randomized clinical trials to guide the therapeutic management of TTS. In this narrative review article, we aim to discuss the recent insights on the epidemiology, pathophysiology, treatment and prognosis of patients affected by TTS discussing the emerging evidence and the remaining knowledge gap in the field.