Current Cardiology Reports最新文献

Purpose of review: This review provides a contemporary surgical view on constrictive and recurrent pericarditis.

Recent findings: Cardiac magnetic resonance imaging, echocardiography, and heart catheterization are complementary tools for diagnosis and management of patients considered for pericardiectomy. Radical pericardiectomy, unlike total/complete, represents the most extensive resection. Radical or total/complete pericardiectomy via median sternotomy is preferred over partial for both recurrent and constrictive pericarditis, to minimize the risk of symptoms and/or constriction recurrence. Utilization of cardiopulmonary bypass may facilitate the completeness and safety of the procedure. In surgical planning, attention should be paid to intraoperative challenges, especially low cardiac output syndrome, tricuspid regurgitation, and coronary injury. A multidisciplinary approach in experienced centers is essential to optimize outcomes. Radical or complete pericardiectomy is advised over partial to avoid the symptoms or constriction recurrence owing to the remaining pericardium. Further research is mandatory to identify the optimal timing and precise extent of pericardiectomy.

Purpose of review: This review article summarizes the established physiologic adaptations seen on echocardiogram in athletes and provides a focus update and perspective on changing diagnostic criteria in several pathologies known to overlap with exercise induced cardiac remodeling.

Recent findings: There have been recent publications regarding improved diagnostic criteria for apical hypertrophic cardiomyopathy, shift towards "excessive trabeculations" rather than historically termed non-compaction, and expanding knowledge of arrhythmogenic cardiomyopathies. Exercise induced cardiac remodeling can be mistaken for these pathologies, among others. As the evaluation of cardiomyopathies changes with the growing understanding of the pathology, it is important that these updates are compared to the potential physiologic adaptation seen in athletic training. It is imperative for the practicing cardiologist to remain knowledgeable of these evolving guidelines.

Purpose of review: Myocardial deformation imaging has transformed noninvasive right heart assessment by providing quantitative assessment of chamber level mechanics. The present review synthesizes current evidence on the clinical utility of right atrial echocardiographic strain, highlighting its physiologic underpinnings, diagnostic performance across cardiopulmonary disease states, and evolving integration into contemporary clinical practice.

Recent findings: Right atrial strain provides a sensitive and reproducible measure of phasic function and chamber compliance, reflecting right-sided filling pressure and atrioventricular interactions. Abnormalities in reservoir and conduit strain are closely linked to diastolic dysfunction and serve as early indicators of right heart maladaptation. Impaired right atrial strain has emerged as an independent predictor of adverse clinical outcomes, including hospitalization, morbidity, mortality, and disease progression across multiple conditions including pulmonary hypertension, heart failure with preserved ejection fraction, valvular heart disease, and connective tissue disease-associated pulmonary vascular disease. Beyond its prognostic significance, right atrial strain provides complementary mechanistic information to right ventricular strain and invasive hemodynamic indices, reflecting atrial compliance, atrioventricular coupling, and systemic venous congestion. Right atrial strain provides mechanistic and prognostic insight beyond conventional echocardiographic measures of chamber size and pressure. As acquisition methods, reference ranges, and analytic standardization mature, right atrial strain is poised to become an essential component of comprehensive right heart evaluation, enabling earlier detection of dysfunction and refined assessment of disease progression and therapeutic efficacy.

Purpose of review: The goal of this review is to evaluate the evolving role of triglycerides (TGs) and TG-rich lipoproteins (TRLs) in cardiovascular disease (CVD) risk and prevention. We examine the mechanistic rationale, genetic and epidemiological evidence, and therapeutic potential of targeting TGs in residual risk reduction, particularly in high-risk populations.

Recent findings: Emerging data from Mendelian randomization studies and large clinical cohorts support a causal link between elevated remnant lipoproteins and atherosclerotic CVD, in which apolipoprotein B may be the principal driver. Although traditional triglyceride-lowering agents have produced mixed results on cardiovascular outcomes, emerging therapies-such as ApoC-III and ANGPTL3 inhibitors-show robust lipid-lowering effects, while selective PPAR modulators have thus far not demonstrated cardiovascular benefit. However, outcome data remain limited. Residual CVD risk persists despite aggressive LDL-C reduction, especially in patients with diabetes, metabolic syndrome, or chronic kidney disease. Selective TG-lowering strategies targeting TRLs-especially those that decrease apolipoprotein B-may provide clinical benefit in high-risk phenotypes. Ongoing trials will clarify whether these promising agents confer meaningful cardiovascular protection and warrant integration into future guidelines.

Purpose of review: A borderline small left ventricle (LV), in which the LV is underdeveloped but not diminutive, represents an ongoing area of research and a challenge in clinical management. In this paper, the authors aimed to review the definition of borderline LV and recruitment strategies with a focus on hybrid, and wholly transcatheter approaches, to achieve the goal of two ventricle circulation.

Recent findings: Hampered by a lack of consensus definition; historically, patients with borderline LV were managed with single-ventricle palliation. However, due to the suboptimal long-term outcomes with single-ventricle palliation, many programs have adopted strategies to promote LV growth with the goal of achieving two-ventricle circulation with different outcomes. Initially dominated by surgical staging, there is growing evidence to support the use of hybrid or entirely transcatheter techniques to achieve first stage palliation in patients with borderline LV. Regardless of technique used (surgical and/or transcatheter), recruiting the LV into a successful biventricular circulation typically requires multiple interventions aimed at improving blood flow through the left heart structures and increasing LV volume loading in an effort to promote LV remodeling. Scoring systems can be helpful tools in determining the candidacy for LV recruitment strategy; however, the optimal scoring system has yet to be established.

Purpose of review: The purpose of this review is to provide an updated overview of mesenchymal stem cell (MSC)-based regenerative therapies in atherosclerosis. We aim to explore the mechanisms, recent advancements, and challenges associated with MSC applications in treating atherosclerosis.

Recent findings: Recent studies highlight the potential of MSCs in modulating inflammation, promoting vascular repair, and reducing plaque formation in atherosclerosis. Novel approaches, such as hypoxia-conditioned MSCs and combination therapies with biomaterials, have shown promising results in preclinical models. This review concludes that MSC-based therapies hold significant promise for treating atherosclerosis, but further clinical trials are needed to validate their safety and efficacy. Future research should focus on optimizing MSC delivery methods and understanding long-term outcomes.