Pub Date : 2026-02-01DOI: 10.1016/j.tcm.2025.08.003
Rachel M Bond
Cardiovascular disease remains the leading cause of death among women in the United States, yet sex-specific disparities in diagnosis, treatment, and outcomes persist. Women's specialized cardiac programs have emerged to address these gaps through inclusive, patient-centered models of care. This article reviews the evolution, structure, and impact of these programs, which function as hubs for clinical care, education, advocacy, and research. Highlighted are best practices, measurable outcomes, and key challenges, offering recommendations for integrating gender-focused cardiovascular care across diverse healthcare settings.
{"title":"Redefining care: The four pillars of women’s cardiovascular programs","authors":"Rachel M Bond","doi":"10.1016/j.tcm.2025.08.003","DOIUrl":"10.1016/j.tcm.2025.08.003","url":null,"abstract":"<div><div>Cardiovascular disease remains the leading cause of death among women in the United States, yet sex-specific disparities in diagnosis, treatment, and outcomes persist. Women's specialized cardiac programs have emerged to address these gaps through inclusive, patient-centered models of care. This article reviews the evolution, structure, and impact of these programs, which function as hubs for clinical care, education, advocacy, and research. Highlighted are best practices, measurable outcomes, and key challenges, offering recommendations for integrating gender-focused cardiovascular care across diverse healthcare settings.</div></div>","PeriodicalId":51199,"journal":{"name":"Trends in Cardiovascular Medicine","volume":"36 2","pages":"Pages 67-72"},"PeriodicalIF":9.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.tcm.2025.08.004
Nawar Alhourani , Christian Ellermann , Julian Wolfes , Christian Meyer , Lars Eckardt
Catheter ablation plays a pivotal role in the management of atrial fibrillation (AF). Recent randomized controlled studies have shown that catheter ablation is superior to conventional antiarrhythmic medical treatment as first-line therapy in reducing symptoms, AF recurrences, and preventing progression of AF. If the examined antiarrhythmic medical regimens were given in therapeutic and adequate doses remains an open question. We performed a PubMed and Medline search for randomized trials comparing first-line antiarrhythmic drug therapy with catheter ablation of AF. Among the 442 patients randomized to the drug arm, 20% to 43% received flecainide, propafenone, and sotalol at lower than recommended doses. Additionally, between 2.5 % and 10.4 % of these patients either have not received or discontinued the designated therapy with Class I/III drugs early. Notably, up to 10% of the patients in the ablation arm were adjunctively treated with antiarrhythmic drugs. This may have contributed to the reported superiority of catheter ablation compared to antiarrhythmic drug therapy.
{"title":"Analysis of randomized controlled studies comparing ablation with antiarrhythmic drugs","authors":"Nawar Alhourani , Christian Ellermann , Julian Wolfes , Christian Meyer , Lars Eckardt","doi":"10.1016/j.tcm.2025.08.004","DOIUrl":"10.1016/j.tcm.2025.08.004","url":null,"abstract":"<div><div>Catheter ablation plays a pivotal role in the management of atrial fibrillation (AF). Recent randomized controlled studies have shown that catheter ablation is superior to conventional antiarrhythmic medical treatment as first-line therapy in reducing symptoms, AF recurrences, and preventing progression of AF. If the examined antiarrhythmic medical regimens were given in therapeutic and adequate doses remains an open question. We performed a PubMed and Medline search for randomized trials comparing first-line antiarrhythmic drug therapy with catheter ablation of AF. Among the 442 patients randomized to the drug arm, 20% to 43% received flecainide, propafenone, and sotalol at lower than recommended doses. Additionally, between 2.5 % and 10.4 % of these patients either have not received or discontinued the designated therapy with Class I/III drugs early. Notably, up to 10% of the patients in the ablation arm were adjunctively treated with antiarrhythmic drugs. This may have contributed to the reported superiority of catheter ablation compared to antiarrhythmic drug therapy.</div></div>","PeriodicalId":51199,"journal":{"name":"Trends in Cardiovascular Medicine","volume":"36 2","pages":"Pages 76-81"},"PeriodicalIF":9.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.tcm.2025.08.007
Joanna Popiolek-Kalisz
Cardiovascular disease (CVD) remains the leading cause of mortality worldwide, and dietary strategies play a key role in its prevention and management. While universal dietary patterns such as the Mediterranean and DASH diets are supported by evidence in numerous populations, including healthy individuals, personalized nutrition offers the potential to optimize outcomes in patients with obesity, diabetes, hypertension, dyslipidemia, or after acute coronary syndrome. This review explores the balance between evidence-based universal recommendations and the feasibility and added value of personalized interventions across the CVD risk continuum. The integration of both approaches universal as a foundation and personalization where clinically indicated, gradually with increased CVD risk, may potentially provide the most effective, scalable model for nutritional cardiovascular protection.
{"title":"The role of nutrition in cardiovascular protection - personalized versus universal dietary strategies","authors":"Joanna Popiolek-Kalisz","doi":"10.1016/j.tcm.2025.08.007","DOIUrl":"10.1016/j.tcm.2025.08.007","url":null,"abstract":"<div><div>Cardiovascular disease (CVD) remains the leading cause of mortality worldwide, and dietary strategies play a key role in its prevention and management. While universal dietary patterns such as the Mediterranean and DASH diets are supported by evidence in numerous populations, including healthy individuals, personalized nutrition offers the potential to optimize outcomes in patients with obesity, diabetes, hypertension, dyslipidemia, or after acute coronary syndrome. This review explores the balance between evidence-based universal recommendations and the feasibility and added value of personalized interventions across the CVD risk continuum. The integration of both approaches universal as a foundation and personalization where clinically indicated, gradually with increased CVD risk, may potentially provide the most effective, scalable model for nutritional cardiovascular protection.</div></div>","PeriodicalId":51199,"journal":{"name":"Trends in Cardiovascular Medicine","volume":"36 2","pages":"Pages 84-90"},"PeriodicalIF":9.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Implantable cardioverter-defibrillators (ICDs) are critical for preventing sudden cardiac death, but their function poses a significant challenge in palliative care, where goals shift from life prolongation to comfort. A substantial percentage of patients receive painful, futile shocks in their final days, causing significant distress. This review synthesizes evidence on the impact of these shocks and underscores the gap between clinical practice and patient-centered care. Key barriers to timely ICD deactivation include clinician discomfort, patient misconceptions, and systemic flaws like fragmented care and absent institutional protocols. Although a robust ethical framework founded on patient autonomy supports deactivation in certain circumstances, its principles are poorly implemented. This review argues for a paradigm shift towards proactive, interdisciplinary care, calling for structured communication, routine advance care planning, and the integration of palliative cardiology models to ensure this life-saving technology does not compromise a dignified death.
{"title":"The implantable cardioverter-defibrillators at the end of life: a double-edged sword of a life-saving technology","authors":"Giacomo Mugnai , Davide Genovese , Luca Tomasi , Alessia Gambaro , Flavio Ribichini","doi":"10.1016/j.tcm.2025.09.005","DOIUrl":"10.1016/j.tcm.2025.09.005","url":null,"abstract":"<div><div>Implantable cardioverter-defibrillators (ICDs) are critical for preventing sudden cardiac death, but their function poses a significant challenge in palliative care, where goals shift from life prolongation to comfort. A substantial percentage of patients receive painful, futile shocks in their final days, causing significant distress. This review synthesizes evidence on the impact of these shocks and underscores the gap between clinical practice and patient-centered care. Key barriers to timely ICD deactivation include clinician discomfort, patient misconceptions, and systemic flaws like fragmented care and absent institutional protocols. Although a robust ethical framework founded on patient autonomy supports deactivation in certain circumstances, its principles are poorly implemented. This review argues for a paradigm shift towards proactive, interdisciplinary care, calling for structured communication, routine advance care planning, and the integration of palliative cardiology models to ensure this life-saving technology does not compromise a dignified death.</div></div>","PeriodicalId":51199,"journal":{"name":"Trends in Cardiovascular Medicine","volume":"36 2","pages":"Pages 116-120"},"PeriodicalIF":9.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.tcm.2025.09.004
Dario F. Riascos-Bernal , Gabriel Quinones , Shadi A. Abdelaal , Mark A. Menegus , Nicholas E.S. Sibinga
Plaque erosion is the second most common cause of acute coronary syndromes. It occurs in the absence of fibrous cap rupture, and typically shows luminal thrombi in direct contact with an intimal surface that lacks endothelial cells (ECs) but is enriched in smooth muscle cells and proteoglycan matrix. First described almost thirty years ago, plaque erosion accounts for an increasing fraction of acute coronary syndromes, but its frequency decreases with age in both men and women. Although a higher prevalence of erosion in women was suggested based on early observations, this has not been clearly borne out in more recent studies. The pathogenesis of plaque erosion is largely unknown; nevertheless, potential etiologic factors include disturbed flow and altered endothelial shear stress, elements of the innate and adaptive immune systems, hyaluronan and Toll-like receptor 2 signaling, activation of the NRF2 transcription factor, matrix metallopeptidase-mediated disruption of EC-extracellular matrix interactions, and distinct thrombotic mechanisms. While several of these factors are also linked to plaque rupture, existing evidence suggests that the biology of plaque erosion is substantially different from that of rupture; therefore, a deeper understanding of the molecular basis of coronary thrombosis associated with plaque erosion may guide the development of biomarkers and specific preventive or therapeutic strategies for acute coronary syndromes with intact fibrous cap. Such progress would pave the way for personalized care of these patients.
{"title":"Pathogenesis of plaque erosion","authors":"Dario F. Riascos-Bernal , Gabriel Quinones , Shadi A. Abdelaal , Mark A. Menegus , Nicholas E.S. Sibinga","doi":"10.1016/j.tcm.2025.09.004","DOIUrl":"10.1016/j.tcm.2025.09.004","url":null,"abstract":"<div><div>Plaque erosion is the second most common cause of acute coronary syndromes. It occurs in the absence of fibrous cap rupture, and typically shows luminal thrombi in direct contact with an intimal surface that lacks endothelial cells (ECs) but is enriched in smooth muscle cells and proteoglycan matrix. First described almost thirty years ago, plaque erosion accounts for an increasing fraction of acute coronary syndromes, but its frequency decreases with age in both men and women. Although a higher prevalence of erosion in women was suggested based on early observations, this has not been clearly borne out in more recent studies. The pathogenesis of plaque erosion is largely unknown; nevertheless, potential etiologic factors include disturbed flow and altered endothelial shear stress, elements of the innate and adaptive immune systems, hyaluronan and Toll-like receptor 2 signaling, activation of the NRF2 transcription factor, matrix metallopeptidase-mediated disruption of EC-extracellular matrix interactions, and distinct thrombotic mechanisms. While several of these factors are also linked to plaque rupture, existing evidence suggests that the biology of plaque erosion is substantially different from that of rupture; therefore, a deeper understanding of the molecular basis of coronary thrombosis associated with plaque erosion may guide the development of biomarkers and specific preventive or therapeutic strategies for acute coronary syndromes with intact fibrous cap. Such progress would pave the way for personalized care of these patients.</div></div>","PeriodicalId":51199,"journal":{"name":"Trends in Cardiovascular Medicine","volume":"36 2","pages":"Pages 105-112"},"PeriodicalIF":9.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-19DOI: 10.1016/j.tcm.2026.01.003
Azadeh Afzalnia, Amir Askarinejad, Parisa Firoozbakhsh, Dorsa Shekouh, Mahmoud Eftekharzadeh, Tommaso Bucci, Enrico Tartaglia, Michele Rossi, Gregory Y H Lip
Atrial fibrillation (AF) increases the risk of stroke and cognitive decline. While anticoagulation with vitamin K antagonists (VKAs) and direct oral anticoagulants (DOACs) prevents stroke, their role in reducing dementia risk in patients with AF remains unclear. To evaluate the effect of anticoagulation therapy on dementia incidence in patients with AF, comparing DOACs versus VKAs. We systematically reviewed PubMed, Scopus, Web of Science, Embase, and Cochrane. Systematic reviews and meta-analyses evaluating the effects of anticoagulation therapies on dementia were included. A total of 11 systematic reviews and meta-analyses were included in this umbrella review. Findings from 6 systematic reviews showed that OAC use was associated with a reduced risk of incident dementia in patients with AF, with effect estimates (RR/HR) ranging from 0.46 [0.28-0.78] to 0.79 [0.67-0.93]. For DOACs versus VKAs, most studies found a lower risk of dementia with DOACs, with effect sizes ranging from HR: 0.51 [0.37-0.71] to RR: 0.88 [0.82-0.94]. However, two studies found no significant difference between DOACs and warfarin in dementia risk (OR: 0.65 [0.34-1.25] and RR: 0.91 [0.75-1.12], respectively). Anticoagulation therapy, particularly with DOACs, may help reduce the risk of dementia in AF patients. The evidence remains of moderate to low certainty, and further high-quality, long-term randomized controlled trials are needed to confirm these findings and explore the neuroprotective mechanisms of OACs.
心房颤动（AF）增加中风和认知能力下降的风险。虽然使用维生素K拮抗剂（VKAs）和直接口服抗凝剂（DOACs）抗凝可以预防中风，但它们在降低房颤患者痴呆风险中的作用尚不清楚。评价抗凝治疗对房颤患者痴呆发生率的影响，比较DOACs与vka。我们系统地回顾了PubMed、Scopus、Web of Science、Embase和Cochrane。包括评估抗凝治疗对痴呆影响的系统综述和荟萃分析。本综述共纳入了11项系统综述和荟萃分析。6项系统评价的结果显示，使用OAC与房颤患者发生痴呆的风险降低相关，其效应估计（RR/HR）范围为0.46[0.28-0.78]至0.79[0.67-0.93]。对于doac与vka，大多数研究发现doac痴呆风险较低，效应值范围为HR: 0.51[0.37-0.71]至RR: 0.88[0.82-0.94]。然而，两项研究发现DOACs与华法林在痴呆风险方面无显著差异（OR: 0.65 [0.34-1.25], RR: 0.91[0.75-1.12]）。抗凝治疗，特别是DOACs，可能有助于降低房颤患者痴呆的风险。证据仍然是中等到低的确定性，需要进一步的高质量、长期随机对照试验来证实这些发现，并探索OACs的神经保护机制。
{"title":"Anticoagulation therapy and dementia in atrial fibrillation: An umbrella review of systematic reviews.","authors":"Azadeh Afzalnia, Amir Askarinejad, Parisa Firoozbakhsh, Dorsa Shekouh, Mahmoud Eftekharzadeh, Tommaso Bucci, Enrico Tartaglia, Michele Rossi, Gregory Y H Lip","doi":"10.1016/j.tcm.2026.01.003","DOIUrl":"10.1016/j.tcm.2026.01.003","url":null,"abstract":"<p><p>Atrial fibrillation (AF) increases the risk of stroke and cognitive decline. While anticoagulation with vitamin K antagonists (VKAs) and direct oral anticoagulants (DOACs) prevents stroke, their role in reducing dementia risk in patients with AF remains unclear. To evaluate the effect of anticoagulation therapy on dementia incidence in patients with AF, comparing DOACs versus VKAs. We systematically reviewed PubMed, Scopus, Web of Science, Embase, and Cochrane. Systematic reviews and meta-analyses evaluating the effects of anticoagulation therapies on dementia were included. A total of 11 systematic reviews and meta-analyses were included in this umbrella review. Findings from 6 systematic reviews showed that OAC use was associated with a reduced risk of incident dementia in patients with AF, with effect estimates (RR/HR) ranging from 0.46 [0.28-0.78] to 0.79 [0.67-0.93]. For DOACs versus VKAs, most studies found a lower risk of dementia with DOACs, with effect sizes ranging from HR: 0.51 [0.37-0.71] to RR: 0.88 [0.82-0.94]. However, two studies found no significant difference between DOACs and warfarin in dementia risk (OR: 0.65 [0.34-1.25] and RR: 0.91 [0.75-1.12], respectively). Anticoagulation therapy, particularly with DOACs, may help reduce the risk of dementia in AF patients. The evidence remains of moderate to low certainty, and further high-quality, long-term randomized controlled trials are needed to confirm these findings and explore the neuroprotective mechanisms of OACs.</p>","PeriodicalId":51199,"journal":{"name":"Trends in Cardiovascular Medicine","volume":" ","pages":""},"PeriodicalIF":9.0,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-13DOI: 10.1016/j.tcm.2026.01.001
Alexander Ibrahim, Shyla Gupta, Ergi Duli, Souzan Yacob, Amin Meghdadi, Nicole Langleben, Shaun Malik, Sergio Juan Baratta, Antonio Arauz, Adrian Baranchuk
Parkinson's disease (PD) is a synucleinopathy best known for its motor symptoms, but emerging research shows it also impacts the cardiovascular system. In this paper, we explore the association between PD and cardiovascular disease (CVD), reviewing six key categories: cardiac dysautonomia, coronary artery disease, arrhythmias, cardiomyopathy, heart valve disease, and heart failure. We also discuss risk factors, epidemiology, and overlapping pathophysiology. Cardiac dysautonomia is the most frequently reported cardiovascular issue in PD and includes orthostatic hypotension, postprandial hypotension, supine hypertension, and nocturnal non-dipping blood pressure. PD also appears to be positively associated with coronary artery disease. Early-stage PD is linked to atrial fibrillation, but overall, there is no consistent increase in arrhythmias outside of certain PD medications. Structural and functional cardiac changes such as left ventricular hypertrophy and diastolic dysfunction have also been reported in PD, which may predispose to heart failure and cardiomyopathy. Dopamine agonists pergolide and cabergoline are associated with valve regurgitation, but this seems to be drug-related rather than caused by PD. Shared risk factors like aging, male sex, diabetes, and inflammation help explain the PD-CVD connection. However, some CVD risk factors like high LDL and smoking are associated with lower PD risk. Autonomic dysfunction, impaired lipid and glucose metabolism, and chronic inflammation may all contribute to disease overlap. Our review consolidates existing research to highlight the importance of recognizing cardiovascular manifestations in PD, which may present before motor symptoms. This has important implications for earlier diagnosis, better screening, and more effective management of PD.
{"title":"Parkinson's disease & cardiovascular disease: A narrative review.","authors":"Alexander Ibrahim, Shyla Gupta, Ergi Duli, Souzan Yacob, Amin Meghdadi, Nicole Langleben, Shaun Malik, Sergio Juan Baratta, Antonio Arauz, Adrian Baranchuk","doi":"10.1016/j.tcm.2026.01.001","DOIUrl":"10.1016/j.tcm.2026.01.001","url":null,"abstract":"<p><p>Parkinson's disease (PD) is a synucleinopathy best known for its motor symptoms, but emerging research shows it also impacts the cardiovascular system. In this paper, we explore the association between PD and cardiovascular disease (CVD), reviewing six key categories: cardiac dysautonomia, coronary artery disease, arrhythmias, cardiomyopathy, heart valve disease, and heart failure. We also discuss risk factors, epidemiology, and overlapping pathophysiology. Cardiac dysautonomia is the most frequently reported cardiovascular issue in PD and includes orthostatic hypotension, postprandial hypotension, supine hypertension, and nocturnal non-dipping blood pressure. PD also appears to be positively associated with coronary artery disease. Early-stage PD is linked to atrial fibrillation, but overall, there is no consistent increase in arrhythmias outside of certain PD medications. Structural and functional cardiac changes such as left ventricular hypertrophy and diastolic dysfunction have also been reported in PD, which may predispose to heart failure and cardiomyopathy. Dopamine agonists pergolide and cabergoline are associated with valve regurgitation, but this seems to be drug-related rather than caused by PD. Shared risk factors like aging, male sex, diabetes, and inflammation help explain the PD-CVD connection. However, some CVD risk factors like high LDL and smoking are associated with lower PD risk. Autonomic dysfunction, impaired lipid and glucose metabolism, and chronic inflammation may all contribute to disease overlap. Our review consolidates existing research to highlight the importance of recognizing cardiovascular manifestations in PD, which may present before motor symptoms. This has important implications for earlier diagnosis, better screening, and more effective management of PD.</p>","PeriodicalId":51199,"journal":{"name":"Trends in Cardiovascular Medicine","volume":" ","pages":""},"PeriodicalIF":9.0,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145991746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-12DOI: 10.1016/j.tcm.2026.01.002
Massimo Imazio, Valentino Collini, Marco Merlo, Alberto Aimo, Camillo Autore, Andrea Barison, Barbara Bauce, Elena Biagini, Francesco Cappelli, Silvia Castelletti, Flavio D'Ascenzi, Cesare De Gregorio, Francesca Marzo, Beatrice Musumeci, Roberto Pedrinelli, Stefania Paolillo, Pasquale Perrone-Filardi, Giuseppe Limongelli, Gianfranco Sinagra
The 2025 European Society of Cardiology (ESC) guidelines and the 2024-2025 American College of Cardiology (ACC) consensus documents redefine the management of myocarditis and pericarditis, with notable convergence, yet key differences. Both emphasize early, accurate diagnosis, particularly through cardiac magnetic resonance (CMR), which now often supersedes immediate biopsy in stable, uncomplicated cases of acute myocarditis. The ESC introduces a unified "inflammatory myopericardial syndrome" (IMPS) framework encompassing myocarditis, pericarditis, and overlap syndromes, while the ACC provides separate pathways, including a novel four-stage clinical classification of myocarditis. Therapeutically, both endorse non-steroidal anti-inflammatory drugs (NSAIDs) and colchicine for pericarditis and myopericarditis, and heart failure-directed therapy for myocarditis, while reserving immunosuppression for select cases. Importantly, interleukin-1 (IL-1) blockade has emerged as a pivotal therapy in recurrent pericarditis, receiving a Class I recommendation in ESC guidelines and strong endorsement in ACC guidance. Prognostic assessment focuses on identifying high-risk features and structured follow-up with imaging and biomarkers. Divergences in terminology, staging, and diagnostic thresholds underscore opportunities for further harmonization. The ESC and ACC documents align in a patient-tailored, evidence-informed approach to management.
{"title":"Myocarditis and pericarditis in focus: A critical appraisal of the 2025 ESC vs ACC position statements from the Italian society of cardiology working group on cardiomyopathies and pericardial diseases.","authors":"Massimo Imazio, Valentino Collini, Marco Merlo, Alberto Aimo, Camillo Autore, Andrea Barison, Barbara Bauce, Elena Biagini, Francesco Cappelli, Silvia Castelletti, Flavio D'Ascenzi, Cesare De Gregorio, Francesca Marzo, Beatrice Musumeci, Roberto Pedrinelli, Stefania Paolillo, Pasquale Perrone-Filardi, Giuseppe Limongelli, Gianfranco Sinagra","doi":"10.1016/j.tcm.2026.01.002","DOIUrl":"10.1016/j.tcm.2026.01.002","url":null,"abstract":"<p><p>The 2025 European Society of Cardiology (ESC) guidelines and the 2024-2025 American College of Cardiology (ACC) consensus documents redefine the management of myocarditis and pericarditis, with notable convergence, yet key differences. Both emphasize early, accurate diagnosis, particularly through cardiac magnetic resonance (CMR), which now often supersedes immediate biopsy in stable, uncomplicated cases of acute myocarditis. The ESC introduces a unified \"inflammatory myopericardial syndrome\" (IMPS) framework encompassing myocarditis, pericarditis, and overlap syndromes, while the ACC provides separate pathways, including a novel four-stage clinical classification of myocarditis. Therapeutically, both endorse non-steroidal anti-inflammatory drugs (NSAIDs) and colchicine for pericarditis and myopericarditis, and heart failure-directed therapy for myocarditis, while reserving immunosuppression for select cases. Importantly, interleukin-1 (IL-1) blockade has emerged as a pivotal therapy in recurrent pericarditis, receiving a Class I recommendation in ESC guidelines and strong endorsement in ACC guidance. Prognostic assessment focuses on identifying high-risk features and structured follow-up with imaging and biomarkers. Divergences in terminology, staging, and diagnostic thresholds underscore opportunities for further harmonization. The ESC and ACC documents align in a patient-tailored, evidence-informed approach to management.</p>","PeriodicalId":51199,"journal":{"name":"Trends in Cardiovascular Medicine","volume":" ","pages":""},"PeriodicalIF":9.0,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145985188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-03DOI: 10.1016/j.tcm.2025.12.009
Onyedika J Ilonze, Larry A Allen
{"title":"Cannabis and cardiovascular disease: Can we cut through the haze to clarify the risks and benefits?","authors":"Onyedika J Ilonze, Larry A Allen","doi":"10.1016/j.tcm.2025.12.009","DOIUrl":"10.1016/j.tcm.2025.12.009","url":null,"abstract":"","PeriodicalId":51199,"journal":{"name":"Trends in Cardiovascular Medicine","volume":" ","pages":""},"PeriodicalIF":9.0,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145906919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.tcm.2025.07.006
Tingting Zheng , Xinqiao Lian , Wenli Zhou , Li Li , Arlene Sirajuddin , Minjie Lu
Cardiac tumors are very rare and their diagnosis and treatment remain challenging. Cardiac magnetic resonance imaging is considered the gold standard for noninvasive diagnosis because of its larger field of view, excellent tissue contrast, multiplanar imaging, and the unique ability to differentiate between different tissue features. CMR can effectively identify cardiac non-neoplastic and neoplastic mass, as well as benign and malignant tumors. This review summarizes the new technology of CMR, diagnosis, differential diagnosis and prognosis in cardiac primary tumor, especially the role of new technologies in cardiac primary tumors.
{"title":"State-of-the-art review:Cardiac magnetic resonance imaging in primary cardiac tumors","authors":"Tingting Zheng , Xinqiao Lian , Wenli Zhou , Li Li , Arlene Sirajuddin , Minjie Lu","doi":"10.1016/j.tcm.2025.07.006","DOIUrl":"10.1016/j.tcm.2025.07.006","url":null,"abstract":"<div><div>Cardiac tumors are very rare and their diagnosis and treatment remain challenging. Cardiac magnetic resonance imaging is considered the gold standard for noninvasive diagnosis because of its larger field of view, excellent tissue contrast, multiplanar imaging, and the unique ability to differentiate between different tissue features. CMR can effectively identify cardiac non-neoplastic and neoplastic mass, as well as benign and malignant tumors. This review summarizes the new technology of CMR, diagnosis, differential diagnosis and prognosis in cardiac primary tumor, especially the role of new technologies in cardiac primary tumors.</div></div>","PeriodicalId":51199,"journal":{"name":"Trends in Cardiovascular Medicine","volume":"36 1","pages":"Pages 15-24"},"PeriodicalIF":9.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号