Trends in Cardiovascular Medicine最新文献

{"title":"Psychological and emotional drivers of atherosclerotic cardiovascular disease: Screening the brain to protect the heart.","authors":"Karim Atmani, Marmar Vaseghi","doi":"10.1016/j.tcm.2025.11.001","DOIUrl":"10.1016/j.tcm.2025.11.001","url":null,"abstract":"","PeriodicalId":51199,"journal":{"name":"Trends in Cardiovascular Medicine","volume":" ","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460379","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}

{"title":"The evidence for treatments for postural orthostatic tachycardia syndrome: a systematic review of randomized trials","authors":"Chun Shing Kwok ,&nbsp;Soyoung Lee ,&nbsp;Mark Hall ,&nbsp;Adnan I. Qureshi ,&nbsp;Gregory Y.H. Lip ,&nbsp;Yoon K Loke ,&nbsp;Satish R Raj ,&nbsp;Eric Holroyd","doi":"10.1016/j.tcm.2025.07.001","DOIUrl":"10.1016/j.tcm.2025.07.001","url":null,"abstract":"<div><div>Postural orthostatic tachycardia syndrome (POTS) is defined as the presence of chronic symptoms of orthostatic intolerance accompanied by an increase in heart rate greater than 30 beats per minute within 10 min of assuming an upright posture in the absences of orthostatic hypotension. It is a condition which lacks a definitive treatment strategy, with weak evidence and clinical expertise to support the available guidelines from the Heart Rhythm Society in 2015 and the Canadian Cardiovascular Society in 2020. The limited systematic reviews evaluating the treatment for POTS only reported three or fewer trials when many more trials have been published.</div><div>In this systematic review, we evaluate the evidence for different treatments for POTS from 21 randomized clinical trials with 750 patients that took place between 2000 and 2023. This review summarizes the available evidence from trials on propranolol, midodrine, pyridostigmine and ivabradine as well as less commonly used medications such as desmopressin, melatonin, atomoxetine, modafinil, sertraline and intravenous immunoglobulins. Moreover, the trial evidence for non-pharmacological treatments is described including increase intake of dietary sodium, exercise training, compression and devices. We conclude that many small trials have evaluated different treatments for POTS. Large randomized trials are needed to determine if mainstay treatments beta-blockers, midodrine, and pyridostigmine should be used as first line treatment(s).</div></div>","PeriodicalId":51199,"journal":{"name":"Trends in Cardiovascular Medicine","volume":"35 8","pages":"Pages 517-527"},"PeriodicalIF":9.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627700","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}

{"title":"Editorial commentary: Low density lipoprotein (LDL) and beyond in the treatment and prevention of cardiovascular disease","authors":"John Dunn ,&nbsp;Charles H. Hennekens","doi":"10.1016/j.tcm.2025.07.005","DOIUrl":"10.1016/j.tcm.2025.07.005","url":null,"abstract":"","PeriodicalId":51199,"journal":{"name":"Trends in Cardiovascular Medicine","volume":"35 8","pages":"Pages 539-540"},"PeriodicalIF":9.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683565","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}

{"title":"Pushing the limits of LDL cholesterol: Emerging paradigms in cardiovascular risk reduction","authors":"Dadmehr Yaghoubi ,&nbsp;Tamer Sallam","doi":"10.1016/j.tcm.2025.07.002","DOIUrl":"10.1016/j.tcm.2025.07.002","url":null,"abstract":"<div><div>LDL cholesterol (LDL-C) has long been recognized as a primary contributor to cardiovascular disease. Over time, guideline-recommended LDL-C targets have varied considerably, trending toward progressively more aggressive therapeutic goals. The focus on residual risk reduction and development of novel therapies—including PCSK9 inhibitors, siRNA-based treatments, and ANGPTL3 inhibitors—have significantly expanded the options for achieving unprecedentedly low LDL-C levels. Given the fundamental role of cholesterol in cellular function, it has been long been postulated that very low cholesterol could be associated with adverse events. In this review, we dissect the benefits and potential risks of very low LDL-C levels. We begin by providing an overview of the evolution of LDL-C targets in previous guidelines and highlighting therapies—including newer agents—used for aggressive LDL-C lowering. Drawing on clinical and genetic evidence, we then examine the benefits and risks associated with achieving very low LDL-C levels. Finally, we present a practical framework for balancing the potential risks and benefits of intensive LDL-C reduction in patient care.</div></div>","PeriodicalId":51199,"journal":{"name":"Trends in Cardiovascular Medicine","volume":"35 8","pages":"Pages 530-538"},"PeriodicalIF":9.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644100","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}

{"title":"Etiology-specific survival and reoperation trends following surgical mitral valve repair and replacement: A meta-analysis of reconstructed time-to-event data","authors":"Mohammed Al-Tawil ,&nbsp;Serge Sicouri ,&nbsp;Yoshiyuki Yamashita ,&nbsp;Basel Ramlawi","doi":"10.1016/j.tcm.2025.06.002","DOIUrl":"10.1016/j.tcm.2025.06.002","url":null,"abstract":"<div><div>Current American and European guidelines recommend mitral valve repair<span> (MVr) over replacement (MVR) whenever feasible. However, these recommendations are primarily based on data from patients with degenerative mitral regurgitation<span><span><span><span> (DMR), whereas evidence supporting MVr in other etiologies, such as infective endocarditis (IE) or ischemic mitral regurgitation (IMR), remains less conclusive. We systematically searched for and identified studies published after 2000 that compared MVr and </span>MVR in patients with specific </span>mitral valve disease<span> etiologies, including DMR, IE, IMR, and rheumatic heart disease (RHD). A total of 61 records (10 DMR, 21 IE, 18 IMR, and 12 RHD) of 59 studies published between 2005 and 2024, were included. MVr consistently demonstrated superior survival compared to MVR in DMR and IE patients. Parametric time-varying hazard ratios revealed a sustained survival benefit of MVr in DMR and IE, whereas in IMR and RHD, the survival advantage was transient—lasting only up to six months and 2.7 years postoperatively, respectively—after which survival hazards between MVr and MVR became comparable. This was further corroborated by the results of a two-year landmark and the propensity-matched subgroup analyses. In DMR, MVr was associated with lower </span></span>reoperation rates compared to MVR; however, in IE, IMR, and RHD, MVr was associated with significantly higher reoperation rates compared to MVR. Our study supports current guidelines favoring MVr over MVR, demonstrating sustained survival benefits in DMR. In IE-specific MR, MVr also showed consistent benefits over MVR, demonstrating that MVr should be prioritized when feasible. However, in IMR and RHD, there was no notable survival advantage of MVr over MVR, with higher reoperation rates observed with MVr. These findings highlight the need for etiology-specific and individualized surgical planning.</span></span></div></div>","PeriodicalId":51199,"journal":{"name":"Trends in Cardiovascular Medicine","volume":"35 8","pages":"Pages 485-494"},"PeriodicalIF":9.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295354","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}

{"title":"Editorial commentary: Navigating the long-term landscape of mitral valve interventions in different mitral diseases","authors":"Francesco Formica","doi":"10.1016/j.tcm.2025.07.010","DOIUrl":"10.1016/j.tcm.2025.07.010","url":null,"abstract":"","PeriodicalId":51199,"journal":{"name":"Trends in Cardiovascular Medicine","volume":"35 8","pages":"Pages 495-496"},"PeriodicalIF":9.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765750","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}

{"title":"Single pill combination therapy for hypertension: New evidence and new challenges","authors":"Martin Rosas-Peralta ,&nbsp;Giuseppe Mancia ,&nbsp;Miguel Camafort ,&nbsp;Héctor Galván-Oseguera ,&nbsp;Carlos M. Ferrario ,&nbsp;Luis Alcocer ,&nbsp;Ernesto Cardona-Muñoz ,&nbsp;Humberto Álvarez-López ,&nbsp;Silvia Palomo-Piñón ,&nbsp;Adolfo Chávez-Mendoza ,&nbsp;Enrique Díaz-Díaz ,&nbsp;José M Enciso-Muñoz","doi":"10.1016/j.tcm.2025.06.004","DOIUrl":"10.1016/j.tcm.2025.06.004","url":null,"abstract":"<div><div>Hypertension (HTN) continues to be one of the most important risk factors for major cardiovascular events and mortality. The global prevalence of hypertension is approximately 30% among adults over 20 years old. Cardiovascular risk stratification is crucial to determine the most appropriate pharmacological therapeutic strategy for hypertensive patients. Despite the many scales to stratify risk, none is perfect and represents weighted mathematical models to determine risk at 10 years. Reports have identified numerous limitations, and the challenge persists. A practical way to determine CV risk is the clinical approach based on 1) the number of risk factors, 2) the degree of elevation of blood pressure, 3) the presence of target organ damage/DM/CKD, and 4) a history of major cardiovascular events. Currently, it is recommended to start with dual therapy in a single pill (either ACE inhibitors or ARB2 + dihydropyridine calcium channel blockers or thiazide/thiazide-like diuretic); however, many patients could need to start with triple therapy (low or standard doses) if they belong to the high- or very high-risk group with elevation grade 2 or 3 of blood pressure. This article discusses this topic and establishes some practical recommendations for the physician of first contact.</div></div>","PeriodicalId":51199,"journal":{"name":"Trends in Cardiovascular Medicine","volume":"35 8","pages":"Pages 497-503"},"PeriodicalIF":9.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561848","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}

{"title":"Editorial commentary: Single pill combination therapy for hypertension management: Clinical benefits and considerations","authors":"Keisuke Narita","doi":"10.1016/j.tcm.2025.06.007","DOIUrl":"10.1016/j.tcm.2025.06.007","url":null,"abstract":"","PeriodicalId":51199,"journal":{"name":"Trends in Cardiovascular Medicine","volume":"35 8","pages":"Pages 504-505"},"PeriodicalIF":9.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555657","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}

{"title":"Editorial commentary: Inflammation and arrhythmias – the never-ending quest for actionable items","authors":"Alessio Gasperetti ,&nbsp;Pasquale Santangeli","doi":"10.1016/j.tcm.2025.07.004","DOIUrl":"10.1016/j.tcm.2025.07.004","url":null,"abstract":"","PeriodicalId":51199,"journal":{"name":"Trends in Cardiovascular Medicine","volume":"35 8","pages":"Pages 483-484"},"PeriodicalIF":9.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668961","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}

{"title":"Inflammasome and ventricular arrhythmogenesis: Pathogenic interplay and potential targets on the horizon","authors":"Maria Lucia Narducci ,&nbsp;Cristina Conte ,&nbsp;Alessandro Telesca ,&nbsp;Giovanna Liuzzo ,&nbsp;Massimo Imazio","doi":"10.1016/j.tcm.2025.05.006","DOIUrl":"10.1016/j.tcm.2025.05.006","url":null,"abstract":"<div><div><span><span><span>Life-threatening ventricular arrhythmias (VAs) pose a significant challenge in clinical management due to their impact on mortality, particularly the risk of </span>sudden cardiac death<span><span>, which remains a concern despite the use of only partially effective anti-arrhythmic drugs and repeated catheterablation. There is also a need for more precise risk stratification tools for </span>implantable cardioverter defibrillators<span> (ICD). Sustained ventricular tachycardia (VT) most commonly occurs in patients with a history of myocardial infarction (MI) or </span></span></span>non ischemic cardiomyopathy<span> characterized by fibrotic ventricular scars, which can be identified as areas of late gadolinium enhancement (LGE) through </span></span>cardiac magnetic resonance<span><span><span> or as low-voltage areas via three-dimensional electroanatomic mapping. Both the presence and extent of cardiac fibrosis<span><span> are linked to ventricular arrhythmogenesis<span> and the risk of sudden death. </span></span>Fibrosis<span> contributes to VAs for several reasons; primarily, it causes structural remodelling that alters the myocardial architecture and promotes reentry circuits. On this regard, increasing evidence highlights the role of inflammation mediated by the NLR family pyrin domain containing 3 (NLRP3) </span></span></span>inflammasome as a key factor in scar development, cardiac electrical instability, and </span>disease progression<span><span>. Secondly, systemic and local sympathetic hyperactivity significantly contribute to electrical instability. The interplay between inflammation, cardiac fibrosis and sympathetic hyperactivity has been neglected for a long time. However, a deep insight in the pathogenesis of VAs is warranted in order to develop new and tailored pharmacological strategies. Therefore, the </span>NLRP3 inflammasome<span> pathway, autonomic imbalance, and early stage of myocardial fibrosis may represent promising therapeutic targets for mitigating adverse ventricular remodeling<span> and the burden of VAs. On this basis of multiple evidence, inflammation plays a role of trigger in a hypothetical Coumel’s triangle of arrhythmogenesis for the pathogenesis of VAs, where the ventricular substrate is represented by cardiac fibrosis, and the favoring modulating factor is provided by sympathetic hyperactivity.</span></span></span></span></div></div>","PeriodicalId":51199,"journal":{"name":"Trends in Cardiovascular Medicine","volume":"35 8","pages":"Pages 479-482"},"PeriodicalIF":9.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295355","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}