US cardiology最新文献

Heart failure (HF) care has increased in complexity over the past decade, with a higher number of interventions and medications offered to patients as part of routine HF care. Studies have consistently shown poor patient understanding of their HF diagnosis and treatment plans, impacting their overall outcomes. Effective communication and literacy-concordant patient education are two key players in comprehensive disease understanding. However, wide variability in HF patient education and the usage of literacy-discordant material have resulted in ineffective patient education, further contributing to fragmented patient understanding of their HF diagnosis. Innovative interventions targeting communication strategies and education delivery methods could significantly alter care delivery and improve multiple domains in HF care.

Mitral annular disjunction (MAD) is an underdiagnosed structural abnormality of the mitral valve apparatus in which the mitral leaflet hinge point is towards the atrium. MAD is associated with mitral valve prolapse and, importantly, increased rates of ventricular arrhythmias, and sudden cardiac death. In this case report and review, we describe the case of a 37-year-old man incidentally found to have MAD during a workup for paroxysmal atrial fibrillation and review the existing literature on the epidemiology, diagnostic methods, natural history, and clinical implications of MAD. Our goal is to highlight important gaps in current guidelines regarding the optimal treatment of patients with MAD.

Transthyretin amyloid cardiomyopathy (ATTR-CM) has transitioned from an underdiagnosed condition to a rapidly evolving therapeutic frontier. This review highlights the expanding treatment landscape, beginning with evidence from key clinical trials for transthyretin tetramer stabilizers and RNA silencers, and extending to novel therapies including gene-editing agents and monoclonal antibody-based fibril depleters. We summarize pivotal trial data - including the ATTR-ACT, HELIOS-B, and APOLLO-B trials - and describe ongoing investigations aimed at broadening therapeutic options. Practical considerations such as route and frequency of administration, tolerability, and regulatory status are outlined to support clinical decision-making. A dedicated section on limitations and special populations addresses the generalizability of trial findings to the diverse patients encountered in practice. Finally, we explore key unresolved questions, including the need for head-to-head comparative trials, the potential role of combination therapy, and the optimal timing for initiating treatment as earlier recognition becomes more common. As novel therapies gain approval this review serves as a timely, focused resource to support clinicians managing ATTR-CM.

Heart failure (HF) is a clinical syndrome characterized by signs and symptoms resulting from any structural or functional deficiency of ventricular filling or blood ejection. The mainstay of initial treatment remains lifestyle modifications, guideline-directed medical therapy, and addressing contributing factors. However, the past two decades have come with significant advances in device therapies to improve morbidity and mortality in HF despite evidence-based management as above. Given the rapidly evolving area of HF research and therapeutic development, it is important for clinicians to be familiar with novel therapies and how they can complement medical management. In this review we discuss the current landscape of novel non-surgical device therapies in HF, their respective trials, major outcomes, and their mechanisms of action and target pathways.

This novel invited article is thanks to CardioNerds: a podcast and platform that democratizes cardiovascular education and invigorates passion for cardiovascular medicine and science. The CardioNerds team held an adult congenital heart disease artistic creations competition in early 2025 for which I (Jamil Aboulhosn) was honored to be selected as winner and asked to publish a piece in this journal, highlighting the role that art plays in my practice of adult congenital cardiology. By sharing select pieces from over the years I will try to take the reader on a short journey through how art helps me understand and teach anatomy, develop interventional and surgical procedures, express emotion, and unwind.

Exercise-induced long QT may mimic congenital long QT syndrome (LQTS), risking misdiagnosis and unnecessary treatment. This scoping review explores its reversibility through detraining and differentiation from congenital LQTS. A systematic search of five databases identified six studies involving 196 subjects. Results showed that exercise-induced long QT is reversible, with QT intervals normalizing after detraining, typically over 1-6 months. Unlike congenital LQTS, affected athletes often lacked genetic mutations or family histories linked to the condition. The difference between congenital LQTS and exercise-induced long QT lies in the reversibility of QT interval prolongation. In those with exercise-induced long QT, the prolonged QT interval would return to normal levels with detraining, unlike in congenital LQTS. Further long-term follow-up is needed to assess the potential arrhythmic risk associated with re-exposure to intensive training. Additionally, negative genetic testing and absence of family history do not entirely exclude congenital LQTS nor indicate benignity, emphasizing the need for careful clinical assessment beyond these factors.

Cardiogenic shock (CS) is a severe and life-threatening condition caused by the heart's inability to provide adequate blood flow, leading to systemic hypoperfusion and multiorgan dysfunction. While acute MI and heart failure with reduced ejection fraction are common causes of CS, restrictive cardiomyopathy (RCM) presents a unique challenge due to its underlying hemodynamic complexities related to myocardial stiffness. RCM is characterized by preserved systolic function but impaired ventricular filling, resulting in elevated diastolic pressures and a tendency for rapid decompensation into shock. This review explores the pathophysiology, diagnostic evaluation, and management of CS in RCM. Diagnostic tools such as echocardiography and hemodynamic monitoring are critical for differentiating the causes of CS. Treatment strategies focus on optimizing volume status, arrhythmia control, and, in some cases, mechanical circulatory support. Heart transplantation remains the definitive treatment for eligible patients. Early recognition and tailored interventions are essential for the enhancement of survival and quality of life in these critically ill patients.

We present the case of a 45-year-old woman (62 kg, 160 cm) who suffered an ischemic stroke associated with patent foramen ovale (PFO) with high-risk anatomical features. The defect was percutaneously closed using a LifeTech CeraFlex PFO 30 mm × 25 mm device deployed via a 12 Fr sheath after multiple implantation attempts. Following release, the right atrial disc exhibited a concave deformation, termed the 'inverted tulip,' which prolonged the procedure and resulted in a significant residual shunt. The shunt resolved spontaneously at the 1-month echocardiographic follow-up.