Prerna Gupta, Mario Enrico Canonico, Christian Faaborg-Andersen, Nicole Prabhu, Lavanya Kondapalli, Raymundo A Quintana
PURPOSE OF REVIEW: To provide a comprehensive review of hypertension among patients with cancer. Several cancer therapies cause hypertension which has resulted in a growing and vulnerable population of patients with difficult to control hypertension which has significant downstream effects. RECENT FINDINGS: Hypertension affects up to 50% of cancer patients and higher comorbidity when compared to the general population. Many anticancer therapies can cause hypertension through their treatment effect...
February 26, 2024: Current Opinion in Cardiology
Rebecca Josowitz, Lindsay S Rogers
PURPOSE OF REVIEW: There has been much variability in the definition of double outlet right ventricle (DORV) spanning the last century. Historically, emphasis has been placed on the assignment of the great arteries to the right ventricle as a definition of DORV. In this review, we aim to underscore the importance of conal muscle, rather than rules surrounding assignment of great arteries to ventricles. We will be outlining the variability in patient anatomy that results from variations in conal muscle development in DORV, which may not fit perfectly into predefined constructs...
February 26, 2024: Current Opinion in Cardiology
Alfred Ngo-Hamilton, Dzhalal Agakishiev, Valmiki Maharaj
PURPOSE OF REVIEW: This review synthesizes recent research on the efficacy, optimal design, and delivery methods of cardiac rehabilitation tailored to heart failure patients. Despite established benefits, cardiac rehabilitation referral and access disparities persist, necessitating elucidation of limitations and solutions. RECENT FINDINGS: Exercise-based cardiac rehabilitation improves long-term mortality and hospitalization rates but not short-term mortality. cardiac rehabilitation further enhances quality of life and medical therapy adherence...
February 26, 2024: Current Opinion in Cardiology
Ana Paula Tagliari, Rodrigo Petersen Saadi, Gilbert H L Tang
PURPOSE OF REVIEW: This review offers insights into percutaneous mitral valve management, emphasizing pivotal trials that contributed to its evolution. RECENT FINDINGS: Mitral regurgitation (MR) is a highly prevalent heart valve disease, with surgical intervention being the gold standard for managing primary MR. However, a notable proportion of patients face ineligibility criteria or are at high surgical risk, particularly in the setting of secondary MR. To fill this gap, transcatheter therapies have emerged as less invasive alternatives...
February 26, 2024: Current Opinion in Cardiology
Emanuele Monda, Martina Caiazza, Giuseppe Limongelli
PURPOSE OF REVIEW: This review aims to delineate the genetic basis of Marfan syndrome (MFS) and underscore the pivotal role of genetic testing in the diagnosis, differential diagnosis, genotype-phenotype correlations, and overall disease management. RECENT FINDINGS: The identification of pathogenic or likely pathogenic variants in the FBN1 gene, associated with specific clinical features such as aortic root dilatation or ectopia lentis, is a major diagnostic criterion for MFS...
February 22, 2024: Current Opinion in Cardiology
Jane C Figueiredo, Neil Adri Bhowmick, Anja Karlstaedt
PURPOSE OF REVIEW: The relationship between metabolism and cardiovascular diseases is complex and bidirectional. Cardiac cells must adapt metabolic pathways to meet biosynthetic demands and energy requirements to maintain contractile function. During cancer, this homeostasis is challenged by the increased metabolic demands of proliferating cancer cells. RECENT FINDINGS: Tumors have a systemic metabolic impact that extends beyond the tumor microenvironment. Lipid metabolism is critical to cancer cell proliferation, metabolic adaptation, and increased cardiovascular risk...
February 22, 2024: Current Opinion in Cardiology
Cara E Saxon, Julia Bast, Josephine C Chou
PURPOSE OF REVIEW: Hypertensive disorders of pregnancy (HDP) pose a significant threat to maternal cardiovascular health, with emerging research shedding light on the enduring risks beyond the gestational period. This review highlights updates regarding cardiovascular risks associated with HDP and their implications for long-term health. RECENT FINDINGS: Patients with a history of HDP are at an elevated risk of developing chronic hypertension, ischemic heart disease, stroke, valvular heart disease, and heart failure...
February 22, 2024: Current Opinion in Cardiology
Gregory R Jackson, Justin Durland, Frank Hoyland
PURPOSE OF REVIEW: This review addresses the evolving intersection of sleep-disordered breathing (SDB) and heart failure, a topic of increasing clinical significance due to the high prevalence of SDB in heart failure patients and its impact on morbidity and mortality. It reflects recent advancements in diagnostic methodologies and therapeutic strategies. It emphasizes the need for heightened awareness among healthcare providers about the complex relationship between SDB and various forms of heart failure...
February 20, 2024: Current Opinion in Cardiology
Art Schuermans, Frederik H Verbrugge
PURPOSE OF REVIEW: To summarize the contemporary evidence on decongestion strategies in patients with acute heart failure (AHF). RECENT FINDINGS: While loop diuretic therapy has remained the backbone of decongestive treatment in AHF, multiple randomized clinical trials suggest that early combination with other diuretic classes or molecules with diuretic properties should be considered. Mineralocorticoid receptor antagonists and sodium-glucose co-transporter-2 inhibitors are disease-modifying drugs in heart failure that favourably influence prognosis early on, advocating their start as soon as possible in the absence of any compelling contraindications...
February 19, 2024: Current Opinion in Cardiology
Stormi E Gale, Andrew Willeford, Katherine Sandquist, Kristin Watson
PURPOSE OF REVIEW: Iron deficiency is common in patients with heart failure, affecting up to half of ambulatory patients and an even greater percentage of patients admitted for acute decompensation. Iron deficiency in this population is also associated with poor outcomes, including worse quality of life in addition to increased hospitalizations for heart failure and mortality. Evidence suggests that patients with iron deficiency in heart failure may benefit from repletion with IV iron...
February 15, 2024: Current Opinion in Cardiology
Abigail White, Anna Zarzycki, Gianluigi Bisleri
PURPOSE OF REVIEW: With the growing complexity of cardiac surgical cases, increased focus on patient safety, and minimally invasive techniques, simulation-based training has experienced a renaissance. This review highlights important elements of simulation-based training, focusing specifically on available simulators for mitral valve repair and the uses for simulation. RECENT FINDINGS: Referring to simulators as being high or low fidelity is oversimplified. Fidelity is a multifactorial concept, and for surgical task trainers, structural and functional fidelity should be discussed...
February 3, 2024: Current Opinion in Cardiology
Federico Capone, Natasha Nambiar, Gabriele G Schiattarella
PURPOSE OF REVIEW: Incretin-based drugs are potent weight-lowering agents, emerging as potential breakthrough therapy for the treatment of obesity-related phenotype of heart failure with preserved ejection fraction (HFpEF). In this review article, we will discuss the contribution of weight loss as part of the benefits of incretin-based medications in obese patients with HFpEF. Furthermore, we will describe the potential effects of glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) receptor agonists on the heart, particularly in relation to HFpEF pathophysiology...
January 31, 2024: Current Opinion in Cardiology
Raj Verma, Nitish K Dhingra, Kim A Connelly
PURPOSE OF REVIEW: Heart failure with preserved ejection fraction (HFpEF) is a leading and growing cause of morbidity and mortality globally. Of the various phenotypes identified, the obesity (or cardiometabolic) phenotype appears to be most common. The purpose of this review is to provide the clinician with an abridged understanding of recent developments that have elucidated obesity/visceral adiposity as a central mechanism linking inflammation/immune dysregulation to the development of the HFpEF syndrome...
January 26, 2024: Current Opinion in Cardiology
Radhika Neicheril, David Snipelisky
PURPOSE OF REVIEW: The role of inotropes has evolved with its use now expanding over multiple indications including cardiogenic shock, low cardiac output states, bridging therapy to transplant or mechanical support, and palliative care. There remains no consensus as to the recommended inotrope for the failing heart. We aim to provide an overview of the recent literature related to inotrope therapy and its application in patients with advanced heart failure and hemodynamic compromise. RECENT FINDINGS: In this review, we outline various clinical scenarios that warrant the use of inotrope therapy and the associated recommendations...
December 27, 2023: Current Opinion in Cardiology
Aliya Izumi, Akachukwu Nwakoby, Raj Verma, Bobby Yanagawa
PURPOSE OF REVIEW: Despite a growing emphasis on burnout in medicine, there remains a paucity of data in cardiac surgery. Herein, we summarize recent data on cardiac surgeon well being and identify factors for consideration in future burnout inquiries and management. RECENT FINDINGS: Overall, 70-90% of cardiothoracic surgeons report job satisfaction in the United States. However, 35-60% still endorse burnout symptoms, and the specialty reports some of the highest rates of depression (35-40%) and suicidal ideation (7%)...
December 21, 2023: Current Opinion in Cardiology
Vincent Chen, Omar Abdul-Jawad Altisent, Rishi Puri
PURPOSE OF REVIEW: The unique pathophysiologic considerations of severe tricuspid regurgitation (TR) have led to advancements in surgical and transcatheter treatments. The purpose of this review is to highlight the current surgical and transcatheter tricuspid valve interventions (TTVI) to functional TR. RECENT FINDINGS: Surgical repair with ring annuloplasty consistently demonstrates better outcomes than surgical replacement or other repair approaches. However, surgical uptake of TR correction remains relatively low, and operative mortality rates are still high owing to multiple comorbidities and advanced tricuspid valve disease/right ventricular dysfunction at time of referral...
December 19, 2023: Current Opinion in Cardiology
Max Puthenpura, Jennifer Wilcox, W H Wilson Tang
PURPOSE OF REVIEW: Worsening heart failure (WHF) has developed as a unique definition within heart failure (HF) in recent years. It captures the disease as a dynamic process. This review describes what is currently known about WHF, why it should be considered a discrete scientific endpoint, and future directions for research. RECENT FINDINGS: There is no single agreed upon definition for WHF. It can be identified as being due to treatment side-effects, related to concomitant comorbidity, or true disease progression...
December 19, 2023: Current Opinion in Cardiology
Mimi Xiaoming Deng, Batol Barodi, Malak Elbatarny, Terrence M Yau
PURPOSE OF REVIEW: Disparities in mitral valve (MV) repair outcomes exist between men and women. This review highlights sex-specific differences in MV disease aetiology, diagnosis, as well as timing and type of intervention. RECENT FINDINGS: Females present with more complicated disease: anterior or bileaflet prolapse, leaflet dysplasia/thickening, mitral annular calcification, and mixed mitral lesions. The absence of indexed echocardiographic mitral regurgitation (MR) severity parameters contributes to delayed intervention in women, resulting in more severe symptom burden at time of surgery...
December 7, 2023: Current Opinion in Cardiology
Savitri Fedson
PURPOSE OF REVIEW: The use of cardiac transplantation following circulatory death (DCD) has been limited worldwide. Concerns about cardiac function after warm ischemia and the potential for decreased graft function have been important considerations in this hesitancy. In addition, ethical and legal questions about the two widely used organ procurement methods have led to discussions and public education in many countries. RECENT FINDINGS: Publication of a US randomized trial of cardiac transplantation following DCD has shown that it is both feasible and has similar short-term outcomes compared with cardiac transplantation following brain death (DBD)...
March 1, 2024: Current Opinion in Cardiology
Philip Nolan, John W McEvoy
PURPOSE OF REVIEW: Given the adverse effects of excess dietary sodium chloride (also known as table salt) on blood pressure (BP) and cardiovascular disease (CVD), restriction of dietary sodium is recommended by numerous guidelines. The strictest of these recommend no more than 1.5 g/day of dietary sodium among hypertensive persons. However, average dietary sodium intake in the population is closer to 5 g/day and there is debate about whether too much sodium restriction may be associated with increased CVD risk...
January 1, 2024: Current Opinion in Cardiology
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