Opinion in 2017

In this Perspectives article, Rodés-Cabau and colleagues discuss the evolving indications and future applications of transcatheter aortic valve implantation (TAVI). The steady improvement in prosthetic heart valves and the development of novel devices have enabled the continued expansion of TAVI indications, including the use of this procedure in low-risk patients or in aortic pathologies such as pure aortic regurgitation and bicuspid valve disease.

Several macromolecular structures coexist in the intercalated discs, which connect cardiomyocytes and control cell-to-cell communication. In this Perspectives article, Moncayo-Arlandi and Brugada suggest that the structures of the intercalated disc form an interactive 'connexome'. They also propose a link between arrhythmogenic cardiomyopathy and Brugada syndrome on the basis of overlapping genetic, molecular, and pathophysiological mechanisms.

In this Perspectives article, Ruilope and colleagues discuss the relevance and caveats of the SPRINT trial, with particular focus on patient cohort characteristics, the method used to measure blood-pressure levels, and applicability of the SPRINT blood-pressure targets in real-world clinical practice and future hypertension management guidelines.

In this Perspectives article, Lauer and colleagues discuss the causes for the increasing costs and inefficiencies in current clinical research, and provide potential strategies to transform clinical research business models, highlighting examples of innovative approaches that have been used successfully to conduct large-scale clinical trials and epidemiological research at relatively low cost.