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Volume 21 Issue 4, April 2024

Global echocardiography for rheumatic heart disease, inspired by the Evidence-based Guidelines on p250.

Cover design: Vicky Summersby

Comment

  • In this Comment, we critically examine the association between the increasing consumption of ultra-processed foods and their negative effect on cardiovascular health. We explore the historical evolution of food processing, the Nova food classification and the epidemiological evidence, and highlight the need for urgent public health interventions.

    • Fernanda Rauber
    • Renata Bertazzi Levy
    Comment

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Clinical Outlook

  • A molecular autopsy is undertaken in cases of sudden cardiac death with no definitive cause found after conventional autopsy, with the aim of identifying a pathological genetic variant that could account for the death. Greater awareness of malignant arrhythmias in the absence of structural changes in inherited cardiomyopathies has increased the applicability of molecular autopsies, and resulted in improved care of families but new challenges for clinicians.

    • Julia C. Isbister
    • Christopher Semsarian
    Clinical Outlook
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Research Highlights

  • A study shows that congenital heart defects in Down syndrome are in part caused by increased dosage of the DYRK1A gene, which lies on chromosome 21, leading to reduced proliferation and mitochondrial dysfunction in cardiomyocytes.

    • Irene Fernández-Ruiz
    Research Highlight
  • Using a porcine model of cardiogenic shock, Lamberti and colleagues develop a clinically accessible, patient-validated metric to assess pulmonary vascular compliance that can predict tolerance to left-sided ventricular assist device support.

    • Karina Huynh
    Research Highlight
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Reviews

  • The NLRP3 inflammasome can sense cardiac ischaemic and non-ischaemic injury, amplify the inflammatory response and induce inflammatory cell death. In this Review, Toldo and Abbate describe the role of the NLRP3 inflammasome in numerous cardiac pathologies and summarize evidence on the use of agents targeting the NLRP3 inflammasome and related cytokines.

    • Stefano Toldo
    • Antonio Abbate
    Review Article
  • Low socioeconomic position (SEP) is associated with an increased risk of cardiovascular disease (CVD), but whether this association is causal is uncertain. In this Review, Bann and colleagues discuss how evidence from divergent study designs can help in understanding the causal relationship between SEP and CVD and how this relationship might have been affected by the COVID-19 pandemic.

    • David Bann
    • Liam Wright
    • Nish Chaturvedi
    Review Article
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Evidence-based Guidelines

  • A panel of experts from the World Heart Federation provide a revised set of guidelines for the echocardiographic detection of rheumatic heart disease (RHD) in patients living in RHD-endemic regions. The guidelines provide updated screening and confirmatory criteria, as well as a new stage-based classification of RHD based on risk of disease progression, which will improve the diagnosis and subsequent management of patients with RHD.

    • Joselyn Rwebembera
    • James Marangou
    • Bo Reményi
    Evidence-based Guidelines
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Perspectives

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