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For patients with heart failure and reduced left ventricular ejection fraction, intravenous iron is likely to deliver clinical and prognostic benefits for those with anaemia and transferrin saturation <20%, especially if serum ferritin exceeds 100 μg/l. A serum ferritin of <100 μg/l does not appear to be useful as a marker of iron deficiency.
Transcatheter aortic valve implantation (TAVI) has become an important treatment option for aortic stenosis, even among younger patients, with similar rates of efficacy as compared with surgical valve replacement. However, complications including device failure persist; these can be addressed by surgical explantation and repeat TAVI. Ongoing research emphasizes the long-term potential of TAVI as an alternative to surgical intervention for aortic stenosis.
The risk of stroke in patients with atrial high-rate episodes (AHREs) depends on age, comorbidities and AHRE burden. Two randomized clinical trials on the use of oral anticoagulant therapy for stroke prevention in older patients with short and rare AHREs have reported conflicting findings on the efficacy of oral anticoagulation in this patient population, although both trials report a significantly increased risk of major bleeding with oral anticoagulation.
Two new studies using cryo-electron microscopy describe the structure and conformation of myosin in the cardiac thick filaments and how it interacts with other thick-filament proteins, such as titin and cardiac myosin-binding protein C, in mammalian hearts.
Treatment with the small interfering RNA patisiran preserves functional capacity and improves health status and quality of life in patients with transthyretin cardiac amyloidosis, according to data from the 12-month double-blind period of the ongoing APOLLO-B trial.
In the LIFE-BTK trial, treatment with an everolimus-eluting resorbable scaffold was superior to angioplasty in improving clinical outcomes in patients with chronic limb-threatening ischaemia due to infrapopliteal artery disease.
Activation of a specific set of vagal sensory neurons connecting the ventricular wall of the heart to the area postrema in the brainstem causes mice to faint. This finding defines a cardiac reflex that recapitulates characteristics of human syncope.
An approach that increases the expression of the chemokine receptor CXCR4 in vascular cells by targeting a microRNA-based repressive pathway attenuates atherosclerosis in mice and promotes atheroprotective functions in human and mouse vascular cells in vitro.
In this Review, the authors present an overview of the role of fibroblast growth factor 23 (FGF23) and klotho in normal mineral homeostasis, discuss disordered mineral homeostasis in chronic kidney disease (CKD), and explore CKD-associated FGF23 excess and klotho deficiency as novel risk factors and potential therapeutic targets for cardiovascular disease.
Heart transplantation for patients with advanced heart failure is limited by a shortage of donor organs. In this Review, Jou and colleagues explore the options to increase the supply of donor hearts, including transplantation from donors with HCV, HIV or SARS-CoV-2 infection, national opt-out organ donation policies, donation after circulatory death, and xenotransplantation.
In this Review, Marsan et al. discuss the different clinical scenarios in which valvular heart diseases and cardiomyopathies coexist, either as the cause of one another or because of a common aetiology, to highlight the need for an improved classification of these diseases with potential repercussions in clinical management and personalized treatment.
In this Roadmap, Föllmer et al. summarize the evidence for the application of artificial intelligence (AI) technology to the imaging of vulnerable plaques in coronary arteries and discuss the current and future approaches to addressing the limitations of AI-guided coronary plaque imaging, such as bias, uncertainty and generalizability.
