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Immune checkpoint inhibitors (ICIs) have become a pillar of cancer therapy. The cardiovascular complications of ICIs extend beyond myocarditis and can involve any component of the cardiovascular system, including the pericardium, coronary arteries and conduction system. Clinicians caring for patients treated with ICIs must be vigilant for the cardiovascular complications of these therapies, which might portend a poor prognosis.
Screening for atrial fibrillation in high-risk populations could contribute to the prevention of cardioembolic stroke. Randomized trials of atrial fibrillation screening are directionally favourable but underpowered for stroke risk assessment; nevertheless, meta-analysis results are encouraging. Consumer-facing wearable devices can detect unknown atrial fibrillation at scale, although they are mostly used by individuals at low risk of stroke.
Virtual reality is a fast-evolving technology that already has several promising applications in medicine. In this Clinical Outlook, we discuss the current evidence and the future challenges for virtual reality applications in cardiac interventions. The incorporation of virtual reality in daily practice will inevitably make clinical care more robust, patient-centred and safe.
More than 50% of patients with chronic heart failure present with iron deficiency, which is associated with reduced quality of life and worse prognosis. Intravenous iron supplementation therapy has been shown to improve clinical outcomes in these patients.
The totality of evidence from large-scale, randomized, controlled clinical trials and mechanistic studies in the laboratory has provided six crucial lessons about the emerging role of SGLT2 inhibitors to prevent the onset of heart failure in patients at high risk and slow the progression of heart failure in patients with established disease.
Wearable devices are widely used and have a high level of societal acceptance, opening unimagined and unexploited possibilities in cardiovascular medicine. In this Clinical Outlook, we highlight the disruptive potential of wearables for cardiovascular disease prevention, diagnosis and management, and suggest strategies for quickly and safely translating these lifestyle products into medical devices.
Paradigm-shifting studies have revealed that the heart contains heterogeneous and dynamic immune and stromal cell populations that are crucial determinants of health and disease. Advances in molecular imaging now make it possible to non-invasively visualize the cardiac cellular landscape in humans, providing a means to guide precision therapies.
Reflecting on the first genetically engineered pig-to-human heart transplantation in this Clinical Outlook article, we discuss the likely future of cardiac xenotransplantation. Initial clinical trials are expected to explore compassionate use as destination therapy in carefully selected adult patients and as a bridge to heart allotransplantation in infant patients with complex congenital heart disease.
Meta-analyses and cardiovascular outcome trials are laying the foundation for seasonal influenza vaccines to be a mainstay in the prevention of cardiovascular disease, rivalling established measures such as statin therapy. In this Clinical Outlook, we highlight current and future approaches for the use of influenza vaccination to reduce the risk of atherosclerotic cardiovascular disease and heart failure.
