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Novel non-steroidal mineralocorticoid receptor antagonists (MRAs) have improved pharmacological properties compared with steroidal MRAs. Among the non-steroidal MRAs, finerenone has been approved for patients with chronic kidney disease who have diabetes mellitus and has demonstrated favourable safety and promising early results in patients with heart failure.
In patients with an acute myocardial infarction, disrupted circadian rhythms during the initial days in the cardiac intensive care unit, caused by factors such as noise, excessive night-time light and frequent patient–staff interactions, can have devastating effects on cardiac repair and long-term prognosis. Providing care that aligns with the patient’s natural circadian rhythms is critical for optimum long-term recovery. Incorporating ‘circadian medicine’ into clinical practice will provide important health-care benefits.
Unloading left atrial hypertension by catheter-based, transvenous creation of atrial shunts is being explored to treat heart failure. So far, trials including sham control have demonstrated safety and efficacy in lowering left-sided cardiac filling pressures. Ongoing trials will determine the effect on clinical outcomes.
In the REPRIEVE trial, pitavastatin treatment in patients with human immunodeficiency virus (HIV) infection without pre-existing cardiovascular disease prevented cardiovascular events compared with placebo.
A new study reveals that the disrupted sleep patterns that are frequently observed in patients with cardiac disease are driven by immune-mediated sympathetic denervation and dysfunction of the pineal gland, which leads to a decrease in the circulating levels of melatonin and subsequent sleep disruption.
A study shows that macrophages undergo substantial expansion in the diseased atria of patients with atrial fibrillation (AF), and identifies two potential immunotherapy targets for the treatment of AF.
In failing cardiomyocytes, depletion of carnitine acetyltransferase promotes cholesterol catabolism via the bile acid synthesis pathway. The intracellular accumulation of bile acid intermediates induces the release of mitochondrial DNA into the cytosol, triggering type I interferon responses and AIM2 inflammasome activation, thereby contributing to chronic myocardial inflammation and heart failure progression.
Patients with hypertension who receive a single subcutaneous dose of zilebesiran, a novel small-interfering RNA that inhibits hepatic angiotensinogen synthesis, have reductions in serum angiotensinogen levels and 24-h ambulatory blood pressure that last for up to 24 weeks, according to a phase I study.
Cardiovascular health is essential to achieving the United Nations Sustainable Development Goals (SDGs), particularly SDG3.4. Barriers include inequalities and a lack of political will and prioritization. A comprehensive approach is needed to reduce the global burden of cardiovascular disease and to achieve SDG3.4. The World Heart Federation addresses the determinants of cardiovascular disease and mobilizes the global community through roadmaps, roundtables and advocacy.
According to two papers from the OPTICO-ACS study, patients with acute coronary syndrome and an intact fibrous cap (plaque erosion), tend to have lower levels of inflammation and better prognosis than patients with rupture of the fibrous cap. In addition, Toll-like receptor 2-mediated neutrophil activation has a key role in plaque erosion.
The FDA-approved drug ruxolitinib has been identified as an inhibitor of Ca2+/calmodulin-dependent protein kinase II (CaMKII) that has the potential to be repurposed to treat arrhythmias induced by CaMKII hyperactivity.
In the multicentre, randomized, placebo-controlled RAPID trial, use of symptom-prompted, self-administered, intranasally delivered etripamil was safe and superior to placebo for the conversion of paroxysmal superventricular tachycardia to sinus rhythm.
Testosterone-replacement therapy in men with hypogonadism and a high risk of cardiovascular disease does not increase the risk of adverse cardiac events, according to data from the TRAVERSE trial.
New research shows that the reduced risk of major adverse cardiovascular events associated with light or moderate alcohol consumption is partly mediated by attenuation of the activity of a stress-related neural network.
An antibody-based therapy for transthyretin amyloid cardiomyopathy is safe, and initial findings from a phase I trial suggest that it might deplete amyloid deposits in the heart.
In a diverse population of patients with heart failure with mildly reduced or preserved ejection fraction stabilized after a recent worsening heart failure event, treatment with sacubitril–valsartan induces greater reductions in plasma NT-proBNP levels and is associated with clinical benefit compared with valsartan alone, despite a higher rate of symptomatic hypotension.
The essential omega-6 polyunsaturated fatty acid γ-linolenic acid present in maternal milk coordinates cardiac adaptation and survival in newborn mice, according to a new study.
Results from the MONITOR-HF trial show that remote monitoring of pulmonary artery pressure using the implantable CardioMEMS sensor in patients with chronic heart failure improves quality of life and reduces hospitalizations.
