2022 ESC Guidelines on Pulmonary Hypertension
Individuals with suspected pulmonary hypertension are suggested to get transthoracic echocardiography guidance for right heart imaging (TTE). Right heart catheterization is recommended to confirm the diagnosis. Initial combination treatment with PDE5i and an endothelin receptor antagonist is advised in individuals with IPAH/HPAH/DPAH who are at low or intermediate risk of mortality.
2022 ESC Guidelines on Cardio-oncology
Echocardiography is suggested as the first-line modality for assessing heart function in cancer patients, with cardiovascular magnetic resonance being evaluated when echocardiography is unavailable or undiagnostic. Cancer prognosis, cancer therapies and CV symptoms need alternative solutions, drug- drug interactions, and patient preferences should be considered when making treatment decisions.
Interventional Solutions For Heart Failure
The FDA has approved an innovative treatment for heart failure called Baroreceptor Stimulation, which relieves symptoms of HFrEF. Baroreflex Activation Therapy (BAT) reduces sympathetic activity while improving parasympathetic activity. In BEAT HF trial, the BAT improved the quality of life and NT-pro-BNP considerably.
LDL-C: New insights Into its Role as Casual Risk Factor and Target For Therapy
An annual dosage of siRNA vaccine presents a viable method for lowering LDL, reducing cardiovascular events, and decreasing the progression of atherosclerosis. Starting at age 55, twice-yearly siRNA treatment reduces LDL by 52%. Injectables ensures compliance.
Addressing The Unmet Needs in LDL-C Lowering - What Can We Expect?
According to evidence, the combination of ezetimibe, bempedoic acid, and inclisiran is more effective in reducing LDL-C levels. At their maximum dose, statins have several drawbacks. Novel agents, such as the CETP inhibitor Obicetrapib, as well as oral PCSK9 modulators, have showed encouraging outcomes.
The Beginning of The End For NOACs? The Extra Mile
NOACs are an effective therapy option for stroke in individuals with NVAF, diabetes, and compromised renal function. NOACs are recommended for the treatment of cancer associated thrombosis by clinical recommendations like as ISTH, ASCO, ESC, NCCN, and ITAC. When compared to LMWH, patients taking a NOAC have greater effectiveness and a comparable overall major bleeding risk.
CV Assessment and Management of Patients Undergoing Non-cardiac Surgery
Patients with CVD, CV risk factors (including age >65 years), or CVD symptoms should utilize hs-cTN or hs-CTN I before immediate or high risk NCS, as well as at 24 and 48 hours thereafter. They should have BNP or NT-proBNP measured before intermediate and high risk NCS. It is not advisable to start beta-blockers before non-cardiac surgery on a regular basis.
SECURE – Secondary Prevention of Cardiovascular Disease in Elderly
A polypill therapy comprising aspirin, atorvastatin, and ramipril resulted in fewer recurrent cardiovascular events after myocardial infarction, likely due to greater adherence. The polypill method is safe to use with no differences in adverse events between groups. Using a polypill as a substitution approach might be an important component of the global strategy to improve secondary prevention.
2022 ESC Guidelines on Ventricular Arrhythmias and Sudden Cardiac Death
Genetic testing and genetic should be undertaken in patients with clinical suspicion or clinical diagnosis of catecholaminergic polymorphic ventricular tachycardia. It is advised that public access defibrillation be made available in areas where cardiac arrest is more prone to occur. Promoting community training in basic life support is advised to boost bystander CPR and AED use.
Efficacy and Safety of Sacubitril And Valsartan on Cognitive Function
Sacubitril & valsartan did not affect cognitive function in a 3-year randomised trial. Beta-amyloid deposition in the brain was less in patients treated with Sacubitril/valsartan compared to valsartan. There was no evidence of an increased risk of cognitive impairment by neprilysin inhibition related to beta-amyloid accumulation in the brains of individuals with HFmrEF or HFpEF.
Clinical Event Reductions in HTN Patients Treated with Renal Denervation
The 10-year MACE events were 35.8% vs. 48.5% for Renal Denervation (RDN) vs. control for all GSR patients, 37.8% vs. 52.4% for the high ASCVD risk cohort, and 40.5% vs. 54.0% for the T2DM cohort. Out of all 3 cohorts, events avoided were highest for stroke and lowest for MI. 10-year NNTs for MACE were comparable between the three cohorts, estimated between 7 to 8.
DNA Methylation Alterations in The Offspring
Maternal obesity or gestational diabetes is a significant risk factor for cardiovascular and metabolic illnesses in the offspring. Additionally, several DNA methylation changes were identified in the offspring. These alterations are at least maintained during the first year of life. DNA methylation changes are linked to areas and genes involved in feeding, hunger, metabolism, and cell signalling.
24-Hour Urine Sodium Excretion Fluctuation Linked to CV and Renal Outcome
High sodium consumption is tracked by monitoring salt excretion in the urine over a 24-hour period. The variability in 24-hour urine sodium excretion has been demonstrated to be mediated by infradian aldosterone and cortisol cycles in addition to salt consumption. 24-hour urine sodium excretion fluctuation could be linked to long-term cardiovascular and renal illness.
Catheter-Based Renal Denervation Improves Blood Pressure
Following catheter-based renal denervation, the research found a significant and robust reduction in ambulatory systolic BP (from 145.7mmHg to 132.8mmHg; p < 0.001) and diastolic blood pressure (from 81.6 mmHg to 72.0 mmHg; p < 0.001) in the long term, despite a reduction in anti-hypertensive drugs, with no evidence of detrimental effects on renal function.
Effect of High Homocysteine and Low Vit B12 Levels on CV and Stroke Risk
High blood homocysteine levels (hyperhomocysteinemia) are linked to an increased risk of cardiovascular disease and are linked to vitamin B12 deficiency, which may potentially raise CV and stroke risk. A resent study showed that individually and synergistically, high homocysteine levels and low vitamin B12 levels are linked to hypertensive patients' underlying CV and stroke risk.
Skin Microvascular Function in Rheumatoid Arthritis (RA) Patients
Microcirculation dynamics appear impaired even in RA patients with relatively low inflammatory load, regardless of CV risk factors. A recent study showed for the first time an association between impaired skin microvascular dynamics assessed with LSCI and microvascular myocardial perfusion using SEVR. Further studies need to evaluate the prognostic potential of LSCI in terms of CV risk in RA.
Do Antihypertensive Medications Increase Skin Cancer Risk?
Some studies suggested that the use of diuretics, particularly hydrochlorothiazide, and calcium channel blockers increased the risk for non-melanoma skin cancer. No antihypertensive drug class was associated with cutaneous malignant melanoma (CMM). Increased NMSC risk was only observed in specific populations such as non-Hispanic whites, patients with coronary heart disease or veterans.
Predicting Long-Term Survival after an Ischemic Stroke
A study analyzed 737 patients following an ischemic stroke. The cumulative risk of death at 1, 3, 5, and 10 years was 13.6%, 20.8%, 29.3%, and 48.3%, respectively. Patients with SBP between 120 and 140 mmHg showed the lowest mortality risk. Higher age, NIHSS on admission, diabetes and smoking linked to higher mortality risk, while the reperfusion therapy and RAS blockers lowered mortality.
Association of Cerebral Oxygenation with Organ Damage
Impaired cerebral oxygenation during exercise is an indicator of cerebral dysfunction. A study suggests that indices of cerebral oxygenation during a submaximal physical task are associated with markers of early, subclinical target organ damage, increased carotid intima-media thickness, arterial stiffness, and retinal arteriolar narrowing in newly diagnosed hypertensive individuals.
Orthostatic Hyperreactivity and Cardiovascular Risk in Hypertension
A study found that the hyperreactors to standing had a greater orthostatic response of diastolic BP. And it had doubled risk of major adverse cardiovascular and renal events (MACE) in young-to-middle-age hypertensive subjects compared to Normoreactors. Hyperreactivity remained an independent predictor of MACE even when ambulatory BP data and incident hypertension were included in the Cox model.
