ACACIA-HCM was positive and ODYSSEY-HCM was not, yet the two myosin-inhibitor trials in nonobstructive HCM showed similar, modest effects: a real but heterogeneous benefit that needs LVEF monitoring.
At a lower-volume center where one surgeon did 146 septal myectomies, outcomes compared favorably with national series: a single-operator model may widen access to HCM surgery.
CMR GUIDE: a scar-guided ICD at LVEF 36% to 50% lowered sudden death but not mortality, in patients at far lower risk than expected, and added harms. Scar alone should not yet prompt an ICD.
Background: In pediatric cardiac catheterization, it may be necessary or beneficial to purposely fracture previously placed stents. We sought to characterize the fracturability of Resolute Onyx and Onyx Frontier coronary stents in the bench setting. Methods: We serially dilated Onyx stents (nominal size 2.0–5.0 mm) and recorded the stent diameter and length using electronic calipers until we observed complete stent fracture. We then performed direct dilation of stents by inf…
This essay argues that in countries where treatment is out of reach in ATTR-CM, disease recognition falters. Increased access is needed in developing countries to improve patient outcomes.
In 10 patients with low-output HFrEF, IV digoxin loading raised median cardiac index from 1.45 to 2.70 L/min/m² at 24 hours and weaned all four off inotropes — an uncontrolled signal that merits a randomized trial.
PA denervation for HF-PH roughly halved clinical worsening in group 2 pulmonary hypertension, but with no sham arm and expectation-sensitive endpoints, this appraisal argues it should not yet change practice.
CARDIO-TTRansform missed its primary endpoint, but eplontersen helped patients not on a stabilizer far more than those on tafamidis. This appraisal puts the nuanced findings into context across other trials in ATTR-CM.
Geroprotectors target conserved mechanisms of biological aging to extend lifespan and healthspan rather than treat individual diseases. Synthesizing data from randomized controlled trials (RCTs), meta-analyses, observational studies, mechanistic investigations, and Mendelian randomization analyses of cardiovascular, renal, metabolic, and longevity outcomes, this narrative review evaluates whether sodium-glucose cotransporter inhibitors (SGLTi) meet that standard and explores…
Background: Sodium nitroprusside (SNP) is an intravenous vasodilator utilized in the management of acute heart failure (AHF) due to its rapid onset, short duration of action, and favorable hemodynamic effects. There is little contemporary data on the transition from SNP to oral (PO) vasodilator medications. This study sought to describe medication tolerance and short-term clinical outcomes of a protocol-guided versus provider-directed dosing transition from SNP to either a r…
CHIP-BCIS3: planned Impella support during high-risk PCI raised flow and spared inotropes but improved no patient-important outcome. This appraisal separates mechanical action from clinical benefit.
Background: Bioprosthetic valve fracture (BVF) improves the hemodynamic results of valve-in-valve transcatheter aortic valve replacement (VIV-TAVR), but it is unknown whether it increases the risk of embolic debris. This study aimed to characterize embolic debris liberated during VIV-TAVR with BVF. Methods: Between 3/2022 and 10/2024, we studied 20 patients who underwent VIV-TAVR with BVF using the SENTINEL cerebral embolic protection device (CEPD). Debris from the SENTINEL…
Researchers fund, write, review and edit the scholarly literature, then pay to publish or read it. This Perspective argues for a physician-led, open-access model that returns that value to the research community.
