This Week in Cardiology

Sep 12 2025 This Week in Cardiology

19 snips
Sep 12, 2025
In this discussion, the latest European guidelines on valvular heart disease take center stage. The conversation dives into the debate around treating asymptomatic aortic stenosis and unpacks the complexities of surgical interventions. A breakthrough drug, Baxdrostat, is scrutinized for its potential to revolutionize treatment for resistant hypertension. Additionally, recent trials on myosin inhibitors offer fresh hope for patients battling hypertrophic cardiomyopathy and heart failure, showcasing new therapies that challenge traditional approaches.
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ANECDOTE

Correction From Copenhagen

  • Mandrola corrected an earlier error: the Dan Block reboot trial randomized 8,000 patients, not 4,000.
  • He also relays Professor Eva Prescott's point that beta blockers may still help patients with EF 40–49% despite modest absolute benefit.
INSIGHT

CTA Preferred Preop Imaging

  • The 2025 ESC valvular guidelines upgrade CTA over invasive angiography to a class 1b recommendation for preop evaluation.
  • John Mandrola warns the supporting evidence is mainly small observational studies and meta-analyses, so the strength may be overstated.
INSIGHT

Early TAVR Recommendation Is Weak

  • ESC gives a 2A recommendation for intervention in asymptomatic severe aortic stenosis driven by trials with bias and few hard events.
  • Mandrola cautions this could markedly increase TAVR use despite limited long-term evidence.
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