ACCEL Lite: Featured ACCEL Interviews on Exciting CV Research

Transcatheter aortic valve replacement (TAVR) has emerged as the preferred treatment for aortic stenosis. However, there is a lack of long-term outcome data for low-risk patients. The 5-year results from the Evolut Low-Risk randomized trial address this gap, offering compelling evidence with no significant negative signals regarding TAVR's clinical outcomes and valve performance.  In this episode, Drs. Richard A. Chazal and Michael J. Reardon delve into the 5-year results from the Evolut Low-Risk randomized trial, offering valuable insights about the future of TAVR and its impact on patient care.  Related References:  1. Popma JJ, Deeb GM, Yakubov SJ, et al; Evolut Low Risk Trial Investigators. Transcatheter Aortic-Valve Replacement with a Self-Expanding Valve in Low-Risk Patients. N Engl J Med. 2019 May 2;380(18):1706-1715. doi: 10.1056/NEJMoa1816885. Epub 2019 Mar 16. PMID: 30883053.  Subscribe on Apple Podcasts| Subscribe to ACCEL 

Fluid restriction is often recommended for heart failure (HF) patients to prevent congestion, but its benefits and safety are unclear. The FRESH-UP study is the first to show that strict fluid restriction does not improve health status for chronic, symptomatic HF patients and may increase thirst distress without reducing mortality, hospitalization, acute kidney injury, or medication needs.  In this interview, Roland RJ van Kimmenade, MD and Alison L. Bailey, MD, FACC discuss the impacts of the FRESH-UP study and how liberal fluid intake is safe for chronic HF patients, even enhancing their well-being. Providers are encouraged to reconsider universal fluid restrictions and adopt a more individualized approach.   RELATED REFERENCES:  Herrmann JJ, Brunner-La Rocca HP, Baltussen LE, et al. Liberal Fluid Intake Versus Fluid Restriction in Chronic Heart Failure: A Randomized Clinical Trial. Nat Med 2025;Mar 30:[Epub ahead of print]. 

Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare and potentially fatal form of elevated blood pressure in the lungs. CTEPH treatment overall is a very complex clinical assessment and medical decision. Treatment options may include pulmonary thromboendarterectomy (PTE) surgery, balloon pulmonary angioplasty (BPA), or medical therapy.      In this interview, Drs. Shashank Sinha and Anjali Vaidya discuss how to approach the treatment decision for CTEPH once a diagnosis has been made.    Subscribe on Apple Podcasts | Subscribe to ACCEL     

The 2024 American Heart Association/American College of Cardiology (AHA/ACC)/multisociety guideline for perioperative cardiovascular (CV) management for noncardiac surgery, released in September 2024, marks the fourth comprehensive revision of the perioperative guideline since its inception in 1996. This latest update reflects the most current, evidence-based recommendations, shaped by expert clinical insight, to guide the management of patients with CV conditions undergoing noncardiac surgery.   In this interview, Drs. Andrew Kates and Annemarie Thompson discuss the key updates from the 2014 guideline, highlighting significant changes and exploring its guidance on evaluating patients with CV disease before noncardiac surgery.     Subscribe on Apple Podcasts | Subscribe to ACCEL  

In this interview, Drs. Richard Chazal and Mikhail Kosiborod explore the rapidly evolving therapeutic landscape of obesity, with a particular focus on the cardiovascular benefits of emerging treatments. They delve into the impact of sodium-glucose co-transporter-2 (SGLT-2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists in enhancing cardiovascular outcomes and improving survival across diverse clinical settings. Their discussion highlights the latest advancements in these therapies, shedding light on their role in reshaping the management of cardiometabolic diseases.     Subscribe on Apple Podcasts | Subscribe to ACCEL  

Drafting messages, summarizing charts, managing appointments, and assessing eligibility are all tasks that large language models can streamline. However, integrating them safely and effectively—whether in small practices or large healthcare institutions—poses unique challenges.  In this interview, Drs. Dipti Itchhaporia and Marly van Assen explore key strategies and safeguards designed to reduce errors and enhance reliability in high-stakes environments like healthcare.   Subscribe on Apple Podcasts | Subscribe on Google Play | Subscribe to ACCEL  

A personalized approach to lowering cholesterol is crucial in preventing heart attacks, as the optimal level, speed, and duration of low-density lipoprotein (LDL) reduction can vary from person to person. Both physicians and patients must carefully assess and monitor these factors to achieve the best cardiovascular outcomes.  In this interview, Drs. Douglas Weaver and Kausik Ray delve into the importance of individualized cholesterol management. They discuss the latest research, the benefits of aggressive LDL reduction, and how tailoring treatment plans can help optimize heart health while minimizing risks.    Subscribe on Apple Podcasts | Subscribe to ACCEL  

Notifying patients and their clinicians about incidental coronary calcium findings can encourage shared decision-making on preventive therapies and significantly boost statin use among high-risk individuals. Each year, tens of millions of chest computed tomography (CT) scans are performed, yet valuable data on coronary calcium often remain unused — an untapped opportunity to enhance cardiovascular prevention.  In this interview, Drs. Glenn Hirsch and Alexander Sandhu discuss how screening previously acquired non-gated chest CTs can help improve statin prescription rates and optimize preventive care.   Subscribe on Apple Podcasts | Subscribe to ACCEL  

Pulmonary hypertension (PH) is most commonly linked to left heart disease (LHD). The 7th World Symposium on Pulmonary Hypertension PH-LHD task force reviewed newly reported randomized clinical trial results and explored novel strategies to enhance patient outcomes. Their findings uncovered key data essential for improving clinical care.  In this interview, Drs. William Boden and Bradley Maron discuss the latest advancements in managing pulmonary hypertension caused by left heart disease.  Subscribe on Apple Podcasts | Subscribe to ACCEL 

Three complementary constructs  ̶  cardiovascular health, cardiovascular-kidney-metabolic (CKM) syndrome, and cardiovascular disease (CVD) risk assessment  ̶  exist to aid physicians in understanding where a patient is in the journey from health to disease and assist with clinical decision-making for preventive interventions across the life course.       In this interview, Drs. Clyde Yancy and Donald Lloyd-Jones review the origins, objectives, and application of these cardiovascular constructs in practice.     SUGGESTED MATERIALS:    1. Lloyd-Jones DM, Allen NB, Anderson CAM, et al; on behalf of the American Heart Association. Life’s Essential 8: updating and enhancing the American Heart Association’s construct of cardiovascular health: a presidential advisory from the American Heart Association. Circulation 2022;146:e18-e43.   2. Ndumele CE, Rangaswami J, Chow SL, et al; on behalf of the American Heart Association. Cardiovascular-kidney-metabolic health: a presidential advisory from the American Heart Association. Circulation 2023;148:1606-35.   3. Khan SS, Matsushita K, Sang Y, et al; for the Chronic Kidney Disease Prognosis Consortium and the American Heart Association Cardiovascular-Kidney-Metabolic Science Advisory Group. Development and validation of the American Heart Association’s PREVENT equations. Circulation 2023;149:430-49.     Subscribe on Apple Podcasts | Subscribe to ACCEL