October 2025 Dispatch for the CV Team

Every month, Section Editor L.A. McKeown curates a roundup of recent news beyond our regular TCTMD coverage, with tidbits from journals and medical meetings around the globe that are of special interest to heart teams and allied cardiovascular professionals.

Level of training, subspecialty, and income status may affect healthcare workers’ knowledge, attitudes, and practice toward CVD prevention, according to a survey of doctors, nurses, and medical students published in the Postgraduate Medical Journal. Nurses, cardiology subspecialists, and healthcare workers from lower middle-income nations had better proficiency in promoting CVD prevention in clinical practice than their counterparts in high- or upper middle-income nations. Only about half of those surveyed put comprehensive interventions for smoking cessation in place, and CV risk factor counselling rates were low in patients who were asymptomatic or overweight. Additionally, there was evidence that clinicians were unlikely to change CVD prevention practices learned in training over time.

Frailty may be a predictor of long-term PCI outcomes independent of clinical and procedural characteristics, a retrospective study published in Catheterization and Cardiovascular Interventions suggests. Compared with nonfrail patients, those with scores of 5 to 9 on the clinical frailty scale (CFS) had higher rates of all-cause and CV mortality, as well as stroke, at 1 year. The researchers say routine frailty assessments could improve risk stratification and guide more personalized care.

Is there a sleep apnea survival paradox? A Swiss study of 744,455 hospitalizations for acute heart disease, published in PLOS One, found that those with a diagnosis of sleep apnea had lower in-hospital mortality, with researchers noting that the effect was independent of comorbidities such as obesity and hypertension. While the reasons for the paradox are largely unclear, one explanation may lie in an interplay of comorbidities, including obesity—which has its own paradox—plus hypoxic preconditioning as an adaptation of sleep apnea, that work together to contribute toward a protective effect.

Despite some progress, the percentage of women in cardiovascular fellowship director roles in the United States has been relatively unchanged for the last 4 years, a survey shows. Writing in JACC: Advances, researchers say the findings reflect the “leaky pipeline” phenomenon, whereby women’s representation declines at each career stage: from 50% of medical students to 40% of internal medicine residents, 23% of cardiovascular medicine fellows, and just 18% of program directors. They add that “systemic change and a more inclusive leadership landscape are essential to addressing these disparities.”

Contemporary exercise-based cardiac rehabilitation is associated with a lower risk of all-cause and CVD-related hospitalization and higher health-related quality of life (QoL) in patients with coronary heart disease. Results from the CaReMATCH study, published in the European Journal of Preventive Cardiology, found that the effects of rehab on QoL were greatest in those who started the intervention with poorer QoL or lower education levels, while the benefits on hospital admissions were greatest in those who started with poorer heart function, lower fitness levels, or a CVD history.

Yet another study is providing evidence for the accumulation of micronanoplastics (MNP) in human atherosclerotic tissue. This time, investigators say they found that patients with peripheral artery disease (PAD) had up to an 80-fold higher concentration of MNP in femoral plaque compared with nonatherosclerotic carotid tissue. Commonly found polymers in tissue included polyethylene, styrene-butadiene rubber, polypropylene, and polyvinyl chloride. “Further studies should more clearly define MNP content in all vascular territories affected by atherosclerosis and leverage multi-omic technologies to probe possible mechanistic factors and link these to relevant clinical outcomes,” the study authors write in JVS-Vascular Science.

The newly introduced adipokine hypothesis suggests that heart failure with preserved ejection fraction (HFpEF) may be driven by obesity and dietary nutrient excess via endocrine-paracrine signaling to the heart. In a state-of-the-art review published in JACC, investigators outline the supportive evidence for this hypothesis, which challenges current thinking and provides a new potential avenue for research, understanding, and treatment.

In patients with calcific aortic valve stenosis, insulin resistance may play a role in risk of mortality. The ARISTOTLE investigators, reporting in Cardiovascular Diabetology, found that each 1-unit increase in the cholesterol, high-density lipoprotein, and glucose (CHG) index was linked to a 53% greater risk of cardiovascular death and a 43% higher risk of all-cause death. According to the authors, the CHG index “can be used as an indicator to evaluate the prognosis of patients with calcific aortic valve stenosis, providing more references for promoting clinical decisions and optimizing the prevention decisions of aortic valve stenosis.”

E-cigarettes or vape pens can have negative effects on respiratory and cardiovascular health, including increasing the risk of reduced lung function and asthma, as well as changes in blood pressure and heart rate, according to a systematic review published in BMJ Open. The authors call for “stringent regulation of these products and public health campaigns to educate people about health risks and protect people’s health.”

The US Food and Drug Administration has approved the first and only intranasal loop diuretic for self-administration by patients with edema associated with heart failure and hepatic or renal disease, including nephrotic syndrome. Manufacturer Corstasis Therapeutics said the bumetanide spray (Enbumyst) is meant to overcome limitations of oral loop diuretics, which can be poorly absorbed by the gastrointestinal tract and have delayed onset.

News Highlights From TCTMD:

A Little Exercise, No Matter When It’s Done, Benefits Older Women

Get More Women to Cardiac Rehab, AHA Asserts

Voice Analysis Picks Up Patients at Risk for HF Hospitalization: COMMUNITY-HF

Two New Scores Help Hone 10-Year CV Death Risk in ASCVD Patients

Education Meets TikTok: Cardiac Surgeons Teach Patient Recovery in New Ways