Background: Transcatheter aortic valve implantation (TAVI) has become a broadly acceptable alternative to AV surgery in patients with aortic stenosis (AS). New valve designs are becoming available to address the shortcomings of their predecessors and improve clinical outcomes. Methods: A systematic review and meta-analysis was carried out to compare Medtronic’s Evolut PRO, a new valve, with the previous Evolut R design. Procedural, functional and clinical endpoints according to the VARC-2 criteria were assessed. Results: Eleven observational studies involving N = 12,363 patients were included. Evolut PRO patients differed regarding age (p < 0.001), sex (p < 0.001) and STS–PROM estimated risk. There was no difference between the two devices in terms of TAVI-related early complications and clinical endpoints. A 35% reduction of the risk of moderate-to-severe paravalvular leak (PVL) favoring the Evolut PRO was observed (RR 0.66, 95%CI, [0.52, 0.86] p = 0.002; I² = 0%). Similarly, Evolut PRO-treated patients demonstrated a reduction of over 35% in the risk of serious bleeding as compared with the Evolut R (RR 0.63, 95%CI, [0.41, 0.96]; p = 0.03; I² = 39%), without differences in major vascular complications. Conclusions: The evidence shows good short-term outcomes of both the Evolut PRO and Evolut R prostheses, with no differences in clinical and procedural endpoints. The Evolut PRO was associated with a lower rate of moderate-to-severe PVL and major bleeding.

Background: Cardiovascular diseases (CVDs) are increasingly contributing to morbidity and mortality in Africa, where demographic and epidemiologic transitions are altering disease patterns. Objectives: This review synthesizes recent evidence on the prevalence, risk factors, pathophysiology, and clinical challenges of CVDs in African populations, highlighting regional specificities and knowledge gaps. Methods: Comprehensive literature searches were conducted in PubMed and related databases to identify peer-reviewed studies on hypertension, ischemic heart disease, heart failure, and cardiomyopathies with a focus on African settings. Results: Hypertension remains the predominant risk factor for CVDs across Africa, driving high rates of stroke, heart failure, and hypertensive heart disease. Although historically under-recognized, ischemic heart disease is rising in prevalence. Heart failure often presents in younger patients, with non-ischemic etiologies such as dilated cardiomyopathy and rheumatic heart disease being common. Structural health system barriers and limited access to diagnostic and therapeutic resources exacerbate outcomes. Conclusion: Cardiovascular diseases pose a significant and growing public health challenge in Africa. Strengthened prevention strategies, improved access to quality care, and context-specific research are essential to mitigate the rising CVD burden.

Gut microbiota is increasingly recognized as a central regulator of host metabolism. Dysbiosis, a perturbation of microbial composition and function, has been linked to obesity, type 2 diabetes mellitus (T2DM), metabolic syndrome, and non-alcoholic fatty liver disease (NAFLD). This narrative review synthesizes evidence from human and animal studies (2004–2025), highlighting mechanisms including microbial metabolites, immune modulation, and intestinal barrier integrity. Dysbiosis can impair SCFA production, disturb bile acid metabolism, increase intestinal permeability, stimulate systemic inflammation, and influence host energy homeostasis. Therapeutic strategies such as dietary interventions, probiotics, prebiotics, synbiotics, and fecal microbiota transplantation (FMT) show promise but require further clinical validation. Understanding host–microbiota interactions offers potential for novel preventive and therapeutic strategies.