Atherosclerosis, a condition characterized by the accumulation of lipids and a culprit behind cardiovascular events, has long been studied. However, in recent years, there has been an increase in interest in its initiation, with researchers shifting focus from traditional pathways involving the vascular infiltration of oxidized lipids and towards the novel presence of chronic inflammatory pathways. The accumulation of pro-inflammatory cytokines, in combination with the activation of transcription factors, creates a positive feedback loop that drives the creation and progression of atherosclerosis. From the upregulation of the nod-like receptor protein 3 (NLRP3) inflammasome and the Notch and Wnt pathways to the increased expression of VEGF-A and the downregulation of connexins Cx32, Cx37, and Cx40, these processes contribute further to endothelial dysfunction and plaque formation. Herein, we aim to provide insight into the molecular pathways and mechanisms implicated in the initiation and progression of atherosclerotic plaques, and to review the risk factors associated with their development.

Cardiac Resynchronization Therapy (CRT) has been established as a major component of heart failure management, resulting in a significant reduction in patient morbidity and death for patients with increased QRS duration, low left ventricular ejection fraction (LVEF), and high risk of arrhythmias. The ability to synchronize both ventricles, lower heart failure hospitalizations, and optimize clinical outcomes are some of the attractive characteristics of biventricular pacing, or CRT. However, the high rate of CRT non-responders has led to the development of new modalities including leadless CRT pacemakers (CRT-P) and devices focused on conduction system pacing (CSP). This comprehensive review aims to present recent findings from CRT clinical trials and systematic reviews that have been published that will likely guide future directions in patient care.

Heart transplantation (HT) remains a critical treatment for patients with end-stage heart failure who remain unresponsive to optimized guideline-directed medical therapy. This review examines recent advancements in pre-, peri-, and post-transplant screening and management aimed at improving patient selection, transplant accessibility, and clinical outcomes. Pre-transplant strategies include comprehensive HT candidate evaluation, risk stratification, donor selection, allocation policies that priotize critically ill patients, and mechanical circulatory support (MCS) to stabilize patients awaiting transplantation. Peri-transplant advances focus on strategies to maintain hemodynamic stability, minimize ischemic injury, and maintain graft viability immediately after HT. Post-transplant management emphasizes individualized immunosuppressive regimens, cardiac allograft rejection surveillance, and the prevention and management of complications to improve graft survival and long-term patient outcomes. Despite substantial progress, significant challenges remain, particularly the shortage of suitable donor organs and the risk of immune-mediated graft rejection. Emerging approaches, including artificial intelligence, xenotransplantation, and regenerative medicine, offer promising opportunities to expand the donor pool, enhance clinical decision-making, and improve HT outcomes. This review examines the research that influences the current policies and practices involved in HT, featuring the pivotal findings as well as any shortcomings present among these studies. Ultimately, continued research and multidisciplinary collaboration in each phase of HT are essential to improve the short and long-term health outcomes of transplant candidates. By integrating established evidence-based practices with emerging technologies, clinicians may further improve equitable access, survival, and quality-of-life for patients with end-stage heart failure.