The main challenges in heart failure (HF) treatment are to manage patients with refractory acute decompensated HF and to stabilize the clinical status of a patient with chronic heart failure. Beyond the use of medications targeted in the inhibition of the neurohormonal system, the balance of salt and fluid plays an important role in the maintenance of clinical compensation in respect of renal function. In the case of heart failure, a debate of opinion exists on salt restriction. Restricted dietary sodium might lead to worse outcomes in heart failure patients due to the activation of the neurohormonal system and malnutrition. On the contrary, positive sodium balance is the primary driver of water retention and, ultimately, volume overload in acute HF. Some recent studies reported associations of decreased salt consumption with higher readmission rates and increased mortality. Thus, the usefulness of salt restriction in heart failure management remains debated. The use of individualized nutritional support, compared with standard hospital food, was effective in reducing these risks, particularly in the group of patients at high nutritional risk.

Background/Objectives: Hypertension exerts negative effects on the vasculature representing a key risk factor for cardiovascular disorders, cerebral and Cerebral Small Vessel Disease (CSVD). Methods: An extensive research in the literature was implemented in order to elucidate the role of hypertension in the pathogenesis of CSVD. Results: Hypertension-mediated vascular dysfunction and chronic cerebral hypoperfusion are closely linked to CSVD. CSVD encompasses a wide range of lesions depicted on brain Magnetic Resonance Imaging (MRI) or Computed Tomography (CT) scans. The presenting symptoms and clinical course are highly variable, as a significant proportion of patients remain asymptomatic. Nevertheless, CSVD is associated with an increased risk of stroke, dementia and mobility disorders. Various randomised controlled trials have been implemented trying to shed light on the effect of vascular risk-modifying agents and lifestyle interventions on the prevention and treatment of small vessel disease. Conclusions: Hypertension has a pivotal role in the pathogenesis of CSVD. However, further research is required for a better understanding of the relationship between blood pressure levels and CSVD progression.

Background: Systemic inflammation is a key driver of heart failure (HF) progression across all ejection fraction (EF) phenotypes, with diet emerging as a modifiable factor influencing cardiac metabolism and inflammatory signaling. This narrative review integrates current evidence on the inflammatory mechanisms underlying HF, their links with common comorbidities and emerging anti-inflammatory therapeutic strategies, with a particular focus on the role of nutrition in supporting healthy cardiac metabolism. Methods: We searched MEDLINE/PubMed, EMBASE, Web of Science, the Cochrane Library, Scopus and reference lists of relevant publications using terms related to systemic inflammation, dietary patterns and HF prioritizing high-impact studies on nutrition–inflammation–HF interactions published from 2000 onward. Results: Major HF comorbidities sustain chronic, low-grade inflammation through elevated cytokine activity. Dietary patterns—especially those with high Dietary Inflammatory Index (DII)—substantially shape inflammatory milieu. The Mediterranean diet appears to have a favorable inflammatory profile with reduction in circulating pro-inflammatory biomarkers, especially C-reactive protein (CRP) and interleukin-6 (IL-6). Established therapies for HF with reduced ejection fraction and vagus nerve stimulation elicit anti-inflammatory efficacy through cytokine suppression. Sodium glucose cotransporter-2 (SGLT2) inhibitors demonstrate positive metabolic effects and anti-inflammatory actions through decrease in IL-6 and tumor necrosis factor-α (TNF-α). Interleukin-1 blockade has produced heterogeneous clinical outcomes, while definitive findings examining the role of IL-6 inhibitors in inflammation suppression and possible benefit on cardiac outcomes are anticipated. Preliminary data show the potential synergistic effects of dietary patterns/nutrients and pharmacological agents combination on improvement of endothelial function and attenuation of the fibrotic process, although there is a need for further research in large-scale trials. Conclusions: Systemic inflammation demonstrates a key role in HF initiation and progression, and the effect of diet on inflammatory pathways is central. Dietary patterns targeting inflammation-related mechanisms (inflammasome, gut dysbiosis) can lead to attenuation of systemic inflammatory response and restoration of cardiac metabolic flexibility. A deeper mechanistic discernment of cardiac inflammatory cascades, together with identification of HF subpopulations with excessive inflammatory activity, may facilitate the design of targeted randomized controlled trials (RCTs) aiming for novel personalized, inflammation-targeted HF therapies with potential clinical benefit.

Introduction: Artificial intelligence (AI) tools have emerged in cardiovascular clinical practice. Regarding transcatheter aortic valve replacement/implantation (TAVR/TAVI) procedures, their utilization optimizes procedural planning, aids physicians with decision making, and predicts possible post-procedural complications. Moreover, machine-learning (ML) models, compared with traditional mortality risk scores, show promising results considering predicted mortality in TAVI patients. However, further validation is required. As the implementation of cardiovascular procedures can be challenging, AI technology broadens the armamentarium of tools that a clinician is able to use for a more comprehensive evaluation of patients, minimizing complications and resulting in optimum clinical outcomes. Methods: A comprehensive literature search was conducted through the PubMed and Google Scholar databases from inception to 20 September 2025, to identify relevant studies. The search strategy included the following keywords: [“TAVI” OR “TAVR”] AND [“AI”, Artificial Intelligence]. Results: According to our database research, 7177 articles were initially screened, and 2145 duplicate articles were excluded. Eventually, 189 articles were evaluated by our reviewers and 51 articles of studies published between 2014 and 2025 were included in our review. Conclusions: AI algorithms could revolutionize the Heart Team decision making process, being not only a tool for patient evaluation but an active member of the team with applications to analyze and optimize all stages of the TAVI procedure, guide decision making and predict outcomes, and, with the contribution and evaluation of information from all human members of the team, enhance even more the patient-mediated medicine/interventions.

Acute coronary syndrome (ACS) remains a leading cause of cardiovascular morbidity and mortality worldwide. Although traditional cardiovascular risk factors remain central to ACS development, recreational drug use is increasingly recognized as a clinically relevant trigger, particularly in younger patients with fewer conventional risk factors. This narrative review synthesized evidence identified through searches of PubMed/MEDLINE and Scopus up to June 2026, including clinical guidelines, systematic reviews, observational studies, mechanistic investigations, and clinically informative case-based evidence. Cannabis, cocaine, amphetamines, methamphetamine, 3,4-methylenedioxymethamphetamine (MDMA), opioids, lysergic acid diethylamide (LSD), synthetic cannabinoids, and polysubstance use may promote myocardial ischemia and infarction through overlapping mechanisms, including sympathetic activation, coronary vasospasm, endothelial dysfunction, oxidative stress, inflammation, platelet activation, thrombosis, arrhythmogenesis, and myocardial oxygen supply–demand mismatch. Clinical presentation may be typical or atypical and may overlap with intoxication, withdrawal, anxiety, neurological symptoms, or non-cardiac chest pain, making diagnosis challenging. Underreporting of recreational drug use is common, and targeted toxicology screening may improve diagnostic accuracy and risk stratification, particularly in patients younger than 50 years, those with few traditional cardiovascular risk factors, or those presenting with otherwise unexplained ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI), coronary vasospasm, arrhythmias, or cardiac arrest. Acute management should generally follow standard ACS guidelines, while considering drug-specific issues such as stimulant-induced vasospasm, sympathetic excess, cautious use of beta-blockers during acute intoxication, and preference for primary percutaneous coronary intervention when fibrinolysis carries increased risk. Long-term care should combine evidence-based secondary prevention with substance-use counseling, addiction medicine referral, cardiac rehabilitation, and behavioural interventions. This review summarizes the pathophysiology, clinical manifestations, epidemiology, treatment considerations, preventive strategies, and knowledge gaps related to recreational drug-associated ACS.

Hepatocellular carcinoma (HCC) is considered to be the fourth most frequent cause of cancer-associated death globally. HCC might be associated, especially in advanced stages, with the formation of tumor thrombus (TT), which can be located in the portal vein, as well as in hepatic and/or inferior vena cava (IVC) veins. Nevertheless, the extension of TT to the right atrium (RA) is infrequent with an unfavorable prognosis. We present a rare case of a male patient with HCC and IVC TT extending to the RA. The atrial thrombus was the first manifestation of HCC diagnosed by cardiac ultrasound. So far, the patient has undergone 4 courses of transarterial chemoembolization in combination with systemic therapy with sorafenib, and under this therapeutic approach long-term survival has been achieved.