Advanced cardiovascular imaging plays a pivotal role in diagnosing, risk-stratifying, and managing a spectrum of cardiac conditions, from ischemic heart disease to cardiomyopathies and valvular disorders. However, rapid technological evolution—spanning echocardiography (echo), cardiovascular computed tomography (CCT), cardiovascular magnetic resonance (CMR), and nuclear cardiology—demands rigorous, standardized training to ensure competency and patient safety. The 2025 Advanced Training Statement on Advanced Cardiovascular Imaging, jointly authored by the American College of Cardiology (ACC), American Heart Association (AHA), American Society of Echocardiography (ASE), American Society of Nuclear Cardiology (ASNC), Society of Cardiovascular Computed Tomography (SCCT), and Society for Cardiovascular Magnetic Resonance (SCMR), and issued by the ACC Competency Management Committee, addresses this need by updating prior frameworks to reflect contemporary practice.
Although evolocumab, a PCSK9 inhibitor, reduces major adverse cardiovascular events (MACE) in patients with prior myocardial infarction (MI), stroke, or peripheral artery disease, its efficacy in preventing first cardiovascular events in patients without such history remained uncertain.
The extended follow-up of the DANISH trial, published in the Journal of the American College of Cardiology on October 22, 2025, provides critical long-term insights into the role of primary prevention implantable cardioverter-defibrillators (ICDs) in patients with nonischemic heart failure with reduced ejection fraction (HFrEF). Originally published in 2016 with a median follow-up of 5.6 years, the trial showed no significant reduction in all-cause mortality with ICDs. This new analysis extends median follow-up to 13.2 years (IQR 11.6–14.6 years), tracking 1,116 randomized patients until death or January 31, 2024.
AstraZeneca announced positive results from the Bax24 Phase III trial on October 10, 2025, evaluating baxdrostat, a highly selective aldosterone synthase inhibitor, in patients with treatment-resistant hypertension (rHTN). The randomized, double-blind, placebo-controlled study met its primary endpoint, demonstrating a statistically significant and clinically meaningful reduction in 24-hour ambulatory systolic blood pressure (SBP) at 12 weeks compared to placebo.
Amgen announced on October 2, 2025, that the Phase 3 VESALIUS-CV trial successfully met its dual primary endpoints, establishing Repatha (evolocumab) as the first PCSK9 inhibitor to significantly reduce cardiovascular events in primary prevention settings. This randomized, double-blind, placebo-controlled study enrolled over 12,000 adults at high cardiovascular risk, including those with known atherosclerotic cardiovascular disease (ASCVD) or high-risk diabetes, but without prior myocardial infarction (MI) or stroke. Participants had elevated lipid levels (LDL-C ≥90 mg/dL, non-HDL-C ≥120 mg/dL, or apolipoprotein B ≥80 mg/dL) despite optimized lipid-lowering therapy, with approximately 85% on high- or moderate-intensity LDL-C reducing regimens like statins.
Dilated cardiomyopathy (DCM) is a leading cause of heart failure (HF), with left ventricular reverse remodeling (LVRR) linked to better outcomes, including reduced hospitalizations and mortality. While guideline-directed medical therapy (GDMT) promotes LVRR in HF with reduced ejection fraction (HFrEF), the role of ivabradine—a selective If-channel inhibitor recommended for HFrEF patients in sinus rhythm with resting heart rate (HR) ≥75 bpm despite GDMT—remains underexplored in relation to achieved HR and LVRR. This retrospective study at Severance Hospital (2012-2021) analyzed 255 patients with idiopathic non-ischemic DCM (NIDCM), defined by LVEF ≤35% and dilated left ventricle (LV), excluding ischemic, valvular, or other secondary etiologies via comprehensive diagnostics including cardiac MRI.
