Edition 2022/02

The reduction of blood pressure (BP) is associated with a significant reduction of cardiovascular events and all-cause mortality. After lifestyle interventions, antihypertensive drugs are routinely administrated to lower BP. The optimization of antihypertensive therapies requires the identification of the best-adapted drugs for each patient, followed by the titration of doses or by the combination of drugs. Automated cuffless BP monitoring devices based on optical sensors have the potential to provide new insights in the daily monitoring of the effectiveness of antihypertensive therapies over weeks. This case report illustrates the use of the CE-marked Aktiia Bracelet optical device for the monitoring of a 39 year-old male hypertensive patient for four months during which two drug therapies were tested.

Occasionally, cardiac disease may manifest acutely with extracardiac symptoms. We present a patient case with pulmonary hemorrhage as first manifestation of rheumatic mitral stenosis which resolved completely after mitral valve surgery. We discuss the pathophysiology and clinical management of this rare manifestation of rheumatic heart disease.

Summary

Cardiac resynchronization therapy (CRT) using biventricular pacing has become standard of care therapy for patients with symptomatic heart failure, wide QRS and left ventricular ejection fraction (LV-EF) < 35% refractory to optimal medical treatment. Tremendous data has demonstrated improvement in quality of life as well as mortality rates in CRT responders. However individual long-term response is difficult to predict as demonstrated by the usual 25-30% rate of non-responders.

Permanent His bundle pacing (HBP) has emerged as an alternative to biventricular pacing to deliver physiologic pacing as well as cardiac resynchronization.

We are presenting the case of a 78-year-old patient in whom resynchronization using His bundle pacing translated into a clearly superior acute electrical result compared to biventricular pacing.

The sodium-glucose co-transporter 2 inhibitors have become an integral part of the treatment of patients with high cardiovascular risk or established cardiovascular disease. In the present review, we summarize the available data from pre-clinical and human studies on the mechanisms underlying the beneficial effects of sodium-glucose co-transporter 2 inhibitors in patients with cardiac dysfunction and heart failure, we discuss the data from clinical trials on the prevention and treatment of heart failure, and we present the recommendation of the most recent international guidelines regarding the use of sodium-glucose co-transporter 2 inhibitors in this context.