Cardiology Letters, 2025 (vol. 34), issue 5-6

Aldosterone synthase inhibitors in the treatment of arterial hypertension

Juraj Dúbrava

Cardiology Letters 2025, 34(5):261-269  

Aldosterone plays a key role in blood pressure regulation. Aldosterone dysregulation occurs in approximately 30% of hypertensive patients. Mineralocorticoid receptor antagonists (MRA) are currently the only class of antihypertensive drugs that specifically target aldosterone. However, MRAs are underused due to concerns about adverse effects; they do not block the nongenomic effect of aldosterone, and are associated with a reactive increase in aldosterone levels. A promising option to MRA are aldosterone synthase inhibitors (ASI), which change the concept of antialdosterone effect. They act "one step ahead" of MRA. ASI inhibit aldosterone synthesis,...

Endothelial dysfunction as a key pathomechanism of long COVID: a potential therapeutic target

Angelika Púzserová, Peter Bališ, Silvia Dobrodenková, Enikő Potocká, Miroslava Kvandová

Cardiology Letters 2025, 34(5):270-282  

Long COVID (LC) refers to the spectrum of long-term health consequences caused by SARS-CoV-2 infection. It includes persistent or new symptoms lasting months to years after the initial infection. Multiple organ systems can be affected, including the cardiovascular system. The pathophysiology of LC is complex and multifactorial, involving viral persistence, immune system dysregulation, endothelial dysfunction, oxidative stress, gut dysbiosis, coagulation disorders, inflammatory processes, and other factors. The endothelium, a key regulator of vascular homeostasis, plays a central role in LC pathophysiology. Endothelial dysfunction leads to altered vascular...

Pivotal clinical trials shaping contemporary cardiology practice. News from the European Society of Cardiology Congress 2025

Miguel Rodriguez Ramos, Gilberto Cairo Saez

Cardiology Letters 2025, 34(5):288-290  

This article presents crucial results from clinical trials presented at the European Society of Cardiology Congress on the management of cardiovascular diseases. Relevant therapeutic updates for the coming years are offered while providing critical insights that inform clinical practice and lay the groundwork for future innovations, promising more effective and accessible solutions to the global burden of these diseases. Ref. 8, on-line full text (Free, PDF), www. cardiologyletters.sk

Atypical presentation of infective endocarditis complicated by dietary-induced warfarin resistance

Adrianna Perzanowska, Zuzanna Tomaszewska, Agata Antoniak, Klaudia Cierlicka

Cardiology Letters 2025, 34(5):283-287  

Infective endocarditis (IE) is a life-threatening disease that often presents with nonspecific symptoms, leading to delayed diagnosis. We present the case of a 39-year-old male without significant comorbidities who presented with lower-limb pain, swelling, and systemic symptoms, initially misdiagnosed as pneumonia. Computed tomography (CT) angiography revealed a thrombus in the distal posterior tibial artery, but IE was suspected only after a new heart murmur was detected. Echocardiography showed vegetations on the aortic valve, mitral valve perforation, and severe aortic regurgitation. Blood cultures remained negative, likely due to prolonged prior...

Intimal cardiac sarcoma diagnosis as an unusual cause of anterior myocardial infarction

António Rocha de Almeida, Rafael Coelho Viana, Kisa Congo, Renato Fernandes

Cardiology Letters 2025, 34(5):291-292