The 2016 American Society of Echocardiography (ASE) guidelines for left ventricular diastolic dysfunction (LVDD) classification resulted in a significant proportion of indeterminate classifications and grades. To address these limitations and incorporate new evidence, the ASE updated its recommendations in 2025. The impact of these revisions in community cohorts remains unclear.

Alternative indexation methods for left atrial volume (LAV) have been proposed to achieve better proportional scaling than the current standard body surface area indexation. However, there are limited data showing that these alternative indices provide long-term prognostic value in individuals with overweight or obesity. The aim of this study was to determine and compare the performance of various LAV indexation methods in predicting all-cause mortality in individuals with overweight or obesity.

Coronary artery bypass grafting is a well-established, durable, and safe surgical intervention. However, coronary artery disease continues to progress after the procedure. Patients who have undergone bypass surgery present unique challenges in terms of secondary prevention resulting from the often severe and diffuse nature of their coronary disease, the complexities of their postoperative recovery, the burden of their comorbid conditions, and the importance of ensuring long-term graft patency and preventing further disease progression. New evidence and advances in secondary prevention strategies in the post-coronary bypass grafting population have emerged since the American Heart Association's 2015 scientific statement on this topic. Secondary prevention strongly correlates with improved outcomes after bypass surgery, providing the rationale and urgency for this updated scientific statement to promote evidence-based practical considerations and to improve their use.

AGENT is the only coronary drug-coated balloon (DCB) approved for treatment of in-stent restenosis (ISR) to date. In this study, we describe trends in DCB use and compare characteristics and in-hospital outcomes between patients who received DCB versus alternative treatments.

Evidence regarding prosthesis-patient mismatch (PPM), measured (mPPM), and predicted (pPPM), after transcatheter aortic valve replacement in bicuspid aortic valve stenosis remains limited. This study sought to evaluate the incidence, predictors, and prognostic implications of mPPM and pPPM in patients with Sievers type 1 bicuspid aortic valve undergoing transcatheter aortic valve replacement.

Institutional and systemic practices and policies contribute to lower-quality care and adverse outcomes among diverse racial and ethnic groups and individuals with limited economic resources. There are ample opportunities to change the trajectory of patients with heart failure (HF) across racial and ethnic groups. Multiple studies and quality improvement initiatives have demonstrated strategies to improve the care of diverse racial and ethnic populations living with HF, yet dissemination remains limited. This state-of-the-art review examines structural racism in the context of HF, outlines evidence-based strategies for HF programs to improve access to advanced HF therapies and reduce disparities in treatment outcomes, and discusses priorities for implementation and dissemination science efforts to address structural causes of disparities in HF care.

Cardiomyopathy remains a leading cause of heart failure-related morbidity and mortality, driven by diverse genetic architectures that include monogenic variants, oligogenic interactions, and polygenic risk. Rapid advances in genomic medicine and vector engineering have positioned cardiac gene therapy as a transformative therapeutic approach. Adeno-associated virus-mediated gene replacement for hypertrophic, dilated, and arrhythmogenic cardiomyopathies has transitioned into early-phase clinical trials, with emerging data providing promising signals of myocardial transgene expression and improvements in circulating biomarkers such as NT-proBNP (N-terminal pro-B-type natriuretic peptide). Genome-editing platforms-including CRISPR-mediated base editing and prime editing-offer the potential for durable variant correction without introducing double-stranded breaks. Yet, major translational challenges remain, including strategies to bypass liver uptake to ensure high-efficiency transduction of cardiomyocytes, overcoming delivery constraints, including the cargo size of adeno-associated virus vectors, addressing toxicities, and establishing adequate immunosuppressive regimens. Novel strategies such as direct antegrade and retrograde coronary infusion, capsid engineering, split-intein dual-adeno-associated virus systems, miniaturization of CRISPR-related proteins, and nonviral nanoparticles are underway. As first-in-human cardiomyopathy gene therapy trials begin to define safety, dosing, and vector tropism in the failing human heart, the field is entering an inflection point where genomic diagnosis, molecular correction, and phenotype-guided delivery can converge into precision heart failure therapeutics. This review highlights current progress, emerging platforms, and scientific hurdles that must be overcome to realize a new era of potentially curative, mechanism-directed therapy for inherited and acquired cardiomyopathies.