Cardiology Research Updates

In the VRONI study, paediatricians in Bavaria offered biochemical screening (fingertip blood LDL-C) to children aged ~5–15 years and performed targeted variant panel testing and gene sequencing for those with LDL‑C ≥3.36 mmol/L. Among 25,431 children screened, sequencing identified FH‑causing variants across LDL‑C strata and yielded a high observed prevalence that, after adjustment for ascertainment bias, predicted a population prevalence of ~1 in 163; the authors conclude biochemical screening effectively selects children for genetic testing and that gene sequencing outperforms focused variant panels.

This debate article reviews evidence comparing transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR), noting guideline shifts favoring TAVI in many patients ≥70 with suitable anatomy and randomized trials showing comparable outcomes up to 5 years. The authors highlight limited data beyond 5 years and concerns about higher rates of pacemaker implantation, paravalvular regurgitation, and uncertain long-term TAVI durability, arguing these factors may still support SAVR as first choice for patients with life expectancy beyond 5 years.

This review summarizes evidence that albuminuria, commonly measured by urinary albumin-to-creatinine ratio (present in nearly half of patients with heart failure), is an independent risk marker for incident heart failure and for worse outcomes in established heart failure even at low levels. It notes that routine UACR screening is not universally recommended in heart-failure guidelines, and that reductions in UACR with therapies (renin-angiotensin inhibitors, SGLT2 inhibitors, finerenone) are associated with lower risks of cardiovascular, heart failure, and chronic kidney disease outcomes, supporting albuminuria as a potential modifiable risk marker.