Large vessel vasculitides (LVV), including giant cell arteritis (GCA) and Takayasu arteritis (TAK), share common features such as inflammation of large sized arteries but differ in several key aspects, including age of onset and pathogenic mechanism. This narrative review gives an update of recent insights into pathogenesis of GCA and TAK, and discusses emerging targeted therapies based on these insights. It highlights omics-based signatures, ULK3 and SLAMF7 in GCA, EGR1 in TAK, alongside genetic and somatic risk factors such as clonal haematopoiesis (DNMT3A/TET2) linked to relapse and ischaemic vision loss in GCA, and the IL6R-p.Asp358Ala variant as a predictor of reduced interleukin (IL)-6 receptor blockade response. Common mechanisms include CD4⁺ T-cell, monocyte/macrophage, and B-cell infiltration with activation of IL-6, JAK/STAT/interferon, and IL-17 pathways. Giant cell arteritis is characterised by GM-CSF-driven macrophages and disrupted programmed cell death (PD)-1/PD-L1 checkpoint regulation, while TAK shows dominance of CD8⁺ T cells and tumour necrosis factor (TNF)-α signalling. Interleukin-6 receptor inhibitors (e.g., tocilizumab) show robust efficacy in GCA but with notable non-responders; the JAK inhibitor upadacitinib demonstrated efficacy in a Phase III study, whereas IL-17 blockade (secukinumab) yielded inconsistent results. In TAK, TNF inhibitors and tocilizumab are comparably effective; early data suggest Janus kinases (JAK) inhibitors promote remission, imaging improvement, and glucocorticoid sparing. Mavrilimumab (GM-CSF receptor blockade) is promising in GCA. Recent studies have increasingly focused on short-term glucocorticoid therapy in combination with biologic agents. Advances in biomarker research, including investigation of the IL-6 receptor and IL-17A gene polymorphisms, may enable more targeted therapeutic strategies.
Personalized cardiac diagnostics requires accurate reconstruction of myocardial displacement fields from sparse clinical imaging data. In this work, we apply the Parametrized-Background Data-Weak (PBDW) approach to three-dimensional (3D) cardiac displacement field reconstruction from limited magnetic resonance image-like observations. We introduce two methodological enhancements: (i) an H-size minibatch worst-case orthogonal matching pursuit algorithm that improves Sensor Selection (SSEL) while maintaining reconstruction accuracy, and (ii) memory optimisation techniques exploiting block matrix structures in vectorial problems. We demonstrate the effectiveness of the method through validation on a three-dimensional left ventricular model with simulated scar tissue. Starting with noise-free reconstruction, we systematically incorporate Gaussian noise and spatial sparsity mimicking realistic Magnetic Resonance Image acquisition protocols. Results show exceptional accuracy in noise-free conditions with relative L_2 error of 1e-5 , robust performance with 10 L_2 error of 1e-2 , and effective reconstruction from sparse measurements with relative L_2 error of 1e-2 . The online reconstruction achieves sub-second computation times for a given patient geometry, enabling rapid clinical feedback and parameter studies that would be prohibitive with full Finite Element simulations, demonstrating significant potential for integration into clinical cardiac modelling workflows.
The 11th Cardiovascular Outcome Trial (CVOT) Summit: Congress on Cardiovascular, Kidney, and Metabolic Outcomes was held virtually on November 20-21, 2025. The Summit provided a multidisciplinary forum to review and discuss recent outcome trials investigating emerging pharmacological therapies targeting diseases of the cardiovascular-kidney-metabolic (CKM) continuum. This report highlights the unique developments of 2025 discussed during the Summit, including the first head-to-head CVOT (SURPASS-CVOT), the growing evidence base for combination therapies across the disease spectrum, new insights into the inflammatory component of the CKM syndrome, and relevant policy developments. The first part of this report summarizes pioneering clinical trials addressing combination therapy with finerenone and empagliflozin (CONFIDENCE), the oral glucagon-like peptide-1 (GLP-1) receptor agonists orforglipron (ATTAIN-1), and the aldosterone synthase inhibitor (ASI) baxdrostat (BaxHTN). The second part presents recent guideline and policy developments discussed by experts in endocrinology, diabetology, cardiology, nephrology, hepatology, and general practice. In addition, advances in medical technology, particularly in continuous glucose and ketone monitoring, are highlighted, as well as emerging therapies for diseases of the CKM continuum. These include pharmacological agents for a broad spectrum of metabolic disorders such as metabolic liver disease and type 1 Diabetes (T1D) alongside emphasis on the importance of early detection and innovative treatment strategies. The 12th Cardiovascular Outcome Trial Summit will be held virtually on 19-20 November 2026 (http://www.cvot.org).
BACKGROUND:We aimed to conduct an individual patient data meta-analysis on blood neurofilament light chain (NfL) in ischemic stroke (IS) to enhance its clinical applicability. METHODS:We performed a systematic literature search of studies on blood NfL measured in adult patients within 30 days after IS onset and derived age- and BMI-adjusted Z-scores based on a previously published reference population of healthy controls. We collected clinical, radiological and biochemical parameters of IS patients and tested associations of NfL at defined timepoints after IS onset (D1: < 24 h; D2: 24-48 h; D3: 48-72 h; D4-5: 72-120 h; D6-7: 120-168 h; D8-30: > 168 h) with baseline characteristics and 3-month follow-up outcomes (modified Rankin Scale, mRS; survival). RESULTS:We included 4081 blood NfL values from 2872 participants (IS n = 1985, transient ischemic attack n = 88, healthy controls n = 799) of 18 published studies and 3 unpublished cohorts. In patients with IS, NfL Z-score progressively increased from D1 [median: 2.0 (IQR: 0.9-2.9)] to D6-7 [median: 3.5 (IQR: 3.0-3.8)], with discriminative ability being high for IS vs. controls (AUC: 0.79-0.97) and fair for IS vs. TIA (AUC: 0.64-0.80). Higher NfL Z-score at D1 was associated with greater risk of symptomatic intracranial hemorrhage (aOR = 1.33, p = 0.014) and, from D2 onwards, with larger infarct lesion volume (highest Spearman's rho: 0.795 at D6-7). NfL independently predicted a mRS > 2 (aOR = 1.31, p < 0.001) and mortality (aOR = 1.67, p < 0.001) at 3 months. CONCLUSIONS:Blood NfL level was progressively elevated after IS, could discriminate IS from healthy controls with high accuracy and had prognostic value for intra-hospital complications and 3-month clinical outcomes in IS.
The 2025 ECCO-ESGAR-ESP-IBUS multisociety guidelines mark a paradigm shift in IBD management, positioning imaging as a central element of the treat-to-target strategy. This critical review analyzes these updates from a radiological perspective. Magnetic resonance enterography (MRE) and intestinal ultrasound (IUS) are now established as co-first-line modalities for diagnosis and monitoring, reflecting their proven accuracy and safety. Evidence from trials such as METRIC, TRUST-UC, and PISA-II demonstrates that cross-sectional imaging reliably detects disease activity, complications, and therapeutic response, enabling proactive, non-invasive disease control. The guidelines promote early imaging-based assessment and incorporate transmural healing as an achievable therapeutic target. However, practical barriers remain, including limited access to MRE, operator dependence on IUS, and heterogeneity in the definition of transmural healing and fibrosis. Implementing standardized protocols and structured training is essential to realize the guidelines’ vision. By positioning imaging at the core of IBD care, the 2025 guidelines transform radiology from a diagnostic adjunct to a strategic driver of precision therapy. Cross-sectional imaging, particularly MRE and IUS, has become indispensable for comprehensive IBD assessment. The 2025 ECCO-ESGAR-ESP-IBUS guidelines integrate imaging into every phase of patient management, underscoring its value for diagnosis, monitoring, and achieving transmural remission. This shift requires structured training and harmonization across Europe.
