Evolving Applications of Echocardiography in the Evaluation of Left Atrial and Right Ventricular Strain
AbstractPurpose of ReviewSpeckle-tracking echocardiography (STE) can assess myocardial motion in non-LV chambers —including assessment of left atrial (LA) and right ventricular (RV) strain. This review seeks to highlight the diagnostic, prognostic, and clinical significance of these parameters in heart failure, atrial fibrillation (AF), diastolic dysfunction, pulmonary hypertension (PH), tricuspid regurgitat ion, and heart transplant recipients.Recent FindingsImpaired LA strain reflects worse LV diastolic function in individuals with and without HF, and this is associated with decreased exercise capacity. Initiating trea...
Source: Current Cardiology Reports - April 22, 2024 Category: Cardiology Source Type: research
Outcomes of Percutaneous Revascularization in Severe Ischemic Left Ventricular Dysfunction
This article presents a comprehensive review of coronary revascularization versus optimal medical therapy (OMT) in patients with severe ischemic left ventricular dysfunction.Recent FindingsThe REVIVED-BCIS2 trial randomized 700 patients with extensive coronary artery disease and left ventricular (LV) ejection fraction (LVEF) ≤ 35% and viability in more than four dysfunctional myocardial segments to percutaneous coronary intervention (PCI) plus OMT versus OMT alone. Over a median duration of 41 months, there was no difference in the composite of all-cause mortality, heart failure hospitalization, or improvement i n ...
Source: Current Cardiology Reports - April 20, 2024 Category: Cardiology Source Type: research
Unexplained Residual Risk In Type 2 Diabetes: How Big Is The Problem?
AbstractPurpose of ReviewWhat is new? Cardiovascular disease (CVD) is the leading cause of mortality in type 2 diabetes (T2D) individuals. Of the major risk factors for CVD, less than 10% of T2D people meet the American Diabetes Association/American Heart Association recommended goals of therapy. The present review examines how much of the absolute cardiovascular (CV) risk in type 2 diabetes patients can be explained by major CV intervention trials.Recent FindingsMultiple long-term cardiovascular (CV) intervention trials have examined the effect of specific target-directed therapies on the MACE endpoint. Only oneprospectiv...
Source: Current Cardiology Reports - April 18, 2024 Category: Cardiology Source Type: research
Occupational Risks of Radiation Exposure to Cardiologists
AbstractPurpose of ReviewInvasive cardiologists are exposed to large amounts of ionizing radiation. This review aims to summarize the main occupational risks in a radiation-exposed cardiology practice.Recent FindingsWe carried out a literature review on the subject. The studies reviewed allowed us to list six main health risk categories possibly associated with radiation exposure among cardiologists: deoxyribonucleic acid (DNA) and biochemical damages; cancers; ocular manifestations; olfaction, vascular, and neuropsychological alterations; musculoskeletal problems; and reproductive risks.SummaryOur descriptive analysis dem...
Source: Current Cardiology Reports - April 16, 2024 Category: Cardiology Source Type: research
Drug-Coated Balloon in Acute Coronary Syndromes: Ready for the Prime Time?
AbstractPurpose of ReviewAcute coronary syndromes (ACS) are a major global health concern. Percutaneous coronary intervention (PCI) with new-generation drug-eluting stents (DES) has been endorsed as safe and effective in the management of culprit and non-culprit lesions of ACS. However, permanent metallic implants may have drawbacks, including the need for prolonged dual antiplatelet therapy (DAPT) and the risk of long-term stent-related complications. An alternative approach using drug-coated balloons (DCBs) is gaining growing interest, having the potential of delivering therapy directly to vulnerable plaques, avoiding th...
Source: Current Cardiology Reports - April 15, 2024 Category: Cardiology Source Type: research
Impact of Social Determinants of Health on Outcomes for Patients with Adult Congenital Heart Disease
AbstractPurpose of ReviewThe study of adults with congenital heart disease (ACHD) is a rapidly growing field; however, more research is needed on the disparities affecting outcomes. With advances in medicine, a high percentage of patients with congenital heart disease (CHD) are advancing to adulthood, leading to an increase in the number of ACHD. This creates a pressing need to evaluate the factors, specifically the social determinants of health (SDOH) contributing to the outcomes for ACHD.Recent FindingsA myriad of factors, including, but not limited to, race, education, and socioeconomic status, have been shown to affect...
Source: Current Cardiology Reports - April 13, 2024 Category: Cardiology Source Type: research
Arrhythmogenesis in Fabry Disease
AbstractPurpose of ReviewFabry Disease (FD) is a rare lysosomal storage disorder characterised by multiorgan accumulation of glycosphingolipid due to deficiency in the enzyme α-galactosidase A. Cardiac sphingolipid accumulation triggers various types of arrhythmias, predominantly ventricular arrhythmia, bradyarrhythmia, and atrial fibrillation. Arrhythmia is likely the primary contributor to FD mortality with sudden cardiac death, the most frequent cardiac mode of death . Traditionally FD was seen as a storage cardiomyopathy triggering left ventricular hypertrophy, diastolic dysfunction, and ultimately, systolic dysfuncti...
Source: Current Cardiology Reports - April 12, 2024 Category: Cardiology Source Type: research
Contemporary Risk Models for In-Hospital and 30-Day Mortality After Percutaneous Coronary Intervention
AbstractPurpose of ReviewRisk models for mortality after percutaneous coronary intervention (PCI) are underutilized in clinical practice though they may be useful during informed consent, risk mitigation planning, and risk adjustment of hospital and operator outcomes. This review analyzed contemporary risk models for in-hospital and 30-day mortality after PCI.Recent FindingsWe reviewed eight contemporary risk models. Age, sex, hemodynamic status, acute coronary syndrome type, heart failure, and kidney disease were consistently found to be independent risk factors for mortality. These models provided good discrimination (C-...
Source: Current Cardiology Reports - April 9, 2024 Category: Cardiology Source Type: research
Caring for the Critically Ill Adult Congenital Heart Disease Patient
AbstractPurpose of ReviewThis review aims to discuss the unique challenges that adult congenital heart disease (ACHD) patients present in the intensive care unit.Recent FindingsRecent studies suggest that ACHD patients make up an increasing number of ICU admissions, and that their care greatly improves in centers with specialized ACHD care. Common reasons for admission include arrhythmia, hemorrhage, heart failure, and pulmonary disease.SummaryIt is critical that the modern intensivist understand not only the congenital anatomy and subsequent repairs an ACHD patient has undergone, but also how that anatomy can predispose t...
Source: Current Cardiology Reports - April 9, 2024 Category: Cardiology Source Type: research
Insights into the Inherited Basis of Valvular Heart Disease
AbstractPurpose of ReviewIncreases in the availability of genetic data and advances in the tools and methods for their analyses have enabled well-powered genetic association studies that have significantly enhanced our understanding of the genetic factors underlying both rare and common valve diseases. Valvular heart diseases, such as congenital valve malformations and degenerative valve lesions, increase the risk of heart failure, arrhythmias, and sudden death. In this review, we provide an updated overview of our current understanding of the genetic mechanisms underlying valvular heart diseases. With a focus on discove...
Source: Current Cardiology Reports - April 6, 2024 Category: Cardiology Source Type: research
Right Ventricle-Pulmonary Artery Coupling in Patients Undergoing Cardiac Interventions
AbstractPurpose of ReviewThis review aims to summarize the fundamentals of RV-PA coupling, its non-invasive means of measurement, and contemporary understanding of RV-PA coupling in cardiac surgery, cardiac interventions, and congenital heart disease.Recent FindingsThe need for more accessible clinical means of evaluation of RV-PA coupling has driven researchers to investigate surrogates using cardiac MRI, echocardiography, and right-sided pressure measurements in patients undergoing cardiac surgery/interventions, as well as patients with congenital heart disease. Recent research has aimed to validate these alternative mea...
Source: Current Cardiology Reports - April 6, 2024 Category: Cardiology Source Type: research
Intraoperative Echocardiography: Guide to Decision-Making
AbstractPurpose of ReviewThis review aims to provide a concise overview of key recommendations, with a specific focus on common challenges faced by intraoperative echocardiographers when dealing with frequently encountered valvular pathologies and mechanical circulatory support. It offers valuable insights for medical practitioners in this field.Recent FindingsThe American Society of Echocardiography (ASE) and the American College of Cardiology/American Heart Association (ACC/AHA) have released updated comprehensive guidelines for the use of transesophageal echocardiography (TEE) for the assessment of cardiac structures an...
Source: Current Cardiology Reports - April 4, 2024 Category: Cardiology Source Type: research
Colchicine for the Prevention of Cardiovascular Disease: Potential Global Implementation
AbstractPurpose of ReviewTargeting traditional cardiovascular risk factors is effective in reducing recurrent cardiovascular events, yet the presence of residual cardiovascular risk due to underlying systemic inflammation is a largely unaddressed opportunity. This review aims to comprehensively assess the evolving role of colchicine as a therapeutic approach targeting residual inflammatory risk in the context of those with coronary artery disease (CAD).Recent FindingsInflammation plays a significant role in promoting atherosclerosis, and targeting anti-inflammatory pathways has the potential to decrease cardiovascular even...
Source: Current Cardiology Reports - April 4, 2024 Category: Cardiology Source Type: research
Polycystic Ovary Syndrome, Insulin Resistance, and Cardiovascular Disease
AbstractPurpose of ReviewPolycystic ovary syndrome (PCOS) is a prevalent endocrine disorder in women of reproductive age. It has been associated with metabolic, reproductive, and psychiatric disorders. Despite its association with insulin resistance (IR) and cardiovascular disease (CVD) risk factors, the association between PCOS and CVD outcomes has been conflicting. This review reports the updated evidence between PCOS, insulin resistance, and CVD events.Recent FindingsIR is highly prevalent occurring in 50 to 95% of general and obese PCOS women. The etiology of PCOS involves IR and hyperandrogenism, which lead to CVD ris...
Source: Current Cardiology Reports - April 3, 2024 Category: Cardiology Source Type: research
Polypill Strategy in Secondary Cardiovascular Prevention
AbstractPurpose of ReviewThe polypill strategy, originally developed to improve medication adherence, has demonstrated efficacy in improving baseline systolic blood pressures and cholesterol levels in multiple clinical trials. However, the long-term clinical impact of improved major cardiovascular events (MACE) outcomes by the polypill remains uncertain.Recent FindingsRecent trials with long-term follow-up, which included minority groups and people with low socioeconomic status, have shown non-inferiority with no difference in adverse effects rates for the secondary prevention of MACE.SummaryAlthough the polypill strategy ...
Source: Current Cardiology Reports - April 1, 2024 Category: Cardiology Source Type: research
