From Pulmonary Artery Repair to Right Ventricular Outflow Tract Replacement

Obstructive lesions to the pulmonary circulation present with nonspecific symptoms varying from chest pain, dyspnea on exertion, and cough to florid right heart failure.1 Congenital pulmonic stenosis, pulmonary embolism (PE), and chronic thromboembolic pulmonary hypertension (CTEPH) are common etiologies.2 Primary tumors of the pulmonary vasculature are less common and more likely occur owing to metastatic involvement.3 Given the rarity of these tumors, their presentation commonly is misdiagnosed, and patients commonly are treated for chronic thromboembolism.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: E-Challenge Source Type: research

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Publication date: Available online 21 November 2019Source: Journal of Acupuncture and Meridian StudiesAuthor(s): Maria P. Volpato, Izabela C.A. Breda, Ravena C. de Carvalho, Caroline de Castro Moura, Laís L. Ferreira, Marcelo L. Silva, Josie R.T. Silva
Source: Journal of Acupuncture and Meridian Studies - Category: Complementary Medicine Source Type: research
Purpose of review Hyperlipidemia, hypertension, diabetes and related metabolic disorders increase the risk for cardiovascular disease (CVD). Despite significant progress in the identification of key mechanisms and genetic polymorphisms linked to various CVDs, the rates of CVDs continue to escalate, underscoring the need to evaluate additional mechanisms for more effective therapies. Environment and lifestyle changes can alter epigenetic mechanisms mediated by histone modifications and long noncoding RNAs (lncRNAs) which play important roles in gene regulation. The review summarizes recent findings on the role of epigenet...
Source: Current Opinion in Cardiology - Category: Cardiology Tags: MOLECULAR GENETICS: Edited by Ali J. Marian Source Type: research
Purpose of review Genetic variance on blood pressure was shown about 100 years ago; a Mendelian inheritance was initially presumed. Platt and Pickering conducted a lively debate, whether blood pressure was inherited in a Mendelian fashion or whether the condition was polygenic. Genetic-hypertension research has appropriately followed both pathways. Recent findings Genome-wide association studies, Pickering model, have identified more than 500 blood-pressure loci, the targets of which are waiting to be evaluated. Then, come the ‘dark-horses’ of hypertension, namely ‘secondary’ causes. These cond...
Source: Current Opinion in Cardiology - Category: Cardiology Tags: MOLECULAR GENETICS: Edited by Ali J. Marian Source Type: research
No abstract available
Source: Current Opinion in Cardiology - Category: Cardiology Tags: CARDIAC FAILURE: Edited by Rebecca Cogswell and Gene Kim Source Type: research
Purpose of review To review the shared pathology of atrial fibrillation and heart failure with preserved ejection fraction (HFpEF) and the prognostic, diagnostic, and treatment challenges incurred by the co-occurrence of these increasingly prevalent diseases. Recent findings Multiple risk factors and mechanisms have been proposed as potentially linking atrial fibrillation and HFpEF, with systemic inflammation more recently being invoked. Nonvitamin K oral anticoagulants, left atrial appendage occlusion devices, and catheter ablation have emerged as alternative treatment options. Other novel pharmacological agents, suc...
Source: Current Opinion in Cardiology - Category: Cardiology Tags: CARDIAC FAILURE: Edited by Rebecca Cogswell and Gene Kim Source Type: research
Purpose of review Atrial arrhythmias are common among individuals with heart failure with a reduced ejection fraction (HFrEF). This review describes management options for these arrhythmias and discusses emerging clinical data supporting catheter ablation. Recent findings Several recent clinical trials indicate that catheter ablation is superior to pharmacologic therapy for management of symptomatic atrial fibrillation in the setting of HFrEF. Restoration and maintenance of sinus rhythm appears to have the greatest benefit with regard to ejection fraction improvement among individuals with a nonischemic heart failure ...
Source: Current Opinion in Cardiology - Category: Cardiology Tags: CARDIAC FAILURE: Edited by Rebecca Cogswell and Gene Kim Source Type: research
Purpose of review Atrial arrhythmias commonly occur in patients with advanced heart failure with reduced ejection fraction (HFrEF) who require left ventricular assist devices (LVADs) implantation. This review summarizes the current literature regarding the incidence, prevalence, and predictors of atrial arrhythmias in LVAD patients and its impact on the clinical outcomes. Moreover, we review the mechanisms and management strategies of atrial arrhythmias in this population. Recent findings Atrial arrhythmias including atrial fibrillation, atrial flutter, and atrial tachycardia are highly prevalent in patients with adva...
Source: Current Opinion in Cardiology - Category: Cardiology Tags: CARDIAC FAILURE: Edited by Rebecca Cogswell and Gene Kim Source Type: research
Purpose of review To provide a framework for approaching ventricular arrhythmias in the setting of cardiomyopathy, outline the latest evidence-based recommendations for catheter ablation and device therapy, and discuss novel treatment strategies. Recent findings Risk stratification of ventricular arrhythmias in systolic heart failure has evolved, with an increasing role for cardiac magnetic resonance imaging to identify underlying substrate and scar burden. Medical therapy for heart failure has greatly improved, and the role of primary prevention defibrillators in nonischemic cardiomyopathy has become more ambiguous. ...
Source: Current Opinion in Cardiology - Category: Cardiology Tags: CARDIAC FAILURE: Edited by Rebecca Cogswell and Gene Kim Source Type: research
Purpose of review Left ventricular assist devices (LVADs) have extended the life expectancy of patients with heart failure. The hemodynamic support afforded by LVADs in this population has also resulted in patients having prolonged ventricular arrhythmias. The purpose of this article is to review the mechanisms of ventricular arrhythmias in LVADs and the available management strategies. Recent findings Recent evidence suggests that prolonged ventricular arrhythmias may result in increased mortality in patients with LVADs. Summary Successful management of ventricular arrhythmias in patients with LVAD requires interd...
Source: Current Opinion in Cardiology - Category: Cardiology Tags: CARDIAC FAILURE: Edited by Rebecca Cogswell and Gene Kim Source Type: research
Purpose of review His bundle pacing (HBP) has emerged as a novel method to achieve electrical resynchronization in bundle branch block and as an alternative means to deliver cardiac resynchronization therapy (CRT). There are now data on HBP in CRT-eligible patients from cohort studies and a single pilot randomized controlled trial (RCT). Recent findings Early clinical data regarding HBP in heart failure have demonstrated echocardiographic and functional improvement similar to traditional biventricular pacing (BiV), mostly when utilized as a bailout to traditional BiV-CRT. A single pilot RCT, His-SYNC, showed a trend t...
Source: Current Opinion in Cardiology - Category: Cardiology Tags: CARDIAC FAILURE: Edited by Rebecca Cogswell and Gene Kim Source Type: research
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