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Yosprala: A Fixed Dose Combination of Aspirin and Omeprazole
Cardiovascular disease is the leading cause of morbidity and mortality in the United States. Patients who survive a primary cerebrovascular or cardiovascular event are at increased risk of a subsequent occurrence. Antiplatelet therapy plays an essential role for secondary prevention in individuals with stroke, transient ischemic attack, acute or chronic artery disease, or peripheral arterial disease. Maintaining high-risk patients on low-dose aspirin therapy is a fundamental component of management. However, poor adherence, secondary to the drug’s gastrointestinal side effects, has been associated with negative cardi...
Source: Cardiology in Review - December 7, 2017 Category: Cardiology Tags: New Therapy Update Source Type: research

Devices for Autonomic Regulation Therapy in Heart Failure With Reduced Ejection Fraction
Heart failure (HF) is associated with significant morbidity and mortality and an increasing economic burden. The persistence of HF’s risk factors, coupled with an aging population, also leads to an increase in its incidence and prevalence. It is well established that sympathetic hyperactivity and parasympathetic withdrawal are instrumental in the development and worsening of HF. Therefore, restoring autonomic balance to the cardiovascular system is an attractive therapeutic approach. The following is a review of current clinical trials of device-based autonomic regulation therapy in the management of HF with a reduce...
Source: Cardiology in Review - December 7, 2017 Category: Cardiology Tags: Review Articles Source Type: research

Milrinone Dosing and a Culture of Caution in Clinical Practice
Milrinone is an invaluable agent in the treatment of end-stage heart failure patients who are refractory to optimal medical therapy. In addition to its use in acute decompensated heart failure, milrinone can also be employed as a home infusion therapy or a bridge to cardiac transplant. Concerns about its adverse effects, such as an increased risk of arrhythmias and hypotension, often limit the doses of milrinone used in clinical practice. In addition, milrinone is infrequently used or avoided entirely in patients with acute renal failure or end-stage renal disease because the drug is primarily cleared by renal excretion. D...
Source: Cardiology in Review - December 7, 2017 Category: Cardiology Tags: Review Articles Source Type: research

Ability of Nonstrain Diastolic Parameters to Predict Doxorubicin-Induced Cardiomyopathy: A Systematic Review With Meta-Analysis
Doxorubicin is an important cause of chemotherapy-induced cardiomyopathy. Prior studies have found conflicting results of whether nonstrain diastolic parameters can predict doxorubicin-induced cardiotoxicity. We performed a systematic review of English written publications using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The following inclusion criteria were applied: cancer subjects, echo-derived nonstrain diastolic profile, and patients compared before and after treatment to predict systolic dysfunction. The following exclusion criteria were applied: other cardiotoxic agents, n...
Source: Cardiology in Review - December 7, 2017 Category: Cardiology Tags: Review Articles Source Type: research

Mitral Valve and Subvalvular Repair for Secondary Mitral Regurgitation: Rationale and Clinical Outcomes of the Papillary Muscle Sling
We present a comprehensive review of the pathophysiology of secondary MR, and the rationale and clinical outcomes of MV repair with papillary muscle sling placement for the treatment of secondary MR. (Source: Cardiology in Review)
Source: Cardiology in Review - December 7, 2017 Category: Cardiology Tags: Review Articles Source Type: research

Cardiosphere-Derived Cells and Ischemic Heart Failure
After a myocardial infarction, heart tissue becomes irreversibly damaged, leading to scar formation and inevitably ischemic heart failure. Of the many available interventions after a myocardial infarction, such as percutaneous intervention or pharmacological optimization, none can reverse the ischemic insult on the heart and restore cardiac function. Thus, the only available cure for patients with scarred myocardium is allogeneic heart transplantation, which comes with extensive costs, risks, and complications. However, multiple studies have shown that the heart is, in fact, not an end-stage organ and that there are endoge...
Source: Cardiology in Review - December 7, 2017 Category: Cardiology Tags: Review Articles Source Type: research

Five Presidents and a Secretary
No abstract available (Source: Cardiology in Review)
Source: Cardiology in Review - December 7, 2017 Category: Cardiology Tags: Editorial Source Type: research

Early Coronary Angiography for Survivors of Out-of-Hospital Cardiac Arrests Without ST Elevation
There are over 300,000 out-of-hospital cardiac arrests (OOHCA) in the United States each year, and the long-term survival rate is less than 10%. Despite improvements in postarrest management, the greatest drop-off in survival occurs during hospitalization, mostly due to myocardial dysfunction and neurological injury. Coronary artery disease is common in postcardiac arrest patients, with an incidence of approximately 60–80%. In patients with a chest pain syndrome and an ST-segment–elevation myocardial infarction pattern evident on the presenting electrocardiogram, immediate revascularization is recommended by ca...
Source: Cardiology in Review - October 7, 2017 Category: Cardiology Tags: Review Articles Source Type: research

Pregnancy in Patients With Congenital Heart Disease: A Contemporary Challenge
The majority of female patients with congenital heart disease (CHD) survives into childbearing age and require evidence-based counseling regarding pregnancy options. Even though most of them will have an uneventful pregnancy, they may be at high risk of cardiac, obstetric, and fetal complications. Predictive factors for these complications have been previously identified in numerous studies and with the use of specific scores [CARdiac disease in PREGnancy, Zwangerschap bij Aangeboren HARtAfwijkingen, and World Health Organization (WHO) risk stratification.] Importantly, the subtype of CHD is of vital importance for the pre...
Source: Cardiology in Review - October 7, 2017 Category: Cardiology Tags: Review Articles Source Type: research

Is Swimming Safe in Heart Failure? A Systematic Review
It is not clear whether swimming is safe in patients with chronic heart failure. Ten studies examining the hemodynamic effects of acute water immersion (WI) (155 patients; average age 60 years; 86% male; mean left ventricular ejection fraction (LVEF) 29%) and 6 randomized controlled trials of rehabilitation comparing swimming with either medical treatment only (n = 3) or cycling (n = 1) or aerobic exercise (n = 2), (136 patients, average age 59 years; 84% male, mean LVEF 31%) were considered. In 7 studies of warm WI (30–35°C): heart rate (HR) fell (2% to −15%), and both cardiac output (CO) (7–37%) and...
Source: Cardiology in Review - October 7, 2017 Category: Cardiology Tags: Review Articles Source Type: research

Neprilysin Inhibition and the Treatment of Heart Failure: Recent Steps in the Right Direction
This article will review the history of the natriuretic peptide system and the investigations into it as a target for heart failure treatment, culminating in the positive results of the PARADIGM-HF trial, as well as planned and potential future directions for research. (Source: Cardiology in Review)
Source: Cardiology in Review - October 7, 2017 Category: Cardiology Tags: Review Articles Source Type: research

Echocardiography in the Evaluation of Pulmonary Embolism
Pulmonary embolism is a major cause of mortality. Acute pulmonary embolism also encompasses a wide clinical spectrum of severity, ranging from asymptomatic silent disease to hemodynamic instability and shock. Echocardiography is a useful modality to improve treatment strategies for pulmonary embolus. Echocardiography plays a role in risk stratification at the time of diagnosis. The evaluation of the right ventricle (RV) has evolved over time. RV variables evaluated by echocardiography include RV size, RV/left ventricular ratio, RV fractional area of change, tricuspid annular plane systolic excursion, RV systolic pressure, ...
Source: Cardiology in Review - October 7, 2017 Category: Cardiology Tags: Review Articles Source Type: research

Vitamins for Cardiovascular Diseases: Is the Expense Justified?
Despite the knowledge that a well-balanced diet provides most of the nutritional requirements, the use of supplemental vitamins is widespread among adults in the United States. Evidence from large randomized controlled trials over the last 2 decades does not support vitamin supplementation for the reduction of cardiovascular risk factors or clinical outcomes. Many of the vitamins used in common practice likely are safe when consumed in small doses, but long-term consumption of megadoses is not only expensive but has the potential to cause adverse effects. Therefore, a need exists to revisit this issue, reminding the public...
Source: Cardiology in Review - October 7, 2017 Category: Cardiology Tags: Review Articles Source Type: research

Contemporary Diagnosis and Management of Atrial Flutter: A Continuum of Atrial Fibrillation and Vice Versa?
Atrial flutter (AFlu) is usually a fast (>240 bpm) and regular right atrial macroreentrant tachycardia, with a constrained critical region of the reentry circuit located at the cavotricuspid isthmus (CTI; typical CTI-dependent AFlu). However, a variety of right and left atrial tachycardias, resulting from different mechanisms, can also present as AFlu (atypical non-CTI-dependent AFlu). The electrocardiogram can provide clues to its origin and location; however, additional entrainment and more sophisticated electroanatomical mapping techniques may be required to identify its mechanism, location, and target area for a suc...
Source: Cardiology in Review - October 7, 2017 Category: Cardiology Tags: Review Articles Source Type: research

Brain-Heart Interactions in Traumatic Brain Injury
The cardiovascular manifestations associated with nontraumatic head disorders are commonly known. Similar manifestations have been reported in patients with traumatic brain injury (TBI); however, the underlying mechanisms and impact on the patient’s clinical outcomes are not well explored. The neurocardiac axis theory and neurogenic stunned myocardium phenomenon could partly explain the brain-heart link and interactions and can thus pave the way to a better understanding and management of TBI. Several observational retrospective studies have shown a promising role for beta-adrenergic blockers in patients with TBI in ...
Source: Cardiology in Review - October 7, 2017 Category: Cardiology Tags: Review Articles Source Type: research

Ascending Aortic Aneurysm Is an Inherited Disease: A Contemporary Literature Review Based on Hill’s Criteria of Specificity, Strength of Association, and Biological Coherence
There is growing evidence of a differential etiological basis for thoracic aortic aneurysms (TAA), with ascending (As) TAAs being genetically mediated and descending (Des) TAAs more strongly related to acquired pathologies. A comprehensive literature review of this hypothesis has not been carried out. We carried out a systematic literature review based on the latest guidelines on TAA endorsed by the American Heart Association. The etiologies were classified as genetic and inherited, the studies were tabulated accordingly, and Hill’s epidemiological criteria of causality were applied. We found 38 studies addressing th...
Source: Cardiology in Review - October 7, 2017 Category: Cardiology Tags: Review Articles Source Type: research

Neuroendovascular Surgery for the Treatment of Ischemic Stroke
This review discusses modern therapeutic interventions for acute ischemic stroke with a focus on endovascular therapy. In 2015, the American Heart Association made major changes to the guidelines for the endovascular treatment of acute ischemic stroke. The Class IA indications for endovascular therapy of stroke patients include symptom onset within 6 h, proven large vessel occlusion of an artery in the anterior circulation, and the use of a stent retriever as part of the mechanical thrombectomy. Advanced perfusion imaging helps identify patients with a low ratio of ischemic core to salvageable penumbra. Equally impo...
Source: Cardiology in Review - October 7, 2017 Category: Cardiology Tags: Review Articles Source Type: research

Adrian Kantrowitz, MD (1918–2008) and His Contributions to Cardiac Transplantation
No abstract available (Source: Cardiology in Review)
Source: Cardiology in Review - October 7, 2017 Category: Cardiology Tags: Editorials Source Type: research

Westchester Medical Center and Its Health Care System: One Hundred Years (1917–2017) of Dedicated Service to Community, Country, and Cardiology
No abstract available (Source: Cardiology in Review)
Source: Cardiology in Review - October 7, 2017 Category: Cardiology Tags: Editorials Source Type: research

Celiprolol: A Unique Selective Adrenoceptor Modulator
Celiprolol is a β-blocker with a unique pharmacologic profile: it is a β1-andrenoceptor antagonist with partial β2 agonist activity. Given this combination of effects, celiprolol may be better described as a selective adrenoreceptor modulator. It has antihypertensive and antianginal properties and is indicated for those uses in various countries around the world. In the United States, however, the proposed indication for this drug will be for the treatment of vascular type Ehlers–Danlos syndrome, a rare connective tissue disorder characterized by fragile arterial structure and an increased risk of life...
Source: Cardiology in Review - August 7, 2017 Category: Cardiology Tags: New Therapy Updates Source Type: research

Droxidopa for Symptomatic Neurogenic Hypotension
Droxidopa is a first-in-class, orally available, synthetic amino acid precursor of norepinephrine that received accelerated Food and Drug Administration approval in February 2014 after Orphan Drug status for a debilitating condition known as symptomatic neurogenic orthostatic hypotension. Neurogenic disorders often lead to postural hypotension as a result of poor norepinephrine release from its storage sites. Clinical data suggest increases in standing systolic blood pressure and improvements in many other markers for subjective relief in patients with symptomatic neurogenic hypotension who received droxidopa therapy over ...
Source: Cardiology in Review - August 7, 2017 Category: Cardiology Tags: New Therapy Updates Source Type: research

Trial of Time: Review of Frailty and Cardiovascular Disease
Frailty has become more frequently recognized as an indicator of predisability. It has been shown to have an association with cardiovascular disease (CVD), just as CVD has an association with frailty, and is a predictor of hospitalization and mortality. The ability to identify this population provides a measure to more accurately assess risk and prognosis which can help the early detection of disease and dictate intervention. This has become even more critical over time with the advent of various therapeutic interventions that are geared toward patients who are poor candidates for aggressive surgical measures, such as tran...
Source: Cardiology in Review - August 7, 2017 Category: Cardiology Tags: Review Articles Source Type: research

Epicardial Fat: Pathophysiology and Clinical Significance
Over the last decade and a half there has been much interest in understanding the role of epicardial adipose tissue (EAT) in cardiac pathology. EAT is a visceral adipose deposit with putative paracrine function. In the nondiseased state, EAT releases cardioprotective cytokines and chemokines to the coronary vasculature. In pathological states, EAT releases an inflammatory cytokine profile that is believed to contribute to the development and progression of coronary artery disease (CAD). EAT imaging with echocardiography, computed tomography, and magnetic resonance imaging has demonstrated a correlation between EAT size and...
Source: Cardiology in Review - August 7, 2017 Category: Cardiology Tags: Review Articles Source Type: research

Novel Oral Anticoagulants in the Peri-Endoscopic Period
Millions of patients in the United States are currently prescribed some form of anticoagulation therapy. Recently, novel oral anticoagulants (NOACs), including direct thrombin inhibitors and direct factor Xa inhibitors, have begun to replace warfarin as the drugs of choice for anticoagulation. As the use of these medications becomes more widespread, it is increasingly important for gastroenterologists to understand the risks associated with performing endoscopic procedures on patients who are taking NOACs. In this review, we provide an overview of the NOACs and current guidelines from international societies regarding the ...
Source: Cardiology in Review - August 7, 2017 Category: Cardiology Tags: Review Articles Source Type: research

Cardiovascular Manifestations of Pheochromocytoma
Pheochromocytomas are rare endocrine tumors that can have a significant impact on a variety of organ systems, including the cardiovascular system. Although the pathophysiology is not completely understood, pheochromocytomas exert their effects through high levels of catecholamines, mainly epinephrine and norepinephrine, which stimulate adrenergic receptors, including those within the cardiovascular system. Although the most common cardiovascular manifestation is hypertension, patients with pheochromocytoma can present with arrhythmia, hypotension, shock, myocardial ischemia, cardiomyopathy, aortic dissection, and periphera...
Source: Cardiology in Review - August 7, 2017 Category: Cardiology Tags: Review Articles Source Type: research

Carotid Stenosis and Impaired Cognition: The Effect of Intervention
There is a clear association between carotid artery stenosis and cognitive impairment. However, there is no consensus as to how to interpret this association, and what, if any, impact this connection should have on the management of carotid stenosis. A review of the relevant literature suggests that although an intervention to relieve carotid stenosis in patients without clinically significant cognitive impairment does not improve cognition, there may be a cognitive benefit with intervention for carotid stenosis in those patients with clinically significant cognitive disorders. (Source: Cardiology in Review)
Source: Cardiology in Review - August 7, 2017 Category: Cardiology Tags: Review Articles Source Type: research

Cardiac Auscultation in the Modern Era: Premature Requiem or Phoenix Rising?
Competent cardiac auscultation remains a most important skill for the detection of heart disease. Currently it is poorly taught and often ignored or poorly performed, resulting in inaccurate and inefficient patient assessments. This review documents that teaching can be over 90% effective with new, proven teaching methods emphasizing repetition and normal-abnormal comparisons of sounds, using computer-aided and online resources. At present, these concepts are not widely adopted by medical schools. Our current knowledge of teaching heart auscultation is critically reviewed, including traditional bedside, clinic and classroo...
Source: Cardiology in Review - August 7, 2017 Category: Cardiology Tags: Review Articles Source Type: research

Teaching of Cardiac Auscultation
No abstract available (Source: Cardiology in Review)
Source: Cardiology in Review - August 7, 2017 Category: Cardiology Tags: Editorial Source Type: research

Influence of Pregnancy in Patients With Congenital Long QT Syndrome
Congenital long QT syndrome (LQTS) is a disorder of myocardial repolarization and is characterized by a prolonged QT interval on an electrocardiogram. A prolonged QT predisposes patients to an increased risk of syncope and sudden cardiac death secondary to polymorphic ventricular tachycardia. Several mutations linked to the LQTS have been identified, the most common of which have been found in the potassium channel KCNQ1 (LQT1) and hERG (LQT2) genes and in the sodium channel SCN5A (LQT3) gene. Female sex is an independent risk factor for the development of torsades de pointes in LQTS. Furthermore, although pregnancy may be...
Source: Cardiology in Review - June 6, 2017 Category: Cardiology Tags: Review Articles Source Type: research

Vitamin D Deficiency and Supplementation in Cardiovascular Disorders
Cardiovascular disease (CVD) is the leading cause of death in developed countries. Similarly, the frequency of vitamin D deficiency is increasing, and a number of epidemiologic and clinical studies have suggested that there is an increased risk of CVD among people with depletion of this vitamin. This has raised much interest in the potential pathogenic and therapeutic role of vitamin D in CVD. However, randomized trials and meta-analyses have not shown a clear benefit of vitamin D supplementation with respect to cardiovascular events. Herein, we provide a comprehensive review of the most relevant evidence to date regarding...
Source: Cardiology in Review - June 6, 2017 Category: Cardiology Tags: Review Articles Source Type: research

Managing Multivessel Coronary Artery Disease in Patients With ST-Elevation Myocardial Infarction: A Comprehensive Review
This article is a comprehensive review of the literature on the treatment of multivessel CAD in patients with STEMI, which provides the reader a critical analysis of the available information to determine the best therapeutic approach. (Source: Cardiology in Review)
Source: Cardiology in Review - June 6, 2017 Category: Cardiology Tags: Review Articles Source Type: research

Coronary Microcirculatory Dysfunction in Human Cardiomyopathies: A Pathologic and Pathophysiologic Review
Cardiomyopathies are a heterogeneous group of diseases of the myocardium. The term cardiomyopathy involves a wide range of pathogenic mechanisms that affect the structural and functional states of cardiomyocytes, extravascular tissues, and coronary vasculature, including both epicardial coronary arteries and the microcirculation. In the developed phase, cardiomyopathies present with various clinical symptoms: dyspnea, chest pain, palpitations, swelling of the extremities, arrhythmias, and sudden cardiac death. Due to the heterogeneity of cardiomyopathic patterns and symptoms, their diagnosis and therapies are great challen...
Source: Cardiology in Review - June 6, 2017 Category: Cardiology Tags: Review Articles Source Type: research

Genetic Insights Into Bicuspid Aortic Valve Disease
We present an overview of the published work on genetic linkage and its association with BAV disease. Presented articles used different discovery strategies ranging from candidate gene association to whole exome sequencing, as well as various validation protocols. Although still very limited, our understanding of the molecular pathology of BAV disease is likely to influence current clinical practice by enabling genetic counseling, prenatal diagnosis, and risk stratification for individual patients. This task will be made possible thanks to increasing availability, as well as the reduced cost of next-generation sequencing a...
Source: Cardiology in Review - June 6, 2017 Category: Cardiology Tags: Review Articles Source Type: research

PFO Closure for Cryptogenic Stroke: A Review and Clinical Treatment Algorithm
We describe the historical context of PFO closure and review the observational and randomized control trial evidence in this field, culminating in the recent Food and Drug Administration approval of the first dedicated closure device for PFO. Guidelines and consensus statements are discussed, and a novel treatment algorithm is proposed. Future directions in PFO closure will include new devices, further data from completed and upcoming clinical trials, and potential expansion into other disease states associated with PFO. (Source: Cardiology in Review)
Source: Cardiology in Review - June 6, 2017 Category: Cardiology Tags: Review Articles Source Type: research

Inhaled Insulin: A Clinical and Historical Review
This article provides a review of the historical development of TI, its safety and efficacy data, and its advantages and disadvantages over traditional injectable insulins. (Source: Cardiology in Review)
Source: Cardiology in Review - April 6, 2017 Category: Cardiology Tags: New Therapy Updates Source Type: research

Cangrelor: A New Route for P2Y12 Inhibition
Antiplatelet therapy with a P2Y12 inhibitor is a key component of treatment for patients with acute coronary syndromes undergoing percutaneous coronary intervention. Before the development of cangrelor (Kengreal, The Medicines Company, Parsippany, NJ), only oral P2Y12 inhibitors were available. Cangrelor is a reversible P2Y12 inhibitor that is administered as an intravenous infusion, and its quick onset and offset make it an appealing option for antiplatelet therapy, particularly for patients who are unable to take oral medications. Although cangrelor struggled to show benefit in early trials, the positive results of the C...
Source: Cardiology in Review - April 6, 2017 Category: Cardiology Tags: New Therapy Updates Source Type: research

Advanced Therapy in Eisenmenger Syndrome: A Systematic Review
Treatment options for patients with the Eisenmenger syndrome have until recently been scarce, but new knowledge in the field of pulmonary arterial hypertension has expanded the therapeutic possibilities for these patients. Advanced therapy with pulmonary vasodilators has become part of the standard treatment, offering long-term benefits on exercise capacity, clinical symptoms, and possibly survival. However, there are currently only few studies to guide the use of advanced therapies in this population, and important questions such as indications for initiation or escalation of advanced therapy and valid effect parameters a...
Source: Cardiology in Review - April 6, 2017 Category: Cardiology Tags: Review Articles Source Type: research

MicroRNAs in Ischemic Heart Disease: From Pathophysiology to Potential Clinical Applications
Despite rapid advances in cardiovascular research and therapeutic strategies, ischemic heart disease (IHD) remains the leading cause of mortality worldwide. MicroRNAs (miRNAs) are small, noncoding RNAs which post transcriptionally regulate gene expression. In the past few years, miRNAs have emerged as key tools for the understanding of the pathophysiology of IHD, with potential uses as new biomarkers and therapeutic targets. Several studies report a regulatory role of miRNAs, with regard to fundamental components of IHD pathogenesis and progression, such as lipoprotein metabolism, atherogenesis, vascular calcification, pla...
Source: Cardiology in Review - April 6, 2017 Category: Cardiology Tags: Review Articles Source Type: research

Identification of the Asymptomatic Patient With Severe Mitral Regurgitation: Discrepancy Between Research and Clinical Practice
Organic mitral regurgitation (MR) is a common disorder, and because of the increase in population and its aging, the occurrence of MR is steadily increasing. Current guideline recommendations on the management of asymptomatic severe MR are conflicting and based solely on registries or nonrandomized trials in expert heart valve clinics, resulting in a lack of evidence for the best treatment strategy. In this review, we will evaluate the latest evidence on diagnostic approaches and treatment strategies for asymptomatic patients without a clear indication for surgical intervention. Implications for management in daily practic...
Source: Cardiology in Review - April 6, 2017 Category: Cardiology Tags: Review Articles Source Type: research

Hypertension in the Kidney Transplant Recipient: Overview of Pathogenesis, Clinical Assessment, and Treatment
Cardiovascular disease is the leading cause of death in patients with chronic renal disease and the most common cause of death and allograft loss among kidney transplant recipients. Transplant patients often have multiple cardiovascular risk factors antedating transplantation. Among the most prominent is hypertension (HTN), which affects at least 90% of transplant patients. Uncontrolled HTN is an independent risk factor for allograft loss. The etiology of HTN in transplant recipients is complex and multifactorial, including the use of essential immunosuppressive medications. Post-transplant HTN management requires a system...
Source: Cardiology in Review - April 6, 2017 Category: Cardiology Tags: Review Articles Source Type: research

The Utility of Teleultrasound to Guide Acute Patient Management
Ultrasound has evolved into a core bedside tool for diagnostic and management purposes for all subsets of adult and pediatric critically-ill patients. Teleintensive care unit coverage has undergone a similar rapid expansion period throughout the United States. Round-the-clock access to ultrasound equipment is very common in today’s intensive care unit, but 24/7 coverage with staff trained to acquire and interpret point-of-care ultrasound in real time is lagging behind equipment availability. Medical trainees and physician extenders require attending level supervision to ensure consistent image acquisition and accurat...
Source: Cardiology in Review - April 6, 2017 Category: Cardiology Tags: Review Articles Source Type: research

Neurocardiac Injury After Cerebral and Subarachnoid Hemorrhages
Cerebrovascular events are associated with high mortality and morbidity rates. Neurocardiac injury after a subarachnoid hemorrhage and cerebral hemorrhage further worsen clinical outcomes. Excess catecholamine-induced cardiotoxicity is currently the most widely accepted pathophysiologic mechanism. Awareness of neurocardiac injury and the cardiac manifestations associated with it will allow for early diagnosis and appropriate management. (Source: Cardiology in Review)
Source: Cardiology in Review - February 8, 2017 Category: Cardiology Tags: Review Articles Source Type: research

Advances in Continuous Flow Left Ventricular Assist Device Support for End-Stage Heart Failure: A Therapy in Evolution
The purpose of this review is to highlight recent advances and challenges in the clinical implementation of continuous flow left ventricular assist devices (CF LVADs) in patients with advanced heart failure. Post approval studies of CF LVAD therapy continue to show a progressive improvement in survival and reduction in adverse events. Major trials are ongoing to compare outcomes of an axial flow device (Heart Mate II) and smaller centrifugal flow pumps (HeartWare VADs and Heart Mate III). Numerous studies have investigated strategies to reduce major hematologic and neurologic adverse events by evaluating hemolysis, antithr...
Source: Cardiology in Review - February 8, 2017 Category: Cardiology Tags: Review Articles Source Type: research

On-X Valve: The Next Generation Aortic Valve
The On-X valve is a newer generation mechanical bileaflet valve. Its key features include the use of pure pyrolytic carbon (devoid of silicon), a length-to-diameter ratio similar to a native valve, an inlet flared orifice, a leaflet opening up to 90 degrees, a shorter leaflet closing angle, a 2-point leaflet contact, and an actuated pivot. These features have translated into increased strength, improved valve hemodynamics, reduced hemolysis, and thrombogenicity. The 2014 American Heart Association/American College of Cardiology guidelines for the management of patients with valvular heart disease recommend an intern...
Source: Cardiology in Review - February 8, 2017 Category: Cardiology Tags: Review Articles Source Type: research

A Review of the Clinical Utility of Intravascular Ultrasound and Optical Coherence Tomography in the Assessment and Treatment of Coronary Artery Disease
This article will also discuss IVUS and OCT’s clinical utility with regard to proper stent placement and follow-up after percutaneous coronary interventions. (Source: Cardiology in Review)
Source: Cardiology in Review - February 8, 2017 Category: Cardiology Tags: Review Articles Source Type: research

Enhanced External Counterpulsation Therapy: Past, Present, and Future
External counterpulsation therapy was first developed over half a century ago as a resuscitative tool to support the failing heart and was based on hemodynamic principles of the intraaortic balloon pump. Over the course of last few decades, it has evolved into the modern enhanced external counterpulsation (EECP) therapy, which has proven to be a safe, effective, and low-cost noninvasive treatment for patients with debilitating angina and chronic heart failure who are poor candidates for revascularization procedures and have suboptimal results from other therapies. Numerous studies have shown EECP to be efficacious in patie...
Source: Cardiology in Review - February 8, 2017 Category: Cardiology Tags: Review Articles Source Type: research

Pulmonary Pressure Monitoring for Patients With Heart Failure
Heart failure (HF) affects over 5.8 million patients in the United States, and can be very costly due to the number of hospitalizations and rehospitalizations during the final years of life. Due to the large number of hospitalizations for HF exacerbations, effective methods for preventing these occurrences are necessary. Improvements in the outpatient treatment of HF, aided by noninvasive and invasive home monitoring methods, can reduce the number of hospitalizations. Pulmonary pressure monitoring through the CardioMEMS system provides one method of hemodynamic assessment of patients. The efficacy of the CardioMEMS system ...
Source: Cardiology in Review - February 8, 2017 Category: Cardiology Tags: Review Articles Source Type: research

Evacetrapib: Another CETP Inhibitor for Dyslipidemia With No Clinical Benefit
Evacetrapib is a cholesteryl ester transfer protein (CETP) inhibitor that has been recently studied as a cholesterol modifying agent to reduce cardiovascular risk and mortality in high risk cardiovascular disease patients. Evacetrapib acts to decrease lipid exchange through CETP inhibition. CETP acts to transfer cholesteryl esters from high-density lipoprotein-cholesterol (HDL-C) to low-density lipoprotein cholesterol (LDL-C) and very-low-density lipoprotein (VLDL-C). HDL-C is involved in reverse cholesterol transport and its blood levels have been shown to be inversely correlated with cardiovascular risk. Thus, a pharmaco...
Source: Cardiology in Review - February 8, 2017 Category: Cardiology Tags: Review Articles Source Type: research

Sports and Driving With an Implantable Cardioverter-Defibrillator
Many patients with implantable cardioverter-defibrillators (ICD) want to participate in sports and many need or wish to operate a personal motor vehicle. Healthcare providers need to advise patients regarding restrictions related to these activities in the context of the clinical indication for the ICD. Ethical considerations need to be considered when advising ICD patients of restrictions to reduce risk of injury to themselves and to others when participating in either sports or driving. Shared decision-making is necessary to have ICD patients understand and comply with recommended restrictions. Guidelines have been devel...
Source: Cardiology in Review - December 6, 2016 Category: Cardiology Tags: Review Articles Source Type: research

Optimal Implantable Cardioverter Defibrillator Programming
Optimal programming of implantable cardioverter defibrillators (ICDs) is essential to appropriately treat ventricular tachyarrhythmias and to avoid unnecessary and inappropriate shocks. There have been a series of large clinical trials evaluating tailored programming of ICDs. We reviewed the clinical trials evaluating ICD therapies and detection, and the consensus statement on ICD programming. In doing so, we found that prolonged ICD detection times, higher rate cutoffs, and antitachycardia pacing (ATP) programming decreases inappropriate and painful therapies in a primary prevention population. The use of supraventricular...
Source: Cardiology in Review - December 6, 2016 Category: Cardiology Tags: Review Articles Source Type: research