Functional Mitral Regurgitation in Heart Failure. Erratum.
No abstract available (Source: Cardiology in Review)
Source: Cardiology in Review - December 6, 2019 Category: Cardiology Tags: Erratum Source Type: research

Left Atrial Appendage Occlusion in the Management of Stroke in Patients With Atrial Fibrillation
Atrial fibrillation (AF) is associated with a substantially higher risk of thromboembolism, particularly stroke events, resulting in significant morbidity and mortality. Oral anticoagulation (OAC), while effective in reducing embolic events in AF patients, is associated with an increased bleeding risk. Thus, not all patients with AF are candidates for OAC and some are only candidates for OAC in the short term. Of the available nonpharmacologic strategies for the management of AF, left atrial appendage occlusion (LAAO) has emerged as a potential approach for reducing the risk of systemic thromboembolism in AF patients eligi...
Source: Cardiology in Review - December 6, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Right Heart Catheterization-Related Complications: A Review of the Literature and Best Practices
Right heart catheterization (RHC) is considered to be the gold standard for the measurement of pulmonary artery pressure and has a class 1 indication to confirm the diagnosis of pulmonary arterial hypertension and to guide treatment decisions. Associated complications with RHC in contemporary practice are uncommon. In this review, we aim to summarize the complications that have been published in case reports or case series with updated management and techniques to prevent and mitigate complications. We searched the PubMed database for the following reports: “right heart catheterization,” “Swan-Ganz cathet...
Source: Cardiology in Review - December 6, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Care of the Post-CABG Patient
An estimated 400,000 coronary artery bypass graft operations are performed annually in the United States. Saphenous vein grafts are the most commonly used conduits; however, graft failure is common. In contrast, left internal mammary artery grafts have more favorable long-term patency rates. Guidelines recommend aggressive secondary prevention. In the 2 decades following surgery, 16% of patients require repeat revascularization, and percutaneous coronary intervention accounts for 98% of procedures performed. Post-coronary artery bypass graft patients presenting with symptoms of acute coronary syndrome or progressive heart ...
Source: Cardiology in Review - December 6, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Beta Adrenergic Blocker Use in Patients With Chronic Obstructive Pulmonary Disease and Concurrent Chronic Heart Failure With a Low Ejection Fraction
Chronic heart failure (CHF) and chronic obstructive pulmonary disease (COPD) often coexist and present clinicians with diagnostic and therapeutic challenges. Beta-blockers are a cornerstone of CHF treatment, in patients with a low ejection fraction, while beta-agonists are utilized for COPD. These 2 therapies exert opposing pharmacological effects. COPD patients are at an increased risk of mortality from cardiovascular events. In addition to CHF, beta-blockers are used in a number of cardiovascular conditions because of their cardioprotective properties as well as their mortality benefit. However, there is reluctance among...
Source: Cardiology in Review - December 6, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Pregnancy Complications as a Window to Future Cardiovascular Disease
Pregnancy is a time of significant hemodynamic, metabolic, and hormonal stress that can unmask underlying subclinical cardiovascular abnormalities, and pregnancy-related complications may serve as early warning signs for future risk of cardiovascular disease. The increased recognition of these sex-specific risk factors could identify women who may benefit from more intensive risk factor modification to reduce morbidity and mortality later in life. In this review, we describe several pregnancy-related complications that have been associated with the risk of cardiovascular disease, including hypertensive disorders of pregnan...
Source: Cardiology in Review - December 6, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Cardiovascular Sequelae of Sickle Cell Disease
Sickle cell disease (SCD) is one of the most common hereditary hemoglobinopathies worldwide. It is a multisystem disease that causes considerable patient morbidity. Despite advances in medical treatment, cardiopulmonary complications remain the most common cause of death in individuals with SCD. A growing body of evidence has shown that SCD results in a spectrum of cardiovascular complications through a variety of mechanisms, including chronic hemolysis, local tissue hypoxia, increased oxidative stress, and autonomic instability. Herein, we will examine the pathophysiology of sickle cell vasculopathy and discuss the spectr...
Source: Cardiology in Review - December 6, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Vulnerable Plaque: A Review of Current Concepts in Pathophysiology and Imaging
Advances in our understanding of the natural history and biology of atherosclerotic vascular disease led to the concept of a vulnerable plaque (VP), which is predisposed toward more rapid progression and acute coronary events. With newer technologies, we now have at our disposal high-quality imaging studies, both invasive and noninvasive, which promise in identifying plaque characteristics that make it more vulnerable. Upcoming trials aim to evaluate the utility of imaging VP in predicting clinical events. We discuss the role of VP imaging in managing atherosclerotic vascular disease. (Source: Cardiology in Review)
Source: Cardiology in Review - December 6, 2019 Category: Cardiology Tags: Review Articles Source Type: research

George Reed, MD: Cardiac Surgical Pioneer and Visionary
No abstract available (Source: Cardiology in Review)
Source: Cardiology in Review - December 6, 2019 Category: Cardiology Tags: Editorial Source Type: research

Functional Mitral Regurgitation in Heart Failure
Functional mitral regurgitation (FMR) in the setting of left ventricular (LV) dysfunction and heart failure portends a poor prognosis. Guideline-directed medical therapy remains the cornerstone of initial treatment, with emphasis placed on treatment of the underlying LV dysfunction, as FMR is a secondary phenomenon and a disease due to LV remodeling. Surgical correction of FMR is controversial because it typically does not address the underlying mechanism and etiology of the condition. However, new, minimally invasive transcatheter therapies, in particular the MitraClip system, have shown promise in the treatment of FMR in...
Source: Cardiology in Review - October 5, 2019 Category: Cardiology Tags: Symposium Source Type: research

Premature Ventricular Contractions and Cardiomyopathy
Premature ventricular contractions (PVCs) are a common arrhythmia that may cause symptoms of variable severity. PVCs have recently garnered interest in their ability to induce adverse structural heart remodeling in an entity known as PVC-induced cardiomyopathy. This entity is a retrospective diagnosis that likely remains under-recognized and may occur concurrently with other forms of cardiomyopathy. The appropriate identification and management of PVCs in the setting of associated cardiomyopathy may have a significant impact on cardiac function and the clinical course, including recovery of left ventricular ejection fracti...
Source: Cardiology in Review - October 5, 2019 Category: Cardiology Tags: Symposium Source Type: research

Using High Sensitivity Troponins to Rule Out Acute Coronary Syndrome and Lower Admission Rates
This article will include a discussion on how to utilize common risk stratification tools in the ED to identify cohorts of patients suitable for discharge without additional testing. ED physicians must understand the limitations and benefits of hs-cTn levels and how to incorporate the information obtained from these biomarkers into risk scores in order to strengthen disposition decisions and safely discharge patients from the ED. (Source: Cardiology in Review)
Source: Cardiology in Review - October 5, 2019 Category: Cardiology Tags: Symposium Source Type: research

Role of Imaging in the Management of Ventricular Arrhythmias
The management of ventricular arrhythmias (VA) has evolved over time to an advanced discipline, incorporating many technologies in the diagnosis and treatment of the myriad types of VA. The first application of imaging is in the assessment for structural heart disease, as this has the greatest impact on prognosis. Advanced imaging has its greatest utility in the planning and execution of ablation for VA. The following review outlines the application of different imaging modalities, such as ultrasonography, magnetic resonance imaging, computed tomography, and positron emission tomography, for the treatment of VA. (Source: Cardiology in Review)
Source: Cardiology in Review - October 5, 2019 Category: Cardiology Tags: Symposium Source Type: research

Insights From Atrial Fibrillation Genomics: From Bedside to Bench and Back Again
From the bedside of patients contributing samples to large genome-wide association studies for atrial fibrillation (AF), over 100 AF risk loci have been identified. The top locus is near a gene implicated in pulmonary vein formation; the ostia of the pulmonary veins harbor initiating triggers of AF, and isolation of these areas is the cornerstone of ablation therapies for AF. Transcriptomic studies suggest that AF is associated with impaired or overwhelmed responses to cell stress. A dual risk model proposes that in genetically-susceptible individuals, inadequate transcriptional responses to stress predispose to AF in late...
Source: Cardiology in Review - October 5, 2019 Category: Cardiology Tags: Symposium Source Type: research

Third-Generation LVADs: Has Anything Changed?
The field of durable left ventricular assist devices has advanced dramatically since its introduction into the clinical realm. From the first-generation pulsatile HeartMate XVE device to the second-generation continuous axial flow HeartMate-2 to the current third-generation centrifugal flow devices, the left ventricular assist device has undergone significant evolution. This review describes the technology and its changes over the course of time, with a focus on the fundamental question: Has anything changed? (Source: Cardiology in Review)
Source: Cardiology in Review - October 5, 2019 Category: Cardiology Tags: Symposium Source Type: research

Cardiovascular Risk Assessment in Renal and Liver Transplant Candidates: A Multidisciplinary Institutional Standardized Approach
In the modern era, renal and liver transplant candidates present with a greater medical complexity driven in part by a higher prevalence of cardiovascular conditions, including coronary artery disease, valvular heart disease, and cardiomyopathies. In fact, cardiovascular disease is the most common cause of death after kidney transplantation worldwide. Similarly, an increase in the number of patients being listed with end-stage liver disease from nonalcoholic steatohepatitis and a rising model for end-stage liver disease scores at the time of liver transplant in the United States parallel an increasing cardiovascular diseas...
Source: Cardiology in Review - October 5, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Very Late Stent Thrombosis in Drug-Eluting Stents New Observations and Clinical Implications
Despite the reduction in stent failure with newer-generation drug-eluting stents, very late stent thrombosis (VLST) remains an unpredictable and potentially catastrophic complication of coronary revascularization procedures and is associated with high morbidity and mortality. Here, we present an updated overview of the latest advances in understanding the causes of VLST. Clinical studies that revealed potential risk factors and pathophysiologic studies on the mechanisms of VLST are discussed. Importantly, novel insights from recent advances in intravascular imaging are included. To date, there is no clinical guideline for ...
Source: Cardiology in Review - October 5, 2019 Category: Cardiology Tags: Review Articles Source Type: research

The Incisura
Analysis of the arterial pressure waveform remains useful in modern practice to assess alterations that may indicate significant abnormalities of cardiovascular parameters. The recognition of abnormalities of the incisura and dicrotic wave should alert the clinician to seek specific etiologic factors. Understanding the physiological origins of the incisura and dicrotic notch enhance its clinical utility in accurately diagnosing abnormal hemodynamic states. This review summarizes the hemodynamic events causing and affecting the inscription of the incisura in the arterial waveform. (Source: Cardiology in Review)
Source: Cardiology in Review - October 5, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Myocardial Injury After Noncardiac Surgery: A Systematic Review and Meta-Analysis
Myocardial injury after noncardiac surgery (MINS) is a common postoperative complication associated with adverse cardiovascular outcomes. The purpose of this systematic review was to determine the incidence, clinical features, pathogenesis, management, and outcomes of MINS. We searched PubMed, Embase, Central and Web of Science databases for studies reporting the incidence, clinical features, and prognosis of MINS. Data analysis was performed with a mixed-methods approach, with quantitative analysis of meta-analytic methods for incidence, management, and outcomes, and a qualitative synthesis of the literature to determine ...
Source: Cardiology in Review - October 5, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Long-Acting Basal Insulins: A Review of the More Recently Approved Agents
Long-acting basal insulins are used for the management of both type 1 and type 2 diabetes mellitus. Long-acting basal insulins were developed utilizing recombinant DNA technology and have been available since 2000 with the approval of insulin glargine U-100 followed by insulin detemir in 2005. In recent years, diabetes management has become more complex with the approval of insulin glargine U-300 and insulin degludec U-100 and U-200. Both insulin glargine U-300 and insulin degludec have been compared with insulin glargine U-100 and have demonstrated longer durations of action, as well as lower rates of hypoglycemia. This r...
Source: Cardiology in Review - August 9, 2019 Category: Cardiology Tags: New Therapy Source Type: research

The Preventive Role of Angiotensin Converting Enzyme Inhibitors/Angiotensin-II Receptor Blockers and β-Adrenergic Blockers in Anthracycline- and Trastuzumab-Induced Cardiotoxicity
Anthracycline (doxorubicin) and trastuzumab treatments for cancer patients have been known to cause cardiotoxicity. The current recommendations for prevention of cardiac events from cancer chemotherapies are largely based on opinion. The American Society of Clinical Oncology recommends active screening and prevention of modifiable cardiovascular risk factors. The risk factors are defined as tobacco use, high blood pressure, high cholesterol, alcohol use, obesity, and physical inactivity. Beta-adrenergic blockers and angiotensin converting enzyme (ACE) inhibitors/angiotensin receptor blockers (ARBs) have been the mainstay o...
Source: Cardiology in Review - August 9, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Should Every Patient With Atrial Fibrillation and a CHA2DS2-VASc Score of 1 Be Anticoagulated? A Systematic Review of 37,030 Patients
Patients with atrial fibrillation (AF) are at risk of thromboembolic events. The CHA2DS2-VASc (congestive heart failure, hypertension, age 65–74, diabetes, female sex and vascular disease, which all count for 1 point, and previous transient ischemic stroke/stroke or age ≥ 75 years, which count for two points) score stratifies this risk and consequently indicates whether anticoagulation is required but leaves room for debate regarding patients with a CHA2DS2-VASc score of 1, irrespective of sex. A score of 1, irrespective of sex, is derived from varying risk factors and may represent different risks. We systematica...
Source: Cardiology in Review - August 9, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Is Anacetrapib Better Than Its CETP Inhibitor Counterparts?
Cholesterol metabolism and transport has been a major focus in cardiovascular disease risk modification over the past several decades. Hydroxymethylglutaryl-CoA reductase inhibitors (statins) have been the most commonly used agents, with the greatest benefit in reducing both the primary and secondary risks of cardiovascular disease. However, heart disease remains the leading cause of death in both men and women in the United States. Further investigation and intervention are required to further reduce the risk for cardiovascular disease and cardiovascular-related deaths. This review will focus on high-density lipoprotein m...
Source: Cardiology in Review - August 9, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Infectious Endocarditis After Transcatheter Aortic Valve Replacement: Epidemiology and Outcomes
With the expansion of the indications of transcatheter aortic valve replacement (TAVR), it is being increasingly performed in older patients with aortic stenosis to improve their quality of life. However, TAVR is not without serious complications. Despite being infrequent, prosthetic valve endocarditis after TAVR is a deadly complication associated with high rates of mortality related to a delayed diagnosis from variable clinical presentations and nonconfirmatory imaging findings. Furthermore, lower intervention rates in these patients, due to their high surgical risk, increases overall mortality. Clinicians should be awar...
Source: Cardiology in Review - August 9, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Cardiotoxicity of Cancer Therapies
Cardiotoxicity is a known complication of many cancer therapies. While the cardiotoxicity of established agents such as anthracyclines, antimetabolites, and alkylating agents is well known, it is important to realize that newer anticancer therapies such as tyrosine kinase inhibitors, angiogenesis inhibitors, and checkpoint inhibitors are also associated with significant adverse cardiovascular effects. Echocardiography, magnetic resonance imaging, and radionuclide imaging have been used to identify these complications early and prevent further consequences. We will discuss the different classes of cancer therapeutic agents ...
Source: Cardiology in Review - August 9, 2019 Category: Cardiology Tags: Review Articles Source Type: research

The Predicament of Gastrointestinal Bleeding in Patients With a Continuous-Flow Left Ventricular Assist Device: Pathophysiology, Evaluation, and Management
Heart failure affects over 5 million Americans, with numbers expected to rise. While heart transplantation is the most effective long-term strategy for end-stage heart failure, there is a limited cardiac donor pool, and these organs are often unavailable at the time of need. Left ventricular assist devices, therefore, continue to be used to bridge this gap. Originally implanted as a bridge to transplant, these devices are now additionally utilized as destination therapy for patients ineligible for transplant. With the widespread applicability of these devices for not just temporary measures, but also for prolonged use, the...
Source: Cardiology in Review - August 9, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Blalock-Taussig Shunt at 75: A Landmark Operation and a Triumph of Diversity Over Prejudice
No abstract available (Source: Cardiology in Review)
Source: Cardiology in Review - August 9, 2019 Category: Cardiology Tags: Editorial Source Type: research

Angiopoietin-Like 3 Protein Inhibition: A New Frontier in Lipid-Lowering Treatment
Angiopoietin-like 3 protein (ANGPTL3) is an inhibitor of both lipoprotein lipase and endothelial lipase in humans. Population studies indicate a relationship between loss of function mutations in ANGPTL3 and favorable reductions in triglycerides and non- high-density lipoprotein cholesterol. In addition, loss of function mutations is associated with a reduced risk of coronary artery disease. Whereas ANGPTL3’s role in human lipid metabolism has yet to be fully clarified, it is unlikely that ANGPTL3 impacts cholesterol uptake via the low-density lipoprotein-receptor, unlike the proprotein convertase subtilisin/kexin9 i...
Source: Cardiology in Review - June 11, 2019 Category: Cardiology Tags: New Therapy Source Type: research

Cardiac Applications of Dual-Energy Computed Tomography
Computed tomography is an established tool in the assessment of cardiac anatomy and function. As demonstrated by single photon emission computed tomography, positron emission tomography, and magnetic resonance, the noninvasive evaluation of coronary hemodynamics is an important step in guiding clinical management. Nevertheless, no single modality has been shown to accurately quantify coronary artery stenosis, evaluate an atherosclerotic plaque’s composition for embolic risk stratification, and assess myocardial perfusion. Although not a novel technology, dual-energy computed tomography has undergone significant advan...
Source: Cardiology in Review - June 11, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Hearts and Minds: Stress, Anxiety, and Depression: Unsung Risk Factors for Cardiovascular Disease
Anxiety, depression, and stress are exceedingly common in patients with cardiovascular disease (CVD). They increase the risk of cardiac events and are associated with much worse outcomes. A causal relationships exists between anxiety/depression and adverse cardiac events such as acute myocardial infarction and sudden cardiac death. Various treatments, including psychologic therapies and pharmacotherapy, can used to treat patients with these disorders. This review discusses the epidemiology, pathogenesis, and treatment options for patients with CVD who suffer from these conditions and argues that they should be treated as c...
Source: Cardiology in Review - June 11, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Precardiogenic Shock: A New Clinical Entity
The pathogenesis of cardiogenic shock (CS) has evolved from an acute event due to a large myocardial infarction to a semiacute event due to rapid hemodynamic deterioration on a background of preexisting left ventricular systolic dysfunction. Pre-CS refers to the period of rapid hemodynamic deterioration that precedes overt CS with hypotension, inflammatory response, and end-organ failure. Mortality remains extremely high in CS and has not improved over the past decades. Pre-CS offers a unique opportunity to initiate early treatment that may result in better clinical outcomes. The present review addresses the definition, re...
Source: Cardiology in Review - June 11, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Predictors of Adverse Outcomes in Patients With Arrhythmogenic Right Ventricular Cardiomyopathy: A Meta-Analysis of Observational Studies
In conclusion, multiple risk factors have been associated with arrhythmic events in AC patients. However, larger studies are needed to discriminate those patients who will benefit from implantable cardioverter defibrillators. (Source: Cardiology in Review)
Source: Cardiology in Review - June 11, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Parathyroid Hormone and Cardiac Electrophysiology: A Review
Calcium has long been known to be essential to cardiac electrical activity. Parathyroid hormone (PTH) is the main regulator of serum calcium and is central to calcium homeostasis. Although there are significant data linking parathyroid disease states with changes in cardiac electrophysiology, most data have focused on how PTH modulates serum calcium to produce these effects. Close scrutiny of early literature demonstrates that the relationship between PTH and electrocardiographic changes is not straightforward, and numerous studies have linked PTH to arrhythmia. Basic science research has demonstrated that there is a basis...
Source: Cardiology in Review - June 11, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Heart Transplantation for Hepatitis C Virus Non-Viremic Recipients From Hepatitis C Virus Viremic Donors
Multiple strategies have been implemented to increase the donor pool to avoid transplant wait-list mortality. The approval of highly effective direct-acting antiviral regimens for the treatment of hepatitis C virus (HCV) has enabled expansion of the donor pool by allowing the transplantation of organs from HCV-viremic donors to HCV-negative recipients. Multiple centers have recently published data on outcomes of heart transplantation from HCV-viremic heart donors to HCV-negative recipients, with acceptable posttransplant outcomes. However, areas of uncertainty remain, particularly in the long-term risks of intentional HCV ...
Source: Cardiology in Review - June 11, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Cardiovascular Effects of Drugs Used to Treat Attention-Deficit/Hyperactivity Disorder Part 2: Impact on Cardiovascular Events and Recommendations for Evaluation and Monitoring
A variety of psychostimulant and nonpsychostimulant medications have proven to be successful in reducing inattention, impulsivity, and hyperactivity in individuals with attention-deficit/hyperactivity disorder (ADHD). Psychostimulants used to treat ADHD include methylphenidate and related drugs and various amphetamine preparations. Nonpsychostimulant medications used to treat ADHD include atomoxetine and 2 α-2 adrenergic agonists: guanfacine extended-release and clonidine extended-release. The psychostimulants and atomoxetine have been shown, on average, to increase heart rate by 3–10 beats/min, systolic blood ...
Source: Cardiology in Review - June 11, 2019 Category: Cardiology Tags: Review Articles Source Type: research

The Brain–Heart Connection and the Northridge Earthquake
No abstract available (Source: Cardiology in Review)
Source: Cardiology in Review - June 11, 2019 Category: Cardiology Tags: Editorial Source Type: research

Angiotensin II (Giapreza): A Distinct Mechanism for the Treatment of Vasodilatory Shock
Septic shock, a form of vasodilatory shock associated with high morbidity and mortality, requires early and effective therapy to improve patient outcomes. Current management of septic shock includes the use of intravenous fluids, catecholamines, and vasopressin for hemodynamic support to ensure adequate perfusion. Despite these interventions, hospital mortality rates are still greater than 40%. Practitioners are continuously faced with cases of refractory shock that are associated with poor clinical outcomes. In December of 2017, the Food and Drug Administration approved the first synthetic human angiotensin II, a potent v...
Source: Cardiology in Review - April 6, 2019 Category: Cardiology Tags: New Therapy Update Source Type: research

Impact of Implantable Cardioverter-Defibrillator Interventions on All-Cause Mortality in Heart Failure Patients: A Meta-Analysis
Implantable cardioverter-defibrillators (ICDs) have a unique role in the primary and secondary prevention of sudden cardiac death. However, appropriate and inappropriate ICD interventions [antitachycardia pacing (ATP) or shocks] can result in deleterious effects. The aim of our study was to systematically review the existing data about the impact of ICD interventions on all-cause mortality in heart failure patients with reduced ejection fraction (HFrEF). We systematically searched MEDLINE (by using PubMed Web-based search engine) without any limits until September 30, 2017. After screening 17,752 records, a total of 17 stu...
Source: Cardiology in Review - April 6, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Evolving Use of Biomarkers in the Management of Heart Failure
Objective, noninvasive, clinical assessment of patients with heart failure can be made using biomarker measurements, including natriuretic peptides, cardiac troponins, soluble suppression of tumorigenicity 2, and galectin-3. The aim of this review is to provide clinicians with guidance on the use of heart failure biomarkers in clinical practice. The authors provide a didactic narrative based on current literature, an exemplary case study, and their clinical experience. (Source: Cardiology in Review)
Source: Cardiology in Review - April 6, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Searching for the Genetic Determinants of Peripheral Arterial Disease: A Review of the Literature and Future Directions
Peripheral arterial disease (PAD) is a significant but under-recognized disease that is poorly understood despite population-scale genetic studies. To address this morbid disease, clinicians need additional tools to identify, prevent, and treat patients at risk for PAD. Genetic studies of coronary artery disease have yielded promising results for clinical application, which have thus far been lacking in PAD. In this article, we review recent findings, discuss limitations, and propose future directions of genomic study and clinical application. However, despite many studies, we still lack definitive genetic markers for PAD....
Source: Cardiology in Review - April 6, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Thermodilution Cardiac Output: A Concept Over 250 Years in the Making
The need to quantify blood flow through the heart has led to the development of different techniques for its measurement. The 3 main approaches are the Fick method, dye dilution, and thermodilution techniques. The latter 2 are based on the use of indicators that indirectly quantify blood flow. These have slowly been developed over centuries, from the concept of measuring blood flow, to a technique, and its clinical utility. Thermodilution is the most popular dilution method used for measuring cardiac output (CO) in the clinical setting. The information obtained during this procedure is relevant in the process of clinical d...
Source: Cardiology in Review - April 6, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Cardiac Manifestations in Idiopathic Inflammatory Myopathies: An Overview
Idiopathic inflammatory myopathies are a group of autoimmune diseases that are characterized by muscle inflammation resulting in elevated muscle enzyme release and distinctive biopsy findings. This group of conditions includes polymyositis, dermatomyositis, inclusion body myositis, and necrotizing autoimmune myopathy. Although they have many similarities, the inflammatory myopathies differ in their clinical, pathological, and treatment realms. Extramuscular manifestations may involve many organs that include the skin, joints, heart, lungs, and gastrointestinal tract. Cardiovascular involvement is one of the leading causes ...
Source: Cardiology in Review - April 6, 2019 Category: Cardiology Tags: Review Articles Source Type: research

The Mediterranean Diet and Cardiovascular Disease: Gaps in the Evidence and Research Challenges
In conclusion, the evidence indicates that the MD prevents CVD. There is a need for RCTs that test the effectiveness of the MD for preventing CVD. Key design features for such a study are proposed. (Source: Cardiology in Review)
Source: Cardiology in Review - April 6, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Effects of Spaceflight on Cardiovascular Physiology and Health
This article reviews the knowledge gained in human experiments in the past half century of spaceflight, and summarizes our knowledge on the effects of short- and long-duration microgravity exposure on cardiovascular physiology and functioning, including fluid redistribution, autonomic reflexes, cardiac parameters, orthostatic intolerance, arrhythmias, aerobic capacity, and cardiac atrophy. This review also discusses current countermeasures for risk reduction during spaceflight, as well as future directions in cardiovascular research in space. (Source: Cardiology in Review)
Source: Cardiology in Review - April 6, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Cardiovascular Effects of Drugs Used to Treat Attention-Deficit/Hyperactivity Disorder: Part 1: Epidemiology, Pharmacology, and Impact on Hemodynamics and Ventricular Repolarization
Attention-deficit/hyperactivity disorder (ADHD) is a clinical syndrome characterized by persistent inattention, impulsivity, and hyperactivity. It is most commonly encountered in children and adolescents but may persist into adulthood. A variety of psychostimulant and nonpsychostimulant medications have proven to be successful in reducing inattention, impulsivity, and hyperactivity in those with ADHD. Psychostimulants used to treat ADHD include methylphenidate and related drugs and various amphetamine preparations. Non-psychostimulant medications used to treat ADHD include atomoxetine and two alpha-2 adrenergic agonists: g...
Source: Cardiology in Review - April 6, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Racial Disparities in the Cardiac Computed Tomography Assessment of Coronary Artery Disease: Does Gender Matter: Erratum
No abstract available (Source: Cardiology in Review)
Source: Cardiology in Review - February 16, 2019 Category: Cardiology Tags: Erratum Source Type: research

Andexanet Alfa for Reversing Factor Xa Inhibition
The direct oral anticoagulants (DOACs) have gained popularity recently among both patients and providers for their comparable or better efficacy and safety profiles compared with warfarin and the lack of need for routine monitoring of anticoagulant effect. One obstacle for the more widespread use of the DOACs in clinical practice has been the lack of a reversal agent. Most DOACs act by directly binding to and inhibiting the effects of factor Xa. Andexanet alfa (Andexxa, Portola Pharmaceuticals, San Francisco, CA) is a modified form of factor Xa that acts as a decoy binding entity for DOACs, thereby allowing endogenous fact...
Source: Cardiology in Review - February 16, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Cardiac Immune-Related Adverse Events in Immune Checkpoint Inhibition Therapy
Immune checkpoint inhibitors present clinicians with both an exciting step forward in cancer treatment and the unknown possibilities of an unshackled immune system. The latter phenomena, known as immune-related adverse events (irAEs), are of particular interest because they may affect any organ system with autoimmune-like pathologies, such as hepatitis and colitis. Within the cardiovascular system, irAEs associated with immune checkpoint blockade exist as a broad clinical spectrum, with autoimmune myocarditis being the best-characterized entity at this time. In general, irAEs are often reversible with immunosuppression. Ho...
Source: Cardiology in Review - February 16, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Cardiovascular Effects of Chemotherapy Used in the Treatment of Breast Cancers
This article will discuss the epidemiology, mechanisms, diagnostic methods, and management of cardiotoxicity from systemic chemotherapy used to treat breast cancer. (Source: Cardiology in Review)
Source: Cardiology in Review - February 16, 2019 Category: Cardiology Tags: Review Articles Source Type: research

Review on Factors Influencing Physician Guideline Adherence in Cardiology
Cardiovascular disease is the most common cause of death in Western countries. Physician adherence to guidelines is often suboptimal, resulting in impaired patient outcome and prognosis. Multiple studies have been conducted to evaluate patterns and the influencing factors of patient adherence, but little is known about factors influencing physician guideline adherence. This review aims to identify factors influencing physician guideline adherence relevant to cardiology and to provide insights and suggestions for future improvement. Physician adherence was measured as adherence to standard local medical practice and applica...
Source: Cardiology in Review - February 16, 2019 Category: Cardiology Tags: Review Articles Source Type: research