A Review of Remdesivir for COVID-19: Data to Date
This article describes remdesivir’s historical background, pharmacology, key trials, adverse events, and issues regarding accessibility. (Source: Cardiology in Review)
Source: Cardiology in Review - October 6, 2020 Category: Cardiology Tags: New Therapy Update Source Type: research

Catecholaminergic Polymorphic Ventricular Tachycardia
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare congenital arrhythmogenic disorder induced by physical or emotional stress. It mainly affects children and younger adults and is characterized by rapid polymorphic and bidirectional ventricular tachycardia. Symptoms can include dizziness, palpitations, and presyncope, which may progress to syncope, hypotonia, convulsive movements, and sudden cardiac death. CPVT is the result of perturbations in Ca2+ ion handling in the sarcoplasmic reticulum of cardiac myocytes. Mutations in the cardiac ryanodine receptor gene and the calsequestrin isoform 2 gene are mo...
Source: Cardiology in Review - October 6, 2020 Category: Cardiology Tags: Invited Review Articles Source Type: research

Arrhythmogenic Right Ventricular Cardiomyopathy Diagnosis
Arrhythmogenic right ventricular cardiomyopathy, formerly called “arrhythmogenic right ventricular dysplasia,” is an under-recognized clinical entity characterized by ventricular arrhythmias and a characteristic ventricular pathology. Diagnosis is often difficult due to the nonspecific nature of the disease and the broad spectrum of phenotypic variations. Therefore, consensus diagnostic criteria have been developed which combine electrocardiographic, echocardiographic, cardiac magnetic resonance imaging and histologic criteria. In 1994, an international task force first proposed the major and minor diagnostic c...
Source: Cardiology in Review - October 6, 2020 Category: Cardiology Tags: Invited Review Articles Source Type: research

Heavy Metal Toxicity in Chronic Renal Failure and Cardiovascular Disease: Possible Role for Chelation Therapy
Exposure to heavy metals is common. This exposure is related to environmental contamination of air, water and soil, occupational exposure, accumulation in food, tobacco, and other factors. Cadmium and lead are notable for their widespread contamination, long-lasting effects in the body, and renal as well as cardiovascular toxicity. Acute toxicity due to high-level exposure, as well as chronic low-level exposure are now well-established pathogenic entities. Both chronic renal failure and ischemic heart disease patients have been treated separately in recent studies with ethylenediaminetetraacetic acid (EDTA) chelation thera...
Source: Cardiology in Review - October 6, 2020 Category: Cardiology Tags: Invited Review Articles Source Type: research

Myocarditis in Multisystem Inflammatory Syndrome in Children Associated With Coronavirus Disease 2019
We present our initial experience managing children with coronavirus disease 2019–related acute myocardial injury. The 3 patients presented here represent a spectrum of the cardiac involvement noted in children with coronavirus disease 2019–related multisystem inflammatory syndrome, including myocarditis presenting as cardiogenic shock or heart failure with biventricular dysfunction, valvulitis, coronary artery changes, and pericardial effusion. (Source: Cardiology in Review)
Source: Cardiology in Review - October 6, 2020 Category: Cardiology Tags: Invited Review Articles Source Type: research

Use of Nonsteroidal Anti-inflammatory Drugs for COVID-19 Infection: Adjunct Therapy?
Severe acute respiratory distress syndrome coronavirus 2 (COVID-19) is the cause of the current pandemic, which remains a tremendous cause of morbidity and mortality worldwide. Although there are numerous trials underway, there is currently no medication known to cure the infection. Nonsteroidal anti-inflammatory drugs (NSAIDs) are inexpensive, widely available medications with antiviral and anti-inflammatory properties and may have utility as an adjunct therapy to improve outcomes in patients with severe COVID-19 infection. A thorough PubMed literature review on the therapeutic use of NSAID was conducted to provide a comp...
Source: Cardiology in Review - October 6, 2020 Category: Cardiology Tags: Invited Review Articles Source Type: research

Elevated d-Dimer Levels Are Associated With Increased Risk of Mortality in Coronavirus Disease 2019: A Systematic Review and Meta-Analysis
The 2019 novel coronavirus, declared a pandemic, has infected 2.6 million people as of April 27, 2020, and has resulted in the death of 181,938 people. d-dimer is an important prognostic tool, is often elevated in patients with severe coronavirus disease-19 (COVID-19) infection and in those who suffered death. In this systematic review, we aimed to investigate the prognostic role of d-dimer in COVID-19-infected patients. We searched PubMed, Medline, Embase, Ovid, and Cochrane for studies reporting admission d-dimer levels in COVID-19 patients and its effect on mortality. Eighteen studies (16 retrospective and 2 prospective...
Source: Cardiology in Review - October 6, 2020 Category: Cardiology Tags: Invited Review Articles Source Type: research

Valve-in-Valve Transcatheter Aortic Valve Replacement: A Review of Procedural Details, Safety, and Clinical Implications
Bioprosthetic valves are increasingly being used to treat young patients needing surgical intervention. The rising number of young patients undergoing bioprosthesis implantation also means that many of these patients will ultimately require reintervention due to the deteriorative nature of these valves. Recently, valve-in-valve transcatheter aortic valve replacement (ViV TAVR) has become the preferred procedure to treat high-risk patients requiring repeat surgical aortic valve replacement. Despite being less invasive, ViV TAVR is accompanied by risks, including coronary obstruction, valvular thrombosis, and postoperative r...
Source: Cardiology in Review - October 6, 2020 Category: Cardiology Tags: Westchester Cardiovascular Symposium: October 3-5, 2019 Guest Editors: Julio Panza MD, Steven Lansman MD, PhD Source Type: research

Noninvasive Radioablation of Ventricular Tachycardia
Ventricular tachycardia (VT) occurs most commonly in the presence of structural heart disease or myocardial scarring from prior infarction. It is associated with increased mortality, especially when it results in cardiac arrest outside of a hospital. When not due to reversible causes (such as acute ischemia/infarction), placement of an implantable cardioverter-defibrillator for prevention of future sudden death is indicated. The current standard of care for recurrent VT is medical management with antiarrhythmic agents followed by invasive catheter ablation for VT that persists despite appropriate medical therapy. Stereotac...
Source: Cardiology in Review - October 6, 2020 Category: Cardiology Tags: Westchester Cardiovascular Symposium: October 3-5, 2019 Guest Editors: Julio Panza MD, Steven Lansman MD, PhD Source Type: research

The Total Artificial Heart: Where Are We?
The total artificial heart (TAH) is a device that replaces the failing ventricles. There have been numerous TAHs designed over the last few decades, but the one with the largest patient experience is the SynCardia temporary TAH. The 50-mL and 70-mL sizes have been approved in the United States, Europe, and Canada as a bridge to transplantation. It is indicated in patients with severe biventricular failure or structural heart issues that preclude the use of a left ventricular assist device. The majority of the patients implanted are Interagency Registry for Mechanically Assisted Circulatory Support profile 1 or 2. The 1-yea...
Source: Cardiology in Review - October 6, 2020 Category: Cardiology Tags: Westchester Cardiovascular Symposium: October 3-5, 2019 Guest Editors: Julio Panza MD, Steven Lansman MD, PhD Source Type: research

The 11th Trial of a Cardiovascular Clinical Trialist—Coronavirus-2, Part 3
No abstract available (Source: Cardiology in Review)
Source: Cardiology in Review - October 6, 2020 Category: Cardiology Tags: Editorial Source Type: research

Chloroquine or Hydroxychloroquine for Management of Coronavirus Disease 2019: Friend or Foe?
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to be a threat to the health of many humans across the world as they confront coronavirus disease 2019 (COVID-19). Previous promising in vitro data that emerged after the SARS-CoV outbreak in 2003, along with the emergent need for pharmacologic management strategies in the fight against COVID-19, prompted interest in the use of chloroquine and hydroxychloroquine across the globe. Unfortunately, the in vitro activity of these drugs did not necessarily correlate with most in vivo studies, which showed no consistent efficacy. Safety is also a major concern...
Source: Cardiology in Review - August 13, 2020 Category: Cardiology Tags: Curbside Consult Source Type: research

Nitrosamine Impurities in Angiotensin Receptor Blockers
Nitrosamines are known carcinogens which have been recently discovered in several angiotensin receptor blockers (ARBs). This led to the recall of valsartan in the United States in 2018, and afterward, the recall of other ARBs as well as unrelated medications (e.g., ranitidine). The presence of nitrosamine in ARBs was likely a result of changes in the manufacturing process, although nitrosamine contamination is believed to occur by different mechanisms with other medications. The United States Food and Drug Administration has since taken steps to identify products affected by nitrosamine contamination and mitigate this conc...
Source: Cardiology in Review - August 13, 2020 Category: Cardiology Tags: Curbside Consult Source Type: research

Myocardial Depression in Sepsis: Beneficial Adaptation or Sequelae that Requires Treatment?
Myocardial depression is a common yet reversible phenomenon that occurs in patients in septic shock. Initially, it was unclear whether this provided an adaptive survival benefit, as early studies showed decreased mortality in septic patients with myocardial depression. However, subsequent larger studies have debunked this myth. Given that no benefit exists, cardiac dysfunction in septic patients may be monitored via echocardiography and may be treated with inotropic agents. Beta-blockers provide a novel avenue of treatment as they aid in reducing adrenergic overstimulation and cytokine production, which may drive the patho...
Source: Cardiology in Review - August 13, 2020 Category: Cardiology Tags: Review Articles Source Type: research

Lipoprotein(a) Testing and Emerging Therapies
The study of lipoprotein(a) [Lp(a)] over the years has been a source of both enlightenment and frustration for the medical community. Accumulating evidence from large sample observational studies, Mendelian randomization studies, and genome-wide association studies has strengthened the association between Lp(a) and the development of atherosclerotic cardiovascular disease. This evidence supports the testing of Lp(a) in certain high-risk populations in order for clinicians to improve the risk profile of patients. Despite a variety of medical therapies that have been proven to reduce Lp(a) levels, the connection between the ...
Source: Cardiology in Review - August 13, 2020 Category: Cardiology Tags: Review Articles Source Type: research

Severe Hypoglycemia and Risk of Subsequent Cardiovascular Events: Systematic Review and Meta-Analysis of Randomized Controlled Trials
Intensive glycemic control significantly increases the risk of hypoglycemia in patients with diabetes mellitus. Recent data have shown that hypoglycemia may also be a marker of cardiovascular disease in these patients. We performed a systemic review and a meta-analysis to evaluate the relationship between severe hypoglycemic events (SHEs) and the subsequent risk of mortality and major adverse cardiovascular events (MACE) in patients with diabetes mellitus. PubMed, Cochrane library, and Embase were searched for randomized controlled trials between January 2006 and December 17, 2018 that reported cardiovascular outcomes in d...
Source: Cardiology in Review - August 13, 2020 Category: Cardiology Tags: Review Articles Source Type: research

A Practical Approach to Hybrid Coronary Revascularization
Combined surgical and percutaneous coronary revascularization, ie, hybrid coronary revascularization (HCR) consists of surgical left internal mammary artery (LIMA) bypass to the left anterior descending artery (LAD) and percutaneous revascularization of other diseased coronary arteries. Developed as a 1-stage procedure, HCR has not been widely adopted by the cardiovascular community. The recommended minimally invasive approach through a small left thoracotomy incision is technically demanding, and same-day percutaneous revascularization requires a hybrid operating room that is not available in most hospitals. In this revie...
Source: Cardiology in Review - August 13, 2020 Category: Cardiology Tags: Review Articles Source Type: research

Towards a Saphenous Vein Graft Moratorium
Atherosclerosis develops and rapidly progresses in saphenous veins grafts after coronary bypass surgery. In contrast to native coronary artery, percutaneous revascularization does not impede the progression of saphenous vein atherosclerosis and saphenous vein graft failure commonly ensues. The protracted patency of arterial grafts is likely to account for most of the long-term superiority of coronary artery bypass surgery over percutaneous revascularization in patients with complex coronary artery disease. Long-lasting, complete coronary revascularization may be best achieved by combining surgical arterial grafting of dise...
Source: Cardiology in Review - August 13, 2020 Category: Cardiology Tags: Review Articles Source Type: research

Cardiovascular Safety and Benefits of Noninsulin Antihyperglycemic Drugs for the Treatment of Type 2 Diabetes Mellitus: Part 2
Ideal drugs to improve outcomes in type 2 diabetes mellitus (T2DM) are those with antiglycemic efficacy, as well as cardiovascular safety that has to be determined in appropriately designed cardiovascular outcome trials as mandated by regulatory agencies. The more recent antihyperglycemic medications have shown promise with regards to cardiovascular disease (CVD) risk reduction in T2DM patients at a high cardiovascular risk. Sodium glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists are associated with better cardiovascular outcomes and mortality in T2DM patients than are dipeptidylpeptidase-4 ...
Source: Cardiology in Review - August 13, 2020 Category: Cardiology Tags: Review Articles Source Type: research

The 11th Trial of a Cardiovascular Clinical Trialist: Coronavirus-2: Part 2
No abstract available (Source: Cardiology in Review)
Source: Cardiology in Review - August 13, 2020 Category: Cardiology Tags: Editorial Source Type: research

Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers in Patients With Coronavirus Disease 2019: Friend or Foe?
This article is to examine and summarize the 2 opposing viewpoints and provide guideline recommendations to support the use or discontinuation of ACE inhibitors and ARBs in patients with COVID-19. (Source: Cardiology in Review)
Source: Cardiology in Review - June 5, 2020 Category: Cardiology Tags: Feature Curbside Consult Source Type: research

The Firehawk Stent: A Review of a Novel Abluminal Groove-Filled Biodegradable Polymer Sirolimus-Eluting Stent
This article provides a review of the current clinical evidence concerning the Firehawk stent. (Source: Cardiology in Review)
Source: Cardiology in Review - June 5, 2020 Category: Cardiology Tags: New Therapy Update Source Type: research

Sudden Cardiac Death in Brugada Syndrome
The Brugada syndrome is an inherited channelopathy that alters the main transmembrane ion currents that constitute the cardiac action potential. These changes not only modify the resting electrocardiogram but also predispose patients to develop malignant ventricular tachyarrhythmias that can lead to syncope, cardiac arrest, and sudden cardiac death. This syndrome is responsible for nearly 20% of all sudden cardiac deaths in patients with structurally normal hearts and up to 12% of all sudden cardiac deaths. Brugada syndrome is diagnosed by its characteristic electrocardiogram consisting of a coved-type ST-segment elevation...
Source: Cardiology in Review - June 5, 2020 Category: Cardiology Tags: Review Articles Source Type: research

Sarcopenia and Cardiac Dysfunction
Although muscle loss is part of the natural course of human aging, sarcopenia has been associated with an increased risk of physical disability and mortality in older patients. Many heart failure patients concomitantly develop deficits in muscle mass and strength, resulting in decreased quality of life and exercise capacity. An underlying state of inflammation is central to the development of sarcopenia and muscle wasting in heart failure; however, additional research in human models is needed to further delineate the pathophysiology of muscle wasting in these patients. Previous studies have shed light on many of the poten...
Source: Cardiology in Review - June 5, 2020 Category: Cardiology Tags: Review Articles Source Type: research

Restarting Oral Anticoagulation in Patients With Atrial Fibrillation After an Intracranial Hemorrhage
Atrial fibrillation is the most common sustained cardiac arrhythmia in the general population. In western countries with aging populations, atrial fibrillation poses a significant health concern, as it is associated with a high risk of thromboembolism, stroke, congestive heart failure, and myocardial infarction. Thrombi are generated in the left atrial appendage, and subsequent embolism into the cerebral circulation is a major cause of ischemic stroke. Therefore, patients have a lifetime risk of stroke, and those at high risk, defined as a CHA2DS2-VASc2 (congestive heart failure, hypertension, age>75 years, diabetes mel...
Source: Cardiology in Review - June 5, 2020 Category: Cardiology Tags: Review Articles Source Type: research

Cardiovascular Safety and Benefits of Noninsulin Antihyperglycemic Drugs for the Treatment of Type 2 Diabetes Mellitus—Part 1
Cardiovascular disease (CVD) is a major contributor to the morbidity and mortality associated with type 2 diabetes mellitus (T2DM). With T2DM growing in pandemic proportions, there will be profound healthcare implications of CVD in person with diabetes. The ideal drugs to improve outcomes in T2DM are those having antiglycemic efficacy in addition to cardiovascular (CV) safety, which has to be determined in appropriately designed CV outcome trials as mandated by regulatory agencies. Available evidence is largely supportive of metformin’s CV safety and potential CVD risk reduction effects, whereas sulfonylureas are eit...
Source: Cardiology in Review - June 5, 2020 Category: Cardiology Tags: Review Articles Source Type: research

The Novel Coronavirus Disease (COVID-19) and Its Impact on Cardiovascular Disease
The coronavirus disease 2019 (COVID-19) pandemic has placed a significant strain on healthcare providers. As the number of patients continue to surge, healthcare workers are now forced to find different approaches to practicing medicine that may affect patient care. In addition, COVID-19 has many cardiovascular complications that affect the clinical course of patients. In this article, we summarize the cardiovascular impact of COVID-19 and some of the challenges that patients and the healthcare system will face during this pandemic. (Source: Cardiology in Review)
Source: Cardiology in Review - June 5, 2020 Category: Cardiology Tags: Review Articles Source Type: research

The 11th Trial of a Cardiovascular Clinical Trialist: Coronavirus-2: Part 1
No abstract available (Source: Cardiology in Review)
Source: Cardiology in Review - June 5, 2020 Category: Cardiology Tags: Editorial Source Type: research

Tafamidis: A Novel Treatment for Transthyretin Amyloid Cardiomyopathy
Transthyretin (TTR) amyloid cardiomyopathy is a life-threatening condition in which amyloid fibrils accumulate in the heart, eventually leading to cardiac symptomatology and death. To date, treatment of this condition has been directed at symptom relief due to a lack of effective treatment options which target the cause of the disease. The discovery that amyloid deposition was a result of dissociation of the TTR protein structure allowed for the development of tafamidis, which acts by stabilizing the TTR tetramer. Due to the rare nature of the disease, there is limited clinical trial data with tafamidis, with the largest c...
Source: Cardiology in Review - April 2, 2020 Category: Cardiology Tags: New Therapy Update Source Type: research

Peripartum Cardiomyopathy Incidence, Risk Factors, Diagnostic Criteria, Pathophysiology, and Treatment Options
This article will provide a comprehensive review and update on this important disease state. (Source: Cardiology in Review)
Source: Cardiology in Review - April 2, 2020 Category: Cardiology Tags: Review Articles Source Type: research

Stem Cell Therapy for Acute Myocardial Infarctions: A Systematic Review
Each year 790,000 people in the United States suffer from a myocardial infarction. This results in the permanent loss of cardiomyocytes and an irreversible loss of cardiac function. Current therapies lower mortality rates, but do not address the core pathology, which opens a pathway to step-wise heart failure. Utilizing stem cells to regenerate the dead tissue is a potential method to reverse these devastating effects. Several clinical trials have already demonstrated the safety of stem cell therapy. In this review, we highlight clinical trials, which have utilized various stem cell lineages, and discuss areas for future r...
Source: Cardiology in Review - April 2, 2020 Category: Cardiology Tags: Review Articles Source Type: research

Does Transcatheter Aortic Valve Implantation for Aortic Stenosis Impact on Cognitive Function?
Aortic stenosis (AS) is the most common valvular heart disease among elderly patients in developed countries. Surgical valve replacement is indicated for severe AS to relieve the obstructed outflow tract. Transcatheter aortic valve implantation (TAVI) has emerged as an alternative for patients with severe AS, particularly in those with high surgical risk. TAVI is a less invasive approach with favorable survival outcomes in high-risk patients compared with open surgery. Despite the remarkable success of TAVI, there is a growing concern on the incidence of postprocedural cognitive impairment. This review aims to evaluate the...
Source: Cardiology in Review - April 2, 2020 Category: Cardiology Tags: Review Articles Source Type: research

Left Ventricular Noncompaction: Diagnostic Approach, Prognostic Evaluation, and Management Strategies
Left ventricular noncompaction cardiomyopathy is a heart disease with relevant potential complications including heart failure, life-threatening arrhythmias, and embolic events. In order to prevent adverse outcomes, it is crucial to appropriately recognize and manage this cardiomyopathy. In this paper, we report the main clinical presentations and imaging modalities used for diagnosis, including echocardiography and magnetic resonance imaging. We highlight the role of a comprehensive functional cardiac evaluation and the possible prognostic implications of both systolic and diastolic dysfunction. Furthermore, we summarize ...
Source: Cardiology in Review - April 2, 2020 Category: Cardiology Tags: Review Articles Source Type: research

Cardiovascular Outcomes With the Use of Sodium-Glucose Cotransporter-2 Inhibitors in Patients With Type 2 Diabetes and Chronic Kidney Disease: An Updated Meta-Analysis of Randomized Controlled Trials
Diabetes mellitus (DM) and chronic kidney disease (CKD) significantly increase the risk of cardiovascular morbidity and mortality. Sodium-glucose cotransporter-2 (SGLT-2) inhibitors are a new class of hypoglycemic agents that have shown significant promise in the reduction of cardiovascular events. Current guideline recommendations do not support the use of these agents in patients with CKD stage 3 or higher. We performed a comprehensive meta-analysis to evaluate their cardiovascular effects in patients with type 2 DM and CKD stage 3 or higher. A comprehensive search was performed in PubMed, Cochrane central, and Embase. S...
Source: Cardiology in Review - April 2, 2020 Category: Cardiology Tags: Review Articles Source Type: research

Mineralocorticoid Receptor Antagonist Use in Heart Failure With Reduced Ejection Fraction and End-Stage Renal Disease Patients on Dialysis: A Literature Review
This article will review the epidemiology of heart failure in ESRD, the pathophysiological derangements of the renin–angiotensin–aldosterone system in patients with kidney disease, and the results from case series and trials of the use of MRAs in ESRD with HFrEF. Although limited to several small trials using MRAs in peritoneal and hemodialysis patients with or without HFrEF, the current literature appears to show the potential for clinical benefits with little risk. (Source: Cardiology in Review)
Source: Cardiology in Review - April 2, 2020 Category: Cardiology Tags: Review Articles Source Type: research

Aspirin for the Primary Prevention of Cardiovascular Disease: A Review of the Literature and Considerations for Clinical Practice
This article reviews landmark clinical trials of aspirin in primary prevention and highlights key changes in dosing strategies and demographics. (Source: Cardiology in Review)
Source: Cardiology in Review - February 6, 2020 Category: Cardiology Tags: Curbside Consult Source Type: research

Biomarkers of Aortopathy in Marfan Syndrome
This article will provide an overview of the literature on potential biomarkers studied so far in MFS, as well as potential future directions. (Source: Cardiology in Review)
Source: Cardiology in Review - February 6, 2020 Category: Cardiology Tags: Review Articles Source Type: research

Primary Aldosteronism: Cardiovascular Risk, Diagnosis, and Management
Primary aldosteronism remains a leading cause of secondary hypertension, and its diagnosis and management continue to pose a challenge for clinicians. In this article, we review the diagnosis of primary aldosteronism along with its cardiovascular manifestations. Treatment is described depending on the diagnostic outcome, focusing on medical management with mineralocorticoid receptor antagonists and unilateral adrenalectomy. Although screening and diagnosing hyperaldosteronism follows well-known algorithms, in practice, physicians may find difficulty establishing the best course of action due to complexity in testing and co...
Source: Cardiology in Review - February 6, 2020 Category: Cardiology Tags: Review Articles Source Type: research

Comprehensive Review of Cardiovascular Diseases, Diabetes, and Hypercholesterolemia in Lebanon
The Middle East and North Africa regions, including Lebanon, have recently witnessed rapid urbanization and modernization over the last couple of decades that has led to a dramatic transformation affecting lifestyle and diet. The World Health Organization reports that the leading cause of death in Lebanon is due to cardiovascular disease (CVD) at 47% of all-cause mortality. Over the last 30 years, especially the last 10, the population of Lebanon has changed dramatically due to the effect of wars in the region and refugees seeking asylum. With a population of around 4.5 million and a relatively high rate of consanguinity i...
Source: Cardiology in Review - February 6, 2020 Category: Cardiology Tags: Review Articles Source Type: research

Cardiovascular Disorders Mediated by Autonomic Nervous System Dysfunction
Cardiovascular disorders, such as orthostatic hypotension and supine hypertension, are common in patients with neurodegenerative synucleinopathies such as Parkinson disease (PD), and may also occur in other conditions, such as peripheral neuropathies, that result in autonomic nervous system (ANS) dysfunction. Dysfunction and degeneration of the ANS are implicated in the development of orthostatic and postprandial hypotension and impaired thermoregulation. Neurogenic orthostatic hypotension (nOH) results from sympathetic failure and is a common autonomic disorder in PD. Supine hypertension may also occur as a result of both...
Source: Cardiology in Review - February 6, 2020 Category: Cardiology Tags: Review Articles Source Type: research

Machine Intelligence in Cardiovascular Medicine
The computer science technology trend called artificial intelligence (AI) is not new. Both machine learning and deep learning AI applications have recently begun to impact cardiovascular medicine. Scientists working in the AI domain have long recognized the importance of data quality and provenance to AI algorithm efficiency and accuracy. A diverse array of cardiovascular raw data sources of variable quality—electronic medical records, radiological picture archiving and communication systems, laboratory results, omics, etc.—are available to train AI algorithms for predictive modeling of clinical outcomes (in-ho...
Source: Cardiology in Review - February 6, 2020 Category: Cardiology Tags: Review Articles Source Type: research

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