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Through the Decades: β-Blocker Use and Outcomes in Acute Coronary Syndromes
This article provides a review of the landmark clinical trials of β-blockers in ACS and highlights the chronology and evolution of guideline recommendations through the decades. (Source: Cardiology in Review)
Source: Cardiology in Review - April 6, 2018 Category: Cardiology Tags: Feature Curbside Consult Source Type: research

Effects of Anti-Inflammatory Medications in Patients With Coronary Artery Disease: A Focus on Losmapimod
Inflammation plays an integral role in atherogenesis and the pathogenesis of coronary artery disease (CAD). The question remains as to whether targeted inhibition of specific pathways of inflammation will have any clinical benefits in CAD. In this article, we will review p38 mitogen-activated protein kinase, one of the key sensors of cellular stress that plays an important role in the inflammatory cascade. In addition, we will review losmapimod, a reversible competitive inhibitor of the α and β isoforms of p38 mitogen-activated protein kinase, and its efficacy when added to standard of care in patients hospitali...
Source: Cardiology in Review - April 6, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Sudden Cardiac Death in Hypertrophic Cardiomyopathy
Hypertrophic cardiomyopathy (HCM) is a heart disease characterized by hypertrophy of the left ventricular myocardium and is most often caused by mutations in sarcomere genes. The structural and functional abnormalities are not explained by flow-limiting coronary artery disease or loading conditions. The disease affects at least 0.2% of the population worldwide and is the most common cause of sudden cardiac death in young people and competitive athletes because of fatal ventricular arrhythmia. In some patients, however, HCM has a benign course. Therefore, it is of utmost importance to properly evaluate patients and single o...
Source: Cardiology in Review - April 6, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Aorto-Atrial Fistulas: A Contemporary Review
Aorto-atrial fistulas (AAFs) are a relatively rare, but potentially life-threatening condition, where an anomalous connection forms between the aortic structures and the cardiac atria. AAFs are most often the result of an underlying condition concerning the cardiac structures. It may be congenital, secondary to conditions such as aortic dissection, infective endocarditis, or valve replacement, or iatrogenic in nature. Secondary causes incite local deterioration of cardiac wall integrity leading to formation of fistulous connections, whereas iatrogenic causes are more traumatic in nature. Signs and symptoms include those of...
Source: Cardiology in Review - April 6, 2018 Category: Cardiology Tags: Review Articles Source Type: research

The Prognostic Implications of Two-Dimensional Speckle Tracking Echocardiography in Hypertrophic Cardiomyopathy: Current and Future Perspectives
Two-dimensional speckle tracking echocardiography represents a novel, simple, and reproducible technique for the estimation of left ventricular myocardial deformation (strain) and the evaluation of left ventricular twist mechanics. During the last few years, its clinical and prognostic implications in cardiomyopathies and hypertrophic cardiomyopathy (HCM), in particular, have been rapidly increasing. Reduced global longitudinal strain is associated with more severe disease and confers an increased risk for major cardiac events, independently of other clinical and echocardiographic risk factors. Left ventricular dyssynchron...
Source: Cardiology in Review - April 6, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Cardiovascular Complications of Proteasome Inhibitors Used in Multiple Myeloma
The use of proteasome inhibitors (PI) as targeted chemotherapeutics have significantly improved survival in patients with multiple myeloma (MM). However, rare and serious cardiovascular complications have occurred as a result of their use, most commonly congestive heart failure, hypertension, and arrhythmias. MM occurs in an aged population with many concurrent cardiovascular risk factors. The primary disease process also contributes to cardiovascular complications. Furthermore, many MM patients have prior exposure to cardiotoxic chemotherapy such as anthracyclines. Because of these occurrences, the identification, prevent...
Source: Cardiology in Review - April 6, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Cardioprotection in the Modern Era of Cancer Chemotherapy
The current arsenal of cancer chemotherapy is broad and rapidly expanding and includes conventional cytotoxic agents and targeted and immune-based therapies. As cancer survival rates have improved, the acute and latent cardiotoxicities of chemotherapy have emerged as important contributors to morbidity and mortality in cancer survivors. All chemotherapeutic agents have the potential for cardiac complications, with manifestations ranging from subclinical left ventricular dysfunction and asymptomatic QT prolongation, to congestive heart failure, myocardial ischemia, myocarditis, arrhythmia, and sudden cardiac death. Efforts ...
Source: Cardiology in Review - April 6, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Switching From Ticagrelor or Prasugrel to Clopidogrel
Ticagrelor and prasugrel are newer antiplatelet drugs which, like clopidogrel, block the P2Y12 platelet receptor to inhibit platelet aggregation. Compared with clopidogrel, both ticagrelor and prasugrel have greater clinical efficacy but also have a higher risk of bleeding and are much more costly. Therefore, some institutions and providers switch patients from ticagrelor or prasugrel to clopidogrel in an effort to lower bleeding risk, stem costs, or otherwise ensure that patients can safely adhere to long-term P2Y12 inhibitor therapy. From a pharmacodynamic perspective, switching patients from ticagrelor or prasugrel to c...
Source: Cardiology in Review - February 10, 2018 Category: Cardiology Tags: Feature Curbside Consult Source Type: research

A Nonsurgical Approach to Mesenteric Vascular Disease
Mesenteric ischemia is a rare disorder, with considerably high morbidity and mortality rates. It can manifest in several ways, including acute mesenteric ischemia, chronic mesenteric ischemia, nonocclusive mesenteric ischemia, mesenteric venous thrombosis, and colonic ischemia. Of these, acute mesenteric ischemia is the most severe form of intestinal ischemia, with a high mortality rate. The mainstay of therapy for mesenteric ischemia is surgical exploration and resection of infarcted bowel; however, medical therapy can play an important adjunctive role. When diagnosed early, before bowel infarction, endovascular therapy c...
Source: Cardiology in Review - February 10, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Acupuncture and Cardiovascular Disease: Focus on Heart Failure
This article serves to examine recent evidence supporting the long-loop pathway as the physiologic mechanism of acupuncture and the sympatholytic, vasodilatory, and cardioprotective effects of acupuncture that could specifically improve cardiac function and quality of life measures in the management of congestive heart failure. (Source: Cardiology in Review)
Source: Cardiology in Review - February 10, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Genetic Origins of Tetralogy of Fallot
Due to improved survival and clinical outcomes, congenital heart disease (CHD) is an area of growing importance within the medical community. As these patients reach adulthood and have children, there has been a growing appreciation for the increased risk of CHD among their offspring, strongly implying a genetic element. Given the growing wealth of genetic data available and these clinical implications, this review serves to reexamine the role of genetics within CHD, using Tetralogy of Fallot as a model pathology. Tetralogy of Fallot (TOF) is one of the oldest documented CHDs, with a growing prevalence of adult patients, a...
Source: Cardiology in Review - February 10, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Impact of Improved Survival in Congenital Heart Disease on Incidence of Disease
Survival rates and life expectancies for patients with congenital heart disease (CHD) have dramatically increased, and these patients are now reaching reproductive age. As they reproduce, questions pertaining to recurrent risk of disease and the impact on incidence rates have emerged. Recurrence rates for CHD have been estimated at 3% to 5%, although, due to the complex genetics underlying CHD, this range may represent an underestimation of the true risk. Debate still exists on whether the impact of recurrence of disease has been reflected in incidence rates. Although incidence rates have undoubtedly increased, the mechani...
Source: Cardiology in Review - February 10, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Sex-Specific Outcomes After Transcatheter Aortic Valve Replacement: A Review of the Literature
Transcatheter aortic valve replacement (TAVR) is a safe and effective therapy for aortic valve replacement in patients ineligible for or at high risk for surgery. However, outcomes after TAVR based on an individual’s sex remain to be fully elucidated. We searched PUBMED and EMBASE using the keywords: “transcatheter aortic valve replacement,” “transcatheter aortic valve implantation,” “sex differences,” “gender,” “sex characteristics” and collected information on baseline features, procedural characteristics, and postprocedural outcomes in women. Inclusion/ex...
Source: Cardiology in Review - February 10, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Chronic Thromboembolic Pulmonary Hypertension: Epidemiology, Diagnosis, and Management
Chronic thromboembolic pulmonary hypertension (CTEPH), classified as World Health Organization (WHO) group 4 pulmonary hypertension (PH), is an interesting and rare pulmonary vascular disorder secondary to mechanical obstruction of the pulmonary vasculature from thromboembolism resulting in PH. The pathophysiology is complex, beginning with mechanical obstruction of the pulmonary arteries, which eventually leads to arteriopathic changes and vascular remodeling in the nonoccluded arteries and in the distal segments of the occluded arteries mediated by thrombus nonresolution, abnormal angiogenesis, endothelial dysfunction, a...
Source: Cardiology in Review - February 10, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Implications of the New National Guidelines for Hypertension
Automated validated devices should be used for measuring blood pressure (BP). A systolic BP between 120 and 129 mm Hg with a diastolic BP (Source: Cardiology in Review)
Source: Cardiology in Review - February 10, 2018 Category: Cardiology Tags: Review Articles Source Type: research

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 - January 1, 2018 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 - January 1, 2018 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 - January 1, 2018 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 - January 1, 2018 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 - January 1, 2018 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 - January 1, 2018 Category: Cardiology Tags: Review Articles Source Type: research

Five Presidents and a Secretary
No abstract available (Source: Cardiology in Review)
Source: Cardiology in Review - January 1, 2018 Category: Cardiology Tags: Editorial Source Type: research

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