Surgical Revascularization for Ischemic Cardiomyopathy in the Post-STICH Era
Coronary artery disease (CAD) accounts for significant morbidity and mortality in the United States and most developed countries. Patients with heart failure secondary to CAD have demonstrable poorer outcomes compared with those patients with heart failure because of other causes. Even when the causative relationship between CAD and systolic dysfunction can be unequivocally established, the controversy of revascularization in patients with ischemic cardiomyopathy continues to challenge clinicians. The potential benefit of revascularization has to be weighed against the higher operative and postoperative mortality of corona...
Source: Cardiology in Review - June 8, 2015 Category: Cardiology Tags: Review Articles Source Type: research

Omega-3-Carboxylic Acid (Epanova) for Hypertriglyceridemia
Hypertriglyceridemia is a prevalent yet under-addressed condition, often seen in association with uncontrolled diabetes mellitus, obesity, and physical inactivity. The control of triglyceride (TG) levels is essential to prevent the development of coronary artery disease and pancreatitis associated with hypertriglyceridemia. Omega-3-carboxylic acid (Epanova) is the third prescription omega-3 fatty acid product approved in the United States as an adjunct to diet for treating severe hypertriglyceridemia (≥500 mg/dL). At the approved dosage, it reduced baseline serum TG levels by 25–30% in a placebo-controlled ...
Source: Cardiology in Review - April 4, 2015 Category: Cardiology Tags: New Therapy Update Source Type: research

Dynamic Mitral Regurgitation: Review of Evidence Base, Assessment and Implications for Clinical Management
Both organic and functional mitral regurgitation are dynamic. Alterations in left ventricular and annular geometry, together with changing loading conditions on exertion, may lead to changes in the severity of mitral regurgitation. Exercise echocardiography is able to identify exercise-induced increases in the severity of mitral regurgitation and pulmonary artery systolic pressure which are responsible for symptoms in patients with mild or moderate dysfunction at rest. Prognostic parameters (exercise induced changes in effective orifice area, ejection fraction, and global longitudinal strain) may help risk-stratify patient...
Source: Cardiology in Review - April 4, 2015 Category: Cardiology Tags: Review Articles Source Type: research

Novel Perspectives on Arrhythmia-Induced Cardiomyopathy: Pathophysiology, Clinical Manifestations and an Update on Invasive Management Strategies
Arrhythmia-induced cardiomyopathy is a partially or completely reversible form of myocardial dysfunction due to sustained supraventricular and ventricular arrhythmias. Asynchrony, rapid cardiac rates and rhythm irregularities are the main factors involved in the development of the disease. The reversible nature of arrhythmia-induced cardiac dysfunction allows only for a retrospective diagnosis of the disease once cardiac function is restored following heart rate control. A high level of suspicion is needed to make a diagnosis at an early stage and prevent further progression of the disease. Although reversible, arrhythmia-...
Source: Cardiology in Review - April 4, 2015 Category: Cardiology Tags: Review Articles Source Type: research

Carotid Sinus Syndrome
Carotid sinus hypersensitivity, first described less than 65 years ago, is an important and often undiagnosed cause of syncope in the elderly. Its pathophysiology is complex and certain aspects are not completely understood. The timely diagnosis and treatment of this condition can improve morbidity and prevent complications in the elderly. In this article, the prevalence, risk factors, pathophysiology, diagnosis, aspects of carotid sinus massage, and treatment options for the different kinds of carotid sinus hypersensitivity are discussed. (Source: Cardiology in Review)
Source: Cardiology in Review - April 4, 2015 Category: Cardiology Tags: Review Articles Source Type: research

Endothelial Dysfunction and Coronary Artery Disease: A State of the Art Review
Atherosclerotic coronary artery disease (CAD) is a major cause of morbidity and mortality in the developed world. Endothelial dysfunction plays an important role in the development of atherosclerosis and predicts cardiovascular (CV) outcomes independent of conventional CV risk factors. In recent years, there have been tremendous improvements in the pharmacological prevention and management of CAD. In this review, the pathophysiology of endothelial dysfunction in relation to CAD is discussed and various techniques of invasive and noninvasive assessments of peripheral and coronary endothelial function described. In addition,...
Source: Cardiology in Review - April 4, 2015 Category: Cardiology Tags: Review Articles Source Type: research

Pathophysiologic and Treatment Strategies for Cardiovascular Disease in End-Stage Renal Disease and Kidney Transplantations
The inextricable link between the heart and the kidneys predestines that significant cardiovascular disease ensues in the face of end-stage renal disease (ESRD). As a point of fact, the leading cause of mortality of patients on dialysis is still from cardiovascular etiologies, albeit differing in particular types of disease from the general population. For example, sudden cardiac death outnumbers coronary artery disease in patients with ESRD, which is the reverse for the general population. In this review, we will focus on the pathophysiology and treatment options of important traditional and nontraditional risk factors fo...
Source: Cardiology in Review - April 4, 2015 Category: Cardiology Tags: Review Articles Source Type: research

Pulmonary Arterial Hypertension: A Review in Pharmacotherapy: Erratum
No abstract available (Source: Cardiology in Review)
Source: Cardiology in Review - February 6, 2015 Category: Cardiology Tags: Erratum Source Type: research

The Role of the Novel Oral Anticoagulants in the Secondary Prevention of Acute Coronary Syndromes
Acute coronary syndromes continue to be a dominant cause of death worldwide. Acute therapies with potent antithrombotic agents have improved in-hospital outcomes; however, despite the use of these therapies, recurrent events continue to occur long term. Statins, renin–angiotensin inhibitors, beta-blockers, and dual antiplatelet therapy all have roles in mitigating long-term risk, but given recurrent thrombotic events on contemporary pharmacologic agents, novel therapies inhibiting thrombin formation have been explored. The intent of the current article is to review recent phase II/III clinical trials of oral anticoag...
Source: Cardiology in Review - February 6, 2015 Category: Cardiology Tags: Review Articles Source Type: research

Update on Work-Related Psychosocial Factors and the Development of Ischemic Heart Disease: A Systematic Review
The present review deals with the relationship between occupational psychosocial factors and the incidence of ischemic heart disease (IHD) with special regard to the statistical power of the findings. This review with 4 inclusion criteria is an update of a 2009 review of which the first 3 criteria were included in the original review: (1) Study: a prospective or case–control study if exposure was not self-reported (prognostic studies excluded); (2) Outcome: definite IHD determined externally; (3) Exposure: psychosocial factors at work (excluding shift work, trauma, violence or accidents, and social capital); and (4) ...
Source: Cardiology in Review - February 6, 2015 Category: Cardiology Tags: Review Articles Source Type: research

Hybrid Coronary Revascularization: A Systematic Review
The hybrid approach to coronary revascularization is an evolving technique that is being used as an alternative to the traditional median sternotomy coronary artery bypass graft surgery. It combines a minimally invasive approach to bypass the left anterior descending coronary artery with a percutaneous approach to revascularize the other coronary arteries. A systematic review of the available literature was conducted to evaluate the benefits, and the short- and long-term outcomes of this procedure. (Source: Cardiology in Review)
Source: Cardiology in Review - February 6, 2015 Category: Cardiology Tags: Review Articles Source Type: research

Sleep-Disordered Breathing and Atrial Fibrillation: Review of the Evidence
Sleep-disordered breathing and atrial fibrillation are two common medical conditions. A strong association between them has been described and has prompted significant research in understanding the mechanism connecting the two conditions while explaining the synergic negative effects in terms of morbidity and mortality in affected patients. This review focuses first on the pathophysiologic mechanisms favoring the development of atrial fibrillation in patients with sleep-disordered breathing, considering specifically and separately obstructive sleep apnea and central sleep apnea. Then, the effects of these two disorders in ...
Source: Cardiology in Review - February 6, 2015 Category: Cardiology Tags: Review Articles Source Type: research

Peripartum Cardiomyopathy: Definition, Incidence, Etiopathogenesis, Diagnosis, and Management
We present a comprehensive review of the literature etiopathogenesis, diagnosis, and management of PPCM. (Source: Cardiology in Review)
Source: Cardiology in Review - February 6, 2015 Category: Cardiology Tags: Review Articles Source Type: research

Consensus Review of the Treatment of Cardiovascular Disease in People With Hemophilia A and B
With advances in care, increasing numbers of people with hemophilia (PWH) achieve near-normal life expectancies and present with typical age-related cardiovascular conditions. Evidence-based guidelines for medical or surgical management of cardiovascular conditions in individuals with hemophilia are limited. Published recommendations exist for the management of some common cardiovascular conditions (eg, ischemic heart disease, atrial fibrillation), but identifying optimal strategies for anticoagulant or antithrombotic therapy constitutes the primary challenge of managing nonoperative cardiovascular disease (CVD) in PWH. In...
Source: Cardiology in Review - February 6, 2015 Category: Cardiology Tags: Review Articles Source Type: research

Pulmonary Arterial Hypertension: A Review in Pharmacotherapy
This article reviews the clinical efficacy and safety of these 3 agents and the roles they play in the management of PAH. Additionally, we review the limitations of using surrogate markers such as change in 6-minute walk distance to assess disease progression. (Source: Cardiology in Review)
Source: Cardiology in Review - January 1, 2015 Category: Cardiology Tags: Review Articles Source Type: research

Beyond PARTNER: Appraising the Evolving Trends and Outcomes in Transcatheter Aortic Valve Replacement
Transcatheter aortic valve replacement (TAVR) has become the preferred treatment in patients with symptomatic severe aortic stenosis deemed to be at prohibitive or high risk for surgical aortic valve replacement. With evolving technology, improving practices and patient selection, outcomes in TAVR have improved. In the not so distant future, TAVR may become an alternative to surgical aortic valve replacement even for patients who are not at high risk for open surgery. However, issues such as stroke, paravalvular leak and pacemaker need remain, and the unknown limitations of TAVR, including durability and undefined options ...
Source: Cardiology in Review - January 1, 2015 Category: Cardiology Tags: Review Articles Source Type: research

Pulmonary Arterial Hypertension: A Review in Pharmacotherapy
This article reviews the clinical efficacy and safety of these 3 agents and the roles they play in the management of PAH. Additionally, we review the limitations of using surrogate markers such as change in 6-minute walk distance to assess disease progression. (Source: Cardiology in Review)
Source: Cardiology in Review - December 5, 2014 Category: Cardiology Tags: Review Articles Source Type: research

Acute Coronary Syndrome Among Older Patients: A Review
Ischemic heart disease is the leading cause of mortality worldwide. Due to advances in medicine in the past few decades, life expectancy has increased resulting in an aging population in developed and developing countries. Acute coronary syndrome causes greater morbidity and mortality in this group of older patients, which appears to be due to age-related comorbidities. This review examines the incidence and prevalence of acute coronary syndrome among older patients, examines current treatment strategies, and evaluates the predictors of adverse outcomes. In particular, the impact of frailty on outcomes and the need for fra...
Source: Cardiology in Review - December 5, 2014 Category: Cardiology Tags: Review Articles Source Type: research

Physical Activity in the Management of Patients with Coronary Artery Disease: A Review
Cardiovascular diseases remain the leading cause of death in the Western world despite advances in therapeutics and interventions. The prescription of physical activity is a key component of cardiac rehabilitation following myocardial infarction. This review aims to outline the impact of physical activity in particular patient cohorts with coronary artery disease. The current understanding of the mechanisms involved in atherosclerosis, plaque rupture and thrombosis, and how these can be modified by physical activity, are also discussed. There is the potential for future research to investigate the clinical and mechanistic ...
Source: Cardiology in Review - December 5, 2014 Category: Cardiology Tags: Review Articles Source Type: research

Cardiovascular Disease and Hepatitis C Virus Infection: An Irrelevant Statement or a Hot Relationship?
Hepatitis C virus (HCV) is well known for being the leading cause of hepatocellular carcinoma and cirrhosis, contributing to a devastating array of metabolic dysfunctions associated with hepatic failure. However, the cardiac manifestations of HCV and chronic hepatitis C (CHC) are being explored, thus illuminating the connection between HCV infection and cardiac disease. Although not all studies agree, the evidence in favor of CHC promoting major risk factors for cardiovascular disease such as hypertension, insulin resistance, diabetes mellitus, and atherosclerosis is compelling. Similarly, properly warranted attention is b...
Source: Cardiology in Review - December 5, 2014 Category: Cardiology Tags: Review Articles Source Type: research

Beyond PARTNER: Appraising the Evolving Trends and Outcomes in Transcatheter Aortic Valve Replacement
Transcatheter aortic valve replacement (TAVR) has become the preferred treatment in patients with symptomatic severe aortic stenosis deemed to be at prohibitive or high risk for surgical aortic valve replacement. With evolving technology, improving practices and patient selection, outcomes in TAVR have improved. In the not so distant future, TAVR may become an alternative to surgical aortic valve replacement even for patients who are not at high risk for open surgery. However, issues such as stroke, paravalvular leak and pacemaker need remain, and the unknown limitations of TAVR, including durability and undefined options ...
Source: Cardiology in Review - December 5, 2014 Category: Cardiology Tags: Review Articles Source Type: research

Prognostic Role of Platelet Reactivity in Patients With Acute Coronary Syndromes
Despite dual antiplatelet treatment with aspirin and clopidogrel, patients with acute coronary syndromes (ACSs) remain at risk for recurrent cardiovascular events. This may be due, at least in part, to an incomplete response to clopidogrel, which is more frequent in ACS patients compared to stable patients because of massive platelet activation and increased platelet turnover. Currently, numerous laboratory-based methods and point-of-care tests are available to assess platelet reactivity. Several studies have tried to establish a standardized definition of high on-treatment platelet reactivity and to evaluate a correlation...
Source: Cardiology in Review - October 7, 2014 Category: Cardiology Tags: Other Review Articles Source Type: research

Circulating Levels of Proprotein Convertase Subtilisin Kexin Type 9 are Elevated by Fibrate Therapy: A Systematic Review and Meta-Analysis of Clinical Trials
Proprotein convertase subtilisin kexin type 9 (PCSK9) affects lipid metabolism through modulation of low-density lipoprotein (LDL) receptor degradation. Circulating PCSK9 status is an important determinant of LDL-cholesterol levels and is thus implicated in atherogenesis. The present study aimed to resolve inconsistencies in clinical findings on the impact of fibrate therapy on circulating PCSK9 concentrations using a meta-analysis of all published studies. A comprehensive literature search in Medline and Scopus was carried out to identify clinical reports on the impact of treatment with fibrates on circulating concentrati...
Source: Cardiology in Review - October 7, 2014 Category: Cardiology Tags: Other Review Articles Source Type: research

Existing Drugs and Agents Under Investigation for Pulmonary Arterial Hypertension
This article will review several of these promising new therapies and will discuss the current evidence regarding their potential benefit in pulmonary arterial hypertension. (Source: Cardiology in Review)
Source: Cardiology in Review - October 7, 2014 Category: Cardiology Tags: Other Review Articles Source Type: research

Percutaneous Mitral Heart Valve Repair—MitraClip
Mitral regurgitation (MR) is the most common cardiac valvular disease in the United States. Approximately 4 million people have severe MR and roughly 250,000 new diagnoses of MR are made each year. Mitral valve surgery is the only treatment that prevents progression of heart failure and provides sustained symptomatic relief. Mitral valve repair is preferred over replacement for the treatment of MR because of freedom from anticoagulation, reduced long-term morbidity, reduced perioperative mortality, improved survival, and better preservation of left ventricular function compared with valve replacement. A large proportion of...
Source: Cardiology in Review - October 7, 2014 Category: Cardiology Tags: Other Review Articles Source Type: research

Inflammation in Coronary Artery Disease
Coronary artery disease (CAD) is the leading cause of death in the United States. Although CAD was formerly considered a lipid accumulation–mediated disease, it has now been clearly shown to involve an ongoing inflammatory response. Advances in basic science research have established the crucial role of inflammation in mediating all stages of CAD. Today, there is convincing evidence that multiple interrelated immune mechanisms interact with metabolic risk factors to initiate, promote, and ultimately activate lesions in the coronary arteries. This review aims to provide current evidence pertaining to the role of infla...
Source: Cardiology in Review - October 7, 2014 Category: Cardiology Tags: Other Review Articles Source Type: research

Cardiopulmonary Stress Testing in Children and Adults With Congenital Heart Disease
Cardiopulmonary exercise stress testing (CPET) is a vital tool used to assess patients with a history of congenital heart disease. There are several tests in the cardiologist’s armamentarium that allow for assessment of cardiac anatomy and function. The majority of these tests are only performed with the body at rest and some even require sedation. Exercise stress testing is unique in allowing assessment of the hemodynamic status of a patient in motion. In addition to providing all the information obtained during an exercise stress test, such as heart rate, rhythm, ST-segment analysis, and blood pressure, the CPET pr...
Source: Cardiology in Review - October 7, 2014 Category: Cardiology Tags: Pediatric Review Articles Source Type: research

Cardio-Oncology Issues Among Pediatric Cancer and Stem Cell Transplant Survivors
Improvements in the survival of children and adolescents diagnosed with cancer have resulted in a growing population of childhood, adolescent and adult cancer and stem cell transplant survivors. Approximately two thirds of these survivors will experience at least 1 late effect of their treatment, and about one third will experience a late effect that is severe or life threatening. Childhood cancer survivors are at high risk for development of severe cardiac disease, particularly after anthracycline and/or radiation exposure. Cardiotoxicity can present as early cardiac dysfunction during or shortly after therapy or as chron...
Source: Cardiology in Review - October 7, 2014 Category: Cardiology Tags: Pediatric Review Articles Source Type: research

Prevention and Treatment In Utero of Autoimmune-Associated Congenital Heart Block
Transplacental transfer of maternal anti-Ro and/or anti-La autoantibodies can result in fetal cardiac disease, including congenital heart block and cardiomyopathy, called cardiac neonatal lupus (NL). Thousands of women are faced with the risk of cardiac NL in their offspring, which is associated with significant morbidity and mortality. There are no known therapies to permanently reverse third-degree heart block in NL, although several treatments have shown some effectiveness in incomplete heart block and disease beyond the atrioventricular node. Fluorinated steroids taken during pregnancy have shown benefit in these situa...
Source: Cardiology in Review - October 7, 2014 Category: Cardiology Tags: Pediatric Review Articles Source Type: research

Anacetrapib: A Potential New Therapy for Dyslipidemia
Anacetrapib is a cholesteryl ester transfer protein (CETP) inhibitor currently in Phase III of development as a treatment for those with dyslipidemia and the risk of cardiovascular disease. The agent acts by inhibiting the CETP, which mediates the transfer of cholesterol esters from high-density lipoprotein cholesterol (HDL-C) to other lipoproteins. HDL-C has been inversely linked to cardiac risk and is thus a potential target for decreasing residual cardiovascular risk, which remains despite aggressive low-density lipoprotein cholesterol therapy with statin drugs. Anacetrapib has been shown to raise HDL-C by up to 138% an...
Source: Cardiology in Review - August 7, 2014 Category: Cardiology Tags: New Therapy Update Source Type: research

Myocardial Viability and Microvascular Obstruction: Role of Cardiac Magnetic Resonance Imaging
Established coronary artery disease has a prevalence of 7% in adult Americans, accounting for 16 million people. As morbidity and mortality rates have risen, research efforts to identify the pathophysiologic mechanisms of systolic dysfunction have risen in parallel. The current goal is to develop new therapeutic strategies with the potential to reverse systolic dysfunction in patients with established coronary artery disease. Cardiac magnetic resonance imaging has gained a key role in cardio vascular medicine. We will comment on the potential pivotal role of cardiac magnetic resonance imaging for the assessment of myocardi...
Source: Cardiology in Review - August 7, 2014 Category: Cardiology Tags: Review Articles Source Type: research

Five Recurrent Misconceptions Regarding Cardiogenic Shock Management
Medical therapeutic knowledge advances by continual action and reaction between retrospective and prospective evaluation on the one hand and clinical real-life observation and assessment on the other. In this regard, our goal is to articulate and demystify certain myths and misconceptions that impede the optimal management of patients with circulatory failure related to acute cardiac diseases. More specifically, we outline 5 statements that represent misconceptions about cardiogenic shock management that we have frequently faced throughout years of caring for critically ill patients. Moreover, for each statement, we sugges...
Source: Cardiology in Review - August 7, 2014 Category: Cardiology Tags: Review Articles Source Type: research

Right Ventricle Functional Assessment: Have New Techniques Supplanted the Old Faithful Conductance Catheter?
This review explores the historical development of conductance catheterization of the human right ventricle (RV) and its current diagnostic role in assessing RV function in an era of contemporary noninvasive imaging. Significant advances in echocardiography, cardiothoracic computed tomography, and cardiac magnetic resonance in the last decade have led a paradigm shift away from invasive hemodynamic assessment toward noninvasive measurement of RV function. However, imaging modalities are not without some disadvantages. For example, they do not provide the beat-to-beat pressure-volume assessment that is obtained by conductan...
Source: Cardiology in Review - August 7, 2014 Category: Cardiology Tags: Review Articles Source Type: research

Association of Aging, Arterial Stiffness, and Cardiovascular Disease: A Review
Coronary heart disease (CHD) is the leading cause of morbidity and mortality in the western world. Primary and secondary prevention strategies have improved tremendously. Conventional risk factors are identified and treated with intensive pharmacotherapy. Despite these measures, the incidence of CHD is on the rise in developed countries. Arterial stiffness has been identified as an independent risk factor for the development of CHD, both in the general population and in those with established CHD. This review examines the association of arterial stiffness with cardiovascular disease. (Source: Cardiology in Review)
Source: Cardiology in Review - August 7, 2014 Category: Cardiology Tags: Review Articles Source Type: research

Pregnancy in Women With Hypertrophic Cardiomyopathy
In conclusion, maternal mortality related to pregnancy in women with HCM is low and appears to be confined to women with a high-risk profile before pregnancy. Fetal mortality is comparable to that in the general population; however, the risk of premature birth is increased. (Source: Cardiology in Review)
Source: Cardiology in Review - August 7, 2014 Category: Cardiology Tags: Review Articles Source Type: research

Perspectives on Sudden Death Prevention in Hypertrophic Cardiomyopathy
Sudden death (SD) is the most dramatic event in hypertrophic cardiomyopathy (HCM), often representing the first clinical manifestation of the disease, and the first concern of the clinicians who take care of such patients. HCM is now recognized as the primary cause of SD in young persons ( (Source: Cardiology in Review)
Source: Cardiology in Review - August 7, 2014 Category: Cardiology Tags: Review Articles Source Type: research

Pharmacological and Nonpharmacological Treatment After Cardiac Surgery
Open-heart surgery has become a common procedure. Postcardiac surgery management is a critical issue and represents a crucial period in terms of physical recovery. Cardiac rehabilitation is increasingly considered as an integral component of the continuum of care for patients with cardiovascular disease. Its usefulness is now widely accepted, and therefore, it is recommended in most contemporary cardiovascular clinical practice guidelines. Similarly, early pharmacological management can modulate the pathophysiological alterations after cardiac surgery, leading to an improvement in the early and long-term outcome. In this r...
Source: Cardiology in Review - August 7, 2014 Category: Cardiology Tags: Review Articles Source Type: research

Pharmacogenomics in Heart Failure: Where Are We Now and How Can We Reach Clinical Application?
Heart failure is becoming increasingly prevalent in the United States and is a significant cause of morbidity and mortality. Several therapies are currently available to treat this chronic illness; however, clinical response to these treatment options exhibit significant interpatient variation. It is now clearly understood that genetics is a key contributor to diversity in therapeutic response, and evidence that genetic polymorphisms alter the pharmacokinetics, pharmacodynamics, and clinical response of heart failure drugs continues to accumulate. This suggests that pharmacogenomics has the potential to help clinicians imp...
Source: Cardiology in Review - August 7, 2014 Category: Cardiology Tags: Review Articles Source Type: research

Role of Magnesium in Cardiovascular Diseases
Magnesium, the fourth most abundant cation in the human body, is involved in several essential physiological, biochemical, and cellular processes regulating cardiovascular function. It plays a critical role in modulating vascular smooth muscle tone, endothelial cell function, and myocardial excitability and is thus central to the pathogenesis of several cardiovascular disorders such as hypertension, atherosclerosis, coronary artery disease, congestive heart failure, and cardiac arrhythmias. This review discusses the vasodilatory, anti-inflammatory, anti-ischemic, and antiarrhythmic properties of magnesium and its current r...
Source: Cardiology in Review - June 6, 2014 Category: Cardiology Tags: Review Articles Source Type: research

Interleukin 1β: A Proinflammatory Target for Preventing Atherosclerotic Heart Disease
Interleukin 1β (IL-1β) is a proinflammatory cytokine that has been implicated in a number of rheumatologic and inflammatory conditions. The production and secretion of IL-1β from inflammatory cells is a tightly regulated process that has been extensively described and studied. In recent years, IL-1β has been associated with several steps in the development of atherosclerotic plaques, as well as other cardiovascular disease modifiers, such as cigarette smoking and type II diabetes mellitus. More recently, IL-1β has become the target of therapy in refractory rheumatologic conditions and is under inve...
Source: Cardiology in Review - June 6, 2014 Category: Cardiology Tags: Review Articles Source Type: research

Comprehensive Review of the Prognostic Value of Galectin-3 in Heart Failure
Heart failure (HF) is a major cause of morbidity and mortality in the United States; however, reliable biomarkers predicting outcomes of patients suffering from HF are still not available. Finding a prognostic indicator in patients with HF could ultimately help improve the quality of goal-directed care for these patients. A number of recent studies suggest that galectin-3, a peptide that has been repeatedly shown to be elevated in the setting of inflammatory processes, may provide information regarding the pathophysiologic process underlying HF. If this is the case, galectin-3 may independently be able to provide more info...
Source: Cardiology in Review - June 6, 2014 Category: Cardiology Tags: Review Articles Source Type: research

Is There a Paradox in Obesity?
In an industrialized society, the increase in obesity incidence has led to an increase in premature morbidity and mortality rates. There is a relationship between body mass index (BMI) and the increased incidence of hypertension, dyslipidemia, type 2 diabetes mellitus, and cardiovascular disease, an increase in mortality. However, obese individuals with these conditions may have better outcomes than their lean counterparts, thus the term “obesity paradox.” Most studies supporting this paradox are cross-sectional and do not take into account the quantity or type of adiposity, the disease severity, and comorbidit...
Source: Cardiology in Review - June 6, 2014 Category: Cardiology Tags: Review Articles Source Type: research

Cardiovascular Risk Assessment Before and After Kidney Transplantation
Cardiovascular disease (CVD) is the leading cause of death in dialysis patients and the most common cause of death and allograft loss among kidney transplant recipients. End-stage renal disease (ESRD) is associated with an increased incidence and prevalence of a wide range of CVDs including coronary artery disease, stroke, congestive heart failure, atrial fibrillation, sudden cardiac death, pulmonary hypertension, and valvular heart disease. CVD risk factors are very common in patients with ESRD, and most patients have multiple risk factors. Kidney transplantation is the treatment of choice for patients with ESRD, as a suc...
Source: Cardiology in Review - June 6, 2014 Category: Cardiology Tags: Review Articles Source Type: research

Inflammation and Atherosclerosis: A Review of the Role of Interleukin-6 in the Development of Atherosclerosis and the Potential for Targeted Drug Therapy
It has recently been appreciated that atherosclerosis is predominantly an inflammatory process. Atherosclerosis begins with a fatty streak, which is made up almost entirely of monocyte-derived macrophages. The development of an atheroma continues as T-cells, mast cells, and other inflammatory cells are recruited to the intima. This collection of inflammatory cells promotes smooth muscle cell replication and extracellular matrix elaboration, thereby increasing the lesion size. Various studies have highlighted that interleukin-6 (IL-6) is an upstream inflammatory cytokine that plays a central role in propagating the downstre...
Source: Cardiology in Review - May 1, 2014 Category: Cardiology Tags: Review Articles Source Type: research

Antihyperlipidemic Therapies Targeting PCSK9
Hyperlipidemia is a major cause of cardiovascular disease despite the availability of first-line cholesterol-lowering agents such as statins. A new therapeutic approach to lowering low-density lipoprotein-cholesterol (LDL-C) acts by blocking LDL-receptor degradation by serum proprotein convertase subtilisin kexin 9 (PCSK9). Human monoclonal antibodies that target PCSK9 and its interaction with the LDL receptor are now in clinical trials (REGN727/SAR23653, AMG145, and RN316). These agents are administered by either subcutaneous or intravenous routes, and have been shown to have major LDL-C and apolipoprotein B effects when ...
Source: Cardiology in Review - May 1, 2014 Category: Cardiology Tags: Review Articles Source Type: research

The Prognostic Impact of Myocardial Late Gadolinium Enhancement
Cardiovascular magnetic resonance using late gadolinium enhancement (LGE) provides a unique opportunity to assess myocardial tissue in vivo. LGE enables tissue characterization in ischemic and nonischemic cardiomyopathies and other cardiac diseases. LGE is associated with adverse clinical outcomes across a range of different cardiac conditions and may improve risk stratification for death, sudden cardiac death, or serious adverse events beyond traditional prognostic markers. Generally, matching data for the prognostic impact of LGE are frequently reached in cardiac disorders. In other diseases, only a limited number of tri...
Source: Cardiology in Review - May 1, 2014 Category: Cardiology Tags: Review Articles Source Type: research

The Use of Coronary CT Angiography for the Evaluation of Chest Pain
Coronary computed tomography angiography (CCTA) may improve the diagnosis and management of acute and stable chest pain syndromes. The key for caregivers of patients presenting with acute chest pain is the early identification and management of life-threatening conditions, such as acute coronary syndromes, pulmonary embolism, and acute aortic dissection. The main goal in stable chest pain syndromes is to determine the extent and severity of coronary artery disease. This review article will critically evaluate the current literature supporting the evidence for the clinical use of CCTA in acute and stable chest pain syndrome...
Source: Cardiology in Review - May 1, 2014 Category: Cardiology Tags: Review Articles Source Type: research

Stem Cell Therapy for Heart Failure
The last decade has witnessed the publication of a large number of clinical trials, primarily using bone marrow–derived stem cells as the injected cell. Much has been learned through these “first-generation” clinical trials. The considerable advances in our understanding include (1) cell therapy is safe, (2) cell therapy has been modestly effective, (3) the recognition that in humans bone marrow–derived stem cells do not transdifferentiate into cardiomyocytes or new blood vessels (or at least in sufficient numbers to have any effect). The primary mechanism of action for cell therapy is now believed ...
Source: Cardiology in Review - May 1, 2014 Category: Cardiology Tags: Review Articles Source Type: research

Canagliflozin: A New Class of Antidiabetic Agent Targeting the Sodium–Glucose Cotransporter
This article reviews the pharmacology of canagliflozin, examines available clinical trials for efficacy and safety, and describes its role in diabetes management. (Source: Cardiology in Review)
Source: Cardiology in Review - February 8, 2014 Category: Cardiology Tags: New Therapy Update Source Type: research

Sortilin: The Mechanistic Link Between Genes, Cholesterol, and Coronary Artery Disease
Hyperlipidemia is an important risk factor for cardiovascular disease globally, but there is still much mystery surrounding the topic of lipid regulation. Many studies have attempted to assess the underlying genetic basis of low-density lipoprotein (LDL) metabolism. Recently, multiple genome-wide association studies identified genes that strongly associate with plasma lipid concentration and cardiovascular disease. Compelling evidence linking the SORT1 gene to both LDL cholesterol (LDL-C) levels and the risk of coronary artery disease emerged from the data, prompting the search for the molecules and mechanisms responsible ...
Source: Cardiology in Review - February 8, 2014 Category: Cardiology Tags: Review Articles Source Type: research