The 11th Trial of a Cardiovascular Clinical Trialist: Coronavirus-2, Part 4 Lessons Learned From the COVID-19 Pandemic
No abstract available (Source: Cardiology in Review)
Source: Cardiology in Review - December 13, 2020 Category: Cardiology Tags: Editorials Source Type: research
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 criteria ...
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
