Recent Advances in T1 and T2 Mapping in the Assessment of Fulminant Myocarditis by Cardiac Magnetic Resonance
AbstractPurpose of ReviewThis review was undertaken to summarise recent data relating to T1 and T2 relaxation times in the assessment of myocarditis using cardiac MRI, and the effect new studies have had on the established diagnostic criteria, leading to recently proposed revised criteria for the cardiac MRI assessment of myocarditis.Recent FindingsIn 2018, updates to the 2009 Lake Louise Criteria (LLC) were proposed, based on studies showing improved accuracy of T1 mapping techniques over T1 signal intensity ratio-based imaging, although for the detection of myocardial oedema either T2-weighted images or increased T2 rela...
Source: Current Cardiology Reports - May 29, 2020 Category: Cardiology Source Type: research

Artificial Intelligence in Intracoronary Imaging
AbstractPurpose of ReviewThis paper investigates present uses and future potential of artificial intelligence (AI) applied to intracoronary imaging technologies.Recent FindingsAdvances in data analytics and digitized medical imaging have enabled clinical application of AI to improve patient outcomes and reduce costs through better diagnosis and enhanced workflow. Applications of AI to IVUS and IVOCT have produced improvements in image segmentation, plaque analysis, and stent evaluation. Machine learning algorithms are able to predict future coronary events through the use of imaging results, clinical evaluations, laborator...
Source: Current Cardiology Reports - May 29, 2020 Category: Cardiology Source Type: research

Chest Pain Evaluation in the Emergency Department: Risk Scores and High-Sensitivity Cardiac Troponin
AbstractPurpose of ReviewAs many as 10 million patients present annually to the emergency department in the USA with symptoms concerning for acute myocardial infarction. The use of risk scores for patients with chest pain or equivalent without ST-segment elevation on the electrocardiogram. The adaptation in the USA of high sensitivity troponin assays requires rethinking of how to best optimize troponin testing within a risk score.Recent FindingsPatients are risk stratified using a combination of validated risk scores, biomarkers, and both noninvasive and invasive testing. The advent of high-sensitivity troponins has served...
Source: Current Cardiology Reports - May 29, 2020 Category: Cardiology Source Type: research

Role of Aspirin for Primary Prevention in Persons with Diabetes Mellitus and in the Elderly
AbstractPurpose of ReviewTo review the clinical evidence of the effect of aspirin as primary prevention for patients with diabetes mellitus and in healthy elderly.Recent FindingsTwo trials were performed to study these two patient populations: ASCEND showed that the use of low-dose aspirin in persons with diabetes, who did not have prior cardiovascular disease, led to a lower risk of cardiovascular events than placebo (8.5% vs 9.6%, rate ratio 0.88, 95% CI 0.79 –0.97;p = 0.01). However, it showed a similar magnitude of increased risk of major bleeding among the aspirin group compared with placebo (4.1% ...
Source: Current Cardiology Reports - May 29, 2020 Category: Cardiology Source Type: research

Burnout Among Women Physicians: a Call to Action
AbstractPurpose of ReviewThe purposes of this discussion are to describe what is known about burnout among women physicians and identify contributing factors, categories of impact, and methods for mitigating the phenomenon. The authors conclude with current gaps in research.Recent FindingsAlthough there are a lack of investigations analyzing and reporting physician burnout data by gender, there is evidence to suggest that women physicians experience stress and burnout differently than their men counterparts. Women physicians are more likely to face gender discrimination, gender biases, deferred personal life decisions, and...
Source: Current Cardiology Reports - May 29, 2020 Category: Cardiology Source Type: research

SPECT Versus PET Myocardial Perfusion Imaging in Patients with Equivocal CT
AbstractPurpose of ReviewThe most pertinent clinical question in post-coronary computed tomography angiography (CCTA) patients is the assessment of the physiological significance of an anatomically identified stenosis. The clinical application of radionuclide MPI using single-photon emission computed tomography (SPECT) versus positron emission tomography (PET) in the evaluation and management of patients with an inconclusive CCTA is reviewed using a case-based approach.Recent FindingsRecent evidence suggests that CCTA is the most sensitive non-invasive test to exclude angiographic CAD and may be an effective first-line tes...
Source: Current Cardiology Reports - May 25, 2020 Category: Cardiology Source Type: research

Single-Cell Transcriptomic Analysis of Cardiac Progenitor Differentiation
AbstractPurpose of ReviewEmerging single-cell RNA sequencing technologies hold great promises to boost our understanding of the heterogeneity and molecular regulation of diverse cell phenotypes during organ development. In this review, we aimed at summarizing recent advances in employing single-cell transcriptomic analysis to depict the landscape of embryonic heart development, in particular, focusing on cardiac progenitor (CP) differentiation.Recent FindingsRecent studies unbiasedly cataloged and characterized cardiac cell types in the spatial and temporal resolution during early heart development. Pseudo-time analysis re...
Source: Current Cardiology Reports - May 19, 2020 Category: Cardiology Source Type: research

Role of Mononuclear Cardiomyocytes in Cardiac Turnover and Regeneration
AbstractPurpose of ReviewThe typical remodeling process after cardiac injury is scarring and compensatory hypertrophy. The limited regeneration potential of the adult heart is thought to be due to the post-mitotic status of postnatal cardiomyocytes, which are mostly binucleated and/or polyploid. Nevertheless, there is evidence for cardiomyocyte turnover in the adult heart. The purpose of this review is to describe the recent findings regarding the proliferative potential of mononuclear cardiomyocytes and to evaluate their function in cardiac turnover and disease.Recent FindingsThere is overwhelming evidence from carbon-dat...
Source: Current Cardiology Reports - May 19, 2020 Category: Cardiology Source Type: research

Advances in PET-Based Cardiac Amyloid Radiotracers
AbstractThe gold standard for diagnosis of cardiac amyloidosis (CA) is endomyocardial biopsy showing Congo red staining followed by mass spectroscopy, but the diagnosis can also be made with high certainty by demonstration of typical cardiac imaging features along with amyloid on biopsy of another involved organ. The use of cardiac imaging techniques to detect amyloid deposits may frequently obviate the need for invasive methods in order to ascertain the presence, and potentially the type, of amyloid deposition.Purpose of ReviewWe aim to review the evidence behind the development of novel positron emission tomography (PET)...
Source: Current Cardiology Reports - May 19, 2020 Category: Cardiology Source Type: research

Cost-effectiveness and Outcomes with Early or Same-Day Discharge After Elective Percutaneous Coronary Intervention
AbstractPurpose of ReviewShorter hospital stay after percutaneous coronary intervention (PCI) can provide economic advantage. Same-day discharge (SDD) after transradial PCI is thought to reduce the cost of care while maintaining the quality and safety. This review summarizes the current knowledge of the benefits and safety of this concept.Recent FindingsIncrease in rate of transradial PCI over the last two decades has resulted in recent growth in rate of acceptance of SDD after a successful procedure. SDD is shown to result in savings of $3500 to $5200 per procedure with comparable adverse event rate of traditional dischar...
Source: Current Cardiology Reports - May 19, 2020 Category: Cardiology Source Type: research

Cardiac Surgery: Increasing Access in Low- and Middle-Income Countries
AbstractPurpose of the ReviewLow- and middle-income countries (LMICs) have long-battled communicable diseases, and now, a rise in non-communicable diseases (NCD) is conferring tremendous burden in these areas. Cardiovascular disease (CVD) remains the number one cause of death among NCDs across the globe. The current review provides insight regarding this disease burden and highlights challenges as well as strategies for establishing functional cardiac surgery centers and sustainable access to comprehensive cardiovascular care within LMICs.Recent FindingsWithout effective prevention and treatment strategies, estimates sugge...
Source: Current Cardiology Reports - May 19, 2020 Category: Cardiology Source Type: research

Soluble ST2 and Soluble Markers of Fibrosis: Emerging Roles for Prognosis and Guiding Therapy
AbstractPurpose of ReviewBiomarkers of cardiac fibrosis closely track the disease state that gives rise to heart failure. The purpose of this review is to highlight recent data on the use of soluble ST2, galectin-3, and procollagen, three markers of cardiac fibrosis, for aiding with prognostication, and to explore the use of these biomarkers for guiding therapy.Recent FindingsSoluble ST2, galectin-3, and procollagen are prognostic in both acute and chronic heart failure, and data are emerging as to their potential uses for guiding therapies. Mortality benefit from exercise, cardiac resynchronization therapy, statin use, as...
Source: Current Cardiology Reports - May 19, 2020 Category: Cardiology Source Type: research

Correction to: Cardiovascular Complications in Patients with COVID-19: Consequences of Viral Toxicities and Host Immune Response
It has been pointed out that the second paragraph of the section “Treatments for SARS-CoV-2 Infection” contains an error. The original article has been corrected. (Source: Current Cardiology Reports)
Source: Current Cardiology Reports - May 13, 2020 Category: Cardiology Source Type: research

Sepsis-Induced Cardiomyopathy: a Comprehensive Review
AbstractPurpose of ReviewTo briefly review epidemiology and pathophysiology of SICM and provide a more extensive review of the data on diagnostic and management strategies.Recent FindingsSICM is likely underdiagnosed and that has mortality implications. Current evidence supports speckle tracking echocardiography to identify decreased contractility irrespective of left ventricular ejection fraction for the diagnosis of SICM. There continues to be a dearth of large clinical trials evaluating the treatment of SICM and current consensus focuses on supportive measures such as vasopressors and inotropes.SummarySepsis is a signif...
Source: Current Cardiology Reports - May 6, 2020 Category: Cardiology Source Type: research

Cardiovascular Risks in Patients with COVID-19: Potential Mechanisms and Areas of Uncertainty
AbstractPurpose of ReviewCOronaVirus Disease 2019 (COVID-19) has spread at unprecedented speed and scale into a global pandemic with cardiovascular risk factors and complications emerging as important disease modifiers. We aim to review available clinical and biomedical literature on cardiovascular risks of COVID-19.Recent FindingsSARS-CoV2, the virus responsible for COVID-19, enters the cell via ACE2 expressed in select organs. Emerging epidemiological evidence suggest cardiovascular risk factors are associated with increased disease severity and mortality in COVID-19 patients. Patients with a more severe form of COVID-19...
Source: Current Cardiology Reports - April 29, 2020 Category: Cardiology Source Type: research

Mechanisms of Neonatal Heart Regeneration
We present recent advances in the understanding of the molecular mechanisms of neonatal cardiac regeneration and the implications for the development of new cardiac regenerative therapies. During the early postnatal period, several cell types and pathways are involved in cardiomyocyte proliferation including immune response, nerve signaling, extracellular matrix, mitochondria substrate utilization, gene expression, miRNAs, and cell cycle progression.SummaryThe early neonatal mammalian heart has remarkable regenerative capacity, which is mediated by proliferation of endogenous cardiomyocytes, and is lost when cardiomyocytes...
Source: Current Cardiology Reports - April 24, 2020 Category: Cardiology Source Type: research

Cardiovascular Complications in Patients with COVID-19: Consequences of Viral Toxicities and Host Immune Response
AbstractPurpose of ReviewCoronavirus disease of 2019 (COVID-19) is a cause of significant morbidity and mortality worldwide. While cardiac injury has been demonstrated in critically ill COVID-19 patients, the mechanism of injury remains unclear. Here, we review our current knowledge of the biology of SARS-CoV-2 and the potential mechanisms of myocardial injury due to viral toxicities and host immune responses.Recent FindingsA number of studies have reported an epidemiological association between history of cardiac disease and worsened outcome during COVID infection. Development of new onset myocardial injury during COVID-1...
Source: Current Cardiology Reports - April 21, 2020 Category: Cardiology Source Type: research

Outcomes in Patients with COVID-19 Infection Taking ACEI/ARB
AbstractPurpose of ReviewSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus responsible for the aggressive coronavirus disease (COVID-19) pandemic. Recently, investigators have stipulated that COVID-19 patients receiving angiotensin-converting-enzyme inhibitors (ACEI) may be subject to poorer outcomes. This editorial presents the available evidence to guide treatment practices during this pandemic.Recent FindingsRecent studies from Wuhan cohorts provide valuable information about COVID-19. A cohort with 52 critically ill patients revealed cardiac injury in 12% of patients. Worse outcomes appear to be...
Source: Current Cardiology Reports - April 14, 2020 Category: Cardiology Source Type: research

Cellular Reprogramming Approaches to Engineer Cardiac Pacemakers
AbstractPurpose of ReviewThe goal of this paper is to review present knowledge regarding biological pacemakers created by somatic reprogramming as a platform for mechanistic and metabolic understanding of the rare subpopulation of pacemaker cells, with the ultimate goal of creating biological alternatives to electronic pacing devices.Recent FindingsSomatic reprogramming of cardiomyocytes by reexpression of embryonic transcription factor T-box 18 (TBX18) converts them into pacemaker-like. Recent studies take advantage of this model to gain insight into the electromechanical, metabolic, and architectural intricacies of the c...
Source: Current Cardiology Reports - March 30, 2020 Category: Cardiology Source Type: research

High-Sensitivity Troponins in Cardiovascular Disease
AbstractEach new troponin assay generation is more sensitive, with recent generation high-sensitivity troponin (hsTn) assays able to detect minimal myocardial injury, even in asymptomatic patients.Purpose of the ReviewWe reviewed recent information on the use of hsTn assays for assessing acute and chronic cardiovascular disease.Recent FindingshsTn is used for early emergency department diagnosis, accelerating early discharge with a low event rate comparable if not better than current strategies. Low levels of hsTn are detected in a variety of chronic cardiac and non-cardiac conditions, non-disease conditions including hear...
Source: Current Cardiology Reports - March 30, 2020 Category: Cardiology Source Type: research

Autoimmunity in Acute Myocarditis: How Immunopathogenesis Steers New Directions for Diagnosis and Treatment
AbstractPurpose of ReviewOver the last decade, myocarditis has been increasingly recognized as common cause of sudden cardiac death in young adults and heart failure overall. The purpose of this review is to discuss hypothesis of development of non-infectious myocarditis, to provide a description of the immunopathogenesis and the most common mechanisms of autoimmunity in myocarditis, and to provide an update on therapeutic options.Recent FindingsA new entity of myocarditis is immune checkpoint inhibitor (ICI) induced myocarditis. ICIs are used in advanced cancer to “disinhibit” the immune system and make it mor...
Source: Current Cardiology Reports - March 20, 2020 Category: Cardiology Source Type: research

Use of a Discharge Educational Strategy Versus Standard Discharge Care on Reduction of Vascular Risk in Patients with Stroke and Transient Ischemic Attack
AbstractPurpose of the ReviewThe burden of ischemic stroke is disproportionally distributed between ethnic and racial subgroups in the USA, minority populations with lower socioeconomic status being at higher risk. These discrepancies are mirrored in susceptibility, primary care, and post-discharge procedures. Post-discharge strategies are of particular importance as their primary goal is to prevent recurrent stroke, which makes up about 25% of stroke cases per year in US. As disadvantaged minorities have faster growing populations, recurrent stroke poses a significant challenge not only for caretakers but also for the hea...
Source: Current Cardiology Reports - March 19, 2020 Category: Cardiology Source Type: research

Four Dimensions of the Cardiac Myocyte Epigenome: from Fetal to Adult Heart
AbstractPurpose of ReviewDevelopment, physiological growth and the response of the heart to injury are accompanied by changes of the transcriptome and epigenome of cardiac myocytes. Recently, cell sorting and next generation sequencing techniques have been applied to determine cardiac myocyte-specific transcriptional and epigenetic mechanisms. This review provides a comprehensive overview of studies analysing the transcriptome and epigenome of cardiac myocytes in mouse and human hearts during development, physiological growth and disease.Recent FindingsAdult cardiac myocytes express>  12,600 genes, and their expr...
Source: Current Cardiology Reports - March 19, 2020 Category: Cardiology Source Type: research

Association Between Obesity and Cardiovascular Outcomes: Updated Evidence from Meta-analysis Studies
We report updated evidence on the association between obesity and CVD events through a review of meta-analysis studies. This review identified that obesity or high body mass index (BMI) was associated with an increased risk of CVD events, including mortality, in the general population and that cardiac respiratory fitness (CRF) and metabolic health status appear to stratify the risk of CVD outcomes. In patients with diabetes, hypertension, or coronary artery disease, mortality displayed a U-shaped association with BMI. This U-shaped association may result from the effect of unintentional weight loss or medication use. By co...
Source: Current Cardiology Reports - March 12, 2020 Category: Cardiology Source Type: research

What Every Cardiologist Should Know About the 2018 Updated Adult Congenital Cardiology Guidelines
AbstractPurpose of ReviewReview the recently updated guidelines for the management of patients with adult congenital heart disease (ACHD) with a focus on the changes between these guidelines and the prior guidelines.Recent FindingsThe 2018 guidelines for the management of patients with ACHD focused on utilizing the available data and limiting the number recommendations based only on expert opinion. These guidelines implement a new anatomic and physiological classification scheme to guide management of patients, which takes into account both the underlying anatomy as well as residual cardiac disease and symptoms. Given a la...
Source: Current Cardiology Reports - February 19, 2020 Category: Cardiology Source Type: research

3D Printing Applications for Transcatheter Aortic Valve Replacement
AbstractPurpose of ReviewA combination of evolving 3D printing technologies, new 3D printable materials, and multi-disciplinary collaborations have made 3D printing applications for transcatheter aortic valve replacement (TAVR) a promising tool to promote innovation, increase procedural success, and provide a compelling educational tool. This review synthesizes the knowledge via publications and our group ’s experience in this area that exemplify uses of 3D printing for TAVR.Recent FindingsPatient-specific 3D-printed models have been used for TAVR pre-procedural device sizing, benchtop prediction of procedural compli...
Source: Current Cardiology Reports - February 17, 2020 Category: Cardiology Source Type: research

Supplemental Vitamins and Minerals for Cardiovascular Disease Prevention and Treatment
The objective of this study is to explore the current literature supporting the use oral multivitamins and multi/minerals (OMVMs) for cardiovascular diseases (CVD) treatment and prevention.Recent FindingsData on multivitamins, vitamin C and D, coenzyme Q, calcium, and selenium, has showed no consistent benefit for the prevention of CVD, myocardial infarction, or stroke, nor was there a benefit for all-cause mortality to support their routine supplementation. Folic acid alone and B vitamins with folic acid, B6 and B12, reduce stroke, whereas niacin and antioxidants are associated with an increased risk of all-cause mortalit...
Source: Current Cardiology Reports - February 14, 2020 Category: Cardiology Source Type: research

How Do PET Myocardial Blood Flow Reserve and FFR Differ?
AbstractPurpose of ReviewThis review discusses similarities and differences between cardiac positron emission tomography (PET), absolute myocardial blood flow, and flow reserve with invasive fractional flow reserve (FFR).Recent FindingsFundamentally, cardiac PET measures absolute myocardial blood flow whereas FFR provides a relative flow reserve. Cardiac PET offers a non-invasive and therefore lower risk alternative, able to image the entire left ventricle regardless of coronary anatomy. While cardiac PET can provide unique information about the subendocardium, FFR pullbacks offer unparalleled spatial resolution. Both diag...
Source: Current Cardiology Reports - February 12, 2020 Category: Cardiology Source Type: research

Sex Differences in Coronary Artery Calcium and Long-term CV Mortality
AbstractPurpose of ReviewTo summarize differences in plaque depositions, coronary artery calcium (CAC) scoring, and the role of CAC in predicting atherosclerotic cardiovascular disease (ASCVD) mortality in men and women.Recent FindingsWomen have coronary plaque that is more lipid-rich, dense, and less calcified than their male counterparts. CAC scoring has emerged as a useful tool to quantify ASCVD burden. However, recent evidence favors the use of sex-adjusted CAC cutoffs for women to account for the relatively lower overall CAC burden and therefore risk stratify women appropriately. Several studies have identified CAC di...
Source: Current Cardiology Reports - February 12, 2020 Category: Cardiology Source Type: research

Current Use and Trends in Unprotected Left Main Coronary Artery Percutaneous Intervention
AbstractPurpose of ReviewTo review the clinical evidence on the use of percutaneous coronary intervention (PCI) revascularization options in left main (LM) disease in comparison with coronary artery bypass graft (CABG). Coronary artery disease (CAD) involving the LM is associated with high morbidity and mortality. Though CABG remains the gold standard for complex CAD involving the LM artery, recent trials have shown a trend towards non-inferiority of the LM PCI when compared with CABG in certain subset of patients.Recent FindingsTwo recent major randomized trials compared the outcomes of PCI versus CABG in the LM and multi...
Source: Current Cardiology Reports - February 8, 2020 Category: Cardiology Source Type: research

The Clinical Significance of Physiological Assessment of Residual Ischemia After Percutaneous Coronary Intervention
AbstractPurpose of ReviewFractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) have emerged as the invasive diagnostic tools of choice for hemodynamic assessment of the severity of CAD (coronary artery disease). We sought to comprehensively review the evidence on the utility of hemodynamic assessment of the coronary stenoses after percutaneous coronary intervention (PCI) using FFR/iFR, mechanisms of positive post-PCI iFR/FFR, and the clinical impact of significant residual ischemia.Recent FindingsThe evidence on the utility of the post-PCI hemodynamic assessment has accumulated over the last few years. The ...
Source: Current Cardiology Reports - February 8, 2020 Category: Cardiology Source Type: research

Diversity of Organism-Wide and Organ-Specific Endothelial Cells
AbstractPurpose of ReviewEndothelial cells are of great importance in many types of diseases including the coronary artery diseases in heart and stroke in brain. In this review, we explore the heterogeneity among endothelial cells from an organism-wide, organ-specific, and healthy versus disease perspective.Recent FindingsRecent studies addressing the cellular heterogeneity between arterial versus venous endothelial cells (ECs) have revealed that arterial ECs have tighter junctions, a decreased immune response, anticoagulant properties while veins have both anticoagulant and procoagulant properties. Blood and lymphatic ECs...
Source: Current Cardiology Reports - February 8, 2020 Category: Cardiology Source Type: research

Effects of Sleep Duration on Cardiovascular Events
AbstractPurpose of ReviewSleep is an essential component of human health, and suboptimal sleep duration has been associated with increased cardiovascular morbidity and mortality. This review summarizes physiological and pathological effects of sleep duration on the cardiovascular system.Recent FindingsBoth decreased and increased duration of sleep lead to increased cardiovascular mortality and has a U-shaped curve. Sleep apnea is an independent risk factor for atherosclerosis and hypertension, and its treatment with continuous positive airway pressure (CPAP) results in increased survival.SummaryEstimated sleep duration of ...
Source: Current Cardiology Reports - February 8, 2020 Category: Cardiology Source Type: research

Cardiovascular Risk Reduction by Pharmacists at the Workplace
AbstractPurpose of ReviewThe burden of cardiovascular disease (CVD) in the USA remains unacceptably high. The associated morbidity and mortality of CVD has important implications on our healthcare system and society. With much of CVD considered preventable an increase emphasis on primary prevention is important. To review the evidence for pharmacists providing CVD primary prevention, particularly as a part of employer-based programs.Recent FindingsA recent study evaluated the impact of a pharmacist-led 12-month preventative health program in 178 at-risk employees at University of British Columbia (UBC). Cardiovascular Asse...
Source: Current Cardiology Reports - February 7, 2020 Category: Cardiology Source Type: research

Tackling Elevated Risk in PAD: Focus on Antithrombotic and Lipid Therapy for PAD
AbstractThe PAD population is at increased risk of major adverse cardiovascular events (MACE) and major adverse limb events (MALE). Risk factor modification, symptom control, antithrombotic, and lipid therapies are the mainstays of PAD medical therapy. Recent data has challenged prior recommendations regarding the optimal secondary prevention strategies in PAD.Purpose of ReviewTo review clinical evidence from large randomized controlled trials showing the benefit of antithrombotic and lipid therapy in the PAD population.Recent FindingsThe COMPASS trial challenged prior recommendations regarding anticoagulation in PAD. Amon...
Source: Current Cardiology Reports - January 29, 2020 Category: Cardiology Source Type: research

Dairy Intake and Risk of Cardiovascular Disease
AbstractPurpose of ReviewDue to inconsistent findings on dairy consumption and CVD and all-cause mortality, we performed a narrative literature review to the current literature on dairy and its association with CVD.Recent FindingsDue to their complex biochemistry, dairy consumption is a rather heterogeneous exposure. Multiple pathways have been proposed from dairy consumption and CVD. Current guidelines advocate for consumption of low-fat dairy products particularly milk, cheese, and yogurt, although the evidence for this is scant. Randomized clinical trials and large prospective studies on lipid-related cardiometabolic di...
Source: Current Cardiology Reports - January 29, 2020 Category: Cardiology Source Type: research

Beta-Blockers, Calcium Channel Blockers, and Mortality in Stable Coronary Artery Disease
AbstractPurpose of ReviewTo examine the current clinical evidence behind the use of calcium channel blockers (CCB) and beta-blockers (BB) for the treatment of patients with stable coronary artery disease (SCAD) and their effect on mortality.Recent FindingsCurrent evidence suggests that BB use as a first line antianginal medication is associated with lower 5-year all-cause mortality only in patients who had MI within a year. This could be driven due to their effects reducing the sympathetic neuro-hormonal activation of more acutely ill patients. The use of CCB as an antianginal therapy, although proven effective in multiple...
Source: Current Cardiology Reports - January 29, 2020 Category: Cardiology Source Type: research

Advances in Pediatric Ductal Intervention: an Open or Shut Case?
AbstractPurpose of ReviewTo review the most recent literature on pediatric transcatheter ductal intervention including ductus arteriosus occlusion and stenting.Recent FindingsWith the development and FDA approval of smaller ductal devices, including most recently the Amplatzer Piccolo Occluder (Abbott, Abbott Park, IL), transcatheter ductus arteriosus device closure is now being safely performed in premature infants and patients
Source: Current Cardiology Reports - January 29, 2020 Category: Cardiology Source Type: research

Targeted Medical Therapies for Hypertrophic Cardiomyopathy
AbstractPurpose of ReviewThe management of hypertrophic cardiomyopathy (HCM) has changed considerably over the years, although molecular therapies targeting core mechanisms of the disease are still lacking. This review provides an overview of the contemporary medical approach to patients with HCM, and of promising novel developments hopefully soon to enter the clinical arena.Recent FindingsOur perception of therapeutic targets for medical therapy in HCM is rapidly evolving. Novel approaches include myocardial metabolic modulation, late sodium current inhibition, and allosteric myosin inhibition, actively pursued to reduce ...
Source: Current Cardiology Reports - January 28, 2020 Category: Cardiology Source Type: research

Microvascular Angina Diagnosed by Absolute PET Myocardial Blood Flow Quantification
AbstractPurpose of ReviewThe aim of this review is to provide an update on the use of positron emission tomography (PET) with myocardial blood flow (MBF) quantification for the diagnosis and management of patients with microvascular disease.Recent FindingsIt is now recognized that a large proportion of patients with classical angina and non-obstructive epicardial disease are suffering from microvascular angina. Microvascular angina shares several key features with epicardial coronary disease, including many risk factors. Clinical criteria for the diagnosis of microvascular angina were recently proposed and PET imaging is c...
Source: Current Cardiology Reports - January 28, 2020 Category: Cardiology Source Type: research

Second Hits in Dilated Cardiomyopathy
AbstractPurpose of ReviewGenetic studies have identified an increasing number of culprit disease genes in patients with dilated cardiomyopathy (DCM). While these studies were originally conducted in patients with primary DCM, recent research has identified culprit mutations among patients who develop DCM in response to an environmental exposure. This review will summarize the genetic architecture of DCM secondary to alcohol, anthracyclines, and pregnancy, as well as the potential modifying role of exercise.Recent FindingsMutations in DCM-associated genes are identified in 10 –20% of patients categorized as having a s...
Source: Current Cardiology Reports - January 24, 2020 Category: Cardiology Source Type: research

Management of Angina Post Percutaneous Coronary Intervention
AbstractPurpose of ReviewOur review discusses the management of post percutaneous coronary intervention angina (PPCIA) which negatively impacts 20 –40% of patients and imposes a high burden on the healthcare system.Recent FindingsMechanisms of PPCIA include microvascular dysfunction, distal coronary vasospasm or disease, microembolization, myocardial bridge, coronary artery disease (CAD) progression, and rarely stent thrombosis or in-stent restenosis. Nitrates, beta blockers (BB), calcium channel blockers, and ranolazine are the common medical management options. Only BB showed 1-year mortality benefit following myoc...
Source: Current Cardiology Reports - January 21, 2020 Category: Cardiology Source Type: research

Obstructive Sleep Apnea, Hypertension, and Cardiovascular Risk: Epidemiology, Pathophysiology, and Management
AbstractPurpose of ReviewGiven the rising prevalence of obstructive sleep apnea (OSA), we aimed to review the epidemiologic and pathophysiologic relationship of OSA, hypertension, and cardiovascular disease, and to summarize recent advances in the treatment of OSA.Recent FindingsOSA is associated with an elevated risk of hypertension and cardiovascular disease. Several pathophysiologic factors contribute to the relationship between OSA and vascular risk, including neurohormonal dysregulation, endothelial dysfunction, and inflammation. While CPAP reduces blood pressure, it has not been demonstrated to reduce cardiovascular ...
Source: Current Cardiology Reports - January 18, 2020 Category: Cardiology Source Type: research

Pacing in Patients with Congenital Heart Disease: When Is It Helpful and When Is It Harmful?
AbstractPurpose of ReviewPacing in pediatric and adult patients with congenital heart disease requires careful evaluation and thoughtful planning. Review of current guidelines with assessment of risk/benefit must be performed along with planning on a case-by-case basis in order to achieve maximal success and reduce risk in this specialized population of patients that is rapidly increasing in size.Recent FindingsGuidelines for pacing in pediatric and congenital heart disease patients span many years. Most recent consensus and summary guidelines address pacing in adult patients with or without congenital heart disease. Pedia...
Source: Current Cardiology Reports - January 16, 2020 Category: Cardiology Source Type: research

Device Therapy for Sudden Cardiac Death Prophylaxis After Acute Coronary Syndrome: When and Why?
AbstractImplantable cardioverter-defibrillators (ICDs) are a powerful tool in preventing sudden cardiac death due to ventricular arrhythmias in ischemic cardiomyopathy. ICD indications and timing in acute coronary syndromes are unclear.Purpose of ReviewWe reviewed several trials that delineated the indications for a cardiac defibrillator in patients with coronary artery disease.Recent FindingsThe role of cardiac defibrillators in secondary prevention has been well established by AVID, CIDS, and CASH trials. AVID showed reduction in both all-cause mortality and arrhythmic death while the two smaller trials showed only impro...
Source: Current Cardiology Reports - January 16, 2020 Category: Cardiology Source Type: research

Diagnosis and Management of Tuberculous Pericarditis: What Is New?
AbstractPurpose of ReviewThis review provides an update on the immunopathogenesis of tuberculous pericarditis (TBP), investigations to confirm tuberculous etiology, the limitations of anti-tuberculous therapy (ATT), and recent efficacy trials.Recent FindingsA profibrotic immune response characterizes TBP, with low levels of AcSDKP, high levels of γ-interferon and IL-10 in the pericardium, and high levels of TGF-β and IL-10 in the blood. These findings may have implications for future therapeutic targets. Despite advances in nucleic acid amplification approaches, these tests remain disappointing for TBP. Trials o...
Source: Current Cardiology Reports - January 15, 2020 Category: Cardiology Source Type: research

Transcarotid Artery Revascularization Results in Low Rates of Periprocedural Neurologic Events, Myocardial Infarction, and Death
AbstractPurpose of ReviewTranscarotid artery revascularization (TCAR) is a novel hybrid procedure that reverses carotid flow and places a stent using surgical access of the carotid artery in the neck under local anesthesia. We discuss the indications for carotid revascularization, the clinical rationale for TCAR, and evidence for its potential role in the management of carotid stenosis.Recent FindingsResults from pre-clinical studies, prospective single-arm studies, and comparative analyses of registry data indicate that TCAR results in low amounts of periprocedural microembolization, cerebral lesions detectable on magneti...
Source: Current Cardiology Reports - January 15, 2020 Category: Cardiology Source Type: research

Harnessing Cardiac Regeneration as a Potential Therapeutic Strategy for AL Cardiac Amyloidosis
AbstractPurpose of ReviewCardiac regeneration has received much attention as a possible means to treat various forms of cardiac injury. This review will explore the field of cardiac regeneration by highlighting the existing animal models, describing the involved molecular pathways, and discussing attempts to harness cardiac regeneration to treat cardiomyopathies.Recent FindingsLight chain cardiac amyloidosis is a degenerative disease characterized by progressive heart failure due to amyloid fibril deposition and light chain –mediated cardiotoxicity. Recent findings in a zebrafish model of light chain amyloidosis sugg...
Source: Current Cardiology Reports - January 13, 2020 Category: Cardiology Source Type: research

Amyloid and the Heart
AbstractPurpose of ReviewWhile morbidity and mortality remain high for amyloid cardiomyopathy (AC), increased awareness, earlier diagnosis, and advances in treatment have improved patient outcomes. This review will discuss the pathophysiology, contemporary diagnostic strategies, and novel and investigational therapeutic strategies for light-chain (AL) and transthyretin (ATTR) AC.Recent FindingsDiagnostic strategies for AC now include cardiac magnetic resonance imaging and bone scintigraphy. Proteosome inhibitor therapy is now front-line therapy for AL AC followed by autologous stem cell transplantation. Emerging disease-mo...
Source: Current Cardiology Reports - December 3, 2019 Category: Cardiology Source Type: research

Congenital Heart Disease in Low- and Lower-Middle –Income Countries: Current Status and New Opportunities
AbstractPurpose of ReviewThe paper summarises the most recent data on congenital heart disease (CHD) in low- and lower-middle –income countries (LLMICs). In addition, we present an approach to diagnosis, management and interventions in these regions and present innovations, research priorities and opportunities to improve outcomes and develop new programs.Recent FindingsThe reported birth prevalence of CHD in LLMICs is increasing, with clear evidence of the impact of surgical intervention on the burden of disease. New methods of teaching and training are demonstrating improved outcomes. Local capacity building remain...
Source: Current Cardiology Reports - November 29, 2019 Category: Cardiology Source Type: research