Predictors of Microvascular Reperfusion After Myocardial Infarction
AbstractPurpose of ReviewIn acute ST-segment elevation myocardial infarction (STEMI), successful restoration of blood flow in the infarct-related coronary artery may not secure effective myocardial reperfusion. The mortality and morbidity associated with acute MI remain significant. Microvascular obstruction (MVO) represents failed microvascular reperfusion. MVO is under-recognized, independently associated with adverse cardiac prognosis and represents an unmet therapeutic need.Recent FindingsMultiple factors including clinical presentation, patient characteristics, biochemical markers, and imaging parameters are associate...
Source: Current Cardiology Reports - February 23, 2021 Category: Cardiology Source Type: research

Obstructive Sleep Apnea Syndrome as a Trigger of Cardiac Arrhythmias
AbstractPurpose of ReviewObstructive sleep apnea syndrome (OSAS) has a high prevalence in western countries. Many papers have been published with the purpose of demonstrating that OSAS acts as an arrhythmia trigger and is responsible for an increase in cardiovascular morbidity and mortality. The aim of this study was to review our knowledge on this topic.Recent FindingsThere is a lot of evidence demonstrating the relationship between OSAS and arrhythmias, but there remains a lack of an interventional randomized trial to demonstrate that by treating OSAS we can reduce arrhythmia burden.SummaryOSAS is a highly prevalent illn...
Source: Current Cardiology Reports - February 20, 2021 Category: Cardiology Source Type: research

Reconsidering the Polypill for Management of Cardiovascular Risk Factors in Underserved Patients
AbstractPurpose of ReviewThe recent publication of “Polypill for Cardiovascular Disease Prevention in an Underserved Population” study prompts a thoughtful review of known care disparities in cardiovascular disease management in underserved patients. A polypill approach as a population health solution to this complex problem should also be revie wed.Recent FindingsMu ñoz and colleagues open-label, randomized controlled trial of polypill vs. usual care was undertaken in minority patients at a federally qualified health center. The polypill, containing atorvastatin, amlodipine, losartan, and hydrochlorothi...
Source: Current Cardiology Reports - February 17, 2021 Category: Cardiology Source Type: research

Clinical Utility of Echocardiographic Strain and Strain Rate Measurements
AbstractPurpose of ReviewAssessment of left ventricular function is pivotal in many decisions, but ejection fraction has fundamental limitations for assessment of mild dysfunction, and especially for repeated assessments. Myocardial deformation imaging using speckle-tracking is widely available on modern echocardiography systems, and is now feasible as a clinical, rather than purely a research tool. Strain can be measured in all cardiac chambers, most commonly as a systolic parameter, although it can be measured in diastole. Generally, speckle tracking is more effective at measuring strain than strain-rate, which requires ...
Source: Current Cardiology Reports - February 16, 2021 Category: Cardiology Source Type: research

5-FU Cardiotoxicity: Vasospasm, Myocarditis, and Sudden Death
AbstractPurpose of Review5-fluorouracil (5-FU) is one of the most common causes of cardiotoxicity associated with chemotherapy. The manifestations of 5-FU cardiotoxicity are diverse, and there are no established clinical guidelines addressing the diagnosis and management of this condition. Here we summarize the mechanistic and clinical data available to guide clinicians in caring for patients with suspected 5-FU cardiotoxicity.Recent FindingsThe decision to resume 5-FU treatment in patients with suspected cardiovascular toxicity remains challenging. Testing for predisposing genetic variants may be helpful, particularly in ...
Source: Current Cardiology Reports - February 3, 2021 Category: Cardiology Source Type: research

Cardiovascular Disease Amongst Women Treated for Breast Cancer: Traditional Cytotoxic Chemotherapy, Targeted Therapy, and Radiation Therapy
AbstractPurpose of ReviewCardiotoxicity can occur acutely during breast cancer treatment and impact the potential for the intended cancer treatment regime to be completed, or as a late effect affecting cancer survivorship. Indeed, the most common cause of mortality in females with early breast cancer is cardiovascular disease, especially in those over the age of 65. Optimal cancer care therefore needs to be delivered without jeopardising cardiovascular health. Understanding the different cardiotoxicities associated with breast cancer treatment is vital to this approach, and therefore, this article seeks to provide an overv...
Source: Current Cardiology Reports - January 26, 2021 Category: Cardiology Source Type: research

Bioresorbable Scaffolds in Percutaneous Coronary Intervention: Facing Old Problems, Raising New Hopes
AbstractPurpose of ReviewIn this review, we discuss about the reasons behind the failure of the Absorb bioresorbable vascular scaffold (BVS) device and about the challenges the future holds for the next generation of the bioresorbable scaffold (BRS) technology.Recent FindingsAbsorb BVS was burdened by intrinsic structural limitations which resulted in augmented rates of device thrombosis and clinical adverse events compared to current-generation metallic stent. Nevertheless, new generation devices with novel design and materials are in development.SummarySecond generation BRS have enhanced mechanical strength, smaller foot...
Source: Current Cardiology Reports - January 25, 2021 Category: Cardiology Source Type: research

Treatment of Hypertension in Patients with Diabetes Mellitus: a Contemporary Approach
AbstractPurpose of ReviewBlood pressure guidelines worldwide have changed their recommended blood pressure goals multiple times over the past decade due to an evolving understanding of the treatment of hypertension in patients with diabetes mellitus. While it is evident through randomized trials that treatment of hypertension in diabetes mellitus prevents complications, the optimal blood pressure goal is not clear.Recent FindingsPost hoc analyses of the Action to Control Cardiovascular Risk in Diabetes-Blood Pressure (ACCORD-BP) trial, its long-term follow along study ACCORDION, and Systolic Blood Pressure Intervention Tri...
Source: Current Cardiology Reports - January 23, 2021 Category: Cardiology Source Type: research

Immunotherapy-Associated Cardiotoxicity of Immune Checkpoint Inhibitors and Chimeric Antigen Receptor T Cell Therapy: Diagnostic and Management Challenges and Strategies
AbstractPurpose of ReviewImmunotherapies have demonstrated robust clinical efficacy in treating malignancies with increasing use and FDA approvals. We review the epidemiology, risk factors, diagnosis, and treatment of immunotherapy-associated cardiovascular toxicities.Recent FindingsCardiotoxicity is reported in patients receiving immune checkpoint inhibitors (ICI) and chimeric antigen receptor (CAR) T cell therapies. The incidence of ICI-related cardiotoxicity is above 1% and includes myocarditis, pericardial disease, arrhythmia, acute coronary syndrome, and vasculitis. The incidence of CAR T cell –associated cardio...
Source: Current Cardiology Reports - January 22, 2021 Category: Cardiology Source Type: research

Reliability and Reproducibility of Absolute Myocardial Blood Flow: Does It Depend on the PET/CT Technology, the Vasodilator, and/or the Software?
AbstractPurpose of ReviewThe COURAGE and ISCHEMIA trials showed no reduced mortality after revascularization compared to medical treatment. Is this lack of benefit due to revascularization having no benefit regardless of CAD severity or to suboptimal patient selection due to non-quantitative cardiac imaging?Recent FindingsComprehensive, integrated, myocardial perfusion quantified by regional pixel distribution of coronary flow capacity (CFC) is the final common expression of objective CAD severity for which revascularization reduces mortality. Current lack of revascularization benefit derives from narrow thinking focused o...
Source: Current Cardiology Reports - January 22, 2021 Category: Cardiology Source Type: research

The Current Evidence for Lipid Management in Patients with Lower Extremity Peripheral Artery Disease: What Is the Therapeutic Target?
AbstractPurpose of ReviewThere is a lack of consistency among the ACC/AHA and ESC Guidelines on the treatment of patients with lower extremity PAD to a targeted LDL-c level. A review of the current guidelines, as well as the evidence that exists for use of various lipid-lower therapies in patients with PAD, is needed to guide clinical practice and to examine the current gaps in evidence that exist.Recent FindingsThere is evidence that statins and PCSK9 inhibitors reduce the risks of major adverse cardiovascular and limb events in patients with PAD. Most statin and non-statin trials have examined the association of LLT use ...
Source: Current Cardiology Reports - January 22, 2021 Category: Cardiology Source Type: research

Role of Clinical Genetic Testing in the Management of Aortopathies
AbstractPurpose of ReviewThoracic aortic aneurysms (TAA) have a strong heritable basis, and identification of a genetic etiology has important implications for patients with TAA and their relatives. This review provides an overview of Mendelian causes of TAA, discusses important considerations for genetic testing, and summarizes the impact a genetic diagnosis may have on a patient ’s medical care.Recent FindingsThoracic aortic disease may be non-syndromic or seen as part of a genetic syndrome, such as Marfan syndrome, Loeys-Dietz syndrome, or vascular Ehlers-Danlos syndrome. Expanded access to genetic testing has rev...
Source: Current Cardiology Reports - January 21, 2021 Category: Cardiology Source Type: research

Hypertrophic Cardiomyopathy: Genetic Testing and Risk Stratification
We describe the genetic basis of HCM, recent advances in genetic testing and the role of genetics in guiding risk stratification and management, both now and in the future.Recent FindingsWhile initially thought to be an exclusively Mendelian disease, we now know there are important HCM sub-groups. A proportion will have sarcomere variants as the cause of their disease, while others will have genetic variants in genes that can give rise to conditions that can mimic HCM. The role of genetics is primarily for cascade genetic testing, though there is emerging evidence of a role for prognosis and patient management.SummaryGenet...
Source: Current Cardiology Reports - January 12, 2021 Category: Cardiology Source Type: research

Management of Cardiovascular Health in People with Severe Mental Disorders
AbstractPurpose of ReviewTo review evidence regarding the association between bipolar disorder and schizophrenia, henceforth referred to as severe mental disorders (SMD), and cardiovascular morbidity and mortality, its mechanisms, and the interventions to reduce this burden.Recent FindingsMuch of the loss in life expectancy in people with SMD remains driven by cardiovascular mortality. Antipsychotics and mood stabilizers are associated with negative cardio-metabolic outcomes, but large inter-individual differences are observed, and not treating SMD might be associated with even greater cardiovascular mortality. Classical m...
Source: Current Cardiology Reports - January 6, 2021 Category: Cardiology Source Type: research

Symptoms Preceding Sports-Related Sudden Cardiac Death in Persons Aged 1 –49 Years
AbstractPurpose of ReviewSports-related sudden cardiac death (Sr-SCD) is a leading natural cause of death in young athletes. To prevent Sr-SCD in athletes, it is important to identify individuals at risk. This review sought to summarize the current knowledge of symptoms prior to Sr-SCD in athletes aged 1 –49 years.Recent FindingsCardiovascular screening of athletes is a subject of interest. However, the cost of ECG screening in a young population is relatively high compared to potential benefits, and systematic screening of athletes is heavily debated. In the background population, both cardiac and non-specific ...
Source: Current Cardiology Reports - January 6, 2021 Category: Cardiology Source Type: research

Update on the Inflammatory Hypothesis of Coronary Artery Disease
AbstractPurpose of ReviewThe pathogenesis and progression of coronary artery disease (CAD) is now known to be largely driven by inflammation on top of the well-accepted role for the disequilibrium between cholesterol deposition and removal from the arterial wall. Recent clinical trials have supported the inflammatory hypothesis of CAD and will be discussed in this review.Recent FindingsThe clinical trial Canakinumab Anti-inflammatory Thrombosis Outcomes Study (CANTOS) found that treatment with canakinumab, an anti-interleukin-1 β agent, resulted in a reduction in non-fatal myocardial infarction, non-fatal stroke, or d...
Source: Current Cardiology Reports - January 6, 2021 Category: Cardiology Source Type: research

Multimodality Imaging of Myocardial Viability
AbstractPurpose of ReviewMyocardial viability is an important pathophysiologic concept which may have significant clinical impact in patients with left ventricular dysfunction due to ischemic heart disease. Understanding the imaging modalities used to assess viability, and the clinical implication of their findings, is critical for clinical decision-making in this population.Recent FindingsThe ability of dobutamine echocardiography, single-photon emission computed tomography, positron emission tomography, and cardiac magnetic resonance imaging to predict functional recovery following revascularization is well-established. ...
Source: Current Cardiology Reports - January 4, 2021 Category: Cardiology Source Type: research

Cardiac Sympathetic Innervation Imaging with PET Radiotracers
AbstractPurpose of ReviewThe present article reviews the pathophysiology of cardiac sympathetic denervation, the principles of positron emission tomography (PET) imaging of the sympathetic innervation of the heart and its potential clinical role, based on current and expected future evidence.Recent FindingsImaging of cardiac sympathetic denervation can be performed with radiolabeled noradrenaline analogues, e.g.,11C-hydroxyephedrine. A greater burden of sympathetic denervation carries prognostic significance, e.g., in patients with ischemic cardiomyopathy and a left ventricular ejection fraction ≤ 35%, who are mo...
Source: Current Cardiology Reports - November 27, 2020 Category: Cardiology Source Type: research

The Role of Autoantibodies in Arrhythmogenesis
AbstractPurpose of ReviewThe role of autoantibodies in arrhythmogenesis has been the subject of research in recent times. This review focuses on the rapidly expanding field of autoantibody-mediated cardiac arrhythmias.Recent FindingsSince the discovery of cardiac autoantibodies more than three decades ago, a great deal of effort has been devoted to understanding their contribution to arrhythmias. Different cardiac receptors and ion channels were identified as targets for autoantibodies, the binding of which either initiates a signaling cascade or serves as a biomarker of underlying remodeling process. Consequently, the wid...
Source: Current Cardiology Reports - November 25, 2020 Category: Cardiology Source Type: research

Management of Arrhythmias Associated with COVID-19
AbstractPurpose of ReviewCardiac arrhythmias are known complications in patients with COVID-19 infection that may persist even after recovery from infection. A review of the spectrum of cardiac arrhythmias due to COVID-19 infection and current guidelines and assessment or risk and benefit of management considerations is necessary as the population of patients infected and covering from COVID-19 continues to grow.Recent FindingsCardiac arrhythmias such as atrial fibrillation, supraventricular tachycardia, complete heart block, and ventricular tachycardia occur in patients infected, recovering and recovered from COVID-19.Sum...
Source: Current Cardiology Reports - November 24, 2020 Category: Cardiology Source Type: research

Home Monitoring of Cardiac Devices in the Era of COVID-19
AbstractPurpose of ReviewDespite the promise of remote patient monitoring (RPM), this technology remained underutilized secondary to a lack of data transparency and systems issues until the COVID-19 pandemic ushered in a new era of telehealth and virtual solutions out of necessity. This review will explore the data supporting the use of RPM via both implantable and wearable devices in the field of cardiology and the role of home monitoring using RPM in the era of COVID-19.Recent FindingsRPM using implantable cardiac devices is a safe alternative to in-person only visits which leads to enhanced patient satisfaction and impr...
Source: Current Cardiology Reports - November 20, 2020 Category: Cardiology Source Type: research

Sarcoid Heart Disease: an Update on Diagnosis and Management
AbstractPurpose of ReviewThe purpose of this review is to provide an update on cardiac sarcoidosis (CS) and to discuss the current recommendations and progress in diagnosis and management of this disease. Sarcoidosis is a multisystem granulomatous disease of unknown etiology. Cardiac involvement is seen in at least 25% and is associated with poor prognosis. Manifestations of cardiac sarcoidosis (CS) can vary from presence of silent myocardial granulomas, which may lead to sudden death, to symptomatic conduction abnormalities, ventricular arrhythmias, and heart failure.Recent FindingsWe discuss newer imaging modalities such...
Source: Current Cardiology Reports - October 29, 2020 Category: Cardiology Source Type: research

Low-density Lipoprotein-Cholesterol Lowering Strategies for Prevention of Atherosclerotic Cardiovascular Disease: Focus on siRNA Treatment Targeting PCSK9 (Inclisiran)
AbstractPurpose of ReviewThe aim of low-density lipoprotein-cholesterol (LDL-C) lowering therapies is to safely achieve a consistent and long-term reduction in exposure of the vasculature to atherogenic lipoproteins in order to reduce the risk of atherosclerotic cardiovascular (CV) disease and the associated CV events, such as myocardial infarctions and ischemic strokes. This review summarizes the concept and clinical development of a novel molecular approach to efficiently lower LDL-C, a synthetic small interfering ribonucleic acid (siRNA) —inclisiran—directed against proprotein convertase subtilisin-kexin typ...
Source: Current Cardiology Reports - October 21, 2020 Category: Cardiology Source Type: research

Psychological Preparation for Cardiac Surgery
AbstractPurpose of ReviewTo review the current state of preoperative psychological preparation to improve outcomes after cardiac surgery.Recent FindingsPreoperative psychosocial factors are associated with short- and long-term outcomes after cardiac surgery. There are several approaches to optimize patients ’ preoperative psychological status with promising effects on postoperative outcomes (e.g., less complications, improved quality of life). Preoperative psychological preparation often aims to improve patients’ knowledge or social support and to modify and optimize expectations and illness belief s.SummaryPre...
Source: Current Cardiology Reports - October 10, 2020 Category: Cardiology Source Type: research

COVID-19 and Cardiovascular Health Among Patients with Cancer
AbstractPurpose of reviewThe coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), continues to spread with rising new cases and deaths. Patients with cancer represent a uniquely vulnerable population not only with higher susceptibility to COVID-19 but also at increased risk for its complications. This review focuses on the implications of COVID-19 in the cardiovascular health of patients with cancer.Recent findingsPatients more susceptible to COVID-19 with increased severity of disease include those with cancer and cardiovascular comorbidities. In additio...
Source: Current Cardiology Reports - October 10, 2020 Category: Cardiology Source Type: research

Shock to the Heart: Psychosocial Implications and Applications of Sudden Cardiac Death in the Young
AbstractPurpose of ReviewAlthough rare, sudden cardiac death (SCD) in the young is a tragic event, having a dramatic impact upon all involved. The psychosocial burden associated with SCD can leave friends, families, and entire communities bereft. With only limited evidence to describe the volatile emotional reactions associated with a young SCD, there is an urgent need for care providers to better understand the psychological complexities and impacts faced by both at-risk individuals and those directly affected by these tragic events.Recent FindingsCurrent knowledge of the psychosocial implications associated with SCD in t...
Source: Current Cardiology Reports - October 10, 2020 Category: Cardiology Source Type: research

Approaching End-of-Life Decisions in Adults with Congenital Heart Disease
AbstractPurposeDespite tremendous advances in medical and surgical care, some adults with congenital heart disease (ACHD) develop terminal conditions where therapy is limited. This paper reviews the important role of palliative care, advance care planning (ACP), and end-of-life (EOL) care in ACHD.Recent FindingsRecent studies suggest that ACP is infrequently utilized in ACHD. Patients generally express interest in learning more about EOL care, though few ACHD providers have received adequate training to confidently conduct these discussions. Most barriers to communication are largely addressable, and an organized approach ...
Source: Current Cardiology Reports - October 10, 2020 Category: Cardiology Source Type: research

Clinical Implications of the Genetic Architecture of Dilated Cardiomyopathy
AbstractPurpose of ReviewDilated cardiomyopathy (DCM) frequently involves an underlying genetic etiology, but the clinical approach for genetic diagnosis and application of results in clinical practice can be complex.Recent FindingsInternational sequence databases described the landscape of genetic variability across populations, which informed guidelines for the interpretation of DCM gene variants. New evidence indicates that loss-of-function mutations in filamin C (FLNC) contribute to DCM and portend high risk of ventricular arrhythmia.SummaryA clinical framework aids in referring patients for DCM genetic testing and app...
Source: Current Cardiology Reports - October 10, 2020 Category: Cardiology Source Type: research

Anticoagulation Therapy After Transcatheter Aortic Valve Replacement
AbstractPurpose of ReviewWe review the prevalence; natural history; impact of subclinical clinical thrombosis on valve hemodynamics, clinical outcomes, and valve durability; and the role of anticoagulation after transcatheter aortic valve replacement (TAVR).Recent FindingsSubclinical leaflet thrombosis is a dynamic finding present in both transcatheter and surgical bioprosthetic aortic valves. This finding is less prevalent in patients on anticoagulation and resolves following initiation of anticoagulation. Routine anticoagulation after TAVR in high-surgical-risk patients was associated with increased mortality and thrombo...
Source: Current Cardiology Reports - October 10, 2020 Category: Cardiology Source Type: research

Radiation-Associated Valvular Disease
AbstractPurpose of ReviewRadiation-associated valvular disease (RAVD) is characterized by late valvular manifestations following radiation exposure to the mediastinum. Review of current guidelines was performed to examine best practices to reduce risk and optimize outcomes in this patient population.Recent FindingsEarly and consistent screening and comprehensive and careful planning are critical in managing RAVD. Due to long latency periods, serial screening and targeted evaluation of risk factors are essential to early detection. Varying and complex presentations of RAVD require an integrated team of experienced specialis...
Source: Current Cardiology Reports - October 10, 2020 Category: Cardiology Source Type: research

Cardiac Tumors: Diagnosis, Prognosis, and Treatment
AbstractPurpose of ReviewCardiac masses frequently present significant diagnostic and therapeutic clinical challenges and encompass a broad set of lesions that can be either neoplastic or non-neoplastic. We sought to provide an overview of cardiac tumors using a cardiac chamber prevalence approach and providing epidemiology, imaging, histopathology, diagnostic workup, treatment, and prognoses of cardiac tumors.Recent FindingsCardiac tumors are rare but remain an important component of cardio-oncology practice. Over the past decade, the advances in imaging techniques have enabled a noninvasive diagnosis in many cases. Indee...
Source: Current Cardiology Reports - October 10, 2020 Category: Cardiology Source Type: research

Obesity Genomics and Metabolomics: a Nexus of Cardiometabolic Risk
AbstractPurpose of ReviewObesity is a significant international public health epidemic with major downstream consequences on morbidity and mortality. While lifestyle factors contribute, there is an evolving understanding of genomic and metabolomic pathways involved with obesity and its relationship with cardiometabolic risk. This review will provide an overview of some of these important findings from both a biologic and clinical perspective.Recent FindingsRecent studies have identified polygenic risk scores and metabolomic biomarkers of obesity and related outcomes, which have also highlighted biological pathways, such as...
Source: Current Cardiology Reports - October 10, 2020 Category: Cardiology Source Type: research

Diagnostic and Management Dilemmas in Women Presenting with Acute Coronary Syndromes
AbstractPurpose of ReviewTo summarize gender- and sex-specific differences in the presentation, diagnosis, management, and pathophysiology of women presenting with acute coronary syndrome (ACS).Recent FindingsSex differences exist in many aspects of ACS that impact the identification, treatment, and outcomes in women. There are delays in the initiation of care, under recognized diagnostic differences based on sex, and inconsistencies in the management of ACS in women compared with men, that ultimately impact outcomes. Additionally, women with ACS are more likely than men to present with non-obstructive coronary artery dise...
Source: Current Cardiology Reports - October 10, 2020 Category: Cardiology Source Type: research

Species-Spanning Echocardiography: Cardiovascular Insights from Across the Animal Kingdom
We present echocardiographic examples of high impact human cardiovascular pathologies, including valvular, vascular, conduction, and myocardial disorders, in a wide range of species in varying environments. Unique features associated with comparative echocardiographic assessments are linked to human cardiology, including natural animal models of resistance and vulnerability.SummaryThe cardiovascular vulnerabilities and strengths of other species can be a source of invaluable insights for human healthcare professionals. Echocardiography is playing a key role in bridging human and veterinary cardiology. Consequently, species...
Source: Current Cardiology Reports - October 10, 2020 Category: Cardiology Source Type: research

Diagnosis and Management of Lymphatic Disorders in Congenital Heart Disease
AbstractPurpose of ReviewLymphatic disorders have received an increasing amount of attention over the last decade. Sparked primarily by improved imaging modalities and the dawn of lymphatic interventions, understanding, diagnostics, and treatment of lymphatic complications have undergone considerable improvements. Thus, the current review aims to summarize understanding, diagnostics, and treatment of lymphatic complications in individuals with congenital heart disease.Recent FindingsThe altered hemodynamics of individuals with congenital heart disease has been found to profoundly affect morphology and function of the lymph...
Source: Current Cardiology Reports - October 10, 2020 Category: Cardiology Source Type: research

The Foundational Role of Cardiovascular Imaging in the Characterization of Mental Stress –Induced Myocardial Ischemia in Patients with Coronary Artery Disease
AbstractPurpose of ReviewMental stress –provoked myocardial ischemia (MSIMI) is an ischemic phenomenon provoked by the experience of psychologically stressful circumstances. While MSIMI was initially identified 50 years ago during activities of daily living through the use of wearable Holter monitor, subsequent research utilized the t echnologies of cardiac imaging—ventriculography and myocardial perfusion—under controlled conditions to pursue an understanding of pathophysiology and prognosis. This work revealed that MSIMI occurs in almost half of patients with stable coronary artery disease (CAD) an...
Source: Current Cardiology Reports - October 10, 2020 Category: Cardiology Source Type: research

Machine Learning in Electrocardiography and Echocardiography: Technological Advances in Clinical Cardiology
AbstractPurpose of ReviewElectrocardiography (ECG) and echocardiography are the most widely used diagnostic tools in clinical cardiology. This review focuses on recent advancements in applying machine learning (ML) in ECG and echocardiography and potential synergistic ML integration of ECG and echocardiography.Recent FindingsML algorithms have been used in ECG for technical quality assurance, arrhythmia identification, and prognostic predictions, and in echocardiography to recognize image views, quantify measurements, and identify pathologic patterns. Synergistic application of ML in ECG and echocardiograph has demonstrate...
Source: Current Cardiology Reports - October 10, 2020 Category: Cardiology Source Type: research

Management of Patients with Acute Coronary Syndrome and Cancer
AbstractAbstractCancer patients with acute coronary syndrome (ACS) have significantly greater mortality compared with non-cancer patients. This risk is partly directly attributable to the malignancy; however these patients are frequently undertreated with respect to guideline recommended treatments for ACS due to higher bleeding risks from anemia and thrombocytopenia. Due to exclusion from large clinical trials, there is a paucity of data regarding how to best treat these complex and high-risk patients.Purpose of ReviewTo review the literature and identify risk factors among cancer patients associated with poor outcomes, p...
Source: Current Cardiology Reports - October 10, 2020 Category: Cardiology Source Type: research

Paravalvular Leak Assessment: Challenges in Assessing Severity and Interventional Approaches
AbstractPurpose of ReviewWith increasing use of prosthetic valves to treat degenerative valvular heart disease (VHD) in an aging population, the incidence and adverse consequences of paravalvular leaks (PVL) are better recognized. The present work aims to provide a cohesive review of the available literature in order to better guide the evaluation and management of PVL.Recent FindingsDespite gains in operator experience and design innovation, significant PVL remains a significant complication that may present with congestive heart failure and/or hemolytic anemia. To date, clear consensus or guidelines on the evaluation and...
Source: Current Cardiology Reports - October 10, 2020 Category: Cardiology Source Type: research

Strategies for Improving Nutrition in Inner-City Populations
AbstractPurpose of ReviewThe social, economic, cultural, and historic reasons for why inner-city communities have struggled with poor nutrition and health outcomes are complex. Creating successful programs to address these problems requires a better understanding of the gaps that exist and formulating solutions to improve access to nutritious food options.Recent FindingsStudies have demonstrated that aggressive evidence-based nutrition can decrease factors linked to cardiovascular diseases, but improving access to these nutritious resources and prioritizing health literacy and behavior modification related to meal choices ...
Source: Current Cardiology Reports - October 10, 2020 Category: Cardiology Source Type: research

Ebstein ’s Anomaly of the Tricuspid Valve: an Overview of Pathology and Management
AbstractPurpose of ReviewEbstein ’s anomaly (EA) is a rare, but complex form of congenital heart disease consisting of a right ventricular myopathy and morphologic tricuspid valve disease leading to a high incidence of right ventricular dysfunction and arrhythmias. This review offers an updated overview of the current understandi ng and management of patients with EA with a focus on the adult population.Recent FindingsIncreased understanding of anatomic accessory atrioventricular pathways in EA has resulted in an improvement in ablation techniques and long-term freedom of atrial arrhythmia recurrence.SummaryDespite a...
Source: Current Cardiology Reports - October 9, 2020 Category: Cardiology Source Type: research

The Promise and Peril of Vaping
This report provides a detailed review of current scientific evidence on potential benefits and health risks associated with e-cigarette use.Recent FindingsE-cigarettes were introduced as a less harmful alternative to combustible cigarette smoking. However, evidence on their use as effective and safe smoking cessation aids remains inconclusive. Their rapid uptake among tobacco-naive individuals can lead to nicotine addiction and subsequent cigarette smoking.SummaryAlthough e-cigarettes appear to be relatively safer than combustible cigarettes, they expose users to known harmful constituents whose long-term health risks rem...
Source: Current Cardiology Reports - October 9, 2020 Category: Cardiology Source Type: research

The Future of Paediatric Heart Interventions: Where Will We Be in 2030?
AbstractPurpose of ReviewCardiac catheterization therapies to treat or palliate infants, children and adults with congenital heart disease have developed rapidly worldwide in both technical innovation and device development in the previous three decades. By reviewing of current status of novel or development of devices and techniques, we will discuss what is likely to happen in paediatric heart intervention in the next decade.Recent FindingsRecently, biodegradable stents and devices, transcatheter pulmonary valve implantation for the native right ventricle outflow tract and MRI-guided interventions have been progressing ra...
Source: Current Cardiology Reports - October 9, 2020 Category: Cardiology Source Type: research

Effects of Psychological Stress on Vascular Physiology: Beyond the Current Imaging Signal
AbstractPurpose of ReviewThis review describes the effects of psychological stress on the physiology of the entire vascular system, from individual cellular components to macrovascular and microvascular responses, and highlights the importance of the vascular system in the context of current limitations in cardiac imaging for evaluation of the cardiovascular response to mental stress.Recent FindingsThe physiological responses that mediate vascular changes are based on evolutionary needs, but there is increasing evidence that the long-term consequences of psychological stress can precipitate the development and progression ...
Source: Current Cardiology Reports - October 9, 2020 Category: Cardiology Source Type: research

Hypertrophic Cardiomyopathy 2020
AbstractPurpose of ReviewTo briefly review the pathophysiology and natural history of hypertrophic cardiomyopathy (HCM) and to describe the diagnosis, assessment, and contemporary management strategies.Recent FindingsHCM-related mortality remains low; however, symptoms due in large part to LVOT obstruction remain a clinical dilemma. Several medical therapies have been shown to reduce symptoms and improve functional capacity, including several recent phase 2 clinical trials involving the novel myosin modulator mavacamten. In patients with refractory symptoms, septal reduction therapy or advanced therapies remain viable opti...
Source: Current Cardiology Reports - October 5, 2020 Category: Cardiology Source Type: research

Treatment of Congenital and Acquired Pulmonary Vein Stenosis
AbstractPurpose of ReviewPulmonary vein stenosis (PVS) is a rare entity that until the last 2 decades was seen primarily in infants and children. Percutaneous and surgical interventions have limited success due to relentless restenosis, and mortality remains high. In adults, acquired PVS following ablation for atrial fibrillation has emerged as a new syndrome. This work will review these two entities with emphasis on current treatment.Recent FindingsGreater emphasis on understanding and addressing the mechanism of restenosis for congenital PVS has led to the use of drug-eluting stents (DES) and systemic drug therapy to tar...
Source: Current Cardiology Reports - October 2, 2020 Category: Cardiology Source Type: research

Correction to: Review of Transthyretin Silencers, Stabilizers, and Fibril Removal Agents in the Treatment of Transthyretin Cardiac Amyloid
On page 2 of the original publication, in the section onTTR Silencers dosing of patisiran in the APOLLO study was stated as being given every 3  months; this is inaccurate as patisiran was dosed every 3 weeks in the APOLLO study. (Source: Current Cardiology Reports)
Source: Current Cardiology Reports - September 27, 2020 Category: Cardiology Source Type: research

Contemporary Understandings of Cardiovascular Disease After Cancer Radiotherapy: a Focus on Ischemic Heart Disease
AbstractPurpose of ReviewRadiation-induced cardiovascular disease, including coronary artery disease, is a well-known sequela of radiation therapy and represents a significant source of morbidity and mortality for cancer survivors. This review examines current literature and guidelines to care for this growing population of cancer survivors.Recent FindingsThe development of radiation-induced ischemic heart disease following radiation can lead even to early cardiotoxicities, inclusive of coronary artery disease, which limit cancer treatment outcomes. These coronary lesions tend to be diffuse, complex, and proximal. Early de...
Source: Current Cardiology Reports - September 22, 2020 Category: Cardiology Source Type: research

BNP and NT-proBNP Interpretation in the Neprilysin Inhibitor Era
AbstractPurpose of ReviewDescribe the mechanisms that may influence change in measured natriuretic peptide levels when using the neprilysin inhibitor sacubitril to treat a patient with heart failure.Recent FindingsPrior to the introduction of the neprilysin inhibitor sacubitril as part of a chemical combination with the angiotensin receptor blocker valsartan shown to reduce mortality and heart failure hospitalizations in patients with heart failure with reduced ejection fraction, the natriuretic peptide assays for B-type natriuretic peptide (BNP) and the amino-terminal proBNP (NT-proBNP) assays were shown to have similar d...
Source: Current Cardiology Reports - September 18, 2020 Category: Cardiology Source Type: research

Re-evaluating the Role of CABG in Acute Coronary Syndromes
We describe the current indications for and outcomes of CABG in patients who present with ACS.Recent FindingsReal-world studies demonstrate better long-term outcomes with CABG than with PCI after NSTE-ACS. Staged CABG after culprit-vessel PCI for STEMI is also a feasible option in certain patients. In patients presenting with ACS and cardiogenic shock who are treated with CABG, the use of mechanical circulatory support has produced a limited but significant reduction in mortality.SummaryThe optimal revascularization strategy after ACS depends on many variables. The pre-eminent factor in selecting the best mode of revascula...
Source: Current Cardiology Reports - September 16, 2020 Category: Cardiology Source Type: research