Autoimmune and Autoinflammatory Pericarditis: Definitions and New Treatments
AbstractPurpose of the ReviewThe purpose of the review is to analyze the pathogenetic mechanisms that underlie acute pericarditis, with attention to autoimmune and autoinflammatory pericarditis, and, in addition, to review the available therapeutic armamentarium.Recent FindingsSeveral studies have been published on the use of anti-IL-1 drugs in recurrent pericarditis, including anakinra and rilonacept. The latest, the RHAPSODY study, based on the use of rilonacept in recurrent pericarditis, has recently reached phase 3 with promising results in terms of efficacy and safety.SummaryAlterations in the function of the inflamma...
Source: Current Cardiology Reports - July 28, 2021 Category: Cardiology Source Type: research

Food for Thought or Feeding a Dogma? Diet and Coronary Artery Disease: a Clinician ’s Perspective
AbstractPurpose of ReviewTo provide an overview of nutrition studies evaluating the association of dietary saturated fat and meat intake with the development of coronary artery disease (CAD) and discuss implications of recent data.Recent FindingsRecent studies have led to the re-evaluation of the role of saturated fat in CAD. Randomized controlled trials (RCTs) support Mediterranean diet to reduce cardiovascular risk. Recent data revealed significant association of intake of meat or poultry with increased risk, but fish consumption was associated with lower risk of incident CAD.SummaryIn this review, we provide a brief ove...
Source: Current Cardiology Reports - July 19, 2021 Category: Cardiology Source Type: research

Update in Paravalvular Leak Closure
AbstractPurpose of ReviewGiven the low occurrence of clinically important paravalvular leak (PVL), there are no large registries or trials in this space to investigate management strategies. This review integrates newer evidence, particularly in imaging guidance for these complex procedures, novel techniques and approaches that our group has taken, as well as approaches to more complex PVL plugging reported in case reports.Recent FindingsPerhaps the largest area of growth in the management of PVL is the use of advanced imaging in both pre-procedure evaluation and intra-procedural guidance with gated cardiac CT, 3D TEE, and...
Source: Current Cardiology Reports - July 16, 2021 Category: Cardiology Source Type: research

Strategies for Recovering an Embolized Percutaneous Device
AbstractPurpose of ReviewDevice embolization is a rare but potentially life-threatening complication of transcatheter structural heart interventions and may require prompt intervention. The present work aims to provide an overview of strategies for device retrievals in order to better guide the evaluation and management of device embolization.Recent FindingsAlthough the evolution of transcatheter device therapies has had a tremendous impact on the management in structural heart disease, availability of various retrieval devices, knowledge in how to use them, and multidisciplinary collaboration are key for successful device...
Source: Current Cardiology Reports - July 16, 2021 Category: Cardiology Source Type: research

Roles of Cardiac Computed Tomography in Guiding Transcatheter Tricuspid Valve Interventions
AbstractPurpose of ReviewThe field of transcatheter tricuspid valve interventions (TTVI) is rapidly evolving to meet a well-defined but unmet clinical need. Severe tricuspid regurgitation is common and is associated with significant morbidity and mortality. Surgical options are limited and of high risk. The success of TTVI depends on careful procedural planning, and cardiac computed tomography (CCT) plays an emerging key role.Recent FindingsTTVI technologies have various targets, including the leaflets, annulus, and venae cavae, along with valve replacement. Based on the planned procedure, CCT allows for device sizing, car...
Source: Current Cardiology Reports - July 16, 2021 Category: Cardiology Source Type: research

Transcatheter Repair and Replacement Technologies for Mitral Regurgitation: a European Perspective
AbstractPurpose of ReviewWe aimed to picture the contemporary landscape of available catheter-based repair and replacement solutions for mitral regurgitation (MR) in Europe.Recent FindingsEdge-to-edge repair remains the dominant technique for transcatheter mitral valve repair especially in the context of secondary mitral regurgitation. Two recent randomized trials reported seemingly contradicting clinical results with transcatheter edge-to-edge repair for patients with heart failure and severe secondary MR. A proportionality framework related to secondary MR was proposed to help explain inconsistencies but requires further...
Source: Current Cardiology Reports - July 16, 2021 Category: Cardiology Source Type: research

Promise and Perils of Telehealth in the Current Era
AbstractPurpose of ReviewThe concept of telehealth has been around since the early twentieth century and has been used in different healthcare specialties. However, with the recent COVID-19 pandemic necessitating physical distancing, there has been an increased emphasis and utilization of this mode of healthcare delivery. With increasing reliance on telehealth services, data from investigator groups have brought to light several merits as well as failings of telehealth.Recent FindingsTelehealth services have been associated with improved healthcare outcomes while remaining a cost-effective mode of healthcare delivery. Impr...
Source: Current Cardiology Reports - July 16, 2021 Category: Cardiology Source Type: research

Intersection Between Chronic Kidney Disease and Cardiovascular Disease
AbstractPurpose of ReviewThe incidence of chronic kidney disease is increasing worldwide, and the previously decreasing incidence of cardiovascular disease has now plateaued. Understanding the intersection of both heart and kidney disease is crucial.Recent FindingsChronic kidney disease and cardiovascular disease share common risk factors and specific pathogenic mechanisms and impact a significant segment of the population. Patients with chronic kidney disease are more likely to have cardiovascular disease than progress to end-stage kidney disease requiring renal replacement therapy.SummaryWe discuss shared risk factors an...
Source: Current Cardiology Reports - July 16, 2021 Category: Cardiology Source Type: research

Colchicine in the Management of Acute and Chronic Coronary Artery Disease
AbstractPurpose of ReviewInflammation is involved in the initiation, progression, and destabilization of atherosclerosis. Anti-inflammatory strategies aimed at reducing residual cardiovascular (CV) risk have gained increasing interest in addition to the traditional management of risk factors. Colchicine is a potent anti-inflammatory therapy that affects the inflammasome and other targets. We will herein review the most recent evidence regarding the usefulness of colchicine in patients with coronary artery disease (CAD).Recent FindingsColchicine has recently been repurposed from its traditional use to a number of CV indicat...
Source: Current Cardiology Reports - July 16, 2021 Category: Cardiology Source Type: research

Computed Tomography Imaging of Aortic Dissections with Endovascular Treatment Considerations
AbstractPurpose of ReviewIn the present review, we discuss the role of CT imaging in the management of aortic dissection, with a particular emphasis on endovascular treatment considerations.Recent FindingsComputed tomography imaging is a fundamental tool in the diagnosis and management of acute and chronic aortic dissection. Its diagnostic accuracy and high resolution contribute to and guide operative strategy.SummaryPersistent high mortality for patients who develop aortic dissections suggests a need for innovative diagnostic and treatment strategies. In the recent era, considerable advances have been made in computed tom...
Source: Current Cardiology Reports - July 16, 2021 Category: Cardiology Source Type: research

Renal Denervation for Patients With Atrial Fibrillation
AbstractPurpose of ReviewDuring the last decade, several case series and small reports have indicated that pulmonary vein isolation (PVI) in combination with renal denervation (RDN) may increase the rate of atrial fibrillation (AF) freedom in patients with hypertension. We aimed to provide a contemporary systematic overview on the techniques, and the efficacy/safety of RDN on AF recurrence, and the current landscape of ongoing investigation.Recent FindingsThe recent Evaluate Renal Denervation in Addition to Catheter Ablation to Eliminate Atrial Fibrillation (ERADICATE-AF) trial has demonstrated convincingly that among pati...
Source: Current Cardiology Reports - July 16, 2021 Category: Cardiology Source Type: research

Acquisition, Processing, and Interpretation of PET 18F-FDG Viability and Inflammation Studies
This article reviews the acquisition protocols and image interpretation for18F-fluorodeoxyglucose (18F-FDG) imaging with positron emission tomography (PET) applied to the evaluation of myocardial viability and inflammation.Recent FindingsCardiac PET with18F-FDG provides essential information for the assessment of myocardial viability and inflammation and is usually combined with PET perfusion imaging using82Rb or13N-ammonia. Viable myocardium maintains glucose metabolism which can be detected via the uptake of18F-FDG by PET imaging. The patient is prepared for viability imaging by shifting the metabolism of the heart to ma...
Source: Current Cardiology Reports - July 16, 2021 Category: Cardiology Source Type: research

The Sarcomeric Spring Protein Titin: Biophysical Properties, Molecular Mechanisms, and Genetic Mutations Associated with Heart Failure and Cardiomyopathy
AbstractPurpose of ReviewThe giant protein titin forms the “elastic” filament of the sarcomere, essential for the mechanical compliance of the heart muscle. Titin serves a biological spring, and therefore structural modifications of titin affect function of the myocardium and are associated with heart failure and cardiomyopathy.Recent FindingsIn this review, we discuss the current understanding of titin ’s biophysical properties and how modifications contribute to cardiac function and heart failure. In addition, we review the most recent data on the clinical impact and phenotype heterogeneity of TTN trunc...
Source: Current Cardiology Reports - July 16, 2021 Category: Cardiology Source Type: research

A Clinico-Pathologic Approach to the Differential Diagnosis of Pericardial Tumors
This article provides a comprehensive review of the most recent literature to develop a structured framework to the differential diagnosis of pericardial tumors. (Source: Current Cardiology Reports)
Source: Current Cardiology Reports - July 16, 2021 Category: Cardiology Source Type: research

Cardiac Rehabilitation: Under-Utilized Globally
AbstractPurpose of ReviewCardiac rehabilitation (CR) is grossly under-utilized. This review summarizes current knowledge about degree of CR utilization, reasons for under-utilization, and strategies to increase use.Recent FindingsICCPR ’s global CR audit quantified for the first time the number of additional CR spots needed per year to treat indicated patients, so there are programs they may use. The first randomized trial of automatic/systematic CR referral has shown it results in significantly greater patient completion. Moreo ver, the recent update of the Cochrane review on interventions to increase use has provid...
Source: Current Cardiology Reports - July 16, 2021 Category: Cardiology Source Type: research

Lipid Monitoring After Initiation of Lipid-Lowering Therapies: Return of Performance Measures?
AbstractPurpose of ReviewThe 2015 American College of Cardiology (ACC)/American Heart Association (AHA) Focused Update of Secondary Prevention Lipid Performance Measures removed low-density lipoprotein cholesterol (LDL-C) assessment as a performance measure. This review discusses the evidence supporting the importance of lipid monitoring in the secondary prevention of atherosclerotic cardiovascular disease (ASCVD).Recent FindingsThe 2018 AHA/ACC Multisociety cholesterol guideline (as did the 2013 guideline) recommends a lipid panel after initiating lipid-lowering therapy to monitor adherence and medication efficacy. The 20...
Source: Current Cardiology Reports - July 16, 2021 Category: Cardiology Source Type: research

Shared Care to Destination Therapy Left Ventricular Assist Device Site: a Novel Strategy to Start a Successful Mechanical Circulatory Support Program
AbstractPurpose of ReviewHeart failure is an important healthcare issue because of its high prevalence, mortality, and morbidity. Advanced heart failure therapies have improved significantly over the years with improved outcomes. Heart transplantation remains an elusive treatment option for most patients; hence, the need for alternative therapy has given rise to the use of mechanical circulatory support (MCS) devices, initially as bridge to transplantation, but with more recent use as destination therapy. This review focuses on the intricacies of establishing a successful left ventricular assist device (LVAD) program for d...
Source: Current Cardiology Reports - July 15, 2021 Category: Cardiology Source Type: research

A Fishy Topic: VITAL, REDUCE-IT, STRENGTH, and Beyond: Putting Omega-3 Fatty Acids into Practice in 2021
AbstractPurpose of ReviewTo examine recently published data from clinical outcome and arteriographic studies that examined the addition of omega-3 fatty acids, eicosapentaenoic acid (EPA)+ docosahexanoic acid (DHA), to standard of care therapy on cardiovascular disease (CVD) risk.Recent FindingsSeveral trials that tested purified EPA(JELIS, REDUCE-IT, EVAPORATE) were associated with reduced CVD risk and regression of low attenuation coronary plaque volume, whereas studies that employed the combination EPA/DHA (VITAL, OMEMI, STRENGTH) failed to derive clinical benefit.SummaryTrials testing purified EPA consistently demonstr...
Source: Current Cardiology Reports - July 11, 2021 Category: Cardiology Source Type: research

Cardiovascular Toxicity of Androgen Deprivation Therapy
AbstractPurpose of ReviewAndrogen deprivation therapy (ADT) is the standard of care for the treatment of advanced prostate cancer (PC). ADT, particularly with GnRH agonists, leads to increased risk of cardiovascular disease, including myocardial infarction, hypertension, and stroke. This review discusses the options of ADT, the mechanism of ADT-associated cardiovascular side effects, and potential benefit by using GnRH antagonists.Recent FindingsGnRH antagonists have relatively less cardiovascular adverse effects compared to GnRH agonists. We highlight on a recently published phase III clinical trial on the oral GnRH antag...
Source: Current Cardiology Reports - July 3, 2021 Category: Cardiology Source Type: research

Echocardiography in the Liver Transplant Patient
AbstractPurpose of ReviewThe aim of this study is to review current echocardiographic modalities utilized in the assessment of the preoperative liver transplant candidate with an emphasis on newer techniques. We sought to assess if newer methods imparted additional diagnostic or prognostic accuracy compared to prior methods based on existing studies.Recent FindingsStandard dobutamine stress echocardiography offers important information regarding operative risk and post-operative survival in liver transplant candidates; however, technologies such as speckle-tracking echocardiography (STE) and evaluation of diastolic functio...
Source: Current Cardiology Reports - July 3, 2021 Category: Cardiology Source Type: research

Which Aortic Valve Can Be Surgically Reconstructed?
AbstractPurpose of ReviewPreservation or repair of the aortic valve has evolved dynamically in the past 20 years. It leads to a high freedom from valve-related complications if an adequate valve durability can be achieved; it may possibly also improve survival. To date, little structured information is available about which valves can be repaired and which should better be replaced.Recent FindingsFor surgical decision-making, the size of the aortic root is important and the anatomy of the aortic valve must be considered. In the presence of root aneurysm, most tricuspid and bicuspid aortic valves can be preserved. In aortic...
Source: Current Cardiology Reports - July 2, 2021 Category: Cardiology Source Type: research

Primary Aldosteronism: a Continuum from Normotension to Hypertension
AbstractPurpose of ReviewPrimary aldosteronism (PA) is the most common cause of secondary hypertension. Emerging evidence suggests that PA is associated with cardiovascular, metabolic, and renal complications, that likely develop insidiously, due to prolonged inappropriate mineralocorticoid receptor activation. In this review, we discuss the expanding clinical and pathological spectrum of PA.Recent FindingsClinical and molecular studies conducted over the recent years reveal that PA traverses a series of contiguous stages. Pre-clinical, but hormonally overt PA has been identified in patients with normal blood pressure, and...
Source: Current Cardiology Reports - July 1, 2021 Category: Cardiology Source Type: research

Current Status of Catheter-based Mitral Valve Replacement
AbstractPurpose of reviewTranscatheter mitral valve replacement (TMVR) has been developed to address the need for an alternative therapeutic option to surgery in patients suffering from severe mitral regurgitation who are at high surgical risk. The present review illustrated the state-of-the-art of catheter-based mitral valve replacement evaluating technical characteristics and early clinical experience of different devices to outline prospects and challenges of TMVR.Recent findingsSeveral devices are currently under clinical assessment. Early experience has demonstrated high procedural success of TMVR. However, TMVR faces...
Source: Current Cardiology Reports - July 1, 2021 Category: Cardiology Source Type: research

Molecular Imaging Using Cardiac PET/CT: Opportunities to Harmonize Diagnosis and Therapy
AbstractPurpose of ReviewCurrent therapeutic strategies to mitigate heart failure progression after myocardial infarction involve support of endogenous repair through molecular targets. The capacity for repair varies greatly between individuals. In this review, we will assess how cardiac PET/CT enables precise characterization of early pathogenetic processes which govern ventricle remodeling and progression to heart failure.Recent FindingsInflammation in the first days after myocardial infarction predicts subsequent functional decline and can influence therapy decisions. The expansion of anti-inflammatory approaches to imp...
Source: Current Cardiology Reports - July 1, 2021 Category: Cardiology Source Type: research

Monogenic and Polygenic Models of Coronary Artery Disease
AbstractPurpose of the ReviewCoronary artery disease (CAD) is a common disease globally attributable to the interplay of complex genetic and lifestyle factors. Here, we review how genomic sequencing advances have broadened the fundamental understanding of the monogenic and polygenic contributions to CAD and how these insights can be utilized, in part by creating polygenic risk estimates, for improved disease risk stratification at the individual patient level.Recent FindingsInitial studies linking premature CAD with rare familial cases of elevated blood lipids highlighted high-risk monogenic contributions, predominantly pr...
Source: Current Cardiology Reports - July 1, 2021 Category: Cardiology Source Type: research

Anomalous Coronary Arteries: When to Follow-up, Risk Stratify, and Plan Intervention
AbstractPurpose of ReviewCoronary artery anomalies are a diverse group of entities, ranging from benign variations of normal anatomy to life-threatening conditions. There is, however, no universal consensus in their classification, risk stratification, and management. The aim of this review is to develop a straightforward clinical approach for the assessment and care of patients with anomalous coronary arteries.Recent FindingsAutopsy series and population screening studies have recently provided useful clinical data on the prevalence and outcomes of coronary anomalies. Also, findings on coronary computed tomography angiogr...
Source: Current Cardiology Reports - July 1, 2021 Category: Cardiology Source Type: research

Mechanisms Driving Immune-Related Adverse Events in Cancer Patients Treated with Immune Checkpoint Inhibitors
AbstractPurpose of ReviewIn the past decade, immune checkpoint inhibitors (ICIs) have revolutionized the field of cancer treatment. With the continuing rise in the number of cancer patients eligible for ICIs, a corresponding rise in immune-related adverse events (irAEs) is occurring. IrAEs are inflammatory reactions against normal, healthy tissue that occur due to ICI-induced activation of the immune system. Although the exact immune pathogenesis driving irAE development remains unknown, we review the main proposed mechanisms, highlighting how they may inform irAE prediction and treatment.Recent FindingsIrAEs are common an...
Source: Current Cardiology Reports - July 1, 2021 Category: Cardiology Source Type: research

The Riskier Lipid: What Is on the HORIZON for Lipoprotein (a) and Should There Be Lp(a) Screening for All?
AbstractPurpose of ReviewDespite widespread targeting of cardiovascular risk factors, many patients continue to experience clinical events. This residual risk has stimulated efforts to develop novel therapeutic approaches to target additional factors underscoring cardiovascular disease. This review aimed to summarize existing evidence supporting targeting of Lp(a) as a novel cardioprotective strategy.Recent FindingsIncreasing evidence has implicated lipoprotein (a) [Lp(a)] in the pathogenesis of both atherosclerotic and calcific aortic valve disease. Therapeutic advances have produced novel agents that selectively lower Lp...
Source: Current Cardiology Reports - July 1, 2021 Category: Cardiology Source Type: research

Weight Management Strategies for the Patient with Diabetes
AbstractPurpose of ReviewObesity is associated with an increased risk for type 2 diabetes, and weight loss in adults with obesity and type 2 diabetes may be indicated to reduce health risk and improve diabetes control. It is important to understand the effectiveness of weight loss interventions for the prevention and treatment of type 2 diabetes.Recent FindingsLifestyle interventions for weight loss show effectiveness for prevention of type 2 diabetes. Weight loss in patients with type 2 diabetes can decrease cardiometabolic risk and improve diabetes control. However, diabetes remission with lifestyle approaches is limited...
Source: Current Cardiology Reports - July 1, 2021 Category: Cardiology Source Type: research

Atrioventricular Septal Defects: Pathology, Imaging, and Treatment Options
AbstractPurpose of ReviewAtrioventricular septal defects (AVSD) represent a broad spectrum of congenital anomalies from simple to the most complex heart defects including some distinct types. Clinical presentation and timing of intervention differ by morphological subset and functional anatomy. Herein, we review morphological variations and characteristics that determine appropriate intervention and provide insights into functional anatomy based on detailed three-dimensional (3D) assessment of AVSDs.Recent FindingsThe understanding of functional morphology of AVSDs has improved significantly with detailed 3D echocardiograp...
Source: Current Cardiology Reports - July 1, 2021 Category: Cardiology Source Type: research

Pulse-Cancellation Echocardiography for Clinical Evaluation of Myocardial Scar Burden
AbstractPurpose of ReviewEchocardiography has been completely abandoned as far as myocardial tissue characterization is concerned, but recently, the possibility to detect scarred myocardial tissue has been revived. We review the most recent studies aiming to assess the presence of myocardial fibrosis or scar using echocardiography.Recent FindingsThe use of a simple and clinically available ultrasound, such as method pulse-cancellation, is a promising add-on to standard echocardiography for the detection of scarred myocardial tissue, mostly, but not only, in the setting of post-myocardial infarction patients.SummaryPulse-ca...
Source: Current Cardiology Reports - July 1, 2021 Category: Cardiology Source Type: research

New Approaches to Management of Pericardial Effusions
AbstractPurpose of ReviewPericardial effusion is a challenging pericardial syndrome and a cause of serious concern for physicians and patients due to its potential progression to life-threatening cardiac tamponade. In this review, we summarize the contemporary evidence of the etiology; diagnostic work-up, with particular emphasis on the contribution of multimodality imaging; therapeutic options; and short- and long-term outcomes of these patients.Recent FindingsIn recent years, an important piece of information has contributed to put together several missing parts of the puzzle of pericardial effusion. The most recent 2015...
Source: Current Cardiology Reports - July 1, 2021 Category: Cardiology Source Type: research

Vasoplegia from Continuous Flow Left Ventricular Assist Devices
AbstractPurpose of ReviewThe contribution of continuous flow left ventricular assist devices (c-LVAD) to vasoplegic syndrome and postoperative outcomes after orthotopic heart transplant (OHT) is contested in the literature. A standardized definition of vasoplegic syndrome (VS) is needed to better recognize and manage vasoplegic shock.Recent FindingsVasoplegic syndrome occurs after orthotopic heart transplant more frequently than after other surgeries requiring cardiopulmonary bypass. c-LVADs lead to small vessel endothelial dysfunction and desensitized adrenal receptors; however, their contribution to the development of va...
Source: Current Cardiology Reports - July 1, 2021 Category: Cardiology Source Type: research

How to Image and Manage Prosthesis-Related Complications After Transcatheter Aortic Valve Replacement
AbstractPurpose of reviewIn this review, we provide an overview of potential prosthesis — related complications after transcatheter aortic valve replacement, their incidences, the imaging modalities best suited for detection, and possible strategies to manage these complications.Recent findingsTherapy for severe aortic valve stenosis requiring intervention has increasingly evolved toward transcatheter aortic valve replacement over the past decade, and the number of procedures performed has increased steadily in recent years. As more and more centers favor a minimalistic approach and largely dispense with general anes...
Source: Current Cardiology Reports - July 1, 2021 Category: Cardiology Source Type: research

PET Imaging of Post-infarct Myocardial Inflammation
AbstractPurpose of ReviewTo examine the use of positron emission tomography (PET) for imaging post-infarct myocardial inflammation and repair.Recent FindingsDysregulated immune responses after myocardial infarction are associated with adverse cardiac remodelling and an increased likelihood of ischaemic heart failure. PET imaging utilising novel tracers can be applied to visualise different components of the post-infarction inflammatory and repair processes. This approach could offer unique pathophysiological insights that could prove useful for the identification and risk-stratification of individuals who would ultimately ...
Source: Current Cardiology Reports - July 1, 2021 Category: Cardiology Source Type: research

Molecular Profiling of the Cardiac Conduction System: the Dawn of a New Era
AbstractPurpose of ReviewRecent technological advances have led to an increased ability to define the gene expression profile of the cardiac conduction system (CCS). Here, we review the most salient studies to emerge in recent years and discuss existing gaps in our knowledge as well as future areas of investigation.Recent FindingsMolecular profiling of the CCS spans several decades. However, the advent of high-throughput sequencing strategies has allowed for the discovery of unique transcriptional programs of the many diverse CCS cell types.SummaryThe CCS, a diverse structure with significant inter- and intra-component cel...
Source: Current Cardiology Reports - July 1, 2021 Category: Cardiology Source Type: research

Exercise Dynamic of Patients with Chronic Heart Failure and Reduced Ejection Fraction
AbstractPurpose of ReviewExercise causes various dynamic changes in all body parts either in healthy subject or in heart failure (HF) patients. The present review of current knowledge about HF patients with reduced ejection fraction focuses on dynamic changes along a “metabo-hemodynamic” perspective.Recent FindingsStudies on the dynamic changes occurring during exercise span many years. Thanks to the availability of advanced methods, it is nowadays possible to properly characterize respiratory, hemodynamic, and muscular function adjustments and their mismatch with the pulmonary and systemic circulations.Summary...
Source: Current Cardiology Reports - June 29, 2021 Category: Cardiology Source Type: research

Patient-Reported Outcomes in Patients with Cardiomyopathy
AbstractPurpose of ReviewAs medicine strives to become more patient-centered, patient-reported outcomes (PROs) are often used to describe patients ’ symptoms, function, and quality of life. This review describes the key concepts of PROs specific to heart failure in clinical trials and their potential role in clinical practice.Recent FindingsAs the Food and Drug Administration has increasingly emphasized how it values PROs as clinical outcome assessments, including its recent qualification of the Kansas City Cardiomyopathy Questionnaire (KCCQ), clinical trials have increasingly used them to evaluate novel therapies. T...
Source: Current Cardiology Reports - June 14, 2021 Category: Cardiology Source Type: research

Cardiovascular Outcome Trials with Glucose-Lowering Drugs
AbstractPurpose of ReviewThis review summarizes recent cardiovascular outcome trials (CVOTs) with glucose-lowering drugs.Recent FindingsThe majority of recent CVOTs with glucose-lowering drugs have tested dipeptidyl peptidase-4 inhibitors (DPP4-i), glucagon-like peptide-1 receptors agonists (GLP1-RA), and sodium-glucose cotransporter 2 inhibitors (SGLT2i), but studies have also been performed with other agents including thiazolidinediones and insulin.SummaryAll CVOTs with DPP4-I, GLP1-RA, and SGLT2-i have demonstrated the cardiovascular (CV) safety of these agents compared to usual care. However, certain GLP1-RAs (liraglut...
Source: Current Cardiology Reports - June 3, 2021 Category: Cardiology Source Type: research

Physiologic Assessment of Coronary Stenosis: Current Status and Future Directions
AbstractPurpose of ReviewPercutaneous coronary intervention (PCI) is a commonly used treatment option in coronary artery disease (CAD). Reduced major adverse cardiovascular events (MACE) in those randomized to PCI compared to optimal medical therapy have been demonstrated only if it is performed for physiologically significant coronary lesions. Despite data demonstrating improved outcomes primarily in stable CAD and then acute settings, physiology-guided PCI remains underutilized. This review summarizes the evidence and commonly used methods for physiologic assessment of coronary stenosis.Recent FindingsFractional flow res...
Source: Current Cardiology Reports - June 3, 2021 Category: Cardiology Source Type: research

Pericardial Diseases in COVID19: a Contemporary Review
This article reviews the possible pathophysiological mechanisms in pericardial involvement in COVID19 and pericardial manifestations of COVID19. It also summarizes the patients with pericarditis secondary to COVID19 and outlines the contemporary treatment strategies in this patient population.Recent FindingsA high degree of suspicion is required to identify the pericardial involvement in COVID19 patients. It is proposed that an underlying hyperinflammatory reaction in COVID19 leads to pericardial inflammation. Acute pericarditis with or without myocardial involvement is diagnosed on clinical presentation, serum inflammator...
Source: Current Cardiology Reports - June 3, 2021 Category: Cardiology Source Type: research

Beyond Statins and PCSK9 Inhibitors: Updates in Management of Familial and Refractory Hypercholesterolemias
AbstractPurpose of ReviewElevation in apolipoprotein B-containing lipoproteins in the blood is a cause of atherosclerosis. Statins have changed the preventive cardiology scenario, and more recently monoclonal proprotein convertase subtilisin kexin type 9 (PCSK9) inhibitors were added as robust agents to further reduce pro-atherogenic lipoproteins and therefore prevent cardiovascular events. However, despite this many dyslipidemic individuals persist with inadequate LDL-C levels and still at risk. The purpose of this review was to discuss current status and describe advances in therapies beyond statins and monoclonal PCSK9 ...
Source: Current Cardiology Reports - June 3, 2021 Category: Cardiology Source Type: research

The Importance of Time-of-Flight Reconstruction and Point Spread Modeling in the Measurement of Myocardial Blood Flow Parameters
AbstractPurpose of ReviewAbsolute quantitation of myocardial blood flow has been recognized as one of the most important advances in nuclear cardiology. The addition of absolute myocardial blood flow quantitation has had a significant impact on the determination of normalcy, artifact/defect differentiation, and the true extent of coronary artery disease in patients with known or suspected coronary disease. Time-of-flight reconstruction and point spread function modeling of the potential to greatly improve resolution and signal to background. This combined with absolute blood flow measurements could improve the reliability ...
Source: Current Cardiology Reports - June 3, 2021 Category: Cardiology Source Type: research

Incremental Value of FDG-PET in the Evaluation of Cardiac Masses
This study aims to review the various roles and evidence underlying the use of fluorodeoxyglucose (FDG) PET/CT and PET/MR for the assessment of cardiac masses.Recent FindingsThe role of FDG-PET for the evaluation of cardiac masses continues to evolve. Studies have shown that FDG-PET is particularly well-suited for differentiating malignant from benign cardiac lesions based on their metabolic activity. Furthermore, FDG-PET is uniquely positioned to investigate patients with cardiac mass as most malignant cardiac lesions are metastasis. Finally, FDG-PET enables staging of patients with primary malignant cardiac tumor, identi...
Source: Current Cardiology Reports - June 3, 2021 Category: Cardiology Source Type: research

Diabetes and Cardiovascular Complications: The Epidemics Continue
AbstractPurpose of ReviewThe cardiovascular complications of type 1 and 2 diabetes are major causes of morbidity and mortality. Extensive efforts have been made to maximize glycemic control; this strategy reduces certain manifestations of cardiovascular complications. There are drawbacks, however, as intensive glycemic control does not impart perennial protective benefits, and these efforts are not without potential adverse sequelae, such as hypoglycemic events.Recent FindingsHere, the authors have focused on updates into key areas under study for mechanisms driving these cardiovascular disorders in diabetes, including rol...
Source: Current Cardiology Reports - June 3, 2021 Category: Cardiology Source Type: research

Therapeutic Outcomes with Surgical and Medical Management of Primary Aldosteronism
AbstractPurpose of ReviewPrimary aldosteronism (PA) is the most common cause of secondary hypertension and is significantly under-diagnosed. Delays in diagnosis and treatment can lead to cardiovascular morbidity and mortality. The goal of this study is to review the management of PA, with a focus on medical and surgical treatment outcomes.Recent FindingsPA causes cardiovascular dysfunction in excess of degree of hypertension. Adrenalectomy demonstrates a therapeutic advantage over mineralocorticoid antagonist (MRA) therapy, after controlling for degree of hypertension and subtype of PA. Higher rates of atrial fibrillation,...
Source: Current Cardiology Reports - June 3, 2021 Category: Cardiology Source Type: research

Relief of Ischemia in Ischemic Cardiomyopathy
AbstractPurpose of the ReviewIschemic heart disease is among the most common causes of morbidity and mortality worldwide. In its stable manifestation, obstructing coronary artery stenoses prevent myocardial blood flow from matching metabolic needs of the heart under exercise conditions, which manifests clinically as dyspnea or chest pain. Prolonged bouts of ischemia may result in permanent myocardial dysfunction, heart failure, and eventually reduced survival. The aim of the present work is to review currently available approaches to provide relief of ischemia in stable coronary artery disease (CAD).Recent FindingsSeveral ...
Source: Current Cardiology Reports - June 3, 2021 Category: Cardiology Source Type: research

Utility of Cardiac Magnetic Resonance Imaging in the Diagnosis, Prognosis, and Treatment of Infiltrative Cardiomyopathies
AbstractPurpose of ReviewDiagnosis of infiltrative cardiomyopathies can be challenging despite differences in clinical manifestations due to overlapping cardiac manifestations. We review the salient findings by cardiac magnetic resonance imaging that aids in diagnosis, as well the potential implications for prognosis and treatment.Recent FindingsCardiac magnetic resonance imaging has added substantially to our understanding of various infiltrative cardiomyopathies, and the addition of late gadolinium enhancement imaging and parametric mapping has yielded additional insights regarding potential diagnoses, prognosis, and the...
Source: Current Cardiology Reports - June 3, 2021 Category: Cardiology Source Type: research

Sex-Specific Plaque Signature: Uniqueness of Atherosclerosis in Women
AbstractPurpose of ReviewCardiovascular disease is a leading cause of morbidity and mortality in both men and women, although there are notable differences in presentation between men and women. Atherosclerosis remains the predominant driver of coronary heart disease in both sexes; however, sex differences in atherosclerosis should be investigated further to understand clinical manifestations between men and women.Recent FindingsThere are sex differences in the prevalence, progression, and prognostic impact of atherosclerosis. Furthermore, developing evidence demonstrates unique differences in atherosclerotic plaque charac...
Source: Current Cardiology Reports - June 3, 2021 Category: Cardiology Source Type: research

Potential Cardiac Amyloid PET/CT Imaging Targets for Differentiating Immunoglobulin Light Chain From Transthyretin Amyloidosis
AbstractPurpose of the ReviewCardiac involvement in amyloidosis plays a critical role in the clinical manifestation and prognostication. Since advanced treatment options for immunoglobulin light chains (AL) or liver-generated protein transthyretin (TTR) are quite different, a non-invasive and comprehensive imaging approach for the identification and characterization of these forms of cardiac amyloidosis is warranted.Recent FindingsVarious18Flabeled radiotracers and positron emission tomography (PET) imaging have been appreciated as a as a valid and non-invasive diagnostic approach to identify and quantify disease activity ...
Source: Current Cardiology Reports - June 3, 2021 Category: Cardiology Source Type: research