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

Point-of-Care Ultrasound
AbstractPurpose of the ReviewPoint-of-care ultrasound using small ultrasound devices has expanded beyond emergency and critical care medicine to many other subspecialties. Awareness of the strengths and limitations of the technology and knowledge of the appropriate settings and common indications for point-of-care ultrasound is important.Recent FindingsPoint-of-care ultrasound is widely embraced as an extension of the physical exam and is employed in acute care and medical education settings. Echocardiography laboratories involved in education must individualize training to the intended scope of practice of the user. Advan...
Source: Current Cardiology Reports - September 16, 2020 Category: Cardiology Source Type: research

Update on MRI Techniques for Evaluation of Pericardial Disease
AbstractPurpose of ReviewCardiovascular magnetic resonance (CMR) provides the most comprehensive imaging assessment of pericardial disease, providing a three-dimensional assessment of the pericardium, functional assessment of its impact on cardiac contractility, and pericardial tissue/fluid characterization. This review presents an update on the utility of CMR imaging in a wide variety of pericardial diseases.Recent FindingsCMR provides both qualitative and quantitative assessment of the pericardium through various imaging techniques. It can also be used as a guide therapy and delineate response to treatment in pericarditi...
Source: Current Cardiology Reports - September 14, 2020 Category: Cardiology Source Type: research

Should We Use Genetic Scores in the Determination of Treatment Strategies to Control Dyslipidemias?
AbstractPurpose of ReviewConventional risk stratification algorithms that rely on age, clustered phenotypic traits, and biomarkers under-recognize the sizeable subgroup of individuals at high polygenic risk for atherosclerotic cardiovascular disease (ASCVD). This review provides perspective on the promising role of genetic testing in cardiovascular prevention through the lens of lipid metabolism.Recent FindingsRecent advances in cardiovascular genetics identified a number of common and rare variants affecting ASCVD risk. This genetic susceptibility can be assessed by polygenic risk scores (PRS) which quantify risk conferre...
Source: Current Cardiology Reports - September 13, 2020 Category: Cardiology Source Type: research

Intensive Care Unit Management of the Adult with Congenital Heart Disease
AbstractPurposeAdults with congenital heart disease (ACHD) are a rapidly growing population with ever-increasing complexity, and intensive care unit (ICU) management is often necessary. This review summarizes common cardiovascular and non-cardiovascular complications in ACHD and provides a framework for ICU care.Recent FindingsHeart failure is the leading cause of hospitalization and mortality in ACHD. Varied anatomy and repairs, as well as differing physiological complications, limit generalized application of management algorithms. Recent studies suggest that earlier mechanical support in advanced cases is feasible and p...
Source: Current Cardiology Reports - September 9, 2020 Category: Cardiology Source Type: research

Psychological aspects of atrial fibrillation: A systematic narrative review
AbstractPurpose of the reviewAtrial fibrillation (AF) is the most frequent arrhythmia in the general population. This review aims to provide a comprehensive overview of the psychological aspects of AF, compiling evidence from epidemiological, clinical, and basic research sources.Recent findingsFindings from large-scale population-based and clinical longitudinal studies reveal an association between negative affectivity (e.g. depression) and the incidence and clinical prognosis of AF. Studies investigating the impact of work stress parameters on AF onset show conflicting results. Researchers have reported the impact of AF o...
Source: Current Cardiology Reports - September 9, 2020 Category: Cardiology Source Type: research

Update on the Current Status and Indications for Transcatheter Edge-to-Edge Mitral Valve Repair
AbstractPurpose of ReviewTo review the current status and indications of transcatheter edge-to-edge mitral valve repair.Recent FindingsMitral regurgitation remains a common valvular disease and can be classified as degenerative (primary) or functional (secondary). Randomized controlled trials have shown that transcatheter edge-to-edge mitral valve repair with MitraClip is successful, safe, and effective in reducing mitral regurgitation. The US Food and Drug Administration approved MitraClip in 2013 for treatment of patients with primary mitral regurgitation at prohibitive surgical risk and in 2019 for secondary mitral regu...
Source: Current Cardiology Reports - September 9, 2020 Category: Cardiology Source Type: research

Acute Cardiorenal Syndrome in Heart Failure: from Dogmas to Advances
AbstractPurpose of ReviewThis review aims to summarize our current understanding and management strategies of acute cardiorenal syndrome (CRS).Recent FindingsThe definition of acute CRS remains debated, in part due to the lack of reliable insights into salt and water handling of the kidneys beyond impairment in glomerular filtration. Protocolized use of loop diuretics to ensure adequate delivery to their target of action, as well as segmental tubular blockade with adjunctive use of thiazide diuretics, acetazolamide, amiloride, or sodium-glucose transporter 2 (SGLT2) inhibitors, may result in more effective natriuresis in p...
Source: Current Cardiology Reports - September 9, 2020 Category: Cardiology Source Type: research

Medication Non-adherence: a Major Cause of Resistant Hypertension
AbstractPurpose of ReviewAs the global burden of hypertension continues to rise, it remains suboptimally controlled despite increased awareness. Poor medication adherence is a well-recognized although underestimated contributing factor of uncontrolled hypertension. This review focuses on medication non-adherence as an important cause of apparent treatment-resistant hypertension and its impact on patient ’s well-being.Recent FindingsIn addition to biochemical screening, electronic technology —including electronic medication packaging devices such as medication event monitoring system, device integrated care deli...
Source: Current Cardiology Reports - September 9, 2020 Category: Cardiology Source Type: research

Ultrasonography in the Critical Care Unit
This article summarizes the utility and evidence supporting the use of ultrasound exams in the intensive care unit.Recent FindingsPoint-of-care ultrasonography (POCUS) is widely used by intensivists managing critically ill patients whereby they can accurately and rapidly assess for many pathologies such as pneumothorax, pulmonary edema, hydronephrosis, hemoperitoneum, and deep vein thrombosis among others. Basic and advanced critical care echocardiography, including transesophageal echocardiography, are routinely performed to determine the etiology of hemodynamic instability in undifferentiated shock and to guide subsequen...
Source: Current Cardiology Reports - September 9, 2020 Category: Cardiology Source Type: research

The Imaging Toolbox to Assess Patients with Suspected Myocardial Infarction in the Absence of Obstructive Coronary Artery Disease (MINOCA)
AbstractPurpose of ReviewThis paper will review myocardial infarction with non-obstructive coronary arteries (MINOCAs) briefly, and then focus on the imaging tools that should be employed when caring for patients with suspected MINOCA.Recent FindingsDiagnostic imaging has a critical role in assessing patients with suspected or confirmed MINOCA. The extent at which these diagnostic tests are used in any given patient will depend on the clinical acumen for the underlying condition, as well as the available resources.SummaryThere are myriad conditions that can lead to MINOCA; further testing to exclude other underlying causes...
Source: Current Cardiology Reports - September 9, 2020 Category: Cardiology Source Type: research

Artificial Intelligence and Texture Analysis in Cardiac Imaging
AbstractPurpose of ReviewThe aim of this structured review is to summarize the current research applications and opportunities arising from artificial intelligence (AI) and texture analysis with regard to cardiac imaging.Recent FindingsCurrent research findings suggest tremendous potential for AI in cardiac imaging, especially with regard to objective image analyses, overcoming the limitations of an observer-dependent subjective image interpretation. Researchers have used this technique across multiple imaging modalities, for instance to detect myocardial scars in cardiac MR imaging, to predict contrast enhancement in non-...
Source: Current Cardiology Reports - September 9, 2020 Category: Cardiology Source Type: research

Bridging Anticoagulation with Mechanical Heart Valves: Current Guidelines and Clinical Decisions
AbstractPurpose of ReviewThe management of patients with mechanical heart valves who require surgery or invasive procedures is a common clinical scenario in contemporary practice. The risk of thromboembolism versus the risk of bleeding is the foundation of optimal patient care.Recent FindingsRandomized, controlled trials are not available; yet, there is a wealth of experience to guide best practice. Current guidelines represent a compilation of data from trials of atrial fibrillation and expert opinion. Results from the PERI-OP trial of patients with either a mechanical heart valve, atrial fibrillation, or atrial flutter r...
Source: Current Cardiology Reports - September 9, 2020 Category: Cardiology Source Type: research

Permanent Bilateral Carotid Filters for Stroke Prevention in Atrial Fibrillation
AbstractPurpose of ReviewA novel permanent carotid filter device for percutaneous implantation was developed for the purpose of stroke prevention. In this review, we cover rationale, existing preclinical and clinical data, and potential future directions for research using such a device.Recent FindingsThe Vine ™ filter was assessed for safety in sheep and in 2 observational human studies, the completed CAPTURE 1 (n = 25) and the ongoing CAPTURE 2 (plannedn = 100). CAPTURE 1 has shown high procedural and long-term implant safety. A control group was not available for comparison.SummaryA mechanical filter for permanent...
Source: Current Cardiology Reports - September 9, 2020 Category: Cardiology Source Type: research

Healthcare Cost Implications of Utilizing a Dietary Intervention to Lower LDL Cholesterol: Proof of Concept Actuarial Analysis and Recommendations
AbstractPurpose of ReviewTo determine if subsidizing the cost of a food-based intervention for managing hyperlipidemia could be cost-effective under commercial insurance and/or Medicare coverage scenarios.Recent FindingsA large number of patients eligible for pharmaceutical treatment of hyperlipidemia either cannot or will not use lipid lowering drugs, leaving them at increased cardiovascular risk. Lipid levels can be modified by diet, but food has never enjoyed covered benefit status. We evaluated the financial implications of providing insurance coverage for a specifically formulated suite of food products previously doc...
Source: Current Cardiology Reports - September 9, 2020 Category: Cardiology Source Type: research

Important Considerations in Pediatric Heart Failure
AbstractPurpose of ReviewThe goal of this paper is to provide an overview of contemporary knowledge specific to the causes, management, and outcome of heart failure in children.Recent FindingsWhile recently there have been subtle improvements in heart failure outcomes in children, these improvements lag significantly behind that of adults. There is a growing body of literature suggesting that pediatric heart failure is a unique disease process with age- and disease-specific myocardial adaptations. In addition, the heterogenous etiologies of heart failure in children contribute to differential response to therapies and chal...
Source: Current Cardiology Reports - September 9, 2020 Category: Cardiology Source Type: research

Advances in the Genetics and Genomics of Heart Failure
AbstractPurpose of ReviewThe purpose of this review is to provide an update on the recent advances in the genetics and genomics of dilated cardiomyopathy and heart failure.Recent FindingsOver the last decade, the approach to the discovery of the genetic contribution to heart failure has evolved from investigation of rare variants implicated in Mendelian cardiomyopathies through linkage studies and candidate gene studies to the exploration of the contribution of common variants through large-scale genome-wide association and genome-first studies.SummaryThe combination and integration of multiple of case-control heart failur...
Source: Current Cardiology Reports - September 9, 2020 Category: Cardiology Source Type: research

Mineralocorticoid Receptor Antagonists: a Comprehensive Review of Finerenone
AbstractPurpose of ReviewWe aim to review the mechanism of action and safety profile of mineralocorticoid receptor antagonists (MRAs) and discuss the differences between selective and non-selective MRAs. More specifically, finerenone is a new medication that is currently under investigation for its promising cardiovascular and nephrological effects.Recent FindingsMRAs are well known for their utility in treating heart failure, refractory hypertension, and diverse nephropathies, namely, diabetic nephropathy. As their name denotes, MRAs inhibit the action of aldosterone at the mineralocorticoid receptor, preventing receptor ...
Source: Current Cardiology Reports - September 9, 2020 Category: Cardiology Source Type: research