Role of Exercise as a Modulating Factor in Arrhythmogenic Cardiomyopathy
AbstractPurpose of ReviewThe review addresses the role of exercise in triggering ventricular arrhythmias and promoting disease progression in arrhythmogenic cardiomyopathy (AC) patients and gene-mutation carriers, the differential diagnosis between AC and athlete ’s heart and current recommendations on exercise activity in AC.Recent FindingsAC is an inherited heart muscle disease caused by genetically defective cell-to-cell adhesion structures (mainly desmosomes). The pathophysiological hallmark of the disease is progressive myocyte loss and replacement by fibro-fatty tissue, which creates the substrates for ventricu...
Source: Current Cardiology Reports - May 7, 2021 Category: Cardiology Source Type: research

Nuclear Imaging for the Assessment of Cardiotoxicity from Chemotherapeutic Agents in Oncologic Disease
AbstractPurpose of ReviewIn this review, we summarize the major known cardiac toxicities of common chemotherapeutic agents and the role of nuclear cardiac imaging for the surveillance and assessment of cancer therapeutics –related cardiac dysfunction in routine clinical practice.Recent FindingsCardiotoxicity from chemotherapy causes a significant mortality and limits potentially life-saving treatment in cancer patients. Close monitoring of cardiac function during chemotherapy is an accepted method for reducing these adverse effects especially in patients with cancer therapeutics –related cardiac dysfunction. Nu...
Source: Current Cardiology Reports - May 7, 2021 Category: Cardiology Source Type: research

SGLT-2 Inhibitors in Heart Failure: Guide for Prescribing and Future Perspectives
AbstractPurpose of ReviewHeart failure is responsible for a significant part of diabetes-associated cardiovascular mortality and morbidity. Sodium-glucose cotransporter-2 (SGLT-2) inhibitors are novel agents approved for the treatment of diabetes mellitus; in recent clinical trials, these agents have shown a significant reduction in cardiovascular death and hospitalization secondary to heart failure.Recent FindingsClinical trials with specific heart failure outcomes have shown the benefit of SGLT-2 inhibitors in reducing the mortality and morbidity associated with heart failure. The guidelines for the management of diabete...
Source: Current Cardiology Reports - May 7, 2021 Category: Cardiology Source Type: research

The Use of Subclinical Atherosclerosis Imaging to Guide Preventive Cardiology Management
AbstractPurpose of the ReviewClinical atherosclerotic cardiovascular disease (ASCVD) requires years to manifest, providing a window of opportunity for preventive cardiovascular management. Subclinical atherosclerosis imaging leverages this long latency period to estimate and improve future ASCVD risk.Recent FindingsCoronary artery calcium (CAC) scoring has the most robust data in the detection of subclinical atherosclerosis. CAC scan significantly enhances cardiovascular risk stratification in addition to traditional risk models. Coronary computed tomography angiography data show similar strengths in subclinical atheroscle...
Source: Current Cardiology Reports - May 7, 2021 Category: Cardiology Source Type: research

Loneliness and Risk for Cardiovascular Disease: Mechanisms and Future Directions
We present evidence for mechanisms underlying this association and propose directions for future research.Recent findingsLoneliness is related to increased risk of early mortality and CVD comparable to other well-established risk factors such as obesity or smoking.SummaryLoneliness has been linked to higher rates of incident CVD, poorer CVD patient outcomes, and early mortality from CVD. Loneliness likely affects risk for these outcomes via health-related behaviours (e.g. physical inactivity and smoking), biological mechanisms (e.g. inflammation, stress reactivity), and psychological factors (e.g. depression) to indirectly...
Source: Current Cardiology Reports - May 7, 2021 Category: Cardiology Source Type: research

The Role of Cardiovascular Magnetic Resonance in ARVC
AbstractPurpose of ReviewAim of the paper was to address all strengths and weakness of cardiac magnetic resonance (CMR) in arrhythmogenic cardiomyopathy, trying to highlight areas where further research and investigations should be carried out to fill current gaps in scientific knowledge.Recent FindingsArrhythmogenic cardiomyopathy represents a multifaceted clinical entity associated with arrhythmias and sudden death. Even though different diagnostic tools are available for appropriate identification and risk stratification, over the last few years cardiac magnetic resonance (CMR) has surfaced as an unmatched non-invasive ...
Source: Current Cardiology Reports - May 7, 2021 Category: Cardiology Source Type: research

Myocarditis: Which Role for Genetics?
AbstractPurpose of ReviewMyocarditis is a polymorphic disease, both in its presentation and clinical course. Recent data suggests that the genetic background, interacting with environmental factors, could be diriment both in the susceptibility and evolution of myocarditis in different clinical presentations. The aim of this paper is to expose the current available evidences and the evolving concepts on this topic, in order to provide insight for improving the clinical management of those patients. In this regard, the main goal is an optimal characterization of each patient ’s risk, with the purpose of individualizing...
Source: Current Cardiology Reports - May 7, 2021 Category: Cardiology Source Type: research

Pheochromocytoma and Paraganglioma in Pregnancy: a New Era
ConclusionsMedical therapy should be initiated when PPGL is diagnosed in pregnancy. Antepartum surgery should be reserved for special circumstances. Case detection testing in high-risk patients can identify PPGL before pregnancy. (Source: Current Cardiology Reports)
Source: Current Cardiology Reports - May 7, 2021 Category: Cardiology Source Type: research

Invasive Therapies for Acute Coronary Syndromes in the COVID-19 Era
AbstractPurpose of ReviewTo identify and address the challenges associated with the care of ACS patients during the coronavirus 2019 pandemic.Recent FindingsThe COVID-19 pandemic has had a considerable global impact with over 2.0 million deaths worldwide so far. There has been considerable evidence suggesting that COVID-19 increases the risk of acute coronary syndromes (ACS).SummaryWe propose characterizing ACS patients into 3 distinct categories to better assist in appropriate triage and management: critically ill patients, non-critically ill ST elevation myocardial infarction (STEMI) patients, and non-critically ill non-...
Source: Current Cardiology Reports - May 7, 2021 Category: Cardiology Source Type: research

Impact of Early Blood Pressure Lowering in Patients Presenting with Acute Ischemic Stroke
AbstractPurpose of ReviewIn this review article we will discuss the acute hypertensive response in the context of acute ischemic stroke and present the latest evidence-based concepts of the significance and management of the hemodynamic response in acute ischemic stroke.Recent FindingsAcute hypertensive response is considered a common hemodynamic physiologic response in the early setting of an acute ischemic stroke. The significance of the acute hypertensive response is not entirely well understood. However, in certain types of acute ischemic strokes, the systemic elevation of the blood pressure helps to maintain the colla...
Source: Current Cardiology Reports - May 7, 2021 Category: Cardiology Source Type: research

Aspirin, Statins, and Primary Prevention: Opportunities for Shared Decision Making in the Face of Uncertainty
AbstractPurpose of ReviewThe utility of aspirin and statins for primary prevention of atherosclerotic cardiovascular disease remains ambiguous in older adults. Current guidelines and recent data are vague and inconclusive. This review seeks to summarize the landscape of primary prevention of cardiovascular disease in older adults and explore the role of shared decision making.Recent FindingsObservational data suggest potential benefit of statin therapy in older adults. Aspirin is presently not recommended for primary prevention based on evidence from recent clinical trials. The implementation of shared decision making and ...
Source: Current Cardiology Reports - May 7, 2021 Category: Cardiology Source Type: research

Should We Be Using Upstream Beta-Blocker Therapy for Acute Myocardial Infarction?
AbstractPurpose of ReviewControversy exists whether beta-blockers should be given before primary percutaneous coronary intervention (PCI) or to defer their administration for up to 24 hours.Recent FindingsAnimal studies, most of them conducted in the 1970s and 1980s, showed evidence that early beta-blocker administration may reduce infarct size. Subsequent human studies had mixed results on infarct size and survival. More specifically, in the current primary PCI era, only four studies evaluated the impact of early intravenous beta-blocker administration after acute myocardial infarction, only two of them before PCI. All st...
Source: Current Cardiology Reports - May 7, 2021 Category: Cardiology Source Type: research

Remote monitoring and telemedicine in heart failure: implementation and benefits
AbstractPurpose of reviewRemote monitoring (RM) of cardiac implantable electronic devices (CIEDs) is recommended as part of the individualized multidisciplinary follow-up of heart failure (HF) patients. Aim of this article is to critically review recent findings on RM, highlighting potential benefits and barriers to its implementation.Recent findingsDevice-based RM is useful in the early detection of CIEDs technical issues and cardiac arrhythmias. Moreover, RM allows the continuous monitoring of several patients' clinical parameters associated with impending HF decompensation, but there is still uncertainty regarding its e...
Source: Current Cardiology Reports - May 7, 2021 Category: Cardiology Source Type: research

Drug Repurposing: Claiming the Full Benefit from Drug Development
AbstractPurpose of ReviewDrug development has evolved over the years from being one-at-a-time to be massive screens in an industrial manner. Bringing a new therapeutic agent from concept to bedside can take a decade and cost billions of dollars —with most concepts failing along the way. Of the few compounds that make it to clinical testing, less than one out of eight make it to approval. This traditional drug development pipeline is challenging for prevalent diseases and makes the development of new therapeutics for rare diseases financi ally intractable.Recent FindingsRepurposing of drugs is an alternative to identi...
Source: Current Cardiology Reports - May 7, 2021 Category: Cardiology Source Type: research

Olive Oil Intake and Cardiovascular Disease Prevention: “Seek and You Shall Find”
AbstractPurpose of ReviewThe present narrative review focuses on the up-to-date clinical data on the correlations between olive oil consumption and cardiovascular (CV) diseases (i.e., CHD, stroke, and peripheral artery disease).Recent FindingsOlive oil contains monounsaturated fats, several antioxidant phenols, and other micronutrients that mediate CV-protective effects via improvements in oxidative stress, endothelial dysfunction, inflammation, thrombosis, blood pressure, and lipid and carbohydrate metabolism. High consumption of olive oil, and in particular the extra-virgin, which is rich in phenolic antioxidants, has be...
Source: Current Cardiology Reports - May 7, 2021 Category: Cardiology Source Type: research

Role of Catheter Ablation for Ventricular Arrhythmias in Brugada Syndrome
AbstractPurpose of ReviewTo discuss the role of catheter ablation in treating life-threatening ventricular arrhythmias associated with Brugada syndrome (BrS), by presenting recent findings of BrS arrhythmogenic substrate, mechanisms underlying ventricular arrhythmias, and how they can be treated with catheter ablation.Recent FindingsAlmost three decades ago when the clinical entity of Brugada syndrome (BrS) was described in patients who had abnormal coved-type ST elevation in the right precordial EKG leads in patients who had no apparent structural heart disease but died suddenly from ventricular fibrillation. Since its de...
Source: Current Cardiology Reports - April 24, 2021 Category: Cardiology Source Type: research

A Disruptive Technology: Determining Need for Permanent Pacing After TAVR
AbstractPurpose of ReviewTranscatheter aortic valve replacement (TAVR) has changed the paradigm for management of severe aortic stenosis. Despite evolution of TAVR over the past 2 decades, conduction system disturbances remain a concern post-TAVR. In this review, we describe (1) permanent pacemaker (PP) implant rates associated with TAVR, (2) risk factors predicting need for PP therapy post-TAVR, (3) management of perioperative conduction abnormalities, and (4) novel areas of research.Recent FindingsConduction disturbances remain a common issue post-TAVR, in particular, left bundle branch block (LBBB). Though newer data de...
Source: Current Cardiology Reports - April 16, 2021 Category: Cardiology Source Type: research

Atherosclerotic Cardiovascular Disease in Individuals with Hepatitis C Viral Infection
AbstractPurpose of ReviewHepatitis C virus (HCV) and atherosclerotic cardiovascular disease (ASCVD) are two diseases that affect millions around the globe. Hepatitis C affects more than 70 million individuals globally. ASCVD is commonly encountered and remains the top cause of death worldwide. A link has been identified between HCV and atherosclerosis.Recent FindingsA review of recent studies which define the association between HCV infection and an increased risk of subclinical ASCVD and experiencing cardiovascular (CV) events.SummaryIt is now recognized that there is an increased burden of atherosclerosis in individuals ...
Source: Current Cardiology Reports - April 6, 2021 Category: Cardiology Source Type: research

Correction to: Transcatheter Mitral Valve Implantation Systematic Review: Focuson Transseptal Approach and Mitral Annulus Calcification
A Correction to this paper has been published:https://doi.org/10.1007/s11886-021-01502-6 (Source: Current Cardiology Reports)
Source: Current Cardiology Reports - April 3, 2021 Category: Cardiology Source Type: research

PET Stress Testing with Coronary Flow Capacity in the Evaluation of Patients with Coronary Artery Disease and Left Ventricular Dysfunction: Rethinking the Current Paradigm
AbstractPurpose of ReviewCardiomyopathy with underlying left ventricular (LV) dysfunction is a heterogenous group of disorders that may be present with, and/or secondary to, coronary artery disease (CAD). The purpose of this review is to demonstrate, via case illustrations, the benefits offered by cardiac positron-emission tomography (PET) stress testing with coronary flow capacity (CFC) in the evaluation and treatment of patients with left ventricular (LV) dysfunction and CAD.Recent FindingsCFC, a metric that is increasing in prominence, represents the integration of several absolute perfusion metrics into clinical strata...
Source: Current Cardiology Reports - March 24, 2021 Category: Cardiology Source Type: research

Exercise Participation for Patients with Valvular Heart Disease: a Review of the Current Guidelines
AbstractPurpose of ReviewValvular heart disease affects many individuals who aspire to partake in competitive or recreational sports. This manuscript reviews the most recent European and American guidelines related to exercise and sport participation in individuals with valvular heart disease (VHD) and identifies areas not addressed by these guidelines.Recent FindingsExercise recommendations for individuals with VHD have been presented since at least 1984. There is limited data on the impact of intensive physical activity on the progression and outcomes of VHD. Therefore, current recommendations are based on consensus opin...
Source: Current Cardiology Reports - March 19, 2021 Category: Cardiology Source Type: research

The Safety of Paclitaxel-Coated Devices for Patients with Peripheral Artery Disease
AbstractPurpose of ReviewPeripheral artery disease (PAD) is a common, debilitating disease that impacts 8.5 million Americans and carries a poor prognosis. The most common manifestation of lower extremity PAD is claudication —a condition which significantly reduces quality of life and functional status. Paclitaxel-coated balloons and stents (PCBs and PESs) represented a breakthrough in the ability to treat medication-refractory patients relative to bare metal stents (BMSs) and percutaneous transluminal angioplasty (PT A) because they improve primary patency rates, reduce target lesion revascularization (TLR), and min...
Source: Current Cardiology Reports - March 18, 2021 Category: Cardiology Source Type: research

Current Challenges and Solutions to Tissue Engineering of Large-scale Cardiac Constructs
AbstractPurpose of ReviewLarge-scale tissue engineering of cardiac constructs is a rapidly advancing field; however, there are several barriers still associated with the creation and clinical application of large-scale engineered cardiac tissues. We provide an overview of the current challenges and recently (within the last 5 years) described promising solutions to overcoming said challenges.Recent FindingsThe five major criteria yet to be met for clinical application of engineered cardiac tissues are successful electrochemical/mechanical cell coupling, efficient maturation of cardiomyocytes, functional vascularization of ...
Source: Current Cardiology Reports - March 17, 2021 Category: Cardiology Source Type: research

Taking Data Science to Heart: Next Scale of Gene Regulation
AbstractPurpose of ReviewTechnical advances have facilitated high-throughput measurements of the genome in the context of cardiovascular biology. These techniques bring a deluge of gargantuan datasets, which in turn present two fundamentally new opportunities for innovation —data processing and knowledge integration—toward the goal of meaningful basic and translational discoveries.Recent FindingsBig data, integrative analyses, and machine learning have brought cardiac investigations to the cutting edge of chromatin biology, not only to reveal basic principles of gene regulation in the heart, but also to aid in ...
Source: Current Cardiology Reports - March 15, 2021 Category: Cardiology Source Type: research

Multimodality Imaging for Cardiac Evaluation in Patients with COVID-19
AbstractPurpose of ReviewA growing number of cardiovascular manifestations resulting from the novel SARS-CoV-2 coronavirus (COVID-19) have been described since the beginning of this global pandemic. Acute myocardial injury is common in this population and is associated with higher rates of morbidity and mortality. The focus of this review centers on the recent applications of multimodality imaging in the diagnosis and management of COVID-19-related cardiovascular conditions.Recent FindingsIn addition to standard cardiac imaging techniques such as transthoracic echocardiography, other modalities including computed tomograph...
Source: Current Cardiology Reports - March 15, 2021 Category: Cardiology Source Type: research

Stroke Rates Following Surgical Versus Percutaneous Revascularization for Ischemic Heart Disease
AbstractPurpose of ReviewCoronary revascularization is a commonly performed major procedure in the hospitals. Stroke is one of the dreaded complications after coronary revascularization procedures. The focus of this review is to understand the stroke risk in percutaneous cutaneous intervention (PCI) and coronary artery bypass grafting (CABG) procedures.Recent FindingsAvailable data show that PCI offers less procedural stroke risk compared to CABG although the survival benefits of CABG are better in certain scenarios. Innovative advancements in techniques, pre-procedural optimum medical therapy (OMT), intraoperative neuro-m...
Source: Current Cardiology Reports - March 15, 2021 Category: Cardiology Source Type: research

PET/CT Myocardial Perfusion Imaging Acquisition and Processing: Ten Tips and Tricks to Help You Succeed
AbstractPurpose of ReviewPositron emission tomography (PET) is a leading non-invasive modality for the diagnosis of coronary artery disease due to its diagnostic accuracy and high image quality. With the latest advances in PET systems, clinicians are able to assess for myocardial ischemia and myocardial blood flow while exposing patients to extremely low radiation doses. This review will focus on the basics of acquisition and processing of hybrid PET/CT systems from appropriate patient selection to common artifacts and pitfalls.Recent FindingsThe continued development of hybrid PET/CT technology is producing scanners with ...
Source: Current Cardiology Reports - March 11, 2021 Category: Cardiology Source Type: research

The Cardiovascular Effects of Electronic Cigarettes
AbstractPurpose of ReviewElectronic cigarettes (e-cigarettes) are gaining rapid popularity among all age groups, especially among youth. They have evolved into technologically advanced devices capable of delivering nicotine concentration and other substances. In addition to nicotine, e-cigarettes ’ constituents possess variety of toxic chemicals that have adverse effects on human body.Recent FindingsIn recent years, steady downward trend in tobacco usage has been observed; however, e-cigarette use is on upward trend. E-cigarettes are advertised as “safer” alternatives to conventional smoking and as an aid...
Source: Current Cardiology Reports - March 11, 2021 Category: Cardiology Source Type: research

Cardiac Rehab in the COVID Era and Beyond: mHealth and Other Novel Opportunities
AbstractPurpose of ReviewThe COVID-19 pandemic has forced many center-based cardiac rehabilitation (CBCR) programs to close or limit their usual offerings. In order for patients to continue to benefit from CR, programs need to rapidly adapt to the current environment. This review highlights ways CR has evolved, and reviews the history of CR and recent advancements in telemedicine including remote patient monitoring, and mobile health that can be applied to CR.Recent FindingsDespite that initial studies indicate that home-based CR (HBCR) is safe and effective, HBCR has faced several challenges that have prevented it from be...
Source: Current Cardiology Reports - March 11, 2021 Category: Cardiology Source Type: research

Clinical Implications of the ISCHEMIA Trial: Invasive vs Conservative Approach in Stable Coronary Disease
AbstractPurpose of ReviewTo identify key strengths and weaknesses of the International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) trial and explore its clinical implications in patients with stable ischemic heart disease.Recent FindingsPrevious studies have shown inconsistent benefit of early angiography and revascularization in patients with stable ischemic heart disease. The ISCHEMIA trial showed no significant reduction in mortality or cardiovascular outcomes in patients undergoing early angiography and revascularization with guideline-directed medical therapy compared to p...
Source: Current Cardiology Reports - March 11, 2021 Category: Cardiology Source Type: research

Understanding Heart Field Progenitor Cells for Modeling Congenital Heart Diseases
AbstractPurpose of ReviewHeart development is a meticulously coordinated process that involves the specification of two distinct populations of cardiac progenitor cells, namely the first and the second heart field. Disruption of heart field progenitors can result in congenital heart defects. In this review, we aim to describe the signaling pathways and transcription factors that link heart field development and congenital heart disease.Recent FindingsSingle-cell transcriptomics, lineage-tracing mouse models, and stem cell-based in vitro modeling of cardiogenesis have significantly improved the spatiotemporal characterizati...
Source: Current Cardiology Reports - March 11, 2021 Category: Cardiology Source Type: research

Prevention and Management of Urgent/Emergent Limb Ischemia
AbstractPurpose of ReviewPatients who require urgent or emergent peripheral revascularization represent one of the highest risk subgroups of PAD patients. They suffer unacceptably high complication rates including recurrent ALI, vascular amputation, and death. In this article, we examine (1) the burden of cardiovascular complications according to PAD severity, (2) discuss medical optimization to improve vascular outcomes in symptomatic LE-PAD patients, and (3) review the evidence for management of patients following urgent/emergent limb ischemia.Recent FindingsThe VOYAGER trial recently demonstrated that rivaroxaban 2.5 mg...
Source: Current Cardiology Reports - March 11, 2021 Category: Cardiology Source Type: research

Transcatheter Mitral Valve Implantation Systematic Review: Focus on Transseptal Approach and Mitral Annulus Calcification
ConclusionTMVI seems to be feasible, achieving good technical success and predictable and durable MR reduction. (Source: Current Cardiology Reports)
Source: Current Cardiology Reports - March 9, 2021 Category: Cardiology Source Type: research

Cardiovascular Magnetic Resonance Imaging and Heart Failure
AbstractPurpose of ReviewThe purpose of this review is to summarize the application of cardiac magnetic resonance (CMR) in the diagnostic and prognostic evaluation of patients with heart failure (HF).Recent FindingsCMR is an important non-invasive imaging modality in the assessment of ventricular volumes and function and in the analysis of myocardial tissue characteristics. The information derived from CMR provides a comprehensive evaluation of HF. Its unique ability of tissue characterization not only helps to reveal the underlying etiologies of HF but also offers incremental prognostic information.SummaryCMR is a useful ...
Source: Current Cardiology Reports - March 8, 2021 Category: Cardiology Source Type: research

Evolution and Outcomes of Premature Coronary Artery Disease
AbstractPurpose of ReviewThe purpose of this review is to explore the evolution and outcomes of premature coronary artery disease (PCAD) while reviewing strategies for effective screening of those at high risk for developing this disease.Recent FindingsPremature coronary artery disease (PCAD) affects a population of patients not typically identified as high risk by current risk stratification guidelines or traditional risk calculation tools. Not only does PCAD represent a large proportion of overall cardiovascular disease, it also afflicts a population in which the rate of mortality from cardiovascular disease has plateaue...
Source: Current Cardiology Reports - March 8, 2021 Category: Cardiology Source Type: research

Therapeutic Approach to Calcified Coronary Lesions: Disruptive Technologies
AbstractPurpose of ReviewModerate or severe calcification is present in approximately one third of coronary lesions in patients with stable ischemic heart disease and acute coronary syndromes and portends unfavorable procedural results and long-term outcomes. In this review, we provide an overview on the state-of-the-art in evaluation and treatment of calcified coronary lesions.Recent FindingsIntravascular imaging (intravascular ultrasound or optical coherence tomography) can guide percutaneous coronary intervention of severely calcified lesions. New technologies such as orbital atherectomy and intravascular lithotripsy ha...
Source: Current Cardiology Reports - March 5, 2021 Category: Cardiology Source Type: research

Ischemia-Guided Approach Versus Early Invasive Approach for NSTE-ACS: How Early Is Early?
AbstractPurpose of ReviewNon-ST segment elevation acute coronary syndromes (NSTE-ACS) account for 70% of the patients with ACS. Most NSTE-ACS patients receive invasive therapies. Despite improvements in the systems of care and interventional techniques, the mortality of NSTE-ACS patients remains high, and delays in the treatment of NSTE-ACS patients continue to be a problem. This paper aims to discuss the importance of timeliness of invasive strategy in the treatment of NSTE-ACS as well as the state-of-the-art approach to this critical health problem.Recent FindingsThe relatively recent guidelines and meta-analyses on the ...
Source: Current Cardiology Reports - March 5, 2021 Category: Cardiology Source Type: research

Successful Peripheral Vascular Intervention in Patients with High-risk Comorbidities or Lesion Characteristics
AbstractPurpose of ReviewCertain comorbidities and lesion characteristics are associated with increased risk for procedural complications, limb events, and cardiovascular events following peripheral vascular intervention (PVI) in patients with peripheral arterial disease (PAD). The purpose of this review is to provide an overview of high-risk modifiable and unmodifiable patient characteristics and its relative impact on clinical outcomes such as amputation risk and mortality. Furthermore, general approaches to potentially mitigating these risks through pre-intervention planning and use of modern devices and techniques are ...
Source: Current Cardiology Reports - March 5, 2021 Category: Cardiology Source Type: research

Medical Therapy Versus Revascularization in Patients with Stable Ischemic Heart Disease and Advanced Chronic Kidney Disease
This article reviews the evidence on optimal medical therapy (OMT) versus coronary revascularization in patients with stable ischemic heart disease (SIHD) and advanced chronic kidney disease (CKD).Recent FindingsA post hoc analysis of the COURAGE trial in patients with SIHD and CKD showed no difference in freedom from angina, death, and nonfatal myocardial infarction (MI) between OMT and percutaneous intervention plus OMT compared with patients without CKD. The ISCHEMIA-CKD trial of 777 patients with advanced CKD revealed no difference in cumulative incidence of death or nonfatal MI at 3 years between OMT and revasculariza...
Source: Current Cardiology Reports - March 2, 2021 Category: Cardiology Source Type: research

Mechanisms and Treatment of Dyslipidemia in Diabetes
AbstractPurpose of ReviewType 2 diabetes mellitus is widespread throughout the world and is a powerful risk factor for the development of atherosclerotic cardiovascular disease (ASCVD). This manuscript explored the mechanisms underlying dyslipidemia in type 2 diabetes as well as currently available treatment options and guideline recommendations.Recent FindingsType 2 diabetes is associated with a characteristic pattern of dyslipidemia, often termed diabetic dyslipidemia. Patients with type 2 diabetes often present with low HDL levels, elevated levels of small dense LDL particles, and elevated triglyceride levels. LDL lower...
Source: Current Cardiology Reports - March 2, 2021 Category: Cardiology Source Type: research

Glucose-Lowering Medications and Cardiovascular Outcomes
AbstractPurpose of the ReviewThe purpose of this review is to examine recent evidence supporting CV safety profile and improvement of CV outcomes of some of the newer classes of diabetic medications.Recent FindingsDiabetes mellitus (DM) is associated with increased risk of cardiovascular disease (CVD). Thus, CVD management is critical in diabetic patients. Since 2008, the US Food and Drug Administration (FDA) has mandated that all newer diabetic medications should establish cardiovascular safety before it is approved for use. Diabetic medications that also lower CV risk would be a significant advancement as shown in recent...
Source: Current Cardiology Reports - March 2, 2021 Category: Cardiology Source Type: research

Into a Fluoroless Future: an Appraisal of Fluoroscopy-Free Techniques in Clinical Cardiac Electrophysiology
AbstractPurpose of ReviewThere are risks to both patients and electrophysiology providers from radiation exposure from fluoroscopic imaging, and there is increased interest in fluoroscopic reduction. We review the imaging tools, their applications, and current uses to eliminate fluoroscopy.Recent FindingsMultiple recent studies provide supporting evidence for the transition to fluoroscopy-free techniques for both ablations and device implantation. The most frequently used alternative imaging approaches include intracardiac echocardiography, cardiac MRI guidance, and 3D electroanatomic mapping systems. Electroanatomic mappi...
Source: Current Cardiology Reports - March 2, 2021 Category: Cardiology Source Type: research

A Roadmap to Heart Regeneration Through Conserved Mechanisms in Zebrafish and Mammals
AbstractPurpose of ReviewThe replenishment of lost or damaged myocardium has the potential to reverse heart failure, making heart regeneration a goal for cardiovascular medicine. Unlike adult mammals, injury to the zebrafish or neonatal mouse heart induces a robust regenerative program with minimal scarring. Recent insights into the cellular and molecular mechanisms of heart regeneration suggest that the machinery for regeneration is conserved from zebrafish to mammals. Here, we will review conserved mechanisms of heart regeneration and their translational implications.Recent FindingsBased on studies in zebrafish and neona...
Source: Current Cardiology Reports - March 2, 2021 Category: Cardiology Source Type: research

New Insights into the Role of Visit-to-Visit Glycemic Variability and Blood Pressure Variability in Cardiovascular Disease Risk
AbstractPurpose of ReviewThere is evidence from epidemiologic studies that variability in cardiovascular risk factors influences risk of cardiovascular disease. We review new studies and novel findings in the relationship between visit-to-visit glycemic variability and blood pressure variability and risk of adverse outcomes.Recent FindingsVisit-to-visit glycemic variability is consistently linked to macrovascular disease. This relationship has been observed in both clinical trials and retrospective studies of electronic health records. Long-term blood pressure variability also predicts cardiovascular outcomes, and the asso...
Source: Current Cardiology Reports - March 2, 2021 Category: Cardiology Source Type: research

Direct Oral Anticoagulant Use in Special Populations: Elderly, Obesity, and Renal Failure
AbstractPurpose of ReviewThe purpose of this review is to examine the safety and effectiveness of direct oral anticoagulants and provide recommendations for the treatment of venous thromboembolism and atrial fibrillation in obese patients, elderly patients, and patients with chronic kidney disease.Recent FindingsMultiple retrospective cohort studies have shown no difference in bleeding, stroke, or venous thromboembolism outcomes between DOACs and warfarin in patients who are obese, elderly, or those with chronic kidney disease or on dialysis. Some studies have shown that DOACs have a lower bleeding risk than warfarin in th...
Source: Current Cardiology Reports - March 2, 2021 Category: Cardiology Source Type: research

Coronary Sinus Reducer for the Treatment of Chronic Refractory Angina: Will This Challenge the Treatment of Coronary Chronic Total Occlusions?
AbstractPurpose of ReviewThe prevalence of angina despite optimal medical therapy is high among patients with coronary chronic total occlusions. Despite advancements in techniques and operator ’s experience, percutaneous revascularization of coronary chronic total occlusions is still associated with a not negligible risk of failures and complications. The Coronary Sinus Reducer, a new device developed to improve angina, has shown promising results in terms of efficacy and safety in pati ents with refractory symptoms. The aim of this review is to summarize the evidence so far available and to guide clinicians in the s...
Source: Current Cardiology Reports - March 2, 2021 Category: Cardiology Source Type: research

New Research Is Shining Light on How Collateral Arteries Form in the Heart: a Future Therapeutic Direction?
AbstractPurpose of ReviewCollateral arteries create artery-artery anastomoses that could serve as natural bypasses that in the heart could relieve the various complications of ischemia heart disease. Recent work using animal models have begun to reveal details of how coronary collateral arteries form.Recent FindingsMouse genetics has been used to study the cellular and molecular mechanisms of collateral artery development. Collateral arteries are not pre-existing in the mouse heart, and only form in response to injury. Myocardial infarction creates tissue hypoxia that triggers the expression of growth factors and chemokine...
Source: Current Cardiology Reports - March 2, 2021 Category: Cardiology Source Type: research

Comprehensive Care Models for Cardiometabolic Disease
AbstractPurpose of ReviewThe high burden of cardiovascular disease and the simultaneous obesity pandemic is placing an extraordinary strain on the health care system. In the current siloed care model, patients with cardiometabolic disease receive only fractionated care from multiple specialists, leading to insufficient treatment, higher costs, and worse outcomes.Recent FindingsThe imminent need for a new care model calls for the creation of a distinct cardiometabolic specialty in conjunction with a cardiometabolic outpatient clinic dedicated to the comprehensive cardiometabolic care. The cardiometabolic clinic would consis...
Source: Current Cardiology Reports - February 24, 2021 Category: Cardiology Source Type: research

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