Exercise as Medicine: Evaluation and Prescription for Adults with Congenital Heart Disease
AbstractPurpose of ReviewUnderstanding exercise physiology as it relates to adult congenital heart disease (ACHD) can be complex. Here we review fundamental physiologic principles and provide a framework for application to the unique ACHD patient population.Recent FindingsACHD exercise participation has changed dramatically in the last 50 years. A modern approach focuses on exercise principles and individual anatomic and physiologic considerations. With an evolving better understanding of ACHD exercise physiology, we can strategize plans for patients to participate in dynamic and static exercises. Newly developed technol...
Source: Current Cardiology Reports - December 20, 2023 Category: Cardiology Source Type: research
Infective Endocarditis Antibiotic Prophylaxis: Review of the Evidence and Guidelines
AbstractPurpose of ReviewThe question of antibiotic prophylaxis and its role in prevention of infective endocarditis (IE) remains controversial, with differing recommendations from international societies. The aim of this review was to compare and contrast current recommendations on antibiotic prophylaxis for IE by the American Heart Association (AHA), the European Society of Cardiology (ESC), and the National Institute for Health and Care Excellence (NICE) and highlight the evidence supporting these recommendations.Recent FindingsInternational guidelines for administration of antibiotic prophylaxis for prevention of IE ar...
Source: Current Cardiology Reports - December 20, 2023 Category: Cardiology Source Type: research
Medical and Mechanical Circulatory Support of the Failing Right Ventricle
AbstractPurpose of ReviewTo describe medical therapies and mechanical circulatory support devices used in the treatment of acute right ventricular failure.Recent FindingsExperts have proposed several algorithms providing a stepwise approach to medical optimization of acute right ventricular failure including tailored volume administration, ideal vasopressor selection to support coronary perfusion, inotropes to restore contractility, and pulmonary vasodilators to improve afterload. Studies have investigated various percutaneous and surgically implanted right ventricular assist devices in several clinical settings.SummaryThe...
Source: Current Cardiology Reports - December 18, 2023 Category: Cardiology Source Type: research
The Role of Artificial Intelligence in Echocardiography: A Clinical Update
AbstractPurpose of reviewIn echocardiography, there has been robust development of artificial intelligence (AI) tools for image recognition, automated measurements, image segmentation, and patient prognostication that has created a monumental shift in the study of AI and machine learning models. However, integrating these measurements into complex disease recognition and therapeutic interventions remains challenging. While the tools have been developed, there is a lack of evidence regarding implementing heterogeneous systems for guiding clinical decision-making and therapeutic action.Recent findingsNewer AI modalities have...
Source: Current Cardiology Reports - December 13, 2023 Category: Cardiology Source Type: research
Assessment of the Severity of Aortic Regurgitation by Noninvasive Imaging
AbstractPurpose of the ReviewThe role of multimodality imaging in the evaluation of patients with aortic regurgitation is summarized in this review.Recent FindingsThe etiology (mechanism) of the aortic regurgitation and the severity of aortic regurgitation and hemodynamic consequences are key in the decision making of patients with severe aortic regurgitation. While echocardiography remains as the leading technique to assess all these parameters, other imaging techniques have become essential for the accurate assessment of aortic regurgitation severity and the timing of aortic intervention. The anatomic suitability of tran...
Source: Current Cardiology Reports - December 13, 2023 Category: Cardiology Source Type: research
Multi-proteomic Biomarker Risk Scores for Predicting Risk and Guiding Therapy in Patients with Coronary Artery Disease
AbstractPurpose of ReviewPatients with established coronary artery disease (CAD) are at high residual risk for adverse events, despite guideline-based treatments. Herein, we aimed to determine whether risk scores based on multiple circulating biomarkers that represent activation of various pathophysiologically important pathways involved in atherosclerosis and myocardial dysfunction help identify those at greatest residual risk.Recent FindingsNumerous circulating proteins, representing dysregulation of the pathways involved in the development and stability of coronary and myocardial diseases, have been identified. When agg...
Source: Current Cardiology Reports - December 11, 2023 Category: Cardiology Source Type: research
Stroke and Recent Myocardial Infarction, Reduced Left Ventricular Ejection Fraction, Left Ventricular Thrombus, and Wall Motion Abnormalities
AbstractPurpose of ReviewTo review the evidence regarding stroke and recent myocardial infarction (MI), reduced left ventricular ejection fraction, left ventricular thrombus (LVT), and wall motion abnormalities (WMA).Recent FindingsThe risk of ischemic stroke associated with acute MI has been greatly reduced with reperfusion treatments that improved myocardium salvage. Acute ischemic stroke is an uncommon complication of diagnostic coronary angiography and percutaneous coronary intervention. For established LVT, anticoagulation is superior to antiplatelet medications to reduce the risk of ischemic stroke. The duration of a...
Source: Current Cardiology Reports - December 11, 2023 Category: Cardiology Source Type: research
Cardiac Rehabilitation After Hospitalization for Acute Coronary Syndrome
AbstractPurpose of ReviewAcute coronary syndrome (ACS) carries a high burden of morbidity and mortality. Cardiac rehabilitation over the past century has developed as an important tool in treating and preventing future myocardial infarction events in this critical group. We summarize the rationale and literature evidence supporting the use of cardiac rehabilitation and its role in ACS patients, with an emphasis on its impact on outcomes following hospitalization.Recent FindingsCurrent literature and large-scale reviews and registry analyses provide conflicting data on the benefits of cardiac rehabilitation after ACS, inclu...
Source: Current Cardiology Reports - December 8, 2023 Category: Cardiology Source Type: research
Multimodality Imaging Approach Evaluation of the Congenital Pericardial Defect: a Contemporary Review
AbstractPurpose of ReviewThis review presents the etiology, clinical manifestations, diagnostic approach, and treatment of congenital pericardial defects. It also highlights the critical role of echocardiography, cardiac computed tomography (CCT), and cardiac magnetic resonance (CMR) in the diagnosis and management approach.Recent FindingsCongenital pericardial defects are rare. Although most cases are found incidentally, some cases could potentially be associated with serious outcomes including sudden cardiac death. The diagnosis is often challenging due to non-specific clinical manifestations and electrocardiogram findin...
Source: Current Cardiology Reports - December 7, 2023 Category: Cardiology Source Type: research
Diagnosis and Management of Congenital Coronary Artery Fistulas in Infants and Children
AbstractPurpose of ReviewCoronary artery fistulas (CAFs) are rare coronary anomalies that most often occur as congenital malformations in children. Although most children with CAFs are asymptomatic at the time of diagnosis, some present with symptoms of congestive heart failure in the setting of large left-to-right shunts. Others may develop additional complications including coronary artery ectasia and coronary thrombosis. Surgical and transcatheter closure techniques have been previously described. This review presents the classifications of CAFs in children and the short and long-term outcomes of CAF closure in children...
Source: Current Cardiology Reports - December 5, 2023 Category: Cardiology Source Type: research
The Echocardiographic Evaluation of the Right Heart: Current and Future Advances
AbstractPurpose of ReviewTo discuss physiologic and methodologic advances in the echocardiographic assessment of right heart (RH) function, including the emergence of artificial intelligence (AI) and point-of-care ultrasound.Recent FindingsRecent studies have highlighted the prognostic value of right ventricular (RV) longitudinal strain, RV end-systolic dimensions, and right atrial (RA) size and function in pulmonary hypertension and heart failure. While RA pressure is a central marker of right heart diastolic function, the recent emphasis on venous excess imaging (VExUS) has provided granularity to the systemic consequenc...
Source: Current Cardiology Reports - December 2, 2023 Category: Cardiology Source Type: research
The Brain –Heart Axis: Neuroinflammatory Interactions in Cardiovascular Disease
AbstractPurpose of ReviewThe role of neuroimmune modulation and inflammation in cardiovascular disease has been historically underappreciated. Physiological connections between the heart and brain, termed the heart-brain axis (HBA), are bidirectional, occur through a complex network of autonomic nerves/hormones and cytokines, and play important roles in common disorders.Recent FindingsAt the molecular level, advances in the past two decades reveal complex crosstalk mediated by the sympathetic and parasympathetic nervous systems, the renin-angiotensin aldosterone and hypothalamus-pituitary axes, microRNA, and cytokines. Aff...
Source: Current Cardiology Reports - November 23, 2023 Category: Cardiology Source Type: research
Polypill and Combination Therapy: Blood Pressure and Cardiovascular Risk Reduction
AbstractPurpose of ReviewThe number of medications prescribed to patients has been progressively increasing, primarily driven by cardioprotective medications. The advent of pharmaceutical 3D printing technology holds the promise of reducing the burden of multiple pills by combining various medications with different release mechanisms into a single tablet. This development encourages a comprehensive review of the evidence supporting the use of combination pills.Recent FindingsRecent randomized studies have shown higher BP control rates in quadpill groups than in monotherapy groups and improved 6-month BP control rates with...
Source: Current Cardiology Reports - November 22, 2023 Category: Cardiology Source Type: research
Cardiovascular and Renal Benefit of Novel Non-steroidal Mineralocorticoid Antagonists in Patients with Diabetes
AbstractPurpose of ReviewNovel non-steroidal mineralocorticoid receptor (MR) antagonists (MRAs) are a new class of drugs blocking adverse MR-mediated effects with an improved benefit-risk profile compared to steroidal MRAs. This review will provide information on the preclinical and clinical pharmacology of this new drug class and will discuss their future clinical applications in patients with cardiorenal disease.Recent FindingsNon-steroidal MRAs such as esaxerenone, AZD9977, apararenone, ocedurenone (KBP-5074), and finerenone are newly approved or in clinical development for patients with cardiorenal disease including ty...
Source: Current Cardiology Reports - November 22, 2023 Category: Cardiology Source Type: research
Global Cardiovascular Research: Gaps and Opportunities
AbstractPurpose of ReviewCardiovascular disease (CVD) is the leading cause of morbidity and mortality worldwide. CVDs contribute to a large health and economic burden on a global scale. We aim to describe the current landscape of global cardiovascular research, highlight significant findings, and identify potential opportunities for further studies.Recent FindingsThere has been remarkable research output regarding cardiovascular health in recent decades. Large-scale collaborative studies have made impactful strides in identifying modifiable risk factors and forming evidence-based guidelines to facilitate improved cardiovas...
Source: Current Cardiology Reports - November 20, 2023 Category: Cardiology Source Type: research
