The Evolving Paradigm of Revascularization in Ischemic Cardiomyopathy: from Recovery of Systolic Function to Protection Against Future Ischemic Events
AbstractPurpose of ReviewWe aim to reevaluate how the assessment of myocardial viability can guide optimal treatment strategies for patients with ischemic cardiomyopathy (ICM) based on a more contemporary understanding of the mechanism of benefit of revascularization.Recent FindingsThe assessment of viability in left ventricular (LV) segments with diminished contraction has been proposed as key to predict the benefit of revascularization and, therefore, as a requisite for the selection of patients to undergo this form of treatment. However, data from prospective trials have diverged from earlier retrospective studies.Summa...
Source: Current Cardiology Reports - October 24, 2023 Category: Cardiology Source Type: research
Indications for Cardiac Catheterization and Percutaneous Coronary Intervention in Patients with Resuscitated Out-of-Hospital Cardiac Arrest
AbstractPurpose of ReviewThe role of emergent cardiac catheterization after resuscitated out-of-hospital cardiac arrest (OHCA) has evolved based on recent randomized evidence. This review aims to discuss the latest evidence and current indications for emergent coronary angiography (CAG) and mechanical circulatory support (MCS) use following OHCA.Recent FindingsIn contrast to previous observational data, recent RCTs evaluating early CAG in resuscitated OHCA patients without ST elevation have uniformly demonstrated a lack of benefit in terms of survival or neurological outcome. There is currently no randomized evidence suppo...
Source: Current Cardiology Reports - October 24, 2023 Category: Cardiology Source Type: research
Emerging Medical Therapies for the Treatment of Obesity in Women with Cardiovascular Diseases
AbstractPurpose of ReviewIn this review, the impact of obesity on cardiovascular disease in women and emerging anti-obesity pharmacologic treatments are discussed.Recent FindingsRobust evidence demonstrates the burden of obesity across the lifespan in women and links obesity to a diverse set of cardiovascular diseases. Female-specific risk factors including sex hormones and pregnancy factors intersect with obesity and cardiovascular risk. Sustained weight loss has potential for cardiovascular benefits. Recent trials demonstrate cardiovascular benefits of emerging agents with weight loss effects including GLP-1 RA and SGLT2...
Source: Current Cardiology Reports - October 24, 2023 Category: Cardiology Source Type: research
Contraception and Cardiovascular Effects: What Should the Cardiologist Know?
AbstractPurpose of ReviewCardiovascular disease (CVD) is the leading cause of death in women. This review highlights contraceptive options and their effects on the cardiovascular system (CVS). It provides guidance to cardiologists to make informed decisions regarding the safety of contraceptive use and cardiovascular risk stratification in the care of women of childbearing age.Recent FindingsApproximately 44% of American women live with some type of CVD. Many women use hormonal contraception during their lifetime. It is imperative that cardiologists have a robust understanding of the forms of contraception in current use a...
Source: Current Cardiology Reports - October 20, 2023 Category: Cardiology Source Type: research
Shock Teams: A Contemporary Review
AbstractPurpose of ReviewCardiogenic shock (CS) is a time-sensitive and often fatal condition. To address this issue, many centers have developed multidisciplinary shock teams with a common goal of expediting the recognition and treatment of CS. In this review, we examine the mission, structure, implementation, and outcomes reported by these early shock teams.Recent FindingsTo date, there have been four observational shock team analyses, each providing unique insight into the utility of the shock team.SummaryThe limited available data supports that shock teams are associated with improved CS mortality. However, there is ...
Source: Current Cardiology Reports - October 20, 2023 Category: Cardiology Source Type: research
Computed Tomography –Guided Pericardiocentesis: A Practical Guide
AbstractPurpose of ReviewThe purpose of this article is to serve as a practical guide to computed tomography (CT) –guided pericardiocentesis and to discuss the role of this approach in current clinical practice. An overview of indications, technique, advantages, and limitations specific to CT-guided pericardiocentesis will be provided. The reader will have an enhanced understanding of the use of this imaging modality to guide pericardial drainage.Recent FindingsUse of CT guidance to drain the pericardial space is safe, especially when adequate echocardiographic evaluation is precluded and when echocardiography-guided per...
Source: Current Cardiology Reports - October 19, 2023 Category: Cardiology Source Type: research
Noninvasive Multimodality Imaging for the Assessment of Anomalous Coronary Artery
AbstractPurpose of ReviewAnomalous aortic origin of a coronary artery (AAOCA) is a rare congenital coronary anomaly with the potential to cause myocardial ischemia and adverse cardiac events. The presence of AAOCA anatomy itself does not necessarily implicate a need for revascularization. Therefore, the purpose of this review is to assess how noninvasive comprehensive anatomic- and physiologic evaluation may guide patient management.Recent FindingsThe assessment of AAOCA includes an accurate description of the anomalous origin/vessel course including anatomical high-risk features such as a slit-like ostium, proximal narrow...
Source: Current Cardiology Reports - October 18, 2023 Category: Cardiology Source Type: research
Congenital Cyanotic Heart Disease and the Association with Pheochromocytomas and Paragangliomas
AbstractPurpose of ReviewPheochromocytomas and paragangliomas (PPGLs) are rare neuroendocrine tumors that commonly produce excess catecholamines causing significant morbidity and mortality. Patients with cyanotic congenital heart disease (CCHD) develop PPGLs at a higher frequency than the general population. This review will summarize recent research in the association of PPGL and CCHD.Recent FindingsAdvances in molecular genetics have provided new insights into a variety of germline mutations and somatic mutations related to PPGLs. In the CCHD population, mutations can occur in the hypoxia signaling pathway with gain-of-f...
Source: Current Cardiology Reports - October 17, 2023 Category: Cardiology Source Type: research
Coronary Angiography Complicated by Acute Ischaemic Stroke and the Use of Thrombolysis: a Cardiology Perspective and Narrative Review of Current Literature
This article aims to review the pathophysiological mechanisms for CAAIS, clarify the current evidence regarding IVT use in this setting, and thus assist cardiologists in the management of CAAIS.Recent FindingsThe pathophysiology for CAAIS may be different from acute ischaemic stroke in the general population. Embolic phenomena from dislodgement of calcium or other debris during manipulation of instrumentation during CA or PCI are likely mechanisms. This may contribute to altered thrombus composition, which affects the efficacy of IVT as suggested in recent studies. Furthermore, IVT in the management of CAAIS has not been e...
Source: Current Cardiology Reports - October 17, 2023 Category: Cardiology Source Type: research
Optimum Dose of Resistance Exercise for Cardiovascular Health and Longevity: Is More Better?
AbstractPurpose of ReviewAlthough there is extensive research on how much aerobic exercise to prescribe in order to reduce the risks of cardiovascular disease (CVD) and premature mortality, there is limited research on how much resistance exercise to prescribe. This review is to help fill important gaps in knowledge on effective minimum dose, beneficial optimum dose, and safe maximum dose of resistance exercise for CVD prevention and longevity.Recent FindingsIn contrast to aerobic exercise where “some is good, more is better," recent observational studies suggested a J-shaped relation where more time in resistance e...
Source: Current Cardiology Reports - October 14, 2023 Category: Cardiology Source Type: research
Obesity, Cardiorespiratory Fitness, and Cardiovascular Disease
AbstractPurpose of ReviewObesity, generally defined by body mass index (BMI), is an established risk factor for the development of cardiovascular disease (CVD), while cardiorespiratory fitness (CRF) decreases risk. In chronic CVD, an obesity survival paradox in which higher BMI is associated with improved prognosis has been reported. This paper will examine the effect of obesity on CVD risk, explore obesity as a risk factor in patients with established CVD, and investigate the relationship between CRF, obesity, and CVD.Recent FindingsThrough metabolic and hemodynamic changes, obesity increases the risk for CVD and contribu...
Source: Current Cardiology Reports - October 13, 2023 Category: Cardiology Source Type: research
Tailored to a Woman ’s Heart: Gender Cardio-Oncology Across the Lifespan
We describe the need for a lifespan-based approach to cardio-oncology for women. Cardio-oncology care tailored to women should rigorously consider cancer treatment/outcomesand concurrent reproductive/hormonal changes, which collectively shape quality of life and cardiovascular outcomes. (Source: Current Cardiology Reports)
Source: Current Cardiology Reports - October 11, 2023 Category: Cardiology Source Type: research
TAVR in TAVR: Where Are We in 2023 for Management of Failed TAVR Valves?
AbstractPurpose of ReviewAs TAVR is increasingly performed on younger patients with a longer life expectancy, the number of redo-TAVR procedures is likely to increase in the coming years. Limited data is currently available on this sometimes challenging procedure. We provide a summary of currently published literature on management of patients with a failed transcatheter aortic valve.Recent FindingsRecent registry data have increased the clinical knowledge on redo-TAVR. Additionally, numerous bench studies have provided valuable insights into the technical aspects of redo-TAVR with various combinations of valve types.Summa...
Source: Current Cardiology Reports - October 10, 2023 Category: Cardiology Source Type: research
Should We “RESPECT EPA” More Now? EPA and DHA for Cardiovascular Risk Reduction
AbstractPurpose of ReviewThere has been much debate surrounding the use of omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), for cardiovascular (CV) risk reduction.Recent FindingsRecent trials of EPA and DHA have offered conflicting evidence. Some demonstrate reduction in CV risk using EPA alone in select populations. Others have demonstrated no benefit, with potential for side effects, such as new-onset atrial fibrillation.SummaryBoth EPA and DHA have favorable impact on lipids and inflammation, suggesting some biological plausibility for CV risk reduction. However, clinical trials of these ...
Source: Current Cardiology Reports - October 9, 2023 Category: Cardiology Source Type: research
Endovascular Interventions for Peripheral Artery Disease: A Contemporary Review
AbstractPurpose of ReviewPeripheral artery disease (PAD) is an increasingly prevalent but frequently underdiagnosed condition that can be associated with high rates of morbidity and mortality. While an initial noninvasive approach is the cornerstone of management, revascularization is often pursued for patients with treatment-refractory claudication or chronic limb-threatening ischemia (CLTI). In this review, we discuss the current state of endovascular interventions for PAD and explore the many new emerging technologies.Recent FindingsThe last decade has resulted in numerous advances in PAD interventions including the ong...
Source: Current Cardiology Reports - October 7, 2023 Category: Cardiology Source Type: research
