Digital Cardiology: Opportunities for Disease Prevention
AbstractPurpose of ReviewCardiovascular diseases (CVD) are the world ’s leading cause of mortality, responsible for 18 million deaths each year. Disease prevention is a critical component to curb the morbidity and mortality due to CVD worldwide, and advances in digital health technologies may facilitate adherence to and effectiveness of preventive measures. In this review, we seek to identify and describe recent developments in the use of digital health for CVD prevention between 2015 and 2019.Recent FindingsPromising digital health technologies have emerged in the field of cardiology. In the diagnostics arena, Alive...
Source: Current Cardiovascular Risk Reports - July 1, 2020 Category: Cardiology Source Type: research

Digital Technologies in Heart Failure Management
AbstractPurpose of ReviewHeart failure (HF) is the leading cause of hospital readmission for patients over 65  years old in the United States. HF is a unique clinical condition requiring frequent monitoring of objective patient variables that cannot be accomplished by office visits alone. With the advent of smartphones, Bluetooth, and Wi-Fi technologies, an opportunity arose for the digital management of H F patients. This paper reviews the current digital technologies available in HF management and future directions that have the potential to change clinical practice.Recent FindingsImplantable, wireless pulmonary art...
Source: Current Cardiovascular Risk Reports - June 15, 2020 Category: Cardiology Source Type: research

Understanding Health Disparities in Cardiovascular Diseases in Pregnancy Among Black Women: Prevalence, Preventive Care, and Peripartum Support Networks
AbstractPurpose of ReviewBlack women have higher morbidity and mortality in pregnancy and postpartum, as compared with women of other races/ethnicities, including white and Hispanic women. Pregnancy-associated deaths are rising in the USA and are higher than in other developed nations. Pregnancy-associated mortality rates are disproportionately higher among non-Hispanic black women. The purpose of this paper is to (1) review the current literature regarding pregnancy-associated cardiovascular disease prevalence in black women compared with women of other races/ethnicities, (2) review proposed factors contributing to these ...
Source: Current Cardiovascular Risk Reports - May 26, 2020 Category: Cardiology Source Type: research

Obesity and Cardiovascular Risk in the Arab Gulf States
AbstractPurpose of ReviewRapid economic growth in the Gulf Cooperation Council (GCC) states over the last half-century has been associated with a rise in obesity and cardiovascular morbidity and mortality. In this review, we shed some light on the factors driving the obesity epidemic, promising interventions to overcome this public health crisis, and challenges precluding a successful public health impact.Recent FindingsOverweight and obesity rates have nearly tripled in the GCC countries over the past four decades. Cardiovascular morbidity and mortality have been rising in parallel. Several sociodemographic, environmental...
Source: Current Cardiovascular Risk Reports - May 20, 2020 Category: Cardiology Source Type: research

Characteristics that Predict Response After Cardiac Resynchronization Therapy
AbstractPurpose of ReviewCardiac resynchronization therapy (CRT) is an established modality for treating heart failure. However, one-third of patients do not respond and it is increasingly recognized that response is not binary and we should be aiming for “best response”. This review looks at factors predicting response and remodelling and highlights areas where we may improve both the proportion of responders but also maximize response in an individual.Recent FindingsWe review the clinical characteristics predicting response including structural and electrical remodelling and discuss areas of debate. We examin...
Source: Current Cardiovascular Risk Reports - May 13, 2020 Category: Cardiology Source Type: research

Multimodality Imaging for Risk Assessment of Inherited Cardiomyopathies
AbstractPurpose of ReviewThis review summarizes the evidence concerning the imaging techniques and features to (a) diagnose and (b) risk stratify patients with, or at risk of, inherited cardiomyopathies. The inherited cardiomyopathies we have focused on are dilated cardiomyopathy (DCM), hypertrophic cardiomyopathy (HCM) and arrhythmogenic cardiomyopathies (arrhythmogenic right ventricular cardiomyopathy (AVRC), arrhythmogenic left ventricular cardiomyopathy (ALVC) and noncompaction cardiomyopathy (NCCM)).Recent FindingsEchocardiogram and cardiac magnetic resonance imaging (CMR) still form the foundations of the diagnosis a...
Source: Current Cardiovascular Risk Reports - April 22, 2020 Category: Cardiology Source Type: research

Sex Difference in Catheter Ablation of Idiopathic Ventricular Arrhythmias and Ventricular Arrhythmias Associated with Structural Heart Disease
AbstractPurpose of ReviewSex differences in clinical manifestations, electrophysiological properties and treatment of ventricular arrhythmias (VA) have been an area of research in the last years. In this review, we focus on sex differences in the catheter ablation of VA in patients with and without structural heart disease.Recent FindingsWomen have more frequently RVOT than LVOT PVC/VTs but intrafascicular re-entry occurs more frequently in men than in women. Sex-dependent differences in the autonomic nervous system, hormonal status and/or arrhythmogenic characteristics of the substrate may explain these differences. Women...
Source: Current Cardiovascular Risk Reports - April 15, 2020 Category: Cardiology Source Type: research

Predictors of Success in Bariatric Surgery
AbstractPurpose of ReviewThe goal of this review is to summarize the current literature on predictors of success in bariatric surgery. These predictors include clinical, psychological, behavioral, and socioeconomic factors. Successful bariatric surgery is defined by excess weight loss, as well as improvement in medical comorbidities and the patient ’s quality of life.Recent FindingsSuccessful bariatric surgery is dependent on clinical, psychological, behavioral, and socioeconomic factors. The choice of operation, as well as the starting body mass index (BMI), has the largest clinical effect on weight loss. The presen...
Source: Current Cardiovascular Risk Reports - February 21, 2020 Category: Cardiology Source Type: research

Medical Management Before Bariatric Surgery
AbstractPurpose of ReviewThe evaluation of patients before bariatric surgery requires identification and optimization of the known comorbidities associated with obesity. Evaluation begins with cardiac and pulmonary assessment for elective noncardiac surgery for patients with severe obesity published inCirculation in 2009 by the AHA.1 The algorithm uses a 5-step approach and evaluation after a comprehensive history and physical exam and lab testing completed.Recent FindingsA standardized preoperative checklist and Clinical Practice Guidelines were updated in 2013 by the American Associations of Clinical Endocrinologists (AC...
Source: Current Cardiovascular Risk Reports - January 27, 2020 Category: Cardiology Source Type: research

Ablation Approaches and Imaging Modalities to Lower Risk of Atrioesophageal Injury During Catheter Ablation for Atrial Fibrillation
AbstractPurpose of ReviewAtrioesophageal fistula (AEF) is a rare yet catastrophic complication of atrial fibrillation (AF) ablation. Limited data exists on measures to prevent AEF. This review focuses on AF ablation approaches, esophageal protective strategies, and imaging modalities that can be utilized to reduce the risk of AEF.Recent FindingsAEF has been reported to occur in less than 0.1% of AF ablation cases. Left untreated, it is associated with 100% mortality. Diagnosing AEF requires a high index of suspicion as symptoms are usually nonspecific. Several AF ablation techniques might reduce the risk of esophageal ther...
Source: Current Cardiovascular Risk Reports - January 7, 2020 Category: Cardiology Source Type: research

Pediatric Obesity: Endocrinologic and Genetic Etiologies and Management
We describe these rare conditions and the dysregulation of neuropathways in obesity and review successes and failures in treatments in both syndromic and nonsyndromic obesity.Recent FindingsThe best-described form of syndromic obesity is Prader –Willi Syndrome (PWS). While recent pharmacotherapies (specifically beloranib) demonstrated improvements in weight in PWS, the unfortunate adverse effect of deep vein thrombosis and pulmonary embolism necessitated the halting of its further development. Additional treatments are in development whi ch target the signaling of ghrelin and other hypothalamic targets known to be dy...
Source: Current Cardiovascular Risk Reports - November 27, 2019 Category: Cardiology Source Type: research

Aortic Stenosis
AbstractPurpose of ReviewAortic stenosis is the most prevalent valvular heart disease. The purpose of this paper is to review the epidemiology, pathophysiology, and diagnosis of aortic valve stenosis.Recent FindingsThe diagnosis of aortic stenosis has evolved over time. Originally diagnosed with cardiac catheterization and echocardiography, more advance imaging techniques including computed tomography, magnetic resonance imaging, and 3D printing have improved our understanding of the physiology and hemodynamic effects of aortic stenosis.SummaryValvular heart disease affects a broad patient population, and the most common f...
Source: Current Cardiovascular Risk Reports - November 22, 2019 Category: Cardiology Source Type: research

A Review of the Emergence and Expansion of Cardiovascular Genetic Counseling
AbstractPurpose of ReviewThe genetic counseling profession is growing rapidly, as is its presence in cardiology. In this review, we will survey recent innovations and research in cardiovascular genetic counseling, as well as findings from the broader genetic counseling field that are relevant to cardiovascular genetic counseling.Recent FindingsResearch into the structure of services finds that genetic counselors are increasingly being embedded within cardiology departments and that cardiologists value their expertise and contributions. Findings from other genetic counseling subspecialties and from clinical psychology sugge...
Source: Current Cardiovascular Risk Reports - November 19, 2019 Category: Cardiology Source Type: research

Vaping and Cardiovascular Health: the Case for Health Policy Action
AbstractPurpose of ReviewE-cigarette smoking is rapidly increasing, especially in adolescents and adults, although data on their safety or harm is still scarce. There have been few systematic studies of the health effects of e-cigarette use and most studies report on the use of e-cigarettes in past or current cigarette smokers. In this paper, we want to summarize cardiovascular effects of e-cigarettes.Recent FindingsE-cigarettes could cause cardiovascular harm especially by the toxic effects and of the e-liquid and induction of oxidative stress. Nicotine has known effects on cardiovascular function that are not different i...
Source: Current Cardiovascular Risk Reports - November 19, 2019 Category: Cardiology Source Type: research

Advances in Technologies to Improve Ventricular Ablation Safety and Efficacy
AbstractPurpose of ReviewThis review focuses on advances within the field of cardiac electrophysiology that have helped to improve the safety and efficacy of ventricular arrhythmia ablation.Recent FindingsImprovements in three-dimensional electroanatomic mapping systems and catheters allow providers to generate high-resolution maps in less time while identifying critical areas of arrhythmogenic substrate with greater efficiency and possibly better accuracy. Advanced imaging integration into the mapping systems have improved pre- and periprocedural planning and safety. Novel ablation catheters and techniques have improved t...
Source: Current Cardiovascular Risk Reports - November 18, 2019 Category: Cardiology Source Type: research

Correction to: Peripheral Artery Disease and African Americans: Review of the Literature
The original version of this article unfortunately contained mistake in the presentation of the author ’s name. (Source: Current Cardiovascular Risk Reports)
Source: Current Cardiovascular Risk Reports - October 31, 2019 Category: Cardiology Source Type: research

Race/Ethnic Disparities in Cardiac Transplantation
AbstractPurpose of ReviewHeart transplant (HT) is the therapy of choice for patients with end-stage heart failure (HF), leading to substantial improvements in quality of life, functional status, and longevity compared to optimal medical therapy for end-stage HF. However, race/ethnic disparities in post-HT survival persist and remain a major concern. The purpose of this review is to describe differences in post-transplant outcomes based on race/ethnicity and to highlight evolving knowledge of the reasons for these persistent disparate outcomes.Recent FindingsBlack HT recipients have the highest risk for allograft failure an...
Source: Current Cardiovascular Risk Reports - October 16, 2019 Category: Cardiology Source Type: research

A Look Beyond Statins and Ezetimibe: a Review of Other Lipid-Lowering Treatments for Cardiovascular Disease Prevention in High-Risk Patients
AbstractPurpose of ReviewThere has been significant progress made during the last few decades in the management of atherosclerotic cardiovascular disease (ASCVD). Despite this, residual risk remains an unmet need for secondary prevention and high-risk primary prevention patients. First onset and recurrent cardiovascular events remain a major issue despite recommendations for a healthy lifestyle and current optimal medical therapy, which includes the use of maximally tolerated statin therapy plus or minus add-on ezetimibe therapy.Recent FindingsThese findings have led to the development of new treatments that modulate lipid...
Source: Current Cardiovascular Risk Reports - October 10, 2019 Category: Cardiology Source Type: research

Functional Mitral Valve Regurgitation
AbstractPurpose of ReviewFunctional mitral regurgitation (FMR) occurs when mitral leaflets are prevented from adequate coaptation by underlying left ventricular (LV) dysfunction, mitral annular dilation, or both. This review aims to clarify the complex clinical issues in FMR, including diagnosis and therapy.Recent FindingsEven mild FMR has been shown to affect survival negatively. FMR is a dynamic condition and can vary within systole and with altered loading conditions. An integrative approach, including qualitative and quantitative echocardiographic data, is mandatory to determine severity of FMR. Treatment of FMR starts...
Source: Current Cardiovascular Risk Reports - September 10, 2019 Category: Cardiology Source Type: research

Cardiovascular Risk Associated with Medical Use of Opioids and Cannabinoids: A Systematic Review
AbstractPurpose of ReviewThe long-term use of opioid and cannabinoid medications to control chronic pain and treat opioid use disorders now involves a large proportion of the population in the United States. Yet, the cardiovascular risks of opioids are not well understood. This systematic review summarizes the current literature to assess the potential cardiovascular disease risks associated with opioid and cannabinoid medications.Recent FindingsThe role of long-term methadone use in increasing QT interval among people receiving methadone treatment for substance use disorders is well established. Routine electrocardiogram ...
Source: Current Cardiovascular Risk Reports - August 30, 2019 Category: Cardiology Source Type: research

Genetic and Genomic Approaches to Predict Cardiac Allograft Rejection
AbstractPurpose of ReviewThe goal of this paper is to review the current state of and ongoing developments in the detection and diagnosis of cardiac allograft rejection using genetic and genomic approaches.Recent FindingsThe current strength of genetic and genomic methods is primarily in reducing the overall number of surveillance endomyocardial biopsies in otherwise low-risk patients. Tissue-based analyses of endomyocardial samples are beginning to identify a more objective phenotypic description of cardiac allograft rejection than traditional histologic evaluation; however, a true “gold” standard remains elus...
Source: Current Cardiovascular Risk Reports - August 29, 2019 Category: Cardiology Source Type: research

Uterine Fibroids, Race, Ethnicity, and Cardiovascular Outcomes
AbstractPurpose of ReviewUterine fibroids are the cause of significant morbidity for women particularly women of racial and ethnic minorities. This review seeks to draw connections between fibroids and another cause of morbidity and mortality, cardiovascular disease. Fibroids are the most common neoplasm affecting women as well as the most common reason for undergoing hysterectomy. Heart disease is the leading cause of death for women in the USA, and heart disease and stroke disproportionately impact women of racial and ethnic minorities.Recent FindingsProspective studies in the last several years have revealed a higher pr...
Source: Current Cardiovascular Risk Reports - July 27, 2019 Category: Cardiology Source Type: research

Peripheral Artery Disease and African Americans: Review of the Literature
AbstractPurpose of ReviewPeripheral artery disease (PAD) is a chronic, obstructive disease of the peripheral vasculature which is a coronary heart disease risk equivalent. African Americans (AA) are at the highest risk for developing this disease at every age group. The purpose of this review is to shed light on the risk factors for PAD and their implications for disease manifestation in AA, and to highlight ways to combat these known racial disparities in order to achieve cardiovascular health equity in this population.Recent FindingsEven after controlling for differences in the prevalence of known cardiovascular risk fac...
Source: Current Cardiovascular Risk Reports - July 25, 2019 Category: Cardiology Source Type: research

Update on Behavioral Weight Loss Treatments to Reduce Obesity and Lower Cardiometabolic Risks
AbstractPurpose of ReviewObesity is an intractable clinical and public health problem that is associated with morbidity and mortality. This review provides an update on current and emerging behavioral weight loss interventions (BWLIs).Recent FindingsBecause lifestyle behaviors are primary determinants of weight loss success, BWLIs are front-line treatments in the clinical management of obesity. BWLIs provide guidance in dietary restriction, increased physical activity, and decreased sedentary behavior to achieve reductions in body weight. Intensive in-person comprehensive BWLIs providing 14 or more sessions over 6  mo...
Source: Current Cardiovascular Risk Reports - July 13, 2019 Category: Cardiology Source Type: research

Bicycling for Transportation and Recreation in Cardiovascular Disease Prevention
AbstractPurpose of ReviewBicycling as a mode of transportation can be an easy and inexpensive way of integrating health enhancing physical activity into everyday life. In the present paper, we summarize the evidence from studies on bicycling for transportation and recreation in relation to cardiovascular disease prevention. We also estimate the population impact of increasing bicycling as a mode of transportation.Recent FindingsThe overall evidence from prospective cohort studies supports that bicycling for transportation or recreation is related to lower risk of development of fatal or non-fatal cardiovascular disease and...
Source: Current Cardiovascular Risk Reports - July 13, 2019 Category: Cardiology Source Type: research

Lipids in South Asians: Epidemiology and Management
AbstractPurpose of ReviewThis review focuses on lipoprotein abnormalities in South Asians (SA) and addresses risk stratification and management strategies to lower atherosclerotic cardiovascular disease (ASCVD) in this high-risk population.Recent FindingsSouth Asians (SAs) are the fastest growing ethnic group in the United States (U.S) and have an increased risk of premature coronary artery disease (CAD). While the etiology may be multifactorial, lipoprotein abnormalities play a key role. SAs have lower low-density lipoprotein cholesterol (LDL-C) compared with Whites and at any given LDL-C level, SA ethnicity poses a highe...
Source: Current Cardiovascular Risk Reports - July 11, 2019 Category: Cardiology Source Type: research

LDL-C Targets in Secondary Prevention: How Low Should We Go?
AbstractPurpose of ReviewThe benefits of lowering low-density lipoprotein cholesterol (LDL-C), mainly using high-intensity statin therapy, and its impact on decreasing the recurrence of atherosclerotic cardiovascular disease (ASCVD) in secondary prevention has been well established. With the advent of non-statin medications, particularly PCSK-9 inhibitors, which can lower LDL-C to very low levels not seen before, it is important to answer some important questions regarding LDL-C lowering and the uses of these medications in clinical practice: how low should we go with LDL-C reduction? Is there a threshold beyond which lowe...
Source: Current Cardiovascular Risk Reports - June 18, 2019 Category: Cardiology Source Type: research

Biodegradable Polymers and Stents: the Next Generation?
AbstractPurpose of ReviewStent design continues to evolve with newer generation of stents aimed at improving clinical outcomes. This review compares different generations of stents with a focus on biodegradable polymers and stents and their potential benefits.Recent FindingsDrug-eluting stents (DES) reduce stent thrombosis when compared with bare-metal stents (BMS). However, they are associated with impaired vascular healing/endothelialization and excess very long-term events (beyond 1  year). Much of these events (beyond 1 year) have been attributed to continued inflammation due to the polymer. Biodegradable-pol...
Source: Current Cardiovascular Risk Reports - June 11, 2019 Category: Cardiology Source Type: research

Consider Preeclampsia as a First Cardiovascular Event
AbstractPurpose of ReviewCardiovascular disease (CVD) is the leading cause of death in women worldwide. Preeclampsia (PE) is an important and acknowledged female-specific risk factor. Women with a history of PE have an elevated risk to develop hypertension in the decade following their index pregnancy. In this paper, we aim to provide recent insights in the future risk of preeclampsia and describe how prevention strategies can be optimized.Recent FindingsThe development of premature hypertension is caused by multiple factors such as genetics and a persistent enhanced inflammatory state after PE. Systemic inflammation accel...
Source: Current Cardiovascular Risk Reports - June 8, 2019 Category: Cardiology Source Type: research

Sex Differences in Heart Failure —Female Representation in Heart Failure Studies
AbstractPurpose of ReviewThe prevalence of heart failure (HF) continues to grow in the USA, and approximately 50% of these patients are women. Despite this, there has been an underrepresentation of women in HF clinical trials, which has led to limitations in understanding of sex-related differences in HF pathophysiology, diagnosis, and treatment. The purpose of this review is to highlight the differences between men and women in various heart failure trials conducted in the last century and emphasize new findings from recent trials in the management of, and outcomes in, women with HF.Recent FindingsHF trials have shown tha...
Source: Current Cardiovascular Risk Reports - May 25, 2019 Category: Cardiology Source Type: research

Lipids in Women: Management in Cardiovascular Disease Prevention and Special Subgroups
AbstractPurpose of ReviewAs the adverse impact of cardiovascular disease continues to afflict women around the world, the identification and treatment of risk factors to reduce cardiovascular morbidity and mortality continue to rise in priority. Dyslipidemia is a significant risk factor for coronary heart disease and should serve as a strong focus point in both primary and secondary prevention. However, women remain undertreated compared with men and receive less evidence-based therapies including cholesterol management. Some of the unique risk factors in women that contribute to cardiovascular disease have been incorporat...
Source: Current Cardiovascular Risk Reports - May 25, 2019 Category: Cardiology Source Type: research

The Use of Risk-Enhancing Factors to Personalize ASCVD Risk Assessment: Evidence and Recommendations from the 2018 AHA/ACC Multi-Society Cholesterol Guidelines
AbstractPurpose of ReviewIn 2018, the AHA/ACC Multi-Society Cholesterol Guidelines introduced the novel concept of risk-enhancing factors to be used as a supplement to the pooled cohort risk equations to personalize atherosclerotic cardiovascular disease risk assessment in primary prevention. In this review, we discuss the rationale and evidence behind each of the risk-enhancing factors to help clinicians perform a more personalized cardiovascular risk assessment.Recent FindingsThe risk-enhancing factors are high-risk features that may guide the use of lipid-lowering therapy particularly in intermediate and select borderli...
Source: Current Cardiovascular Risk Reports - May 23, 2019 Category: Cardiology Source Type: research

Prevalence, Clinical Presentation, and Management of Channelopathies and Cardiomyopathies, Long QT Syndrome, Brugada Syndrome, Arrhythmogenic Cardiomyopathy, and Hypertrophic Cardiomyopathy
AbstractPurpose of ReviewWith this paper, we aim to summarize the knowledge on gender differences in the most common inheritable channelopathies and cardiomyopathies, focusing on aspects that are of clinical importance for patient management and follow-up.Recent FindingsDespite autosomal dominant inheritance patterns in most of the inheritable cardiac channelopathies and cardiomyopathies, there is increasing awareness that there are important gender differences in disease penetrance and severity, affecting prevalence, clinical presentation, and patient management.SummaryImportant gender differences are present in Long QT s...
Source: Current Cardiovascular Risk Reports - May 2, 2019 Category: Cardiology Source Type: research

Characteristic Symptoms in Women with Ischemic Heart Disease
AbstractPurpose of ReviewAdvances in coronary imaging techniques have revealed that there are important sex differences in the pattern of ischemic heart disease. In this review, we aim to summarize our current knowledge and focus on the relation between a distinct symptom presentation in women and their underlying type of coronary artery disease.Recent FindingsWomen in the age group 40 –70 years more often have non-obstructive coronary artery disease (CAD) and coronary vasomotor disorders compared with the traditional obstructive CAD as seen in men. These differences in pathophysiology translate into another sym...
Source: Current Cardiovascular Risk Reports - May 2, 2019 Category: Cardiology Source Type: research

Review on Future Targets and Current Trends in Transcatheter Left Atrial Appendage Closure
AbstractPurpose of ReviewAtrial fibrillation is cause for a growing burden of thromboembolic stroke. Transcatheter left atrial appendage closure is an alternative to lifelong oral anticoagulation for many patients with nonvalvular atrial fibrillation. Reviewed here are three commonly used devices (Watchman, Amplatzer Cardiac Plug/Amulet, and Lariat) and their key clinical trials, special candidate patient populations, and recent investigations of the impact of post-procedure antithrombotic strategies.Recent FindingsTranscatheter left atrial appendage closure devices provide noninferior thromboembolic stroke risk reduction ...
Source: Current Cardiovascular Risk Reports - April 30, 2019 Category: Cardiology Source Type: research

Evaluation and Management of the Vulnerable Plaque
AbstractPurpose of ReviewCoronary plaque rupture is the dominant mechanism of acute myocardial infarction and sudden coronary death. If we are to make a major inroads on reducing morbidity and mortality from cardiovascular disease, more accurate prediction of an individual ’s near-term cardiovascular risk (i.e., prediction of future coronary events) than what we can offer today is the ultimate goal to enable a more patient-tailored treatment strategy for coronary artery disease. In this review, we address the value of the vulnerable plaque concept in the context of an integrative cardiovascular risk assessment.Recent...
Source: Current Cardiovascular Risk Reports - April 26, 2019 Category: Cardiology Source Type: research

The Role of Pacing in Elderly Patients with Unexplained Syncope
AbstractPurpose of ReviewTo discuss the role of pacing in elderly patients with unexplained syncope.Recent FindingsIn patients with recurrent syncope with suspected reflex mechanism, the decision of pacemaker implantation can be guided by a standardized algorithm which includes carotid sinus massage, tilt-table testing, and implantable loop recorder. Cardiac pacing may reduce recurrent syncope in cardioinhibitory carotid sinus syndrome. In select elderly patients with recurrent cardioinhibitory vasovagal syncope, cardiac pacing may also reduce syncope recurrence. There is no role of cardiac pacing in patients with without ...
Source: Current Cardiovascular Risk Reports - April 26, 2019 Category: Cardiology Source Type: research

Transcatheter Mitral Valve Therapy: Repair and Replacement
AbstractPurpose of ReviewIn this paper, we discuss the salient clinical and anatomic challenges in percutaneous mitral valve repair and replacement.Recent FindingsThe mitral valve is complex structure and understanding its intricacies and anatomic relationships to surrounding structures (i.e., aortic valve and papillary muscles) is central to delivery of therapies. Part of the complexity is treatment of primary and secondary mitral regurgitation, where in primary regurgitation the valve is the primary issue and treatment should be curative or treatment of secondary mitral regurgitation, where the valve is subject to distor...
Source: Current Cardiovascular Risk Reports - April 24, 2019 Category: Cardiology Source Type: research

Emerging Lipid-Lowering Therapies in Secondary Prevention
AbstractPurpose of ReviewThe primary purpose of this article was to review the next-generation lipid-lowering therapies that are under current development and clinical testing. We reviewed the mechanism of action of these drugs and how they act on different pathways of lipid metabolism. Additionally, we aimed to present data from clinical trials evaluating clinical outcomes, efficacy, and safety of these novel agents. Lastly, we sought to provide recommendations for clinical practice and to comment on the cost-benefit analyses of such drugs.Recent FindingsWe evaluated the following lipid-lowering agents as they pertain to ...
Source: Current Cardiovascular Risk Reports - April 17, 2019 Category: Cardiology Source Type: research

A Review of the Use of Cryoballoon Ablation for the Treatment of Persistent Atrial Fibrillation
AbstractPurpose of ReviewCryoballoon ablation is the standard-of-care treatment for patients with paroxysmal atrial fibrillation, but its efficacy in addressing persistent atrial fibrillation is unclear. Current research is underway to identify origins of persistent atrial fibrillation in locations outside of the pulmonary veins, which are likely high-yield targets for catheter ablation.Recent FindingsRandomized studies suggest that targeting non-pulmonary vein (PV) locations has not proven to significantly improve outcomes in patients with persistent atrial fibrillation. A growing body of evidence suggests that cryoballoo...
Source: Current Cardiovascular Risk Reports - March 28, 2019 Category: Cardiology Source Type: research

LGE-MRI Characterization of Left Atrial Fibrosis: a Tool to Establish Prognosis and Guide Atrial Fibrillation Ablation
AbstractPurpose of ReviewAtrial fibrillation (AF) is the most frequent arrhythmia and also an important cause of morbidity, hospitalization, and mortality. Pulmonary vein isolation (PVI) is often the preferred therapy, but the incidence of recurrences is still significant. This review summarizes the contribution of atrial substrate identification using late gadolinium enhancement magnetic resonance imaging (LGE-MRI) to establish prognosis and to guide AF ablation.Recent FindingsLeft atrial (LA) fibrosis is thought to create the necessary substrate to sustain AF. The accuracy of LGE-MRI to identify areas of atrial fibrosis ...
Source: Current Cardiovascular Risk Reports - March 28, 2019 Category: Cardiology Source Type: research

Approaches to the Diagnosis and Management of Atrial-Esophageal Fistula After Catheter Ablation for Atrial Arrhythmias
AbstractPurpose of ReviewCatheter ablation has become a cornerstone of therapy in the management of patients with atrial fibrillation (AF). Thermal energy generated in the left atrium (LA) during ablation has the potential to damage adjacent structures. The most feared and rare complication in these ablations is atrial-esophageal fistula (AEF) result from the thermal injury to the esophagus due to the proximity to the LA, with potential catastrophic outcome. This review focuses on the diagnosis and management of AEF after catheter ablation for AF, including preventive measures to avoid esophageal lesions.Recent FindingsSym...
Source: Current Cardiovascular Risk Reports - March 16, 2019 Category: Cardiology Source Type: research

Neighborhood Social Environment and Cardiovascular Disease Risk
AbstractPurpose of ReviewLimited physical activity (PA) and obesity are two primary risk factors for cardiovascular disease (CVD). Within a socio-ecological framework, neighborhood social environment may play a key role in influencing PA and obesity. However, the mechanisms underlying this relationship remain ambiguous. Our goals in this review are as follows: (1) to summarize findings from the recent studies on neighborhood social environment in relation to PA and obesity as CVD risk factors, and (2) to briefly describe several innovative approaches to assessing neighborhood social environment.Recent FindingsAlmost all re...
Source: Current Cardiovascular Risk Reports - March 8, 2019 Category: Cardiology Source Type: research

Triglycerides: Mendelian Randomization Studies Suggest Causal Role, but How to Treat in 2019?
AbstractPurpose of ReviewHypertriglyceridemia (HTG), defined by fasting levels at or exceeding 200  mg/dL, is characterized as a pro-inflammatory, pro-thrombotic, metabolic state associated with endothelial dysfunction, insulin resistance, type 2 diabetes mellitus (T2DM), and increased risk of cardiovascular disease (CVD). Mendelian randomization studies now support a causal role for TG-rich lip oproteins in CVD risk enhancement. Yet, until recently, only post-hoc analyses from clinical trials suggested that treating HTG would translate into reduced CVD risk.Recent FindingsThe results of Reduction of Cardiovascular Ev...
Source: Current Cardiovascular Risk Reports - February 28, 2019 Category: Cardiology Source Type: research

The Role of Atrial Arrhythmia Ablation in Adolescent and Adult Congenital Heart Disease
AbstractPurpose of ReviewAtrial arrhythmias cause significant morbidity in patients with congenital heart disease (CHD). Catheter ablation remains one of the most effective treatment modalities for atrial arrhythmias. However, patients with congenital heart disease present unique challenges for catheter ablation.Recent FindingsRecent expert consensus guidelines inform physicians about treating arrhythmias in patients with CHD. These guidelines outline appropriate selection criteria for ablation and highlight treatment alternatives. The authors also suggest electrophysiology laboratory and physician standards for performing...
Source: Current Cardiovascular Risk Reports - February 18, 2019 Category: Cardiology Source Type: research

How to Choose Between His Bundle Pacing and Biventricular Pacing for Cardiac Resynchronization Therapy
AbstractPurpose of ReviewThe goal of this critical appraisal is to evaluate the role for His bundle pacing (HBP) in cardiac resynchronization, examine early clinical and physiologic data, as well as offer recommendations for selecting patients for HBP versus biventricular pacing for CRT.Recent FindingsBiventricular pacing with a left ventricular (LV) coronary sinus lead has been the primary mode of delivering cardiac resynchronization therapy (CRT) for over two decades. By fusing multiple wavefronts of activation, biventricular pacing shortens and homogenizes ventricular activation, increases left ventricular ejection frac...
Source: Current Cardiovascular Risk Reports - February 11, 2019 Category: Cardiology Source Type: research

Optimizing Anticoagulation in Older Patients with Nonvalvular Atrial Fibrillation
AbstractPurpose of ReviewWe sought to review the current issues on optimization of anticoagulation in elderly patients with nonvalvular atrial fibrillation (NVAF).Recent FindingsAdvanced age is a risk factor for stroke and as one advances in age, the risk of stroke also increases. One of the many challenges of oral anticoagulation for stroke prevention in the elderly patients with NVAF is the underutilization of anticoagulants. Commonly cited reasons for hesitation by physician in prescribing oral anticoagulants are advanced age, increase risk of bleeding, and the difficulty in maintaining an adequate time in therapeutic r...
Source: Current Cardiovascular Risk Reports - January 25, 2019 Category: Cardiology Source Type: research

Worldwide Dyslipidemia Guidelines
AbstractPurpose of ReviewThis review aims to identify common features of guidelines by comparing and summarizing similarities between five guidelines distributed by high-profile cardiovascular societies across the globe. We include guidelines from North America: ACC/AHA (2013 American College of Cardiology/American Heart Association Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults) and CCS (2016 Canadian Cardiovascular Society Guidelines for the Management of Dyslipidemia for the Prevention of Cardiovascular Disease in the Adult) and from Europe: PoLA (2016 Polish Lipi...
Source: Current Cardiovascular Risk Reports - January 25, 2019 Category: Cardiology Source Type: research

Noninvasive Cardiac Radioablation for Ventricular Arrhythmias
AbstractPurpose of ReviewIn this review, we describe the general principles and clinical use of stereotactic radioablation (SR) and its specific application to the treatment of malignant cardiac ventricular arrhythmias, or stereotactic arrhythmia radioablation (STAR). The principles of STAR, and the unmet needs in cardiac arrhythmia ablation are described. The basic pathophysiology of radioablative effect on cardiac tissues, the clinical experience to date, and future directions are discussed.Recent FindingsBasic preclinical research has demonstrated in large animal models (porcine, canine) that delivery of SR energy to ca...
Source: Current Cardiovascular Risk Reports - January 21, 2019 Category: Cardiology Source Type: research

Management of Brugada Syndrome in the Developing Countries
AbstractPurpose of ReviewThe goal of this article is to review the current paradigm for the diagnosis and management of Brugada Syndrome.Recent FindingsOne area of particular interest is the recent reports on the use of ablation for treatment and the relevance to our understanding of this genetic disorder.SummaryThis review discusses issues with management and treatment of Brugada Syndrome that have applications that should apply to patients in the developed and developing world. (Source: Current Cardiovascular Risk Reports)
Source: Current Cardiovascular Risk Reports - November 20, 2018 Category: Cardiology Source Type: research