Coronavirus disease 2019: a comprehensive review and meta-analysis on cardiovascular biomarkers
In this study, we conducted a systematic review and meta-analysis, focusing on the association between COVID-19 severity and cardiac-specific biomarkers, including N-terminal pro-B-type natriuretic peptide (NT-proBNP), troponin T (TnT)/troponin I (TnI), lactate dehydrogenase (LDH), creatine kinase, and creatine kinase isoenzyme (CK-MB). TnT had the highest odds ratio or OR (11.83) indicating the greatest association with COVID-19 severity, followed by NT-proBNP (7.57), TnI (6.32), LDH (4.79), D-dimer (4.10), creatine kinase (3.43), and CK-MB (3.35). All of the biomarkers studied were significantly correlated with COVID-19 ...
Source: Current Opinion in Cardiology - April 16, 2021 Category: Cardiology Tags: CARDIAC FAILURE: Edited by Rebecca Cogswell and Gene Kim Source Type: research

Racial disparities in Coronavirus Disease 2019 (COVID-19) outcomes
Purpose of review The Coronavirus Disease 2019 (COVID-19) pandemic has exposed preexisting racial disparities in the healthcare system. This review discusses racial-ethnic differences in COVID-19 related outcomes with an emphasis on the social determinants of health that are responsible for these disparities. Recent findings Higher hospitalizations and deaths have been reported amongst minority individuals after a COVID-19 infection. Cardiovascular disease and its risk factors are also more common in minority populations and negatively impact clinical outcomes after a COVID-19 illness. The racial disparities see...
Source: Current Opinion in Cardiology - April 16, 2021 Category: Cardiology Tags: CARDIAC FAILURE: Edited by Rebecca Cogswell and Gene Kim Source Type: research

Racial differences in outcomes after receiving advanced heart failure therapies
Purpose of review Despite advances in medical and device-based therapies for advanced heart failure as well as public policy, disparities by race/ethnicity persist in heart failure clinical outcomes. The purpose of this review is to describe disparities in outcomes by race--ethnicity in patients after receipt of heart transplantation and left ventricular assist device (LVAD), and the current understanding of factors contributing to these disparities. Recent findings The proportion of black and Latinx patients receiving advanced heart failure therapies continues to rise, and they have worse hemodynamic profiles a...
Source: Current Opinion in Cardiology - April 16, 2021 Category: Cardiology Tags: CARDIAC FAILURE: Edited by Rebecca Cogswell and Gene Kim Source Type: research

Are the current evaluation tools for advanced therapies biased?
Purpose of review Despite attention to racial disparities in outcomes for heart failure (HF) and other chronic diseases, progress against these inequities has been gradual at best. The disparities of COVID-19 and police brutality have highlighted the pervasiveness of systemic racism in health outcomes. Whether racial bias impacts patient access to advanced HF therapies is unclear. Recent findings As documented in other settings, racial bias appears to operate in HF providers’ consideration of patients for advanced therapy. Multiple medical and psychosocial elements of the evaluation process are particularl...
Source: Current Opinion in Cardiology - April 16, 2021 Category: Cardiology Tags: CARDIAC FAILURE: Edited by Rebecca Cogswell and Gene Kim Source Type: research

Disparities in acute decompensated heart failure
Purpose of review The aim of this review is to discuss racial and sex disparities in the management and outcomes of patients with acute decompensated heart failure (ADHF). Recent findings Race and sex have a significant impact on in-hospital admissions and overall outcomes in patients with decompensated heart failure and cardiogenic shock. Black patients not only have a higher incidence of heart failure than other racial groups, but also higher admissions for ADHF and worse overall survival, while women receive less interventions for cardiogenic shock complicating acute myocardial infarction. Moreover, White pat...
Source: Current Opinion in Cardiology - April 16, 2021 Category: Cardiology Tags: CARDIAC FAILURE: Edited by Rebecca Cogswell and Gene Kim Source Type: research

Representation of Black patients in heart failure clinical trials
Purpose of review Black patients with heart failure in the United States are underrepresented in clinical trials relative to their overrepresentation in the heart failure population and in adverse heart failure outcomes. We aim to evaluate historical trends in this space and highlight recent developments. Recent findings Multiple landmark heart failure trials published since 2019 have underrepresented Black patients, though several discussed this lack of representation as limitations. A review of large heart failure clinical trials from 2001 to 2016 found persistent underrepresentation of Black patients without ...
Source: Current Opinion in Cardiology - April 16, 2021 Category: Cardiology Tags: CARDIAC FAILURE: Edited by Rebecca Cogswell and Gene Kim Source Type: research

Racial and ethnic disparities in heart failure: current state and future directions
Purpose of review This review discusses the current state of racial and ethnic inequities in heart failure burden, outcomes, and management. This review also frames considerations for bridging disparities to optimize quality heart failure care across diverse communities. Recent findings Treatment options for heart failure have diversified and overall heart failure survival has improved with the advent of effective pharmacologic and nonpharmacologic therapies. With increased recognition, some racial/ethnic disparity gaps have narrowed whereas others in heart failure outcomes, utilization of therapies, and advance...
Source: Current Opinion in Cardiology - April 16, 2021 Category: Cardiology Tags: CARDIAC FAILURE: Edited by Rebecca Cogswell and Gene Kim Source Type: research

Editorial: A call to action: let's work together to end racial disparities in heart failure
No abstract available (Source: Current Opinion in Cardiology)
Source: Current Opinion in Cardiology - April 16, 2021 Category: Cardiology Tags: CARDIAC FAILURE: Edited by Rebecca Cogswell and Gene Kim Source Type: research

Clinical approach to genetic testing in amyloid cardiomyopathy: from mechanism to effective therapies
Purpose of review To highlight the evolving understanding of genetic variants, utility of genetic testing, and the selection of novel therapies for cardiac amyloidosis. Recent findings The last decade has seen considerable progress in cardiac amyloidosis recognition given the advancement in cardiac imaging techniques and widespread availability of genetic testing. A significant shift in the understanding of a genetic basis for amyloidosis has led to the development of disease-modifying therapeutic strategies that improve survival. Summary The systemic amyloidoses are disorders caused by extracellular depo...
Source: Current Opinion in Cardiology - April 16, 2021 Category: Cardiology Tags: MOLECULAR GENETICS: Edited by Ali J. Marian Source Type: research

The genetics of left ventricular noncompaction
This article summarises current understanding of the genetic architecture underpinning left ventricular noncompaction (LVNC) and highlights the difficulty in differentiating LVNC from hypertrabeculation seen in normal, healthy individuals, that caused by physiological adaptation or that seen in association with cardiomyopathy phenotypes. Recent findings Progress has been made in better defining the LVNC phenotype and those patients who may benefit from genetic testing. Yield of diagnostic genetic testing may be low in the absence of syndromic features, systolic dysfunction and a family history of cardiomyopathy. Sar...
Source: Current Opinion in Cardiology - April 16, 2021 Category: Cardiology Tags: MOLECULAR GENETICS: Edited by Ali J. Marian Source Type: research

Emergent expansion of clinical epigenetics in patients with cardiovascular diseases
Purpose of review Cardiovascular diseases (CVDs) are typically caused by multifactorial events including mutations in a large number of genes. Epigenetic-derived modifications in the cells are normal but can be amended by aging, lifestyle, and exposure to toxic substances. Major epigenetic modifications are DNA methylation, histone modification, chromatin remodeling as well as the noncoding RNAs. These pivotal players are involved in the epigenetic-induced modifications observed during CVDs. Nevertheless, despite impressive efforts capitalized in epigenetic research in the last 50 years, clinical applications are still...
Source: Current Opinion in Cardiology - April 16, 2021 Category: Cardiology Tags: MOLECULAR GENETICS: Edited by Ali J. Marian Source Type: research

Genetics of dilated cardiomyopathy
Purpose of review Dilated cardiomyopathy (DCM), which include genetic and nongenetic forms, is the most common form of cardiomyopathy. DCM is characterized by left ventricular or biventricular dilation with impaired contraction. In the United States, DCM is a burden to healthcare that accounts for approximately 10,000 deaths and 46,000 hospitalizations annually. In this review, we will focus on the genetic forms of DCM and on recent advances in the understanding of cytoskeletal, sarcomeric, desmosomal, nuclear membrane, and RNA binding genes that contribute to the complexity and genetic heterogeneity of DCM. Recent ...
Source: Current Opinion in Cardiology - April 16, 2021 Category: Cardiology Tags: MOLECULAR GENETICS: Edited by Ali J. Marian Source Type: research

Genetics of atrial fibrillation
Purpose of review Atrial fibrillation is the most common sustained cardiac arrhythmia. In addition to traditional risk factors, it is increasingly recognized that a genetic component underlies atrial fibrillation development. This review aims to provide an overview of the genetic cause of atrial fibrillation and clinical applications, with a focus on recent developments. Recent findings Genome-wide association studies have now identified around 140 genetic loci associated with atrial fibrillation. Studies into the effects of several loci and their tentative gene targets have identified novel pathways associated ...
Source: Current Opinion in Cardiology - April 16, 2021 Category: Cardiology Tags: MOLECULAR GENETICS: Edited by Ali J. Marian Source Type: research

Contemporary perspectives on the genetics and clinical use of lipoprotein(a) in preventive cardiology
Purpose of review The pathogenicity of lipoprotein(a) [Lp(a)] as a risk factor for atherosclerotic cardiovascular disease (ASCVD) is well evidenced and recognized by international consensus-based guidelines. However, the measurement of Lp(a) is not routine clinical practice. Therapeutic agents targeting Lp(a) are now progressing through randomised clinical trials, and it is timely for clinicians to familiarize themselves with this complex and enigmatic lipoprotein particle. Recent findings Recent developments in the understanding of genetic influences on the structure, plasma concentration and atherogenicity of ...
Source: Current Opinion in Cardiology - April 16, 2021 Category: Cardiology Tags: MOLECULAR GENETICS: Edited by Ali J. Marian Source Type: research

Genetics of hypertriglyceridemia and atherosclerosis
Purpose of review The relationship between elevated triglyceride levels (i.e. hypertriglyceridemia) and risk of atherosclerotic cardiovascular disease (ASCVD) has been investigated for decades. Recent genetic studies have sought to resolve the decades-old question of a causal relationship. Recent findings Genetic studies seem to demonstrate associations between elevated triglyceride levels and ASCVD risk. Mendelian randomization studies suggest this association may be causal. However, simultaneous pleiotropic effects of metabolically linked lipid variables – such as non-HDL cholesterol, apolipoprotein B an...
Source: Current Opinion in Cardiology - April 16, 2021 Category: Cardiology Tags: MOLECULAR GENETICS: Edited by Ali J. Marian Source Type: research

RNA therapeutics for cardiovascular disease
Purpose of review The development of mRNA vaccines against coronavirus disease 2019 has brought worldwide attention to the transformative potential of RNA-based therapeutics. The latter is essentially biological software that can be rapidly designed and generated, with an extensive catalog of applications. This review aims to highlight the mechanisms of action by which RNA-based drugs can affect specific gene targets and how RNA drugs can be employed to treat cardiovascular disease, with the focus on the therapeutics being evaluated in clinical trials. The recent advances in nanotechnology aiding the translation of suc...
Source: Current Opinion in Cardiology - April 16, 2021 Category: Cardiology Tags: MOLECULAR GENETICS: Edited by Ali J. Marian Source Type: research

Editorial: Cardiovascular complications of COVID-19
No abstract available (Source: Current Opinion in Cardiology)
Source: Current Opinion in Cardiology - April 16, 2021 Category: Cardiology Tags: MOLECULAR GENETICS: Edited by Ali J. Marian Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Cardiology)
Source: Current Opinion in Cardiology - April 16, 2021 Category: Cardiology Tags: EDITORIAL INTRODUCTIONS Source Type: research

Cardiovascular implications and complications of the coronavirus disease-2019 pandemic: a world upside down
Purpose of review The new pandemic of coronavirus disease-2019 (COVID-19) has produced a global tumult and has overburdened national health systems. We herein discuss the cardiovascular implications and complications of this pandemic analyzing the most recent data clustered over the last several months. Recent findings COVID-19 afflicts the cardiovascular system producing acute cardiac injury in 10–20% of cases with mild disease but in greater than 50–60% in severe cases, contributing to patients’ demise. Other cardiovascular complications include arrhythmias, heart failure, pulmonary embolism ...
Source: Current Opinion in Cardiology - February 12, 2021 Category: Cardiology Tags: HEART FAILURE: Edited by Frank W. Smart Source Type: research

COVID-19 myocarditis and long-term heart failure sequelae
Purpose of review The clinical syndrome of coronavirus disease 2019 (COVID-19) has become a global pandemic leading to significant morbidity and mortality. Cardiac dysfunction is commonly seen in these patients, often presenting as clinical heart failure. Accordingly, we aim to provide a comprehensive review on COVID-19 myocarditis and its long-term heart failure sequelae. Recent findings Several suspected cases of COVID-19 myocarditis have been reported. It is often not clear if the acute myocardial dysfunction is caused by myocarditis or secondary to generalized inflammatory state of cytokine release or microv...
Source: Current Opinion in Cardiology - February 12, 2021 Category: Cardiology Tags: HEART FAILURE: Edited by Frank W. Smart Source Type: research

Machine learning: at the heart of failure diagnosis
This article is an overview of recent applications of ML to achieve improved diagnosis of HF and the resultant implications for patient management. (Source: Current Opinion in Cardiology)
Source: Current Opinion in Cardiology - February 12, 2021 Category: Cardiology Tags: HEART FAILURE: Edited by Frank W. Smart Source Type: research

Skeletal muscle (dys)function in heart failure with preserved ejection fraction
Purpose of review Skeletal muscle dysfunction contributes to exercise intolerance, which manifests as dyspnea and fatiguability in patients with heart failure with preserved ejection fraction (HFpEF). This review aims to summarize the current understanding of skeletal muscle dysfunction in HFpEF. Recent findings Animal and human studies in HFpEF provide insights into the pathophysiological alterations in skeletal muscle structure and function with the identification of several molecular mechanisms. Exercise training and novel pharmacological therapies that target skeletal muscle are proposed as therapeutic inter...
Source: Current Opinion in Cardiology - February 12, 2021 Category: Cardiology Tags: HEART FAILURE: Edited by Frank W. Smart Source Type: research

Novel technologies in the management of heart failure with preserved ejection fraction: a promise during the time of disappointment from pharmacological approaches?
Purpose of review Despite numerous attempts, none of a wide variety of tested drugs achieved meaningful improvement in the outcomes of heart failure with preserved ejection fraction (HFpEF), making new therapeutic strategies a major unmet medical need. The medical device industry embraced the challenge, developing novel technologies directed to face specific aspects of the pathophysiology of HFpEF. This review focuses on some of the most promising technologies attaining meaningful clinical progress recently in the field of HFpEF therapy. Recent findings Implantable pulmonary artery pressure, monitoring for optim...
Source: Current Opinion in Cardiology - February 12, 2021 Category: Cardiology Tags: HEART FAILURE: Edited by Frank W. Smart Source Type: research

Pulmonary hypertension in heart failure
Purpose of review Pulmonary hypertension (PH) occurs frequently in heart failure (HF) and confers worse prognosis. It becomes important to adequately identify these patients to optimize treatment. The purpose of this review is to inform about the updated classification of PH in left heart disease, in addition to current and upcoming trials regarding treatment. Recent findings The updated classification of PH due to left heart disease now utilizes pulmonary vascular resistance instead of diastolic pulmonary gradient to differentiate between isolated postcapillary and combined pre and postcapillary PH. In regards ...
Source: Current Opinion in Cardiology - February 12, 2021 Category: Cardiology Tags: HEART FAILURE: Edited by Frank W. Smart Source Type: research

Update of clinical echocardiographic assessment of heart failure with preserved ejection fraction
Purpose of review Heart failure with preserved ejection fraction (HFpEF) has an increasing global prevalence. Diastolic dysfunction is the predominant cause of symptoms, most commonly, exertional dyspnea. Although prevalent, the syndrome is challenging to identify due to the comorbid conditions that can present similarly. This paper will review established, guideline recommended, echocardiographic variables, and pathophysiology. Recent findings Echocardiography is the primary diagnostic modality. The latest advances in strain analysis, algorithmic use of multiple parameters, and deeper understanding of exercise ...
Source: Current Opinion in Cardiology - February 12, 2021 Category: Cardiology Tags: HEART FAILURE: Edited by Frank W. Smart Source Type: research

Ambulatory advanced heart failure patients: timing of mechanical circulatory support – delaying the inevitable?
Purpose of review Current indications for continuous-flow left ventricular assist device (cfLVAD) implantation is for patients in cardiogenic shock or inotrope-dependent advanced heart failure. Risk stratification of noninotrope dependent ambulatory advanced heart failure patients is a subject of registries designed to help shared-decision making by clinicians and patients regarding the optimal timing of mechanical circulatory support (MCS). Recent findings The Registry Evaluation of Vital Information for VADs in Ambulatory Life enrolled ambulatory noninotrope dependent advanced systolic heart failure patients w...
Source: Current Opinion in Cardiology - February 12, 2021 Category: Cardiology Tags: HEART FAILURE: Edited by Frank W. Smart Source Type: research

Mitral valve surgery for rheumatic heart disease: replace, repair, retrain?
Purpose of review Rheumatic heart disease (RHD) affects over 30 million people worldwide. Substantial variation exists in the surgical treatment of patients with RHD. Here, we aim to review the surgical techniques to treat RHD with a focus on rheumatic mitral valve (MV) repair. We introduce novel educational paradigms to embrace repair-oriented techniques in cardiac centers. Recent findings Due to the low prevalence of RHD in high-income countries, limited expertise in MV surgery for RHD, technical complexity of MV repair for RHD and concerns about durability, most surgeons elect for MV replacement. However, in ...
Source: Current Opinion in Cardiology - February 12, 2021 Category: Cardiology Tags: VALVULAR HEART DISEASE: Edited by Subodh Verma and Bobby Yanagawa Source Type: research

Generalizability of Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention Trial in patients with a history of coronary artery bypass graft surgery
This article aims to ascertain the proportion of patients with a history of CABG that would be eligible for IPE treatment. Recent findings A review of recent literature highlights the presence of residual ischemic following CABG. Using the Québec Heart Database, a repository of contemporary Canadian cardiac patient information, was searched between 1 January 2006 and 31 December 2016, to ascertain generalizability of IPE. Summary In a large (N = 12 641), contemporary, Canadian cohort of patients with a history of CABG and currently on statin therapy, 21.9, 33.6 and 26.4% would be eligible for IPE...
Source: Current Opinion in Cardiology - February 12, 2021 Category: Cardiology Tags: VALVULAR HEART DISEASE: Edited by Subodh Verma and Bobby Yanagawa Source Type: research

Transcatheter mitral valve repair and replacement: the next frontier of transcatheter valve intervention
Purpose of review We summarize the recent developments in transcatheter mitral valve repair (TMVr) and replacement (TMVR), discuss determinants of MitraClip outcomes in various mitral regurgitation causes, and highlight newly emerging devices and randomized trials. Recent findings The discordant results published in the two recent randomized trials for MitraClip, the COAPT and the MITRA-FR trial have led to the emergence of a new conceptual framework such as the proportionate versus disproportionate mitral regurgitation and hemodynamics assessment tools like the real-time continuous left atrial pressure monitori...
Source: Current Opinion in Cardiology - February 12, 2021 Category: Cardiology Tags: VALVULAR HEART DISEASE: Edited by Subodh Verma and Bobby Yanagawa Source Type: research

Surgical repair of ischemic mitral regurgitation: one ring does not fit all
Purpose of review The review summarizes the key parameters that can aid in determining the optimal treatment of ischemic mitral regurgitation (IMR). Recent findings Left ventricular (LV) and mitral valve (MV) parameters are important for surgical planning and risk stratification in IMR. Although LV dimensions is one of the main parameters used in the guidelines, volumes more accurately depict LV remodelling. Furthermore, wall motion abnormalities and wall motion score index can also be useful for surgical planning in treatment of IMR. Viability is best measured with cardiac magnetic resonance, but it is not feas...
Source: Current Opinion in Cardiology - February 12, 2021 Category: Cardiology Tags: VALVULAR HEART DISEASE: Edited by Subodh Verma and Bobby Yanagawa Source Type: research

Combined transcatheter mitral and tricuspid edge-to-edge repair: expanding the horizons of interventional heart failure
Purpose of review The combination of mitral regurgitation and tricuspid regurgitation is common in patients with multiple valvular disease and patient management can be challenging. Surgical combined mitral and tricuspid valve surgery is a treatment option for patients meeting criteria but has demonstrated inconsistent long-term benefits. Recent findings Transcatheter mitral and tricuspid edge-to-edge repair has demonstrated early promising results in patients with a prohibitive surgical risk, making it an interesting treatment option. The present review will discuss the physiopathology of this complex disease a...
Source: Current Opinion in Cardiology - February 12, 2021 Category: Cardiology Tags: VALVULAR HEART DISEASE: Edited by Subodh Verma and Bobby Yanagawa Source Type: research

Two-year outcomes from the PARTNER 3 trial: where do we stand?
Purpose of review The PARTNER 3 trial was conducted to compare outcomes after transcatheter aortic valve replacement (TAVR) with a balloon-expandable valve and surgical aortic valve replacement (SAVR) in individuals at low surgical risk with aortic stenosis. Recently reported rates of death, stoke and valve thrombosis in the TAVR arm have raised concerns about the longevity of this intervention in low-risk individuals. It is incumbent on all members of the Heart Team to understand the potential consequences of these findings. Recent findings TAVR was initially superior to SAVR at 1 year for a primary composite e...
Source: Current Opinion in Cardiology - February 12, 2021 Category: Cardiology Tags: VALVULAR HEART DISEASE: Edited by Subodh Verma and Bobby Yanagawa Source Type: research

Review of transapical off-pump mitral valve intervention with NeoChord implantation
Purpose of review Mitral valve repair surgery has recently shifted from resection-based techniques to leaflet sparing approaches using synthetic neochordae. This has facilitated the growth of a new strategy of transapical off-pump mitral valve intervention with neochord implantation. Recent findings Minimally invasive approaches for mitral valve repair with robotic or video-assisted mini-right anterolateral thoracotomy have been developed to mitigate the morbidity associated with conventional median sternotomy. Recently, an alternative, less invasive surgical strategy has emerged. This transapical off-pump techn...
Source: Current Opinion in Cardiology - February 12, 2021 Category: Cardiology Tags: VALVULAR HEART DISEASE: Edited by Subodh Verma and Bobby Yanagawa Source Type: research

Resurgence of the edge-to-edge repair of the mitral valve
Purpose of review To provide a critical review of the application and outcomes of surgical edge-to-edge (E2E) or Alfieri repair for mitral valvulopathy. Recent findings The E2E repair is a surgical technique to address mitral regurgitation, particularly suited when the responsible mechanism is bileaflet prolapse combined with enlarged annular area. It can also be used for a range of mitral valve pathologies. Surgically, the technique has been employed as a bailout for unsuccessful repair including residual mitral regurgitation because of systolic anterior motion (SAM). E2E repair should be accompanied by a ring ...
Source: Current Opinion in Cardiology - February 12, 2021 Category: Cardiology Tags: VALVULAR HEART DISEASE: Edited by Subodh Verma and Bobby Yanagawa Source Type: research

Antithrombotic therapy after transcatheter aortic valve replacement: current perspective
Purpose of review Transcatheter aortic valve replacement (TAVR) has expanded as a treatment option for severe aortic stenosis throughout the surgical risk spectrum. Decreasing procedural risk and inclusion of lower risk population has shifted the focus to optimization of postprocedural management and balancing the thrombotic and bleeding complications. In this review, we outline various patient and procedure related factors affecting choice of antithrombotic therapy post TAVR and provide an update of recent development in this area. Recent findings Multiple studies have confirmed the high incidence of both ische...
Source: Current Opinion in Cardiology - February 12, 2021 Category: Cardiology Tags: VALVULAR HEART DISEASE: Edited by Subodh Verma and Bobby Yanagawa Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Cardiology)
Source: Current Opinion in Cardiology - February 12, 2021 Category: Cardiology Tags: EDITORIAL INTRODUCTIONS Source Type: research

COVID-19 will forever change the landscape of telemedicine
This article discusses novel ways of using telehealth during the current pandemic and measures that would need to be taken to sustain telehealth and teleconsultations. Recent findings Telehealth has expanded to outpatient pediatric cardiology clinics across the globe during the pandemic. Technological advancements in video conferencing and the abundance of readily available wearable devices have allowed cardiologists to establish a preliminary diagnosis and set forth a treatment plan. Additional support by insurance providers and relaxation of mandatory regulations by the government have allowed telehealth to succee...
Source: Current Opinion in Cardiology - December 7, 2020 Category: Cardiology Tags: PEDIATRICS: Edited by Mitchell I. Cohen Source Type: research

Culture, teamwork and engagement: 40 years of finding the right ingredients
Purpose of review Changing demands in healthcare, new leadership structures and physician preferences on work-life balance have made culture, teamwork and engagement vitally important for the long-term success of medical practices. With recent emphasis placed on culture, teamwork and engagement, leaders have had to acquire management skills that extend beyond the scope of being a successful clinician, educator and researcher. Recent findings Over the last two decades, experts throughout the business and medical fields have worked to define culture. Furthermore, these authors have shown that success in businesses...
Source: Current Opinion in Cardiology - December 7, 2020 Category: Cardiology Tags: PEDIATRICS: Edited by Mitchell I. Cohen Source Type: research

Health anxiety among adults with congenital heart disease
Purpose of review Adults with congenital heart disease (CHD) may experience anxiety specifically related to their medical condition. This review introduces the concepts of health anxiety and heart-focused anxiety, summarizes what is currently known about heart-focused anxiety among adults with CHD and offers suggestions to help adult CHD providers address heart-focused anxiety in their patients. Recent findings Although minimal research has been conducted specific to this outcome, health anxiety may occur at any point across the lifespan of individuals with CHD. A recent study found that children and adolescents...
Source: Current Opinion in Cardiology - December 7, 2020 Category: Cardiology Tags: PEDIATRICS: Edited by Mitchell I. Cohen Source Type: research

Improving outcomes collaboratively with families: what works and what doesn’t
Purpose of review As attention begins to shift from short-term surgical outcomes to long-term clinical and quality of life outcomes, patients and families are becoming increasingly responsible for outcomes. For this reason, it is essential to effectively include them in the outcome planning, goal setting, and evaluation processes. Recent findings There are a number of tools and strategies available to maximize patient engagement. These must be employed in direct patient care and system and policy conversations, for meaningful patient partnerships that can lead to improved outcomes. Summary As we move from...
Source: Current Opinion in Cardiology - December 7, 2020 Category: Cardiology Tags: PEDIATRICS: Edited by Mitchell I. Cohen Source Type: research

Delivering pediatric cardiac care in sub-Saharan Africa: a model for the developing countries
Purpose of review It is projected that by 2050, around 40% of all births, and about 40% of all children, will be in Africa, up from about 10% in 1950. Consequently, this trend will cause an increase in noncommunicable diseases in children, such as congenital and rheumatic heart diseases. The current state of pediatric cardiac care in sub-Saharan Africa is dire with some countries without cardiac surgical services at all. The purpose of this review is to highlight those components needed to build a sustainable model for a pediatric cardiac care center in sub-Saharan Africa. Recent findings Review of the literatur...
Source: Current Opinion in Cardiology - December 7, 2020 Category: Cardiology Tags: PEDIATRICS: Edited by Mitchell I. Cohen Source Type: research

Newer risk assessment strategies in hypertrophic cardiomyopathy
Purpose of review The present article serves to review current risk assessment guidelines for sudden cardiac death (SCD) in patients with hypertrophic cardiomyopathy (HCM) and to discuss how these guidelines can be applied to patients with childhood HCM. New diagnostic techniques that could lead to more accurate risk assessment tools are also discussed. Recent findings Current guidelines for risk assessment in childhood HCM are extrapolated from adult guidelines and lack background research to validate their use. Continuous variables, such as wall thickness, are converted to binary variables, which is particular...
Source: Current Opinion in Cardiology - December 7, 2020 Category: Cardiology Tags: PEDIATRICS: Edited by Mitchell I. Cohen Source Type: research

Update on pediatric pulmonary arterial hypertension
Purpose of review Pulmonary arterial hypertension (PAH) causes high morbidity and mortality in children. In this review, we discuss advances in diagnosis and treatment of this disorder. Recent findings Proceedings published from the 2018 World Symposium updated the definition of pulmonary hypertension to include all adults and children with mean pulmonary artery pressure more than 20 mmHg. Targeted PAH therapy is increasingly used off-label, but in 2017, bosentan became the first Food and Drug Administration-targeted PAH therapy approved for use in children. Summary In recent years, advanced imaging and...
Source: Current Opinion in Cardiology - December 7, 2020 Category: Cardiology Tags: PEDIATRICS: Edited by Mitchell I. Cohen Source Type: research

Calmodulinopathies: throwing back the veil on the newest life-threatening genetic arrhythmia syndrome
Purpose of review This review provides a basic understanding of the calmodulin gene and its role in calcium homeostasis. We outline the functional effects and clinical expression of CALM mutations and review disease expression and management. Recent findings Calmodulinopathies are rare life-threatening arrhythmia syndromes affecting young individuals. They are caused by mutations in any of the three genes (CALM 1-3) that encode calmodulin (CaM), a ubiquitously expressed Ca2+ signaling protein with multiple targets that in the heart, modulates several ion channels. Patients express varied phenotypes: long QT synd...
Source: Current Opinion in Cardiology - December 7, 2020 Category: Cardiology Tags: PEDIATRICS: Edited by Mitchell I. Cohen Source Type: research

The placenta as the window to congenital heart disease
This article reviews the role of the placenta and the potential impact of placental insufficiency on fetuses with congenital heart disease. Recent findings The fetal heart and the placenta are directly linked because they develop concurrently with shared regulatory and signaling pathways. Placental disease is more common in pregnancies carrying a fetus with congenital heart disease and the fetal response to placental insufficiency may lead to the postnatal persistence of cardiac remodeling. The mechanisms underlying this placental–fetal axis of interaction potentially include genetic factors, oxidative stress,...
Source: Current Opinion in Cardiology - December 7, 2020 Category: Cardiology Tags: PEDIATRICS: Edited by Mitchell I. Cohen Source Type: research

Telemedicine in cardiac procedures: considerations for a remote future
Purpose of review Present a review of relevant literature and suggest a framework for discussion of the considerations affecting the evolution and adoption of Telerobotic Support and Telerobotic Collaboration in the practice of cardiac procedural medicine. Recent findings Recent medical practice has undergone remarkable transformation in the adoption of telemedicine. This evolution has been accelerated by the COVID-19 (SARS-CoV-2) pandemic and has largely been focused on outpatient medicine. Clinical studies and opinion articles have highlighted benefits including reduced costs, increased patient engagement, and...
Source: Current Opinion in Cardiology - December 7, 2020 Category: Cardiology Tags: ARRHYTHMIAS: Edited by Wilber W. Su Source Type: research

The functional medicine approach to atrial fibrillation: can a cure for atrial fibrillation be found in the gut?
Purpose of review The importance of addressing the proximal causes of atrial fibrillation is recognized, yet frustration with the currently applied preventive measures is high. This review describes the functional medicine model (FMM), which identifies the proximal causes of atrial fibrillation at the level of gene-environment interaction. Recent findings The pathological processes leading to atrial fibrillation sustaining disorder have been elucidated in translational studies and are described as ‘nodal points.’ Examples are inflammation, oxidative stress, autoimmune mechanisms, and visceral adiposi...
Source: Current Opinion in Cardiology - December 7, 2020 Category: Cardiology Tags: ARRHYTHMIAS: Edited by Wilber W. Su Source Type: research

Percutaneous left atrial appendage occlusion
In conclusion, percutaneous LAAO appears to be a promising option for NVAF patients who are not candidates for long-term OAC in the current era. Further evidence guiding optimal patient selection and periprocedural antithrombotic regimen will help identify the patients who would benefit the most from this procedure. (Source: Current Opinion in Cardiology)
Source: Current Opinion in Cardiology - December 7, 2020 Category: Cardiology Tags: ARRHYTHMIAS: Edited by Wilber W. Su Source Type: research

Artificial intelligence in cardiovascular medicine
Purpose of review Artificial intelligence is a broad set of sophisticated computer-based statistical tools that have become widely available. Cardiovascular medicine with its large data repositories, need for operational efficiency and growing focus on precision care is set to be transformed by artificial intelligence. Applications range from new pathophysiologic discoveries to decision support for individual patient care to optimization of system-wide logistical processes. Recent findings Machine learning is the dominant form of artificial intelligence wherein complex statistical algorithms ‘learn’ ...
Source: Current Opinion in Cardiology - December 7, 2020 Category: Cardiology Tags: ARRHYTHMIAS: Edited by Wilber W. Su Source Type: research

Cryoballoon ablation for extrapulmonary vein targets
Purpose of review Cryoballoon catheter can create large and contiguous lesions with stable contact during ablation. It has proven to be well tolerated and effective in pulmonary vein isolation. But atrial arrhythmias, including atrial fibrillation, atrial tachycardia, and atrial flutter (AFL), also relate to many extrapulmonary vein targets. It is necessary to understand the current evidence for the use of cryoballoon ablation for targets outside of pulmonary veins. Recent findings Studies have shown that the cryoballoon ablation can be used in extrapulmonary vein area, including left atrium roof, left atrial ap...
Source: Current Opinion in Cardiology - December 7, 2020 Category: Cardiology Tags: ARRHYTHMIAS: Edited by Wilber W. Su Source Type: research