Amyloidosis cardiomyopathy: update in the diagnosis and treatment of the most common types
Purpose of review The present article provides an update about the recent advances in the diagnosis and management of the most common types of cardiac amyloidosis, including light chain, wild-type transthyretin (ATTRwt), and mutant transthyretin (ATTRm). Recent findings The document reviews the utility of diagnostic tools including innovative echocardiographic indices, magnetic resonance T1 mapping and measurement of extracellular volume, and the role and validation of bone scintigraphy for the noninvasive assessment of ATTR amyloidosis. It summarizes the data about therapies for light chain amyloidosis including bort...
Source: Current Opinion in Cardiology - August 9, 2018 Category: Cardiology Tags: Special Commentary Source Type: research

Should functional assessment of lesion severity be used to guide coronary bypass?
Purpose of review The purpose of this article is to investigate the potential role of fractional flow reserve (FFR) to guide surgical revascularization. Recent findings Coronary artery bypass is planned and executed primarily based on angiographic coronary anatomy. FFR is the most well-established tool for functional assessment of coronary lesions. Randomized trials have demonstrated the benefit of FFR-guided percutaneous coronary intervention (PCI) to determine the ischemic burden of intermediate lesions. Surgically, FFR is predominantly used to determine the functional severity of intermediate lesions of the left an...
Source: Current Opinion in Cardiology - August 9, 2018 Category: Cardiology Tags: COMPLEX ISSUES IN CORONARY REVASCULARIZATION: Edited by Subodh Verma and Bobby Yanagawa Source Type: research

Altered branched chain amino acid metabolism: toward a unifying cardiometabolic hypothesis
Purpose of review Atherosclerotic cardiovascular disease (CVD) and type II diabetes (T2D) share common etiologic pathways that may long precede the development of clinically evident disease. Early identification of risk markers could support efforts to individualize risk prediction and improve the efficacy of primary prevention, as well as uncover novel therapeutic targets. Recent findings Altered metabolism of branched-chain amino acids (BCAAs), and their subsequent accumulation in circulation, may precede the development of insulin resistance and clinically manifest cardiometabolic diseases. BCAAs – the essent...
Source: Current Opinion in Cardiology - August 9, 2018 Category: Cardiology Tags: COMPLEX ISSUES IN CORONARY REVASCULARIZATION: Edited by Subodh Verma and Bobby Yanagawa Source Type: research

Diabetes and multivessel disease: coronary artery bypass grafting remains king
Purpose of review Review the recently published scientific evidence to support the decision-making process of revascularization strategy in patients with diabetes mellitus (DM) and multivessel coronary artery disease (MVD). Recent findings Recently published observational analyses have proven the superiority of coronary artery bypass grafting (CABG) in patients presenting with other comorbidities together with DM, such as renal disease or heart failure. Summary Significant challenges and controversies surrounded the choice of the appropriate revascularization method in patients with DM and MVD over the last decades...
Source: Current Opinion in Cardiology - August 9, 2018 Category: Cardiology Tags: COMPLEX ISSUES IN CORONARY REVASCULARIZATION: Edited by Subodh Verma and Bobby Yanagawa Source Type: research

Management of patients with end-stage renal disease: coronary artery bypass graft surgery versus percutaneous coronary intervention
Purpose of review Coronary artery disease is common in patients with end-stage renal disease (ESRD) on hemodialysis. ESRD patients are prone to atherosclerosis and are likely to present with advanced CAD requiring coronary artery bypass graft surgery (CABG) or percutaneous coronary intervention (PCI). Recent findings Individual observational studies and aggregated results comparing PCI to CABG have shown an increased risk of early postoperative mortality in the CABG group followed by a decrease in late mortality and cardiovascular events. Drug eluting stents are preferred to bare metal stents in patients undergoing PC...
Source: Current Opinion in Cardiology - August 9, 2018 Category: Cardiology Tags: COMPLEX ISSUES IN CORONARY REVASCULARIZATION: Edited by Subodh Verma and Bobby Yanagawa Source Type: research

What is the state of hybrid coronary revascularization in 2018?
Purpose of review Hybrid coronary revascularization (HCR) combines minimally invasive surgical bypass with percutaneous coronary intervention (PCI) using drug-eluting stents, the goal being to leverage the strengths of each approach. Here we provide an update on HCR from the past 12 months. Recent findings HCR represents a minority of surgical revascularization cases from a small number of highly experienced surgical centers. Most single-center observational series show no differences in major cardiovascular outcomes comparing HCR and coronary artery bypass graft (CABG) or HCR and PCI. The 5-year results of the first ...
Source: Current Opinion in Cardiology - August 9, 2018 Category: Cardiology Tags: COMPLEX ISSUES IN CORONARY REVASCULARIZATION: Edited by Subodh Verma and Bobby Yanagawa Source Type: research

New biomarker strategies to enable precision cardiovascular medicine
Purpose of review Precision medicine is the concept of disease treatment and prevention using an individual's genomic profile in addition to personal and environmental factors. This review outlines examples of new biomarker strategies that enable the practice of precision cardiovascular medicine. Recent findings Although commonly attributed to identifying causative genetic variants, mono-genetic causes of cardiovascular diseases (CVD) are not common and largely focused on lipoprotein analyses. Nevertheless, rare clinical presentations in families with extreme phenotypes can sometimes identify novel pathways that can s...
Source: Current Opinion in Cardiology - August 9, 2018 Category: Cardiology Tags: PREVENTION: Edited by Andrew Pipe Source Type: research

Genetic stratification for primary prevention of coronary artery disease
Purpose of review To review the literature showing genetic risk variants is a reliable means of stratifying for risk of CAD for primary prevention. Recent findings Over 90 genetic risk variants have been discovered that predispose to CAD. Results of several studies show that these risk variants effectively stratify for risk of CAD in asymptomatic individuals. Summary The total individual genetic risk can be summarized into a single number referred to as the genetic risk score (GRS). The GRS unlike the Framingham Risk Score is not dependent on age and independent of conventional risk factors. As DNA does not change ...
Source: Current Opinion in Cardiology - August 9, 2018 Category: Cardiology Tags: PREVENTION: Edited by Andrew Pipe Source Type: research

In sickness and in health: relationship quality and cardiovascular risk and management
Purpose of review To review the link between couple relationships and cardiovascular health, the plausible mechanisms by which relationship quality affects heart health, and to provide an overview of couple-based interventions aimed at improving cardiovascular health. Recent findings Marriage and the quality of the couple relationship bond are robust predictors of long-term health outcomes. Chronic relationship conflict and disconnection can be deadly. There are direct and indirect pathways by which couple relationship quality affect cardiovascular health. Direct pathways include effects of relationship quality on car...
Source: Current Opinion in Cardiology - August 9, 2018 Category: Cardiology Tags: PREVENTION: Edited by Andrew Pipe Source Type: research

Women's heart health: a focus on nurses’ physical activity and sedentary behaviour
Purpose of review This review focuses on recent literature examining and targeting the physical activity and sedentary behaviour of nurses. The role of physical activity and sedentary behaviour in preventing and managing cardiovascular disease (CVD) in women is also discussed. Recent findings Nurses (most of whom are women) represent the largest professional group within the health care workforce and many present with risk factors for CVD (e.g. physical inactivity, sedentary behaviour, overweight/obesity, hypertension, dyslipidemia, diabetes, smoking, depression, anxiety). Several studies have measured the physical ac...
Source: Current Opinion in Cardiology - August 9, 2018 Category: Cardiology Tags: PREVENTION: Edited by Andrew Pipe Source Type: research

Women's health: making cardiovascular disease real
Purpose of review When patients are seen for persistent chest pain in the absence of obstructive coronary artery disease, the physician must decide if the symptoms are due to myocardial ischemia in order to guide treatment. Recent findings Recent findings indicate that ischemia due to coronary microvascular dysfunction (CMD) is associated with subclinical coronary atherosclerosis and an adverse prognosis. Therapeutic probe trials suggest that antiatherosclerotic and anti-ischemic therapeutic strategies may be useful. A large randomized clinical trial of high-intensity statin, maximally tolerated angiotensin-converting...
Source: Current Opinion in Cardiology - August 9, 2018 Category: Cardiology Tags: PREVENTION: Edited by Andrew Pipe Source Type: research

Sex-specific risk factors for cardiovascular disease in women-making cardiovascular disease real
Purpose of review Sex-specific differences in pathophysiology, prevalence, and impact of cardiovascular disease (CVD) risk factors may explain the high cardiovascular mortality rates in women. Recent findings We review the sex differences in traditional risk factors (dyslipidemia, hypertension, diabetes, and smoking) and nontraditional risk factors (menopause and hormones, pregnancy, inflammation and autoimmune diseases, anemia, depression, and migraines) and their prognostic and therapeutic implications. Summary Recent research indicates that with respect to traditional risk factors such as dyslipidemia, hypertens...
Source: Current Opinion in Cardiology - August 9, 2018 Category: Cardiology Tags: PREVENTION: Edited by Andrew Pipe Source Type: research

Cardiovascular disease prevention: challenges remain; opportunities grow
No abstract available (Source: Current Opinion in Cardiology)
Source: Current Opinion in Cardiology - August 9, 2018 Category: Cardiology Tags: PREVENTION: Edited by Andrew Pipe Source Type: research

Applications of left ventricular strain measurements to patients undergoing chemotherapy
Purpose of review We aim to summarize the utility of strain in monitoring the effects of cancer therapy-related cardiotoxicity (CTRC) on the development of left ventricular (LV) dysfunction. Recent findings Serial assessment of cardiac function at baseline and during treatment is recommended in patients undergoing cancer treatment. Historically, the use of left ventricular ejection fraction (LVEF) has been used to monitor for cardiac toxicity from cancer therapies but myocardial mechanic parameters, in particular global longitudinal strain (GLS), have emerged as powerful adjunctive tools. On the basis of longitudinal ...
Source: Current Opinion in Cardiology - August 9, 2018 Category: Cardiology Tags: IMAGING AND HEART FAILURE: MYOCARDIAL STRAIN: Edited by Sherif Nagueh Source Type: research

Right ventricular strain: measurement and clinical application
Purpose of review Right ventricular (RV) assessment has long been challenging and technically difficult using echocardiography. This is mainly the result of the asymmetrical shape of the RV making it difficult to visualize on one-or-two dedicated views, thus requiring multiple integrated views and subjective assessment. Measurement of tricuspid annular systolic plane excursion and RV tissue Doppler velocity have become relied-upon methods of objective assessments; however, have limitations for characterizing true RV physiology. Recent findings Studies suggest that two-dimensional RV free wall longitudinal systolic str...
Source: Current Opinion in Cardiology - August 9, 2018 Category: Cardiology Tags: IMAGING AND HEART FAILURE: MYOCARDIAL STRAIN: Edited by Sherif Nagueh Source Type: research

Left atrial strain: measurement and clinical application
Purpose of review To summarize recent literature on the use of left atrial strain in the diagnosis and management of patients with heart failure. Recent findings Left atrial dysfunction is a hallmark of diastolic dysfunction and heart failure, in particular, heart failure with preserved ejection fraction (HFpEF). Recently, myocardial deformation analysis via strain and strain rate measurements have been applied to the left atrium. These measurements have been shown to aid in the diagnosis of heart failure and be accurate predictors of cardiac pressures, diastolic dysfunction, exercise performance, and clinical outcome...
Source: Current Opinion in Cardiology - August 9, 2018 Category: Cardiology Tags: IMAGING AND HEART FAILURE: MYOCARDIAL STRAIN: Edited by Sherif Nagueh Source Type: research

Application of left ventricular strain in patients with aortic and mitral valve disease
Purpose of review Left ventricular (LV) global longitudinal strain (GLS) is widely recognized as a more sensitive measure of LV systolic function compared with LV ejection fraction (LVEF). In addition, the measurement of LVGLS is more reproducible than two-dimensional LVEF. Current guidelines for diagnosis and treatment of valvular heart disease include LVEF as one of the parameters to take into consideration in the clinical decision-making. However, a large body of evidence is showing that LVGLS may be a better prognosticator than LVEF in various valvular heart diseases. In this timely state-of-the-art review, the evide...
Source: Current Opinion in Cardiology - August 9, 2018 Category: Cardiology Tags: IMAGING AND HEART FAILURE: MYOCARDIAL STRAIN: Edited by Sherif Nagueh Source Type: research

Application of left ventricular strain to patients with coronary artery disease
The objective of this article was to review the potential application of two-dimensional (2D) and three-dimensional (3D) strains in patients with coronary artery disease. Recent findings Reports on the diagnostic accuracy of myocardial deformation analysis using 2D and 3D speckle-tracking analyses to detect significant coronary stenosis at rest or during stress and to evaluate myocardial viability are limited. A newer 2D strain approach that uses layer-specific strain analysis might be sensitive in the detection of subtle regional myocardial dysfunction induced by myocardial ischemia. However, its potential accuracy is ...
Source: Current Opinion in Cardiology - August 9, 2018 Category: Cardiology Tags: IMAGING AND HEART FAILURE: MYOCARDIAL STRAIN: Edited by Sherif Nagueh Source Type: research

An introduction to left ventricular strain
This article reviews the definition of left ventricular strain, outlines the types of strain and reviews how strain is acquired and measured. In addition, the advantages of strain analysis over LVEF as well as the incremental prognostic value of strain are examined. We further review the challenges associated with strain imaging as well as outline the future of strain imaging. (Source: Current Opinion in Cardiology)
Source: Current Opinion in Cardiology - August 9, 2018 Category: Cardiology Tags: IMAGING AND HEART FAILURE: MYOCARDIAL STRAIN: Edited by Sherif Nagueh Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Cardiology)
Source: Current Opinion in Cardiology - August 9, 2018 Category: Cardiology Tags: Editorial Introductions Source Type: research

New antihyperglycaemic agents and cardiovascular disease: let's be optimistic
Purpose of review Cardiovascular disease (CVD) substantially increases mortality in diabetes mellitus. This narrative review highlights recent research on the putative associations between dipeptyl peptidase 4 inhibitors, glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium glucose co-transporter 2 inhibitors (SGLT-2is) and several cardiovascular risk factors. Recent findings New antihyperglycaemic agents favourably modulate several CVD risk factors, including fasting and postprandial plasma glucose levels, body weight, blood pressure, lipids, microalbuminuria, nonalcoholic fatty liver disease, serum uric a...
Source: Current Opinion in Cardiology - June 11, 2018 Category: Cardiology Tags: LIPIDS AND EMERGING RISK FACTORS: Edited by Dimitri P. Mikhailidis and Anthony S. Wierzbicki Source Type: research

Statin loading in cardiovascular surgery: never too early to treat
Purpose of review The effects of statin loading before, during or after vascular interventions on cardiovascular and renal outcomes are discussed. Furthermore, the selection of optimal statin type and dose, according to current evidence or guidelines, is considered. The importance of treating statin intolerance and avoiding statin discontinuation is also discussed. Recent findings Statin loading has been shown to beneficially affect cardiovascular outcomes, total mortality and/or contrast-induced acute kidney injury, in patients undergoing vascular procedures such as percutaneous coronary intervention (PCI), coronary ...
Source: Current Opinion in Cardiology - June 11, 2018 Category: Cardiology Tags: LIPIDS AND EMERGING RISK FACTORS: Edited by Dimitri P. Mikhailidis and Anthony S. Wierzbicki Source Type: research

HIV infection and lipids
Purpose of review We comment on the role of dyslipidaemia in cardiovascular disease (CVD) in HIV-infected patients. We have discussed various risk factors, including traditional CVD risk factors, HIV-related risk factors and antiretroviral therapy (ART)-induced dyslipidaemia. Recent findings HIV-infected individuals are prone to lipid and lipoprotein abnormalities as a result of the infection itself and the effect of ART. The older drugs used for the treatment of HIV were associated with an increased risk of these abnormalities. New therapies used to treat HIV are lipid friendly. Calculating CVD risk in the HIV popula...
Source: Current Opinion in Cardiology - June 11, 2018 Category: Cardiology Tags: LIPIDS AND EMERGING RISK FACTORS: Edited by Dimitri P. Mikhailidis and Anthony S. Wierzbicki Source Type: research

New diet trials and cardiovascular risk
Purpose of review The prevalence of cardiovascular disease (CVD) is increasing to epidemic proportions and current management centred on treatment with drugs is not enough to stop this pandemic. CVD prevention is of paramount importance. In this context, diet and behavioural intervention programs are the first step and have the advantage of lesser cost and side effects than pharmacological approaches. In this review, we will examine the most recent evidence related to dietary prevention of CVD risk. Recent findings Healthy dietary patterns such as the dietary approaches to stop hypertension, the vegetarian, the low-fa...
Source: Current Opinion in Cardiology - June 11, 2018 Category: Cardiology Tags: LIPIDS AND EMERGING RISK FACTORS: Edited by Dimitri P. Mikhailidis and Anthony S. Wierzbicki Source Type: research

An update on trials of novel lipid-lowering drugs
Purpose of review A number of novel trials have assessed the efficacy of new lipid-lowering therapies in cardiovascular disease (CVD). Recent findings Proprotein convertase subtilisin kexin-9 inhibitors reduce low-density lipoprotein cholesterol (LDL-C) by 50–55%. A CVD outcome trial in patients with acute coronary syndromes with evolocumab achieved a LDL-C of 0.8 mmol/l (31 mg/dl) and a 20% relative risk reduction in CVD events in 2.2 years. Cholesterol ester transfer protein inhibitors raise high-density lipoprotein cholesterol and can lower LDL-C. Anacetrapib reduced coronary artery disease events by 7%, ...
Source: Current Opinion in Cardiology - June 11, 2018 Category: Cardiology Tags: LIPIDS AND EMERGING RISK FACTORS: Edited by Dimitri P. Mikhailidis and Anthony S. Wierzbicki Source Type: research

Future pharmacological therapy in hypertension
Purpose of review Hypertension (HTN) is a widespread and growing disease, with medication intolerance and side-effect present among many. To address these obstacles novel pharmacotherapy is an active area of drug development. This review seeks to explore future drug therapy for HTN in the preclinical and clinical arenas. Recent findings The future of pharmacological therapy in HTN consists of revisiting old pathways to find new targets and exploring wholly new approaches to provide additional avenues of treatment. In this review, we discuss the current status of the most recent drug therapy in HTN. New developments in...
Source: Current Opinion in Cardiology - June 11, 2018 Category: Cardiology Tags: HYPERTENSION: Edited by Hector O. Ventura and Carl J. Lavie Source Type: research

The role of clinic blood pressure for the diagnosis of hypertension
Purpose of review Recent data from randomized clinical trials and updates to hypertension guidelines warrant a review of the literature for the diagnosis and management of hypertension in the clinic setting. Although there have been significant advances in ambulatory blood pressure (BP) monitoring and home BP monitoring, office BP (OBP) measurements remains the primary means of diagnosis and treatment. Recent findings The current review focuses on updated guidelines, proper technique, device selection, and the recent controversy regarding unattended BP measurements. We review the data on cardiovascular outcomes, the c...
Source: Current Opinion in Cardiology - June 11, 2018 Category: Cardiology Tags: HYPERTENSION: Edited by Hector O. Ventura and Carl J. Lavie Source Type: research

Physical activity and fitness for the prevention of hypertension
Purpose of review The aim of this review is to evaluate the most recent literature about the role of physical activity, exercise, and fitness in hypertension prevention. Recent findings Strong evidence indicates that performing moderate-to-vigorous physical activity, particularly aerobic exercise, and improving cardiorespiratory fitness (CRF) reduce blood pressure (BP) levels and lower hypertension incidence. Although evidence is limited, performing resistance exercise or improving muscular strength appears to be associated with a lower incidence of hypertension. Furthermore, reducing sedentary time or replacing seden...
Source: Current Opinion in Cardiology - June 11, 2018 Category: Cardiology Tags: HYPERTENSION: Edited by Hector O. Ventura and Carl J. Lavie Source Type: research

The role of diet for prevention and management of hypertension
Purpose of review Regular consumption of a diet high in sodium, energy dense foods, fat content, refined carbohydrates, added sugar and low in fruits and vegetables contributes to an increased risk of developing hypertension (HTN) and cardiovascular disease. This review aims to provide a synopsis of evidence-based dietary approaches that have been effective in lowering blood pressure (BP) in pre-HTN and individuals with HTN. Recent findings Recent dietary recommendations have emphasized overall dietary patterns and its relation between food and BP. The Dietary Approaches to Stop Hypertension (DASH) diet and modificati...
Source: Current Opinion in Cardiology - June 11, 2018 Category: Cardiology Tags: HYPERTENSION: Edited by Hector O. Ventura and Carl J. Lavie Source Type: research

The role of the pharmacist in hypertension management
This article aims to provide an update on the proven methods in which pharmacists contribute to the management of hypertensive patients. Recent findings Several recently published studies demonstrate the positive impact of pharmacist intervention and care on patient outcomes in ambulatory and community settings. These practice models include medication therapy management, collaborative drug therapy management, telehealth and team-based care. Summary The role of the pharmacist in hypertension encompasses medication management, disease state education and patient counseling and is most successful when integrated into t...
Source: Current Opinion in Cardiology - June 11, 2018 Category: Cardiology Tags: HYPERTENSION: Edited by Hector O. Ventura and Carl J. Lavie Source Type: research

Salt and hypertension: what do we know?
Purpose of review To evaluate the evidence for population-wide sodium restriction. Recent findings The recommendations for population-wide sodium restriction largely rely on one surrogate marker (blood pressure). However, recent evidence suggests that when looking beyond blood pressure (e.g. heart rate, aldosterone, renin, cholesterol, triglycerides, noradrenaline and adrenaline), the net effect of sodium restriction is likely harmful. Prospective studies support the notion that those consuming the lowest amounts of salt are at the highest risk of cardiovascular events and premature death. Summary There is no defin...
Source: Current Opinion in Cardiology - June 11, 2018 Category: Cardiology Tags: HYPERTENSION: Edited by Hector O. Ventura and Carl J. Lavie Source Type: research

Hypertension: management and measurements
No abstract available (Source: Current Opinion in Cardiology)
Source: Current Opinion in Cardiology - June 11, 2018 Category: Cardiology Tags: HYPERTENSION: Edited by Hector O. Ventura and Carl J. Lavie Source Type: research

Antithrombotic drugs in cardiovascular medicine: a year in review
Purpose of review To provide an up to date review of the most recent randomized clinical trials in the field of antithrombotic drugs for cardiovascular diseases. Recent findings In 2017, low-dose anti-Xa treatment added to aspirin proved to be more efficacious than either treatment alone in patients with stable atherosclerotic disease despite the increase in nonfatal bleeding events. Furthermore, anticoagulation strategy during coronary interventions was again tested in a registry-based trial and showed comparable efficacy and safety between heparin alone and bivalirudin. Data from safety trials demonstrated lower ris...
Source: Current Opinion in Cardiology - June 11, 2018 Category: Cardiology Tags: CLINICAL TRIALS: Edited by Neal S. Kleiman Source Type: research

Transcatheter valvular interventions in 2017: some things old, some things new!
Purpose of review Transcatheter valvular interventions have changed the landscape of valvular therapies. We examine some studies on transcatheter valvular interventions published in the year 2017 to better understand their implications on clinical practice and future research. Recent findings Findings from the SURTAVI study suggest TAVR to be a reasonable option in intermediate risk patients with aortic stenosis. Recent studies indicate that valve leaflet thrombosis is associated with poor outcomes. Data from the TVT registry on current transcatheter mitral valve repair are encouraging; alternative repair systems have...
Source: Current Opinion in Cardiology - June 11, 2018 Category: Cardiology Tags: CLINICAL TRIALS: Edited by Neal S. Kleiman Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Cardiology)
Source: Current Opinion in Cardiology - June 11, 2018 Category: Cardiology Tags: Editorial Introductions Source Type: research

Genetic cardiomyopathies
Purpose of review To describe recent advancements in cardiovascular genetics made possible by leveraging next-generation sequencing (NGS), and to provide a framework for practical applications of genetic testing for hypertrophic (HCM), dilated (DCM), and arrhythmogenic right ventricular cardiomyopathies (ARVC). Recent findings The availability of NGS has made possible extensive reference databases. These, combined with recent initiatives to compile previously siloed commercial and research cardiomyopathy data sets, provide a more powerful and precise approach to cardiovascular genetic medicine. HCM, DCM and ARVC are c...
Source: Current Opinion in Cardiology - April 13, 2018 Category: Cardiology Tags: CARDIAC FAILURE: Edited by Nir Uriel and Stavros Drakos Source Type: research

Peripartum cardiomyopathy: approach to management
Purpose of review To provide recommendations for the diagnosis and management of patients with peripartum cardiomyopathy (PPCM). Recent findings PPCM is pregnancy-associated myocardial disease that occurs during pregnancy or postpartum and is characterized by the development of heart failure due to marked left ventricular (LV) systolic dysfunction. The disease is relatively uncommon, but its incidence is increasing, and it remains an important cause of cardiac-related maternal morbidity and mortality in previously healthy young women. With early diagnosis and treatment, the majority of the patients demonstrate recover...
Source: Current Opinion in Cardiology - April 13, 2018 Category: Cardiology Tags: CARDIAC FAILURE: Edited by Nir Uriel and Stavros Drakos Source Type: research

Myocarditis and cardiomyopathy
Purpose of review The aim of this study is to summarize the literature describing the pathogenesis, diagnosis and management of cardiomyopathy related to myocarditis. Recent findings Myocarditis has a variety of causes and a heterogeneous clinical presentation with potentially life-threatening complications. About one-third of patients will develop a dilated cardiomyopathy and the pathogenesis is a multiphase, mutlicompartment process that involves immune activation, including innate immune system triggered proinflammatory cytokines and autoantibodies. In recent years, diagnosis has been aided by advancements in cardi...
Source: Current Opinion in Cardiology - April 13, 2018 Category: Cardiology Tags: CARDIAC FAILURE: Edited by Nir Uriel and Stavros Drakos Source Type: research

Iron overload cardiomyopathy: from diagnosis to management
Purpose of review Iron overload cardiomyopathy (IOC) is an important predictor of prognosis in a significant number of patients with hereditary hemochromatosis and hematologic diseases. Its prevalence is increasing because of improved treatment strategies, which significantly improve life expectancy. We will review diagnosis, treatment, and recent findings in the field. Recent findings The development of preclinical translational disease models during the last years have helped our understanding of specific disease pathophysiological pathways that might eventually change the outcomes of these patients. Summary IOC ...
Source: Current Opinion in Cardiology - April 13, 2018 Category: Cardiology Tags: CARDIAC FAILURE: Edited by Nir Uriel and Stavros Drakos Source Type: research

Viral myocarditis: a prime example for endomyocardial biopsy-guided diagnosis and therapy
Purpose of review Myocarditis is an inflammatory disease of the cardiac muscle mainly caused by viral infection. Due to the diverse clinical presentation of myocarditis, accurate diagnosis demands simultaneous histologic, immunohistochemical and molecular biological workup of endomyocardial biopsies (EMBs) as defined by the position statement of the Working Group on Myocardial and Pericardial Diseases of the European Society of Cardiology on myocarditis. Recent findings Endomyocardial biopsy-based analysis of viral transcriptional activity, mRNA expression, epigenetics and region-specific protein expression analysis v...
Source: Current Opinion in Cardiology - April 13, 2018 Category: Cardiology Tags: CARDIAC FAILURE: Edited by Nir Uriel and Stavros Drakos Source Type: research

Heart health in the age of highly active antiretroviral therapy: a review of HIV cardiomyopathy
Purpose of review Advancements in highly active antiretroviral therapy (HAART) for human immunodeficiency virus (HIV) has led to increased survival, approaching that of the general population. These patients are at an increased risk for heart disease, specifically HIV-associated cardiomyopathy. Recent findings Initially, HIV-associated cardiomyopathy was predominantly noted as systolic dysfunction, but diastolic dysfunction has become more common with increased use of HAART. The pathogenesis of HIV-associated cardiomyopathy involves direct viral infection, cytokine activity, focal myocarditis, HAART side effects, immu...
Source: Current Opinion in Cardiology - April 13, 2018 Category: Cardiology Tags: CARDIAC FAILURE: Edited by Nir Uriel and Stavros Drakos Source Type: research

HDLs and the pathogenesis of atherosclerosis
Purpose of review Plasma levels of HDL cholesterol are a biomarker of cardiovascular health but not a therapeutic target, as demonstrated by the failure of pharmacological modulation of HDL cholesterol to prevent or treat atherosclerotic cardiovascular disease. In health, HDL particles exert pleiotropic effects against atherosclerosis, including cholesterol removal from foam cells, vasodilatory effects through vascular endothelial cell nitric oxide production, decreased vascular inflammation and oxidative damage, endothelial cell proliferation and antiapoptotic effects. Recent findings These functional effects of HDL ...
Source: Current Opinion in Cardiology - April 13, 2018 Category: Cardiology Tags: MOLECULAR GENETICS: Edited by Ali J. Marian Source Type: research

Genetics of atrial fibrillation: an update
Purpose of review Atrial fibrillation is a common cardiac arrhythmia with a high morbidity and mortality affecting 34 million worldwide. Current therapies are inadequate and often fail to directly address molecular mechanisms of the disease. In this review, we will provide an overview of recent advances in our understanding of the genetic underpinnings of atrial fibrillation. Recent findings Large-scale genetic association studies have more than doubled the number of genetic loci associated with atrial fibrillation during the last year. Studies examining how genes at or near these loci can affect the pathogenesis of a...
Source: Current Opinion in Cardiology - April 13, 2018 Category: Cardiology Tags: MOLECULAR GENETICS: Edited by Ali J. Marian Source Type: research

Genetic risk stratification in cardiac arrhythmias
Purpose of review The current article provides a concise summary of the possibilities and limitations of genotype-based risk stratification of cardiac arrhythmias. We will outline the most important findings of the recent years in the light of their chronological and conceptual development. Recent findings Genotype–phenotype association studies in families with single-gene disorders as well as in the general population led to the discovery of several DNA variants significantly associated with the risk of sudden death or life-threatening arrhythmias. In genetic (monogenic) diseases, the disease-causing mutations ...
Source: Current Opinion in Cardiology - April 13, 2018 Category: Cardiology Tags: MOLECULAR GENETICS: Edited by Ali J. Marian Source Type: research

Extracellular vesicles in cardiovascular homeostasis and disease
Purpose of review Extracellular vesicles have emerged as one of the most important means through which cells interact with each other and the extracellular environment, but extracellular vesicle research remains challenging due to their small size, limited amount of material required for traditional molecular biology assays and inconsistency in the methods of their isolation. The advent of new technologies and standards in the field, however, have led to increased mechanistic insight into extracellular vesicle function. Herein, the latest studies on the role of extracellular vesicles in cardiovascular physiology and dise...
Source: Current Opinion in Cardiology - April 13, 2018 Category: Cardiology Tags: MOLECULAR GENETICS: Edited by Ali J. Marian Source Type: research

The long noncoding RNA landscape in cardiovascular disease: a brief update
Purpose of review In this review, we summarize new knowledge on long noncoding RNAs (lncRNAs) linked to cardiovascular disease, in particular to heart failure. Recent findings LncRNAs are dysregulated in specific developmental and pathological conditions and regulate critical responses to stress. LncRNAs are being recognized as molecules regulating myocardial remodeling during disease, participating for instance in the regulation of cardiomyocyte hypertrophy and function and fibroblast proliferation. Summary LncRNAs add a new layer of complexity to the regulation of the biological processes underlying normal cardia...
Source: Current Opinion in Cardiology - April 13, 2018 Category: Cardiology Tags: MOLECULAR GENETICS: Edited by Ali J. Marian Source Type: research

Genetic basis of arrhythmogenic cardiomyopathy
Purpose of review To date 16 genes have been associated with arrhythmogenic cardiomyopathy (ACM). Mutations in these genes can lead to a broad spectrum of phenotypic expression ranging from disease affecting predominantly the right or left ventricle, to biventricular subtypes. Understanding the genetic causes of ACM is important in diagnosis and management of the disorder. This review summarizes recent advances in molecular genetics and discusses the application of next-generation sequencing technology in genetic testing in ACM. Recent findings Use of next-generation sequencing methods has resulted in the identificati...
Source: Current Opinion in Cardiology - April 13, 2018 Category: Cardiology Tags: MOLECULAR GENETICS: Edited by Ali J. Marian Source Type: research

Proprotein convertase subtilisin/kexin type 9: from genetics to clinical trials
Purpose of review This review describes the pivotal role of genetic insights and technologies in the discovery of proprotein convertase subtilisin/kexin type 9 (PCSK9) and the rapid development of PCSK9 inhibitors – a revolutionary new class of lipid-lowering agents. Recent findings PCSK9 was discovered as a the third gene implicated in familial hypercholesterolemia. Population genetics studies, enabled by technological advances, were instrumental in validating PCSK9 as a therapeutic target. Monoclonal antibodies against PCSK9 were introduced in the clinic after an unprecedently rapid development path, in which ...
Source: Current Opinion in Cardiology - April 13, 2018 Category: Cardiology Tags: MOLECULAR GENETICS: Edited by Ali J. Marian Source Type: research

Genetics in the prevention and management of coronary artery disease
Purpose of review The current review is to describe the genetic risk variants that have been discovered predisposing to coronary artery disease (CAD) and how they are utilized to stratify for risk of CAD. Recent findings Over 90 genetic risk variants have been discovered that predispose to risk for CAD. Summary The total genetic risk burden for CAD is proportional to the number of risk variants inherited and can be combined into a single number referred to as the genetic risk score (GRS). GRS has been utilized in multiple studies and shown to be more effective in risk stratification for CAD than conventional risk f...
Source: Current Opinion in Cardiology - April 13, 2018 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 13, 2018 Category: Cardiology Tags: Editorial Introductions Source Type: research