Hypertension and race/ethnicity
Purpose of review
United States racial/ethnic minorities may experience disproportionate hypertension (HTN) morbidity and mortality. This review discusses recent literature regarding the differential impact of HTN, especially among African Americans and Hispanics.
Recent findings
Although disparities in HTN prevalence, control, and outcomes persist in racial/ethnic minorities relative to non-Hispanic Whites, racial/ethnic minorities are frequently underrepresented in genetic and clinical studies. Genomics have improved our understanding of HTN, but with no clinically useful application, the role of social determinants...
Source: Current Opinion in Cardiology - June 6, 2020 Category: Cardiology Tags: HYPERTENSION: Edited by Hector O. Ventura and Carl J. Lavie Source Type: research
Editorial: Hypertension in special populations and the role in comoborbities
No abstract available (Source: Current Opinion in Cardiology)
Source: Current Opinion in Cardiology - June 6, 2020 Category: Cardiology Tags: HYPERTENSION: Edited by Hector O. Ventura and Carl J. Lavie Source Type: research
Clinical trials of acute mechanical circulatory support in cardiogenic shock and high-risk percutaneous coronary intervention
Purpose of review
Acute mechanical circulatory support devices have become widely used in cardiogenic shock and high-risk percutaneous coronary intervention (PCI) but there remains significant controversy over the evidence supporting their use and the specific roles of various devices. In this review, we summarize major recent studies and identify key areas of future investigation.
Recent findings
In cardiogenic shock, uncontrolled single arm studies emphasizing early mechanical circulatory support (MCS) have showed promising results, but randomized trials have either been stopped prematurely or enrolled patients with...
Source: Current Opinion in Cardiology - June 6, 2020 Category: Cardiology Tags: CLINICAL TRIALS: Edited by Neal S. Kleiman Source Type: research
The year in review: advances in interventional cardiology in 2019
Purpose of review
Major studies in interventional cardiology in 2019 have added substantial new evidence for pharmaco-invasive management of coronary artery disease. The review highlights the main findings of a selection of these trials and summarizes their impact on clinical practice.
Recent findings
Recent randomized studies examining the efficacy of revascularization or medical treatment in stable ischemic heart disease (SIHD), treatment of acute coronary syndromes, emerging interventional devices, adjunctive pharmacotherapy, and intravascular imaging and physiology guidance have substantially advanced the evidence...
Source: Current Opinion in Cardiology - June 6, 2020 Category: Cardiology Tags: CLINICAL TRIALS: Edited by Neal S. Kleiman Source Type: research
2019 clinical trials in lipid lowering
This article reviews the most recent lipid-lowering therapy trials, many of which provide a unique opportunity to further reduce low-density lipoprotein cholesterol (LDL-C) levels and ASCVD risk on top of statin therapy, and in doing so further decrease the number of future major adverse cardiovascular events.
Recent findings
Although statin therapy has been the mainstay of treatment for lowering LDL-C levels for many years, many individuals require additional or alternative options for further reducing their risk. Trials on previously studied therapies, such as PCSK9 inhibitors, and new therapies, including inclisiran,...
Source: Current Opinion in Cardiology - June 6, 2020 Category: Cardiology Tags: CLINICAL TRIALS: Edited by Neal S. Kleiman Source Type: research
Recent clinical trials in valvular heart diseases
Purpose of review
In recent years, no other field of cardiology has experienced a greater influx of transformational therapeutic options as valvular heart disease. The present review discusses the landmark trials published in the last 18 months that have shaped the modern day management of valvular heart diseases.
Recent findings
There have been several landmark trials in recent years, which have expanded the indications for transcatheter aortic valve replacement to low-risk surgical patients and the use of MitraClip for patients with functional mitral regurgitation. Options for transcatheter management of right-sided...
Source: Current Opinion in Cardiology - June 6, 2020 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 6, 2020 Category: Cardiology Tags: EDITORIAL INTRODUCTIONS Source Type: research
Arrhythmias and sudden cardiac death in post-cardiac transplant patients
Purpose of review
Orthotopic heart transplantation (OHT) significantly improves morbidity and mortality in patients with end-stage heart disease. Despite advances in surgical technique, immunosuppressive therapies, and patient monitoring, long-term risk of arrhythmias and sudden cardiac death (SCD) in the denervated heart remains unchanged.
Recent findings
SCD is responsible for approximately 10% of all posttransplant deaths with a pooled incidence rate of 1.30 per 100 person years and is strongly associated with cardiac allograft vasculopathy (CAV). Risk factors for SCD and CAV include higher donor age, younger recip...
Source: Current Opinion in Cardiology - April 7, 2020 Category: Cardiology Tags: CARDIAC FAILURE: Edited by Rebecca Cogswell and Gene Kim Source Type: research
Keeping pace with the competition: His bundle versus biventricular pacing in heart failure
Purpose of review
His bundle pacing (HBP) has emerged as a novel method to achieve electrical resynchronization in bundle branch block and as an alternative means to deliver cardiac resynchronization therapy (CRT). There are now data on HBP in CRT-eligible patients from cohort studies and a single pilot randomized controlled trial (RCT).
Recent findings
Early clinical data regarding HBP in heart failure have demonstrated echocardiographic and functional improvement similar to traditional biventricular pacing (BiV), mostly when utilized as a bailout to traditional BiV-CRT. A single pilot RCT, His-SYNC, showed a trend t...
Source: Current Opinion in Cardiology - April 7, 2020 Category: Cardiology Tags: CARDIAC FAILURE: Edited by Rebecca Cogswell and Gene Kim Source Type: research
Management of ventricular arrhythmias in patients with LVAD
Purpose of review
Left ventricular assist devices (LVADs) have extended the life expectancy of patients with heart failure. The hemodynamic support afforded by LVADs in this population has also resulted in patients having prolonged ventricular arrhythmias. The purpose of this article is to review the mechanisms of ventricular arrhythmias in LVADs and the available management strategies.
Recent findings
Recent evidence suggests that prolonged ventricular arrhythmias may result in increased mortality in patients with LVADs.
Summary
Successful management of ventricular arrhythmias in patients with LVAD requires interd...
Source: Current Opinion in Cardiology - April 7, 2020 Category: Cardiology Tags: CARDIAC FAILURE: Edited by Rebecca Cogswell and Gene Kim Source Type: research
Ventricular arrhythmias in heart failure with reduced ejection fraction
Purpose of review
To provide a framework for approaching ventricular arrhythmias in the setting of cardiomyopathy, outline the latest evidence-based recommendations for catheter ablation and device therapy, and discuss novel treatment strategies.
Recent findings
Risk stratification of ventricular arrhythmias in systolic heart failure has evolved, with an increasing role for cardiac magnetic resonance imaging to identify underlying substrate and scar burden. Medical therapy for heart failure has greatly improved, and the role of primary prevention defibrillators in nonischemic cardiomyopathy has become more ambiguous. ...
Source: Current Opinion in Cardiology - April 7, 2020 Category: Cardiology Tags: CARDIAC FAILURE: Edited by Rebecca Cogswell and Gene Kim Source Type: research
Atrial arrhythmias in patients with left ventricular assist devices
Purpose of review
Atrial arrhythmias commonly occur in patients with advanced heart failure with reduced ejection fraction (HFrEF) who require left ventricular assist devices (LVADs) implantation. This review summarizes the current literature regarding the incidence, prevalence, and predictors of atrial arrhythmias in LVAD patients and its impact on the clinical outcomes. Moreover, we review the mechanisms and management strategies of atrial arrhythmias in this population.
Recent findings
Atrial arrhythmias including atrial fibrillation, atrial flutter, and atrial tachycardia are highly prevalent in patients with adva...
Source: Current Opinion in Cardiology - April 7, 2020 Category: Cardiology Tags: CARDIAC FAILURE: Edited by Rebecca Cogswell and Gene Kim Source Type: research
Atrial arrhythmias in heart failure with a reduced ejection fraction
Purpose of review
Atrial arrhythmias are common among individuals with heart failure with a reduced ejection fraction (HFrEF). This review describes management options for these arrhythmias and discusses emerging clinical data supporting catheter ablation.
Recent findings
Several recent clinical trials indicate that catheter ablation is superior to pharmacologic therapy for management of symptomatic atrial fibrillation in the setting of HFrEF. Restoration and maintenance of sinus rhythm appears to have the greatest benefit with regard to ejection fraction improvement among individuals with a nonischemic heart failure ...
Source: Current Opinion in Cardiology - April 7, 2020 Category: Cardiology Tags: CARDIAC FAILURE: Edited by Rebecca Cogswell and Gene Kim Source Type: research
Atrial fibrillation in patients with heart failure with preserved ejection fraction
Purpose of review
To review the shared pathology of atrial fibrillation and heart failure with preserved ejection fraction (HFpEF) and the prognostic, diagnostic, and treatment challenges incurred by the co-occurrence of these increasingly prevalent diseases.
Recent findings
Multiple risk factors and mechanisms have been proposed as potentially linking atrial fibrillation and HFpEF, with systemic inflammation more recently being invoked. Nonvitamin K oral anticoagulants, left atrial appendage occlusion devices, and catheter ablation have emerged as alternative treatment options. Other novel pharmacological agents, suc...
Source: Current Opinion in Cardiology - April 7, 2020 Category: Cardiology Tags: CARDIAC FAILURE: Edited by Rebecca Cogswell and Gene Kim Source Type: research
Editorial: Electrophysiology in heart failure: notes from the cutting edge
No abstract available (Source: Current Opinion in Cardiology)
Source: Current Opinion in Cardiology - April 7, 2020 Category: Cardiology Tags: CARDIAC FAILURE: Edited by Rebecca Cogswell and Gene Kim Source Type: research
