Molecular genetics of human hypertension
Purpose of review
Genetic variance on blood pressure was shown about 100 years ago; a Mendelian inheritance was initially presumed. Platt and Pickering conducted a lively debate, whether blood pressure was inherited in a Mendelian fashion or whether the condition was polygenic. Genetic-hypertension research has appropriately followed both pathways.
Recent findings
Genome-wide association studies, Pickering model, have identified more than 500 blood-pressure loci, the targets of which are waiting to be evaluated. Then, come the ‘dark-horses’ of hypertension, namely ‘secondary’ causes. These conditions have been...
Source: Current Opinion in Cardiology - April 7, 2020 Category: Cardiology Tags: MOLECULAR GENETICS: Edited by Ali J. Marian Source Type: research
Recent advances in genome editing for cardiovascular disease
Purpose of review
This review highlights recent progress in applying genome editing to the study and treatment of cardiovascular disease (CVD).
Recent findings
Recent work has shown that genome editing can be used to determine the pathogenicity of variants of unknown significance in patient-derived induced pluripotent stem cells. These cells can also be used to test therapeutic genome editing approaches in a personalized manner. Somatic genome editing holds great promise for the treatment of CVD, and important proof of concept experiments have already been performed in animal models. Here we briefly review recent prog...
Source: Current Opinion in Cardiology - April 7, 2020 Category: Cardiology Tags: MOLECULAR GENETICS: Edited by Ali J. Marian Source Type: research
Role of epigenetic mechanisms regulated by enhancers and long noncoding RNAs in cardiovascular disease
Purpose of review
Hyperlipidemia, hypertension, diabetes and related metabolic disorders increase the risk for cardiovascular disease (CVD). Despite significant progress in the identification of key mechanisms and genetic polymorphisms linked to various CVDs, the rates of CVDs continue to escalate, underscoring the need to evaluate additional mechanisms for more effective therapies. Environment and lifestyle changes can alter epigenetic mechanisms mediated by histone modifications and long noncoding RNAs (lncRNAs) which play important roles in gene regulation. The review summarizes recent findings on the role of epigenet...
Source: Current Opinion in Cardiology - April 7, 2020 Category: Cardiology Tags: MOLECULAR GENETICS: Edited by Ali J. Marian Source Type: research
The brave new world of genetic testing in the management of the dyslipidaemias
Purpose of review
With the exception of familial hypercholesterolaemia, the value of genetic testing for managing dyslipidaemias is not established. We review the genetics of major dyslipidaemias in context of clinical practice.
Recent findings
Genetic testing for familial hypercholesterolaemia is valuable to enhance diagnostic precision, cascade testing, risk prediction and the use of new medications. Hypertriglyceridaemia may be caused by rare recessive monogenic, or by polygenic, gene variants; genetic testing may be useful in the former, for which antisense therapy targeting apoC-III has been approved. Familial hi...
Source: Current Opinion in Cardiology - April 7, 2020 Category: Cardiology Tags: MOLECULAR GENETICS: Edited by Ali J. Marian Source Type: research
Genetics of age-related clonal hematopoiesis and atherosclerotic cardiovascular disease
Purpose of review
While advanced age is the major risk factor for the development of atherosclerotic cardiovascular disease (ASCVD), we have a poor understanding of how aging promotes the progression of this disease. Recent evidence suggests that the age-dependent accumulation of somatic mutations in hematopoietic cells may represent a new causal risk factor for ASCVD.
Recent findings
A hallmark of aging is the accumulation of somatic DNA mutations in all tissues of the body. Accordingly, evidence shows that hematopoietic stem/progenitor cells accumulate somatic mutations as a function of age in nonsymptomatic individ...
Source: Current Opinion in Cardiology - April 7, 2020 Category: Cardiology Tags: MOLECULAR GENETICS: Edited by Ali J. Marian Source Type: research
Gut microbiome and cardiovascular disease
Purpose of review
This review aims to highlight the association between gut microbiome and cardiovascular disease (CVD) with emphasis on the possible molecular mechanisms by which how gut microbiome contributes to CVD.
Recent findings
Increasingly, the roles of gut microbiome in cardiovascular health and disease have gained much attention. Most of the investigations focus on how the gut dysbiosis contributes to CVD risk factors and which gut microbial-derived metabolites mediate such effects.
Summary
In this review, we discuss the molecular mechanisms of gut microbiome contributing to CVD, which include gut microbe...
Source: Current Opinion in Cardiology - April 7, 2020 Category: Cardiology Tags: MOLECULAR GENETICS: Edited by Ali J. Marian Source Type: research
Functional characterization of long noncoding RNAs
Purpose of review
Mounting evidence suggests that long noncoding RNAs (lncRNAs) are essential regulators of gene expression. Although few lncRNAs have been the subject of detailed molecular and functional characterization, it is believed that lncRNAs play an important role in tissue homeostasis and development. In fact, gene expression profiling studies reveal lncRNAs are developmentally regulated in a tissue-type and cell-type specific manner. Such findings have brought significant attention to their potential contribution to disease cause. The current review summarizes recent studies of lncRNAs in the heart.
Recent fi...
Source: Current Opinion in Cardiology - April 7, 2020 Category: Cardiology Tags: MOLECULAR GENETICS: Edited by Ali J. Marian Source Type: research
RNA-based therapeutics in cardiovascular disease
Purpose of review
Cardiovascular disease is the leading cause of death globally, with the number of deaths rising every year. Much effort has gone into development of new treatment strategies. Many RNA species have important regulatory functions in disease initiation and progression, providing interesting new treatment options. This review focuses on different classes of RNA-based therapeutics and provides examples of current clinical and preclinical studies. Current challenges that prevent clinical translation and possibilities to overcome them will be discussed.
Recent findings
Different RNA-based molecules have bee...
Source: Current Opinion in Cardiology - April 7, 2020 Category: Cardiology Tags: MOLECULAR GENETICS: Edited by Ali J. Marian Source Type: research
Editorial: Overcoming current limitations of genetic testing in cardiovascular medicine
No abstract available (Source: Current Opinion in Cardiology)
Source: Current Opinion in Cardiology - April 7, 2020 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 7, 2020 Category: Cardiology Tags: EDITORIAL INTRODUCTIONS Source Type: research
Sodium-glucose cotransporter 2 inhibitors and type 2 diabetes: clinical pearls for in-hospital initiation, in-hospital management, and postdischarge
Purpose of review
The aim of this article is to provide practical recommendations on safe initiation of sodium-glucose cotransporter 2 (SGLT2) inhibitors to in-patients as well as management of those who are already on SGLT2 inhibitors.
Recent findings
Robust data from stable outpatient cohorts indicate that the SGLT2 inhibitors are associated with clinically meaningful reductions in major adverse cardiovascular events, lower rates of hospitalization for heart failure, and a reduction in major kidney outcomes There is however a lack of information on how to initiate and manage SGLT2 inhibitors in an acute in-patient s...
Source: Current Opinion in Cardiology - February 6, 2020 Category: Cardiology Tags: SPECIAL COMMENTARY Source Type: research
Global longitudinal strain is a better metric than left ventricular ejection fraction: lessons learned from cancer therapeutic-related cardiac dysfunction
Purpose of the review
This review aims to highlight the utility of global longitudinal strain (GLS) in cancer therapeutic-related cardiac dysfunction (CTRCD), with an attempt to stipulate that GLS might be a better measure than left ventricular ejection fraction (LVEF).
Recent findings
Increasingly, GLS quantification has been employed in various cardiovascular diseases especially with its ability to detect left ventricular dysfunction subclinically, even before a change in LVEF is visualized. In fact, several studies reveal that GLS may be a superior predictor of mortality and morbidity than LVEF in this context. A r...
Source: Current Opinion in Cardiology - February 6, 2020 Category: Cardiology Tags: HEART FAILURE: Edited by Haissam Haddad Source Type: research
Choosing the best antithrombotic regimen in patients with ventricular assist devices
Purpose of review
Two major complications compromise the outcomes and quality of life for left ventricular assist device (LVAD) patients. This review aims to discuss the mechanisms of thrombosis and bleeding, recent literature on the optimal approaches for antithrombotic therapy, and novel approaches to prevent bleeding.
Recent findings
Recent studies with the newly designed LVAD, the fully magnetically levitated rotor, show lower thrombotic risk but sustain similar bleeding risk. Small studies present options for less intense antithrombotic regimens with the newer devices. Bridging anticoagulation when needed in this...
Source: Current Opinion in Cardiology - February 6, 2020 Category: Cardiology Tags: HEART FAILURE: Edited by Haissam Haddad Source Type: research
End-of-life care in patients with advanced heart failure
Purpose of review
With an aging population with heart failure, there is a growing need for end-of-life care in this population, including a focus on symptom management and quality-of-life considerations.
Recent findings
Targeted therapies focusing on symptom control and improving quality of life is the cornerstone of providing care in patients with heart failure near the end of life. Such therapies, including the use of inotropes for palliative purposes, have been shown to improve symptoms without an increase in mortality. In addition, recent evidence shows that implementing certain strategies in planning for end of l...
Source: Current Opinion in Cardiology - February 6, 2020 Category: Cardiology Tags: HEART FAILURE: Edited by Haissam Haddad Source Type: research
Hyperkalemia in heart failure
Purpose of review
Hyperkalemia is increasingly prevalent in the heart failure population as more people live with heart failure and comorbid conditions such as diabetes and chronic kidney disease. Furthermore, renin–angiotensin–aldosterone (RAAS) inhibitors are a key component of clinical therapy in these populations. Until now, we have not had any reliable or tolerable therapies for treatment of hyperkalemia resulting in inability to implement or achieve target doses of RAAS inhibition. This review will focus on two new therapies for hyperkalemia: patiromer and sodium zirconium cyclosilicate (SZC).
Recent findings ...
Source: Current Opinion in Cardiology - February 6, 2020 Category: Cardiology Tags: HEART FAILURE: Edited by Haissam Haddad Source Type: research
