Current Perspective on Menopause Hormone Therapy and Cardiovascular Risk
AbstractPurpose of reviewIn past decades, there has a been a paradigm shift concerning menopause, hormone therapy (HT), and cardiovascular disease (CVD). While initial observational studies suggested hormone replacement to provide a cardioprotective benefit for all menopausal women, subsequent large randomized trials have not confirmed these benefits and furthermore brought to light the risks of HT with regard to CVD, venous thrombosis, and stroke. The goal of this review is to summarize current recommendations regarding HT as it pertains to cardiovascular risk.Recent FindingsMenopause HT remains the most effective treatme...
Source: Current Treatment Options in Cardiovascular Medicine - May 5, 2021 Category: Cardiology Source Type: research

Chronic Total Occlusion PCI Techniques in 2020
AbstractPurpose of reviewChronic total occlusions (CTO) represent a frequently encountered subset of coronary lesions, where percutaneous coronary intervention is considered particularly challenging. Recent advances in equipment dedicated for CTO have resulted in improved outcomes and have inspired the discovery of several novel techniques.Recent findingsThe most significant advancement in the field of CTO interventions is the incorporation of the available techniques in integrated algorithms. These algorithms are tailored to lesion characteristics and allow for prompt and seamless transition across the available treatment...
Source: Current Treatment Options in Cardiovascular Medicine - May 5, 2021 Category: Cardiology Source Type: research

Acute Thoracic Complications of Minimally Invasive Cardiac Procedures
AbstractPurpose of reviewComplications of minimally invasive cardiac procedures range from self-limiting to life-threatening. This review article will highlight the incidence, risk factors, and imaging features of acute thoracic complications of three of the most common minimally invasive cardiac procedures encountered in practice: transcatheter aortic valve replacement, cardiac implantable electronic devices, and pulmonary vein isolation.Recent findingsMost minimally invasive cardiac procedures have a relatively low risk profile. Acute thoracic complications are usually detected during the procedure; however, delayed pres...
Source: Current Treatment Options in Cardiovascular Medicine - May 5, 2021 Category: Cardiology Source Type: research

The New Role of Cardiac Imaging Following the ISCHEMIA Trial
AbstractPurpose of reviewThis review is aimed at summarizing the recently published ISCHEMIA trial (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches) and how its findings may impact cardiac imaging for stable ischemic heart disease (SIHD) moving forward.Recent findingsThe ISCHEMIA trial compared an initial invasive management strategy with goal of complete coronary revascularization versus an initial medical therapy strategy among stable patients with newly diagnosed moderate to severe myocardial ischemia on non-invasive testing. The trial results showed that an early invasive st...
Source: Current Treatment Options in Cardiovascular Medicine - May 5, 2021 Category: Cardiology Source Type: research

Imaging the Coronary Venous System: Current Trends and Risk Stratification
AbstractPurpose of reviewThe coronary venous system has been a rather unique source of investigation over the last 20  years in regard to cardiac imaging, with primary focus/attention on variant anatomy, pre-ablative planning imaging, as well as congenital heart evaluation. Progressive advances in fast imaging using both MDCT and CMR have made the techniques shared below become more widely available. This review h ighlights the advances in coronary venous imaging over the last 10 years with emphasis on the most up to date clinical treatment options given the advancements in the various imaging modalities. These p...
Source: Current Treatment Options in Cardiovascular Medicine - May 5, 2021 Category: Cardiology Source Type: research

The Role of Biomarkers and Imaging to Predict Preeclampsia and Subsequent Cardiovascular Dysfunction
AbstractPurpose of reviewPreeclampsia is a major cause of maternal morbidity and mortality worldwide. Despite decades of research, the ability of clinicians to accurately predict the onset of preeclampsia prior to the manifestation of symptoms has not significantly improved. In this review, we will examine the pathophysiology underlying preeclampsia and discuss the role of potential biomarkers for early prediction and diagnosis. In addition, we will explore imaging modalities in the detection of early myocardial and vascular endothelial dysfunction associated with preeclampsia.Recent findingsCirculating angiogenic and anti...
Source: Current Treatment Options in Cardiovascular Medicine - May 5, 2021 Category: Cardiology Source Type: research

New Advances and Ongoing Challenges in the Use of Biologic Agents in Cardiac Sarcoidosis and Other Inflammatory Cardiomyopathies
AbstractPurpose of reviewInflammatory cardiomyopathies encompass several different conditions revolving around inflammation. Experts, supported primarily by experience, have utilized immunosuppression as a treatment option to halt the inflammation and prevent the common end result of dilated cardiomyopathy. Very limited evidence exists to support a uniformed approach.Recent findingsStandard immunosuppression protocols are typically used to treat inflammatory cardiomyopathies associated with systemic inflammatory diseases. However, specific features such as eosinophilic infiltration or fulminant course merit a more aggressi...
Source: Current Treatment Options in Cardiovascular Medicine - May 5, 2021 Category: Cardiology Source Type: research

Counseling Women With Peripartum Cardiomyopathy About Subsequent Pregnancies
AbstractPurpose of reviewPeripartum cardiomyopathy (PPCM) is a potentially catastrophic form of heart failure caused by left ventricular systolic dysfunction that develops during pregnancy or in the early postpartum period. After the initial diagnosis and treatment, many women desire another pregnancy; however, risks of a subsequent pregnancy need to be considered, as PPCM may lead to significant adverse outcomes for both mother and fetus. The goal of this review is to provide information about risk stratification prior to subsequent pregnancy, strategies to mitigate the risk of subsequent pregnancy, and long-term maternal...
Source: Current Treatment Options in Cardiovascular Medicine - May 5, 2021 Category: Cardiology Source Type: research

Machine Learning Applications in Heart Failure Disease Management: Hype or Hope?
AbstractPurpose of the reviewMachine learning (ML) approaches have emerged as powerful tools in medicine. This review focuses on the use ML to assess risk of events in patients with heart failure (HF). It provides an overview of the ML process, challenges in developing risk scores, and strategies to mitigate problems.Recent findingsRisk scores developed using standard statistical methods have limited accuracy, particularly when they are applied to populations other than the one in which they were developed. Computerized ML algorithms which identify correlations between descriptive variables in complex, non-linear, multi-di...
Source: Current Treatment Options in Cardiovascular Medicine - May 5, 2021 Category: Cardiology Source Type: research

Novel Therapies in Heart Failure with Reduced Ejection Fraction: from Soluble Guanylyl Cyclase Stimulators to Cardiac Myosin Activators
AbstractPurpose of reviewIn this review, our goal was to provide a brief background on the evolution of therapeutic targets for heart failure with reduced ejection fraction (HFrEF), summarize the results of recent clinical trials with diverse pharmacological targets, discuss potential limitations of these findings, and provide future perspectives.Recent findingsDespite advances in pharmacological and device therapy, HFrEF still carries a considerably high morbidity and mortality. For the past four decades, the neurohormonal model has been pivotal in the development of efficacious pharmacotherapies for HFrEF. However, recen...
Source: Current Treatment Options in Cardiovascular Medicine - March 26, 2021 Category: Cardiology Source Type: research

Invasive Hemodynamic and Metabolic Evaluation of HFpEF
AbstractPurpose of reviewHeart failure with preserved ejection fraction (HFpEF) is a complex and heterogeneous condition of multiple causes, characterized by a clinical syndrome resulting from elevated left ventricular filling pressures, with an apparently unimpaired left ventricular systolic function. Although HFpEF has been long recognized as a distinct entity with significant morbidity for patients, its diagnosis remains challenging to this day. In recent years, few diagnostic algorithms have been postulated to aid in the identification of this condition. Invasive hemodynamic and metabolic evaluation is often warranted ...
Source: Current Treatment Options in Cardiovascular Medicine - March 26, 2021 Category: Cardiology Source Type: research

Management of In-laboratory Cardiopulmonary Arrest
AbstractPurpose of reviewThe purpose of this review is to update the reader on the risk factors, causes, and mechanisms for cardiac arrest in the cardiac catheterization laboratory. In addition, the review provides a summary of recently published data specifically pertaining to the management of in-lab cardiac arrest.Recent findingsThe incidence of cardiac arrest in unselected patients undergoing cardiac catheterization is approximately 0.5%. ST elevation myocardial infarction and cardiogenic shock account for the majority of cases. Pulseless electrical activity is the most common initial rhythm. Mechanical chest compressi...
Source: Current Treatment Options in Cardiovascular Medicine - March 23, 2021 Category: Cardiology Source Type: research

New Approaches to Donor Selection and Preparation in Heart Transplantation
AbstractPurpose of reviewWith increasing survival of patients with stage D heart failure, the demand for heart transplantation has increased. The supply of donor hearts remains relatively limited. Strategies have been investigated and new technologies have been developed to expand the current donor pool. These new approaches will be discussed herein.Recent findingsDonor hearts are often considered “marginal” due to risk factors such as older age, size mismatch with the intended recipient, prolonged ischemic time, presence of left ventricular hypertrophy, and hepatitis B/C infection. We reviewed recent data rega...
Source: Current Treatment Options in Cardiovascular Medicine - March 23, 2021 Category: Cardiology Source Type: research

A Critical Review of Hemodynamically Guided Therapy for Cardiogenic Shock: Old Habits Die Hard
AbstractPurpose of reviewHere, we review the importance of using hemodynamic data to guide therapy and risk stratification in cardiogenic shock as well as the various definitions of this syndrome that have been used in prior studies. Furthermore, we provide perspective regarding the controversy surrounding pulmonary artery (PA) catheter use as well as current society guidelines and scientific statements. Lastly, we review the technical aspects for accurate interpretation of data of cardiogenic shock.Recent findingsMore recent studies specifically evaluating cardiogenic shock patients have shown higher mortality when PA cat...
Source: Current Treatment Options in Cardiovascular Medicine - March 23, 2021 Category: Cardiology Source Type: research

Cardiac Testing in Search for Occult Atrial Fibrillation after Ischemic Stroke
AbstractPurpose of reviewDetermining the etiology of ischemic stroke is critical to administering targeted therapy to prevent recurrent stroke and further neurologic deterioration. Ischemic strokes of cardioembolic and cryptogenic etiologies are frequent and are often ultimately attributed to atrial fibrillation (AF). However, the paroxysmal nature of AF presents challenges for accurate and timely detection to prevent a recurrent stroke. The purpose of this review is to evaluate serologic, electrographic, echocardiographic, and radiologic markers of AF after an ischemic stroke.Recent findingsInnovative applications of biot...
Source: Current Treatment Options in Cardiovascular Medicine - March 23, 2021 Category: Cardiology Source Type: research

Case Selection During the COVID-19 Pandemic: Who Should Go to the Cardiac Catheterization Laboratory?
AbstractPurpose of reviewTo summarize the best available evidence and recommendations regarding case selection for cardiac catheterization laboratory (CCL) during the coronavirus disease 2019 (COVID-19) pandemic with emphasis on ST segment elevation myocardial infarction (STEMI) management.Recent findingsThe restructuring of cardiovascular services to preserve hospital beds and personal protective equipment during the COVID-19 pandemic had a profound effect on healthcare delivery around the world with unintended consequences. In the United States, a significant 38% reduction in CCL activations for STEMI was noted in the ea...
Source: Current Treatment Options in Cardiovascular Medicine - March 18, 2021 Category: Cardiology Source Type: research

Contemporary Cardiovascular Imaging Advancements and Social Media
AbstractPurpose of reviewSocial media (SoMe) as a means of knowledge dissemination has grown significantly in cardiovascular imaging in recent years. This media platform allows for a free exchange of ideas, the development of new communities, and the ability to disseminate advancements rapidly. While the social media platforms offer limitless potential, their public domain necessitates several important suggestions around best practices.Recent findingsIn cardiovascular imaging, specific hashtags have emerged to encompass the major modalities to include #EchoFirst, #YesCCT, #WhyCMR, and #CVNuc. Cardiovascular imaging journa...
Source: Current Treatment Options in Cardiovascular Medicine - March 15, 2021 Category: Cardiology Source Type: research

Multimodality Imaging of Cardiac Trauma
AbstractPurpose of reviewThe purpose of this article is to review the imaging findings of blunt and penetrating traumatic cardiac injury.Recent findingsDue to its speed of acquisition and ready availability, multidetector CT has become the gold standard for imaging of both blunt and penetrating cardiac trauma. Echocardiography is the first-line modality for evaluation of the valves. While magnetic resonance imaging provides the most comprehensive examination, it should only be utilized for problem solving or follow-up.SummaryCardiac traumatic injury is a rare entity that may result in significant adverse clinical outcomes....
Source: Current Treatment Options in Cardiovascular Medicine - March 15, 2021 Category: Cardiology Source Type: research

Evaluation and Management of Pulmonic Valve Disease
AbstractPurpose of reviewThe goal of this review is to provide information about the causes, consequences, exam, echocardiographic findings, and guideline-based treatment options for pulmonic valve lesions.Recent findingsBalloon pulmonic valvuloplasty and surgical valve replacement are the primary treatment options for hemodynamically significant stenosis and regurgitation, respectively. Transcatheter pulmonic valve replacement has emerged as a treatment option for select native valve lesions or dysfunctional surgical conduits.SummarySymptoms of pulmonic valve disease can be overlooked, and long-term effects on right ventr...
Source: Current Treatment Options in Cardiovascular Medicine - March 15, 2021 Category: Cardiology Source Type: research

Advances in Mapping and Ablation of Ventricular Fibrillation
AbstractPurpose of reviewCatheter ablation of ventricular fibrillation (VF) is challenging due to the difficulty in interpreting fibrillatory electrograms and the complete hemodynamic collapse with VF precluding detailed mapping. Successful ablation can be performed by eliminating triggers of VF. We review the contemporary advances in VF ablation, especially targeting the substrate for VF.Recent findingsStrategies to map and eliminate the substrate for VF can be applied generally, even in the absence of a reliable trigger. VF substrate can be mapped during sinus rhythm with signature low-voltage, fractionated, and late ele...
Source: Current Treatment Options in Cardiovascular Medicine - March 12, 2021 Category: Cardiology Source Type: research

New Hemodynamic Insights in Pulmonary Vascular Disease and Heart Failure with Preserved Ejection Fraction
AbstractPurpose of reviewPatients often present with a mixed phenotype of pulmonary vascular disease and heart failure with preserved ejection fraction (HFpEF). Identifying the exact hemodynamic culprits in such cases has important therapeutic implications. This review discusses the hemodynamic characterization and treatment options in patients with pulmonary vascular disease, HFpEF, and their combination.Recent findingsThe threshold for pulmonary hypertension (PH) has been lowered toward a mean pulmonary arterial pressure (mPAP)> 20  mmHg at rest.Exercise-induced PH is defined as mPAP> 30  mmHg during exer...
Source: Current Treatment Options in Cardiovascular Medicine - February 22, 2021 Category: Cardiology Source Type: research

Structural Transcatheter Cardiac Interventions in the Cardio-Oncology Population
AbstractPurpose of reviewModern cancer therapies have resulted in prolonged survival and decreased mortality for many types of cancer. Consequently, cancer patients with concomitant cardiovascular disease (CVD) present prior to diagnosis of cancer, resulting from various forms of cancer therapy, or developing after cancer remission are at higher risk for development of cardiovascular-associated morbidity and mortality. Management of CVD, particularly structural heart disease, in this patient population is challenging and associated with elevated surgical risk. Minimally invasive transcatheter procedures have emerged as low...
Source: Current Treatment Options in Cardiovascular Medicine - February 22, 2021 Category: Cardiology Source Type: research

Sustainable Resumption of Cardiac Catheterization Laboratory Procedures, and the Importance of Testing, During Endemic COVID-19
ConclusionOur patients are at definite risk from their cardiovascular disease, and a return to suspension of proven prognostic interventional treatments on an elective  basis – the default for the first wave – must be avoided at all costs. (Source: Current Treatment Options in Cardiovascular Medicine)
Source: Current Treatment Options in Cardiovascular Medicine - February 22, 2021 Category: Cardiology Source Type: research

Contemporary Use of Radial to Peripheral Access for Management of Peripheral Artery Disease
AbstractPurpose of the reviewCompared with femoral access, transradial access for percutaneous vascular intervention has demonstrated several advantages, including lower risks of access site complications, faster patient recovery time, and lower health care costs. This has led to a growing interest in utilization of transradial access as the primary access site for certain peripheral vascular interventions (PVIs). This review outlines the rationale for transradial access for PVI, offers tips on equipment selection and special procedure-specific considerations, discusses challenges and barriers to widespread utilization, an...
Source: Current Treatment Options in Cardiovascular Medicine - February 2, 2021 Category: Cardiology Source Type: research

Practical Approaches to Catheter Ablation of Idiopathic Ventricular Arrhythmias
AbstractPurpose of reviewIn this review, we provide a practical approach to the catheter ablation of idiopathic focal ventricular arrhythmias (VAs) by summarizing the electrocardiographic (ECG) characteristics, mapping strategies, and ablation techniques for each of the major types of idiopathic VAs. We identify special considerations to be taken when treating specific forms of idiopathic VAs with catheter ablation that can increase success rates and reduce complications.Recent findingsInsights on ECG morphologies of VAs have led to novel criteria that can aid in accurate identification and localization of VA sites of orig...
Source: Current Treatment Options in Cardiovascular Medicine - February 2, 2021 Category: Cardiology Source Type: research

Percutaneous Closure of Aortic and Mitral Paravalvular Leaks —Diagnostic and Therapeutic Considerations
AbstractPurpose of reviewParavalvular leak (PVL) represents a suboptimal procedural outcome resulting in an eccentric regurgitant jet following surgical or transcatheter aortic or mitral valve replacements. In this review, the role of integrated imaging modalities, including transthoracic echocardiography, transesophageal echocardiography, cardiac computed tomography, and cardiac magnetic resonance imaging, for the diagnosis and evaluation of aortic and mitral PVL is comprehensively discussed. Interventional procedures for aortic or mitral PVL using various percutaneous closure devices are reviewed. Clinical outcomes of pe...
Source: Current Treatment Options in Cardiovascular Medicine - February 2, 2021 Category: Cardiology Source Type: research

An Update on Coronary Artery Disease in Pregnancy
AbstractPurpose of reviewWe review recent literature regarding coronary artery disease in pregnant women or women desiring pregnancy. This includes preconception counseling, prenatal care, labor and delivery, management of acute events in pregnancy, and postpartum care.Recent findingsThe pregnancy outcomes for women with coronary artery disease and their babies correlate with the degree of recovery from the initial event, coronary revascularization, and current maternal cardiac status. Preconception care includes assessment of cardiac function and management of cardiac medications. Prenatal care includes monitoring for rec...
Source: Current Treatment Options in Cardiovascular Medicine - February 2, 2021 Category: Cardiology Source Type: research

Complete Revascularization in Patients With STEMI and Multivessel Coronary Artery Disease: Is It Beneficial?
AbstractPurpose of reviewMultivessel coronary artery disease is usually present in up to 50% of patients presenting with ST-elevation myocardial infarction (STEMI). The optimal revascularization approach for non-infarct related lesions has been a topic of recent debate. Various observational studies and clinical trials have been conducted to assess the impact of multivessel revascularization. In this review, we aim to present the currently available evidence behind the different revascularization strategies.Recent findingsEarly observational studies, registry-based analyses, and meta-analyses had suggested a benefit of cul...
Source: Current Treatment Options in Cardiovascular Medicine - January 28, 2021 Category: Cardiology Source Type: research

Role of Inferior Vena Cava Filter Retrieval in Patients on Chronic Anticoagulation Therapy
AbstractPurpose of reviewDescribe the role of inferior vena cava filter (IVCF) retrieval in patients on chronic anticoagulation given the overlap of these treatment options in the management of patients with venous thromboembolic disease.Recent findingsDespite the increase in IVCF retrievals since the Food and Drug Administration safety communications in 2010 and 2014, retrieval rates remain low. Previous studies have shown that longer filter dwell times are associated with greater risk for filter complications and more difficulty with filter retrievals. Recent findings suggest that complications are more frequent in the f...
Source: Current Treatment Options in Cardiovascular Medicine - January 25, 2021 Category: Cardiology Source Type: research

Prenatal Detection of Congenital Heart Disease: the Past, Present, and Future
AbstractPurpose of reviewPrenatal diagnosis of congenital heart disease (CHD) is continuously evolving with each passing decade. Early efforts in fetal cardiology focused on identifying CHD in mid-gestation and understanding of fetal circulation in pathologic conditions. Improving prenatal detection rates for CHD remains an ongoing challenge and increasingly the field of fetal cardiology is moving to not only diagnosing CHD prenatally but also assessing the impact of prenatal diagnosis of CHD outcomes. Future directions include earlier diagnosis of fetal CHD, improved diagnostic rates, widespread sonographer education, and...
Source: Current Treatment Options in Cardiovascular Medicine - January 22, 2021 Category: Cardiology Source Type: research

Updates on the Role of Imaging in Cardiac Amyloidosis
AbstractPurpose of reviewImaging of cardiac amyloidosis has traditionally been hindered by nonspecific findings or diagnosis late in disease. Recent imaging techniques aim to address these gaps.Recent findingsT1 mapping, extracellular volume (ECV) quantification, myocardial strain imaging, positron emission tomography/computed tomography (PET/CT), bone-seeking agents, and cardiac computed tomography angiography (CCTA) are a few of the imaging modalities and techniques used to image cardiac amyloidosis. Many offer the possibility of earlier cardiac amyloidosis detection. PET/CT and bone-seeking agents may allow for quantifi...
Source: Current Treatment Options in Cardiovascular Medicine - January 16, 2021 Category: Cardiology Source Type: research

Outcomes and Procedural Considerations for Women Undergoing PCI
AbstractPurpose of reviewWomen continue to be underrepresented in cardiovascular studies, while heart disease remains a major cause of mortality and morbidity in women as in men. In this review, we explore the differences in presentation, characteristics, and treatment of women presenting for coronary intervention for stable coronary disease or acute coronary syndromes.Recent findingsRecent, large meta-analyses of clinical trials have shown that the sex differences in outcomes after non-ST-elevation acute coronary syndrome are attenuated after thorough adjustment for baseline comorbidities, but worse outcomes and more comp...
Source: Current Treatment Options in Cardiovascular Medicine - January 16, 2021 Category: Cardiology Source Type: research

Digital Health Applications in Heart Failure: a Critical Appraisal of Literature
AbstractPurpose of the reviewDespite advancements in the diagnostic and therapeutic armamentarium, heart failure (HF) remains a major public health concern in the USA and worldwide. Digital health applications hold promise to bridge this gap and improve HF care. This review will provide the reader with a concise overview of the current digital health applications in HF, the main challenges to its use, and discuss the future of digital health for promoting care for HF patients.Recent findingsEmerging evidence continues to support the potential role of digital health across the continuum of HF disease process including prima...
Source: Current Treatment Options in Cardiovascular Medicine - January 16, 2021 Category: Cardiology Source Type: research

The Impact of Depression and Anxiety on Cardiovascular Disease Risk and Outcomes in Women
AbstractPurpose of ReviewDepression and anxiety are known to potentiate cardiovascular disease and result in worse outcomes. These disorders disproportionately affect women. The purpose of this review is to examine the impact of depression and anxiety on cardiovascular outcomes in women.Recent FindingsDepression, anxiety, and psychosocial stressors work through a number of mechanisms to decrease health behavior engagement and increase cardiovascular risk in women. Ultimately, this leads to worsened quality of life, cardiovascular morbidity, and mortality among affected women. Notably, because these conditions are more prev...
Source: Current Treatment Options in Cardiovascular Medicine - January 16, 2021 Category: Cardiology Source Type: research

Preventive Cardio-Oncology: Cardiovascular Disease Prevention in Cancer Patients and Survivors
AbstractPurposeTo review the most common forms of cardiovascular toxicities from anti-cancer drugs, with a focus on their prevention via cardioprotective pharmacologic or lifestyle therapy, risk factors management, screening, monitoring, and surveillance methods.Recent findingsThere are almost 20 million cancer survivors in the USA, and their leading cause of death besides cancer recurrence or a secondary cancer is cardiovascular disease (CVD). CVD is prevalent in this population, with the most common forms being cardiomyopathy, ischemia, atrial fibrillation, and hypertension from cancer drugs or radiation therapy. The fie...
Source: Current Treatment Options in Cardiovascular Medicine - January 4, 2021 Category: Cardiology Source Type: research

Current Treatment Options in Cardiovascular Medicine Arrhythmia Section From the His Bundle to the Left Bundle: Clinical Applications of Conduction System Pacing
ConclusionCSP seeks to engage the His-Purkinje system either at the His bundle or the proximal fascicular system. Available data support a role for CSP in patients with bradyarrhythmia indications, and with growing experience in CRT applications. Present data best supports HBP, but LBBAP and LVSP may serve as alternative routes for CSP going forward. (Source: Current Treatment Options in Cardiovascular Medicine)
Source: Current Treatment Options in Cardiovascular Medicine - January 4, 2021 Category: Cardiology Source Type: research

Multimodality Imaging in the Evaluation and Treatment of Pulmonary Valve Disorders
AbstractPurpose of reviewTo discuss the epidemiology of pulmonary valve (PV) disorders, anatomy and pathology of the PV, and current treatment strategies for PV disorders with special attention to the patient with congenital heart disease. The focus will be on utilization of multimodality imaging methods including echocardiography, cardiac CT, and MRI in the evaluation and management of PV disorders.Recent findingsThe PV is affected in a myriad of congenital and acquired conditions, leading to stenotic, regurgitant, or mixed lesions. In addition to echocardiography, imaging modalities such as cardiac magnetic resonance ima...
Source: Current Treatment Options in Cardiovascular Medicine - January 2, 2021 Category: Cardiology Source Type: research

Treating Moderate Aortic Stenosis: Too Early or Too Late?
This article will consider treatment strategies for moderate AS, including early surgical and transcatheter aortic valve replacement and medical therapy.Recent findingsThere are few randomized controlled trials dedicated to medical and surgical therapies for moderate AS. Statins, antihypertensive agents and bisphosphonates have not consistently demonstrated an effect on AS progression, timing of aortic valve replacement, or improvement in patient outcomes. Early surgical intervention for patients with concomitant left ventricular dysfunction has been studied in a retrospective manner and appears promising.SummaryAside from...
Source: Current Treatment Options in Cardiovascular Medicine - January 2, 2021 Category: Cardiology Source Type: research

Cardiotoxicity Related to Immune Checkpoint Inhibitors
AbstractPurpose of reviewImmune checkpoint inhibitors (ICI) have modified the management of patients with cancer. Their administration is associated with an increased risk of toxicities that can affect every organ. Cardiovascular toxicities, particularly myocarditis, can occur with a low incidence (
Source: Current Treatment Options in Cardiovascular Medicine - November 26, 2020 Category: Cardiology Source Type: research

Risk Stratification for Subsequent Pregnancy After Prior Peripartum Cardiomyopathy
AbstractPurpose of reviewPeripartum cardiomyopathy (PPCM) is a rare but serious cardiac complication of pregnancy. Patients with PPCM may not have completed their reproductive years and may desire future pregnancies. This review summarizes the epidemiology and pathophysiology of PPCM and gives an overview of the current knowledge of risk factors that can be used to assess the risk of pregnancy after PPCM.Recent findingsAn increasing body of work has been reported on pregnancy outcomes in women with a history of PPCM. The most dominant determinate of poor outcome in subsequent pregnancies (SSP) is left ventricular ejection ...
Source: Current Treatment Options in Cardiovascular Medicine - November 26, 2020 Category: Cardiology Source Type: research

Deep Phenotyping in Cardiovascular Disease
AbstractPurpose of reviewTo review the opportunities and challenges of phenotyping cardiovascular diseases in the modern era.Recent findingsMore recently, the emerging field of precision medicine aims to provide the best available care for each patient based on stratification into new disease subclasses with a common biological basis. The discovery of such subclasses at the correct scale and speed, as well as the translation of this knowledge into clinical care, will depend critically upon digital and computational resources to capture, store, and exchange phenotypic data and upon sophisticated algorithms to integrate thes...
Source: Current Treatment Options in Cardiovascular Medicine - November 26, 2020 Category: Cardiology Source Type: research

The Role of Cardiac Computed Tomography in Valve Disease and Valve Intervention Planning
AbstractPurpose of reviewThis review aims to provide an overview of cardiac CT role in detection of valvular lesions and in transcatheter valve replacement.Recent findingsModern CT scans and protocols allow valve evaluation with high spatial and temporal resolution with reduced radiation dose. Cardiac CT is now mainstay of transcatheter aortic valve replacement (TAVR) planning. It plays a role in sizing of transcatheter aortic valve prosthesis, risk assessment for potential complications, prediction of ideal fluoroscopic angles, and selection of vascular access. Cardiac CT ’s role in transcatheter mitral, pulmonic, a...
Source: Current Treatment Options in Cardiovascular Medicine - November 26, 2020 Category: Cardiology Source Type: research

The Impact of Premature Menopause on Future Risk of Cardiovascular Disease
AbstractPurpose of ReviewCardiovascular disease remains the leading cause of morbidity and mortality for women in the USA. Recent multi-society guideline updates endorse using a history of premature menopause, defined as occurring before age 40  years, as a risk-enhancing factor for atherosclerotic cardiovascular disease risk assessment in women. Here, we review recent literature on cardiovascular disease risk in women with premature menopause, possible mechanisms linking premature menopause to cardiovascular disease, and the role of meno pausal hormone therapy in postmenopausal women.Recent FindingsLarge cohort studi...
Source: Current Treatment Options in Cardiovascular Medicine - November 20, 2020 Category: Cardiology Source Type: research

Arrhythmias Associated with Inflammatory Cardiomyopathies
AbstractPurpose of reviewTo provide an approach to the diagnosis and treatment of arrhythmias associated with inflammatory cardiomyopathies.Recent findingsInflammatory cardiomyopathies are increasingly recognized as the etiology of both ventricular and supraventricular arrhythmias. There have been recent studies providing novel insights into the pathogenesis of arrhythmias in inflammatory cardiomyopathies and exploring the role of various diagnostic tools and treatment strategies.SummaryPatients with inflammatory cardiomyopathies often present with one or more arrhythmias, including atrioventricular block, atrial and ventr...
Source: Current Treatment Options in Cardiovascular Medicine - November 19, 2020 Category: Cardiology Source Type: research

Disparities in Cardiovascular Care and Outcomes for Women From Racial/Ethnic Minority Backgrounds
AbstractPurpose of reviewRacial, ethnic, and gender disparities in cardiovascular care are well-documented. This review aims to highlight the disparities and impact on a group particularly vulnerable to disparities, women from racial/ethnic minority backgrounds.Recent findingsWomen from racial/ethnic minority backgrounds remain underrepresented in major cardiovascular trials, limiting the generalizability of cardiovascular research to this population. Certain cardiovascular risk factors are more prevalent in women from racial/ethnic minority backgrounds, including traditional risk factors such as hypertension, obesity, and...
Source: Current Treatment Options in Cardiovascular Medicine - November 17, 2020 Category: Cardiology Source Type: research

Vascular Endothelial Growth Factor (VEGF) Inhibitor Cardiotoxicity: What Should We Know?
AbstractPurpose of reviewCancer therapy-induced cardiovascular toxicity is a growing clinical problem with many unanswered questions about the optimal screening, prevention, and management, especially in patients treated with new targeted drugs. Among them, the use of vascular endothelial growth factor inhibitors (VEGFi) has become one of the most promising strategies to successfully approach a wide range of tumors. However, they have been associated with important cardiovascular complications such as systemic hypertension, heart failure, QTc prolongation, and venous and arterial thrombosis. This review addresses a multidi...
Source: Current Treatment Options in Cardiovascular Medicine - November 16, 2020 Category: Cardiology Source Type: research

Sex Differences in HFpEF
AbstractPurpose of reviewHeart failure with preserved ejection fraction (HFpEF) disproportionately affects women. Though no unifying theory exists to explain this phenomenon, the purpose of this review is to explore the many factors that likely contribute to this female predominance.Recent findingsInflammation and microvascular ischemia are increasingly thought to play a role in promoting HFpEF, as is the presence of cardiometabolic traits including hypertension, diabetes, and obesity. All of these factors are more common in women. Female-specific risk factors, including a history of hypertensive disorders of pregnancy and...
Source: Current Treatment Options in Cardiovascular Medicine - November 14, 2020 Category: Cardiology Source Type: research

Cardiovascular Evaluation and Considerations for Women of Advanced Maternal Age Desiring Pregnancy
AbstractPurpose of reviewPregnancy in women of advanced maternal age (AMA) is increasingly common. Women of AMA have higher pregnancy risks, including higher risk of cardiovascular complications such as hypertensive disorders of pregnancy. This review highlights recent data comparing pregnancy risks in both younger women and women of AMA, as well as how these risks are influenced using assisted reproductive therapies (ART). It highlights long-term cardiovascular risks in women of AMA and suggestions on how to perform cardiovascular evaluations both preconception and during pregnancy in this group of women. It also highligh...
Source: Current Treatment Options in Cardiovascular Medicine - November 13, 2020 Category: Cardiology Source Type: research

Management of Cervico-Cranial Arterial Dissections
AbstractPurpose of reviewCervico-cranial arterial dissections are a distinct etiology of both ischemic and hemorrhagic neurovascular events. These dissections can involve the extracranial carotid or vertebral arteries, classified collectively as cervical artery dissections, or can be intracranial arterial dissections, and complications and management of each differ. The most recent evidence is reviewed in this publication.Recent findingsSignificant heterogeneity regarding treatments of dissections exists among providers and with recent advances in endovascular approaches to neurovascular care, appreciating the latest evide...
Source: Current Treatment Options in Cardiovascular Medicine - November 13, 2020 Category: Cardiology Source Type: research

Swimming: What the Sports Cardiologist Should Know
AbstractPurpose of reviewTo inform the reader on the current knowledge of the cardiovascular effects of swimming and review the characteristics and treatments of unique cardiac conditions affecting the swimmer including swimming-induced pulmonary edema, long QT syndrome, troponin elevation, and sudden cardiac arrest/death.Recent findingsNew research has characterized swimming-induced cardiac remodeling as eccentric remodeling notable for greater left ventricular chamber dilation relative to wall thickening suggesting that swimming primarily challenges the heart with a volume load. Additionally, recent data from triathlons ...
Source: Current Treatment Options in Cardiovascular Medicine - November 12, 2020 Category: Cardiology Source Type: research