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Transcatheter Aortic Valve Implantation in Low and Intermediate Surgical Risk Patients: a Critical Appraisal of Seminal Studies
AbstractPurposeTranscatheter aortic valve implantation (TAVI) has grown in popularity as an alternative to surgical aortic valve replacement (SAVR) for the management of aortic stenosis. In this review, we perform a critical appraisal of the key studies comparing TAVI and SAVR in aortic stenosis patients with intermediate and low risk of operative mortality.Recent findingsEarly data from TAVI vs. SAVR trials in low and intermediate surgical risk patients suggest equivalent outcomes at 2 years, with some hints of superiority for TAVI over SAVR in the low-risk group. Initial mid-term data are a bit less favorable for TAVI ...
Source: Current Treatment Options in Cardiovascular Medicine - February 19, 2022 Category: Cardiology Source Type: research

Focused Cardiac Ultrasound for the Evaluation of Heart Valve Disease in Resource-Limited Settings
AbstractPurpose of reviewsThere are many places in the world where comprehensive echocardiography is not available, including remote or rural regions of high-income countries and outside urban centers of low- to middle-income countries. In this review, we discuss the use case for focused cardiac ultrasound (FoCUS) in remote and low-resource settings including its use by non-expert providers as well as its accuracy and limitations in the assessment of the most common heart valve lesions.Recent findingsFoCUS requires a different workflow compared to comprehensive echocardiography including a system for remote review and repo...
Source: Current Treatment Options in Cardiovascular Medicine - November 5, 2021 Category: Cardiology Source Type: research

Gender Differences in Implantable Cardioverter-Defibrillator Utilization for Primary Prevention of Sudden Cardiac Death
AbstractPurpose of reviewImplantable cardioverter-defibrillator (ICD) implantation is a guideline-recommended indication for primary prevention of sudden cardiac death (SCD) in high-risk patients. ICD implantation is lower in women than in men, a difference that has persisted over the last two decades. The goal of this review is to explore potential factors in under- utilization of ICDs in women and to provide information on gender differences in mortality benefit of ICDs.Recent findingsEpidemiological evidence shows that women with cardiovascular disease tend to present at an older age, have more non-ischemic cardiomyopat...
Source: Current Treatment Options in Cardiovascular Medicine - November 5, 2021 Category: Cardiology Source Type: research

Managing Cancer Patients and Survivors With Advanced Heart Failure
AbstractPurpose of reviewThe number of cancer patients grows globally. An important subset may develop heart failure.Recent findingsA paucity of data exists regarding outcomes and response to traditional intervention in cancer patients who develop heart failure. Advanced HF treatments in this population require special considerations. Since cancer treatment schedules are anticipated, emphasis should be placed on preventive interventions. Once left ventricular dysfunction ensues, early recognition and prompt treatment of heart failure may improve prognosis. Small studies have shown that guideline-directed medical therapies,...
Source: Current Treatment Options in Cardiovascular Medicine - November 5, 2021 Category: Cardiology Source Type: research

Echocardiographic Imaging for Transcatheter Tricuspid Valve Interventions
AbstractPurpose of ReviewTricuspid regurgitation (TR) represents an important, overlooked, and often undertreated valve disorder. The advent of novel transcatheter approaches directed towards the mitral and aortic valves has generated interest in the possible management of right-sided valve disease using similar strategies. The identification of anatomically suitable candidates by echocardiography is essential in ensuring good outcomes. The assessment of tricuspid valve (TV) morphology and regurgitation severity poses challenges to cardiac imagers and requires careful analysis of two- and three-dimensional echocardiographi...
Source: Current Treatment Options in Cardiovascular Medicine - November 3, 2021 Category: Cardiology Source Type: research

Heart Failure with Preserved Ejection Fraction and Cardiomyopathy: an Under-recognized Complication of Systemic Sclerosis
AbstractPurpose of ReviewHeart failure with preserved ejection fraction (HFpEF) and diastolic dysfunction are major sequelae of primary cardiac disease in patients with systemic sclerosis (SSc) and contribute to increased mortality in this population.Recent FindingsStudies of animal models of SSc and human tissue samples indicate that the pathophysiology underlying these conditions involves microvascular dysfunction, cardiomyocyte apoptosis, and replacement fibrosis. Diagnostic recommendations for HFpEF in SSc include clinical examination and screening with laboratory studies and cardiac imaging to detect diastolic dysfunc...
Source: Current Treatment Options in Cardiovascular Medicine - October 29, 2021 Category: Cardiology Source Type: research

Virtual Transformation and the Use of Social Media: Cardiac Electrophysiology Education in the Post-COVID-19 Era
AbstractPurpose of ReviewThe COVID-19 pandemic has significantly impacted the delivery of education for all specialties, including cardiac electrophysiology. This review will provide an overview of the COVID-19 spurred digital transformation of electrophysiology education for practicing clinicians and trainees in electrophysiology and cover the use of social media in these educational efforts.Recent FindingsMajor international, national, and local meetings and electrophysiology fellowship –specific educational sessions have transitioned rapidly to virtual and distanced learning, enhanced by social media. This has allowed...
Source: Current Treatment Options in Cardiovascular Medicine - October 19, 2021 Category: Cardiology Source Type: research

Advances in Mapping of Ventricular Tachycardia
AbstractPurpose of ReviewImplantable cardioverter defibrillator shocks are common with catheter ablation procedures being increasingly used to minimize recurrent ventricular tachycardia (VT). The purpose of the review is to provide an update on approaches to identify critical portions of VT circuits.Recent FindingsVT ablation has evolved from a surgical approach to a percutaneous minimally invasive approach. Pre-procedural planning including the use of cardiac MRI can provide valuable information about the underlying substrate. Mapping of the VT circuit with multipolar catheters and improved detection of slow conduction zo...
Source: Current Treatment Options in Cardiovascular Medicine - October 15, 2021 Category: Cardiology Source Type: research