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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 (<  1%) in patients treated with ICI, but with a high fatality rate (30–50%). In this review, we discuss the mechanisms, diagnostic work-up, and management of cardiovascular toxicities associated with ICI.Recent findingsThe main mechanisms of ICI-related myocarditis were first described in 2016 and are due to an infiltrate...
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, and t...
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 studies a...
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

Cardiovascular Complications of Prostate Cancer Therapy
AbstractPurpose of reviewWith treatment advances, the most common cause of death in prostate cancer patients is cardiovascular disease. Discerning the contribution of prostate cancer treatment on cardiovascular complications versus the natural progression of cardiovascular disease remains an ongoing area of investigation. Evaluating the research and identifying opportunities for further investigation is critical for optimal care of this prostate cancer patient population.Recent findingsThe degree that hormone therapy contributes to cardiovascular morbidity and mortality remains uncertain with conflicting results from large...
Source: Current Treatment Options in Cardiovascular Medicine - November 12, 2020 Category: Cardiology Source Type: research

Contraception for the Cardiac Patient: a Cardiologist ’s Primer
AbstractPurpose of reviewCardiovascular disease (CVD) is the number one cause of maternal mortality in the USA. There are many cardiac conditions which pose significant risk to maternal health, and these women should be offered options to avoid unwanted pregnancies. Individualized contraceptive counseling focusing on woman ’s desire for future pregnancy, comorbid conditions, and desire for hormone or non-hormonal (contraceptive) options is paramount to avoid adverse or unwanted side effects. The purpose of this review is to give general guidance on prescribing both hormonal and non-hormonal contraceptives for provid ers ...
Source: Current Treatment Options in Cardiovascular Medicine - November 9, 2020 Category: Cardiology Source Type: research