Angiotensin Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers and Outcomes in patients with COVID-19: A Systematic Review and Meta-Analysis.
CONCLUSION: use of ACEI/ARB was not associated with increased mortality or severe COVID-19. PMID: 32945216 [PubMed - as supplied by publisher] (Source: Expert Review of Cardiovascular Therapy)
Source: Expert Review of Cardiovascular Therapy - September 20, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Correction.
Authors: PMID: 32931353 [PubMed - as supplied by publisher] (Source: Expert Review of Cardiovascular Therapy)
Source: Expert Review of Cardiovascular Therapy - September 17, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Rivaroxaban for the treatment of venous thromboembolism in pediatric patients.
Authors: Cohen O, Levy-Mendelovich S, Ageno W Abstract INTRODUCTION: Anticoagulant therapy is in use for both prevention and treatment of venous and arterial thromboembolic disorders. Delivering safe and effective anticoagulation in the pediatric population is challenging, since the available standard therapy with parenteral UFH and LMWH is troublesome for most pediatric patients, and VKAs require frequent INR monitoring due to the unpredictable pharmacokinetics and numerous food and drug interactions. Rivaroxaban, a direct FXa inhibitor, offers the convenience of oral administration and predictable pharmacokinetic...
Source: Expert Review of Cardiovascular Therapy - September 17, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Cancer-associated venous thromboembolism and the non-vitamin K antagonist oral anticoagulants: a review of clinical outcomes and patient perspectives.
Authors: Overvad TF, Larsen TB, Søgaard M, Albertsen IE, Ording AG, Noble S, Højen AA, Nielsen PB Abstract INTRODUCTION: Cancer-associated venous thromboembolism remains an important but challenging aspect in the treatment of patients with cancer. Recently, alternatives to injection of low-molecular-weight heparin (LMWH) have been introduced, the non-vitamin K antagonist oral anticoagulants (NOACs), which could potentially alleviate patients from burdensome daily injections. AREAS COVERED: This review discusses the available evidence exploring the role of NOACs in the treatment and secondary preve...
Source: Expert Review of Cardiovascular Therapy - September 13, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Empagliflozin effects on cardiac remodeling: re-shaping the future of heart failure prevention.
Authors: Katsiki N, Kotsa K, Kotsis V PMID: 32897742 [PubMed - as supplied by publisher] (Source: Expert Review of Cardiovascular Therapy)
Source: Expert Review of Cardiovascular Therapy - September 10, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Cost-utility analysis of home-based cardiac rehabilitation as compared to usual post-dischargecare: systematic review and meta-analysis of randomized controlled trials.
Authors: Bakhshayeh S, Hoseini B, Bergquist R, Nabovati E, Gholoobi A, Mohammad-Ebrahimi S, Eslami S Abstract INTRODUCTION: . Determining cost-utility differences between home-based cardiac rehabilitation (HBCR) on the one hand, and usual post-discharge care (UC) on the other, can improve resource-allocation in healthcare settings. AREAS COVERED: . In June 2019, PubMed, Web of Science, Scopus and Cochrane library were searched for randomized controlled HBCR trials. Standardized mean differences (SMDs) of cost and quality-adjusted life years (QALYs) between HBCRs and UCs were calculated using random effect model...
Source: Expert Review of Cardiovascular Therapy - September 9, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Effects of physical exercise on the autonomic nervous system in patients with coronary artery disease: A systematic review.
The objective of this systematic review was to investigate the effects of physical exercise on heart rate variability in individuals with coronary artery disease (CAD). The PubMed, PEDro, Scielo, Lilacs and Cochrane databases were systematically searched, for articles which performed supervised exercises in phase II of cardiac rehabilitation in patients with CAD.Expert opinion: Given the differences between studies on interventions and population characteristics, it is difficult to justify similarities or divergences in terms of results. In addition to the variation in sample size, intervention duration, carrying out an ad...
Source: Expert Review of Cardiovascular Therapy - September 6, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Current Challenges in Cardiac Rehabilitation: Strategies to Overcome Social Factors and Attendance Barriers.
Authors: Chindhy S, Taub PR, Lavie CJ, Shen J Abstract Introduction Cardiac rehabilitation (CR) significantly reduces secondary cardiovascular events and mortality and is a class 1A recommendation by the American Heart Association (AHA) and American College of Cardiology (ACC). However, it remains an underutilized intervention and many eligible patients fail to enroll or complete CR programs. The aim of this review is to identify barriers to CR attendance and discuss strategies to overcome them. Areas Covered Specific barriers to CR attendance and participation will be reviewed. This will be followed by a discussio...
Source: Expert Review of Cardiovascular Therapy - September 6, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Outcomes of Percutaneous Intervention in In-stent versus De-novo Chronic Total Occlusion: A Meta-analysis.
CONCLUSION: PCI for in-stent CTO might be associated with higher odds of MACE and MI compared to PCI for de-novo CTO. These complications, however, do not translate into an increased risk of cardiovascular mortality or failure of procedure. PMID: 32842807 [PubMed - as supplied by publisher] (Source: Expert Review of Cardiovascular Therapy)
Source: Expert Review of Cardiovascular Therapy - August 28, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

COVID-19 and Renin-Angiotensin System Modulators: What Do We Know So Far?
Authors: de la Cruz A, Ashraf S, Vittorio TJ, Bella JN Abstract INTRODUCTION: . The novel coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory system-coronavirus-2 (SARS-CoV-2), is an important medical problem worldwide. Increased risk of mortality has been reported in patients with cardiovascular disease, such as hypertension (HTN). SARS-CoV-2 invades the pulmonary alveolar epithelial cells by binding to the surface receptor, angiotensin-converting enzyme 2 (ACE2). Renin-angiotensin system (RAS) modulators can increase levels of ACE2. Thus, concerns have been raised regarding an increased ri...
Source: Expert Review of Cardiovascular Therapy - August 28, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

The Efficacy and Safety of Transradial and Transfemoral Approach in Treatment of Coronary Chronic Total Occlusion: A Systematic Review and Meta-Analysis.
Authors: Soud M, SayedAhmad Z, Kajy M, Alahdab F, Darmoch F, Al-Khadra Y, Pacha HM, Sattar Y, Ullah W, King F, Saad AB, Alhatemi G, Hakim Z, Ali OA, Glazier JJ, Alraies MC Abstract BACKGROUND: Transradial coronary intervention (TR) has been shown to be associated with lower bleeding and length of stay compared to femoral artery access for coronary artery interventions. There is limited data on the efficacy and the safety of the TR for percutaneous coronary intervention (PCI) of coronary chronic total occlusion (CTO), particularly in comparison with the transfemoral approach (TF). Objectives: We sought to study the ...
Source: Expert Review of Cardiovascular Therapy - August 24, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Evaluation of inter-patient variability in the pharmacodynamic indices of warfarin.
Authors: Sridharan K, Al Banny R, Qader AM, Ahmed A Abstract OBJECTIVES: Warfarin exhibits huge inter-individual variability in therapeutic response. We assessed the extent and the factors affecting inter-individual variability in the anticoagulation control using pre-validated pharmacodynamic indices. METHODS: Patients receiving warfarin for at least 6 months were recruited. CHA₂DS₂-VASc, HASBLED, SAMe-TT2R2 scores, warfarin sensitive index (WSI), log-INR variability and warfarin composite measure (WCM) were assessed. National Institute for Health and Care Excellence (NICE) guideline was adhered for assess...
Source: Expert Review of Cardiovascular Therapy - August 23, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Focus on a rare clinical entity: unicuspid aortic valve disease.
This article aims to give an overview on the most recent literature addressing the pathophysiology, the diagnostic tools and appropriate surgical therapy options of unicuspid aortic valve. Due to the rare prevalence, the understanding of pathophysiology is still missing. Further, symptomatic aortic valve disease are seen much earlier life-stage in this cohorts. Thus, it highlights the several surgical treatment options with pro and contra especially for the young adult cohorts. EXPERT OPINION: Large scale prospective observational studies using standardized diagnostic criteria are needed to reveal the clinical course. ...
Source: Expert Review of Cardiovascular Therapy - August 21, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Update on diagnosis and management of neoplastic pericardial disease.
Authors: Avondo S, Andreis A, Casula M, Imazio M Abstract INTRODUCTION: Pericardial neoplasms are uncommon, mostly due to secondary involvement of the pericardium by extracardiac tumors. Clinical presentation is nonspecific, frequently leading to a delayed diagnosis. Moreover, both benign and malignant pericardial tumors may be associated with myocardial infiltration and mechanical compression of cardiac chambers, possibly precipitating clinical conditions. Pericardial tumors are indeed a diagnostic and therapeutic clinical challenge. AREAS COVERED: This review aims to provide an overview of the main clinical c...
Source: Expert Review of Cardiovascular Therapy - August 18, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Effect of ambrisentan on echocardiographic and Doppler measures from patients in China with pulmonary arterial hypertension.
Authors: Zhao QH, Peng FH, Yu ZX, Zhang GC, Ji QS, Wang Y, Liu JM, Huo Y, Zeng XF, Li JH, Zi L, Jing ZC Abstract BACKGROUND: We retrospectively evaluated the echocardiographic data of ambrisentan-treated patients with pulmonary arterial hypertension (PAH) (NCT01808313). METHODS: Change from baseline in right ventricle (RV) systolic function, right heart structure, and pulmonary artery systolic pressure (PASP) prognosis to Weeks 12 and 24 was evaluated by echocardiography. RESULTS: In the overall population, the mean tissue Doppler-derived tricuspid lateral annular systolic velocity (S') increased by 0.6 cm/...
Source: Expert Review of Cardiovascular Therapy - August 18, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Tissue engineered heart valves for transcatheter aortic valve implantation: current state, challenges, and future developments.
Authors: Poulis N, Zaytseva P, Gähwiler E, Motta SE, Fioretta ES, Cesarovic N, Falk V, Hoerstrup SP, Emmert MY Abstract INTRODUCTION: The establishment of transcatheter aortic valve implantation (TAVI) has revolutionized the treatment of severe aortic stenosis. However, with TAVI being approved for low-risk patients, valve durability is becoming of central importance. Here, we summarize how tissue engineered heart valves (TEHVs) may provide a clinically-relevant durable valve replacement compatible with TAVI. AREAS COVERED: Since its introduction, TAVI prostheses have advanced in design and development. Ho...
Source: Expert Review of Cardiovascular Therapy - August 16, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Cardiopulmonary exercise testing - refining the clinical perspective by combining assessments.
Authors: Arena R, Canada JM, Popovic D, Trankle CR, Del Buono M, Lucas A, Abbate A Abstract INTRODUCTION: Cardiorespiratory fitness (CRF) is now established as a vital sign. Cardiopulmonary exercise testing (CPX) is the gold-standard approach to assessing CRF. AREAS COVERED: A body of literature spanning several decades clearly supports the clinical utility of CPX in those who are apparently health and at risk for chronic disease as well as numerous patient populations. While CPX, in and of itself, is a valid and reliable clinical assessment, combining findings with other available assessments may provide a mor...
Source: Expert Review of Cardiovascular Therapy - August 13, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Aspirin and low dose rivaroxaban - the dual pathway concept in patients with stable atherosclerotic disease: a comprehensive review.
Authors: Parascandolo E, Eisen A Abstract INTRODUCTION: Cardiovascular disease is the leading cause of morbidity and mortality in adults in western nations. In the last decades, tremendous research has been conducted in the field of secondary prevention in order to reduce recurrent cardiovascular events. This review summarizes the novel dual pathway concept of aspirin and very low-dose rivaroxaban, from mechanisms to clinical practice. AREAS COVERED: The COMPASS trial demonstrated that in patients with stable atherosclerotic disease, very low-dose rivaroxaban, a direct factor Xa inhibitor, when combined with as...
Source: Expert Review of Cardiovascular Therapy - August 13, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

The Association of the Metabolic Syndrome with Target Organ Damage: Focus on the Heart, Brain and Central Arteries.
Authors: Saeed S, Waje-Andreassen U, Nilsson PM Abstract INTRODUCTION: The metabolic syndrome (MetS) is an adverse metabolic state composed of obesity, hyperglycemia/pre-diabetes, hypertension and dyslipidemia. It substantially increases the risk of type 2 diabetes, cardiovascular disease (CVD) and mortality, and has a huge impact on public health. AREA COVERED: The present review gives an update on the definition and prevalence of MetS, and its impact on cardiac structure and function as well as on the brain and central arteries. The association with CVD and mortality risk is discussed. Focus is mainly directe...
Source: Expert Review of Cardiovascular Therapy - August 13, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Balloon-expandable versus self-expanding transcatheter aortic valve replacement: a comparison and evaluation of current findings.
Authors: Costa G, Criscione E, Reddavid C, Barbanti M Abstract INTRODUCTION: Currently, several balloon-expandable(BE) and self-expanding(SE) transcatheter aortic valves(TAVs) are available in clinical practice.Each of them has potential advantages and disadvantages that must be taken into account. AREAS COVERED: New-generation BE and SE TAVs showed similar mid-term outcomes after transfemoral transcatheter aortic valve replacement(TAVR) and better results compared to early-generation devices.BE TAVs showed better results in terms of residual paravalvular regurgitation(PVR) and permanent pacemaker implantation(...
Source: Expert Review of Cardiovascular Therapy - August 13, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Antithrombotic treatment in atrial fibrillation patients undergoing percutaneous coronary interventions: focus on stent thrombosis.
Authors: Vitolo M, Javed S, Capodanno D, Rubboli A, Boriani G, Lip GY Abstract INTRODUCTION: Coronary artery disease (CAD) commonly coexists with atrial fibrillation (AF), requiring oral anticoagulation (OAC) in a significant subset of patients. These patients also often require revascularization with percutaneous coronary intervention (PCI), which traditionally is supported with dual antiplatelet therapy (DAPT) to prevent complications including stent thrombosis (ST). Recent clinical studies have demonstrated that dual therapy (DAT, i.e. OAC plus single P2Y12 inhibitor) has a more favorable safety profile than tri...
Source: Expert Review of Cardiovascular Therapy - August 13, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Response to "new pharmacotherapy in heart failure".
Response to "new pharmacotherapy in heart failure". Expert Rev Cardiovasc Ther. 2020 Aug 01;:1-2 Authors: Ioannou A, Metaxa S, Simon S, Mandal AKJ, Missouris CG PMID: 32744124 [PubMed - as supplied by publisher] (Source: Expert Review of Cardiovascular Therapy)
Source: Expert Review of Cardiovascular Therapy - August 4, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Correlation between myocardial strain and adverse remodeling in a non-diabetic model of heart failure following empagliflozin therapy.
CONCLUSION: Empagliflozin enhances myocardial deformation, assessed by STE techniques, in a non-diabetic porcine model of ischemic HF. This may be related to a mitigation of adverse cardiac remodeling following ischemia reperfusion injury. In contrast, FTCMR technique needs further development and validation. PMID: 32713221 [PubMed - as supplied by publisher] (Source: Expert Review of Cardiovascular Therapy)
Source: Expert Review of Cardiovascular Therapy - July 28, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Management of valvular heart disease in the pregnant patient.
Authors: Hutt E, Desai MY Abstract INTRODUCTION: Among cardiovascular disease in pregnancy, valvular heart disease remains a prevalent cause of maternal and fetal morbidity. The physiological changes of pregnancy can lead to decompensation of known or silent valvular heart disease. This poses a challenge to both physicians and patients in determining the best timing and management of valvular disease in the pre and post conception settings. This condition requires specific care to minimize both maternal and fetal morbidity and mortality. AREAS COVERED: In this article, we review the recommended management of va...
Source: Expert Review of Cardiovascular Therapy - July 28, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Pharmacotherapeutic considerations for the management of cardiovascular diseases among hospitalized COVID-19 patients.
Authors: Kow CS, Thiruchelvam K, Hasan SS Abstract INTRODUCTION: Cardiovascular diseases (CVDs) are among the most frequently identified comorbidities in hospitalized patients with COVID-19. Patients with cardiovascular (CV) comorbidities are typically prescribed with long-term medications. We reviewed the management of co-medications prescribed for CVDs among hospitalized COVID-19 patients. AREAS COVERED: There is no specific contraindication or caution related to COVID-19 on the use of antihypertensives unless patients develop hypotension from septic shock where all antihypertensives should be discontinued or...
Source: Expert Review of Cardiovascular Therapy - July 25, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

More than a matter of the heart: the concept of intravascular multimorbidity in cardiac rehabilitation.
Authors: Hwang CL, Elokda A, Ozemek C, Arena R, Phillips SA Abstract INTRODUCTION: Coronary artery disease (CAD) is the major cause of death of cardiovascular disease. It is initiated by atherosclerosis, which narrows the coronary arteries and limits blood flow and oxygen to the heart. Multiple pathophysiological conditions within the arteries, such as arterial wall thickening, endothelial dysfunction, and arterial stiffening, are associated with the development of atherosclerosis. AREAS COVERED: We introduce a new concept of "intravascular multimorbidity", the presence and integration of multiple pat...
Source: Expert Review of Cardiovascular Therapy - July 25, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Vulnerability for Ventricular Arrhythmias in Patients with Chronic Coronary Total Occlusion.
Authors: Assaf A, Diletti R, Hoogendijk MG, van der Graaf M, Zijlstra F, Szili-Torok T, Yap SC Abstract INTRODUCTION: The presence of a chronic total occlusion (CTO) is associated with an increased risk of ventricular arrhythmias. AREAS COVERED: This review provides an overview of the relationship between CTO and ventricular arrhythmias, arrhythmogenic mechanisms, and the effect of revascularization. EXPERT OPINION: Studies in recipients of an implantable cardioverter-defibrillator (ICD) have shown that a CTO is an independent predictor of appropriate ICD therapy. The myocardial territory supplied by a CTO ...
Source: Expert Review of Cardiovascular Therapy - July 22, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Heart failure in congenital heart disease: management options and clinical challenges.
Authors: Leusveld EM, Kauling RM, Geenen LW, Roos-Hesselink JW Abstract INTRODUCTION: The population of adults with congenital heart disease (ACHD) is rapidly expanding and one of the major complications is heart failure. Timely diagnosis and treatment are crucial, but strong evidence for effectiveness of heart failure treatment in ACHD is currently lacking. Components of the medical history, physical examination and further diagnostic tests including ECG, echocardiography, cardiac magnetic resonance imaging, exercise testing, and biomarkers can identify patients at risk for early mortality or heart failure. AR...
Source: Expert Review of Cardiovascular Therapy - July 22, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Clinical considerations and assessment of risk factors when choosing endovascular thrombectomy for acute stroke.
Authors: Wadhwa A, Joundi R, Menon B Abstract INTRODUCTION: The advent of endovascular thrombectomy (EVT) has been a game changer for the management of acute ischemic stroke due to large vessel occlusion. However, the selection of suitable candidates for EVT remains a significant challenge. AREAS COVERED: This review focuses on the clinical, radiological and procedural considerations for EVT in acute stroke that assist in optimal patient selection. EXPERT OPINION: All patients presenting with significant clinical deficits with treatable occlusions, who have salvageable brain tissue at presentation might ben...
Source: Expert Review of Cardiovascular Therapy - July 22, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Epidemiology, prognosis and clinical manifestation of cardiovascular disease in COVID-19.
Authors: Capone V, Cuomo V, Esposito R, Canonico ME, Ilardi F, Prastaro M, Esposito G, Santoro C Abstract INTRODUCTION: At the end of 2019, a novel coronavirus was identified as the cause of a pneumonia cluster in Wuhan, China. Since then, the contagion has rapidly spread all over the world resulting in a global pandemic. Since frequent cardiovascular (CV) system involvement has soon been detected in patients occurring coronavirus disease 2019 (COVID-19), we would provide a simple review available to cardiologists who are going to be involved in the management of COVID-19 patients from several levels: from diagnosi...
Source: Expert Review of Cardiovascular Therapy - July 18, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

An update on genetic risk scores for coronary artery disease: Are they useful for predicting disease risk and guiding clinical decisions?
Authors: Lieb W, Vasan RS PMID: 32672491 [PubMed - as supplied by publisher] (Source: Expert Review of Cardiovascular Therapy)
Source: Expert Review of Cardiovascular Therapy - July 18, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Utilization of percutaneous left atrial appendage closure in patients with atrial fibrillation: an update on patient outcomes.
Authors: Kleinecke C, Gloekler S, Meier B Abstract INTRODUCTION: Atrial fibrillation (AF) is associated with an increased risk of stroke, morbidity and overall mortality. So far, oral anticoagulation (OAC) is the standard of care for stroke prevention, either with vitamin K antagonists or with non-vitamin K oral anticoagulants (NOACs). The left atrial appendage (LAA) can be eliminated by epicardial or endocardial exclusion. Left atrial appendage closure (LAAC) represents a mechanical thromboprophylaxis - which has also been termed mechanical vaccination - against stroke, bleeding and death. AREAS COVERED: Studi...
Source: Expert Review of Cardiovascular Therapy - July 15, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

An updated drug profile of ticagrelor with considerations on the treatment of patients with coronary artery disease and diabetes mellitus.
Authors: Calderone D, Capodanno D, Angiolillo DJ Abstract INTRODUCTION: - Ticagrelor is an antiplatelet agent acting through direct and reversible competitive inhibition of the platelet P2Y12 receptor. While the clinical merits of ticagrelor in patients who experienced an acute coronary syndrome are widely accepted, its role in stable coronary artery disease is less established. Recently, large-scale trials of ticagrelor have been published in this setting, including a trial in patients with diabetes mellitus (DM). AREAS COVERED: - This review aims to inform about recent findings on ticagrelor, by appraising th...
Source: Expert Review of Cardiovascular Therapy - July 15, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Current assessment and management of endoleaks after advanced EVAR: new devices, new endoleaks?
Authors: Cannavale A, Lucatelli P, Corona M, Nardis P, Cannavale G, De Rubeis G, Santoni M, Maher B, Catalano C, Bezzi M Abstract Introduction In recent years there has been an increasing application of advanced EVAR techniques to tackle complex clinical and anatomical scenarios. In a bid to overcome the limitations of the traditional stent-grafts, newer EVAR endografts and techniques have been developed and introduced into clinical practice, permitting endovascular management of difficult infrarenal, juxta-renal and thoracoabdominal aneurysms for which previously there was no endovascular solution. As a consequenc...
Source: Expert Review of Cardiovascular Therapy - July 8, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Latest Developments in Chronic Total Occlusion Percutaneous Coronary Intervention.
We describe recent clinical and technological developments in CTO PCI from 2018 to 2020. EXPERT OPINION: After publication of 6 randomized controlled trials, improving patient symptoms remains the principal indication for CTO PCI. Although good outcomes can be achieved with CTO PCI at experienced centers, success rates are significantly lower at less experienced centers, despite increased use in CTO crossing algorithms and development of novel and improved equipment and techniques. PMID: 32594784 [PubMed - as supplied by publisher] (Source: Expert Review of Cardiovascular Therapy)
Source: Expert Review of Cardiovascular Therapy - July 1, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Current controversies in pre-participation cardiovascular screening for young competitive athletes.
Authors: Petek BJ, Baggish AL Abstract INTRODUCTION: Pre-participation cardiovascular screening (PPCS) in athletes is recommended by numerous medical and sporting societies. While there is consensus that young athletes should be screened prior to participation in competitive sports, there are on-going debates regarding the true incidence of sudden cardiac death (SCD), the most frequent causes of SCD, and the optimal methods for PPCS. AREAS COVERED: This review focuses on the current evidence for the incidence of SCD, causes of SCD, and the pros and cons of a history and physical exam (H&P) and electrocardio...
Source: Expert Review of Cardiovascular Therapy - July 1, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Predicting and improving outcomes of transcatheter aortic valve replacement in older adults and the elderly.
Authors: Bruno AG, Santona L, Palmerini T, Taglieri N, Marrozzini C, Ghetti G, Orzalkiewicz M, Galiè N, Saia F Abstract INTRODUCTION: Indications for transcatheter aortic valve replacement (TAVR) are progressively extending to younger and lower risk patients. In this scenario, minimizing periprocedural complications and optimizing procedural result are both crucial to achieve an excellent long-term outcome. AREAS COVERED: In this review, we summarize the main strategies that can be adopted before, during, and after TAVR to predict and prevent complications, to optimize procedural results and ultimately i...
Source: Expert Review of Cardiovascular Therapy - June 21, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Infant blood lipids: a systematic review of predictive value and influential factors.
Authors: Felzer-Kim IT, Visker JP, Ferguson D, Hauck JL Abstract INTRODUCTION: Blood lipid screening recommendations begin at ages 9 - 11 years, despite poor adherence and evidence of fatty streaks in coronary arteries by 3-years of age. For cardiovascular disease (CVD) prevention, there may be value in earlier measurement of blood lipids. AREAS COVERED: The present systematic review examines evidence concerning total cholesterol, low-density lipoprotein, high-density lipoprotein, and triglycerides during the infant period. Included are studies examining the extent to which infant blood lipids predict later val...
Source: Expert Review of Cardiovascular Therapy - June 18, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

How to Minimize Peri-procedural Complications during Subcutaneous Defibrillator Implant?
Authors: Afzal MR, Okabe T, Hsu K, Cook S, Koppert T, Weiss R Abstract INTRODUCTION: Subcutaneous defibrillator (S-ICD) is the latest development in the clinically available devices for sudden cardiac death prevention. Experience from pivotal trials and post-marketing studies has proven the feasibility and safety of S-ICD. Extra-cardiac location of S-ICD obviates the need for transvenous leads which translates into lower incidence of lead-related complications and systemic infections. This is a review on peri-procedural interventions to minimize complications associated with S-ICD during implant and follow-up. ...
Source: Expert Review of Cardiovascular Therapy - June 18, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Novel diagnostic and imaging techniques in endovascular iliac artery procedures.
Authors: De Boer SW, Heinen SGH, Goudeketting SR, De Haan MW, Mees BM, Van Den Heuvel DAF, De Vries JPM Abstract INTRODUCTION: Endovascular revascularization has become the preferred treatment for most patients with iliac artery obstructions, with a high rate of clinical and technical success. AREAS COVERED: This review will describe novel developments in the diagnosis and treatment of iliac artery obstructions including the augmentation of preprocedural imaging with advanced flow models, image fusion techniques, and state-of-the-art device-tracking capabilities. EXPERT OPINION: The combination of these dev...
Source: Expert Review of Cardiovascular Therapy - June 18, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

New Pharmacotherapy for Heart Failure with Reduced Ejection Fraction.
Authors: Sotirakos S, Wheen P, Spiers J, Armstrong R Abstract INTRODUCTION: The European Society of Cardiology (ESC), Canadian Cardiovascular Society, and the American College of Cardiology Heart Failure (HF) guidelines all currently recommend the use of Angiotensin Converting Enzyme (ACE) inhibitors or Angiotensin Receptor Blockers (ARBs) and Beta Blockers (BB) in in the treatment of HF with a reduced ejection fraction (HFrEF). Newer medications targeting combining an ARB with a neprilysin inhibitor (ARNI) sacubitril/valsartan have shown benefits in mortality and can be used in place of an ACE inhibitor or an ARB....
Source: Expert Review of Cardiovascular Therapy - June 18, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Bempedoic acid for the treatment of hypercholesterolemia.
Authors: Yang J Abstract INTRODUCTION: Although several lipid-lowering drugs are available, they are not sufficient for some patients. Bempedoic acid is a small molecule adenosine triphosphate citrate lyase inhibitor indicated for the treatment of adults with hypercholesterolemia. AREAS COVERED: We performed a systematic review of the literature using PubMed database, and the following keywords were used: "bempedoic acid", "hypercholesterolemia", and "adenosine triphosphate citrate lyase" . The chemical property, mechanism of action, pharmacokinetics, clinical efficacy, and safety ...
Source: Expert Review of Cardiovascular Therapy - June 15, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Targeting apoC-III and ANGPTL3 in the treatment of hypertriglyceridemia.
Authors: Nurmohamed NS, Dallinga-Thie GM, Stroes ESG Abstract INTRODUCTION: The prevalence of hypertriglyceridemia (HTG) is increasing. Elevated triglyceride (TG) levels are associated with an increased cardiovascular disease (CVD) risk. Moreover, severe HTG results in an elevated risk of pancreatitis, especially in severe HTG with an up to 350-fold increased risk. Both problems emphasize the clinical need for effective TG lowering. AREAS COVERED: The purpose of this review is to discuss the currently available therapies and to elaborate the most promising novel therapeutics for TG lowering. EXPERT OPINION:...
Source: Expert Review of Cardiovascular Therapy - June 10, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Clinical outcomes for congenital heart disease patients presenting with infective endocarditis.
Authors: Di Filippo S Abstract INTRODUCTION: Infective endocarditis (IE) is a life-threatening adverse event for patients with congenital heart disease (CHD). Its incidence has changed little over time despite progress in techniques for diagnosis and treatment, and guidelines for prophylaxis. AREAS COVERED: The review sought for key-words: 'congenital heart disease,' 'infective endocarditis,' 'microbial diagnosis,' 'imaging diagnosis,' 'surgical techniques,' 'prognosis,' 'prophylaxis.' Objectives were to investigate epidemiology, novel techniques for imaging and microbial diagnosis, therapeutic management and p...
Source: Expert Review of Cardiovascular Therapy - June 3, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Anticoagulant treatment and bleeding complications in patients with left ventricular assist devices.
Authors: den Exter PL, Beeres SLMA, Eikenboom J, Klok FA, Huisman MV Abstract INTRODUCTION: The treatment options for advanced heart failure patients drastically changed with the introduction of left ventricular assist devices (LVADs), either as bridge to transplant or as destination therapy for patients ineligible for transplant. Despite major benefits in terms of survival, functional status and quality of life, managing patients with LVADs comes with several challenges. The most significant challenge is balancing between the risks of thrombotic and bleeding complications. AREAS COVERED: The present review des...
Source: Expert Review of Cardiovascular Therapy - May 26, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Accurate assessment of right heart function before and after long-term left ventricular assist device implantation.
Authors: Dandel M, Javier MFDM, Javier Delmo EMD, Hetzer R Abstract Introduction: Because end-stage heart failure (HF) often involves both ventricles even if its initial cause was left-sided heart disease, assessment of RV size, geometry and function before, during and after LVAD implantation is of crucial importance.Areas covered: This review discusses the usefulness, benefits, particular challenges and limits of RV assessment in patients with end-stage HF due to primarily impaired LV function who necessitate LVAD support, with or without an additional RV mechanical support.Expert opinion: Although LV unloading of...
Source: Expert Review of Cardiovascular Therapy - May 23, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Current practice in atrial septal defect occlusion in children and adults.
This article intended to review all aspects of ASD; anatomy, pathophysiology, clinical presentation, natural history, and indication for treatment. Also, we covered the transcatheter therapy in detail, including the procedural aspect, available devices, and outcomes. EXPERT OPINION: There has been a remarkable improvement in the treatment strategy of ASD over the last few decades. Transcatheter closure of ASD is currently accepted as the treatment of choice in most patients with appropriately selected secundum ASDs. This review will focus on the most recent advances in diagnosis and treatment strategy of secundum ASD. ...
Source: Expert Review of Cardiovascular Therapy - May 23, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Correction.
Authors: PMID: 32427009 [PubMed - as supplied by publisher] (Source: Expert Review of Cardiovascular Therapy)
Source: Expert Review of Cardiovascular Therapy - May 21, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Endothelial function in obesity and effects of bariatric and metabolic surgery.
Authors: Sanches E, Topal B, Proczko M, Stepaniak PS, Severin R, Philips SA, Sabbahi A, Pujol Rafols J, Pouwels S Abstract IntroductionDue to the lifestyle changes and the on-going urbanization waves there is obesity pandemic. The visceral fatty tissue of patients with obesity, in comparison with subcutaneous fat, has more gene expression related to inflammation, oxidative stress, cytokine production and angiogenesis. The abovementioned leads to a decrease in arteriolar function and also an impaired endothelial vasodilatation and eventually endothelial dysfunction.Areas CoveredThis review aims to provide an overvie...
Source: Expert Review of Cardiovascular Therapy - May 15, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Chronic total occlusion percutaneous coronary interventions: identifying patients at risk of complications.
Authors: Neupane S, Gupta A, Basir M, Alaswad K Abstract Introduction: Angina refractory to medical therapy and providing complete revascularization (after acute coronary syndrome or in patients with ischemic cardiomyopathy) are common indications for CTO PCI. Unfortunately, CTO PCI is associated with higher rates of complications when compared with non-CTO PCI.Areas covered: In this article, we review available studies on risk prediction in CTO PCI and outline strategies to avoid complications.Expert opinion: Identifying patients at increased risk of periprocedural major adverse cardiovascular events (MACE) is of ...
Source: Expert Review of Cardiovascular Therapy - May 1, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research