Coronary artery calcification on noncardiac chest CT: Incidental but impactful
Coronary artery calcification (CAC) by gated CT imaging has historically been used as a screening tool for the detection of atherosclerotic coronary artery disease (CAD). Advances in computed tomography (CT) technology have allowed for increased detection of CAC when performing routine non-gated chest CT for pulmonary pathology and lung cancer screening. The reporting of incidental CAC on these studies is neither common nor standardized. To date, only those patients enrolled in the American College of Radiology (ACR) lung cancer screening registry are required to have documentation of CAC, only if moderate or severe [1]. (...
Source: Trends in Cardiovascular Medicine - May 16, 2017 Category: Cardiology Authors: Aalap Chokshi, James E. Udelson Source Type: research
Editorial Commentary: Atrial fibrillation: Challenges and opportunities
Atrial fibrillation (AF) is the most common arrhythmia requiring treatment, and AF is currently a global public health problem linked to an aging population. There have been significant advances in recent years in understanding the mechanisms of AF and treatment of patients with AF. It has become evident that in addition to ageing, genetic, environmental, and various cardiac and non-cardiac factors contribute to onset of AF. Catheter ablation techniques have significantly reduced the symptoms of specific groups of patients with AF and randomized controlled trials with novel anticoagulants (NOAC) have substantially decrease...
Source: Trends in Cardiovascular Medicine - May 15, 2017 Category: Cardiology Authors: Heikki V. Huikuri Source Type: research
Atrial fibrillation: Challenges and opportunities
Atrial fibrillation (AF) is the most common arrhythmia requiring treatment, and AF is currently a global public health problem linked to an aging population. There have been significant advances in recent years in understanding the mechanisms of AF and treatment of patients with AF. It has become evident that in addition to ageing, genetic, environmental, and various cardiac and non-cardiac factors contribute to onset of AF. Catheter ablation techniques have significantly reduced the symptoms of specific groups of patients with AF and randomized controlled trials with novel anticoagulants (NOAC) have substantially decrease...
Source: Trends in Cardiovascular Medicine - May 15, 2017 Category: Cardiology Authors: Heikki V. Huikuri Source Type: research
Causes of death in atrial fibrillation: Challenges and opportunities
Atrial fibrillation (AF) is an age-related arrhythmia associated with several co-morbidities and significant mortality. Most AF patients are in need of anticoagulation due to increased risk of stroke. Despite anticoagulation, AF patients still have a significant risk of death (about 5% per year). Approximately half of deaths in AF are due to heart-related causes (i.e.: sudden death, heart failure, myocardial infarction), one third of deaths are due to non-vascular causes (i.e.: cancer, respiratory diseases, infections, etc) and the remaining AF patients die from stroke or hemorrhage (about 6% each), or other causes. (Sourc...
Source: Trends in Cardiovascular Medicine - May 10, 2017 Category: Cardiology Authors: Antonio G ómez-Outes, Ma Luisa Suárez-Gea, Jose Manuel García-Pinilla Source Type: research
Recording Sympathetic Nerve Activity from the Skin
Sympathetic tone is important in cardiac arrhythmogenesis; however, methods to estimate sympathetic tone are either to invasive or require proper sinus node function that may be abnormal in disease states. Because of the direct and extensive connections among various nerve structures, it is possible for the sympathetic nerves in the various structures to activate simultaneously. Therefore, we hypothesized that nerve activity can be recorded from the skin and it can be used to estimate the cardiac sympathetic tone. (Source: Trends in Cardiovascular Medicine)
Source: Trends in Cardiovascular Medicine - May 10, 2017 Category: Cardiology Authors: Thomas H. Everett, Anisiia Doytchinova, Yong-Mei Cha, Peng-Sheng Chen Source Type: research
Treatment of persistent ventricular tachycardia: drugs or ablation?
Implantable cardioverter defibrillators (ICDs) reduce the mortality risk associated with recurrent ventricular tachycardia (VT) and can frequently terminate VT episodes painlessly, but do not prevent recurrent episodes. For patients with symptomatic recurrences, frequent asymptomatic recurrences, ICD shocks, or VT storm, most clinicians recommend strategies to suppress VT. The proarrhythmic mortality risk of anti-arrhythmic drugs (AADs) may be mitigated by the presence of an ICD, but these medications are limited by high recurrence rates, and unfavorable side effect profiles. (Source: Trends in Cardiovascular Medicine)
Source: Trends in Cardiovascular Medicine - May 10, 2017 Category: Cardiology Authors: Ciorsti J. MacIntyre, John L. Sapp Source Type: research
Time-honored treatments for the initial management of acute coronary syndromes: Challenging the status quo
Morphine, oxygen and nitrates are time-honored therapies for the initial management of acute coronary syndrome (ACS). The traditional goal of these agents in ACS has been to 1) relieve symptoms, 2) prevent infarction or limit its size, and 3) improve outcomes, both acutely and during follow-up. Despite their ongoing use in routine ACS care, nitrates, morphine and oxygen have no evidence of clinical outcomes benefit from randomized trials. Furthermore, emerging data have recently suggested that, in certain situations, morphine and oxygen may actually be associated with harm in the setting of ACS. (Source: Trends in Cardiovascular Medicine)
Source: Trends in Cardiovascular Medicine - May 9, 2017 Category: Cardiology Authors: Cian P. McCarthy, Eoin Donnellan, Jason H. Wasfy, Deepak L. Bhatt, John W. McEvoy Source Type: research
Incidental coronary calcifications on routine chest CT: Clinical implications
Coronary artery calcification (CAC) is a marker of atherosclerosis and an independent risk factor for cardiac-related mortality, with much of the 50% decline in mortality over the past 30 years being attributed to early detection of coronary disease and intervention of modifiable risk factors. With over 10 million computed tomography (CT) examinations of the chest performed in the U.S. yearly, CAC can be identified in a very large number of patients. In this review, we discuss the clinical evidence underlying the relationship between radiologic identification of CAC, atherosclerosis, and cardiac outcomes and the implicatio...
Source: Trends in Cardiovascular Medicine - April 28, 2017 Category: Cardiology Authors: Michael Pakdaman, Alan Rozanski, Daniel S. Berman Source Type: research
Editorial commentary: Endothelial-to-mesenchymal transition: When the good one goes bad
The inner lumen of the blood vessels is covered by a thin layer of cells, known as endothelial cells. The integrity of endothelial cells is important for the development of the cardiovascular system and for the protection against cardiovascular diseases. Endothelial cells have been reported to possess the ability to transdifferentiate into mesenchymal cells (endothelial-to-mesenchymal transition, EndMT) [1 –3]. During the process of EndMT, endothelial cells lose their specific cell surface markers of ve-Cadherin and CD31, and instead express markers for mesenchymal or myofibroblastic cells, such as α-SMA, type I collage...
Source: Trends in Cardiovascular Medicine - April 26, 2017 Category: Cardiology Authors: Yixuan Zhang, Hua Cai Source Type: research
Endothelial to mesenchymal transition: When the good one goes bad
The inner lumen of the blood vessels is covered by a thin layer of cells, known as endothelial cells. The integrity of endothelial cells is important for the development of the cardiovascular system and protection against cardiovascular diseases. Endothelial cells have been reported to possess the ability to transdifferentiate into mesenchymal cells (endothelial to mesenchymal transition, EndMT) [1 –3]. During the process of EndMT, endothelial cells lose their specific cell surface markers of ve-Cadherin and CD31, and instead express markers for mesenchymal or myofibroblastic cells, such as α-SMA, type I collagen, and v...
Source: Trends in Cardiovascular Medicine - April 26, 2017 Category: Cardiology Authors: Yixuan Zhang, Hua Cai Source Type: research
Ed Board
(Source: Trends in Cardiovascular Medicine)
Source: Trends in Cardiovascular Medicine - April 18, 2017 Category: Cardiology Source Type: research
Table of Contents
(Source: Trends in Cardiovascular Medicine)
Source: Trends in Cardiovascular Medicine - April 18, 2017 Category: Cardiology Source Type: research
Editorial commentary: Importance of triglycerides
The relationship between low-density lipoprotein (LDL) cholesterol and cardiovascular disease (CVD) is clear both epidemiologically and genetically, from the clinical course of familial hypercholesterolemia. Moreover, the randomized controlled intervention trials in CVD prevention using statins [1] and most recently with evolocumab, a proprotein convertase subtilisin –kexin type 9 inhibitor [2] show a consistent and graded effect between LDL lowering and CVD event reduction. The same clear understanding is not present for the relationship between the plasma triglyceride concentration and disease. (Source: Trends in Cardiovascular Medicine)
Source: Trends in Cardiovascular Medicine - April 11, 2017 Category: Cardiology Authors: Alan F. Jones Source Type: research
Editorial commentary: Here today, gone tomorrow: The LAA and stroke
Stroke prevention in the setting of non-valvular atrial fibrillation (NVAF) continues to attract great clinical interest [1,2], the result of several known issues including (1) the high morbidity and mortality associated with stroke, which is the number one cause of death and disability, (2) the frequency of non-valvular atrial fibrillation and its association with an increased incidence of stroke —greater than 20% of strokes particularly in elderly patients are related to the NVAF, (3) the findings that approximately 90% of strokes in this setting are related to thrombus in the left atrial appendage (LAA) [3], (4) antic...
Source: Trends in Cardiovascular Medicine - April 11, 2017 Category: Cardiology Authors: Paul A. Friedman, David R. Holmes Source Type: research
Editorial commentary: Genetic contributions to cardiovascular disease: The blurred lines between monogenic and polygenic traits
Understanding the genetic contribution to cardiovascular disease has been a research focus for decades. From ascertaining the numerous variants that each contribute to a small proportion of a polygenic trait such as coronary artery disease (CAD), to careful tracking of a single pathogenic variant through a large pedigree, like in autosomal dominantly inherited hypertrophic cardiomyopathy (HCM). CAD is one of the leading causes of death globally [1] and the underlying pathophysiology involves numerous environmental and genetic factors. (Source: Trends in Cardiovascular Medicine)
Source: Trends in Cardiovascular Medicine - April 11, 2017 Category: Cardiology Authors: Jodie Ingles, J. Martijn Bos Source Type: research
