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Progress in Cardiovascular Diseases

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https://www.readbyqxmd.com/read/28502849/the-interaction-of-cardiorespiratory-fitness-with-obesity-and-the-obesity-paradox-in-cardiovascular-disease
#1
REVIEW
Ahmet Afşin Oktay, Carl J Lavie, Peter F Kokkinos, Parham Parto, Ambarish Pandey, Hector O Ventura
Overweight and obesity are well-established risk factors for most cardiovascular diseases (CVD), including coronary heart disease (CHD), heart failure (HF), and atrial fibrillation. Despite the strong link between excess adiposity and risk of CVD, growing evidence has demonstrated an obesity paradox in patients with CVD. This phenomenon is characterized by a better prognosis in overweight and mildly obese CVD patients than their leaner counterparts. Moreover, the worst outcomes are often incurred by underweight CVD patients, followed by those of normal weight or severely obese...
May 12, 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/28502848/exercise-training-in-athletes-with-heart-disease
#2
REVIEW
Antonio B Fernandez, Paul D Thompson
Exercise events and sport participation have increased over recent decades. The average age of sports participants has also increased with a potential parallel increase in the number of exercise participants with both occult and diagnosed cardiovascular disease (CVD). Habitual physical activity and exercise training reduce atherosclerotic CVD (ASCVD) risk in a curvilinear fashion by affecting multiple ASCVD risk factors. Nonetheless, exercise also increases the risk of sudden cardiac death in both young and adult individuals with occult CVD making it important to balance the risks and benefits of exercise and exercise training in these individuals...
May 12, 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/28502847/the-role-for-cardiologists-in-stroke-intervention
#3
REVIEW
Richard R Heuser
Even though cardiovascular disease (CVD) is still the leading cause of death in the United States, stroke is the second leading of global cause of death behind CVD . In the 21st Century, less than 40% of overall stroke patients are discharged to home and almost 25% of Medicare beneficiaries do not survive 90days. In spite of the fact that tissue plasminogen activator (TPA) has been approved for stroke care for 20years, only .75% of annual strokes are actually treated with intravenous (IV) TPA. Similar to how interventional cardiologists evolved from IV to catheter mechanical treatment for acute myocardial infarctions (AMI) over 30years ago, over the last few years, neurointerventionists now perform endovascular stroke therapy in many of these patients using stent retrievers...
May 11, 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/28501337/late-in-hospital-management-of-patients-hospitalized-with-acute-heart-failure
#4
REVIEW
Nicole B Cyrille, Snehal R Patel
Acute Heart Failure (AHF) hospitalization presents a significant financial burden and portends a poor prognosis following discharge. As such, there has been significant emphasis on the late inpatient management of patients hospitalized with AHF to ensure successful transition to the outpatient setting and to reduce overall readmission and mortality rates. Thorough discharge planning and a multidisciplinary team approach are essential and as outlined in this review should focus on four key elements: the assessment of patients' readiness for discharge, optimization of goal directed medical therapy and appropriate device therapy, patient education and transition to the outpatient care...
May 10, 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/28483606/palliative-care-in-heart-failure-what-triggers-specialist-consultation
#5
REVIEW
Mitchell A Psotka, Kanako Y McKee, Albert Y Liu, Giovanni Elia, Teresa De Marco
Heart failure (HF) continues to cause substantial death and suffering despite the availability of numerous medical, surgical, and technological therapeutic advancements. As a patient-centered holistic discipline focused on improving quality of life and decreasing anguish, palliative care (PC) has a crucial role in the care of HF patients that has been acknowledged by multiple international guidelines. PC can be provided by all members of the HF care team, including but not limited to practitioners with specialty PC training...
May 5, 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/28478115/asymptomatic-carotid-artery-stenosis-revascularization
#6
REVIEW
Robert D Safian
In patients with carotid stenosis, the most common cause of stroke is atheroembolization, and the risk is strongly related to stenosis severity and symptomatic status (stroke or transient ischemic attack within 6months). Carotid revascularization by carotid endarterectomy (CEA) or carotid artery stenting (CAS) result in plaque "passivation" by lumen enlargement, plaque removal, or plaque coverage with subsequent endothelialization. While there is considerable circumstantial evidence linking a decrease in the risk of stroke to the use of "optimal medical therapy (OMT)", the components of OMT have not been defined, and such therapy has not been rigorously evaluated in any randomized clinical trial (RCT) compared with revascularization...
May 3, 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/28465001/neuroprotection-in-the-treatment-of-acute-ischemic-stroke
#7
REVIEW
Rajan A G Patel, Paul W McMullen
Neuroprotection remains one of the holy grails of acute ischemic stroke therapy. The ability to protect the ischemic brain from injury until reperfusion and then to protect the brain from reperfusion injury could theoretically improve freedom from disability among stroke survivors. This manuscript reviews the molecular and cellular pathophysiology of stroke and summarizes pharmacologic and other therapies that showed promise in pre-clinical testing as neuroprotection agents. However to date, no compelling efficacy data have been published regarding any pharmacologic or other therapies...
April 29, 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/28457791/left-atrial-appendage-occlusion-for-stroke-prevention
#8
Arijit Chanda, John P Reilly
More than 2.3 millions adults in the United States have atrial fibrillation (AF), which exposes them to a 5- fold increased risk of stroke. The left atrial appendage (LAA) appears to be the source of thrombus formation in the vast majority of these patients. Anticoagulation significantly reduces the risk of stroke, but often we encounter patients who have absolute or relative contraindication to anticoagulation. Percutaneous LAA exclusion offers an alternative to anticoagulation to decrease the risk of stroke...
April 27, 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/28457790/initial-assessment-and-triage-of-the-stroke-patient
#9
Richard M Zweifler
Nearly 800,000 strokes occur in the United States each year, and stroke is the leading cause of preventable permanent disability. Timely recognition and treatment are imperative to reduce stroke-related morbidity and mortality. Given the evidence supporting intravenous thrombolysis and mechanical thrombectomy for ischemic stroke, stroke symptoms must be rapidly identified and mimics quickly excluded prior to therapeutic decisions. Intravenous tissue plasminogen activator is recommended for all qualified patients and patients with presentations suggesting large vessel occlusion should be evaluated for mechanical thrombectomy...
April 27, 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/28442330/symptomatic-carotid-artery-disease-revascularization
#10
REVIEW
Piero Montorsi, Stefano Galli, Paolo M Ravagnani, Marco Roffi
Patients with symptomatic carotid artery disease should be managed by a multidisciplinary team including neurologists, vascular surgeons and interventionalists. Duplex ultrasound is the most widely used diagnostic modality to assess carotid disease, followed by additional imaging tests (CT- or MR-angiography) to confirm the severity of the stenosis, detect brain lesions, and assess intracranial circulation as well as the supra-aortic anatomy. Although overall randomized trial results favored (CEA) over carotid artery stenting (CAS) in symptomatic patients, this was likely related to the insufficient expertise of the endovascular specialists in several of the trials...
April 22, 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/28442329/association-of-telomere-length-with-myocardial-infarction-a-prospective-cohort-from-the-population-based-hunt-2-study
#11
REVIEW
Ida Beate Øyen Østhus, Stian Lydersen, Håvard Dalen, Javaid Nauman, Ulrik Wisløff
As possible markers of biological age, telomere length (TL) has been associated with age-related diseases such as myocardial infarction (MI) with conflicting findings. We sought to assess the relationship between TL and risk of future MI in 915 healthy participants (51.7% women) 65 years or older from a population-based prospective cohort (the HUNT 2 study, Norway). Mean TL was measured by quantitative PCR expressed as relative T (telomere repeat copy number) to S (single copy gene number) ratio, and log-transformed...
April 22, 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/28385556/high-intensity-interval-training-for-maximizing-health-outcomes
#12
REVIEW
Trine Karlsen, Inger-Lise Aamot, Mark Haykowsky, Øivind Rognmo
Regular physical activity and exercise training are important actions to improve cardiorespiratory fitness and maintain health throughout life. There is solid evidence that exercise is an effective preventative strategy against at least 25 medical conditions, including cardiovascular disease, stroke, hypertension, colon and breast cancer, and type 2 diabetes. Traditionally, endurance exercise training (ET) to improve health related outcomes has consisted of low- to moderate ET intensity. However, a growing body of evidence suggests that higher exercise intensities may be superior to moderate intensity for maximizing health outcomes...
April 3, 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/28377168/a-reference-equation-for-normal-standards-for-vo2-max-analysis-from-the-fitness-registry-and-the-importance-of-exercise-national-database-friend-registry
#13
REVIEW
Jonathan Myers, Leonard A Kaminsky, Ricardo Lima, Jeffrey Chistle, Euan Ashley, Ross Arena
Existing normal standards for maximal oxygen uptake (VO2 max) are problematic because they tend to be population specific, lack normal distribution and portability, and are poorly represented by women. The objective of the current study was to apply the Fitness Registry and the Importance of Exercise: A National Data Base (FRIEND) Registry to improve upon previous regression formulas for normal standards for VO2 max using treadmill testing. Maximal treadmill tests were performed in 7783 healthy men and women (20-79years; maximal RER >1...
April 1, 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/28372946/the-role-of-embolic-protection-in-carotid-stenting-progress-in-cardiovascular-diseases-pcvd
#14
REVIEW
Taisei Kobayashi, Jay Giri
Embolic protection device (EPD) use has become ubiquitous and is currently mandated by the Centers for Medicare and Medicaid (CMS) for reimbursement in conjunction with carotid artery stenting (CAS). There are two classes of EPD devices: distal filter EPD (f-EPD) and proximal EPD (p-EPD). Measuring the incremental benefit of one strategy over the other remains problematic for several reasons. The first lies in the difficulty of defining an embolic event as transcranial Doppler and diffusion-weighted magnetic resonance imaging abnormalities may not correlate with clinical events...
March 31, 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/28365297/endovascular-therapy-for-acute-stroke
#15
REVIEW
Maria Politi, Andreas Kastrup, Konstantinos Marmagkiolis, Iris Q Grunwald, Panagiotis Papanagiotou
Stroke is the most common cause of permanent disability, the second most common cause of dementia, and the fourth most common cause of death in the Western world. Recently, based on positive multicenter randomized clinical trials, endovascular therapy for acute stroke has undergone a revolution. Routine mechanical thrombectomy in addition to intravenous thrombolysis has been shown to provide excellent outcomes for patients with proximal anterior circulation occlusions. This procedure reduces disability and benefits are seen across a wide range of age and initial stroke severity...
March 30, 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/28365296/running-as-a-key-lifestyle-medicine-for-longevity
#16
REVIEW
Duck-Chul Lee, Angelique G Brellenthin, Paul D Thompson, Xuemei Sui, I-Min Lee, Carl J Lavie
Running is a popular and convenient leisure-time physical activity (PA) with a significant impact on longevity. In general, runners have a 25%-40% reduced risk of premature mortality and live approximately 3 years longer than non-runners. Recently, specific questions have emerged regarding the extent of the health benefits of running versus other types of PA, and perhaps more critically, whether there are diminishing returns on health and mortality outcomes with higher amounts of running. This review details the findings surrounding the impact of running on various health outcomes and premature mortality, highlights plausible underlying mechanisms linking running with chronic disease prevention and longevity, identifies the estimated additional life expectancy among runners and other active individuals, and discusses whether there is adequate evidence to suggest that longevity benefits are attenuated with higher doses of running...
March 30, 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/28286137/impact-of-cardiorespiratory-fitness-on-all-cause-and-disease-specific-mortality-advances-since-2009
#17
REVIEW
Matthew P Harber, Leonard A Kaminsky, Ross Arena, Steven N Blair, Barry A Franklin, Jonathan Myers, Robert Ross
Cardiorespiratory fitness (CRF) has been one of the most widely examined physiological variables, particularly as it relates to functional capacity and human performance. Over the past three decades, CRF has emerged as a strong, independent predictor of all-cause and disease-specific mortality. The evidence supporting the prognostic use of CRF is so powerful that the American Heart Association recently advocated for the routine assessment of CRF as a clinical vital sign. Interestingly, the continuity of evidence of the inverse relationship between CRF and mortality over the past decade exists despite a wide variation of methods used to assess CRF in these studies, ranging from the gold-standard method of directly measured maximal oxygen uptake (VO2max) during cardiopulmonary exercise testing to estimation from exercise tests and non-exercise prediction equations...
March 9, 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/28284683/endovascular-treatment-of-vertebral-artery-stenosis
#18
REVIEW
J Stephen Jenkins, Merrill Stewart
Endovascular treatment of vertebral artery stenosis (VAS) is a safe and effective technique for treating symptoms caused by posterior circulation ischemia with high technical and clinical success rates, low complication rates and durable long-term results. Variable restenosis rates have been reported in the literature with small improvements demonstrated using drug eluting stents. Although there is insufficient evidence from randomized trials to demonstrate superiority of endovascular compared to optimal medical therapy for the treatment of this disease, patients who fail medical therapy should be considered for endovascular stenting for symptomatic VAS...
March 8, 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/28274819/impact-of-changes-in-cardiorespiratory-fitness-on-hypertension-dyslipidemia-and-survival-an-overview-of-the-epidemiological-evidence
#19
REVIEW
Xuemei Sui, Mark A Sarzynski, Duck-Chul Lee, Peter F Kokkinos
Over the last fifty years, cardiorespiratory fitness (CRF) has been firmly established as an important risk factor for cardiovascular disease (CVD) and all-cause mortality. Mounting evidence supports a strong and inverse association between baseline CRF and the risk of developing hypertension (HTN) and dyslipidemia. Accumulating evidence also suggests that improving or maintaining a certain level of CRF over time leads to lower incidence of HTN and dyslipidemia and improves survival. These findings are promising, with significant public health importance, and warrant further evaluation to elucidate the role of longitudinal changes in CRF during the lifespan on CVD morbidity and mortality, as well as all-cause survival...
March 6, 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/28274818/personal-activity-intelligence-pai-sedentary-behavior-and-cardiovascular-risk-factor-clustering-the-hunt-study
#20
REVIEW
Nina Zisko, Kjerstin Næss Skjerve, Atefe R Tari, Silvana Bucher Sandbakk, Ulrik Wisløff, Bjarne M Nes, Javaid Nauman
Prolonged sedentary behavior (SB) positively associates with clustering of risk factors for cardiovascular disease (CVD). The recently developed metric for physical activity (PA) tracking called Personal Activity Intelligence (PAI) takes into account age, sex, resting and maximum heart rate, and a score of ≥100 weekly PAI has been shown to reduce the risk of premature CVD death in healthy as well as individuals with known CVD risk factors, regardless of whether or not the current PA recommendations were met...
March 6, 2017: Progress in Cardiovascular Diseases
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