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Current Problems in Cardiology

Claudia Martinez, Rishi Rikhi, Tahir Haque, Amara Fazal, Michael Kolber, Barry E Hurwitz, Neil Schneiderman, Todd T Brown
Transgender individuals represent a medically underserved and under researched population. There is a growing number of studies illustrating the importance of hormone therapy treatments in transgender men and women to assist ameliorating gender dysphoria and promoting well-being. However, the cardiovascular effects of these hormones are controversial. Large longitudinal epidemiological studies of cardiovascular event outcomes in these populations do not exist. In addition, studies of cardiovascular complications of transgender hormone therapy are limited in number and complicated by poor control of medication regimen, presence of gender confirming surgery, use of prescribed medications for prevailing conditions, and alcohol, smoking or illicit substance use, and comorbidities, such as HIV infection...
September 20, 2018: Current Problems in Cardiology
Pooja S Jagadish, Mariana Aziz, Viswanatha Chinta, Rami N Khouzam
Annually in the United States, sudden cardiac death (including out-of-hospital cardiac arrests) is responsible for over 300,000 deaths, comprising 40%-50% of total mortality rates from cardiovascular disease. Among the highest-risk patients are those with ischemic and nonischemic cardiomyopathy who have a reduced left ventricular ejection fraction (≤ 35%-40%). However, not everyone is a candidate for an implantable cardioverter defibrillator. In 2002, the wearable cardioverter defibrillator (WCD) gained Food and Drug Administration approval for its efficacy in the prevention of sudden cardiac arrest or death in certain at-risk populations and has been making its way into national guidelines with Class IIa to IIb strength of evidence...
September 18, 2018: Current Problems in Cardiology
Vittorio Emanuele Bianchi
The metabolic sources of energy for myocardial contractility include mainly free fatty acids (FFA) for 95%, and in lesser amounts for 5% from glucose and minimal contributions from other substrates such lactate, ketones, and amino acids. However, myocardial efficiency is influenced by metabolic condition, overload, and ischemia. During cardiac stress, cardiomyocytes increase glucose oxidation and reduce FFA oxidation. In patients with ischemic coronary disease and heart failure, the low oxygen availability limits myocardial reliance on FFA and glucose utilization must increase...
September 11, 2018: Current Problems in Cardiology
Meron K Teshome, Khalid Najib, Chioma C Nwagbara, Oluwaseun A Akinseye, Uzoma N Ibebuogu
No abstract text is available yet for this article.
September 8, 2018: Current Problems in Cardiology
Oluwaseun A Akinseye, Showkat A Haji, Santhosh K G Koshy, Uzoma N Ibebuogu, Rami N Khouzam, Nadish Garg
Percutaneous coronary intervention (PCI) of chronic total occlusion (CTO) is not favored in facilities without on-site surgical backup. We reviewed outcomes of patients who had CTO intervention with remote surgical backup in our institution. All patients who underwent attempted antegrade intraluminal CTO PCI from January 2013 to July 2017 were analyzed. Twenty cases (18 patients, 58.1 ± 7.0years, 70% males) were identified. Procedure was successful in 85% (17 of 20). There were 2 nonflow limiting dissections and 1 wire perforation...
August 22, 2018: Current Problems in Cardiology
(no author information available yet)
No abstract text is available yet for this article.
November 2018: Current Problems in Cardiology
(no author information available yet)
No abstract text is available yet for this article.
October 2018: Current Problems in Cardiology
Mark R Heckle, Nephertiti Efeovbokhan, Fridjof Thomas, Mary Blumer, Mason Chumpia, Uzoma Ibebuogu, Guy L Reed, Rami N Khouzam
The incidence of inappropriate cardiac catheterization lab activation for treatment of a false ST-segment elevation myocardial infarction (STEMI) has been reported to be 2.6%-36%. Excessive inappropriate catheterization lab activation may be associated with risks to patients, provider fatigue and improper resource usage. HYPOTHESIS: To derive and validate a prediction score to more accurately classify patients with STEMI. METHODS AND RESULTS: We conducted a retrospective cohort analysis of 1144 consecutive patients initially diagnosed with STEMI between September 2008 and January 2013...
October 2018: Current Problems in Cardiology
(no author information available yet)
No abstract text is available yet for this article.
September 2018: Current Problems in Cardiology
Tobias Jonathan Pfeffer, Denise Hilfiker-Kleiner
Cardiovascular diseases are major complications in pregnancy worldwide and the number of patients who develop cardiac problems during pregnancy is increasing. Pregnancy-associated hypertensive complications such as pre-eclampsia (PE) or peripartum cardiomyopathy (PPCM) are potentially life-threatening heart diseases emerging during pregnancy, under delivery or in the first postpartal months in previously healthy women. Both disease entities display substantial morbidity and mortality in the acute phase. Long-term effects are just beginning to be evaluated...
September 2018: Current Problems in Cardiology
Katherine E Di Palo, Khusbu Patel, Troy Kish
Most cardiovascular diseases are caused by modifiable risk factors yet prevalence continues to increase and heart disease remains the leading cause of death in the United States. Screening, identifying and appropriately managing high risk patients are strategies to shift the paradigm from treatment to prevention. Pharmacists are an underutilized population health resource despite robust evidence to support their roles as interdisciplinary team members and direct patient care providers in both inpatient and outpatient settings...
August 4, 2018: Current Problems in Cardiology
(no author information available yet)
No abstract text is available yet for this article.
August 2018: Current Problems in Cardiology
Marko D Banovic, Serge D Nikolic
Survival of symptomatic patients with severe aortic stenosis (AS) is very poor, with an average mortality reaching up to 2% per month. Approach to diagnosis and treatment of patients with AS was conservative; patients were referred to surgery only if the AS-induced symptoms become apparent and significantly limit the quality of patient' life. In the past 15 years, the novel treatment strategy in subgroups of symptomatic patients with AS have been the subject of extensive research, starting from introduction of transcatheter aortic valve implant (TAVI) in inoperable symptomatic patients with severe AS and continuing further to patients with very high and high operative risk...
August 2018: Current Problems in Cardiology
Oluwaseun A Akinseye, Aradhana Pathak, Uzoma N Ibebuogu
Aortic regurgitation (AR) has an estimated prevalence of 4.9% in the Framingham study, with moderate or severe AR occurring in 0.5% of the study population. The incidence and severity of AR increases with age, and may occur acutely or as a chronic valvular disease with distinct presentations, natural history and management strategy. Our review is a comprehensive description of the varied presentation of aortic regurgitation and its management.
August 2018: Current Problems in Cardiology
Viswanatha Chinta, Sameh Askandar, Amit Nanda, Arindam Sharma, Peter Abader, Rajesh Kabra, Rami N Khouzam
The link between atrial fibrillation and cognitive decline and dementia has gained interest of the medical community lately. More research is being conducted to prevent and or delay this morbidity as no curative therapy is available for cognitive decline and dementia. The exact mechanism of causation is unclear. Multiple pathophysiological mechanisms have been implicated. Lately, treatment for atrial fibrillation including anticoagulation and catheter ablation therapies have shown to decrease the risk of deterioration of cognitive function...
July 11, 2018: Current Problems in Cardiology
Anthony Faiola, Elizabeth Lerner Papautsky, Miriam Isola
Healthcare providers are shifting to a value-based model that acknowledges the importance of a healthy lifestyle for managing chronic disease and mental health. This approach empowers patients to adopt and/or sustain healthy lifestyle choices through the use of innovative technologies-providing beneficial ways of delivering health literacy, self-monitoring, and patient-provider collaboration. Such pathways have the potential to enable healthy lifestyle management for a growing U.S. cohort-the "baby boomer" generation (BBG)-who are at risk for developing heart disease, stroke, arthritis, high cholesterol, and diabetes, etc...
July 9, 2018: Current Problems in Cardiology
Subhankar Chatterjee, Dhrubajyoti Bandyopadhyay, Raktim K Ghosh, Uddalak Majumdar, Ashish Aneja, Carl J Lavie, Prakash Deedwania
Inhibitors of sodium-glucose cotransporters type-2 are the most recent addition to the armamentarium of oral antidiabetic agents. This class of drugs has shown promising results in glycemic control and most importantly to reduce cardiovascular disease (CVD) mortality risk. Despite the encouraging data, there is concern regarding their potential for causing or worsening peripheral artery disease (PAD), which may increase the risk of lower extremity amputations. Following the publication of results of CANVAS and CANVAS-R trials, which revealed that leg and mid-foot amputations occurred about twice as often in patients treated with canagliflozin compared to placebo, the Food and Drug Administration (FDA) in the United States issued a black box warning of leg and foot amputations associated with canagliflozin use...
July 6, 2018: Current Problems in Cardiology
Steven R Goldsmith, Bradley A Bart, Ileana L Pin A
Decompensated or acute heart failure (AHF) is characterized by increased ventricular and atrial pressures which may lead to and be caused by circulatory congestion. Unless due to a primary decrease in cardiac function, congestion arises from volume expansion or vasoconstriction. In turn, volume expansion and vasoconstriction are due to neurohormonal imbalance since both result from activation of the sympathetic nervous system, the renin-angiotensin-aldosterone axis and excess secretion of arginine vasopressin...
July 2018: Current Problems in Cardiology
Chiara Mozzini, Luciano Cominacini, Alder Casadei, Cosima Schiavone, Maurizio Soresi
Heart failure (HF) is a clinical syndrome caused by structural and/or functional cardiac abnormalities, resulting in a reduced cardiac output and/or elevated intracardiac pressures at rest or during stress. It is the leading cause of hospitalization in Internal Medicine departments. This article aims at reviewing evidence of the importance of ultrasound in HF both for hospitalized patients and in the follow-up. Ultrasound may be used as a recovery monitoring instrument at the bedside and also as a global cardiovascular assessment tool for these patients...
June 21, 2018: Current Problems in Cardiology
Ross Arena, Cemal Ozemek, Deepika Laddu, Tavis Campbell, Codie R Rouleau, Robert Standley, Samantha Bond, Eulàlia P Abril, Andrew P Hills, Carl J Lavie
Healthy living medicine (HLM) is an emerging concept that recognizes the importance of: (1) Moving more and sitting less; (2) Consuming a healthy diet at the appropriate caloric load; (3) Maintaining a healthy body weight; and (4) Not smoking. Suffice to say, HLM should be practiced by all health professionals, prescribing a personalized healthy living polypill to individuals under their care while titrating the dosage for optimal adherence and therapeutic efficacy. Traditionally, HLM, particularly when practiced in the context of physical activity and diet, is commonly viewed as an all-or-none and one-size-fits-all paradigm...
June 14, 2018: Current Problems in Cardiology
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