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Cardiology Clinics

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https://www.readbyqxmd.com/read/27886794/five-reasons-why-global-health-matters-to-cardiologists
#1
EDITORIAL
Gerald S Bloomfield, Melissa S Burroughs Peña
No abstract text is available yet for this article.
February 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/27886793/innovative-approaches-to-hypertension-control-in-low-and-middle-income-countries
#2
REVIEW
Rajesh Vedanthan, Antonio Bernabe-Ortiz, Omarys I Herasme, Rohina Joshi, Patricio Lopez-Jaramillo, Amanda G Thrift, Jacqui Webster, Ruth Webster, Karen Yeates, Joyce Gyamfi, Merina Ieremia, Claire Johnson, Jemima H Kamano, Maria Lazo-Porras, Felix Limbani, Peter Liu, Tara McCready, J Jaime Miranda, Sailesh Mohan, Olugbenga Ogedegbe, Brian Oldenburg, Bruce Ovbiagele, Mayowa Owolabi, David Peiris, Vilarmina Ponce-Lucero, Devarsetty Praveen, Arti Pillay, Jon-David Schwalm, Sheldon W Tobe, Kathy Trieu, Khalid Yusoff, Valentin Fuster
Elevated blood pressure, a major risk factor for ischemic heart disease, heart failure, and stroke, is the leading global risk for mortality. Treatment and control rates are very low in low- and middle-income countries. There is an urgent need to address this problem. The Global Alliance for Chronic Diseases sponsored research projects focus on controlling hypertension, including community engagement, salt reduction, salt substitution, task redistribution, mHealth, and fixed-dose combination therapies. This paper reviews the rationale for each approach and summarizes the experience of some of the research teams...
February 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/27886792/diagnosis-and-management-of-endomyocardial-fibrosis
#3
REVIEW
Andrea Beaton, Ana Olga Mocumbi
Endomyocardial fibrosis (EMF) remains an important cause of restrictive cardiomyopathy worldwide. Patients cluster in specific geographic locations and are almost universally living in extreme poverty. Specific etiology remains elusive and is likely multifactorial. Untreated EMF has a very poor prognosis. Medical management can mitigate symptoms for a time but has no curative benefit. Early surgical interventions may improve survival but are not readily available in most EMF-endemic regions. Increased awareness, advocacy, and research are needed to further understand this neglected tropical cardiomyopathy and to improve survival of those affected...
February 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/27886791/environmental-exposures-and-cardiovascular-disease-a-challenge-for-health-and-development-in-low-and-middle-income-countries
#4
REVIEW
Melissa S Burroughs Peña, Allman Rollins
Environmental exposures in low- and middle-income countries lie at the intersection of increased economic development and the rising public health burden of cardiovascular disease. Increasing evidence suggests an association of exposure to ambient air pollution, household air pollution from biomass fuel, lead, arsenic, and cadmium with multiple cardiovascular disease outcomes, including hypertension, coronary heart disease, stroke, and cardiovascular mortality. Although populations in low- and middle-income countries are disproportionately exposed to environmental pollution, evidence linking these exposures to cardiovascular disease is derived from populations in high-income countries...
February 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/27886790/cardiac-disease-associated-with-human-immunodeficiency-virus-infection
#5
REVIEW
Gerald S Bloomfield, Claudia Leung
Over the last 2 decades human immunodeficiency virus (HIV) infection has become a chronic disease requiring long-term management. Aging, antiretroviral therapy, chronic inflammation, and several other factors contribute to the increased risk of cardiovascular disease in patients infected with HIV. In low-income and middle-income countries where antiretroviral therapy access is limited, cardiac disease is most commonly related to opportunistic infections and end-stage manifestations of HIV/acquired immunodeficiency syndrome, including HIV-associated cardiomyopathy, pericarditis, and pulmonary arterial hypertension...
February 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/27886789/electrophysiology-in-the-developing-world-challenges-and-opportunities
#6
REVIEW
Michael Bestawros
As a subset of the growing epidemic of cardiovascular morbidity and mortality in low-income and middle-income countries (LMICs), the significant burdens of heart rhythm disorders also increase. Effective diagnostic and treatment modalities exist, but financial resources and expertise are limited. Cost-effective strategies exist to address most of these limitations, but many surmountable barriers need to be overcome to introduce and improve electrophysiologic care in LMICs. In this article, current and potential solutions are offered for the diagnostic and therapeutic challenges of managing bradyarrhythmias and tachyarrhythmias...
February 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/27886788/chagas-cardiomyopathy-clinical-presentation-and-management-in-the-americas
#7
REVIEW
Catherine Pastorius Benziger, Gabriel Assis Lopes do Carmo, Antonio Luiz Pinho Ribeiro
The initial infection of Chagas disease is typically asymptomatic, but approximately 30% of people will progress to a chronic cardiac form, and others develop the gastrointestinal form. Death is often sudden due to arrhythmias or progressive heart failure. Prevention through vector control programs and blood bank screening, along with strengthened surveillance systems and rapid information sharing, are key to decreasing disease burden globally. The epidemiology, diagnostic evaluation, diagnosis, and treatment of acute and chronic Chagas cardiac disease are discussed with focus on educating the primary care professionals and general cardiologists in nonendemic areas who have limited experience treating this disease...
February 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/27886787/rheumatic-heart-disease-the-unfinished-global-agenda
#8
REVIEW
Shanti Nulu, Gene Bukhman, Gene F Kwan
Primarily affecting the young, rheumatic heart disease (RHD) is a neglected chronic disease commonly causing premature morbidity and mortality among the global poor. Standard clinical prevention and treatment is based on studies from the early antimicrobial era, as research investment halted soon after the virtual eradication of the disease from developed countries. The emergence of new global data on disease burden, new technologies, and a global health equity platform have revitalized interest and investment in RHD...
February 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/27886786/infective-endocarditis-in-low-and-middle-income-countries
#9
REVIEW
Benson Njuguna, Adrian Gardner, Rakhi Karwa, François Delahaye
Infective endocarditis (IE) is a rare, life-threatening disease with a mortality rate of 25% and significant debilitating morbidities. Although much has been reported on contemporary IE in high-income countries, conclusions on the state of IE in low- and middle-income countries (LMICs) are based on studies conducted before the year 2000. Furthermore, unique challenges in the diagnosis and management of IE persist in LMICs. This article reviews IE studies conducted in LMICs documenting clinical experiences from the year 2000 to 2016...
February 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/27886785/approaches-to-sustainable-capacity-building-for-cardiovascular-disease-care-in-kenya
#10
REVIEW
Felix A Barasa, Rajesh Vedanthan, Sonak D Pastakia, Susie J Crowe, Wilson Aruasa, Wilson K Sugut, Russ White, Elijah S Ogola, Gerald S Bloomfield, Eric J Velazquez
Cardiovascular diseases are approaching epidemic levels in Kenya and other low- and middle-income countries without accompanying effective preventive and therapeutic strategies. This is happening in the background of residual and emerging infections and other diseases of poverty, and increasing physical injuries from traffic accidents and noncommunicable diseases. Investments to create a skilled workforce and health care infrastructure are needed. Improving diagnostic capacity, access to high-quality medications, health care, appropriate legislation, and proper coordination are key components to ensuring the reversal of the epidemic and a healthy citizenry...
February 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/27886784/tuberculosis-and-the-heart
#11
REVIEW
Arthur K Mutyaba, Mpiko Ntsekhe
Owing to the high prevalence of tuberculosis (TB) and human immunodeficiency virus/AIDS, tuberculous heart disease remains an important problem in TB endemic areas. In this review, we reiterate salient aspects of the traditional understanding and approach to its management, and provide important updates on the pathophysiology, diagnosis, and treatment garnered over the past decade of focused clinical and basic science research. We emphasize that, if implemented widely, these improved evidence-based approaches to the disease can build on the early progress made in treating tuberculous heart disease and help further the goal of significantly reducing its historically high morbidity and mortality...
February 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/27886783/mhealth-interventions-to-counter-noncommunicable-diseases-in-developing-countries-still-an-uncertain-promise
#12
REVIEW
Andrea Beratarrechea, Daniela Moyano, Vilma Irazola, Adolfo Rubinstein
mHealth constitutes a promise for health care delivery in low- and middle-income countries (LMICs) where health care systems are unprepared to combat the threat of noncommunicable diseases (NCDs). This article assesses the impact of mHealth on NCD outcomes in LMICs. A systematic review identified controlled studies evaluating mHealth interventions that addressed NCDs in LMICs. From the 1274 abstracts retrieved, 108 articles were selected for full text review and 20 randomized controlled trials were included from 14 LMICs...
February 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/27886782/ensuring-patient-centered-access-to-cardiovascular-disease-medicines-in-low-income-and-middle-income-countries-through-health-system-strengthening
#13
REVIEW
Dan N Tran, Benson Njuguna, Timothy Mercer, Imran Manji, Lydia Fischer, Marya Lieberman, Sonak D Pastakia
Cardiovascular disease (CVD) is the leading cause of global mortality and is expected to reach 23 million deaths by 2030. Eighty percent of CVD deaths occur in low-income and middle-income countries (LMICs). Although CVD prevention and treatment guidelines are available, translating these into practice is hampered in LMICs by inadequate health care systems that limit access to lifesaving medications. In this review article, we describe the deficiencies in the current LMIC supply chains that limit access to effective CVD medicines, and discuss existing solutions that are translatable to similar settings so as to address these deficiencies...
February 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/27886781/ambulatory-blood-pressure-monitoring-a-complementary-strategy-for-hypertension-diagnosis-and-management-in-low-income-and-middle-income-countries
#14
REVIEW
Marwah Abdalla
Ambulatory blood pressure monitoring (ABPM) can assess out-of-clinic blood pressure. ABPM is an underutilized resource in low-income and middle-income countries but should be considered a complementary strategy to clinic blood pressure measurement for the diagnosis and management of hypertension. Potential uses for ABPM in low-income and middle-income countries include screening of high-risk individuals who have concurrent communicable diseases, such as HIV, and in task-shifting health care strategies.
February 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/27886780/global-shifts-in-cardiovascular-disease-the-epidemiologic-transition-and-other-contributing-factors-toward-a-new-practice-of-global-health-cardiology
#15
REVIEW
Walter Mendoza, J Jaime Miranda
One of the major drivers of change in the practice of cardiology is population change. This article discusses the current debate about epidemiologic transition paired with other ongoing transitions with direct relevance to cardiovascular conditions. Challenges specific to patterns of risk factors over time; readiness for disease surveillance and meeting global targets; health system, prevention, and treatment efforts; and physiologic traits and human-environment interactions are identified. This article concludes that a focus on the most populated regions of the world will contribute substantially to protecting the large gains in global survival and life expectancy accrued over the last decades...
February 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/27692229/sports-cardiology-comprehensive-clinical-care-for-athletes-and-highly-active-individuals
#16
Aaron Baggish, André La Gerche
No abstract text is available yet for this article.
November 2016: Cardiology Clinics
https://www.readbyqxmd.com/read/27692228/beyond-the-bruce-protocol-advanced-exercise-testing-for-the-sports-cardiologist
#17
Satyam Sarma, Benjamin D Levine
Exercise testing is an important tool for determining baseline fitness as well as to diagnose limitations in performance. The Bruce protocol has become the standard for exercise testing protocol in many exercise physiology laboratories, but is rarely a suitable test for athletes who often have complex hemodynamic and metabolic demands during exercise required for practice and competition. We describe the approach for exercise testing beyond the Bruce protocol and focus on strategies to individualize the testing protocol to the metabolic demands of an athlete's sport...
November 2016: Cardiology Clinics
https://www.readbyqxmd.com/read/27692227/exercise-prescription-for-the-athlete-with-cardiomyopathy
#18
Sara Saberi, Sharlene M Day
Inherited cardiomyopathies have highly variable expression in terms of symptoms, functional limitations, and disease severity. Associated risk of sudden cardiac death is also variable. International guidelines currently recommend restriction of all athletes with cardiomyopathy from participation in competitive sports. While the guidelines are necessarily conservative because predictive risk factors for exercise-triggered SCD have not been clearly identified, the risk is clearly not uniform across all athletes and all sports...
November 2016: Cardiology Clinics
https://www.readbyqxmd.com/read/27692226/congenital-heart-disease-and-the-athlete-what-we-know-and-what-we-do-not-know
#19
Peter N Dean, Robert W Battle
Since outcomes for patients with congenital heart disease (CHD) have greatly improved, most patients with CHD are surviving into adulthood and creating dilemmas for practitioners with regard to competitive sports participation. Much time, effort, and expertise have gone into developing the new American Heart Association/American College of Cardiology's guidelines and the European Society of Cardiology's guidelines. Practitioners should consult the guidelines but also be aware of gaps in the literature and should individualize recommendations for each patient...
November 2016: Cardiology Clinics
https://www.readbyqxmd.com/read/27692225/atrial-fibrillation-in-endurance-athletes-from-mechanism-to-management
#20
Adrian D Elliott, Rajiv Mahajan, Dennis H Lau, Prashanthan Sanders
Exercise training has considerable health benefits. However, recent research has demonstrated a greater risk of atrial arrhythmias in endurance athletes. The mechanisms promoting atrial fibrillation in athletes are unclear but there seems to be a central role for atrial remodeling, accompanied by autonomic alterations and inflammation. Animal studies have provided unique insights, yet prospective human data are lacking. Treatment options seem to yield similar efficacy to that seen in a nonathletic population and may be justified as an early rhythm control strategy...
November 2016: Cardiology Clinics
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