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Current Opinion in Cardiology

Heather E Tulloch, Paul S Greenman
PURPOSE OF REVIEW: To review the link between couple relationships and cardiovascular health, the plausible mechanisms by which relationship quality affects heart health, and to provide an overview of couple-based interventions aimed at improving cardiovascular health. RECENT FINDINGS: Marriage and the quality of the couple relationship bond are robust predictors of long-term health outcomes. Chronic relationship conflict and disconnection can be deadly. There are direct and indirect pathways by which couple relationship quality affect cardiovascular health...
July 13, 2018: Current Opinion in Cardiology
Jose Nativi-Nicolau, Mathew S Maurer
PURPOSE OF REVIEW: The present article provides an update about the recent advances in the diagnosis and management of the most common types of cardiac amyloidosis, including light chain, wild-type transthyretin (ATTRwt), and mutant transthyretin (ATTRm). RECENT FINDINGS: The document reviews the utility of diagnostic tools including innovative echocardiographic indices, magnetic resonance T1 mapping and measurement of extracellular volume, and the role and validation of bone scintigraphy for the noninvasive assessment of ATTR amyloidosis...
July 13, 2018: Current Opinion in Cardiology
Akhil Narang, Karima Addetia
PURPOSE OF REVIEW: The assessment of left ventricular function by two-dimensional (2D) transthoracic echocardiography (TTE) is conventionally performed by measuring the ejection fraction, which has been shown to have important prognostic implications. However, left ventricular ejection fraction (LVEF) has notable shortcomings, including limited reproducibility, suboptimal inter/intraobserver variability and dependence on load/volume. Furthermore, subclinical left ventricular dysfunction cannot be measured with LVEF...
July 13, 2018: Current Opinion in Cardiology
Bobby Yanagawa, Subodh Verma, Akshay Bagai, John D Puskas
PURPOSE OF REVIEW: The purpose of this article is to investigate the potential role of fractional flow reserve (FFR) to guide surgical revascularization. RECENT FINDINGS: Coronary artery bypass is planned and executed primarily based on angiographic coronary anatomy. FFR is the most well-established tool for functional assessment of coronary lesions. Randomized trials have demonstrated the benefit of FFR-guided percutaneous coronary intervention (PCI) to determine the ischemic burden of intermediate lesions...
July 9, 2018: Current Opinion in Cardiology
Kristen Bede, Wai H Wilson Tang
PURPOSE OF REVIEW: Precision medicine is the concept of disease treatment and prevention using an individual's genomic profile in addition to personal and environmental factors. This review outlines examples of new biomarker strategies that enable the practice of precision cardiovascular medicine. RECENT FINDINGS: Although commonly attributed to identifying causative genetic variants, mono-genetic causes of cardiovascular diseases (CVD) are not common and largely focused on lipoprotein analyses...
July 9, 2018: Current Opinion in Cardiology
Jennifer L Reed, Stephanie A Prince
PURPOSE OF REVIEW: This review focuses on recent literature examining and targeting the physical activity and sedentary behaviour of nurses. The role of physical activity and sedentary behaviour in preventing and managing cardiovascular disease (CVD) in women is also discussed. RECENT FINDINGS: Nurses (most of whom are women) represent the largest professional group within the health care workforce and many present with risk factors for CVD (e.g. physical inactivity, sedentary behaviour, overweight/obesity, hypertension, dyslipidemia, diabetes, smoking, depression, anxiety)...
July 9, 2018: Current Opinion in Cardiology
Bobby Yanagawa, Kathryn Hong, Asim Cheema, Akshay Bagai, Subodh Verma
PURPOSE OF REVIEW: Hybrid coronary revascularization (HCR) combines minimally invasive surgical bypass with percutaneous coronary intervention (PCI) using drug-eluting stents, the goal being to leverage the strengths of each approach. Here we provide an update on HCR from the past 12 months. RECENT FINDINGS: HCR represents a minority of surgical revascularization cases from a small number of highly experienced surgical centers. Most single-center observational series show no differences in major cardiovascular outcomes comparing HCR and coronary artery bypass graft (CABG) or HCR and PCI...
July 9, 2018: Current Opinion in Cardiology
Deirdre K Tobias, Samia Mora, Subodh Verma, Patrick R Lawler
PURPOSE OF REVIEW: Atherosclerotic cardiovascular disease (CVD) and type II diabetes (T2D) share common etiologic pathways that may long precede the development of clinically evident disease. Early identification of risk markers could support efforts to individualize risk prediction and improve the efficacy of primary prevention, as well as uncover novel therapeutic targets. RECENT FINDINGS: Altered metabolism of branched-chain amino acids (BCAAs), and their subsequent accumulation in circulation, may precede the development of insulin resistance and clinically manifest cardiometabolic diseases...
July 9, 2018: Current Opinion in Cardiology
Lucas Colombo Godoy, Vivek Rao, Michael E Farkouh
PURPOSE OF REVIEW: Review the recently published scientific evidence to support the decision-making process of revascularization strategy in patients with diabetes mellitus (DM) and multivessel coronary artery disease (MVD). RECENT FINDINGS: Recently published observational analyses have proven the superiority of coronary artery bypass grafting (CABG) in patients presenting with other comorbidities together with DM, such as renal disease or heart failure. SUMMARY: Significant challenges and controversies surrounded the choice of the appropriate revascularization method in patients with DM and MVD over the last decades...
July 9, 2018: Current Opinion in Cardiology
Janet Wei, Chrisandra Shufelt, C Noel Bairey Merz
PURPOSE OF REVIEW: When patients are seen for persistent chest pain in the absence of obstructive coronary artery disease, the physician must decide if the symptoms are due to myocardial ischemia in order to guide treatment. RECENT FINDINGS: Recent findings indicate that ischemia due to coronary microvascular dysfunction (CMD) is associated with subclinical coronary atherosclerosis and an adverse prognosis. Therapeutic probe trials suggest that antiatherosclerotic and anti-ischemic therapeutic strategies may be useful...
July 5, 2018: Current Opinion in Cardiology
Robert Roberts, Arlene Campillo
PURPOSE OF REVIEW: To review the literature showing genetic risk variants is a reliable means of stratifying for risk of CAD for primary prevention. RECENT FINDINGS: Over 90 genetic risk variants have been discovered that predispose to CAD. Results of several studies show that these risk variants effectively stratify for risk of CAD in asymptomatic individuals. SUMMARY: The total individual genetic risk can be summarized into a single number referred to as the genetic risk score (GRS)...
July 3, 2018: Current Opinion in Cardiology
C Noel Bairey Merz, Tina Ramineni, Derek Leong
PURPOSE OF REVIEW: Sex-specific differences in pathophysiology, prevalence, and impact of cardiovascular disease (CVD) risk factors may explain the high cardiovascular mortality rates in women. RECENT FINDINGS: We review the sex differences in traditional risk factors (dyslipidemia, hypertension, diabetes, and smoking) and nontraditional risk factors (menopause and hormones, pregnancy, inflammation and autoimmune diseases, anemia, depression, and migraines) and their prognostic and therapeutic implications...
June 29, 2018: Current Opinion in Cardiology
Reena Karkhanis, Derrick Y Tam, Stephen E Fremes
PURPOSE OF REVIEW: Coronary artery disease is common in patients with end-stage renal disease (ESRD) on hemodialysis. ESRD patients are prone to atherosclerosis and are likely to present with advanced CAD requiring coronary artery bypass graft surgery (CABG) or percutaneous coronary intervention (PCI). RECENT FINDINGS: Individual observational studies and aggregated results comparing PCI to CABG have shown an increased risk of early postoperative mortality in the CABG group followed by a decrease in late mortality and cardiovascular events...
June 29, 2018: Current Opinion in Cardiology
Jonathan Buggey, Brian D Hoit
PURPOSE OF REVIEW: To summarize recent literature on the use of left atrial strain in the diagnosis and management of patients with heart failure. RECENT FINDINGS: Left atrial dysfunction is a hallmark of diastolic dysfunction and heart failure, in particular, heart failure with preserved ejection fraction (HFpEF). Recently, myocardial deformation analysis via strain and strain rate measurements have been applied to the left atrium. These measurements have been shown to aid in the diagnosis of heart failure and be accurate predictors of cardiac pressures, diastolic dysfunction, exercise performance, and clinical outcomes such as cardiac hospitalizations and mortality...
June 14, 2018: Current Opinion in Cardiology
Arnold C T Ng, Victoria Delgado, Jeroen J Bax
PURPOSE OF REVIEW: Left ventricular (LV) global longitudinal strain (GLS) is widely recognized as a more sensitive measure of LV systolic function compared with LV ejection fraction (LVEF). In addition, the measurement of LVGLS is more reproducible than two-dimensional LVEF. Current guidelines for diagnosis and treatment of valvular heart disease include LVEF as one of the parameters to take into consideration in the clinical decision-making. However, a large body of evidence is showing that LVGLS may be a better prognosticator than LVEF in various valvular heart diseases...
June 9, 2018: Current Opinion in Cardiology
Masaaki Takeuchi, Victor Chien-Chia Wu
PURPOSE OF REVIEW: Myocardial strain imaging has gained popularity during the last decade in various clinical scenarios. The objective of this article was to review the potential application of two-dimensional (2D) and three-dimensional (3D) strains in patients with coronary artery disease. RECENT FINDINGS: Reports on the diagnostic accuracy of myocardial deformation analysis using 2D and 3D speckle-tracking analyses to detect significant coronary stenosis at rest or during stress and to evaluate myocardial viability are limited...
June 7, 2018: Current Opinion in Cardiology
Mohamed Ayan, Sabeeda Kadavath, Patrick T Campbell
PURPOSE OF REVIEW: Recent data from randomized clinical trials and updates to hypertension guidelines warrant a review of the literature for the diagnosis and management of hypertension in the clinic setting. Although there have been significant advances in ambulatory blood pressure (BP) monitoring and home BP monitoring, office BP (OBP) measurements remains the primary means of diagnosis and treatment. RECENT FINDINGS: The current review focuses on updated guidelines, proper technique, device selection, and the recent controversy regarding unattended BP measurements...
July 2018: Current Opinion in Cardiology
Cemal Ozemek, Deepika R Laddu, Ross Arena, Carl J Lavie
PURPOSE OF REVIEW: Regular consumption of a diet high in sodium, energy dense foods, fat content, refined carbohydrates, added sugar and low in fruits and vegetables contributes to an increased risk of developing hypertension (HTN) and cardiovascular disease. This review aims to provide a synopsis of evidence-based dietary approaches that have been effective in lowering blood pressure (BP) in pre-HTN and individuals with HTN. RECENT FINDINGS: Recent dietary recommendations have emphasized overall dietary patterns and its relation between food and BP...
July 2018: Current Opinion in Cardiology
Esmée A Bakker, Xuemei Sui, Angelique G Brellenthin, Duck-Chul Lee
PURPOSE OF REVIEW: The aim of this review is to evaluate the most recent literature about the role of physical activity, exercise, and fitness in hypertension prevention. RECENT FINDINGS: Strong evidence indicates that performing moderate-to-vigorous physical activity, particularly aerobic exercise, and improving cardiorespiratory fitness (CRF) reduce blood pressure (BP) levels and lower hypertension incidence. Although evidence is limited, performing resistance exercise or improving muscular strength appears to be associated with a lower incidence of hypertension...
July 2018: Current Opinion in Cardiology
Hector O Ventura, Carl J Lavie
No abstract text is available yet for this article.
July 2018: Current Opinion in Cardiology
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