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Current Opinion in Cardiology

Sonya K Hui, Emma Lindale, Louise Sun, Marc Ruel
PURPOSE OF REVIEW: Patients with multivessel coronary artery disease (CAD) may undergo revascularization by either percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG). This review will discuss the use of polygenic risk scores for risk-stratification of patients with multivessel CAD in order to guide the choice of revascularization. RECENT FINDINGS: A 57-single nucleotide polymorphism (SNP)-polygenic risk score can accurately risk-stratify patients with CAD and identify those who will receive greater benefit from statin therapy...
September 3, 2018: Current Opinion in Cardiology
Simeng Zhang, Yanqing Chen, Qingsheng Lu
PURPOSE OF REVIEW: Retrograde type A aortic dissection (RTAD) is a fatal complication after endovascular therapy of type B aortic dissection and descending thoracic aneurysm disease. This review aims to elaborate this lethal complication, the potential risks of its incidence, and feasible approaches to lower the occurrence rate. RECENT FINDINGS: Many articles have shown lower incidence of RTAD in patients with thoracic aneurysm than those with aortic dissection...
September 3, 2018: Current Opinion in Cardiology
Janet M C Ngu, Marc Ruel, Louise Y Sun
PURPOSE OF REVIEW: In 2013, heart failure with recovered ejection fraction (HFrecEF) was introduced as a new heart failure phenotype. This review provides an overview of HFrecEF and the comparative effects of percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) on left ventricular ejection fraction (LVEF) recovery in patients with ischemic cardiomyopathy. RECENT FINDINGS: There has been emerging data indicating that LV functional recovery is possible and HFrecEF is associated with improved survival and better quality of life...
August 29, 2018: Current Opinion in Cardiology
Erika Opingari, Arun C R Partridge, Subodh Verma, Harpreet S Bajaj
PURPOSE OF REVIEW: To address common concerns regarding sodium-glucose cotransporter 2 (SGLT2) inhibitor use for patients with type 2 diabetes mellitus (T2DM) in cardiovascular practice. RECENT FINDINGS: SGLT2 inhibitors provide glycemic control and improve cardiovascular and renal endpoints in T2DM. Cardiovascular outcome trials have demonstrated sustained cardiovascular, heart failure and renal benefits independent of glycemic control, which persist down to an eGFR of 30 ml/min/1...
August 24, 2018: Current Opinion in Cardiology
Harpreet S Bajaj, Badr Al-Jabri, Subodh Verma
PURPOSE OF REVIEW: Cardiovascular outcome trials (CVOT) with glucagon-like peptide-1 receptor agonists (GLP-1 RA) have had variable results to date: with two CVOTs being positive and two concluding neutrality/safety results for primary cardiovascular outcome. Mechanistic insights delving into the pathophysiologic mechanisms that may link certain GLP-1 RA to cardioprotection may help define the application of this medication class in clinical practice based on the evidence of the CVOT data...
August 22, 2018: Current Opinion in Cardiology
Chethan R Kasargod Prabhakar, Ralph Stewart
PURPOSE OF REVIEW: To review recent literature on associations between habitual physical activity and mortality in general populations and patients with stable coronary heart disease. RECENT FINDINGS: There are substantial decreases in cardiovascular and all-cause mortality between people who take little or no exercise and those who take regular light or moderate physical activity. The benefits associated with increasing high-intensity exercise are smaller, and an increase in mortality risk is possible...
August 22, 2018: Current Opinion in Cardiology
Christopher S Johns, David G Kiely, Andrew J Swift
PURPOSE OF REVIEW: Pulmonary hypertension is a life-shortening condition, which may be idiopathic but is more frequently seen in association with other conditions. Current guidelines recommend cardiac catheterization to confirm the diagnosis of pulmonary hypertension. Evidence suggests an increasing role for noninvasive imaging modalities in the initial diagnostic and prognostic assessment and evaluation of treatment response. RECENT FINDINGS: In this review we examine the evidence for current noninvasive imaging methodologies: echocardiography computed tomography and MRI in the diagnostic and prognostic assessment of suspected pulmonary hypertension and explore the potential utility of modeling and machine-learning approaches...
August 18, 2018: Current Opinion in Cardiology
Bilal Ayach, Nowell M Fine, Lawrence G Rudski
PURPOSE OF REVIEW: Right ventricular (RV) assessment has long been challenging and technically difficult using echocardiography. This is mainly the result of the asymmetrical shape of the RV making it difficult to visualize on one-or-two dedicated views, thus requiring multiple integrated views and subjective assessment. Measurement of tricuspid annular systolic plane excursion and RV tissue Doppler velocity have become relied-upon methods of objective assessments; however, have limitations for characterizing true RV physiology...
September 2018: Current Opinion in Cardiology
Andrew Pipe
No abstract text is available yet for this article.
September 2018: Current Opinion in Cardiology
Suparna C Clasen, Marielle Scherrer-Crosbie
PURPOSE OF REVIEW: We aim to summarize the utility of strain in monitoring the effects of cancer therapy-related cardiotoxicity (CTRC) on the development of left ventricular (LV) dysfunction. RECENT FINDINGS: Serial assessment of cardiac function at baseline and during treatment is recommended in patients undergoing cancer treatment. Historically, the use of left ventricular ejection fraction (LVEF) has been used to monitor for cardiac toxicity from cancer therapies but myocardial mechanic parameters, in particular global longitudinal strain (GLS), have emerged as powerful adjunctive tools...
September 2018: 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...
September 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...
September 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...
September 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...
September 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...
September 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)...
September 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...
September 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...
September 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...
September 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...
September 2018: Current Opinion in Cardiology
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