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Current Opinion in Cardiology

Girish M Nair, Roshan Raut, Karan Bami, Pablo B Nery, Calum J Redpath, Mouhannad M Sadek, Martin S Green, David H Birnie
PURPOSE OF REVIEW: Pulmonary vein reconnection leading to recurrence of atrial arrhythmias after pulmonary vein isolation (PVI) for atrial fibrillation remains a significant challenge. A number of adjunctive measures during PVI have been used to attempt to reduce pulmonary vein reconnection and recurrence of atrial arrhythmias. We performed a systematic review of the literature and meta-analysis of studies evaluating the efficacy of adjunctive measures used during PVI in reducing recurrent atrial arrhythmias...
October 15, 2016: Current Opinion in Cardiology
Andrew C T Ha, Harindra C Wijeysundera, David H Birnie, Atul Verma
PURPOSE OF REVIEW: Catheter-based ablation for atrial fibrillation is a useful and effective form of rhythm-control therapy for symptomatic patients. This article reviews the 'real-world' experience on the outcomes, complications, and costs of atrial fibrillation ablation. RECENT FINDINGS: Currently, real-world outcomes of atrial fibrillation ablation are derived from retrospective analysis of administrative databases or prospective registries from selected centers and patients...
October 15, 2016: Current Opinion in Cardiology
Sven Reek
PURPOSE OF REVIEW: The wearable cardioverter-defibrillator has been available for over a decade. In recent years, the device has been prescribed increasingly for a wide range of indications. The purpose of this review is to describe the technical and clinical aspects of the wearable cardioverter-defibrillator. The available literature on safety, efficacy and cost-effectiveness is reviewed, and indications for use will be discussed. RECENT FINDINGS: The wearable cardioverter-defibrillator has been used successfully in more than 100 000 patients for a variety of indications...
October 15, 2016: Current Opinion in Cardiology
(no author information available yet)
No abstract text is available yet for this article.
November 2016: Current Opinion in Cardiology
Cheng Sun, Heng Zhang, Zhe Zheng
PURPOSE OF REVIEW: The efficacy and safety of β-blockers in the treatment of cardiovascular diseases, such as ischemic heart disease, cardiac arrhythmias, and heart failure, have been well established for decades. In this article, we review the current opinions on the application of β-blockers for secondary prevention in patients undergoing coronary artery bypass grafting (CABG) surgery. RECENT FINDINGS: As the average age of patients treated surgically for coronary artery disease (CAD) is increasing, it is not uncommon to have candidates for CABG presenting with concomitant atrial fibrillation, heart failure or hypertension, most of which were caused by excessive activation of the adrenergic nervous system...
November 2016: Current Opinion in Cardiology
David Glineur, Cyrus E Kuschner, Juan B Grau
PURPOSE OF REVIEW: Bilateral internal thoracic arteries (BITAs) have demonstrated their superiority over all other types of graft in terms of patency and survival benefit. BITA implementation requires the surgeon's evaluation of the patient's coronary anatomy and demographics. There is no single ideal approach to BITA utilization, but instead a variety of configurations that can be implemented based on the patient characteristics. RECENT FINDINGS: This article details the advantages and disadvantages of several BITA configurations in the setting of left-sided myocardial revascularization and right-sided myocardial revascularization...
November 2016: Current Opinion in Cardiology
Alon Eisen, Robert P Giugliano
PURPOSE OF REVIEW: Proprotein convertase subtilisin kexin type 9 (PCSK9) inhibitors are promising therapies that inhibit the degradation of low-density lipoprotein (LDL) receptors in the hepatocyte and thus increase LDL cholesterol (LDL-C) uptake from the blood. This review summarizes main findings in the field of PCSK9 inhibitors, from basic mechanism to clinical studies, and aims to provide a contemporary and practical overview of the clinical implication and future directions with PCSK9 inhibitors...
November 2016: Current Opinion in Cardiology
Viviany R Taqueti, Marcelo F Di Carli
PURPOSE OF REVIEW: The importance of physiologic assessments in ischemic heart disease is well recognized. Coronary flow reserve (CFR) is a novel physiologic imaging biomarker that complements both anatomic and semiquantitative perfusion assessments of coronary artery disease (CAD) severity. RECENT FINDINGS: Beyond this, assessment of CFR may provide clinical insights useful for refining diagnosis, prognosis, and eventually, management of patients along the full range of ischemic heart disease phenotypes, from multivessel obstructive CAD to diffuse coronary microvascular dysfunction...
November 2016: Current Opinion in Cardiology
Edward Hulten, Ron Blankstein, Marcelo F Di Carli
PURPOSE OF REVIEW: Contemporary diagnosis and management of stable chest pain symptoms possibly due to coronary ischemia is a frequent clinical challenge that involves a variety of test options, based upon either coronary angiographic (anatomic) or functional imaging. This review will discuss the evolution of coronary computed tomography derived fractional flow reserve (FFRCT) from basic science to a currently clinically approved diagnostic test. RECENT FINDINGS: In recent years, FFR measured invasively in the coronary catheterization lab has demonstrated clinical outcome benefit for coronary revascularization decisions...
November 2016: Current Opinion in Cardiology
Najib T Ayas, Carolyn M Taylor, Ismail Laher
PURPOSE OF REVIEW: There is an increased awareness of obstructive sleep apnea (OSA) and its potential impact on cardiovascular diseases (CVDs). The number of patients diagnosed with OSA is likely to increase as the obesity epidemic continues to grow. We review recent publications that have examined the links between OSA and CVD. RECENT FINDINGS: The cardiovascular consequences of OSA include hypertension, strokes, atrial fibrillation, and heart failure. It is likely that these are related to OSA-induced changes in endothelial dysfunction, oxidative stress, and systemic inflammation...
November 2016: Current Opinion in Cardiology
Jun Feng, Frank Sellke
PURPOSE OF REVIEW: The purpose of the current review is to describe the changes of microvascular function in patients with diabetes after cardioplegic arrest and cardiopulmonary bypass (CPB) and cardiac surgery. RECENT FINDINGS: Cardiac surgery, especially that involving cardioplegia and CPB, is associated with significant changes in vascular reactivity of coronary/peripheral microcirculation, vascular permeability, gene/protein expression, and programmed cell death, as well as with increased morbidity and mortality after surgical procedures...
November 2016: Current Opinion in Cardiology
Chiara Lestuzzi
PURPOSE OF REVIEW: Primary cardiac tumors are a rare disease, which may have severe clinical consequences. Malignant tumors may be misdiagnosed as mixomas, with improper treatment. The aim of this review is to report how to make a differential diagnosis using old and modern tools, the latest trends in tumor classification and treatment, and their possible impact on prognosis. RECENT FINDINGS: Papillary fibroelastomas seem to be more frequent than previously reported, and surgery is also suggested in asymptomatic patients...
November 2016: Current Opinion in Cardiology
Lidia R Bons, Jolien W Roos-Hesselink
PURPOSE OF REVIEW: During pregnancy, cardiac disease is the most important cause of maternal mortality, with aortic disease being the most important contributor. This review describes the impact of pregnancy, risk stratification for and the management of aortic diseases during pregnancy and delivery. RECENT FINDINGS: The most common aortic diseases with an increased risk of complications during pregnancy are genetic syndromes such as Marfan, Loeys-Dietz, vascular Ehlers-Danlos, Turner syndrome and bicuspid aortic valve...
November 2016: Current Opinion in Cardiology
John A Bittl
PURPOSE OF REVIEW: To analyze evidence from randomized clinical trials (RCTs) that identifies the optimal duration of dual antiplatelet therapy (DAPT) after implantation of newer generation drug-eluting stents (DESs) in diabetic patients. RECENT FINDINGS: Patients with diabetes mellitus have increased risk of ischemic events and bleeding after DES implantation. The optimal duration of DAPT for this population is currently unknown. In a subgroup analysis of 8542 diabetic patients enrolled in eight RCTs of DAPT duration after implantation of newer generation DESs, prolonged courses of DAPT of 12-36 months in duration resulted in rates of major adverse cardiac events that were no different from those seen after shorter courses of DAPT of 3-12 months in duration (odds ratio 1...
November 2016: Current Opinion in Cardiology
Gianluigi Bisleri
PURPOSE OF REVIEW: Recently, there has been a renewed interest with regard to surgical strategies for aortic valve preservation in the presence of isolated valve disease or concomitant aortic root disease, despite concerns having been raised about the mid/long-term durability of such repair techniques for the aortic valve. The aim of the present review is to analyze the currently available evidence about aortic valve repair strategies, for either bicuspid or tricuspid valves. RECENT FINDINGS: An improved understanding of the surgical anatomy and functional analysis of the aortic valve and root has allowed a systematic classification for the mechanisms of aortic valve insufficiency...
November 2016: Current Opinion in Cardiology
Martin Czerny, Bartosz Rylski, Friedhelm Beyersdorf
PURPOSE OF REVIEW: Type B aortic dissection has largely been regarded as the nice dissection with regard to its natural course, especially when compared with type A aortic dissection. However, a more thorough look into the natural course of the disease has shown that a high number of patients with type B aortic dissection will experience complications and will require therapy, sooner or later. RECENT FINDINGS: Reasons and timepoints are different, being malperfusion, contained rupture and retrograde propagation of the disease into the aortic arch or into the ascending aorta in the early phase and being mainly aneurysmal formation in the chronic phase of the disease...
November 2016: Current Opinion in Cardiology
Maria G Andreassi, Alessandro Della Corte
PURPOSE OF REVIEW: The incidence of aortic dilation and acute complications (rupture and dissection) is higher in patients with a bicuspid aortic valve (BAV), the most frequent congenital heart defect.The present review focuses on the current knowledge in the genetics of BAV, emphasizing the clinical implications for early detection and personalized care. RECENT FINDINGS: BAV is a highly heritable trait, but the genetic causes remain largely elusive. NOTCH1 is the only proven candidate gene to be associated with both familial and sporadic BAV...
November 2016: Current Opinion in Cardiology
Alexander Kulik
PURPOSE OF REVIEW: Despite the benefits of surgical coronary revascularization, patients continue to be at risk for ischemic events in the years that follow coronary artery bypass graft surgery (CABG), mandating the role for postoperative secondary preventive therapy. The purpose of this review was to present a summary on the subject of secondary prevention after CABG, including an overview of a recently published scientific statement, and highlight the newest studies in the field. RECENT FINDINGS: Aspirin and statin therapy continue to be the mainstay of secondary prevention after CABG, although newer antiplatelet and lipid-lowering medicines are being actively studied for their potential benefits...
November 2016: Current Opinion in Cardiology
(no author information available yet)
No abstract text is available yet for this article.
September 2016: Current Opinion in Cardiology
Michael A Grandner, Pamela Alfonso-Miller, Julio Fernandez-Mendoza, Safal Shetty, Sundeep Shenoy, Daniel Combs
PURPOSE OF REVIEW: Sleep plays many roles in maintenance of cardiovascular health. This review summarizes the literature across several areas of sleep and sleep disorders in relation to cardiometabolic disease risk factors. RECENT FINDINGS: Insufficient sleep duration is prevalent in the population and is associated with weight gain and obesity, inflammation, cardiovascular disease, diabetes, and mortality. Insomnia is also highly present and represents an important risk factor for cardiovascular disease, especially when accompanied by short sleep duration...
September 2016: Current Opinion in Cardiology
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