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Current Opinion in Cardiology

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https://www.readbyqxmd.com/read/29028634/establishing-a-successful-transition-care-plan-for-the-adolescent-with-congenital-heart-disease
#1
Christopher Talluto
PURPOSE OF REVIEW: In this review we explore the aspects needed to develop a successful transition program for adolescents with congenital heart disease and the barriers that exist to the development of such a program. RECENT FINDINGS: We review the literature including more recent publications which support the development of a transition program in order to facilitate transfer from the pediatric to the adult healthcare system. SUMMARY: With the development of a successful transition program patients will hopefully receive high-quality, continuous life-long care in the appropriate setting...
October 11, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29028633/acute-kidney-injury-in-congenital-heart-disease
#2
Katja M Gist, David M Kwiatkowski, David S Cooper
PURPOSE OF REVIEW: Acute kidney injury (AKI) is associated with significant morbidity and mortality in patients with congenital heart disease undergoing cardiac surgery or in pediatric patients with congestive heart failure. RECENT FINDINGS: This review describes the definition and various manifestations of AKI, the impact of biomarkers on the diagnosis of AKI, the importance of fluid overload as a consequence of AKI and its long-term impact. SUMMARY: There are novel biomarkers for AKI detection that should facilitate early recognition and intervention to prevent or attenuate the effects of AKI and fluid overload...
October 11, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28984650/diagnosis-and-clinical-management-of-long-qt-syndrome
#3
Christian Steinberg
PURPOSE OF REVIEW: To give an overview over the substantial advances in the diagnosis and management of Long-QT syndrome since its first description 60 years ago. RECENT FINDINGS: LQT syndrome remains the most common inherited arrhythmia and is a leading cause for sudden unexplained death accounting for up to 20-25% of cases. Rapid progress of genetic technology over the past 2 decades has significantly improved our understanding of molecular and genetic mechanisms of LQT...
October 4, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28984649/orthostatic-hypotension-for-the-cardiologist
#4
Philip L Mar, Satish R Raj
PURPOSE OF REVIEW: Orthostatic hypotension is a phenomenon commonly encountered in a cardiologist's clinical practice that has significant diagnostic and prognostic value for a cardiologist. Given the mounting evidence associating cardiovascular morbidity and mortality with orthostatic hypotension, cardiologists will play an increasing role in treating and managing patients with orthostatic hypotension. RECENT FINDINGS: The American College of Cardiology, American Heart Association, and Heart Rhythm Society recently published consensus guidelines on the diagnosis, treatment, and management of syncope and their instigators, including orthostatic hypotension...
October 4, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29023288/gut-microbiome-and-its-role-in-cardiovascular-diseases
#5
Shadi Ahmadmehrabi, W H Wilson Tang
PURPOSE OF REVIEW: In recent years, an interest in intestinal microbiota-host interactions has increased due to many findings about the impact of gut bacteria on human health and disease. Dysbiosis, a change in the composition of the gut microbiota, has been associated with much pathology, including cardiovascular diseases (CVD). This article will review normal functions of the gut microbiome, its link to CVD, and potential therapeutic interventions. RECENT FINDINGS: The recently discovered contribution of gut microbiota-derived molecules in the development of heart disease and its risk factors has significantly increased attention towards the connection between our gut and heart...
November 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28902715/protecting-the-heart-from-ischemia-reperfusion-injury-an-update-on-remote-ischemic-preconditioning-and-postconditioning
#6
Martín Donato, Pablo Evelson, Ricardo J Gelpi
PURPOSE OF REVIEW: The most effective strategy for reducing acute myocardial ischemic injury is timely and effective reperfusion. However, myocardial reperfusion can induce further cardiomyocyte death (reperfusion injury). Interventions that protect the heart from ischemia/reperfusion injury, reducing infarct size, can involve remote ischemic preconditioning and postconditioning. These interventions have a promising potential clinical application, and have been the focus of recent research...
November 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28858911/less-invasive-coronary-artery-bypass-grafting-international-landscape-and-progress
#7
Keita Kikuchi, Makoto Mori
PURPOSE OF REVIEW: Less-invasive coronary artery bypass grafting (CABG) has evolved in multiple forms. Specifically noteworthy are recent technical refinement and reports of mid-term outcomes from well designed trials and observational studies in off-pump CABG, minimally invasive coronary artery bypass grafting (MICS CABG) and hybrid coronary revascularization (HCR). This review summarizes the historical evolution and recent development in less-invasive coronary artery bypass grafting...
November 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28841637/evolving-understanding-of-the-heterogeneous-natural-history-of-individual-coronary-artery-plaques-and-the-role-of-local-endothelial-shear-stress
#8
Antonios P Antoniadis, Peter H Stone
PURPOSE OF REVIEW: Anatomic and morphologic features of high-risk coronary plaque have been identified by novel imaging modalities, but it has been less clear which ostensibly high-risk plaques will actually destabilize and cause a new cardiac event. Different plaques with different morphologies coexist within the same artery, but the impact of this heterogeneity on the natural history of coronary artery disease has not been extensively investigated. RECENT FINDINGS: Coronary plaques exhibit remarkable heterogeneity of local morphological and blood-flow patterns, including endothelial shear stress (ESS), along their longitudinal axis, with important implications for the heterogeneous natural history of coronary disease...
November 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28834794/quality-of-life-after-coronary-artery-bypass-graft-surgery-versus-percutaneous-coronary-intervention-what-do-the-trials-tell-us
#9
Alexander Kulik
PURPOSE OF REVIEW: With an ever-aging population, the treatment of multi-vessel coronary artery disease (CAD) has increasingly become focused not only on mortality, but on symptom relief and improving quality of life (QOL). The purpose of this review is to present a summary on the subject of QOL after percutaneous coronary intervention (PCI) and coronary artery bypass graft surgery (CABG), highlighting the latest comparative trials in the field. RECENT FINDINGS: About 1 month after revascularization, patients recovering from either PCI or CABG report improvements in angina frequency...
November 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28834793/surgical-ventricular-remodeling-should-we-stich-or-not
#10
Vivek Rao
PURPOSE OF REVIEW: The surgical management of patients with ischemic cardiomyopathy, especially those with left ventricular ejection fractions less than 20% has historically been controversial. The original trials of surgical revascularization versus medical therapy intentionally excluded those patients with an ejection fraction less than 35%. The significant advances in medical therapy for heart failure over the past 30 years (β-blockade, angiotensin converting enzyme inhibitors, internal cardiac defibrillator and so on) also mandated a reevaluation of the potential benefits of surgical revascularization in this high-risk subset...
November 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28806185/graft-quality-verification-in-coronary-artery-bypass-graft-surgery-how-when-and-why
#11
Teresa M Kieser
PURPOSE OF REVIEW: The coronary artery bypass graft (CABG) operation is one of the few remaining operations/interventions on diseased arteries that are not routinely verified during or immediately after the procedure. This review answers the 'how', 'when' and 'why' of intraoperative CABG assessment. RECENT FINDINGS: More recent than new literature on this topic, is the increased interest in quality assurance of CABG. This is most likely due to reports in the last 5 years suggesting CABG superiority to percutaneous coronary intervention (PCI) for improved mid-term and long-term outcomes; for example, for patients with diabetes mellitus (Freedom Trial by Farkouh in 2012), and for patients with SYNTAX score ≥ 33 (SYNTAX Trial by Mohr in 2013)...
November 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28806184/noninfectious-aortitis-what-the-cardiologist-needs-to-know
#12
Ingolf Töpel
PURPOSE OF REVIEW: To sum up a group of noninfectious inflammatory diseases of the aorta and its branches relevant to a cardiologist's daily routine. To describe pathogenetic and clinical advances as well as modern diagnostic tools. To overview most recent treatment options and patient-tailored therapies. To provide an insight in future directions of research. RECENT FINDINGS: Pathophysiology of large vessel vasculitides (LVV) are still poorly defined. At least a certain number of patients with idiopathic periaortitis seem to part of the group of IgG4-related diseases which has implications for therapy...
November 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28799979/management-strategies-in-acute-type-b-aortic-intramural-hematoma
#13
Akiko Tanaka, Samuel Leake, Anthony L Estrera
PURPOSE OF REVIEW: Intramural hematoma (IMH) is one of the acute aortic syndromes. IMH was originally noted as an 'aortic dissection without intimal tear.' It had been speculated that IMHs were caused by ruptured vasa vasorum in the aortic media and distinguished from classical aortic dissections. However, the majority of IMHs are now detected with an intimal defect using high-resolution computed tomography, which implies that IMHs may be a subset of aortic dissections with very limited flow in the false lumen...
November 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28799978/role-of-fractional-flow-reserve-in-the-evaluation-and-management-of-patients-with-acute-coronary-syndrome
#14
Abdul Hakeem, Ahmed Almomani, Barry F Uretsky
PURPOSE OF REVIEW: The aim of this review is to appraise the clinical and prognostic value and pitfalls of FFR across different spectra of ACS presentations and lesion subsets. RECENT FINDINGS: Preponderance of evidence on this subject is from observational nonrandomized studies with conflicting results and short-term outcomes. Multiple recent studies evaluating the role of FFR-based deferral in non-STE ACS from a potentially culprit lesion have demonstrated poor long-term prognosis as related to future risk of target vessel failure (myocardial infarction/revascularization)...
November 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28795978/update-on-bicuspid-aortic-valve-aortopathy
#15
Evaldas Girdauskas, Johannes Petersen
PURPOSE OF REVIEW: The appropriate treatment of bicuspid aortic valve (BAV)-associated aortopathy is still controversial. We aimed to summarize recent evidence from the literature that focused on the prediction of aortopathy progression and adverse aortic events. RECENT FINDINGS: Following the detailed description of valvulo-aortic phenotypes in BAV disease in the previous imaging studies, the most current research focused on the definition of hemodynamic markers that may affect the progression of BAV-associated aortopathy and search for blood-born biomarkers to improve the prediction of adverse aortic events...
November 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28787299/clampless-versus-clamped-coronary-bypass-grafting-does-it-make-a-difference
#16
Hidetake Kawajiri, Hitoshi Yaku, David Glineur, Marc Ruel
PURPOSE OF REVIEW: The techniques of coronary artery bypass grafting (CABG) have evolved remarkably over the last two decades since the introduction of off-pump coronary artery bypass (OPCAB). This article focuses on the clinical outcomes of 'clampless' CABG strategies, that include OPCAB with a partial clamp, OPCAB with a proximal suture device, and aorta no-touch OPCAB. RECENT FINDINGS: Observational studies have shown the superiority of OPCAB for preventing strokes and pulmonary complications...
November 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28786864/long-noncoding-rnas-in-cardiovascular-disease-diagnosis-and-therapy
#17
Stefan Haemmig, Viorel Simion, Dafeng Yang, Yihuan Deng, Mark W Feinberg
PURPOSE OF REVIEW: Long noncoding RNAs (lncRNAs) have emerged as powerful regulators of nearly all biological processes. Their cell-type and tissue-specific expression in health and disease provides new avenues for diagnosis and therapy. This review highlights the role of lncRNAs that are involved in cardiovascular disease (CVD) with a special focus on cell types involved in cardiac injury and remodeling, vascular injury, angiogenesis, inflammation, and lipid metabolism. RECENT FINDINGS: Almost 98% of the genome does not encode for proteins...
November 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28786863/acute-and-chronic-pulmonary-embolism-the-role-of-the-pulmonary-embolism-response-team
#18
Alison S Witkin
PURPOSE OF REVIEW: Acute pulmonary embolism is a life-threatening condition that can lead to both acute and long-term morbidity and mortality. Patients with acute pulmonary embolism are at risk for significant complications including the development of chronic pulmonary embolism and chronic thromboembolic pulmonary hypertension. This review will describe the rationale for and structure of pulmonary embolism response teams, with a focus on the recognition and treatment of patients with persistent morbidity following pulmonary embolism...
November 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28786862/percutaneous-coronary-intervention-versus-coronary-artery-bypass-grafting-where-are-we-after-noble-and-excel
#19
Jacqueline H Fortier, Richard E Shaw, David Glineur, Juan B Grau
PURPOSE OF REVIEW: The publication of the NOBLE and EXCEL trials, with seemingly conflicting results, brought into question whether percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) is better for low-risk patients with left main coronary artery stenosis (LMCAS). This review appraises the methods and results of NOBLE and EXCEL, contextualizes them within the literature, and determines how they may affect clinical practice. RECENT FINDINGS: We appraised the trials and describe differences in methodology and results...
November 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28759471/the-ross-procedure-in-adults-which-patients-which-disease
#20
Amine Mazine, Ismail El-Hamamsy, Maral Ouzounian
PURPOSE OF REVIEW: The purpose of this article is to review the contemporary evidence surrounding the use of the Ross procedure in young and middle-aged adults and to identify the subset patients who are most likely to derive a benefit from this operation. RECENT FINDINGS: In appropriately selected young and middle-aged adults undergoing aortic valve replacement (AVR), the Ross procedure is currently the only operation that can restore long-term survival that is equivalent to that of the age-matched healthy general population...
November 2017: Current Opinion in Cardiology
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