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Cardiology in Review

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https://www.readbyqxmd.com/read/28379903/inhaled-insulin-a-clinical-and-historical-review
#1
Jason Chan, Angela Cheng-Lai
Insulin is the most effective blood glucose lowering agent and remains one of the cornerstones of diabetes management. However, many individuals with diabetes are either reluctant to initiate or are nonadherent to their insulin therapy for various reasons, including fear of frequent injections. Technosphere Insulin (TI) is a novel inhaled insulin powder that is approved by the United States Food and Drug Administration for the management of diabetes. The results from 2 phase III clinical trials have shown that TI was noninferior to subcutaneous insulin aspart and superior to inhaled placebo in lowering HbA1c in patients with diabetes mellitus types 1 and 2, respectively...
May 2017: Cardiology in Review
https://www.readbyqxmd.com/read/28379902/cangrelor-a-new-route-for-p2y12-inhibition
#2
Alexandra M Sible, James J Nawarskas
Antiplatelet therapy with a P2Y12 inhibitor is a key component of treatment for patients with acute coronary syndromes undergoing percutaneous coronary intervention. Before the development of cangrelor (Kengreal, The Medicines Company, Parsippany, NJ), only oral P2Y12 inhibitors were available. Cangrelor is a reversible P2Y12 inhibitor that is administered as an intravenous infusion, and its quick onset and offset make it an appealing option for antiplatelet therapy, particularly for patients who are unable to take oral medications...
May 2017: Cardiology in Review
https://www.readbyqxmd.com/read/28379901/the-utility-of-teleultrasound-to-guide-acute-patient-management
#3
Christian Becker, Mario Fusaro, Dhruv Patel, Isaac Shalom, William H Frishman, Corey Scurlock
Ultrasound has evolved into a core bedside tool for diagnostic and management purposes for all subsets of adult and pediatric critically-ill patients. Teleintensive care unit coverage has undergone a similar rapid expansion period throughout the United States. Round-the-clock access to ultrasound equipment is very common in today's intensive care unit, but 24/7 coverage with staff trained to acquire and interpret point-of-care ultrasound in real time is lagging behind equipment availability. Medical trainees and physician extenders require attending level supervision to ensure consistent image acquisition and accurate interpretation...
May 2017: Cardiology in Review
https://www.readbyqxmd.com/read/27548684/hypertension-in-the-kidney-transplant-recipient-overview-of-pathogenesis-clinical-assessment-and-treatment
#4
Daniel Glicklich, Rajat Lamba, Rahul Pawar
Cardiovascular disease is the leading cause of death in patients with chronic renal disease and the most common cause of death and allograft loss among kidney transplant recipients. Transplant patients often have multiple cardiovascular risk factors antedating transplantation. Among the most prominent is hypertension (HTN), which affects at least 90% of transplant patients. Uncontrolled HTN is an independent risk factor for allograft loss. The etiology of HTN in transplant recipients is complex and multifactorial, including the use of essential immunosuppressive medications...
May 2017: Cardiology in Review
https://www.readbyqxmd.com/read/27548683/identification-of-the-asymptomatic-patient-with-severe-mitral-regurgitation-discrepancy-between-research-and-clinical-practice
#5
Rosemarijn Jansen, Jolanda Kluin, Simon G Ray, Maarten Jan M Cramer, Willem J L Suyker, Steven A J Chamuleau
Organic mitral regurgitation (MR) is a common disorder, and because of the increase in population and its aging, the occurrence of MR is steadily increasing. Current guideline recommendations on the management of asymptomatic severe MR are conflicting and based solely on registries or nonrandomized trials in expert heart valve clinics, resulting in a lack of evidence for the best treatment strategy. In this review, we will evaluate the latest evidence on diagnostic approaches and treatment strategies for asymptomatic patients without a clear indication for surgical intervention...
May 2017: Cardiology in Review
https://www.readbyqxmd.com/read/27465537/micrornas-in-ischemic-heart-disease-from-pathophysiology-to-potential-clinical-applications
#6
Jose Lima, Jonathan A Batty, Hannah Sinclair, Vijay Kunadian
Despite rapid advances in cardiovascular research and therapeutic strategies, ischemic heart disease (IHD) remains the leading cause of mortality worldwide. MicroRNAs (miRNAs) are small, noncoding RNAs which post transcriptionally regulate gene expression. In the past few years, miRNAs have emerged as key tools for the understanding of the pathophysiology of IHD, with potential uses as new biomarkers and therapeutic targets. Several studies report a regulatory role of miRNAs, with regard to fundamental components of IHD pathogenesis and progression, such as lipoprotein metabolism, atherogenesis, vascular calcification, platelet function, and angiogenesis...
May 2017: Cardiology in Review
https://www.readbyqxmd.com/read/27054605/advanced-therapy-in-eisenmenger-syndrome-a-systematic-review
#7
Cristel S Hjortshøj, Annette S Jensen, Lars Søndergaard
Treatment options for patients with the Eisenmenger syndrome have until recently been scarce, but new knowledge in the field of pulmonary arterial hypertension has expanded the therapeutic possibilities for these patients. Advanced therapy with pulmonary vasodilators has become part of the standard treatment, offering long-term benefits on exercise capacity, clinical symptoms, and possibly survival. However, there are currently only few studies to guide the use of advanced therapies in this population, and important questions such as indications for initiation or escalation of advanced therapy and valid effect parameters and treatment goals remain unanswered...
May 2017: Cardiology in Review
https://www.readbyqxmd.com/read/28170357/on-x-valve-the-next-generation-aortic-valve
#8
REVIEW
Rahul Chaudhary, Jalaj Garg, Parasuram Krishnamoorthy, Neeraj Shah, Bruce A Feldman, Matthew W Martinez, Ronald Freudenberger
The On-X valve is a newer generation mechanical bileaflet valve. Its key features include the use of pure pyrolytic carbon (devoid of silicon), a length-to-diameter ratio similar to a native valve, an inlet flared orifice, a leaflet opening up to 90 degrees, a shorter leaflet closing angle, a 2-point leaflet contact, and an actuated pivot. These features have translated into increased strength, improved valve hemodynamics, reduced hemolysis, and thrombogenicity. The 2014 American Heart Association/American College of Cardiology guidelines for the management of patients with valvular heart disease recommend an international normalized ratio (INR) of 2...
March 2017: Cardiology in Review
https://www.readbyqxmd.com/read/28099220/evacetrapib-another-cetp-inhibitor-for-dyslipidemia-with-no-clinical-benefit
#9
REVIEW
Vaughn A Eyvazian, William H Frishman
Evacetrapib is a cholesteryl ester transfer protein (CETP) inhibitor that has been recently studied as a cholesterol modifying agent to reduce cardiovascular risk and mortality in high risk cardiovascular disease patients. Evacetrapib acts to decrease lipid exchange through CETP inhibition. CETP acts to transfer cholesteryl esters from high-density lipoprotein-cholesterol (HDL-C) to low-density lipoprotein cholesterol (LDL-C) and very-low-density lipoprotein (VLDL-C). HDL-C is involved in reverse cholesterol transport and its blood levels have been shown to be inversely correlated with cardiovascular risk...
March 2017: Cardiology in Review
https://www.readbyqxmd.com/read/28099219/a-review-of-the-clinical-utility-of-intravascular-ultrasound-and-optical-coherence-tomography-in-the-assessment-and-treatment-of-coronary-artery-disease
#10
REVIEW
Stephen Daniel Matthews, William H Frishman
Coronary artery disease remains one of the leading causes of morbidity and mortality in the United States. As a medical society, we continue to search for ways to better treat coronary artery disease and prevent acute coronary syndrome (ACS). As it stands, only statins and antiplatelet agents have been proven to significantly reduce the occurrence of ACS. A histopathological understanding of the pathogenesis of ACS has provided insight into the importance of plaque morphology. Therefore, it has been proposed that increasing the ability to detect true vulnerable, "at-risk" lesions, would foster the use of percutaneous coronary intervention as a means for the prevention of ACS...
March 2017: Cardiology in Review
https://www.readbyqxmd.com/read/27548685/enhanced-external-counterpulsation-therapy-past-present-and-future
#11
REVIEW
Anoshia Raza, Kate Steinberg, Joseph Tartaglia, William H Frishman, Tanush Gupta
External counterpulsation therapy was first developed over half a century ago as a resuscitative tool to support the failing heart and was based on hemodynamic principles of the intraaortic balloon pump. Over the course of last few decades, it has evolved into the modern enhanced external counterpulsation (EECP) therapy, which has proven to be a safe, effective, and low-cost noninvasive treatment for patients with debilitating angina and chronic heart failure who are poor candidates for revascularization procedures and have suboptimal results from other therapies...
March 2017: Cardiology in Review
https://www.readbyqxmd.com/read/27465539/advances-in-continuous-flow-left-ventricular-assist-device-support-for-end-stage-heart-failure-a-therapy-in-evolution
#12
REVIEW
Omar Saeed, Ulrich P Jorde
The purpose of this review is to highlight recent advances and challenges in the clinical implementation of continuous flow left ventricular assist devices (CF LVADs) in patients with advanced heart failure. Post approval studies of CF LVAD therapy continue to show a progressive improvement in survival and reduction in adverse events. Major trials are ongoing to compare outcomes of an axial flow device (Heart Mate II) and smaller centrifugal flow pumps (HeartWare VADs and Heart Mate III). Numerous studies have investigated strategies to reduce major hematologic and neurologic adverse events by evaluating hemolysis, antithrombotic therapy, and blood pressure control...
March 2017: Cardiology in Review
https://www.readbyqxmd.com/read/27465538/pulmonary-pressure-monitoring-for-patients-with-heart-failure
#13
REVIEW
Jennifer T Wang, William H Frishman
Heart failure (HF) affects over 5.8 million patients in the United States, and can be very costly due to the number of hospitalizations and rehospitalizations during the final years of life. Due to the large number of hospitalizations for HF exacerbations, effective methods for preventing these occurrences are necessary. Improvements in the outpatient treatment of HF, aided by noninvasive and invasive home monitoring methods, can reduce the number of hospitalizations. Pulmonary pressure monitoring through the CardioMEMS system provides one method of hemodynamic assessment of patients...
March 2017: Cardiology in Review
https://www.readbyqxmd.com/read/27465536/neurocardiac-injury-after-cerebral-and-subarachnoid-hemorrhages
#14
REVIEW
Sowmya Pinnamaneni, Wilbert S Aronow, William H Frishman
Cerebrovascular events are associated with high mortality and morbidity rates. Neurocardiac injury after a subarachnoid hemorrhage and cerebral hemorrhage further worsen clinical outcomes. Excess catecholamine-induced cardiotoxicity is currently the most widely accepted pathophysiologic mechanism. Awareness of neurocardiac injury and the cardiac manifestations associated with it will allow for early diagnosis and appropriate management.
March 2017: Cardiology in Review
https://www.readbyqxmd.com/read/27922469/sports-and-driving-with-an-implantable-cardioverter-defibrillator
#15
REVIEW
Aileen M Ferrick, Kevin J Ferrick
Many patients with implantable cardioverter-defibrillators (ICD) want to participate in sports and many need or wish to operate a personal motor vehicle. Healthcare providers need to advise patients regarding restrictions related to these activities in the context of the clinical indication for the ICD. Ethical considerations need to be considered when advising ICD patients of restrictions to reduce risk of injury to themselves and to others when participating in either sports or driving. Shared decision-making is necessary to have ICD patients understand and comply with recommended restrictions...
January 2017: Cardiology in Review
https://www.readbyqxmd.com/read/27922468/optimal-implantable-cardioverter-defibrillator-programming
#16
REVIEW
Bindi K Shah
Optimal programming of implantable cardioverter defibrillators (ICDs) is essential to appropriately treat ventricular tachyarrhythmias and to avoid unnecessary and inappropriate shocks. There have been a series of large clinical trials evaluating tailored programming of ICDs. We reviewed the clinical trials evaluating ICD therapies and detection, and the consensus statement on ICD programming. In doing so, we found that prolonged ICD detection times, higher rate cutoffs, and antitachycardia pacing (ATP) programming decreases inappropriate and painful therapies in a primary prevention population...
January 2017: Cardiology in Review
https://www.readbyqxmd.com/read/27922467/lead-extraction-considerations-for-the-referring-cardiologist
#17
REVIEW
Ayman A Hussein, Bruce L Wilkoff
The population of patients with cardiac implantable electronic devices (CIEDs) continues to grow due to increasing indications in an aging population and breakthroughs in both the medical and the surgical care of patients with heart disease. As a result, there has been a growing need for device and lead extractions due to the growing population of patients with CIEDs and the subsequent need for system upgrades or revisions because of complications, infections, and lead advisory alerts.
January 2017: Cardiology in Review
https://www.readbyqxmd.com/read/27922466/smartphone-based-electrocardiographic-and-cardiac-implantable-electronic-device-monitoring
#18
REVIEW
Suneet Mittal
The field of arrhythmia monitoring is changing rapidly. The rapid advent of technology in combination with marked improvements in cellular communication and an increased desire by patients to be actively engaged in their care has ushered in a new era of clinical care. Today, physicians need to think about their patients outside the traditional in-office setting. Two technologies that embody this changing landscape are smartphone-based electrocardiographic (ECG) monitors and remote monitoring of cardiac implantable electronic devices (CIEDs)...
January 2017: Cardiology in Review
https://www.readbyqxmd.com/read/27922465/welcome-peter-zimetbaum-md
#19
EDITORIAL
William H Frishman
No abstract text is available yet for this article.
January 2017: Cardiology in Review
https://www.readbyqxmd.com/read/27922464/cardiology-in-review-the-first-25-years
#20
EDITORIAL
William H Frishman
No abstract text is available yet for this article.
January 2017: Cardiology in Review
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