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Cardiology in Review

William H Frishman
No abstract text is available yet for this article.
September 19, 2018: Cardiology in Review
Sara Paul, Karol Harshaw-Ellis
Objective, noninvasive, clinical assessment of patients with heart failure can be made using biomarker measurements, including natriuretic peptides, cardiac troponins, soluble suppression of tumorigenicity-2, and galectin-3. The aim of this review is to provide clinicians with guidance on the use of heart failure biomarkers in clinical practice. The authors provide a didactic narrative based on current literature, an exemplary case study, and their clinical experience.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4...
September 5, 2018: Cardiology in Review
Sahil Khera, Pedro A Villablanca, Dhaval Kolte, Tanush Gupta, Mohammed Hasan Khan, Poonam Velagapudi, Ankur Kalra, Neal Kleiman, Herbert D Aronow, J Dawn Abbott, Kenneth Rosenfield, Douglas E Drachman, Sripal Bangalore, Deepak L Bhatt, Srihari S Naidu
There are no dedicated data to guide drug eluting stent (DES) versus bare metal stent (BMS) selection in patients with end stage renal disease undergoing dialysis (ESRD-D). It is unclear whether long-term benefits of a specific stent-type outweigh risks in this population at high risk for both bleeding and ischemic events. We performed a meta-analysis of non-randomized studies extracted from PubMed, Scopus, and EMBASE; assessing the safety and effectiveness of DES versus BMS in ESRD-D patients. Odds ratios (OR) and 95% confidence intervals (CI) were computed with the Mantel-Haenszel method...
August 28, 2018: Cardiology in Review
Alexandra L Silverman, Alfred A Herzog, David I Silverman
Anxiety, depression and stress are exceedingly common in patients with cardiovascular disease (CVD). They increase the risk of cardiac events and are associated with much worse outcomes. A causal relationships exists between anxiety/depression and adverse cardiac events such as acute myocardial infarction and sudden cardiac death. Various treatments, including psychological therapies and pharmacotherapy, can used to treat patients with these disorders. This review discusses the epidemiology, pathogenesis and treatment options for patients with CVD who suffer from these conditions, and argues that they should be treated as concomitant risk factors for CVD...
August 20, 2018: Cardiology in Review
Katie Lee, Samantha Cham, Sum Lam
Venous thromboembolism (VTE) is a common and preventable cause of morbidity and mortality in hospitalized patients. Low molecular weight heparin, low dose unfractionated heparin, fondaparinux and warfarin have been the mainstay options for the prevention and treatment of VTE before the emergence of non-vitamin K antagonist oral anticoagulants (NOACs) such as dabigatran, rivaroxaban, apixaban and edoxaban. Despite the advantages of NOACs in improving patient adherence, none of them are approved for the prevention of VTE in acutely ill medical patients at high risk of thromboembolism...
July 31, 2018: Cardiology in Review
Raquel N Rozner, William H Frishman
Attempts to carry out clinical trials to improve the treatment of breast cancers, including chemotherapy and targeted oncologic therapies, often exclude women with baseline cardiovascular compromise, such as low ejection fraction or arrhythmia. Therefore, despite concrete evidence of cardiotoxicity from a select number of chemotherapeutic agents, it has been difficult to better characterize the progression of cardiac dysfunction in women with pre-existing cardiac conditions who receive chemotherapy. Women who have impaired cardiac function should be included in future clinical trials, or at least placed in separate trials with careful monitoring, to better assess this high-risk population...
July 26, 2018: Cardiology in Review
George Bazoukis, Gary Tse, Panagiotis Korantzopoulos, Tong Liu, Konstantinos P Letsas, Stavros Stavrakis, Katerina K Naka
Implantable cardioverter-defibrillators (ICDs) have a unique role in the primary and secondary prevention of sudden cardiac death. However, appropriate and inappropriate ICD interventions [anti-tachycardia pacing (ATP) or shocks] can result in deleterious effects. The aim of our study was to systematically review the existing data about the impact of ICD interventions on all-cause mortality in heart failure patients with reduced ejection fraction (HFrEF). We systematically searched MEDLINE (by using PubMed Web-based search engine) without any limits until 30 September 2017...
July 26, 2018: Cardiology in Review
Zaneta Smolenska, Rufus Barraclough, Karolina Dorniak, Arkadiusz Szarmach, Zbigniew Zdrojewski
The heart is one of the major organs commonly involved in systemic sclerosis. Myocardial fibrosis has been identified in a high percentage of these patients. Most systemic sclerosis patients with cardiac involvement are subclinical, especially early on in the course of their disease. To accurately identify cardiac involvement and improve diagnosis and treatment, imaging techniques should be implemented on a regular basis following diagnosis. In this review, we discuss the up-to-date pathophysiologic basis of cardiac involvement, the cardiac manifestations, and the diagnostic methods which have been published in the literature...
July 9, 2018: Cardiology in Review
Brian K W Yum, William H Frishman
Heart failure (HF) patients with either reduced ejection fraction or preserved ejection fraction experience a high mortality rate. The most recent pharmacologic advance for treating patients with HF with reduced ejection fraction has been with sacubitril/valsartan. Along with pharmaceutical research, there has been interest in device-based therapies as another treatment approach. One novel interventional device therapy that has shown promise in early tests and trials is the interatrial shunt device developed by Corvia Medical Inc...
September 2018: Cardiology in Review
Lowie M R Van Assche, Mark J Ricciardi
Functional mitral regurgitation (FMR) is common in patients with heart failure and portends a poor prognosis. The etiology is secondary to nonischemic or ischemic (postmyocardial infarction) adverse remodeling. Treatment includes guideline-directed medical therapy, cardiac resynchronization therapy, and in some cases, surgical repair or replacement. Transcatheter mitral valve (MV) repair with the MitraClip device is approved in patients with degenerative MR and is currently under investigation for use in FMR, as are several transcatheter MV replacement devices...
September 2018: Cardiology in Review
Tanveer Rab, Spencer B King
Percutaneous coronary intervention of the left main coronary artery has evolved through registries and meta analyses, supported by results from the EXCEL [Everolimus-Eluting Stents (EES) or Bypass Surgery for Left Main Coronary Artery Disease] and NOBLE (Percutaneous Coronary Angioplasty versus Coronary Artery Bypass Grafting in Treatment of Unprotected Left Main Stenosis) trials as an acceptable alternative to coronary artery bypass grafting in patients with low and intermediate Syntax scores. Advances in stenting strategies and the availability of larger diameter drug-eluting stents improve patient safety and optimize procedural and patient outcomes...
September 2018: Cardiology in Review
Gabriela Andries, Srikanth Yandrapalli, Srihari S Naidu, Julio A Panza
Hypertrophic cardiomyopathy (HCM) is an inherited disease characterized by unexplained left ventricular hypertrophy. Although it is estimated to affect 1 out of 500 people, the HCM gene carrier prevalence is much more common, probably as high as 1 in 200 people. Most affected individuals have a normal life expectancy, whereas some patients may develop sudden cardiac death or end-stage heart failure. Despite significant developments in the treatment of HCM with surgical, interventional, and device-based procedures, the main focus of current pharmacological therapy has not evolved from the basic objectives of relief of symptoms and improvement in functional capacity...
September 2018: Cardiology in Review
Shannon W Finks, Paul P Dobesh, Toby C Trujillo, George H Crossley
As direct oral anticoagulants (DOACs) have demonstrated favorable efficacy and safety outcomes compared with vitamin K antagonists for the treatment and prevention of venous thromboembolism and the prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation, their role in the management of anticoagulation during electrophysiological procedures continues to evolve. At present, guidelines are limited regarding specific recommendations for the use of DOACs in these clinical settings...
September 2018: Cardiology in Review
Deepak Acharya
Myocardial infarction (MI) complicated by cardiogenic shock (MI-CS) is a major cause of cardiovascular morbidity and mortality. Predictors of outcomes in MI-CS include clinical, laboratory, radiologic variables, and management strategies. This article reviews the existing literature on short- and long-term predictors and risk stratification in MI complicated by CS.
September 2018: Cardiology in Review
Syed Raza Shah, Richard Alweis
Acute coronary artery dissection is a rare, complex disease occurring particularly in young women without traditional cardiovascular risk factors. The pathophysiology and treatment are different from acute coronary syndrome caused by plaque rupture or erosion. Its clinical presentation may vary from unstable angina to sudden cardiac death. Hence, early detection is crucial to manage the dissection and reduce the mortality and morbidity rates. Most coronary dissections will heal spontaneously, and conservative treatment is recommended for uncomplicated cases...
September 2018: Cardiology in Review
(no author information available yet)
No abstract text is available yet for this article.
July 2018: Cardiology in Review
Jessica M Lewis-Gonzalez, James J Nawarskas
Much debate has centered on whether or not the standard 12-month duration of dual antiplatelet therapy (DAPT) is still necessary postpercutaneous coronary intervention, given recent improvements in stent technology. The benefits of shorter (3-6 months) durations of DAPT include a potential lower risk for bleeding and less patient drug cost and pill burden. Although randomized clinical trials have shown noninferiority for shorter versus longer DAPT regimens in many regards, some endpoints (e.g., myocardial infarction) may still occur less frequently with longer DAPT regimens, particularly in higher risk populations (e...
July 2018: Cardiology in Review
Mohammad Roostan, William H Frishman
Xenon is an inert, highly polarizable noble gas with demonstrated safety and application in general anesthesia for over 50 years. A potent inhibitor of the N-methyl-D-aspartate subtype of glutamate receptors, xenon has a well-documented ameliorating effect on excitotoxic neuronal injury in numerous cellular and animal models of hypoxic-ischemic brain injury. The most important determinant of overall survival and morbidity in out-of-hospital cardiac arrest is the severity of neurological injury. The only approved neuroprotective strategy in this setting is mild therapeutic hypothermia, which has demonstrated significant, albeit modest, improvements in mortality...
July 2018: Cardiology in Review
George Hines
No abstract text is available yet for this article.
July 2018: Cardiology in Review
Anna Koulava, Abdallah Sannani, Avi Levine, Chhaya Aggarwal Gupta, Sarina Khanal, William Frishman, Roxana Bodin, David C Wolf, Wilbert S Aronow, Gregg M Lanier
Portopulmonary hypertension (POPH) is seen in 5-8% of orthotopic liver transplantation (OLT) candidates and has significant implications for clinical outcomes. POPH is characterized by vasoconstriction and remodeling of the pulmonary vasculature. It is exacerbated by the hyperdynamic circulation that is common in advanced liver disease. Screening all OLT candidates with transthoracic echocardiography to assess pulmonary pressures and right ventricular function is crucial, as clinical symptoms alone are not reliable...
July 2018: Cardiology in Review
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