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Cardiology in Review

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https://www.readbyqxmd.com/read/29994849/cardiac-involvement-in-systemic-sclerosis-diagnostic-tools-and-evaluation-methods
#1
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
https://www.readbyqxmd.com/read/29939849/functional-mitral-regurgitation-an-interventional-cardiologist-s-perspective
#2
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 non-ischemic or ischemic (post myocardial infarction) adverse remodeling. Treatment includes guideline-directed medical therapy, cardiac resynchronization therapy, and in some cases, surgical repair or replacement. Transcatheter mitral valve 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 mitral valve repair devices...
June 22, 2018: Cardiology in Review
https://www.readbyqxmd.com/read/29939848/bempedoic-acid-etc-1002-atp-citrate-lyase-inhibitor-review-of-a-first-in-class-medication-with-potential-benefit-in-statin-refractory-cases
#3
Nicole K Zagelbaum, Srikanth Yandrapalli, Christopher Nabors, William H Frishman
Bempedoic acid (ETC-1002) is a new agent that reduces cholesterol synthesis through inhibition of adenosine triphosphate citrate lyase (ACL), an enzyme upstream from 3-hydroxy-3-methylglutaryl-coenzyme (HMG-CoA). In animal models, bempedoic acid also influences fatty acid synthesis but in humans its role is limited primarily to lowering low-density lipoprotein cholesterol (LDL-C). In early clinical trials, bempedoic acid has been well tolerated and without major side effects. Alone or in various combinations with Atorvastatin and/or Ezetimibe, LDL-C lowering has ranged from 17% to 64%...
June 22, 2018: Cardiology in Review
https://www.readbyqxmd.com/read/29912044/cardiac-immune-related-adverse-events-in-immune-checkpoint-inhibition-therapy
#4
Aaron D Brumbaugh, Roshni Narurkar, Kaushal Parikh, Michael Fanucchi, William H Frishman
Immune checkpoint inhibitors present clinicians with both an exciting step forward in cancer treatment and the unknown possibilities of an unshackled immune system. The latter phenomena, known as immune-related adverse events (irAEs), are of particular interest because they may affect any organ system with autoimmune-like pathologies, such as hepatitis and colitis. Within the cardiovascular system, irAEs associated with immune checkpoint blockade exist as a broad clinical spectrum, with autoimmune myocarditis being the best-characterized entity at this time...
June 14, 2018: Cardiology in Review
https://www.readbyqxmd.com/read/29870421/obesity-in-kidney-transplantation-impact-on-transplant-candidates-recipients-and-donors
#5
Daniel Glicklich, M Raza Mustafa
Obesity is now common among children and adults who are kidney transplant candidates and recipients. It is associated with an increased risk of cardiovascular disease and kidney failure. This also pertains to potential living kidney donors with obesity. Obese patients with endstage renal disease benefit from transplantation as do non-obese patients, but obesity is also associated with more risk. A complicating factor is that obesity is also associated with increased survival on maintenance dialysis in adults, but not in children...
June 4, 2018: Cardiology in Review
https://www.readbyqxmd.com/read/29794808/acromegalic-cardiomyopathy-an-overview-of-risk-factors-clinical-manifestations-and-therapeutic-options
#6
Michael D Goldberg, Natasha Vadera, Srikanth Yandrapalli, William H Frishman
Acromegaly is a rare endocrine disorder that carries a significant burden of cardiovascular morbidity and mortality. Abnormalities of the growth hormone/insulin-like growth factor-1 axis in acromegaly lead to the characteristic CV manifestations of this disease. One hallmark feature of the disease is acromegalic cardiomyopathy, a syndrome of progressive cardiac dysfunction characterized by left ventricular hypertrophy, diastolic dysfunction, and combined systolic and diastolic dysfunction in the very advanced stage...
May 23, 2018: Cardiology in Review
https://www.readbyqxmd.com/read/29794807/left-main-disease-what-is-the-correct-approach-to-revascularization
#7
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 Everolimus-Eluting Stents(EES) or Bypass Surgery for Left Main Coronary Artery Disease (EXCEL) and Percutaneous Coronary Angioplasty versus Coronary Artery Bypass Grafting in Treatment of Unprotected Left Main Stenosis (NOBLE) 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 improves patient safety and optimizes procedural and patient outcomes...
May 23, 2018: Cardiology in Review
https://www.readbyqxmd.com/read/29746258/gi-bleeding-during-cf-lvad-support-state-of-the-field
#8
Rachna Kataria, Ulrich P Jorde
Continuous-flow left ventricular assist devices (CF-LVADs) are increasingly used for the management of advanced heart failure refractory to optimal medical therapy. Despite the encouraging outcomes with CF-LVADs, gastrointestinal bleeding (GIB) continues to be a rather concerning complication resulting in increased rates of readmission and increased morbidity. The exact pathophysiology of CF-LVAD associated GIB remains poorly understood and this lack of knowledge limits our ability to control this morbid complication...
May 9, 2018: Cardiology in Review
https://www.readbyqxmd.com/read/29746257/novel-pharmacotherapy-in-hypertrophic-cardiomyopathy
#9
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, while 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...
May 9, 2018: Cardiology in Review
https://www.readbyqxmd.com/read/29734198/exercise-for-preventing-hospitalization-and-readmission-in-adults-with-congestive-heart-failure
#10
Wilbert S Aronow, Tatyana A Shamliyan
We critically appraised all available evidence regarding exercise interventions for improving patient survival and reducing hospital admissions in adults with chronic heart failure (HF). We searched 4 databases up to April 2018 and graded the quality of evidence according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group approach. We reviewed 7 meta-analyses and the publications of 48 randomized, controlled trials (RCT). In HF with reduced ejection fraction, low-quality evidence suggests that exercise prevents all-cause hospitalizations (RR 0...
May 4, 2018: Cardiology in Review
https://www.readbyqxmd.com/read/29864088/a-nonsurgical-approach-to-mesenteric-vascular-disease-erratum
#11
(no author information available yet)
No abstract text is available yet for this article.
July 2018: Cardiology in Review
https://www.readbyqxmd.com/read/29734199/are-shorter-durations-of-dual-antiplatelet-therapy-acceptable-following-percutaneous-coronary-intervention
#12
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
https://www.readbyqxmd.com/read/29608502/xenon-an-emerging-neuroprotectant-with-potential-application-for-cardiac-arrest-care
#13
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
https://www.readbyqxmd.com/read/29608500/frank-cole-spencer-md-surgeon-innovator-and-educator
#14
EDITORIAL
George Hines
No abstract text is available yet for this article.
July 2018: Cardiology in Review
https://www.readbyqxmd.com/read/29608499/diagnosis-treatment-and-management-of-orthotopic-liver-transplant-candidates-with-portopulmonary-hypertension
#15
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
https://www.readbyqxmd.com/read/29608497/his-bundle-pacing-hemodynamics-and-clinical-outcomes
#16
Brijesh Patel, Jalaj Garg, Rahul Chaudhary, Naveen Sablani, Rahul Gupta, Mahek Shah, Talha Nazir, Babak Bozorgnia, Andrea Natale
From 1993 to 2009, nearly 2.9 million pacemakers were implanted in the United States; the majority of which were dual-chamber pacemakers. One of the major physiologic advantages of dual-chamber pacing over single-chamber ventricular pacing is atrioventricular synchrony, which prevents the pacemaker syndrome. However, patients who are pacemaker dependent or use right ventricle (RV) apical pacing more than 40% of the time are at a risk of developing heart failure from electromechanical dyssynchrony. Studies have also shown that RV pacing results in nonphysiological activation of the left ventricle, leading to adverse clinical outcomes...
July 2018: Cardiology in Review
https://www.readbyqxmd.com/read/29608496/antithrombotic-management-of-patients-with-prosthetic-heart-valves
#17
Abdallah Sanaani, Srikanth Yandrapalli, Joseph M Harburger
Valvular heart disease is a major public health issue. The prevalence of valvular heart disease is expected to increase due to an aging population. Valve dysfunction manifests as valve stenosis, regurgitation, or both due to various etiologies. Valve repair and replacement are the main treatment options for severe valve dysfunction. Valve replacement is achieved by using either a mechanical or a bioprosthetic valve. Mechanical valves are more durable but require lifelong anticoagulation with associated complications...
July 2018: Cardiology in Review
https://www.readbyqxmd.com/read/29608495/medical-management-of-rheumatic-heart-disease-a-systematic-review-of-the-evidence
#18
E Anne Russell, Warren F Walsh, Ben Costello, Alex J A McLellan, Alex Brown, Christopher M Reid, Lavinia Tran, Graeme P Maguire
Rheumatic heart disease (RHD) is an important cause of heart disease globally. Its management can encompass medical and procedural (catheter and surgical) interventions. Literature pertaining to the medical management of RHD from PubMed 1990-2016 and via selected article reference lists was reviewed. Areas included symptom management, left ventricular dysfunction, rate control in mitral stenosis, atrial fibrillation, anticoagulation, infective endocarditis prophylaxis, and management in pregnancy. Diuretics, angiotensin blockade and beta-blockers for left ventricular dysfunction, and beta-blockers and If inhibitors for rate control in mitral stenosis reduced symptoms and improved left ventricular function, but did not alter disease progression...
July 2018: Cardiology in Review
https://www.readbyqxmd.com/read/29369824/was-the-enalapril-dose-too-low-in-the-paradigm-hf-trial
#19
Sabrina Bernardez-Pereira, Felix José Alvares Ramires, Rachel Figueiredo Tavares de Melo, Antonio Carlos Pereira-Barretto
Heart failure (HF) is a common clinical syndrome associated with significant morbidity and mortality, and there remains a clear need for innovative therapies that can modify disease progression. Sacubitril/valsartan (LCZ696) is a novel complex that combines simultaneous neprilysin inhibition and angiotensin II receptor blockade, that has demonstrated significant cardiovascular death or HF hospitalization reduction in the Prospective Comparison of Angiotensin Receptor/Neprilysin Inhibitor (ARNI) With Angiotensin-Converting Enzyme (ACE) Inhibitors to Determine Impact on Global Mortality and Morbidity in Heart Failure (PARADIGM-HF) trial when compared with evidence-based doses of the gold standard ACE inhibitor enalapril...
July 2018: Cardiology in Review
https://www.readbyqxmd.com/read/29621050/sudden-cardiac-death-in-hypertrophic-cardiomyopathy
#20
Daria M Adamczak, Zofia Oko-Sarnowska
Hypertrophic cardiomyopathy (HCM) is a heart disease characterized by hypertrophy of the left ventricular myocardium and is most often caused by mutations in sarcomere genes. The structural and functional abnormalities are not explained by flow-limiting coronary artery disease or loading conditions. The disease affects at least 0.2% of the population worldwide and is the most common cause of sudden cardiac death in young people and competitive athletes because of fatal ventricular arrhythmia. In some patients, however, HCM has a benign course...
May 2018: Cardiology in Review
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