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Current Treatment Options in Cardiovascular Medicine

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https://www.readbyqxmd.com/read/28624885/cardiac-rehabilitation-following-acute-coronary-syndrome-in-women
#1
REVIEW
Amanda L Bennett, Carl J Lavie, Sherry L Grace
Acute coronary syndrome (ACS) is among the leading burdens of disease among women. It is a significant driver of morbidity and chronically undermines their quality of life. Cardiac rehabilitation (CR) is indicated for ACS patients in clinical practice guidelines, including those specifically for women. CR is a multi-component model of care, proven to reduce mortality and morbidity, including in women. However, women are significantly less likely to be referred to CR by providers, and if they are referred, to enroll and adhere to programs...
August 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28620783/advanced-neuroimaging-of-cerebral-small-vessel-disease
#2
REVIEW
Gordon W Blair, Maria Valdez Hernandez, Michael J Thrippleton, Fergus N Doubal, Joanna M Wardlaw
Cerebral small vessel disease (SVD) is characterised by damage to deep grey and white matter structures of the brain and is responsible for a diverse range of clinical problems that include stroke and dementia. In this review, we describe advances in neuroimaging published since January 2015, mainly with magnetic resonance imaging (MRI), that, in general, are improving quantification, observation and investigation of SVD focussing on three areas: quantifying the total SVD burden, imaging brain microstructural integrity and imaging vascular malfunction...
July 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28567565/promoting-limb-salvage-through-multi-disciplinary-care-of-the-diabetic-patient
#3
REVIEW
Nichol L Salvo, Mark D Walsh, Luke P Brewster
Despite an explosion in the number of options available for helping diabetic patients heal wounds, major amputation remains a critical issue for these persons. Since diabetes prematurely ages tissues and no organ system is immune to its presence, it makes inherent sense that multi-disciplinary team approaches to these patients is necessary to make significant strides forward. Here, we present literature from the fields of podiatric surgery/medicine, vascular and plastic surgery and introduce the successes that a multi-disciplinary limb salvage center can have on the lives and limbs of patients with diabetes...
July 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28560534/exercise-testing-and-stress-imaging-in-aortic-valve-disease
#4
REVIEW
Luc A Pierard, Raluca Dulgheru
Aortic valve disease and especially aortic stenosis (AS) is a growing cardiac pathology. Aortic valve replacement (AVR) is still the only treatment with proven benefit on survival in symptomatic patients and in patients with a left ventricular ejection fraction (LVEF) <50%. The benefit of prophylactic AVR in asymptomatic patients is still unproven. Once symptoms develop, the prognosis worsens. Exercise testing has emerged as a tool to unmask the "pseudo-asymptomatic" patients with AS (those without self-reporting symptoms), to link "exercise induced dyspnea" more confidently and more objectively to aortic valve disease and to allow for a safe "watchful waiting strategy" in "pseudo-symptomatic" patients (those with dyspnea unrelated to aortic valve disease)...
July 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28547673/valvular-heart-disease-in-cancer-patients-etiology-diagnosis-and-management
#5
REVIEW
Merrill H Stewart, Eiman Jahangir, Nichole M Polin
Cardiac valvular disease as consequence of radiation and chemotherapy during treatment for malignancy is growing in its awareness. While the overwhelming emphasis in this population has been on the monitoring and preservation of left ventricular systolic function, we are now developing a greater appreciation for the plethora of cardiac sequelae beyond this basic model. To this end many institutions across the country have developed cardio-oncology programs, which are collaborative practices between oncologists and cardiologists in order to minimize a patient's cardiovascular risk while allowing them to receive the necessary treatment for their cancer...
July 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28536893/neurologic-recovery-after-cardiac-arrest-a-multifaceted-puzzle-requiring-comprehensive-coordinated-care
#6
REVIEW
Carolina B Maciel, Mary M Barden, David M Greer
Surviving cardiac arrest (CA) requires a longitudinal approach with multiple levels of responsibility, including fostering a culture of action by increasing public awareness and training, optimization of resuscitation measures including frequent updates of guidelines and their timely implementation into practice, and optimization of post-CA care. This clearly goes beyond resuscitation and targeted temperature management. Brain-directed physiologic goals should dictate the post-CA management, as accumulating evidence suggests that the degree of hypoxic brain injury is the main determinant of survival, regardless of the etiology of arrest...
July 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28523441/progress-in-the-presence-of-failure-updates-in-chronic-systolic-heart-failure-management
#7
REVIEW
Katie M Murphy, Julie L Rosenthal
The therapeutic heart failure armamentarium has evolved from drugs to transplantation to devices through further understanding of its complex pathophysiology and pathogenesis. Current medications capitalize on our evolving understanding of the sympathetic and renin-angiotensin-aldosterone systems that subsequently promote both beneficial and maladaptive responses that ultimately yield a decrease in cardiac function. Despite these advancements, the prevalence of heart failure continues to rise and carries a significant burden on our patients and health care system...
July 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28523440/assessing-and-modifying-coronary-artery-disease-risk-in-women
#8
REVIEW
Amy Sarma, Nandita S Scott
Despite continued advances in the field, cardiovascular disease remains the leading cause of death in women in the USA with an annual mortality rate that has remained higher for women as compared to men. The factors leading to this sex difference remain incompletely understood. Likely contributors include atypical symptoms at presentation and lack of recognition of cardiovascular risk by women and their providers alike. In addition, women have a higher burden of comorbidities at the time of disease diagnosis and can have differential pathophysiological mechanisms of their acute events...
July 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28516275/the-role-of-cardiac-biomarkers-in-pregnancy
#9
REVIEW
Emily S Lau, Amy Sarma
Cardiovascular disease (CVD) is the leading cause of pregnancy-associated mortality, with an increasingly complex pregnant population. While our understanding of CVD in pregnancy continues to evolve, there remains a need to develop widely accessible tools to follow pregnant women both with and without preexisting disease with respect to cardiovascular risk, particularly for those presenting with symptoms suggestive of cardiovascular pathology. Thus, research is emerging with respect to the potential role of novel and established cardiac biomarkers in diagnosing and following CVD in pregnancy...
July 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28508119/lipoprotein-a-a-lipoprotein-whose-time-has-come
#10
REVIEW
Erik Kelly, Linda Hemphill
Cardiovascular disease is a leading cause of morbidity and mortality in the USA and around the world. While we are now able to achieve significant low-density lipoprotein cholesterol (LDL-C) lowering with current therapies, many patients remain at risk for cardiovascular disease (CVD). Elevated lipoprotein(a) [Lp(a)] has been shown to be an independent risk factor for CVD and accounts for some of the residual CVD risk after LDL-C lowering in several large clinical trials. Moreover, there is now strong evidence supporting the causal relationship between Lp(a) and aortic stenosis as well as peripheral arterial disease...
July 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28474324/role-of-imaging-in-cardio-oncology
#11
REVIEW
Erick Avelar, Caitlin R Strickland, Guido Rosito
Recent advances in cancer treatment and research have greatly improved survival rates for patients with cancer. However, many of these cancer survivors are developing cardiac disease-most commonly heart failure as a result of this treatment. Certain chemotherapeutic agents, including anthracyclines and trastuzumab, have been linked to cardiotoxicity-induced cardiomyopathy in cancer patients. It has been reported as early as during infusion and as late as several years following treatment. Radiation therapy, particularly to the left breast, has also been linked to cardiac disease...
June 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28474323/update-on-treatment-in-cardiac-sarcoidosis
#12
REVIEW
Laura Young, Brett W Sperry, Rory Hachamovitch
The prevalence of cardiac sarcoidosis has exponentially increased over the past decade, primarily due to increased awareness and diagnostic modalities for the disease entity. Despite an expanding patient cohort, the optimal management of cardiac sarcoidosis remains yet to be established with a significant lack of prospective trials to support current practice. Corticosteroids remain first-line treatment of this disorder, and we recommend that immunosuppressive therapy should be initiated in all patients diagnosed with cardiac sarcoidosis...
June 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28470367/venous-compression-syndromes-a-review
#13
REVIEW
Sunil Iyer, John F Angle, Andre Uflacker, Aditya M Sharma
Venous compression syndromes present a diagnostic and therapeutic challenge as the clinical presentation can be vague, diagnostic criteria are often not present, and high quality standardization of when and how to treat is not available in part due to the limited number of cases reported and also due to the limited literature available. Significant venous compression should be considered when clinical symptoms correlate to location of compression and there is evidence of hemodynamic changes including venous hypertension, collateral/variceal formation, and/or thrombus formation...
June 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28466121/cardiovascular-disease-prevention-the-role-of-policy-interventions
#14
REVIEW
Andrew Oseran, Jason H Wasfy
Health outcomes in cardiovascular disease in the USA have generally been improving over the past several decades. Those gains have been related to both developments in prevention and treatment of cardiovascular disease. To further enhance improvement in health outcomes, including cardiovascular outcomes, health policies have been implemented to incentivize prevention. These policies have strong conceptual appeal and have been associated with improvements in some health metrics. However, robust research methods, accounting for bias and statistical confounding, are critical to confirm that these policies are associated with prevention of cardiovascular events for patients over time...
June 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28466120/pulmonary-hypertension-and-cancer-etiology-diagnosis-and-management
#15
REVIEW
Fatima A Ballout, Ahmad S Manshad, Tochukwu M Okwuosa
Pulmonary hypertension is caused by cancer and its therapeutic agents including chemotherapy, radiotherapy, and even the targeted therapies. Ironically, some of the cancer therapies that cause one type of pulmonary hypertension (PH) could potentially be employed in the treatment of another PH type. Greater awareness on the role of cancer therapeutic agents in causing PH is required. Conversely, since PH is mostly incurable, the potential role of some of these cancer therapeutic agents in the cure of PH should be recognized...
June 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28466119/critical-care-management-of-acute-ischemic-stroke
#16
REVIEW
Matthew B Bevers, W Taylor Kimberly
Ischemic stroke accounts for approximately 85% of all strokes. Although severe strokes constitute a minority of cases, they are associated with a majority of the subsequent disability and death. Reperfusion therapy with intravenous tissue plasminogen activator (tPA) and/or endovascular thrombectomy is a mainstay of acute stroke management. Intensive care management of stroke is focused on reducing complications of reperfusion, such as hemorrhagic transformation, and minimizing secondary brain injury, including brain edema and progressive stroke...
June 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28466118/who-should-be-referred-for-left-atrial-appendage-occlusion-therapy
#17
REVIEW
Sidakpal S Panaich, David R Holmes
Atrial fibrillation (AF) is the most common cardiac arrhythmia affecting approximately 7 million individuals in USA. It is one of the most significant arrhythmias, which accounts for a majority of embolic strokes, especially in elderly individuals. Although oral anti-coagulation is beneficial in lowering the risk of stroke, 1 in 10 patients have a contra-indication to warfarin therapy. Among patients who do tolerate either warfarin or novel oral anticoagulant (NOAC), major or recurrent bleeding, intracranial bleeds, etc...
June 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28466117/invasive-hemodynamic-assessment-of-patients-with-heart-failure-and-pulmonary-hypertension
#18
REVIEW
Rupa K Patil, Parag Goyal, Rajesh V Swaminathan, Luke K Kim, Dmitriy N Feldman
Right heart catheterization (RHC) with a pulmonary artery (PA) catheter is a minimally invasive method of obtaining hemodynamic data (e.g., right atrial and pulmonary pressures, cardiac output, pulmonary vascular resistance), which are used to diagnose and manage patients with advanced heart failure (HF), HF with preserved ejection fraction, and pulmonary hypertension (PH). Invasive hemodynamic data obtained from RHC can aid in the prognostication of HF and PH patients and are important in guiding decisions of implanting mechanical circulatory support devices and listing patients for heart and/or lung transplantation...
June 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28455809/renal-denervation-therapy-for-drug-resistant-hypertension-does-it-still-work
#19
REVIEW
Venkatesh K Raman, Costas Tsioufis, Michael Doumas, Vasilios Papademetriou
Hypertension is a global public health problem affecting one-fourth of the world's population. A subset of these patients with resistant hypertension presents a particular management problem and suffers a marked increase in cardiovascular risk. Treatment options have been limited, but the past decade has witnessed the emergence of catheter-based renal denervation to interrupt the sympathetic nervous system, long considered to play an important role in the development and maintenance of hypertension. Phase 1 and 2 studies reported remarkable reductions in blood pressure and sparked an excessive exuberance that ground to a halt with negative results of the SYMPLICITY HTN-3 pivotal trial...
May 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28447320/should-ablation-be-first-line-therapy-for-patients-with-paroxysmal-af
#20
REVIEW
Sergio Conti, Atul Verma
Atrial fibrillation is the most common cardiac arrhythmia and the number of patients is expected to continuously increase in the next years. Catheter ablation is an effective, safe, and well-established treatment for patient with symptomatic and drug-resistant paroxysmal atrial fibrillation (PAF). Over the last decade, there was an increasing body of evidence demonstrating superiority of catheter ablation over antiarrhythmic drugs (AADs) in maintaining sinus rhythm. However, randomized clinical trials have not been conclusive to consider catheter ablation as a first-line therapy for PAF...
May 2017: Current Treatment Options in Cardiovascular Medicine
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