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Current Cardiology Reports

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https://www.readbyqxmd.com/read/27864787/glycaemic-effects-of-non-statin-lipid-lowering-therapies
#1
REVIEW
Patrick D Collins, Naveed Sattar
Since the publication of the JUPITER trial, attention has been focused on the adverse glycemic effects of statin therapy. Although the modest increase in the risk of new diabetes mellitus is outweighed by the reduction in cardiovascular events for statins, emerging biochemical and genetic links between lipid metabolism and glycemic control raise the prospect of a broader diabetogenic effect of lipid-lowering therapies. For the novel and powerful PCSK9-inhibitor class available evidence does not support a major glycaemic effect with the results of large scale trials awaited although preliminary genetic data does suggest a link...
December 2016: Current Cardiology Reports
https://www.readbyqxmd.com/read/27837385/roads-maps-and-destinations-the-journey-of-left-ventricular-assist-device-implantation-in-ambulatory-patients-with-advanced-heart-failure
#2
REVIEW
Barry H Trachtenberg, Jerry D Estep
PURPOSE OF REVIEW: The benefit of left ventricular assist devices in patients dependent on inotropes or temporary mechanical support is clear. There is a large population of advanced heart failure patients who are ambulatory and not dependent on inotropes, but in whom mortality remains high. We review the limited evidence regarding the benefits and risks of LVADs in this population. RECENT FINDINGS: The REVIVE-IT trial, which aimed to study the use of LVADs in patients who are less sick and do not meet current FDA-indications, was suspended due to lack of equipoise in the setting of a spike in pump thromboses...
December 2016: Current Cardiology Reports
https://www.readbyqxmd.com/read/27837384/hypertension-in-pregnancy-defining-blood-pressure-goals-and-the-value-of-biomarkers-for-preeclampsia
#3
REVIEW
Pitchaphon Nissaisorakarn, Sairah Sharif, Belinda Jim
Hypertensive disorders in pregnancy have been the cause of much clinical dilemma, affecting up to 10 % of all pregnancies. The precise blood pressure to achieve in a pregnant woman is usually a battle between minimizing end organ damage to the mother and providing adequate perfusion to the placenta and the fetus. This predicament is becoming more, not less, frequent as maternal ages increase in high resource nations. Biomarkers to predict preeclampsia, a subcategory of hypertension in pregnancy, have always been elusive...
December 2016: Current Cardiology Reports
https://www.readbyqxmd.com/read/27826901/use-of-mobile-health-technology-in-the-prevention-and-management-of-diabetes-mellitus
#4
REVIEW
Jacob Hartz, Leah Yingling, Tiffany M Powell-Wiley
Cardiovascular disease is the leading cause of morbidity and mortality globally, with diabetes being an independent risk factor. Adequate diabetes management has proven to be resource-intensive, requiring frequent lab work, primary care and specialist visits, and time-consuming record-keeping by the patient and care team. New mobile health (mHealth) technologies have enhanced how diabetes is managed and care is delivered. While more recent work has investigated mHealth devices as complementary tools in behavioral interventions for diabetes prevention and management, little is still known about the effectiveness of mHealth technology as stand-alone intervention tools for reducing diabetes risk...
December 2016: Current Cardiology Reports
https://www.readbyqxmd.com/read/27796866/percutaneous-mitral-valve-repair-with-mitraclip-patient-and-valve-selection-for-optimal-outcome
#5
REVIEW
Devdas T Inderbitzin, Maurizio Taramasso, Fabian Nietlispach, Francesco Maisano
In the real world of mitral regurgitation, the patient selection process for MitraClip (Abbott, Abbott Park, IL, USA) to achieve optimal outcome has become a challenge. With the opening of the Endovascular Valve Edge-to-Edge Repair Study criteria, the implant experience was extended towards functional mitral regurgitation and anatomically more complex mitral pathologies in many centers worldwide. We provide a review of the current literature to identify an appropriate patient selection process for MitraClip therapy and suggest a simple two-dimensional decision-making algorithm...
December 2016: Current Cardiology Reports
https://www.readbyqxmd.com/read/27796865/hypertension-in-patients-with-heart-failure-with-reduced-ejection-fraction
#6
REVIEW
Massimo Volpe, Caterina Santolamazza, Giuliano Tocci
Hypertension (HTN) is a well-known health problem associated with considerable morbidity and mortality and it is an important risk factor for the development of heart failure (HF). These findings support the need for optimizing the antihypertensive strategies to prevent the progression to HF. Interestingly, the progression from HTN to HF, among other things, may be a consequence of inappropriate over-activation of the renin-angiotensin-aldosterone system (RAAS), sympathetic nervous system (SNS), and the natriuretic peptide system (NPS)...
December 2016: Current Cardiology Reports
https://www.readbyqxmd.com/read/27796864/functional-mitral-regurgitation-appraising-the-evidence-behind-recommended-treatment-strategies
#7
REVIEW
Zainab Samad, Eric J Velazquez
Functional mitral regurgitation (MR) is the most common type of MR encountered in clinical practice. Because the disease arises from the ventricular aspect of the mitral valve apparatus, treatment therapies are less defined and outcomes are poor. In this review, the state of evidence for medical and surgical therapy in functional MR is appraised. Future directions for research in this area are also defined.
December 2016: Current Cardiology Reports
https://www.readbyqxmd.com/read/27796863/nutritional-supplements-for-the-treatment-of-hypertension-a-practical-guide-for-clinicians
#8
REVIEW
Jeffrey M Turner, Erica S Spatz
Nutraceuticals are dietary components with pharmacologic properties that can be used to treat various disease states. There is growing interest among patients in the use of nutraceuticals for the management of hypertension; as such, it is important that clinicians are prepared to engage in meaningful discussions with their patients about these substances. Flavonoids, beetroot, garlic, and unsaturated fats have garnered significant attention for their blood pressure lowering properties. We review the clinical evidence and reported mechanisms of action for these substances in an attempt to offer a practical guide for clinicians to engage with patients who are highly motivated to seek out nutraceutical therapies to manage their hypertension...
December 2016: Current Cardiology Reports
https://www.readbyqxmd.com/read/27796862/evaluation-and-treatment-of-hypertension-in-end-stage-renal-disease-patients-on-hemodialysis
#9
REVIEW
Peter Noel Van Buren
Hypertension is one of the most common cardiovascular comorbidities in end-stage renal disease patients on hemodialysis. Its complex pathophysiology is related to extracellular volume overload, increased vascular resistance stemming from factors related to uremia or abnormal signaling from the failing kidneys, as well as the unique blood pressure changes that take place during and between hemodialysis treatments. Despite the changing nature of blood pressure over time in hemodialysis patients, hypertension diagnosed in or out of the hemodialysis unit is associated with increased cardiovascular morbidity and mortality...
December 2016: Current Cardiology Reports
https://www.readbyqxmd.com/read/27796861/recent-advances-in-leukoaraiosis-white-matter-structural-integrity-and-functional-outcomes-after-acute-ischemic-stroke
#10
REVIEW
Mark R Etherton, Ona Wu, Natalia S Rost
Leukoaraiosis, a radiographic marker of cerebral small vessel disease detected on T2-weighted brain magnetic resonance imaging (MRI) as white matter hyperintensity (WMH), is a key contributor to the risk and severity of acute cerebral ischemia. Prior investigations have emphasized the pathophysiology of WMH development and progression; however, more recently, an association between WMH burden and functional outcomes after stroke has emerged. There is growing evidence that WMH represents macroscopic injury to the white matter and that the extent of WMH burden on MRI influences functional recovery in multiple domains following acute ischemic stroke (AIS)...
December 2016: Current Cardiology Reports
https://www.readbyqxmd.com/read/27796860/genetic-risk-factors-for-ischemic-and-hemorrhagic-stroke
#11
REVIEW
Ganesh Chauhan, Stéphanie Debette
Understanding the genetic risk factors for stroke is an essential step to decipher the underlying mechanisms, facilitate the identification of novel therapeutic targets, and optimize the design of prevention strategies. A very small proportion of strokes are attributable to monogenic conditions, the vast majority being multifactorial, with multiple genetic and environmental risk factors of small effect size. Genome-wide association studies and large international consortia have been instrumental in finding genetic risk factors for stroke...
December 2016: Current Cardiology Reports
https://www.readbyqxmd.com/read/27796859/anxiety-and-cardiovascular-disease-risk-a-review
#12
REVIEW
Phillip J Tully, Nathan J Harrison, Peter Cheung, Suzanne Cosh
Unrecognized anxiety is a difficult clinical presentation in cardiology. Anxiety leads to recurring emergency department visits and the need for numerous diagnostic evaluations to rule out cardiovascular disease (CVD). This review focuses broadly on anxiety and its subtypes in relation to the onset and progression of CVD while describing helpful guidelines to better identify and treat anxiety. Potential mechanisms of cardiopathogenesis are also described. An emerging literature demonstrates that anxiety disorders increase the risk for incident CVD but a causal relationship has not been demonstrated...
December 2016: Current Cardiology Reports
https://www.readbyqxmd.com/read/27796858/how-to-develop-and-implement-a-specialized-heart-failure-with-preserved-ejection-fraction-clinical-program
#13
REVIEW
Sanjiv J Shah, Rebecca Cogswell, John J Ryan, Kavita Sharma
Heart failure with preserved ejection fraction (HFpEF), a highly prevalent and complex clinical syndrome with high morbidity and mortality, is often unrecognized and not optimally treated. Clinical trials for HFpEF have been plagued by low enrollment, and clinicians often approach HFpEF patients with "therapeutic nihilism" given the perceived lack of available therapies based on the disappointing results of these prior trials. Due to these challenges, we have pioneered the successful creation of dedicated, specialized HFpEF clinical programs...
December 2016: Current Cardiology Reports
https://www.readbyqxmd.com/read/27796857/turning-failure-into-success-trials-of-the-heart-failure-clinical-research-network
#14
REVIEW
Emer Joyce, Michael M Givertz
The Heart Failure Clinical Research Network (HFN) was established in 2008 on behalf of the NIH National Heart, Lung and Blood Institute, with the primary goal of improving outcomes in heart failure (HF) by designing and conducting high-quality concurrent clinical trials testing interventions across the spectrum of HF. Completed HFN trials have answered several important and relevant clinical questions concerning the safety and efficacy of different decongestive and adjunctive vasodilator therapies in hospitalized acute HF, phosphodiesterase-5 inhibition and nitrate therapies in HF with preserved ejection fraction, and the role of xanthine oxidase inhibition in hyperuricemic HF...
December 2016: Current Cardiology Reports
https://www.readbyqxmd.com/read/27796856/psychological-aspects-of-heart-failure
#15
REVIEW
Debra K Moser, Cynthia Arslanian-Engoren, Martha J Biddle, Misook Lee Chung, Rebecca L Dekker, Muna H Hammash, Gia Mudd-Martin, Abdullah S Alhurani, Terry A Lennie
Psychological conditions such as depression can have a greater impact on morbidity and mortality outcomes than traditional risk factors for these outcomes. Despite their importance, it is rare for clinicians to assess patients for these conditions and rarer still for them to consistently and adequately manage them. Illumination of the phenomena of comorbid psychological conditions in heart failure may increase awareness of the problem, resulting in improved assessment and management.
December 2016: Current Cardiology Reports
https://www.readbyqxmd.com/read/27796855/mental-stress-and-ventricular-arrhythmias
#16
REVIEW
Rachel Lampert
Anger and other negative emotions can precipitate sudden death, as shown in studies of population stressors. Clinical studies of patients with implantable defibrillators demonstrate that anger can trigger ventricular arrhythmias. Long-term negative emotions also increase vulnerability to arrhythmias. Mechanisms linking anger and arrhythmias include autonomic changes, which alter repolarization, possibly enhanced in patients with sympathetic denervation, which in turn trigger potentially lethal polymorphic ventricular tachycardias...
December 2016: Current Cardiology Reports
https://www.readbyqxmd.com/read/27796854/the-effect-of-vigorous-versus-moderate-intensity-aerobic-exercise-on-insulin-action
#17
REVIEW
Robert W McGarrah, Cris A Slentz, William E Kraus
Due to the beneficial effects on a wide range of modern medical conditions, most professional societies recommend regular aerobic exercise as part of a healthy lifestyle. Many of the exercise-related health benefits exhibit a dose-response relationship: Up to a point, more exercise is more beneficial. However, recent studies have suggested that different exercise intensities may provide distinct health benefits, independent of energy expenditure (i.e., exercise dose). One of these benefits, primarily mediated by the skeletal muscle, is exercise-related changes in insulin action and glucose homeostasis...
December 2016: Current Cardiology Reports
https://www.readbyqxmd.com/read/27761786/post-pericardiotomy-syndrome
#18
Balaji K Tamarappoo, Allan L Klein
Post-pericardiotomy syndrome (PPS) occurs in a subgroup of patients who have undergone cardiothoracic surgery and is characterized by fever, pleuritic pain, pleural effusion, and pericardial effusion. It is associated with significant morbidity, and the leading complications include tamponade and constrictive pericarditis. Epidemiologic studies have found that PPS often occurs among younger patients; however, there is a lack of comprehensive risk stratification. It is therefore important to be able to identify patients who are at high risk for developing this disease...
November 2016: Current Cardiology Reports
https://www.readbyqxmd.com/read/27747489/current-consensus-and-controversies-in-guidelines-for-lipid-and-hypertension-management-in-diabetes
#19
Om P Ganda, Joanna Mitri
Despite major advances, many patients with diabetes are currently achieving suboptimal control of lipids and blood pressure. The new cholesterol guidelines by the ACC/AHA have reignited the emphasis on more intensive treatment with statins in the population at high risk of CVD, including those with diabetes. While these guidelines do not include specific lipid goals, several other guidelines have retained previously defined risk-based LDL-C and non-HDL-C goals. More recent data indicate potential benefits in CVD outcomes with non-statin therapy added to statin therapy...
November 2016: Current Cardiology Reports
https://www.readbyqxmd.com/read/27747488/angiotensin-neprilysin-inhibition-as-a-paradigm-for-all
#20
Muthiah Vaduganathan, Akshay S Desai
Composite angiotensin receptor-neprilysin inhibition (ARNi) represents a novel pharmacologic strategy for treatment of heart failure with reduced ejection fraction (HFrEF). In the PARADIGM-HF (Prospective comparison of ARNi with ACEi to Determine Impact on Global Mortality and Morbidity in Heart Failure) trial of 8399 subjects with HFrEF, treatment with the ARNi LCZ696 (sacubitril/valsartan) was associated with statistically important reductions in cardiovascular death, all-cause mortality, and the composite of cardiovascular death or heart failure hospitalization in comparison with enalapril...
November 2016: Current Cardiology Reports
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