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Reviews in Cardiovascular Medicine

Peter A McCullough, Mohammad Kazem Fallahzadeh, Refaat M Hegazi
There is an expanding prevalence pool of heart failure (HF) due to the increasing prevalence of survivors of myocardial infarction, diabetes, hypertension, chronic kidney disease, and obesity. There is increasing interest in the role of nutrition in all forms of HF, given observations concerning micro- and macronutrient deficiencies, loss of lean body mass or sarcopenia, and their relationships with hospitalization and death. This review examines the relationships among loss of lean body mass, macro- and micronutrient intake, and the natural history of HF, particularly in the elderly, in whom the risks for all-cause rehospitalization, infection, falls, and mortality are increased...
2016: Reviews in Cardiovascular Medicine
Barry H Greenberg
The treatment of heart failure with reduced ejection (HFrEF) is changing rapidly. Advances over the past several decades have focused on blocking the adverse effects of neurohormonal activation. This approach has resulted in marked improvement in outcomes in the HFrEF population. Despite these advances, however, mortality and morbidity remain high and HFrEF patients have poor quality of life. New approaches to therapy now offer additional benefits. Combined neprilysin inhibition and angiotensin receptor blockade using sacubitril-valsartan (LCZ696) has been shown to be superior to an angiotensin-converting enzyme inhibitor in HFrEF patients...
2016: Reviews in Cardiovascular Medicine
Sandeep K Krishnan, Norman E Lepor
Hyperkalemia is a common electrolyte disorder associated with life-threatening cardiac arrhythmias and increased mortality. Patients at greatest risk for hyperkalemia include those with diabetes and those with impaired renal function in whom a defect in the excretion of renal potassium may already exist. Hyperkalemia is likely to become more common clinically because angiotensin receptor blockers and angiotensin-converting enzyme inhibitors are increasingly being used in higher doses and are thought to confer cardiovascular and renal protection...
2016: Reviews in Cardiovascular Medicine
(no author information available yet)
No abstract text is available yet for this article.
2016: Reviews in Cardiovascular Medicine
Juan M Vinardell, Maria D Avila, Orlando Santana
Isolated left ventricular noncompaction is either a distinct cardiomyopathy or a morphologic trait shared by several different types of cardiomyopathies. Although there is no current gold standard for its diagnosis, cardiac imaging is the most commonly accepted modality. Described is a case of left ventricular noncompaction that resolved 2 years after the initial diagnosis.
2016: Reviews in Cardiovascular Medicine
Manish Patwardhan, Sanjay Mehra, Assad Movahed, Ramesh Daggubati
The percutaneous transradial approach for coronary angiography and percutaneous coronary intervention is increasing in the United States. Although its vascular safety profile is better than the traditional femoral approach, it is important to learn about potential complications. In this article, we present two cases of vascular complications, namely, pseudoaneurysm and radial artery occlusion, after transradial cardiac catheterization, along with a review of the relevant literature.
2016: Reviews in Cardiovascular Medicine
Emily Tat, Richard Cheng, Jeffrey S Helfenstein
A 48-year-old woman with 40 years of intermittent squeezing chest pain presented with worsening symptoms. Results of an ambulatory electrocardiogram, echocardiogram, and exercise treadmill were unremarkable. Persistent symptoms prompted a computed tomography coronary angiogram (CTCA) that revealed mid-left anterior descending artery myocardial bridging (MB) that was not physiologically significant by exercise single-photon emission CT. Conservative treatment was pursued. Anatomic MB is prevalent in a large proportion of the general population and are increasingly identified by CTCA...
2016: Reviews in Cardiovascular Medicine
Seema Pursnani, Raj Khandwalla, Rigved Tadwalkar
No abstract text is available yet for this article.
2016: Reviews in Cardiovascular Medicine
Norman E Lepor
No abstract text is available yet for this article.
2016: Reviews in Cardiovascular Medicine
Marco Marchesini, Lucia Uguccioni, Rosario Parisi, Gianmaria Mattioli, Francesca Terzi, Roberto Olivieri, Alessandro Capucci, Rossella Fattori
Until recently, the only imaging technique for the diagnosis and management of hypertrophic cardiomyopathy (HCM) was two-dimensional echocardiography, and the use of cardiac magnetic resonance imaging (cMRI) was limited to patients with poor acoustic windows. Now, cMRI has gained an essential role in the diagnosis of HCM, providing superior visualization of myocardial hypertrophy-even in remote zones of the left ventricle-and visualization of subtle changes in thickness and contractility over time. The morphologic accuracy of cMRI allows for the differentiation of HCM from other pathologic conditions with hypertrophic phenotype...
2016: Reviews in Cardiovascular Medicine
Ankit B Shah, Neil Coplan
Altitude plays an important role in cardiovascular performance and training for athletes. Whether it is mountaineers, skiers, or sea-level athletes trying to gain an edge by training or living at increased altitude, there are many potential benefits and harms of such endeavors. Echocardiographic studies done on athletes at increased altitude have shown evidence for right ventricular dysfunction and pulmonary hypertension, but no change in left ventricular ejection fraction. In addition, 10% of athletes are susceptible to pulmonary hypertension and high-altitude pulmonary edema...
2016: Reviews in Cardiovascular Medicine
Rohit Kumar, Aref M Rahman, Brian L Henry
Dabigatran was the first direct-acting oral anticoagulant approved by the US Food and Drug Administration for prevention of stroke and systemic embolism in people with atrial fibrillation, based on data from the Randomized Evaluation of Long-Term Anticoagulation Therapy (RE-LY) trial. Over 18,000 patients with nonvalvular atrial fibrillation and a moderate-to-high risk of thromboembolic stroke were randomized to warfarin or dabigatran. With respect to the primary endpoints for efficacy and safety, dabigatran was superior to warfarin in the prevention of stroke and thromboembolism and noninferior with respect to major bleeding...
2016: Reviews in Cardiovascular Medicine
Leandro Slipczuk, Asim M Rafique, Carlos D Davila, Roy Beigel, Gregg S Pressman, Robert J Siegel
Mitral regurgitation (MR) is a common valvular disorder that has important health and economic consequences. Standardized guidelines exist regarding when and in whom to perform mitral valve surgery, but little information is available regarding medical treatment of MR. Many patients with moderate or severe MR do not meet criteria for surgery or are deemed to be at high risk for surgical therapy. We reviewed the available published data on medical therapy in the treatment of patients with primary MR. b-blockers and renin-angiotensin-aldosterone system inhibitors had the strongest supporting evidence for providing beneficial effects...
2016: Reviews in Cardiovascular Medicine
Seth J Baum, Daniel Soffer, P Barton Duell
Familial hypercholesterolemia (FH) is an autosomal co-dominant disorder marked by extremely high low-density lipoprotein (LDL) cholesterol levels and concomitant premature vascular disease. FH is caused by mutations that most commonly affect three genes integrally involved in the LDL receptor's ability to clear LDL particles from the circulation. Primary intervention efforts to lower LDL cholesterol have centered on therapies that upregulate the LDL receptor. Unfortunately, most patients are insufficiently responsive to traditional LDL-lowering medications...
2016: Reviews in Cardiovascular Medicine
David C Lange, Morton J Kern
Fractional flow reserve (FFR) is a well-validated tool for determining the functional significance of a coronary artery stenosis, facilitating clinical decisions regarding the need for revascularization. FFR-guided revascularization improves clinical and economic outcomes. However, its application remains challenging in certain complex anatomic subsets, including left main coronary artery stenosis, bifurcation disease, and saphenous vein graft disease. This article reviews recent data supporting the use of FFR in these complex anatomic subsets...
2016: Reviews in Cardiovascular Medicine
David C Lange, Ivan C Rokos, David C Larson, Scott W Sharkey, William J French, William J Koenig, Timothy D Henry
Over the past 20 years, care for patients with ST-elevation myocardial infarction (STEMI) has rapidly evolved, not just in terms of how patients are treated, but where patients are treated. The advent of regional STEMI systems of care has decreased the number of "eligible but untreated" patients while improving access to primary percutaneous coronary intervention for patients. These regional STEMI systems of care have consistently demonstrated that rapid transport of STEMI patients is safe and effective, and have shown marked improvements in a variety of clinical outcomes...
2016: Reviews in Cardiovascular Medicine
Carlos E Velasco, Mahir Patel, Jaime Mogollon, Jerrold M Grodin, Robert C Stoler
Myocardial infarction (MI) secondary to acute coronary occlusion related to trauma is rare. A previously healthy man developed acute MI shortly after a motor vehicle accident. This case illustrates the feasibility of primary percutaneous coronary intervention for acute MI due to complete coronary artery occlusion related to trauma, including the use of manual thrombectomy, stents, and dual antiplatelet therapy. This approach requires the intervention of a multidisciplinary team in a Level 1 trauma center that can rapidly evaluate the patient and rule out other life-threatening injuries that could preclude antiplatelet therapy...
2015: Reviews in Cardiovascular Medicine
Cao Tran, Ehtesham Ul Haq, Ngoc Nguyen, Bassam Omar
Bicuspid aortic valve is a common congenital anomaly associated with aortopathy, which can cause aortic root dilatation, necessitating regular screening if the aortic root is > 4.0 cm. Despite the low absolute incidence of aortic complications associated with bicuspid aortic valve in the general population, the consequences of such complications for an individual patient can be devastating. Herein we propose a balanced algorithm that incorporates recommendations from the three major guidelines for follow-up imaging of the aortic root and ascending thoracic aorta in patients with a bicuspid aortic valve, maintaining the current recommendations with regard to surgical thresholds...
2015: Reviews in Cardiovascular Medicine
Norman E Lepor
No abstract text is available yet for this article.
2015: Reviews in Cardiovascular Medicine
Sarika K Desai, Jerold Shinbane, Jayanta R Das, James Mirocha, Suhail Dohad
Takotsubo cardiomyopathy (TC) is a reversible characteristic of left ventricular (LV) ballooning on cardiac imaging without significant coronary artery disease that is precipitated by stress. We performed a retrospective analysis of consecutive patient records to analyze outcomes of patients with TC. Of 100 patients with TC (90% women, mean age 67.7 y, SD = 15.96), 44 patients presented to the emergency room with chest pain, biomarker elevation, and electrocardiographic changes (ST segment elevation in 47%; primary TC) and 56 patients subsequently developed TC after an alternative initial diagnosis (ST segment elevation 27%; secondary TC; P = 0...
2015: Reviews in Cardiovascular Medicine
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