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Expert Review of Cardiovascular Therapy

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https://www.readbyqxmd.com/read/27918214/immunosuppression-and-adult-heart-transplantation-emerging-therapies-and-opportunities
#1
Nicholas Furiasse, Jon A Kobashigawa
Immunosuppression following heart transplantation has improved graft longevity through the reduction of cellular and antibody mediated rejection. The attempt to limit the unintended consequences of immunosuppressive therapies and address sensitized patients has led to a revolution in immunosuppression. Areas Covered: This review will focus on the current emerging immunosuppressive therapies in heart transplantation while reviewing the effective contemporary treatments, and explore the potential development of new immunomodulatory therapies...
December 5, 2016: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/27905211/minimally-invasive-mitral-repair-surgery-why-does-controversy-still-persist
#2
Jeevan Nagendran, Jorge Catrip, Katie L Losenno, Corey Adams, Bob Kiaii, Michael W A Chu
Surgical treatment for mitral valve disease has evolved and remains a rapidly expanding field. Minimally invasive mitral valve repair (MI-MVR) is a well-known alternative to conventional sternotomy mitral valve repair (cMVR). However, controversy as to the efficacy of MI-MVR persists, hindering the adoption and potential benefits of this less invasive approach. Areas covered: In this review, we provide an updated summary evaluation of the latest evidence, including observational studies, clinical trials and meta-analyses, regarding MI-MVR in comparison to cMVR...
December 1, 2016: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/27892770/myocardial-infarction-with-non-obstructive-coronary-arteries-minoca-a-whole-new-ball-game
#3
Nana Poku, Stephane Noble
MINOCA is a clinical syndrome that encompasses a subgroup of heterogeneous patients who present with myocardial infarction yet do not have any significant coronary artery obstruction on angiogram. As many as one in ten patients with acute myocardial infarction (AMI) will not have an occluded coronary artery, and the reported prevalence keeps rising, in part due to better recognition of this syndrome. Current guidelines offer several diagnostic algorithms but MINOCA remains largely under-recognised and little is known about whether patients might benefit from a more specific treatment modality...
November 28, 2016: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/27892731/is-arachidonic-acid-stimulation-really-a-test-for-the-response-to-aspirin-time-to-think-again
#4
Bartosz Olechowski, Alexander Ashby, Mark Mariathas, Vikram Khanna, Michael Mahmoudi, Nick Curzen
Platelets play a key role in pathogenesis of atherothrombosis. Activated platelets initiate thrombus formation. Antiplatelet therapy (APT) modifies these properties. APT involves aspirin. The existence of "aspirin resistance" is reported in many populations with cardiovascular disease. The prevalence of this phenomenon is highly variable, affecting more than 50% of patient subgroups in some papers. Areas covered: This review describes the prevalence of "aspirin resistance", analyses why there is so much apparent variation and addresses whether the commonly used tests of aspirin response are in fact accurately assessing its functional performance...
November 28, 2016: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/27858465/established-and-novel-treatment-options-in-acute-myocarditis-with-or-without-heart-failure
#5
George Lazaros, Evangelos Oikonomou, Dimitris Tousoulis
Acute myocarditis is a disorder characterized by an unpredictable clinical course which ranges from asymptomatic, incidentally discovered forms, to cases with fulminant course and adverse outcome. The most challenging issues in the context of acute myocarditis are the appearance of difficult to treat heart failure in the acute phase and the potential progression in the long-term to dilated cardiomyopathy. Areas covered: With respect to available treatment options in acute myocarditis, in the absence of specific guidelines, management is supportive and overall empirical, especially for the oligo- or asymptomatic patients with preserved ejection fraction...
November 23, 2016: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/27801604/noncompaction-cardiomyopathy-and-stem-cell-therapy-from-pathogenesis-to-targeted-therapy
#6
Ozcan Ozeke, Dursun Aras, Omac Tufekcioglu, Sinan Aydogdu
No abstract text is available yet for this article.
November 17, 2016: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/27801597/stem-or-progenitor-cells-for-treating-noncompaction
#7
Josef Finsterer, Claudia Stöllberger
No abstract text is available yet for this article.
November 1, 2016: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/27780367/the-role-of-multi-modality-imaging-in-selecting-patients-and-guiding-lead-placement-for-the-delivery-of-cardiac-resynchronization-therapy
#8
Jonathan M Behar, Simon Claridge, Tom Jackson, Ben Sieniewicz, Bradley Porter, Jessica Webb, Ronak Rajani, Stamatis Kapetanakis, Gerald Carr-White, Christopher A Rinaldi
Cardiac resynchronization therapy (CRT) is an effective pacemaker delivered treatment for selected patients with heart failure with the target of restoring electro-mechanical synchrony. Imaging techniques using echocardiography have as yet failed to find a metric of dyssynchrony to predict CRT response. Current guidelines are thus unchanged in recommending prolonged QRS duration, severe systolic function and refractory heart failure symptoms as criteria for CRT implantation. Evolving strain imaging techniques in 3D echocardiography, cardiac MRI and CT may however, overcome limitations of older methods and yield more powerful CRT response predictors...
October 26, 2016: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/27701930/prasugrel-hydrochloride-for-the-treatment-of-acute-coronary-syndrome-patients
#9
Ashan Gunarathne, Shahana Hussain, Anthony H Gershlick
Dual antiplatelet therapy (DAPT) with aspirin combined with either a thienopyridine (clopidogrel or prasugrel) or acyclopentyl-triazolo-pyrimidine (ticagrelor) plays a vital role in the management of acute coronary syndrome (ACS) especially in those undergoing percutaneous coronary intervention (PCI) but even those being managed medically. Observational studies and some formal studies have shown patients on the standard dual antiplatelet regimen (clopidogrel and aspirin) continue to have further ischemic events and can suffer stent thrombosis...
October 4, 2016: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/27817220/ectopic-fat-a-target-for-cardiometabolic-risk-management
#10
Amalia Gastaldelli, Melania Gaggini
No abstract text is available yet for this article.
December 2016: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/27817218/risk-stratification-after-st-segment-elevation-myocardial-infarction
#11
Sergio Buccheri, Piera Capranzano, Antonio Condorelli, Matteo Scalia, Corrado Tamburino, Davide Capodanno
Risk stratification according to the timing of assessment, treatment modality and outcome of interest is highly advisable in patients with ST-elevation myocardial infarction (STEMI) to identify optimal treatment strategies, proper length of hospital stay and correct timing of follow-up. Areas covered: This review is an overview summarizing the characteristics and performance of available risk-scoring systems for STEMI. In particular, we sought to highlight the characteristics of STEMI cohorts used for derivation and validation of the available algorithms and appraise their discrimination ability, calibration and global accuracy...
December 2016: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/27785921/multimodality-ultrasound-imaging-in-stroke-current-concepts-and-future-focus
#12
Yumei Liu, Yang Hua, Wuwei Feng, Bruce Ovbiagele
Stroke is a leading cause of disability and mortality worldwide. Ultrasound is a real-time imaging technique that is inexpensive, portable, non-invasive, and safe, with high diagnostic accuracy. Ultrasonic imaging can provide useful direct and indirect information about the characteristics of various vessels in the both intracranial and extracranial segments. Areas covered: In this review, we will discuss multimodal applications of ultrasonic imaging in stroke prevention and management including checking carotid intima-media thickness progression, evaluating the plaque morphology, calibrating the degree of stenosis, detecting the presence of patent foramen ovale, monitoring microembolization, and screening for stroke risk in patients with sickle cell disease...
December 2016: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/27778514/advanced-heart-failure-an-appraisal-of-the-potential-of-levosimendan-in-this-end-stage-scenario-and-some-related-ethical-considerations
#13
Sonja Fruhwald, Piero Pollesello, Friedrich Fruhwald
The later stages of heart failure are characterized by a steady decline in quality of life. Clinical priorities should be to maintain functional capacity and quality of life. In the absence of sufficient organs for transplantation, options include left ventricular assist devices and inotropic support. Areas covered: We examined data published in the last two decades on the use of inotropes and inodilators in advanced heart failure. Expert commentary: In the literature, use of conventional inotropes, including adrenergic agonists and phosphodiesterase inhibitors, appears to be suboptimal for achieving the clinical priorities of late-stage heart failure...
December 2016: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/27758146/targeting-mitochondrial-dysfunction-in-the-treatment-of-heart-failure
#14
Hani N Sabbah
Heart failure (HF) has reached epidemic proportions worldwide. Despite the availability of drugs that reduce mortality and afford good symptom relief, HF continues to exact a considerable clinical and economic burden. Current HF therapies elicit benefit by reducing cardiac workload by lowering heart rate and loading conditions, thereby reducing myocardial energy demands. Areas covered: Recent recognition that the failing heart is 'energy deprived' and its primary energy source, the mitochondria, is dysfunctional, has focused attention on mitochondria as a worthy therapeutic target...
December 2016: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/27740874/current-controversies-in-the-use-of-aspirin-and-ticagrelor-for-the-treatment-of-thrombotic-events
#15
Aung Myat, Udaya S Tantry, Jacek Kubica, Paul A Gurbel
A P2Y12 inhibitor plus aspirin is the most widely used antiplatelet strategy to prevent adverse outcomes in the setting of atherothrombotic vascular disease. Areas covered: A paucity of robust evidence for an optimal dose, gastrointestinal toxicity, ineffectiveness in high-risk patients and interactions with other antiplatelet agents, are major controversies associated with aspirin therapy. Ticagrelor is a reversibly binding oral P2Y12 receptor blocker that mediates potent inhibition of adenosine diphosphate-induced platelet function...
December 2016: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/27740860/management-of-idiopathic-venous-thromboembolism
#16
Benilde Cosmi
Idiopathic or unprovoked venous thromboembolism is an event occurring in the absence of any apparent provoking or triggering environmental risk factors, such as surgery, trauma, and immobilization. Areas covered: Unprovoked VTE can be associated with occult cancer, but only limited, and not extensive cancer screening, may be warranted, as the rate of occult cancer is low in such patients. Routine thrombophilia testing is not currently recommended as it does not influence the management of the disease. The duration of anticoagulation for unprovoked VTE after the first three months is still debated as the disease tends to recur regardless of treatment duration...
December 2016: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/27653189/chemotherapy-induced-cardiotoxicity-importance-of-early-detection
#17
Daniela Cardinale, Carlo Maria Cipolla
No abstract text is available yet for this article.
December 2016: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/27636535/renal-dysfunction-and-transcatheter-aortic-valve-implantation-outcomes
#18
Marco Barbanti, Giuseppe Gargiulo, Corrado Tamburino
Transcatheter aortic valve implantation (TAVI) underwent progressive improvements until it became the default therapy for inoperable patients, and a recommended therapy in high-risk operable patients with symptomatic severe aortic stenosis. Recent evidence will further support TAVI as treatment for a growing number of patients. Areas covered: This review will discuss on the current knowledge about the role of both pre-procedural chronic kidney disease (CKD) and post-procedural acute kidney injury (AKI) in adult patients with severe aortic stenosis undergoing TAVI...
December 2016: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/27624221/previous-challenges-and-current-progress-the-use-of-total-artificial-hearts-in-patients-with-end-stage-heart-failure
#19
Corbin E Goerlich, O H Frazier, William E Cohn
No abstract text is available yet for this article.
October 2016: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/27548654/creating-a-pro-active-health-care-system-to-combat-chronic-diseases-in-sri-lanka-the-central-role-of-preventive-medicine-and-healthy-lifestyle-behaviors
#20
Michael Sagner, Ross Arena, Amy McNeil, Ginnela N V Brahmam, Andrew P Hills, H Janaka De Silva, R P Palitha Karunapema, Chandrika N Wijeyaratne, Carukshi Arambepola, Pekka Puska
INTRODUCTION: The current burden and future escalating threat of chronic diseases, constitutes the major global public health challenge. In Sri Lanka, cardiovascular diseases account for the majority of annual deaths. Data from Sri Lanka also indicate a high incidence and prevalence of pre-diabetes and diabetes; 1 in 5 adults have elevated blood sugar in Sri Lanka. It is well established that chronic diseases share four primary behavioral risk factors: 1) tobacco use; 2) unhealthy diet; 3) physical inactivity; and 4) harmful use of alcohol...
October 2016: Expert Review of Cardiovascular Therapy
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