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Heart Failure Clinics

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https://www.readbyqxmd.com/read/28279426/cardio-oncology-a-rapidly-evolving-and-expanding-field-of-medicine
#1
EDITORIAL
Daniel J Lenihan, Douglas B Sawyer
No abstract text is available yet for this article.
April 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/28279425/current-concepts-of-cardiac-amyloidosis-diagnosis-clinical-management-and-the-need-for-collaboration
#2
REVIEW
Alexandra J Ritts, Robert F Cornell, Kris Swiger, Jai Singh, Stacey Goodman, Daniel J Lenihan
Cardiac amyloidosis is a complex and vexing clinical condition that requires a high degree of suspicion for the diagnosis with a substantial amount of discipline to discern the extent of disease and the best available therapy. There is a complex interplay between multiple organ systems, and the clinical presentation may involve a myriad of confusing clinical symptoms. The diagnosis of cardiac amyloidosis can be confirmed with a combination of physical findings, cardiac biomarkers, noninvasive testing, and, if necessary, myocardial biopsy...
April 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/28279424/cardio-oncology-the-role-of-big-data
#3
REVIEW
Anant Mandawat, Andrew E Williams, Sanjeev A Francis
Despite its challenges, a "big data" approach offers a unique opportunity within the field of cardio-oncology. A pharmacovigilant approach using large data sets can help characterize cardiovascular toxicities of the rapidly expanding armamentarium of targeted therapies. Creating a broad coalition of data sharing can provide insights into the incidence of cardiotoxicity and stimulate research into the underlying mechanisms. Population health necessitates the use of big data and can help inform public health interventions to prevent both cancer and cardiovascular disease...
April 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/28279423/alternative-biomarkers-for-combined-biology
#4
REVIEW
Yong-Hyun Kim, Jennifer Kirsop, Wai Hong Wilson Tang
Chemotherapy-related cardiac dysfunction (CRCD) has challenged clinicians to hesitate in using cardiotoxic agents such as anthracycline and several protein kinase inhibitors. As early detection of CRCD and timely cessation of cardiotoxic agents became a strategy to avoid CRCD, cardiac troponin and natriuretic peptide are measured to monitor cardiotoxicity; however, there are inconsistencies in their predictability of CRCD. Alternative biomarkers have been researched extensively for potential use as more sensitive and accurate biomarkers...
April 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/28279422/cardio-oncology-related-to-heart-failure-common-risk-factors-between-cancer-and-cardiovascular-disease
#5
REVIEW
Anne Blaes, Anna Prizment, Ryan J Koene, Suma Konety
There is a growing body of evidence that suggests cancer and cardiovascular disease have a shared biological mechanism. Although there are several shared risk factors for both diseases, including advancing age, gender, obesity, diabetes, physical activity, tobacco use, and diet, inflammation and biomarkers, such as insulinlike growth factor 1, leptin, estrogen, and adiponectin, may also play a role in the biology of these diseases. This article provides an overview of the shared biological mechanism between cancer and cardiovascular disease...
April 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/28279421/how-to-develop-a-cardio-oncology-fellowship
#6
REVIEW
Michelle N Johnson, Richard Steingart, Joseph Carver
Management of cardiovascular disease in patients with cancer and cancer survivors requires particular clinical expertise and skills that are central to cardio-oncology. The areas of knowledge required include specific cardiovascular complications directly related to oncologic therapies and the impact of cancer and its therapies on existing or potential cardiovascular comorbidities. Many cancer therapeutics have potential cardiotoxicity. The conversion of many cancers to chronic conditions, rather than fatal diseases, has produced a population of patients with cancer at high risk for cardiovascular diseases that require specialized knowledge of treating physicians...
April 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/28279420/how-to-develop-a-cardio-oncology-clinic
#7
REVIEW
David Snipelisky, Jae Yoon Park, Amir Lerman, Sharon Mulvagh, Grace Lin, Naveen Pereira, Martin Rodriguez-Porcel, Hector R Villarraga, Joerg Herrmann
Cardiovascular demands to the care of cancer patients are common and important given the implications for morbidity and mortality. As a consequence, interactions with cardiovascular disease specialists have intensified to the point of the development of a new discipline termed cardio-oncology. As an additional consequence, so-called cardio-oncology clinics have emerged, in most cases staffed by cardiologists with an interest in the field. This article addresses this gap and summarizes key points in the development of a cardio-oncology clinic...
April 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/28279419/cardiac-dysfunction-and-heart-failure-in-hematopoietic-cell-transplantation-survivors-emerging-paradigms-in-pathophysiology-screening-and-prevention
#8
REVIEW
Saro H Armenian, Thomas D Ryan, Michel G Khouri
Hematopoietic cell transplantation (HCT) has been used for curative intent in patients with hematologic and nonhematologic malignancies, resulting in an increasing number of HCT survivors. These survivors are at risk for serious and life-threatening complications, including cardiovascular disease (CVD). This article provides an overview of CVD in HCT survivors, describing the pathophysiology of disease, with a special emphasis on therapeutic exposures and comorbidities unique to this population. This article also discusses novel screening and prevention strategies that have shown promise in non-HCT cancer populations, emphasizing opportunities for collaboration between cardiologists and hematologists to improve the cardiovascular health of HCT survivors...
April 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/28279418/advanced-heart-failure-therapies-for-cancer-therapeutics-related-cardiac-dysfunction
#9
REVIEW
Christopher M Bianco, Sadeer G Al-Kindi, Guilherme H Oliveira
End-stage heart failure in cancer survivors may result from cardiotoxic chemotherapy and/or chest radiation and require advanced therapies, including left ventricular assist devices (LVADs) and transplantation. Traditionally, such therapies have been underutilized in cancer survivors owing to lack of experience and perceived risk of cancer recurrence. Recent data from large registries, however, have shown excellent outcomes of LVADs and transplantation in cancer survivors, albeit subject to careful selection and special considerations...
April 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/28279417/cardio-oncology-related-to-heart-failure-pediatric-considerations-for-cardiac-dysfunction
#10
REVIEW
Kirsten Rose-Felker, William L Border, Borah J Hong, Eric J Chow
Although tremendous advances in pediatric cancer treatment have improved the survival of many children, these patients remain at increased risk of early morbidity and mortality with cardiovascular disease as a leading cause of death. Heightened awareness in providers with increased surveillance and improvement in cardiovascular imaging modalities have led to earlier detection of cardiac dysfunction, but the outcomes remain poor once this has dysfunction developed. A great deal of work remains to be done to refine screening and identify high-risk patients more precisely, and to develop more evidence-based strategies for effective primary and secondary cardioprotection and treatment...
April 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/28279416/cardio-oncology-related-to-heart-failure-epidermal-growth-factor-receptor-target-based-therapy
#11
REVIEW
Benjamin Kenigsberg, Varun Jain, Ana Barac
Cancer therapy targeting the epidermal growth factor receptor (EGFR)/erythroblastic leukemia viral oncogene B (ErbB)/human EGFR receptor (HER) family of tyrosine kinases has been successfully used in treatment of several malignancies. The ErbB pathways play a role in the maintenance of cardiac homeostasis. This article summarizes current knowledge about EGFR/ErbB/HER receptor-targeted cancer therapeutics focusing on their cardiotoxicity profiles, molecular mechanisms, and implications in clinical cardio-oncology...
April 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/28279415/proteasome-inhibitors-as-a-potential-cause-of-heart-failure
#12
REVIEW
Georgios Koulaouzidis, Alexander R Lyon
Proteasome inhibitors have become an important drug class in the treatment of multiple myeloma. In addition to its role in myeloma cells, the proteasome plays a critical role in the myocardium, particularly in the context of cardiac stress. The growing awareness of the cardiovascular toxicity of proteasome inhibitors is emerging following the phase 3 trials and the transition into real-world practice. This article reviews the background to this problem and the incidence of the problem in phase 3 trials and subsequent phase 2 trials in new patient cohorts and discusses the strategy to detect and manage this emerging problem...
April 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/28279414/management-of-heart-failure-in-cancer-patients-and-cancer-survivors
#13
REVIEW
Jose Emanuel Finet
The number of cancer survivors increases annually, because of advances in detection and treatment, and the aging and growth of the population. This increase has brought a concomitant increase in morbidity and mortality from other conditions related to the adverse effects of cancer treatments. Cardiovascular diseases, and in particular left ventricular dysfunction and heart failure, are among the most significant of these. There are no unified and universally accepted evidence-based practice guidelines on the management of heartfailure in this population...
April 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/27886935/robotic-assisted-left-ventricular-lead-placement
#14
REVIEW
Advay G Bhatt, Jonathan S Steinberg
Robot-assisted left ventricular lead implantation for cardiac resynchronization therapy is a feasible and safe technique with superior visualization, dexterity, and precision to target the optimal pacing site. The technique has been associated with clinical response and beneficial reverse remodeling comparable with the conventional approach via the coronary sinus. The lack of clinical superiority and a residual high nonresponder rate suggest that the appropriate clinical role for the technique remains as rescue therapy...
January 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/27886934/coronary-sinus-lead-positioning
#15
REVIEW
Attila Roka, Rasmus Borgquist, Jagmeet Singh
Although cardiac resynchronization therapy improves morbidity and mortality in patients with cardiomyopathy, heart failure, and electrical dyssynchrony, the rate of nonresponders using standard indications and implant techniques is still high. Optimal coronary sinus lead positioning is important to increase the chance of successful resynchronization. Patient factors such as cause of heart failure, type of dyssynchrony, scar burden, coronary sinus anatomy, and phrenic nerve capture may affect the efficacy of the therapy...
January 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/27886933/the-role-of-cardiovascular-magnetic-resonance-in-cardiac-resynchronization-therapy
#16
REVIEW
Francisco Leyva
Randomized, controlled trials have shown that cardiac resynchronization therapy (CRT) is beneficial in patients with heart failure, impaired left ventricular (LV) systolic function, and a wide QRS complex. Other studies have shown that targeting the LV pacing site can also improve patient outcomes. Cardiovascular magnetic resonance (CMR) is a radiation-free imaging modality that provides unparalleled spatial resolution. In addition, emerging data suggest that targeted LV lead deployment over viable myocardium improves the outcome of patients undergoing CRT...
January 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/27886932/newer-echocardiographic-techniques-in-cardiac-resynchronization-therapy
#17
REVIEW
John Gorcsan, Bhupendar Tayal
Echocardiographic imaging plays a major role in patient selection for cardiac resynchronization therapy (CRT). One-third of patients do not respond; there is interest in advanced echocardiographic imaging to improve response. Current guidelines favor CRT for patients with electrocardiographic (ECG) QRS width of 150 milliseconds or greater and left bundle branch block. ECG criteria are imperfect; there is interest in advanced echocardiographic imaging to improve patient selection. This discussion focuses on newer echocardiographic methods to improve patient selection, improve delivery, and identify patients at risk for poor outcomes and serious ventricular arrhythmias...
January 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/27886931/exploring-the-electrophysiologic-and-hemodynamic-effects-of-cardiac-resynchronization-therapy-from-bench-to-bedside-and-vice-versa
#18
REVIEW
Rick Schreurs, Rob F Wiegerinck, Frits W Prinzen
Cardiac resynchronization therapy (CRT) is an important therapy for heart failure patients with prolonged QRS duration. In patients with left bundle branch block the altered left ventricular electrical activation results in dyssynchronous, inefficient contraction of the left ventricle. CRT aims to reverse these changes and to improve cardiac function. This article explores the electrophysiologic and hemodynamic changes that occur during CRT in patient and animal studies. It also addresses how novel techniques, such as multipoint and endocardial pacing, can further improve the electromechanical response...
January 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/27886930/cellular-and-molecular-aspects-of-dyssynchrony-and-resynchronization
#19
REVIEW
Jonathan A Kirk, David A Kass
Dyssynchronous contraction of the ventricle significantly worsens morbidity and mortality in patients with heart failure (HF). Approximately one-third of patients with HF have cardiac dyssynchrony and are candidates for cardiac resynchronization therapy (CRT). The initial understanding of dyssynchrony and CRT was in terms of global mechanics and hemodynamics, but lack of clinical benefit in a sizable subgroup of recipients who appear otherwise appropriate has challenged this paradigm. This article reviews current understanding of these cellular and subcellular mechanisms, arguing that these aspects are key to improving CRT use, as well as translating its benefits to a wider HF population...
January 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/27886929/cardiac-resynchronization-therapy-follow-up-role-of-remote-monitoring
#20
REVIEW
Cecilia Linde, Frieder Braunschweig
Cardiac resynchronization therapy (CRT) is increasingly used in heart failure treatment and management of these patients imposes significant challenges. Remote monitoring is becoming essential for CRT follow-up and allows close surveillance of device function and patient condition. It is helpful to reduce clinic visits, increase device longevity and provide early detection of device failure. Clinical effects include prevention of appropriate and inappropriate shocks and early detection of arrhythmias, such as atrial fibrillation...
January 2017: Heart Failure Clinics
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