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Future Cardiology

Parham Parto, Carl J Lavie, Ross Arena, Samantha Bond, Dejana Popovic, Hector O Ventura
The prevalence of obesity among adults and children worldwide has reached epic proportions and has become a major independent risk factor for the development of heart failure (HF), in addition to a contributor of hypertension and cardiovascular disease. The implications of obesity in the development of HF involve adverse effects on cardiac structure and function. Despite all of this, in the setting of chronic HF, excess body mass is associated with improved clinical outcomes, demonstrating the presence of an obesity paradox...
October 20, 2016: Future Cardiology
Michele Malagù, Alessandra Ferri, Ottavia Mancuso, Filippo Trevisan, Marianna Nardozza, Matteo Bertini
Implantable cardioverter defibrillator (ICD) is the cornerstone of primary and secondary prevention of sudden cardiac death. In 35 years of technologic improvement and clinical trials, there has been a continuous increase in implantation rate. Purpose of this review is to point out and discuss every aspect related to actual ICD management, investigating implantation procedure and predischarge care, office and remote monitoring follow-up, diagnostic evaluations, management of patients with suspected therapies or malfunctions, heart failure, surgery, radiotherapy and endoscopic procedures...
October 20, 2016: Future Cardiology
Giacomo Murana, Mariano Cefarelli, Geoffrey Kloppenburg, Wim J Morshuis, Robin H Heijmen
In adult the patent ductus arteriosus is a rare condition associated sometimes with lethal complications. We describe the case of a 44-year-old woman with a history of systemic lupus erythematosus admitted to our hospital with hoarseness and severe dyspnea. Clinical imaging examinations indicated a saccular aneurysm within a persistent ductus arteriosus with signs of impending rupture. Patient was not considered suitable for transcatheter closure and therefore she underwent open aortic repair. The procedure was uneventful and any significant complications occurred during postoperative course...
October 19, 2016: Future Cardiology
Saeed Alipour Parsa, Isa Khaheshi, Mehdi Memaryan, Mohammadreza Naderian
To present an unusual case in order to clarify one of the most important differential diagnoses of ST-elevation myocardial infarction in a postmenopausal woman. A 72-year-old woman with asthma attack and retrosternal chest pain was presented to our emergency unit. She had used albuterol spray ten-times before admission due to accentuated dyspnea. Initial ECG revealed ST-segment elevation in leads V1-V6, I and aVL. Emergent coronary angiography indicated normal coronary arteries, and left ventriculography showed significant akinesia of apical segments...
October 19, 2016: Future Cardiology
Carl J Lavie, Ross Arena, Steven N Blair
No abstract text is available yet for this article.
October 19, 2016: Future Cardiology
Vivencio Barrios, Jaime Masjuan
The majority of patients with atrial fibrillation should receive oral anticoagulation to reduce the risk of stroke. The limitations of vitamin K antagonists have led to an underuse of anticoagulants in clinical practice which has been associated with a higher risk of stroke, hospitalizations and healthcare costs. Direct oral anticoagulants (DOACs) overcome some of the limitations of vitamin K antagonists and may therefore increase the use of oral anticoagulants in clinical practice. Since no head-to-head trials have been performed, only indirect comparisons can be made among them...
October 12, 2016: Future Cardiology
Konstantin Schwarz, Satnam Singh, Satish Kumar Parasuraman, Maggie Bruce, Lee Shepstone, Martin Feelisch, Magdalena Minnion, Shakil Ahmad, John Horowitz, Dana K Dawson, Michael P Frenneaux
In an aging western population, a significant number of patients continue to suffer from angina once all revascularization and optimal medical treatment options are exhausted. Under experimental conditions, oral supplementation with inorganic nitrate was shown to exhibit a blood pressure-lowering effect, and has also been shown to promote angiogenesis, improve endothelial dysfunction and mitochondrial efficiency in skeletal muscle. It is unknown whether similar changes occur in cardiac muscle. In the current study, we investigate whether oral sodium nitrate treatment will improve myocardial ischemia in patients with stable angina...
October 12, 2016: Future Cardiology
Jeff Patrick, Andrew Johnson, Larry Dillaha, Andrew T Pennell
AIM: To evaluate tolerability of a new extended-release acetylsalicylic acid (ER-ASA). MATERIALS & METHODS: Daily ER-ASA (162.5-1300 mg) for up to 6 weeks was evaluated (four studies; n = 565). Safety of ER-ASA, immediate-release (IR; 150-1200 mg) ASA and enteric-coated ASA (75 mg) was assessed. RESULTS: Forty-three out of 184 (23.4%) patients with atherosclerosis (ER-ASA 162.5 mg group) experienced adverse events versus 51/195 (26.2%) patients receiving IR-ASA 150 mg...
August 22, 2016: Future Cardiology
Matthew C Black, Erin M Schumer, Michael Rogers, Jaimin Trivedi, Mark S Slaughter
Advanced heart failure (HF) patients not meeting criteria for ventricular assist device or heart transplant with life-limiting symptoms are limited to medical and resynchronization therapy. The Sunshine Heart C-Pulse, based on intra-aortic balloon pump physiology, provides implantable, on-demand, extra-aortic counterpulsation, which reduces afterload and improves cardiac perfusion in New York Heart Association Class III and ambulatory Class IV HF. The C-Pulse reduces New York Heart Association Class, improves 6-min walk distances, inotrope requirements and HF symptom questionnaires...
September 2016: Future Cardiology
Larisa H Cavallari, Julio D Duarte
No abstract text is available yet for this article.
September 2016: Future Cardiology
Wasim Javed, Parminder S Chaggar, Rajamiyer Venkateswaran, Steven M Shaw
Left ventricular assist devices (LVADs) are well established in the management of end-stage heart failure as either destination therapy, a bridge prior to cardiac transplantation or during myocardial recovery. Despite LVADs requiring adequate left ventricular preload to effectively augment systemic circulation, there have been rare cases of patients with LVADs surviving sustained, normally fatal arrhythmias, such as ventricular fibrillation and asystole. Whilst current reports describe an LVAD patient surviving 15 days with such an arrhythmia, we describe the case of a patient with an LVAD surviving 104 days of asystole via a Fontan mechanism of circulation, which we believe is the longest known survival of a sustained fatal arrhythmia...
September 2016: Future Cardiology
Shu-Ching Chang, Mansen Wang, James G Beckerman, Mark Sanz, Tyler J Gluckman, Gary L Grunkemeier
AIM: To propose a method for estimating the lifetime advantage of statins. METHODS: Kaplan-Meier survival curves from published 4S and LIPID studies with 5.8- and 6.1-year follow-up were digitized. Gompertz distributions were fit up to the end of the trials, and then extrapolated out to the end of the patients' predicted lifetimes for each study. RESULTS: The method results in a 9.9 (95% CI: 8.7-11.9) and 2.8 (95% CI: 2.3-3.3) years' increases for the statin groups for 4S and LIPID studies, respectively...
September 2016: Future Cardiology
Natale Daniele Brunetti, Francesco Santoro, Luisa De Gennaro, Michele Correale, Hayashi Kentaro, Antonio Gaglione, Matteo Di Biase
Several therapeutic options are available for the treatment of the acute phase of stress cardiomyopathy, pharmacological (β-blockers, diuretics, anticoagulants, antiarrhythmics, noncatecholamine inotropics [levosimendan]), and nonpharmacological (intra-aortic balloon pumping, extracorporeal membrane oxygenation), according to the wide possible clinical presentation and course of the disease. However, there is a gap in evidence, and very few data come from randomized and adequately powered studies. Some evidence supports the use of β-blockers, in particular with a short half-life, in the case of left ventricular outflow tract obstruction, and angiotensin-converting enzyme inhibitors in secondary prevention...
September 2016: Future Cardiology
Jean-Jacques Mourad, Jean-Christophe Guillerm
Jean-Jacques Mourad & Jean-Christophe Guillerm speak to Henry Ireland, Drug Evaluation Editor: Jean-Jacques Mourad talks about his vision of the current landscape and unmet medical needs in the field of hypertension. Jean-Christophe Guillerm describes the family of antihypertensive treatments from Servier, which were designed to address the current challenges in the management of hypertension by providing an adapted solution to doctors and to the specific needs of each patient. Jean-Jacques Mourad currently works as Professor of Medicine and is the Head of the Hypertension Unit at the Hôpital Avicenne in Bobigny, France...
September 2016: Future Cardiology
Hassan Alkhawam, Robert Sogomonian, Mohammed El-Hunjul, Mohamad Kabach, Umer Syed, Neil Vyas, Sumair Ahmad, Timothy J Vittorio
OBJECTIVE: In this study, we assessed the risk factor profile in premature coronary artery disease (CAD) and acute coronary syndrome for adults ≤40 years old. METHODS: A retrospective chart analysis of 397 patients ≤40 years old admitted from 2005 to 2014 for chest pain and who underwent coronary arteriography. RESULTS: Of 397 patients that had undergone coronary arteriography, 54% had CAD while 46% had normal coronary arteries. When compared with patients with normal coronary arteries, patients with CAD were more likely to smoke tobacco, have dyslipidemia, be diabetic, have BMI >30 kg/m(2), have a family history of premature CAD and be male in gender...
September 2016: Future Cardiology
Aldo Clerico, Claudio Passino, Maria Franzini, Michele Emdin
Several studies indicated that B-type natriuretic peptide (BNP) assay is able to detect patients even in the early phases of heart failure (HF), when the myocardial remodeling process may be still reversible. BNP assay may assist the physician to initiate appropriate and prompt pharmacological treatments. However, clinical relevance and result interpretation of BNP assay for the guide of therapy or in particular clinical conditions, such as renal failure or treatment with inhibitors of enzymes degrading BNP in HF patients, are still debated...
September 2016: Future Cardiology
Robert J Henning
Stem cells encode vascular endothelial growth factors (VEGFs), fibroblastic growth factors (FGFs), stem cell factor, stromal cell-derived factor, platelet growth factor and angiopoietin that can contribute to myocardial vascularization. VEGFs and FGFs are the most investigated growth factors. VEGFs regulate angiogenesis and vasculogenesis. FGFs stimulate vessel cell proliferation and differentiation and are regulators of endothelial cell migration, proliferation and survival. Clinical trials of VEGF or FGF for myocardial angiogenesis have produced disparate results...
September 2016: Future Cardiology
Jeffrey M Tyler, Ryan Jw Burris, Arnold H Seto
Oral ADP-receptor antagonists combined with aspirin are the standard for dual antiplatelet therapy (DAPT) during percutaneous coronary intervention (PCI). However, the oral route of administration of ADP-receptor antagonists leaves them vulnerable to unpredictable and often inadequate platelet inhibition at the time of PCI, while their prolonged effects often lead to the decision not to load them prior to PCI. Intravenous antiplatelet agents, including glycoprotein IIb/IIIa inhibitors (GPI) and cangrelor, a reversible P2Y12 inhibitor, address these shortcomings...
September 2016: Future Cardiology
Alastair J Moss, Philip D Adamson, David E Newby, Marc R Dweck
Inflammation has a central role in the progression of coronary atherosclerosis. Recent developments in cardiovascular imaging with the advent of hybrid positron emission tomography have provided a window into the molecular pathophysiology underlying coronary plaque inflammation. Using novel radiotracers targeted at specific cellular pathways, the potential exists to observe inflammation, apoptosis, cellular hypoxia, microcalcification and angiogenesis in vivo. Several clinical studies are now underway assessing the ability of this hybrid imaging modality to inform about atherosclerotic disease activity and the prediction of future cardiovascular risk...
July 2016: Future Cardiology
Kimberley Lee, Nishant P Shah, Eric S Christenson, Sammy Zakaria, Ike Okwuosa
Decompensated heart failure affects 5 million Americans and nearly 15 million individuals worldwide. Heart failure can be attributed to numerous etiologies, with autoimmune conditions representing a rare category of acute decompensations. Here, we report of case of a 66-year-old woman who presented with acute decompensated heart failure as a result of a rare vasculitis known as idiopathic aortitis. In addition to describing the case, we highlight the importance of proper ascending aorta evaluation in patients presenting with new onset heart failure, especially in the setting of aortic regurgitation...
July 2016: Future Cardiology
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