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Future Cardiology

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https://www.readbyqxmd.com/read/28169557/the-evolution-of-cardiology-changes-future-challenges-and-opportunities
#1
Gianfranco Sinagra, Enrico Fabris, Luigi Tavazzi
The field of cardiovascular medicine continues to rapidly evolve in both diagnostic and therapeutic arenas. Subspecialization is required to keep pace with evolving practice; however, a multidisciplinary approach in a framework of cost-benefit care will be equally crucial in the management of increasing numbers of complex patients. Information technology and translational medicine may radically change clinical research and practice. It is important to consider the evolution of medicine and reflect on it in order to set the right course to achieve patient-centered goals...
February 7, 2017: Future Cardiology
https://www.readbyqxmd.com/read/28169555/aspiration-thrombectomy-and-intracoronary-tirofiban-via-guideliner-%C3%A2-catheter-for-a-thrombosed-aneurysmal-vessel
#2
James Fry, Ali Naqvi, Amit Bahia, Arnold Seto
A 52-year-old Asian male with no traditional risk factors for coronary artery disease presented with acute coronary syndrome. Coronary angiography showed complete thrombotic occlusion of the left circumflex with a large thrombus burden in the setting of diffuse aneurysmal enlargement of the coronary arteries consistent with antecedent Kawasaki disease. Manual thrombectomy with adjunctive intracoronary tirofiban was performed utilizing the GuideLiner catheter. Stent implantation was deferred. Follow-up imaging 48 h later showed preserved coronary flow and decreased thrombus burden...
February 7, 2017: Future Cardiology
https://www.readbyqxmd.com/read/28111968/first-high-risk-percutaneous-coronary-intervention-under-use-of-the-ivac2l-system-in-germany
#3
Alexander Samol, Stefanie Schmidt, Melanie Zeyse, Stefanie Dürrwald, Marcus Wiemer
Percutaneous coronary intervention of complex stenoses is becoming more and more of an alternative to coronary bypass surgery. Nevertheless, complications can occur and lead to the need for circulatory support and/or emergency surgery. Circulatory support devices like the intra-aortic balloon pump showed only low benefit in patients' outcome. Devices with higher cardiac output necessitate more complex implantation procedures. We report the case of the first successful use of a transfemoral pulsatile ventricular assist device with up to 2 l additional cardiac output during high-risk percutaneous coronary intervention in a 74-year-old man with complex stenosis...
January 23, 2017: Future Cardiology
https://www.readbyqxmd.com/read/28198201/clinical-implications-of-reversal-agents-for-direct-oral-anticoagulants
#4
Sarah Monagle, John W Eikelboom, Kuan H Ng, Vinai C Bhagirath
Direct oral anticoagulants (DOACs) are effective in preventing and treating venous thromboembolism, and preventing stroke in atrial fibrillation. Until recently, there has been no specific reversal agent for DOACs. Now, a specific antidote for the direct thrombin inhibitor, dabigatran has been approved for use, and antidotes for factor Xa inhibitors (rivaroxaban, apixaban and edoxaban) are being developed. We review the evidence for currently used and emerging reversal strategies, and discuss possible clinical implications, including increased prescription of DOACs, use of DOACs in clinical situations previously felt to pose too great a risk of bleeding, and use of reversal agents beyond currently approved indications...
March 2017: Future Cardiology
https://www.readbyqxmd.com/read/28185473/statins-for-secondary-prevention-clinical-use-in-patients-with-acute-coronary-syndrome-in-wales
#5
Majd B Protty, Arron Lacey, Jamie Hayes, Phillip Freeman
AIM: Statins have a proven role for the secondary prevention of cardiovascular disease. Despite this, typical patient use in real life is variable. Our aim was to investigate the typical clinical use, including adherence, for statins in a sample population in South Wales (UK). METHODS: We identified 2248 patients admitted to hospitals in South Wales with acute coronary syndrome using a retrospective 3-year-long longitudinal study. We performed data linkage using the Secure Anonymized Information Linkage databank...
March 2017: Future Cardiology
https://www.readbyqxmd.com/read/28185469/hypertension-treatment-in-the-elderly-a-sprint-to-the-finish
#6
Christine Parsons, Farouk Mookadam, Martina Mookadam
No abstract text is available yet for this article.
March 2017: Future Cardiology
https://www.readbyqxmd.com/read/28181450/management-of-iatrogenic-aortal-dissection-as-a-complication-of-coronary-intervention-wait-and-watch
#7
Rajesh Dandale, Alexander Krapivsky, Feraydoon Niroomand
Iatrogenic aortic dissection (AD) is quite a rare complication during percutaneous coronary intervention (PCI). The exact mechanism of iatrogenic AD during PCI is unknown. A standard of care in the management of iatrogenic AD is still lacking. We describe a case of an 83-year-old man, with an aortocoronary bypass graft, who underwent complex PCI with rotational atherectomy catheterization with a radial approach for a chronic right coronary artery stenosis, complicated by AD. According to our experience, retrograde dissection into the aorta during PCI can be sealed with a coronary stent that covers the coronary ostium and should be treated conservatively in most circumstances, unless complication like extension of dissection into other vessels or pericardial effusion or hemodynamic instability occurs...
March 2017: Future Cardiology
https://www.readbyqxmd.com/read/28181443/new-pharmacological-approaches-in-heart-failure-therapy-developments-and-possibilities
#8
Joseph J Cuthbert, Pierpaolo Pellicori, Parin Shah, Andrew L Clark
There have been few major breakthroughs in heart failure (HF) drug therapies in recent years yet HF morbidity and mortality remain high, and there is a clear need for further research. Several newer agents that appear promising in Phase I and II trials do not progress to show clinical benefit in later trials. Part of the failure to find new therapies may lie in flawed trial design compounded by the need for ever-increasing patient numbers in order to prove outcome benefit. We summarize some of the most recent and promising medical therapies for HF...
March 2017: Future Cardiology
https://www.readbyqxmd.com/read/27990847/a-developmental-approach-to-induced-pluripotent-stem-cells-based-tissue-engineered-heart-valves
#9
Mark J Vander Roest, W David Merryman
No abstract text is available yet for this article.
January 2017: Future Cardiology
https://www.readbyqxmd.com/read/27990845/the-effect-of-obstructive-sleep-apnea-treatment-on-cardiovascular-outcomes
#10
Christine Parsons, Farouk Mookadam, Martina Mookadam
No abstract text is available yet for this article.
January 2017: Future Cardiology
https://www.readbyqxmd.com/read/27990844/artificial-heart-pumps-bridging-the-gap-between-science-technology-and-personalized-medicine-by-relational-medicine
#11
Federica Raia, Mario C Deng
In the US population of 300 million, 3 million have heart failure with reduced ejection fraction and 300,000 have advanced heart failure. Long-term mechanical circulatory support will, within the next decade, be recommended to 30,000 patients annually in the USA, 3000 undergo heart transplantation annually. What do these advances mean for persons suffering from advanced heart failure and their loved ones/caregivers? In this perspective article, we discuss - by exemplifying a case report of a 27-year-old man receiving a Total Artificial Heart - a practice concept of modern medicine that fully incorporates the patient's personhood perspective which we have termed Relational Medicine™...
January 2017: Future Cardiology
https://www.readbyqxmd.com/read/27990843/impact-of-qt-interval-prolongation-following-antiarrhythmic-drug-therapy-on-left-ventricular-function
#12
Konstantinos Chouchoulis, John Chiladakis, Nikolaos Koutsogiannis, Periklis Davlouros, Maria Kaza, Dimitrios Alexopoulos
AIM: We assessed whether antiarrhythmic drug-induced QT interval prolongation affects left ventricular function. METHODS: Study population included 54 patients with symptomatic recent onset atrial fibrillation spontaneously cardioverted to sinus rhythm. Electrocardiographic and echocardiographic studies were done before initiating and after achieving drug's steady state. RESULTS: Significantly prolonged corrected QT interval (QTc) was noticed following only sotalol and amiodarone...
January 2017: Future Cardiology
https://www.readbyqxmd.com/read/27990841/management-of-pregnancy-in-cardiomyopathies-and-heart-failure
#13
Enrica Golia, Rita Gravino, Alessandra Rea, Daniele Masarone, Marta Rubino, Annapaola Cirillo, Roberta Pacileo, Fiorella Fratta, Maria Giovanna Russo, Giuseppe Pacileo, Giuseppe Limongelli
Pregnancy exposes women with inherited cardiomyopathies to increased risk for arrhythmias and heart failure. In asymptomatic patients with inherited cardiomyopathies, pregnancy is generally well tolerated. Preconception evaluation, risk assessment and proper counseling by a team of experienced physicians are mandatory in managing women with inherited cardiomyopathies planning pregnancy. In this paper, we reviewed the clinical course, risk assessment and management during pregnancy of women with cardiomyopathies...
January 2017: Future Cardiology
https://www.readbyqxmd.com/read/27990840/novel-strategies-for-assessing-platelet-reactivity
#14
Mohammad Algahtani, Stan Heptinstall
There are many approaches to assessing platelet reactivity and many uses for such measurements. Initially, measurements were based on the ability of platelets separated from other blood cells to aggregate together following activation with an appropriate 'aggregating agent'. Later, measurements of platelet aggregation in blood itself were performed, and this led to a point-of-care approach to platelet function testing. Measurement of secretory activity through the appearance of the activation marker P-selectin on platelets now provides an alternative approach, which enables remote testing...
January 2017: Future Cardiology
https://www.readbyqxmd.com/read/27976927/interview-with-sanofi-s-dr-tunde-falode
#15
Tunde Falode
Dr Tunde Falode speaks to Elena Conroy, Commissioning Editor: Dr Tunde Falode is General Manager for the Diabetes and Cardiovascular Business Unit in the UK and Ireland at Sanofi, a global pharmaceutical company. Following graduation from the University of Jos Medical School in Nigeria, he secured a basic surgical training post through Guy's and St Thomas' hospitals in London, eventually specializing in cardiac and thoracic surgery, before changing his career path. In addition to his current role at Sanofi, he recently completed his specialist training in pharmaceutical medicine and has a keen interest in sports...
January 2017: Future Cardiology
https://www.readbyqxmd.com/read/27936920/management-of-children-with-congenital-heart-defect-state-of-the-art-and-future-prospects
#16
Marie-Christine Seghaye
The treatment of children with congenital heart defects has evolved in the last 60 years from conservative care to a highly specialized management where advances in imaging, surgical, interventional and support techniques meet together to ensure satisfactory development and good quality of life to the child and to the upcoming grown up. Management of congenital heart defects best begins before birth with the aim, whenever possible, to maintain or establish biventricular physiology or, if this is excluded, to optimize the conditions for univentricular physiology...
January 2017: Future Cardiology
https://www.readbyqxmd.com/read/27731650/use-of-direct-oral-anticoagulants-in-patients-with-nonvalvular-atrial-fibrillation-according-to-clinical-profile
#17
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...
January 2017: Future Cardiology
https://www.readbyqxmd.com/read/27892684/angiotensin-receptor-neprilysin-inhibitor-lcz696-pharmacology-pharmacokinetics-and-clinical-development
#18
Yue Hua, Ian Wang, Bin Liu, Darren J Kelly, Christopher Reid, Danny Liew, Yingchun Zhou, Bing H Wang
Heart failure still has a significant disease burden with poor outcomes worldwide despite advances in therapy. The standard therapies have been focused on blockade of renin-angiotensin-aldosterone system with angiotensin-converting enzyme inhibitors, angiotensin receptor blockers and mineralocorticoid antagonists and the sympathetic nervous system with β-blockers. The natriuretic peptide system is a potential counter-regulatory system that promotes vasodilatation and natriuresis. Angiotensin receptor neprilysin inhibitors are a new class drug capable of blocking the renin-angiotensin-aldosterone system and enhancing the natriuretic peptide system to improve neurohormonal balance...
November 28, 2016: Future Cardiology
https://www.readbyqxmd.com/read/27885840/factors-associated-with-the-reduction-of-albumin-excretion-in-diabetic-hypertensive-patients-differential-effect-of-manidipine-versus-amlodipine
#19
Margarita Saiz-Satjes, Francisco Javier Martinez-Martin, Alex Roca-Cusachs
AIMS: In AMANDHA trial, the addition of manidipine, but not amlodipine, in diabetic patients with uncontrolled hypertension, microalbuminuria and preserved renal function resulted in a large decrease of urinary albumin excretion (UAE) despite similar blood pressure (BP) reductions. Factors associated with the reduction of UAE were analyzed. METHODS: For this purpose, a multivariable analysis was performed. RESULTS: Although after 6 months of treatment, manidipine and amlodipine decreased BP to a similar extent, reductions of UAE were higher with manidipine...
November 25, 2016: Future Cardiology
https://www.readbyqxmd.com/read/27759421/takotsubo-cardiomyopathy-following-recurrent-doses-of-albuterol-due-to-asthma-attack-a-very-rare-case-report
#20
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...
November 2016: Future Cardiology
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