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Clinical Medicine Insights. Cardiology

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https://www.readbyqxmd.com/read/28638244/cardiac-rehabilitation-for-patients-with-coronary-artery-disease-a-practical-guide-to-enhance-patient-outcomes-through-continuity-of-care
#1
Catherine Giuliano, Belinda J Parmenter, Michael K Baker, Braden L Mitchell, Andrew D Williams, Katie Lyndon, Tarryn Mair, Andrew Maiorana, Neil A Smart, Itamar Levinger
Coronary artery disease (CAD) is a leading cause of disease burden worldwide. Referral to cardiac rehabilitation (CR) is a class I recommendation for all patients with CAD based on findings that participation can reduce cardiovascular and all-cause mortality, as well as improve functional capacity and quality of life. However, programme uptake remains low, systematic progression through the traditional CR phases is often lacking, and communication between health care providers is frequently suboptimal, resulting in fragmented care...
2017: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/28607546/histologic-sequelae-of-apical-hypertrophic-cardiomyopathy-dystrophic-calcification
#2
Shahryar G Saba, John N Makaryus, Navid Rahmani, Ram Jadonath
We present cardiac computed tomography (CT) findings demonstrating apical hypertrophic cardiomyopathy with dystrophic calcification of the left ventricular apex. The absence of significant epicardial coronary artery disease demonstrated by coronary CT angiography suggests that increased wall tension and decreased microvascular perfusion over time account for the dyskinetic apical myocardium, rather than myocardial infarction secondary to atherosclerotic plaque rupture. These observations support CT as the imaging modality of choice to visualize the deposition of calcium in injured myocardial tissue, a recognized occurrence in chronically infarcted myocardium...
2017: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/28607545/the-genetics-of-aortopathies-in-clinical-cardiology
#3
REVIEW
Amit Goyal, Ali R Keramati, Matthew J Czarny, Jon R Resar, Arya Mani
Aortopathies pose a significant healthcare burden due to excess early mortality, increasing incidence, and underdiagnosis. Understanding the underlying genetic causes, early diagnosis, timely surveillance, prophylactic repair, and family screening are keys to addressing these diseases. Next-generation sequencing continues to expand our understanding of the genetic causes of heritable aortopathies, rapidly clarifying their underlying molecular pathophysiology and suggesting new potential therapeutic targets...
2017: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/28579858/cardiovascular-magnetic-resonance-imaging-incremental-value-in-a-series-of-361-patients-demonstrating-cost-savings-and-clinical-benefits-an-outcome-based-study
#4
Vinayak A Hegde, Robert Ww Biederman, J Ronald Mikolich
BACKGROUND: This study was designed to assess the clinical impact and cost-benefit of cardiovascular magnetic resonance imaging (CMR). In the face of current health care cost concerns, cardiac imaging modalities have come under focused review. Data related to CMR clinical impact and cost-benefit are lacking. METHODS AND RESULTS: Retrospective review of 361 consecutive patients (pts) who underwent CMR exams was conducted. Indications for CMR were tabulated for appropriateness criteria...
2017: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/28469496/use-and-misuse-of-aspirin-in-primary-cardiovascular-prevention
#5
REVIEW
Sergio Coccheri
The use of low-dose aspirin in primary prevention of cardiovascular (CV) events in healthy or apparently healthy people is a widely debated topic. Many arguments indicate that "primary prevention" is only a conventional definition and that the transition from primary to secondary prevention represents a continuum of increasing levels of CV risk. Although there are no direct proofs of a different efficacy of aspirin at different CV risk levels, in low-risk populations aspirin will appear to be less efficient...
2017: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/28469495/psychological-responses-to-acute-aerobic-resistance-or-combined-exercise-in-healthy-and-overweight-individuals-a-systematic-review
#6
REVIEW
Thomas J Elkington, Samantha Cassar, André R Nelson, Itamar Levinger
INTRODUCTION: Psychological distress and depression are risk factors for cardiovascular disease (CVD). As such, a reduction in psychological distress and increase in positive well-being may be important to reduce the risk for future development of CVD. Exercise training may be a good strategy to prevent and assist in the management of psychological disorders. The psychological effects of the initial exercise sessions may be important to increase exercise adherence. The aims of this systematic review were (a) to examine whether acute aerobic, resistance, or a combination of the 2 exercises improves psychological well-being and reduces psychological distress in individuals with healthy weight and those who are overweight/obese but free from psychological disorders, and (b) if so, to examine which form of exercise might yield superior results...
2017: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/28469494/studying-dyadic-structure-function-relationships-a-review-of-current-modeling-approaches-and-new-insights-into-ca-2-mis-handling
#7
Mary M Maleckar, Andrew G Edwards, William E Louch, Glenn T Lines
Excitation-contraction coupling in cardiac myocytes requires calcium influx through L-type calcium channels in the sarcolemma, which gates calcium release through sarcoplasmic reticulum ryanodine receptors in a process known as calcium-induced calcium release, producing a myoplasmic calcium transient and enabling cardiomyocyte contraction. The spatio-temporal dynamics of calcium release, buffering, and reuptake into the sarcoplasmic reticulum play a central role in excitation-contraction coupling in both normal and diseased cardiac myocytes...
2017: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/28469493/beyond-the-electrocardiogram-mutations-in-cardiac-ion-channel-genes-underlie-nonarrhythmic-phenotypes
#8
REVIEW
Thomas M Roston, Taylor Cunningham, Anna Lehman, Zachary W Laksman, Andrew D Krahn, Shubhayan Sanatani
Cardiac ion channelopathies are an important cause of sudden death in the young and include long QT syndrome, Brugada syndrome, catecholaminergic polymorphic ventricular tachycardia, idiopathic ventricular fibrillation, and short QT syndrome. Genes that encode ion channels have been implicated in all of these conditions, leading to the widespread implementation of genetic testing for suspected channelopathies. Over the past half-century, researchers have also identified systemic pathologies that extend beyond the arrhythmic phenotype in patients with ion channel gene mutations, including deafness, epilepsy, cardiomyopathy, periodic paralysis, and congenital heart disease...
2017: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/28469492/diagnostic-strategies-for-early-recognition-of-cancer-therapeutics-related-cardiac-dysfunction
#9
REVIEW
Carlos R Manrique, Michael Park, Nidhish Tiwari, Juan Carlos Plana, Mario J Garcia
Cardiovascular toxicity in the form of cardiac dysfunction continues to be an obstacle for patients with cancer. Survival and quality of life of cancer survivors are frequently affected by increased incidence of cardiovascular disease. The involvement of the cardiovascular system by primary or secondary malignancies, as well as its dysfunction secondary to the administration of antineoplastics, has led to the development of a new discipline called Cardio-Oncology, an exciting cardiology subspecialty with more questions than answers and as a result an enormous opportunity for research in the field...
2017: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/28469491/synthetic-growth-hormone-releasing-peptides-ghrps-a-historical-appraisal-of-the-evidences-supporting-their-cytoprotective-effects
#10
REVIEW
Jorge Berlanga-Acosta, Angel Abreu-Cruz, Diana García-Del Barco Herrera, Yssel Mendoza-Marí, Arielis Rodríguez-Ulloa, Ariana García-Ojalvo, Viviana Falcón-Cama, Francisco Hernández-Bernal, Qu Beichen, Gerardo Guillén-Nieto
BACKGROUND: Growth hormone-releasing peptides (GHRPs) constitute a group of small synthetic peptides that stimulate the growth hormone secretion and the downstream axis activity. Mounting evidences since the early 1980s delineated unexpected pharmacological cardioprotective and cytoprotective properties for the GHRPs. However, despite intense basic pharmacological research, alternatives to prevent cell and tissue demise before lethal insults have remained as an empty niche in the clinical armamentarium...
2017: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/28469490/species-dependent-mechanisms-of-cardiac-arrhythmia-a-cellular-focus
#11
REVIEW
Andrew G Edwards, William E Louch
Although ventricular arrhythmia remains a leading cause of morbidity and mortality, available antiarrhythmic drugs have limited efficacy. Disappointing progress in the development of novel, clinically relevant antiarrhythmic agents may partly be attributed to discrepancies between humans and animal models used in preclinical testing. However, such differences are at present difficult to predict, requiring improved understanding of arrhythmia mechanisms across species. To this end, we presently review interspecies similarities and differences in fundamental cardiomyocyte electrophysiology and current understanding of the mechanisms underlying the generation of afterdepolarizations and reentry...
2017: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/28096699/the-major-role-of-ik1-in-mechanisms-of-rotor-drift-in-the-atria-a-computational-study
#12
Omer Berenfeld
Maintenance of paroxysmal atrial fibrillation (AF) by fast rotors in the left atrium (LA) or at the pulmonary veins (PVs) is not fully understood. This review describes the role of the heterogeneous distribution of transmembrane currents in the PVs and LA junction (PV-LAJ) in the localization of rotors in the PVs. Experimentally observed heterogeneities in IK1, IKs, IKr, Ito, and ICaL in the PV-LAJ were incorporated into models of human atrial kinetics to simulate various conditions and investigate rotor drifting mechanisms...
2016: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/28008297/altered-calcium-handling-and-ventricular-arrhythmias-in-acute-ischemia
#13
REVIEW
Peter Baumeister, T Alexander Quinn
Acute ischemia results in deadly cardiac arrhythmias that are a major contributor to sudden cardiac death (SCD). The electrophysiological changes involved have been extensively studied, yet the mechanisms of ventricular arrhythmias during acute ischemia remain unclear. What is known is that during acute ischemia both focal (ectopic excitation) and nonfocal (reentry) arrhythmias occur, due to an interaction of altered electrical, mechanical, and biochemical properties of the myocardium. There is particular interest in the role that alterations in intracellular calcium handling, which cause changes in intracellular calcium concentration and to the calcium transient, play in ischemia-induced arrhythmias...
2016: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/28008296/point-of-care-ultraportable-echocardiography-predicts-diuretic-response-in-patients-admitted-with-acute-decompensated-heart-failure
#14
Dena K Krishnan, Barbara Pawlaczyk, Peter A McCullough, Susan Enright, Arvind Kunadi, Thomas E Vanhecke
BACKGROUND: Routine management of patients with acute decompensated heart failure (ADHF) requires careful attentiveness to fluid status and diuretic treatment efficacy. New advances in ultrasound have made ultraportable echocardiography (UE) available to physicians for point-of-care use. The purpose of this study is to explore physiologic measures of intravascular fluid volume derived from UE and explore predictors of diuretic response in ADHF. METHODS: Various echocardiography imaging measurements, particularly diameter and collapse of inferior vena cava (IVC), were collected from 77 patients admitted with a primary diagnosis of ADHF...
2016: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/27980442/understanding-the-outcome-of-randomized-trials-with-drug-eluting-stents-and-coronary-artery-bypass-graft-in-patients-with-multivessel-disease-a-review-of-a-25-year-journey
#15
Alfredo E Rodriguez, Hernán Pavlovsky, Juan Francisco Del Pozo
Randomized clinical trials (RCTs) with first- and second-generation drug-eluting stents (DESs) confirmed the superiority of coronary artery bypass surgery (CABG) in patients with multiple vessel disease. In spite of different DES designs, investigators in these trials used similar percutaneous coronary intervention (PCI) strategies hoping to achieve complete revascularization, meaning that all intermediate lesions would be stented. One of these studies also included small vessels in the revascularization policy...
2016: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/27867305/pulmonary-hypertension-in-heart-failure-patients-presenting-at-oauthc-ile-ife-nigeria
#16
Valentine N Amadi, Olufemi E Ajayi, Anthony O Akintomide, Olugbenga O Abiodun, Olaniyi J Bamikole, Michael O Balogun
BACKGROUND: Pulmonary hypertension (PH) is common in heart failure patients. Literature on PH in heart failure is sparse in Nigeria. This study was carried out to determine the prevalence of PH in heart failure patients and ascertain the relationship between left ventricular systolic and diastolic function and the degree of PH. METHODS: A total of 125 heart failure patients had echocardiography done. PH was diagnosed using tricuspid regurgitation jet and pulmonary ejection jet profile...
2016: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/27840581/light-based-approaches-to-cardiac-arrhythmia-research-from-basic-science-to-translational-applications
#17
REVIEW
Thomas V Karathanos, Patrick M Boyle, Natalia A Trayanova
Light has long been used to image the heart, but now it can be used to modulate its electrophysiological function. Imaging modalities and techniques have long constituted an indispensable part of arrhythmia research and treatment. Recently, advances in the fields of optogenetics and photodynamic therapy have provided scientists with more effective approaches for probing, studying and potentially devising new treatments for cardiac arrhythmias. This article is a review of research toward the application of these techniques...
2016: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/27840580/rationale-and-design-of-randomized-clinical-trial-for-the-assessment-of-macitentan-efficiency-as-coadjuvant-treatment-to-open-and-endovascular-revascularization-in-critical-limb-ischemia
#18
Ignacio Michel, Joaquin De Haro, Silvia Bleda, Ilsem V Laime, Jhenifer Uyaguari, Francisco Acin
INTRODUCTION: Critical limb ischemia (CLI) is defined by ischemic rest pain, tissue loss, or both, secondary to arterial insufficiency, and its prevalence is increasing mainly as a result of the worldwide high prevalence of diabetes. Currently, there are no available conclusive data on the efficacy of any coadjuvant therapy after revascularization procedure benefiting amputation and patency rates. Macitentan is an orally active dual endothelin (ET) receptor antagonist that may contribute to reduce the amputation rate and improve revascularization patency in CLI...
2016: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/27812293/atrial-electrophysiological-remodeling-and-fibrillation-in-heart-failure
#19
REVIEW
Sandeep V Pandit, Antony J Workman
Heart failure (HF) causes complex, chronic changes in atrial structure and function, which can cause substantial electrophysiological remodeling and predispose the individual to atrial fibrillation (AF). Pharmacological treatments for preventing AF in patients with HF are limited. Improved understanding of the atrial electrical and ionic/molecular mechanisms that promote AF in these patients could lead to the identification of novel therapeutic targets. Animal models of HF have identified numerous changes in atrial ion currents, intracellular calcium handling, action potential waveform and conduction, as well as expression and signaling of associated proteins...
2016: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/27790050/arrhythmogenic-right-ventricular-dysplasia-in-neuromuscular-disorders
#20
REVIEW
Josef Finsterer, Claudia Stöllberger
OBJECTIVES: Arrhythmogenic right ventricular dysplasia (ARVD) is a rare, genetic disorder predominantly affecting the right ventricle. There is increasing evidence that in some cases, ARVD is due to mutations in genes, which have also been implicated in primary myopathies. This review gives an overview about myopathy-associated ARVD and how these patients can be managed. METHODS: A literature review was done using appropriate search terms. RESULTS: The myopathy, which is most frequently associated with ARVD, is the myofibrillar myopathy due to desmin mutations...
2016: Clinical Medicine Insights. Cardiology
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