Cardiology

The advent of coronary angiography in the 1960s allowed for the risk stratification of patients with stable angina. Patients with unprotected left main coronary artery disease have an increased risk of death related to the large amount of myocardium supplied by this vessel. Although coronary angiography remains the preferred imaging modality for the evaluation of left main coronary artery stenosis, this technique has important limitations. Angiograms of the left main coronary artery segment can be difficult to interpret, and almost one-third of patients can be misclassified when fractional flow reserve is used as the reference...

Cardiovascular disease (CVD) is the leading global cause of death, accounting for 17.3 million deaths per year. Preventive treatment that reduces CVD by even a small percentage can substantially reduce, nationally and globally, the number of people who develop CVD and the costs of caring for them. This American Heart Association presidential advisory on dietary fats and CVD reviews and discusses the scientific evidence, including the most recent studies, on the effects of dietary saturated fat intake and its replacement by other types of fats and carbohydrates on CVD...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

Heart failure is one of the leading causes of hospitalizations in the United States. Concomitant and significant renal dysfunction is common in patients with heart failure. Increasingly, the syndrome of heart failure is one of cardiorenal failure, in which concomitant cardiac and renal dysfunctions exist, with each accelerating the progression of the other. One fourth of patients hospitalized for the treatment of acute decompensated heart failure will experience significant worsening of renal function, which is associated with worse outcomes...

BACKGROUND: Higher levels of sodium intake are reported to be associated with higher blood pressure. Whether this relationship varies according to levels of sodium or potassium intake and in different populations is unknown. METHODS: We studied 102,216 adults from 18 countries. Estimates of 24-hour sodium and potassium excretion were made from a single fasting morning urine specimen and were used as surrogates for intake. We assessed the relationship between electrolyte excretion and blood pressure, as measured with an automated device...

BACKGROUND: High sodium intake increases blood pressure, a risk factor for cardiovascular disease, but the effects of sodium intake on global cardiovascular mortality are uncertain. METHODS: We collected data from surveys on sodium intake as determined by urinary excretion and diet in persons from 66 countries (accounting for 74.1% of adults throughout the world), and we used these data to quantify the global consumption of sodium according to age, sex, and country...

OBJECTIVE: We aimed to derive and validate a clinical decision rule (CDR) for suspected cardiac chest pain in the emergency department (ED). Incorporating information available at the time of first presentation, this CDR would effectively risk-stratify patients and immediately identify: (A) patients for whom hospitalisation may be safely avoided; and (B) high-risk patients, facilitating judicious use of resources. METHODS: In two sequential prospective observational cohort studies at heterogeneous centres, we included ED patients with suspected cardiac chest pain...

No abstract text is available yet for this article.

Calcific aortic valve disease (CAVD) is the most common heart valve disorder. There is no medical treatment to prevent and/or promote the regression of CAVD. Hence, it is of foremost importance to delineate and understand the key basic underlying mechanisms involved in CAVD. In the past decade our comprehension of the underpinning processes leading to CAVD has expanded at a fast pace. Hence, our understanding of the basic pathobiological processes implicated in CAVD might lead eventually to the development of novel pharmaceutical therapies for CAVD...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

The association between aortic stenosis and gastrointenstinal bleeding due to acquired von Willebrand syndrome (AVWS) has been well established. We report a patient with AVWS from underlying severe endocarditis-associated aortic regurgitation and pre-existing mitral regurgitation. Cardiovascular disease-related AVWS occurs from a selective loss of the largest multimers of von Willebrand factor from high shear forces, and desmopressin leads to transient clinical improvement.

The management of asymptomatic patients with aortic stenosis (AS) is controversial and the mechanisms leading to symptom generation and adverse outcome are not fully understood. Novel imaging techniques offer a noninvasive tool for in vivo assessment of AS and its pathophysiological consequences on the myocardium. Exercise echocardiography provides insight into the mechanisms responsible for exercise limitation and symptom generation. Speckle tracking allows the detection of reduced myocardial strain, which is associated with adverse events in asymptomatic patients...

DESCRIPTION: In February 2014, the American Heart Association/American Stroke Association released their first guideline focused on stroke prevention in women. This new guideline highlights unique risk factors for stroke in women, including oral contraception and hormone therapy, and pregnancy-associated disorders, such as preeclampsia, that may have long-lasting consequences on a woman's health. It also addresses hypertension; atrial fibrillation; migraine headache with aura; and the epidemiology of types of stroke, such as aneurysmal subarachnoid hemorrhage and cerebral vein thrombosis, that are predominant in women...

No abstract text is available yet for this article.

BACKGROUND: Approximately 10% of ischemic strokes are caused by carotid artery stenosis (CAS). Estimated prevalence of asymptomatic CAS is 1%. PURPOSE: To evaluate evidence on screening and treating asymptomatic adults for CAS. DATA SOURCES: MEDLINE, the Cochrane Library, EMBASE, and trial registries through September 2013; MEDLINE through March 2014 for trials. STUDY SELECTION: Good- or fair-quality trials of screening, carotid endarterectomy (CEA), or stenting compared with medical therapy or of intensification of medical therapy; systematic reviews; multi-institution studies reporting harms; and externally validated risk-stratification tools...