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By César Gerardo Martínez Hernández General and Nuclear Cardiologist
https://www.readbyqxmd.com/read/27766049/management-of-venous-thromboembolism-an-update
#1
REVIEW
Siavash Piran, Sam Schulman
Venous thromboembolism (VTE), which constitutes pulmonary embolism and deep vein thrombosis, is a common disorder associated with significant morbidity and mortality. Landmark trials have shown that direct oral anticoagulants (DOACs) are as effective as conventional anticoagulation with vitamin K antagonists (VKA) in prevention of VTE recurrence and associated with less bleeding. This has paved the way for the recently published guidelines to change their recommendations in favor of DOACs in acute and long-term treatment of VTE in patients without cancer...
2016: Thrombosis Journal
https://www.readbyqxmd.com/read/27978950/gene-therapy-with-angiotensin-1-9-preserves-left-ventricular-systolic-function-after-myocardial-infarction
#2
Caroline Fattah, Katrin Nather, Charlotte S McCarroll, Maria P Hortigon-Vinagre, Victor Zamora, Monica Flores-Munoz, Lisa McArthur, Lorena Zentilin, Mauro Giacca, Rhian M Touyz, Godfrey L Smith, Christopher M Loughrey, Stuart A Nicklin
BACKGROUND: Angiotensin-(1-9) [Ang-(1-9)] is a novel peptide of the counter-regulatory axis of the renin-angiotensin-aldosterone system previously demonstrated to have therapeutic potential in hypertensive cardiomyopathy when administered via osmotic mini-pump. Here, we investigate whether gene transfer of Ang-(1-9) is cardioprotective in a murine model of myocardial infarction (MI). OBJECTIVES: The authors evaluated effects of Ang-(1-9) gene therapy on myocardial structural and functional remodeling post-infarction...
December 20, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28043978/the-year-in-cardiology-2016-valvular-heart-disease
#3
Ottavio Alfieri, Alec Vahanian
No abstract text is available yet for this article.
January 2, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28030676/aortic-stenosis
#4
Faisal G Bakaeen, Todd K Rosengart, Blase A Carabello
This issue provides a clinical overview of aortic stenosis, focusing on screening, diagnosis, treatment, and practice improvement. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of additional science writers and physician writers...
January 3, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27990270/recent-advances-in-the-management-of-pulmonary-arterial-hypertension
#5
REVIEW
Halley Tsai, Yon K Sung, Vinicio de Jesus Perez
Over the past 20 years, there has been an explosion in the development of therapeutics to treat pulmonary arterial hypertension (PAH), a rare but life-threatening disorder associated with progressive elevation of pulmonary pressures and severe right heart failure. Recently, the field has seen the introduction of riociguat, a soluble guanylate cyclase stimulator, a new endothelin receptor antagonist (macitentan), and oral prostanoids (treprostinil and selexipag). Besides new drugs, there have been significant advances in defining the role of upfront combination therapy in treatment-naïve patients as well as proposed methods to deliver systemic prostanoids by use of implantable pumps...
2016: F1000Research
https://www.readbyqxmd.com/read/27879279/heart-rate-turbulence-is-a-powerful-predictor-of-cardiac-death-and-ventricular-arrhythmias-in-postmyocardial-infarction-and-heart-failure-patients-a-systematic-review-and-meta-analysis
#6
Marcello Disertori, Michela Masè, Marta Rigoni, Giandomenico Nollo, Flavia Ravelli
BACKGROUND: Heart rate turbulence (HRT) has been proposed as a candidate marker of altered autonomic tone, and some studies showed its prognostic value for both cardiac death (CD) and sudden death. Nevertheless, HRT is not currently used in the clinical practice. METHODS AND RESULTS: We performed a systematic review and meta-analysis of the predictive value of HRT for the end points of total mortality, CD, and fatal and nonfatal ventricular arrhythmias in postacute myocardial infarction and heart failure patients...
December 2016: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28012615/acc-aats-aha-ase-asnc-scai-scct-sts-2016-appropriate-use-criteria-for-coronary-revascularization-in-patients-with-acute-coronary-syndromes-a-report-of-the-american-college-of-cardiology-appropriate-use-criteria-task-force-american-association-for-thoracic-surgery
#7
https://www.readbyqxmd.com/read/27993908/implantable-cardioverter-defibrillator-for-non-ischemic-cardiomyopathy-an-updated-meta-analysis
#8
Harsh Golwala, Navkaranbir Singh Bajaj, Garima Arora, Pankaj Arora
Use of Implantable cardioverter-defibrillators (ICD) have been a major advancement in patients with ischemic cardiomyopathy (ICM) with reduced ejection fraction <35%.(1) While the data supporting the use of ICDs are robust in patients with ICM, limited randomized controlled clinical trial (RCT) data exist for similar benefit in patients with non-ischemic cardiomyopathy (NICM).(2) A prior meta-analysis that included both primary and secondary prevention ICD trials in 2004 by Desai et al. demonstrated a 31% reduction in all-cause mortality with ICD use in patients with NICM...
December 19, 2016: Circulation
https://www.readbyqxmd.com/read/27941935/renal-metabolic-and-cardiovascular-considerations-of-sglt2-inhibition
#9
REVIEW
Ralph A DeFronzo, Luke Norton, Muhammad Abdul-Ghani
The kidney has a pivotal role in maintaining glucose homeostasis by using glucose as a metabolic fuel, by producing glucose through gluconeogenesis, and by reabsorbing all filtered glucose through the sodium-glucose cotransporters SGLT1 and SGLT2 located in the proximal tubule. In patients with diabetes, the maximum glucose reabsorptive capacity (TmG) of the kidney, as well as the threshold for glucose spillage into the urine, are elevated, contributing to the pathogenesis of hyperglycaemia. By reducing the TmG and, more importantly, the threshold of glucosuria, SGLT2 inhibitors enhance glucose excretion, leading to a reduction in fasting and postprandial plasma glucose levels and improvements in both insulin secretion and insulin sensitivity...
January 2017: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/28011759/-end-stage-heart-failure-therapy-potential-lessons-from-congenital-heart-disease-from-pulmonary-artery-banding-and-interatrial-communication-to-parallel-circulation
#10
REVIEW
Dietmar Schranz, Hakan Akintuerk, Norbert F Voelkel
The final therapy of 'end-stage heart failure' is orthotopic heart, lung or heart-lung transplantation. However, these options are not available for many patients worldwide. Therefore, novel therapeutical strategies are needed. Based on pathophysiological insights regarding (1) the long-term impact of an obstructive pulmonary outflow tract in neonates with congenitally corrected transposition of the great arteries, (2) the importance of a restrictive versus a non-restrictive atrial septum in neonates born with a borderline left ventricle and (3) the significance of both, a patent foramen ovale and/or open ductus arteriosus for survival of newborns with persistent pulmonary hypertension, the current review introduces some therapeutical strategies that may be applicable to selected patients with heart failure...
December 23, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27986651/effects-of-pcsk9-inhibition-with-alirocumab-on-lipoprotein-metabolism-in-healthy-humans
#11
Gissette Reyes-Soffer, Marianna Pavlyha, Colleen Ngai, Tiffany Thomas, Stephen Holleran, Rajasekhar Ramakrishnan, Wahida Karmally, Renu Nandakumar, Nelson Fontanez, Joseph C Obunike, Santica M Marcovina, Alice H Lichtenstein, Nirupa R Matthan, James Matta, Magali Maroccia, Frederic Becue, Franck Poitiers, Brian Swanson, Lisa Cowan, William J Sasiela, Howard K Surks, Henry N Ginsberg
BACKGROUND: -Alirocumab, a monoclonal antibody to proprotein convertase subtilisin/kexin type 9 (PCSK9), lowers plasma low density lipoprotein cholesterol (LDL-C) and apolipoprotein B100 (apoB). Although studies in mice and cells have identified increased hepatic LDL receptors as the basis for LDL lowering by PCSK9 inhibitors, there have been no human studies characterizing the effects of PCSK9 inhibitors on lipoprotein metabolism. In particular, it is not known if inhibition of PCSK9 has any effects on very low density lipoprotein (VLDL) or intermediate density lipoprotein (IDL) metabolism...
December 16, 2016: Circulation
https://www.readbyqxmd.com/read/27794017/predictors-of-atrial-fibrillation-in-hypertrophic-cardiomyopathy
#12
Oliver P Guttmann, Menelaos Pavlou, Constantinos O'Mahony, Lorenzo Monserrat, Aristides Anastasakis, Claudio Rapezzi, Elena Biagini, Juan Ramon Gimeno, Giuseppe Limongelli, Pablo Garcia-Pavia, William J McKenna, Rumana Z Omar, Perry M Elliott
OBJECTIVES: Atrial fibrillation (AF) is associated with increased morbidity and mortality in patients with hypertrophic cardiomyopathy (HCM). The primary aim of this study (HCM Risk-AF) was to determine the predictors of AF in a large multicentre cohort of patients with HCM. Exploratory analyses were performed to investigate the association between AF and survival and the efficacy of antiarrhythmic therapy in maintaining sinus rhythm (SR). METHODS: A retrospective, longitudinal cohort of patients recruited between 1986 and 2008 in seven centres was used to develop multivariable Cox regression models fitted with preselected predictors...
October 28, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27840364/25-years-of-proton-pump-inhibitors-a-comprehensive-review
#13
REVIEW
Daniel S Strand, Daejin Kim, David A Peura
Proton pump inhibitors (PPIs) were clinically introduced more than 25 years ago and have since proven to be invaluable, safe, and effective agents for the management of a variety of acid-related disorders. Although all members in this class act in a similar fashion, inhibiting active parietal cell acid secretion, there are slight differences among PPIs relating to their pharmacokinetic properties, metabolism, and Food and Drug Administration (FDA)-approved clinical indications. Nevertheless, each is effective in managing gastroesophageal reflux disease and uncomplicated or complicated peptic ulcer disease...
January 15, 2017: Gut and Liver
https://www.readbyqxmd.com/read/27855810/computed-tomography-and-cardiac%C3%A2-magnetic-resonance-in-ischemic%C3%A2-heart%C3%A2-disease
#14
REVIEW
Marc R Dweck, Michelle C Williams, Alastair J Moss, David E Newby, Zahi A Fayad
Ischemic heart disease is a complex disease process caused by the development of coronary atherosclerosis, with downstream effects on the left ventricular myocardium. It is characterized by a long preclinical phase, abrupt development of myocardial infarction, and more chronic disease states such as stable angina and ischemic cardiomyopathy. Recent advances in computed tomography (CT) and cardiac magnetic resonance (CMR) now allow detailed imaging of each of these different phases of the disease, potentially allowing ischemic heart disease to be tracked during a patient's lifetime...
November 15, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27881565/low-dose-aspirin-for-primary-prevention-of-cardiovascular-events-in-patients-with-type-2-diabetes-10-year-follow-up-of-a-randomized-controlled-trial
#15
Yoshihiko Saito, Sadanori Okada, Hisao Ogawa, Hirofumi Soejima, Mio Sakuma, Masafumi Nakayama, Naofumi Doi, Hideaki Jinnouchi, Masako Waki, Izuru Masuda, Takeshi Morimoto
BACKGROUND: -The long-term efficacy and safety of low-dose aspirin for primary prevention of cardiovascular events in patients with type 2 diabetes are still inconclusive. METHODS: -The Japanese Primary Prevention of Atherosclerosis with Aspirin for Diabetes (JPAD) trial was a randomized, open-label, standard-care controlled trial examining whether low-dose aspirin affected cardiovascular events in 2539 Japanese patients with type 2 diabetes and without pre-existing cardiovascular disease...
November 15, 2016: Circulation
https://www.readbyqxmd.com/read/25081992/cardiovascular-morbidity-and-mortality-after-kidney-transplantation
#16
REVIEW
Sokratis Stoumpos, Alan G Jardine, Patrick B Mark
Kidney transplantation is the optimal treatment for patients with end stage renal disease (ESRD) who would otherwise require dialysis. Patients with ESRD are at dramatically increased cardiovascular (CV) risk compared with the general population. As well as improving quality of life, successful transplantation accords major benefits by reducing CV risk in these patients. Worldwide, cardiovascular disease remains the leading cause of death with a functioning graft and therefore is a leading cause of graft failure...
January 2015: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/26483101/reverse-remodeling-and-prognosis-following-kidney-transplantation-in-contemporary-patients-with-cardiac-dysfunction
#17
Nael Hawwa, Kevin Shrestha, Muhammad Hammadah, Poh Shuan Daniel Yeo, Richard Fatica, W H Wilson Tang
BACKGROUND: Cardiac dysfunction influences candidate selection for kidney transplantation. There is a paucity of data regarding predictors of myocardial recovery following kidney transplantation and long-term outcomes. OBJECTIVES: The purpose of this study was to identify the extent of reverse remodeling in our kidney transplant population and the predictors of such changes, and to assess outcomes in these patients. METHODS: We reviewed 232 patients who underwent kidney transplantation at the Cleveland Clinic from 2003 to 2013 and who had baseline and post-transplant echocardiograms; patients with simultaneous heart transplantation were excluded...
October 20, 2015: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27884252/differentiation-of-constriction-and-restriction-complex-cardiovascular-hemodynamics
#18
REVIEW
Jeffrey B Geske, Nandan S Anavekar, Rick A Nishimura, Jae K Oh, Bernard J Gersh
Differentiation of constrictive pericarditis (CP) from restrictive cardiomyopathy (RCM) is a complex and often challenging process. Because CP is a potentially curable cause of heart failure and therapeutic options for RCM are limited, distinction of these 2 conditions is critical. Although different in regard to etiology, prognosis, and treatment, CP and RCM share a common clinical presentation of predominantly right-sided heart failure, in the absence of significant left ventricular systolic dysfunction or valve disease, due to impaired ventricular diastolic filling...
November 29, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/15970476/uremic-cardiomyopathy-role-of-circulating-digitalis-like-substances
#19
REVIEW
Behram Mohmand, Deepak K Malhotra, Joseph I Shapiro
Patients with chronic renal failure develop a cardiomyopathy characterized by marked diastolic dysfunction and left ventricular hypertrophy. Interestingly, they also have substantial increases in the circulating concentrations of digitalis like substances. Digitalis like substances produce reactive oxygen species as part of the signal cascade induced by binding to the sodium pump and patients, and this signal cascade appears to induce hypertrophy of cardiac myocytes grown in culture. Also, patients with chronic renal failure develop an oxidant stress state without a known mechanism...
September 1, 2005: Frontiers in Bioscience: a Journal and Virtual Library
https://www.readbyqxmd.com/read/23615021/uremic-cardiomyopathy-an-underdiagnosed-disease
#20
REVIEW
Eyad Alhaj, Nehad Alhaj, Ifad Rahman, Tariq O Niazi, Robert Berkowitz, Marc Klapholz
Uremic cardiomyopathy is responsible for high morbidity and mortality rates among patients with chronic kidney disease (CKD) or end-stage renal disease (ESRD); however, the early implementation of hemodialysis may halt its progression. Nonconventional hemodialysis, such as frequent hemodialysis, appears to have an advantage over conventional hemodialysis. Kidney transplantation has been shown to reverse uremic cardiomyopathy and to confer a significant survival advantage over hemodialysis. Targeting future therapies at the underlying cellular mechanisms of uremic cardiomyopathy may finally start to reduce the burden of uremic cardiomyopathy in the CKD and ESRD population...
July 2013: Congestive Heart Failure
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