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Current Opinion in Cardiology

Amanda W Cai, Marian H Taylor, Bhavadharini Ramu
PURPOSE OF REVIEW: The number of cancer survivors is increasing, and cardiovascular events are a significant cause of morbidity and mortality in these patients. Preexisting cardiovascular conditions as well as the development of cancer therapeutics-related cardiac dysfunction (CTRCD), in particular left ventricular dysfunction and heart failure, limit the options for cancer therapies for these patients and contribute to reduced cancer survival. RECENT FINDINGS: Recent guidelines and position statements from various cardiology and oncology societies provide an outline for the practicing physician for the management of CTRCD...
February 11, 2019: Current Opinion in Cardiology
Yiqiang Zhan, Sara Hägg
PURPOSE OF REVIEW: Telomere length has been hypothesized as a putative biomarker for cardiovascular disease. However, the findings are mixed and shared confounding factors may explain these associations. The current review aims to summarize the recent literature on the role of telomere length in cardiovascular disease and give directions for future potential as a predictive biomarker. RECENT FINDINGS: In this review, we outline the biology of telomeres as a biomarker of aging through its shortening capacity across the life course...
February 11, 2019: Current Opinion in Cardiology
Beau van Driel, Louise Nijenkamp, Roy Huurman, Michelle Michels, Jolanda van der Velden
PURPOSE OF REVIEW: Hypertrophic cardiomyopathy (HCM) is the most common genetic cardiomyopathy, diagnosed by left ventricular hypertrophy of at least 15 mm maximal wall thickness (MWT). Recent studies reported a sex difference in clinical presentation, progression and outcome of HCM. This review provides an overview of recent studies into sex differences in HCM. RECENT FINDINGS: A higher number of men (55-65% of total HCM patient group) with manifest HCM has been observed, whereas female patients are older at first evaluation and diagnosis, present more frequently with symptoms, and have worse survival...
February 11, 2019: Current Opinion in Cardiology
Diane Fatkin, Inken G Huttner, Renee Johnson
PURPOSE OF REVIEW: Atrial cardiomyopathy is a frequently encountered but underappreciated clinical entity that is characterized by altered atrial size and function. Although traditionally considered a primary atrial disorder, atrial cardiomyopathy was recently redefined to include secondary atrial remodelling. This conceptual shift has implications for the scope of etiological factors and intervention strategies. Our aim was to evaluate the potential contribution of genetics to atrial cardiomyopathy...
January 21, 2019: Current Opinion in Cardiology
Satya Shreenivas, Tsuyoshi Kaneko, Gilbert H L Tang
PURPOSE OF REVIEW: Transcatheter aortic valve replacement (TAVR) has become the cornerstone for aortic valve intervention since the first implantation in 2002. Recent advances with novel devices and introduction into lower risk cohorts have been successful. In this review, we discuss the ongoing limitations to transcatheter aortic valve therapy and whether it will replace surgical aortic valve replacement in the foreseeable future. RECENT FINDINGS: A better understanding of valve durability, high-grade heart block, and stroke post TAVR has led to practice changes that improve patient outcome...
January 11, 2019: Current Opinion in Cardiology
Edwin C Ho, Geraldine Ong, Neil P Fam
PURPOSE OF REVIEW: Worldwide experience in transcatheter tricuspid valve intervention is increasing as more options become available for the treatment of severe tricuspid regurgitation. These devices can be categorized by their primary mechanism of action, including edge-to-edge leaflet devices, space occupying devices, annuloplasty devices, complete valve replacement and caval valve implantation. This review summarizes the current technologies in use, early clinical results and factors that may affect procedural success...
January 11, 2019: Current Opinion in Cardiology
Géraldine Ong, Andrew T Yan, Kim A Connelly
PROPOSE OF REVIEW: To highlight the evidence to support the measurement of left ventricular (LV) global longitudinal strain (GLS) in the risk assessment and management of patients with valvular heart disease. RECENT FINDINGS: Subclinical myocardial dysfunction that is characterized by impaired LV GLS is often present in patients with valvular disease. The addition of GLS to the LV systolic function assessment refines disease classification and improves both prognosis and management of valvular disease...
January 9, 2019: Current Opinion in Cardiology
Nicholas Wettersten, Alan S Maisel
PURPOSE OF REVIEW: Biomarkers play a fundamental role in the management of heart failure. Both new and old biomarkers are evaluated every year with new information gained for their use in heart failure. Major advancements have been made in the past 2 years in key biomarkers that will surely become part of standard clinical management of heart failure. This review will focus on major developments since 2016. RECENT FINDINGS: Soluble suppression of tumorigenicity 2 has had multiple breakthrough studies solidifying its prognostic use in both acute and chronic heart failure and with multiple studies showing a strong benefit with serial monitoring...
January 9, 2019: Current Opinion in Cardiology
Bradley Brochu, Michael Chan
PURPOSE OF REVIEW: Diabetes is a well-recognized risk factor for the development of cardiovascular disease. In recent years, several new glucose-lowering drugs (GLD) have shown improvements in cardiovascular outcomes, renewing interest of cardiovascular specialists in diabetes management. RECENT FINDINGS: Individual studies in the last 5 years have demonstrated the cardiovascular safety of certain dipeptidyl peptidase-4 inhibitors, glucagon-like peptide 1 agonists, and sodium glucose cotransporter 2 inhibitors...
January 2, 2019: Current Opinion in Cardiology
Yohan Bossé, Patrick Mathieu, Sébastien Thériault
PURPOSE OF REVIEW: Novel medical treatments are urgently needed to stem the escalating socioeconomic burden of calcific aortic valve stenosis (CAVS). Herein, we describe the discovery of PALMD as a disease-causing gene for CAVS and discuss its implications for the understanding of disease pathogenesis and the development of new treatment options. RECENT FINDINGS: Large-scale genomic approaches are finally starting to yield genetic loci robustly associated with CAVS...
January 2, 2019: Current Opinion in Cardiology
Andrew C T Ha, Atul Verma, C David Mazer, Bobby Yanagawa, Subodh Verma
PURPOSE OF REVIEW: We provide an updated review on the incidence of postoperative atrial fibrillation (POAF) after cardiac surgery as determined by enhanced cardiac rhythm monitoring technology and provide a rationale for why a more aggressive detection approach for POAF may be clinically useful. RECENT FINDINGS: Most of the published literature had focused on the in-hospital incidence of POAF after cardiac surgery. However, recent studies using continuous cardiac rhythm technologies revealed that the incidence of POAF during the postdischarge, subacute (<1 month) phase could be as high as 28%...
December 24, 2018: Current Opinion in Cardiology
Shuhua Luo, Osami Honjo
PURPOSE OF REVIEW: It has been more than 4 decades since the development of Fontan operation. With the contemporary surgical strategies to treat the patients with a single ventricle physiology, the medium-term survival of the patients following Fontan operation is excellent. Nonetheless, the Fontan circulation with a pumpless pulmonary circulation has fundamental physiologic limitations, which are associated with late Fontan failure and deaths. There has been an exponential growth of adolescence and adults living with a Fontan circulation, which poses significant challenges in future...
December 19, 2018: Current Opinion in Cardiology
Amine Mazine, Subodh Verma, Bobby Yanagawa
PURPOSE OF REVIEW: The purpose of this study is to review the contemporary evidence surrounding aortic bioprosthetic valve deterioration, with a focus on early failure of surgically implanted valves. RECENT FINDINGS: Structural valve deterioration (SVD) remains the most frequent cause of premature bioprosthetic aortic valve failure. However, recent evidence suggests that SVD represents a spectrum, and that clinically silent hemodynamic valve deterioration frequently precedes and predisposes to overt SVD...
December 19, 2018: Current Opinion in Cardiology
Adilah F Ahmad, Natalie C Ward, Girish Dwivedi
PURPOSE OF REVIEW: The human gut is populated by a complex community of microbiota that coexists with the host to maintain homeostasis. Accumulating evidence shows that changes in the composition and diversity of gut microbiota, known as dysbiosis, is associated with cardiovascular diseases, such as atherosclerosis, hypertension, and heart failure. RECENT FINDINGS: Although recent advances in biochemical and molecular analyses have contributed to the detection, identification, and characterization of a variety of gut microbiota genomes and their associated metabolites, the exact mechanisms of action remain unclear...
December 19, 2018: Current Opinion in Cardiology
Erwan Salaun, Nancy Côté, Marie-Annick Clavel, Philippe Pibarot
PURPOSE OF REVIEW: Bioprosthetic valves are now used for the majority of surgical aortic valve replacements and for all transcatheter aortic valve replacements. However, bioprostheses are subject to structural valve deterioration (SVD) and have, therefore limited durability. RECENT FINDINGS: Clinical, imaging, and circulating biomarkers may help to predict or indicate the presence of bioprosthetic valve SVD. The most important biomarkers of SVD includes: patient-related clinical biomarkers, such as diabetes and renal failure; valve-related biomarkers, such as absence of antimineralization process and severe prosthesis-patient mismatch; imaging biomarkers: the presence of valve leaflet mineralization on multidetector computed tomography or sodium fluoride uptake on positron emission tomography; and circulating biomarkers including: increased levels of HOMA index, ApoB/ApoA-I ratio, PCSK9, Lp-PLA2, phosphocalcic product...
December 17, 2018: Current Opinion in Cardiology
Pishoy Gouda, Justin A Ezekowitz
PURPOSE OF REVIEW: To highlight the advances in the diagnosis and management of acute heart failure (AHF) from recent clinical trials and observational studies. RECENT FINDINGS: We highlight date from recent studies examining the use of novel biomarkers (micro RNAs, osteopontin, insulin-like growth-factor binding protein-7) for the diagnosis of AHF. In addition, we summarize the evidence for novel pharmacological therapies including: serelaxin, ularitide, clevidipine, urocortins, BMS-986231, TRB027, vericiguat, omecamtiv, and torsemide...
December 12, 2018: Current Opinion in Cardiology
Hamed Nazzari, Colin D Chue, Mustafa Toma
PURPOSE OF REVIEW: Use of durable left ventricular assist devices (LVADs) has increased considerably in recent years because of the insufficient supply of donor hearts for cardiac transplantation and improvement in outcomes from refinements in technology. This review examines clinical utility of these devices and summarizes the most recent evidence supporting the use of LVAD therapy. RECENT FINDINGS: There continues to be significant advancements made in LVAD technology, which has resulted in improvements in the rates of adverse events and overall patient quality of life...
March 2019: Current Opinion in Cardiology
Benjamin Bartlett, Herbert P Ludewick, Silvia Lee, Girish Dwivedi
PURPOSE OF REVIEW: Pneumonia, an inflammatory disease, is the single largest infectious cause of death. Pneumonia has recently been established as an important contributing factor to major adverse cardiovascular events including heart failure. Developing an intermechanistic understanding of pneumonia and cardiovascular disease is crucial for successful future drug therapy and reducing healthcare expenditure. RECENT FINDINGS: Up to 30% of patients admitted with pneumonia develop cardiovascular complications such as heart failure within 10 years of hospital discharge...
March 2019: Current Opinion in Cardiology
Ali Fatehi Hassanabad, Julio Garcia, Subodh Verma, James A White, Paul W M Fedak
PURPOSE OF REVIEW: Bicuspid aortic valve (BAV) results from fusion of two adjacent aortic valve cusps, and is associated with dilatation of the aorta, known as BAV-associated aortopathy, or bicuspid aortopathy. Bicuspid aortopathy is progressive, increasing the risk of life-threatening clinical events, such as aortic dissection. Regular monitoring and timely intervention with prophylactic surgical resection of the proximal aorta is recommended. RECENT FINDINGS: Aortopathy is heterogeneous among patients...
March 2019: Current Opinion in Cardiology
Dominique Kushneriuk, Haissam Haddad, Rashpal Basran, Jay S Shavadia
PURPOSE OF REVIEW: Secondary mitral regurgitation commonly complicates heart failure. Although the evidence for its management is most robust for treating the underlying cardiomyopathy, treatment aimed at additionally reducing the severity of mitral regurgitation with a percutaneous edge-to-edge device, MitraClip, has recently emerged. RECENT FINDINGS: Despite the use of contemporary evidence-based heart failure therapies, patients with secondary mitral regurgitation and heart failure continue to remain at high risk for adverse clinical events; in both the MITRA-FR and COAPT trials, an extremely high event rate was evident in the medically managed arms over the respective 12-24-month follow-up...
March 2019: Current Opinion in Cardiology
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