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Current Treatment Options in Cardiovascular Medicine

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https://read.qxmd.com/read/30767157/evaluation-and-monitoring-of-pulmonary-hypertension-in-neonates-with-congenital-diaphragmatic-hernia
#1
REVIEW
Aura A Sanchez Mejia, Nathan J Rodgers
PURPOSE OF REVIEW: This review aims to describe the assessment of pulmonary hypertension and ventricular function in neonates with congenital diaphragmatic hernia and the long-term follow-up of their pulmonary vascular disease. RECENT FINDINGS: In 2015, the pediatric pulmonary hypertension guidelines from the American Heart Association and American Thoracic Society suggested class I level of evidence B guidelines for routine evaluation of patients with congenital diaphragmatic hernia, including longitudinal care in an interdisciplinary pulmonary hypertension program and following the recommendations offered for all children with pulmonary hypertension...
February 15, 2019: Current Treatment Options in Cardiovascular Medicine
https://read.qxmd.com/read/30767138/comprehensive-evaluation-of-right-heart-performance-and-pulmonary-hemodynamics-in-neonatal-pulmonary-hypertension-evaluation-of-cardiopulmonary-performance-in-neonatal-pulmonary-hypertension
#2
REVIEW
Soume Bhattacharya, Shawn Sen, Philip T Levy, Danielle R Rios
PURPOSE OF REVIEW: Pulmonary hypertension is characterized by an elevation of pulmonary artery pressures and prolonged exposure of the right ventricle to high afterload that collectively contribute to morbidity and mortality in both the term and preterm infants. This review summarizes the pathogenesis, etiologies, and hemodynamic profiles of the conditions that result in pulmonary hypertension in neonates. We explore the application of echocardiographic techniques for the assessment of right ventricular performance and pulmonary hemodynamics that enhance and guide the diagnosis and management strategies in neonates...
February 15, 2019: Current Treatment Options in Cardiovascular Medicine
https://read.qxmd.com/read/30767074/prelude-to-pediatric-and-congenital-heart-disease
#3
REVIEW
Gautam K Singh
No abstract text is available yet for this article.
February 15, 2019: Current Treatment Options in Cardiovascular Medicine
https://read.qxmd.com/read/30762137/preterm-birth-is-a-novel-independent-risk-factor-for-altered-cardiac-remodeling-and-early-heart-failure-is-it-time-for-a-new-cardiomyopathy
#4
REVIEW
Holger Burchert, Adam J Lewandowski
PURPOSE OF REVIEW: Around 10% of the global population is born preterm (< 37 weeks' gestation). Preterm birth is associated with an increased risk of cardiovascular events, with preterm-born individuals demonstrating a distinct cardiac phenotype. This review aims to summarize the main phenotypic features of the preterm heart and directions for future research to develop novel intervention strategies. RECENT FINDINGS: Being born between 28 and 31 weeks' gestation results in a 4-fold higher risk of heart failure in childhood and adolescence and 17-fold increased risk when born less than 28 weeks' gestation...
February 14, 2019: Current Treatment Options in Cardiovascular Medicine
https://read.qxmd.com/read/30762119/renal-artery-denervation-for-hypertension
#5
REVIEW
Lauren S Ranard, Rajesh V Swaminathan
PURPOSE OF REVIEW: Hypertension (HTN) has a growing impact, already affecting over 1 billion people. An estimated 2-16% of those with HTN have resistant HTN. The sympathetic nervous system (SNS) is a recognized contributor to the pathophysiology of resistant HTN. Current hypertensive pharmacotherapy has not fully targeted the SNS; therefore, the SNS has become a prominent research therapeutic target. This review summarizes the evidence and rationale behind renal denervation (RDN) therapy and the technology available...
February 14, 2019: Current Treatment Options in Cardiovascular Medicine
https://read.qxmd.com/read/30739224/comprehensive-noninvasive-evaluation-of-right-ventricle-pulmonary-circulation-axis-in-pediatric-patients-with-pulmonary-hypertension
#6
REVIEW
Pei-Ni Jone, Dunbar D Ivy
PURPOSE OF REVIEW: The purpose of this review is to detail the advanced echocardiographic studies that evaluated outcomes in pediatric PH using these advanced imaging techniques: (1) right heart size and function (using 2D and 3D echocardiography), (2) myocardial mechanics, and (3) right ventricular (RV) to pulmonary arterial coupling. RECENT FINDINGS: Advanced echocardiographic imaging tools in pediatric PH include RV/left ventricular ratio, 3D echocardiographic assessment of RV volumes and ejection fraction, right atrial and RV strain, and RV-pulmonary arterial coupling ratio that allow for evaluation of clinical outcomes in this patient population...
February 9, 2019: Current Treatment Options in Cardiovascular Medicine
https://read.qxmd.com/read/30739215/coronary-revascularization-in-high-risk-stable-patients-with-significant-comorbidities-challenges-in-decision-making
#7
REVIEW
Joshua Schulman-Marcus, Kellsey Peterson, Riju Banerjee, Sanjay Samy, Neil Yager
PURPOSE OF REVIEW: There is a growing cohort of complex high-risk patients with stable ischemic heart disease (SIHD) who present for coronary artery bypass graft (CABG) surgery and percutaneous coronary intervention (PCI). These patients are older, have complex coronary disease, and a substantial comorbidity burden including frailty. The procedural risks and outcomes of CABG and PCI in these patients are more difficult to assess based on the available literature, which has generally studied a younger population with a lower comorbidity burden...
February 9, 2019: Current Treatment Options in Cardiovascular Medicine
https://read.qxmd.com/read/30729357/revascularization-in-cardiogenic-shock-and-advanced-heart-failure
#8
REVIEW
Youssef Rahban, Carlos D Davila, Peter S Natov, Navin K Kapur
PURPOSE OF REVIEW: Ischemic heart disease is the most common cause of heart failure with systolic dysfunction. The progressive course of heart failure characterized by increasing levels of care and worsening quality of life often indicates an advanced stage. Similarly, cardiogenic shock remains a major clinical problem with prohibitively high mortality rates despite major advances in clinical care. Here, we review the current treatment options and available data for revascularization in patients with ischemic cardiomyopathy, advanced heart failure, and cardiogenic shock...
February 7, 2019: Current Treatment Options in Cardiovascular Medicine
https://read.qxmd.com/read/30729324/antithrombotic-strategies-in-patients-with-atrial-fibrillation-undergoing-percutaneous-coronary-intervention
#9
REVIEW
Bharath Rajagopalan, Christopher Madias
PURPOSE OF REVIEW: The choice of appropriate antithrombotic therapy in patients with atrial fibrillation (AF) undergoing percutaneous coronary interventions (PCI) should be approached prudently. Careful consideration is necessary, balancing the ischemic and bleeding risk. Traditionally, triple antithrombotic therapy comprising of aspirin, a P2Y12 inhibitor, and an oral anticoagulant is associated with high bleeding rates. RECENT FINDINGS: Recent trials have evaluated the safety and effectiveness of dual antithrombotic therapy in AF patients undergoing PCI...
February 7, 2019: Current Treatment Options in Cardiovascular Medicine
https://read.qxmd.com/read/30685799/radial-percutaneous-coronary-intervention-in-complex-arm-and-chest-vasculature-tips-and-tricks
#10
REVIEW
Devang S Parikh, Kejal Gandhi, Adhir Shroff
PURPOSE OF REVIEW: The purpose of this review is to identify the anatomical difficulties an operator may encounter during the transradial approach for cardiac catheterization and to offer tips and tricks to overcome those challenges. RECENT FINDINGS: With increasing implementation of the transradial approach for cardiac catheterization, many new techniques have been utilized to overcome anatomical challenges. This article also discusses the difficulties faced during transradial approach in patients with prior coronary artery bypass grafting (CABG)...
January 26, 2019: Current Treatment Options in Cardiovascular Medicine
https://read.qxmd.com/read/30659365/contemporary-approach-to-chronic-total-occlusion-interventions
#11
REVIEW
Mahesh Anantha-Narayanan, Santiago Garcia
PURPOSE OF REVIEW: Chronic total occlusion (CTO) poses one of the greatest technical challenges to interventional cardiologists. Despite recent advancements in techniques and clinical trials showing significant benefits of CTO percutaneous coronary interventions (PCI), the proportion of patients with untreated CTOs remains high. We therefore aim to perform a comprehensive review of the various techniques available, recent advancements, benefits, and complications associated with CTO PCI...
January 18, 2019: Current Treatment Options in Cardiovascular Medicine
https://read.qxmd.com/read/30456469/interpreting-the-athlete-s-ecg-current-state-and-future-perspectives
#12
REVIEW
Joyee Basu, Aneil Malhotra
Sudden cardiac death (SCD) is the leading cause of death in athletes. A large proportion of these deaths are associated with undiagnosed cardiovascular disease. Screening for high-risk individuals enables early detection of pathology, as well as permitting lifestyle modification or therapeutic intervention.ECG changes in athletes occur as a result of electrical and structural adaptations secondary to repeated bouts of exercise. Such changes are common and may overlap with patterns suggestive of underlying cardiovascular disease...
November 19, 2018: Current Treatment Options in Cardiovascular Medicine
https://read.qxmd.com/read/30421267/vascular-genetics-presentations-testing-and-prognostics
#13
REVIEW
Aaron W Aday, Sarah E Kreykes, Christina L Fanola
PURPOSE OF REVIEW: Numerous studies have begun to unravel the genetic basis of not only aortic disease but also other forms of commonly encountered vascular diseases. The goal of this review is to provide clinicians a reference to help identify and diagnose different types of vascular disease with a genetic underpinning. RECENT FINDINGS: Ongoing studies have identified numerous genes involved in the TGF-β signaling pathway that are also associated with thoracic aortic aneurysm and dissection, and it is possible to test for pathogenic variants in these genes in the clinical setting using commercially available genetic testing panels...
November 13, 2018: Current Treatment Options in Cardiovascular Medicine
https://read.qxmd.com/read/30417314/state-of-the-art-management-of-mechanical-heart-valves-during-pregnancy
#14
REVIEW
Shivani R Aggarwal, Katherine E Economy, Anne M Valente
PURPOSE OF THE REVIEW: To review the management of women with mechanical heart valves during pregnancy, from preconception counseling through delivery with a summary of the latest guidelines. RECENT FINDINGS: The hypercoagulability of pregnancy combined with the imperfect choices of anticoagulant agents contribute to a high risk of complications in pregnant women with mechanical heart valves. Valve thrombosis remains a major concern, much of which occurs during the first trimester transition to heparin-based products...
November 12, 2018: Current Treatment Options in Cardiovascular Medicine
https://read.qxmd.com/read/30390143/the-female-athlete-s-heart-facts-and-fallacies
#15
REVIEW
Clea Simone S S Colombo, Gherardo Finocchiaro
PURPOSE OF THE REVIEW: For many years, competitive sport has been dominated by men. Recent times have witnessed a significant increase in women participating in elite sports. As most studies investigated male athletes, with few reports on female counterparts, it is crucial to have a better understanding on physiological cardiac adaptation to exercise in female athletes, to distinguish normal phenotypes from potentially fatal cardiac diseases. This review reports on cardiac adaptation to exercise in females...
November 3, 2018: Current Treatment Options in Cardiovascular Medicine
https://read.qxmd.com/read/30367318/left-ventricular-hypertrophy-in-athletes-differentiating-physiology-from-pathology
#16
REVIEW
Daniel X Augustine, Liz Howard
PURPOSE OF REVIEW: The changes that occur in athlete's heart are influenced by a number of factors including age, gender, ethnicity and the type of cardiovascular training. It is therefore important that the clinician is able to integrate all of these factors when assessing athletes to be able to guide investigations appropriately and to distinguish pathology from physiology. This review discusses the potential diagnostic conundrums when trying to differentiate physiological left ventricular hypertrophy from pathological hypertrophic cardiomyopathy in athletes...
October 26, 2018: Current Treatment Options in Cardiovascular Medicine
https://read.qxmd.com/read/30367314/visceral-artery-aneurysms-diagnosis-surveillance-and-treatment
#17
REVIEW
Fady Ibrahim, Jonathan Dunn, John Rundback, John Pellerito, Andrew Galmer
Visceral artery aneurysms (VAAs) are a rare, but serious clinical entity as rupture confers a high rate of mortality. Data regarding the prevalence, treatment, and prognosis of VAAs is largely from case series, as true randomized trials are lacking. The incidence of VAAs has risen over the decades with advances in imaging technology, availability, and utilization. Even in the presence of symptoms, the prompt diagnosis of VAAs may be challenging as symptoms are often nonspecific and varied. Although there are no definitive treatment guidelines, asymptomatic VAAs require treatment in the following scenarios: when the aneurysm diameter is greater than 2 cm, when identified during pregnancy, when multiple aneurysms are present, and in the case of hepatic transplant...
October 26, 2018: Current Treatment Options in Cardiovascular Medicine
https://read.qxmd.com/read/30367273/left-ventricular-trabeculations-in-athletes-epiphenomenon-or-phenotype-of-disease
#18
REVIEW
Mark Abela, Andrew D'Silva
PURPOSE OF REVIEW: Excessive trabeculation attracting a diagnosis of left ventricular noncompaction cardiomyopathy (LVNC) has been reported in ostensibly healthy athletes. This review aims to explain why this occurs and whether this represents a spectrum of athletic physiological remodelling or unmasking of occult cardiomyopathy. RECENT FINDINGS: Genetic studies have yet to identify a dominant mutation associated with the LVNC phenotype and reported gene mutations overlap with many distinct cardiomyopathies and ion channel disorders, implying that the phenotype is shared across different genetic conditions...
October 26, 2018: Current Treatment Options in Cardiovascular Medicine
https://read.qxmd.com/read/30367270/transcatheter-mitral-valve-planning-and-the-neo-lvot-utilization-of-virtual-simulation-models-and-3d-printing
#19
REVIEW
Keshav Kohli, Zhenglun Alan Wei, Ajit P Yoganathan, John N Oshinski, Jonathon Leipsic, Philipp Blanke
PURPOSE OF REVIEW: Transcatheter mitral valve replacement (TMVR) is an emerging alternative for patients with severe mitral valve regurgitation who are considered at high risk for conventional surgical options. The early clinical experience with TMVR has shown that pre-procedural planning with computed tomography (CT) is needed to mitigate the risk of potentially lethal procedural complications such as left ventricular outflow tract (LVOT) obstruction. The goal of this review is to provide an overview of key concepts relating to TMVR pre-procedural planning, with particular emphasis on imaging-based methods for predicting TMVR-related LVOT obstruction...
October 26, 2018: Current Treatment Options in Cardiovascular Medicine
https://read.qxmd.com/read/30367267/atrial-fibrillation-af-in-endurance-athletes-a-complicated-affair
#20
REVIEW
Dimitrios Stergiou, Edward Duncan
PURPOSE OF REVIEW: A complex relationship exists between exercise and atrial fibrillation (AF). Moderate exercise reduces AF risk whereas intense strenuous exercise has been shown to increase AF burden. It remains unclear at which point exercise may become detrimental. Overall, endurance athletes remain at lower cardiovascular risk and experience fewer strokes. The questions that arise therefore are whether AF is an acceptable byproduct of strenuous exercise, whether athletes who experience AF should be told to reduce exercise volume and how should they be managed...
October 26, 2018: Current Treatment Options in Cardiovascular Medicine
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