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Expert Review of Cardiovascular Therapy

Sjaak Pouwels, Besir Topal, Mireille T Knook, Alper Celik, Magnus Sundbom, Rui Ribeiro, Chetan Parmar, Surendra Ugale
Obesity, defined as a Body Mass Index (BMI) of ≥30 kg/m2, is the most common chronic metabolic disease worldwide and its prevalence has been strongly increasing. Obesity is associated with various diseases such as cardiovascular disease, type 2 diabetes and hypertension. Regarding heart rhythm disorders, obesity is associated with an increase in atrial fibrillation (AF), the most common arrhythmia in clinical practice. AF is associated with an increased cardiovascular morbidity and mortality. Obesity, a novel risk factor, is responsible for a 50%-increased incidence of AF...
February 13, 2019: Expert Review of Cardiovascular Therapy
Ashley Verburg, Jasper L Selder, Martin J Schalij, Mark J Schuuring, Roderick W Treskes
Cardiac rehabilitation is aimed at risk factor modification and improving quality of life. eHealth has a couple of potential benefits to improve this aim. The primary purpose of this review is to summarize available literature for eHealth strategies that have been investigated in randomized controlled trials in post-myocardial infarction (MI) patients. The second purpose of this review is to investigate the clinical effectiveness in post-MI patients. Areas covered: The literature was searched using PubMed. Randomized controlled trials (RCTs) describing interventions in patients that had experienced a ST-elevation myocardial infarction or non ST acute coronary syndrome were eligible for inclusion...
February 7, 2019: Expert Review of Cardiovascular Therapy
Leonardo Seoane, Marcia Cortés, Diego Conde
The past few years have given rise to extensive research on interatrial block and its clinical relevance, mainly its association with supraventricular arrhythmias. In 2015, the authors of this article reviewed the Bayes syndrome for the first time and after three years there has been so much evidence accumulated that it seems reasonable to rewrite an update, based fundamentally on the new findings. Focused on its relationship with cardioembolic strokes, today efforts are being targeted at understand its pathophysiology, its diagnosis and its prognostic implications, in order to learn if it should be treated...
February 4, 2019: Expert Review of Cardiovascular Therapy
Paul Guedeney, Sabato Sorrentino, Bimmer Claessen, Roxana Mehran
Anemia is one of the most frequent comorbidities in acute coronary syndrome (ACS) patients and is associated with a significant impact on clinical outcomes. This review summarizes the knowledge and updated management of anemia in the setting of ACS. Areas covered: We provide a review on the prevalence, pathophysiology, prognosis, impact, and updated management of anemia. Expert opinion: Patients with anemia represent a therapeutic challenge in the setting of acute coronary syndrome and require specific acute and chronic management...
February 4, 2019: Expert Review of Cardiovascular Therapy
Nesrine Farhat, Frederic Lador, Maurice Beghetti
Paediatric pulmonary arterial hypertension (PAH) remains a rare and severe disease with a poor prognosis. PAH may be idiopathic, heritable or associated to systemic conditions in particular associated with congenital heart disease. Areas covered: A thorough and extensive diagnostic approach is required for a correct diagnosis. Outcome has improved over the last decade with a better diagnostic approach and with the initiation of new targeted therapies. However, there is still significant progress to achieve as there is still no cure for this devastating disease...
January 30, 2019: Expert Review of Cardiovascular Therapy
Ammar M Killu, Samuel J Asirvatham
The number of procedures for which percutaneous pericardial access is used for has gradually increased since its initial description, and now includes mapping/ablation, atrial appendage ligation and pericardial biopsy. Areas covered: Successful percutaneous pericardial access is predicated on having a thorough understanding of regional anatomy, indications for attempting pericardial puncture and potential complications with appropriate management which are highlighted in this review. In addition, we will discuss the access technique itself, provide tips and pitfalls and highlight future directions with an emphasis on patients with prior cardiac surgery...
December 29, 2018: Expert Review of Cardiovascular Therapy
Mohan Satish, Devendra K Agrawal
Despite advances in drug eluting technologies, neointimal hyperplasia (NIH) and restenosis still plagues endovascular therapy in atherosclerotic diseases. By appreciating atherosclerosis and NIH as complex inflammatory processes, specialized pro-resolving mediators (SPMs) are a superfamily of endogenous unsaturated fatty-acid derived lipids with the potential for inflammatory resolution. Areas covered: Inquiry into SPMs in this context is a novel approach and is the focus of this review, with emphasis on our understanding with NIH...
December 22, 2018: Expert Review of Cardiovascular Therapy
John H Rosenberg, John H Werner, Gilman D Plitt, Victoria V Noble, Jordan T Spring, Brooke A Stephens, Aleem Siddique, Helenmari L Merritt-Genore, Michael J Moulton, Devendra K Agrawal
Recurrent atrial fibrillation (RAF) following ablation therapy occurs in about 50% of patients. The pathogenesis of RAF is unknown, but is believed to be driven by atrial remodeling in the setting of background inflammation. Structural, electrophysiological and mechanical remodeling has been associated with atrial fibrillation (AF). Inflammation and fibrotic remodeling are the major factors perpetuating AF, as mediators released from the atrial tissues and cardiomyocytes due to mechanical and surgical injury could initiate the inflammatory process...
December 22, 2018: Expert Review of Cardiovascular Therapy
Claudia Stöllberger, Josef Finsterer
When >3 trabeculations associated with interventricular recesses are found, this is termed "left ventricular hypertrabeculation/noncompaction"(LVHT). Cardiac-imaging methods detect LVHT in all ages, isolated or associated with extracardiac, especially neuromuscular disorders(NMDs). Many issues about LVHT are unclear. The review gives an update about pathomorphologic findings in patients >14 years and the role of NMDs in LVHT. Areas covered: A PubMed-search for the terms "noncompaction" or "non-compaction" or "hypertrabeculation" AND "autopsy" or "biopsy" or "ultrastructure" or "electron microscopy" AND "neuromuscular" or "myopathy" or "neuropathy" was carried out from 1985 to July 2018...
December 20, 2018: Expert Review of Cardiovascular Therapy
Hideki Wada, Katsumi Miyauchi, Hiroyuki Daida
Women have been at a higher risk for adverse cardiac events following percutaneous coronary intervention (PCI), compared with men. Areas covered: In this review, authors discuss the gender differences that can affect the clinical outcomes after PCI and the important points that can be improved on. Expert commentary: Various factors, such as old age and higher prevalence of comorbidities, have been considered to account for the worse clinical outcomes of PCI in women than in men. In addition, men and women have different presentations of angina or acute coronary syndrome (ACS); atypical symptoms are more frequent in women...
December 20, 2018: Expert Review of Cardiovascular Therapy
Richard Armstrong, Giovanni Luigi De Maria, Roberto Scarsini, Adrian P Banning
Microvascular dysfunction in the setting of acute ST segment elevation myocardial infarction (STEMI) is an indicator of poor long-term prognosis. Prompt assessment and pharmacological or procedural therapy (prophylactic or post onset of dysfunction) may improve outcomes in STEMI post primary percutaneous intervention. Areas covered: The aim of this review is to provide a comprehensive analysis of the evidence available about the assessment and management of coronary microcirculatory injury/dysfunction in STEMI...
December 20, 2018: Expert Review of Cardiovascular Therapy
Anna Vittoria Mattioli
No abstract text is available yet for this article.
December 4, 2018: Expert Review of Cardiovascular Therapy
Sandeep Jha, Rickard Zeijlon, Aaron Shekka Espinosa, Jessica Alkhoury, Jonatan Oras, Elmir Omerovic, Björn Redfors
Takotsubo syndrome (TS) is an increasingly recognized acute heart failure syndrome which is self-limiting in most cases but can result in life-threatening complications. TS is difficult to distinguish from acute myocardial infarction (AMI) early in the disease course and currently lacks evidence-based treatment recommendations. Areas covered: Based on the available literature this systematic review discusses the clinical management of patients with TS during (i) the diagnostic workup; (ii) acutely after establishing the TS diagnosis; and (iii) after recovery of cardiac function...
December 4, 2018: Expert Review of Cardiovascular Therapy
Ross Arena, Cemal Ozemek
No abstract text is available yet for this article.
December 3, 2018: Expert Review of Cardiovascular Therapy
Aeshah Althunayyan, Steffen E Petersen, Guy Lloyd, Sanjeev Bhattacharyya
Mitral valve prolapse is a common valve pathology with a spectrum of disease from isolated prolapse to myxomatous, multi-scallop Barlow's disease. The main complications relate to progression of mitral regurgitation, endocarditis, sudden death and stroke. The timing of intervention in patients with asymptomatic severe mitral regurgitation is controversial. Areas covered: This article reviews the pathophysiology, genetics, clinical features, diagnostic imaging, complications, long term outcomes and indications for intervention in mitral valve prolapse...
November 28, 2018: Expert Review of Cardiovascular Therapy
Raphael Mendes Ritti-Dias, Marilia de Almeida Correia, Aluísio Andrade-Lima, Gabriel Grizzo Cucato
Patients with symptomatic peripheral artery disease (PAD) exhibit reduced functional capacity and increased mortality due to cardiovascular disease. Although exercise has been a cornerstone for clinical treatment to improve walking capacity in patients with symptomatic PAD, its effects on cardiovascular parameters have been poorly explored. Areas covered: This review examines the role of exercise in improving blood pressure in patients with symptomatic PAD and summarizes the current evidence on the acute (single bout of exercise) and chronic effects of walking and resistance exercise on blood pressure and its determinants...
November 27, 2018: Expert Review of Cardiovascular Therapy
Shinichiro Morishita, Atsuhiro Tsubaki, Masatoshi Nakamura, Satoshi Nashimoto, Jack B Fu, Hideaki Onishi
The American College of Sports Medicine and American Heart Association recommends resistance training involving 60-70% of 1-repetition maximum (1RM) for 8-12 repetitions on 2 or 3 nonconsecutive days per week for the elderly. The Borg 6-20 scale, Borg category ratio (CR-10) scale, and OMNI scale are used to determine the rating of perceived exertion (RPE) for resistance training. Areas covered: RPE scales for resistance training performed by elderly individuals are described. The RPE has been related to resistance training intensity, and the RPE scale was used to determine the resistance training intensity of elderly or ill individuals...
February 2019: Expert Review of Cardiovascular Therapy
Kevin Goodwin, Austin Kluis, Tamas Alexy, Ranjit John, Rochus Voeller
Associated with significant morbidity and mortality, neurological complications in adult patients with left ventricular assist devices (LVAD) approaches a prevalence as high as 25%. As the number of individuals using LVAD support grows, it is increasingly important for providers to understand the hematologic and hemodynamic changes associated with LVAD implantation, the risk factors for neurological complications and their mitigation strategies. Areas covered: PubMed searches were completed using the terms 'Left ventricular assist device and stroke' (994 results) then 'Left ventricular assist device and stroke risk factors' (199 results)...
December 2018: Expert Review of Cardiovascular Therapy
Joshua R Niska, Cameron S Thorpe, Sorcha M Allen, Thomas B Daniels, William G Rule, Steven E Schild, Carlos E Vargas, Farouk Mookadam
Recent trials in radiotherapy have associated heart dose and survival, inadequately explained by the existing literature for radiation-related late cardiac effects.  Authors aimed to review the recent literature on cardiac dosimetry and survival/cardiac endpoints. Areas covered: Systematic review of the literature in the past 10 years (2008-2017) was performed to identify manuscripts reporting both cardiac dosimetry and survival/cardiac endpoints.  Authors identified 64 manuscripts for inclusion, covering pediatrics, breast cancer, lung cancer, gastrointestinal diseases (primarily esophageal cancer), and adult lymphoma...
December 2018: Expert Review of Cardiovascular Therapy
Keisuke Narita, Satoshi Hoshide, Kazuomi Kario
Randomized controlled trials and meta-analyses have established the benefits of blood pressure (BP) lowering. The 2017 American Heart Association/American College of Cardiology (AHA/ACC) guidelines for the management of hypertension established 130/80 mmHg as the threshold for the diagnosis- and treatment-target BP level. Area covered: The global trends are thought to be heading toward intensive BP-lowering management. In this paper, authors summarize the evidence on lowering the BP target in hypertensive patients with a focus on the 2017 AHA/ACC guidelines...
December 2018: Expert Review of Cardiovascular Therapy
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