Current Cardiology Reports最新文献

{"title":"Evolving Applications of Echocardiography in the Evaluation of Left Atrial and Right Ventricular Strain.","authors":"A. Serafin, W. Kosmala, Thomas H. Marwick","doi":"10.1007/s11886-024-02058-x","DOIUrl":"https://doi.org/10.1007/s11886-024-02058-x","url":null,"abstract":"","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140676231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Percutaneous Revascularization in Severe Ischemic Left Ventricular Dysfunction","authors":"Roshan Bista, Mohamed Zghouzi, Manasa Jasti, Hady Lichaa, Jimmy Kerrigan, Elias Haddad, M. Chadi Alraies, Timir K. Paul","doi":"10.1007/s11886-024-02045-2","DOIUrl":"https://doi.org/10.1007/s11886-024-02045-2","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose of Review</h3><p>This article presents a comprehensive review of coronary revascularization versus optimal medical therapy (OMT) in patients with severe ischemic left ventricular dysfunction.</p><h3 data-test=\"abstract-sub-heading\">Recent Findings</h3><p>The REVIVED-BCIS2 trial randomized 700 patients with extensive coronary artery disease and left ventricular (LV) ejection fraction (LVEF) ≤ 35% and viability in more than four dysfunctional myocardial segments to percutaneous coronary intervention (PCI) plus OMT versus OMT alone. Over a median duration of 41 months, there was no difference in the composite of all-cause mortality, heart failure hospitalization, or improvement in LVEF with PCI plus OMT versus OMT alone at 6 and 12 months, quality of life scores at 24 months, or fatal ventricular arrhythmia. The STICH randomized trial was conducted between 2002 and 2007, involving patients with LV dysfunction and coronary artery disease. The patients were assigned to either CABG plus medical therapy or medical therapy alone. At the 5-year follow-up, the trial showed that CABG plus medical therapy reduced cardiovascular disease-related deaths and hospitalizations but no reduction in all-cause mortality. However, a 10-year follow-up showed a significant decrease in all-cause mortality with CABG.</p><h3 data-test=\"abstract-sub-heading\">Summary</h3><p>The currently available evidence showed no apparent benefit of PCI in severe ischemic cardiomyopathy as compared to OMT, but that CABG improves outcomes in this patient population. The paucity of data on the advantages of PCI in this patient population underscores the critical need for optimization of medical therapy for better survival and quality of life until further evidence from RCTs is available.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140630084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unexplained Residual Risk In Type 2 Diabetes: How Big Is The Problem?","authors":"Sivaram Neppala, Jemema Rajan, Eric Yang, Ralph A. DeFronzo","doi":"10.1007/s11886-024-02055-0","DOIUrl":"https://doi.org/10.1007/s11886-024-02055-0","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose of Review</h3><p>What is new? Cardiovascular disease (CVD) is the leading cause of mortality in type 2 diabetes (T2D) individuals. Of the major risk factors for CVD, less than 10% of T2D people meet the American Diabetes Association/American Heart Association recommended goals of therapy. The present review examines how much of the absolute cardiovascular (CV) risk in type 2 diabetes patients can be explained by major CV intervention trials.</p><h3 data-test=\"abstract-sub-heading\">Recent Findings</h3><p>Multiple long-term cardiovascular (CV) intervention trials have examined the effect of specific target-directed therapies on the MACE endpoint. Only one <u>prospective</u> study, STENO-2, has employed a <u>multifactorial</u> intervention comparing intensified versus conventional treatment of modifiable risk factors in T2D patients, and demonstrated a 20% absolute CV risk reduction.</p><h3 data-test=\"abstract-sub-heading\">Summary</h3><p>If the absolute CV risk reduction in these trials is added to that in the only prospective multifactorial intervention trial (STENO-2), the unexplained CV risk is 44.1%.</p><p>What are the clinical implications?</p><ul>\u0000<li>\u0000<p>Potential explanations for the unaccounted-for reduction in absolute CV risk in type 2 diabetes (T2D) patients are discussed.</p>\u0000</li>\u0000<li>\u0000<p>Hypothesis: failure to take into account synergistic interactions between major cardiovascular risk factors is responsible for the unexplained CV risk in T2D patients.</p>\u0000</li>\u0000<li>\u0000<p>Simultaneous treatment of all major CV risk factors to recommended AHA/ADA guideline goals is required to achieve the maximum reduction in CV risk.</p>\u0000</li>\u0000</ul>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140626217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occupational Risks of Radiation Exposure to Cardiologists","authors":"Jean-Benoît Veillette, Marc-Antoine Carrier, Stéphane Rinfret, Julien Mercier, Jean Arsenault, Jean-Michel Paradis","doi":"10.1007/s11886-024-02056-z","DOIUrl":"https://doi.org/10.1007/s11886-024-02056-z","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose of Review</h3><p>Invasive cardiologists are exposed to large amounts of ionizing radiation. This review aims to summarize the main occupational risks in a radiation-exposed cardiology practice.</p><h3 data-test=\"abstract-sub-heading\">Recent Findings</h3><p>We carried out a literature review on the subject. The studies reviewed allowed us to list six main health risk categories possibly associated with radiation exposure among cardiologists: deoxyribonucleic acid (DNA) and biochemical damages; cancers; ocular manifestations; olfaction, vascular, and neuropsychological alterations; musculoskeletal problems; and reproductive risks.</p><h3 data-test=\"abstract-sub-heading\">Summary</h3><p>Our descriptive analysis demonstrates higher risks of DNA damage and lens opacities among radiation-exposed cardiology staff. Surveys and questionnaires have demonstrated a higher risk of musculoskeletal disease in exposed workers. Studies reported no difference in cancer frequency between radiation-exposed workers and controls. Changes in olfactory performance, neuropsychological aspects, and vascular changes have also been reported. Limited literature supports the security of continuing radiation-exposed work during pregnancy. Therefore, there is an urgent need to increase knowledge of the occupational risks of radiation exposure and to adopt technologies to reduce them.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140609052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug-Coated Balloon in Acute Coronary Syndromes: Ready for the Prime Time?","authors":"Simone Fezzi, Sara Malakouti, Jegan Sivalingam, Jacinthe Khater, Flavio Ribichini, Bernardo Cortese","doi":"10.1007/s11886-024-02037-2","DOIUrl":"https://doi.org/10.1007/s11886-024-02037-2","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose of Review</h3><p>Acute coronary syndromes (ACS) are a major global health concern. Percutaneous coronary intervention (PCI) with new-generation drug-eluting stents (DES) has been endorsed as safe and effective in the management of culprit and non-culprit lesions of ACS. However, permanent metallic implants may have drawbacks, including the need for prolonged dual antiplatelet therapy (DAPT) and the risk of long-term stent-related complications. An alternative approach using drug-coated balloons (DCBs) is gaining growing interest, having the potential of delivering therapy directly to vulnerable plaques, avoiding the need for permanent metallic implants, and potentially allowing for better long-term medical treatment. Despite limited evidence, DCB is being explored in several patients’ subgroups. This review aims to discuss the existing evidence regarding DCB in ACS management.</p><h3 data-test=\"abstract-sub-heading\">Recent Findings</h3><p>DCB appears to be a promising strategy in the management of ACS, showing comparable angiographic and clinical results as compared to new-generation DES in relatively small clinical trials or large prospective registries. The advantage of avoiding permanent implants is particularly appealing in this setting, where DCB has the potential of delivering anti-atherogenic local therapy directly to vulnerable plaques still amenable to atherogenic regression. This review seeks to underline the theoretical background of DCB use and reports the available evidence in its support in the specific setting of ACS.</p><h3 data-test=\"abstract-sub-heading\">Summary</h3><p>In the context of ACS, the use of DCB is highly attractive, offering a dedicated anti-atherogenic local therapy, capable of addressing a broad range of vulnerable plaques and patients.</p><h3 data-test=\"abstract-sub-heading\">Graphical Abstract</h3><p>A snapshot of the entire manuscript demonstrating DCB technology with potential benefits in ACS settings and particularly its role in vulnerable plaques with a scheme defining these vulnerable plaques and identifying the patient population who benefits the most from DCB approach treatment.</p>\u0000","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140588090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Social Determinants of Health on Outcomes for Patients with Adult Congenital Heart Disease","authors":"Suhas Babu, Paulamy Ganguly, Nandan Shettigar, C. Huie Lin","doi":"10.1007/s11886-024-02059-w","DOIUrl":"https://doi.org/10.1007/s11886-024-02059-w","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose of Review</h3><p>The study of adults with congenital heart disease (ACHD) is a rapidly growing field; however, more research is needed on the disparities affecting outcomes. With advances in medicine, a high percentage of patients with congenital heart disease (CHD) are advancing to adulthood, leading to an increase in the number of ACHD. This creates a pressing need to evaluate the factors, specifically the social determinants of health (SDOH) contributing to the outcomes for ACHD.</p><h3 data-test=\"abstract-sub-heading\">Recent Findings</h3><p>A myriad of factors, including, but not limited to, race, education, and socioeconomic status, have been shown to affect ACHD outcomes. Existing data from hospitalizations, mortality and morbidity, advanced care planning, patient and physician awareness, financial factors, and education alongside race and socioeconomic status present differences in ACHD outcomes.</p><h3 data-test=\"abstract-sub-heading\">Summary</h3><p>With SDOH having a significant impact on ACHD subspecialty care outcomes, ACHD centers need to be constantly adapting and innovating, incorporating SDOH into patient management, and providing additional healthcare resources to manage the care of ACHD.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140588565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arrhythmogenesis in Fabry Disease","authors":"Ashwin Roy, Max J. Cumberland, Christopher O’Shea, Andrew Holmes, Manish Kalla, Katja Gehmlich, Tarekegn Geberhiwot, Richard P. Steeds","doi":"10.1007/s11886-024-02053-2","DOIUrl":"https://doi.org/10.1007/s11886-024-02053-2","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose of Review</h3><p>Fabry Disease (FD) is a rare lysosomal storage disorder characterised by multiorgan accumulation of glycosphingolipid due to deficiency in the enzyme α-galactosidase A. Cardiac sphingolipid accumulation triggers various types of arrhythmias, predominantly ventricular arrhythmia, bradyarrhythmia, and atrial fibrillation. Arrhythmia is likely the primary contributor to FD mortality with sudden cardiac death, the most frequent cardiac mode of death. Traditionally FD was seen as a storage cardiomyopathy triggering left ventricular hypertrophy, diastolic dysfunction, and ultimately, systolic dysfunction in advanced disease. The purpose of this review is to outline the current evidence exploring novel mechanisms underlying the arrhythmia substrate.</p><h3 data-test=\"abstract-sub-heading\">Recent Findings</h3><p>There is growing evidence that FD cardiomyopathy is a primary arrhythmic disease with each stage of cardiomyopathy (accumulation, hypertrophy, inflammation, and fibrosis) contributing to the arrhythmia substrate via various intracellular, extracellular, and environmental mechanisms. It is therefore important to understand how these mechanisms contribute to an individual’s risk of arrhythmia in FD.</p><h3 data-test=\"abstract-sub-heading\">Summary</h3><p>In this review, we outline the epidemiology of arrhythmia, pathophysiology of arrhythmogenesis, risk stratification, and cardiac therapy in FD. We explore how advances in conventional cardiac investigations performed in FD patients including 12-lead electrocardiography, transthoracic echocardiography, and cardiac magnetic resonance imaging have enabled early detection of pro-arrhythmic substrate. This has allowed for appropriate risk stratification of FD patients. This paves the way for future work exploring the development of therapeutic initiatives and risk prediction models to reduce the burden of arrhythmia.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140588458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caring for the Critically Ill Adult Congenital Heart Disease Patient","authors":"Thomas Das, Penelope Rampersad, Joanna Ghobrial","doi":"10.1007/s11886-024-02034-5","DOIUrl":"https://doi.org/10.1007/s11886-024-02034-5","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose of Review</h3><p>This review aims to discuss the unique challenges that adult congenital heart disease (ACHD) patients present in the intensive care unit.</p><h3 data-test=\"abstract-sub-heading\">Recent Findings</h3><p>Recent studies suggest that ACHD patients make up an increasing number of ICU admissions, and that their care greatly improves in centers with specialized ACHD care. Common reasons for admission include arrhythmia, hemorrhage, heart failure, and pulmonary disease.</p><h3 data-test=\"abstract-sub-heading\">Summary</h3><p>It is critical that the modern intensivist understand not only the congenital anatomy and subsequent repairs an ACHD patient has undergone, but also how that anatomy can predispose the patient to critical illness. Additionally, intensivists should rely on a multidisciplinary team, which includes an ACHD specialist, in the care of these patients.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140588088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contemporary Risk Models for In-Hospital and 30-Day Mortality After Percutaneous Coronary Intervention","authors":"Christine Chow, Jacob Doll","doi":"10.1007/s11886-024-02047-0","DOIUrl":"https://doi.org/10.1007/s11886-024-02047-0","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose of Review</h3><p>Risk models for mortality after percutaneous coronary intervention (PCI) are underutilized in clinical practice though they may be useful during informed consent, risk mitigation planning, and risk adjustment of hospital and operator outcomes. This review analyzed contemporary risk models for in-hospital and 30-day mortality after PCI.</p><h3 data-test=\"abstract-sub-heading\">Recent Findings</h3><p>We reviewed eight contemporary risk models. Age, sex, hemodynamic status, acute coronary syndrome type, heart failure, and kidney disease were consistently found to be independent risk factors for mortality. These models provided good discrimination (<i>C</i>-statistic 0.85–0.95) for both pre-catheterization and comprehensive risk models that included anatomic variables.</p><h3 data-test=\"abstract-sub-heading\">Summary</h3><p>There are several excellent models for PCI mortality risk prediction. Choice of the model will depend on the use case and population, though the CathPCI model should be the default for in-hospital mortality risk prediction in the United States. Future interventions should focus on the integration of risk prediction into clinical care.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140588086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Right Ventricle-Pulmonary Artery Coupling in Patients Undergoing Cardiac Interventions","authors":"Crosby Culp, Jon Andrews, Katherine Wang Sun, Kendall Hunter, Anne Cherry, Mihai Podgoreanu, Alina Nicoara","doi":"10.1007/s11886-024-02052-3","DOIUrl":"https://doi.org/10.1007/s11886-024-02052-3","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose of Review</h3><p>This review aims to summarize the fundamentals of RV-PA coupling, its non-invasive means of measurement, and contemporary understanding of RV-PA coupling in cardiac surgery, cardiac interventions, and congenital heart disease.</p><h3 data-test=\"abstract-sub-heading\">Recent Findings</h3><p>The need for more accessible clinical means of evaluation of RV-PA coupling has driven researchers to investigate surrogates using cardiac MRI, echocardiography, and right-sided pressure measurements in patients undergoing cardiac surgery/interventions, as well as patients with congenital heart disease. Recent research has aimed to validate these alternative means against the gold standard, as well as establish cut-off values predictive of morbidity and/or mortality. This emerging evidence lays the groundwork for identifying appropriate RV-PA coupling surrogates and integrating them into perioperative clinical practice.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140588001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}