S. Stewart, Amy R Stewart, Laura H. Waite, J. Beilby
{"title":"Out with the Old and In with the New: Primary Care Management of Heart Failure with Preserved Ejection Fraction","authors":"S. Stewart, Amy R Stewart, Laura H. Waite, J. Beilby","doi":"10.15420/cfr.2021.27","DOIUrl":"https://doi.org/10.15420/cfr.2021.27","url":null,"abstract":"Primary care plays an integral role in the management of complex, chronic disease states such as heart failure. However, there is a disconnect between the characteristics of those recruited into clinical trials and those managed in the real world, which means the contribution and consideration of primary care in current guidelines is suboptimal. In this article, the authors explore key issues in the diagnosis and management of heart failure that need to be addressed from a primary care perspective. This article focuses on the issue of heart failure with preserved ejection fraction and the integration of new clinical epidemiology and trial evidence into clinical practice. In response, the authors advocate for dedicated guidelines for the primary care management of heart failure, the development of strategies to facilitate communications between health professionals in acute and community care and a renewed focus on researching optimal models of heart failure care in the community.","PeriodicalId":33741,"journal":{"name":"Cardiac Failure Review","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46944998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Karine Grigoryan, Camelia Demetrescu, Ioannis Kasouridis, Olukayode Abiola, Pier Giorgio Masci, Didem Oguz, Giulia Benedetti, Mak SzeMun, Purvi Parwani, Rebecca Preston, Amedeo Chiribiri, Jane Hancock, Tiffany Patterson, Simon Redwood, Bernard Prendergast, Julia Grapsa
{"title":"Multimodality Imaging in Valvular Structural Interventions.","authors":"Karine Grigoryan, Camelia Demetrescu, Ioannis Kasouridis, Olukayode Abiola, Pier Giorgio Masci, Didem Oguz, Giulia Benedetti, Mak SzeMun, Purvi Parwani, Rebecca Preston, Amedeo Chiribiri, Jane Hancock, Tiffany Patterson, Simon Redwood, Bernard Prendergast, Julia Grapsa","doi":"10.15420/cfr.2022.10","DOIUrl":"https://doi.org/10.15420/cfr.2022.10","url":null,"abstract":"<p><p>Structural valvular interventions have skyrocketed in the past decade with new devices becoming available and indications for patients who would previously have been deemed inoperable. Furthermore, while echocardiography is the main imaging tool and the first line for patient screening, cardiac magnetic resonance and CT are now essential tools in pre-planning and post-procedural follow-up. This review aims to address imaging modalities and their scope in aortic, mitral and tricuspid structural valvular interventions, including multimodality imaging. Pulmonary valve procedures, which are mostly carried out in patients with congenital problems, are discussed. This article presents a guide on individualised imaging approcahes on each of the available interventional procedures.</p>","PeriodicalId":33741,"journal":{"name":"Cardiac Failure Review","volume":"8 ","pages":"e31"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/99/38/cfr-08-e31.PMC9820006.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10590120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardiac Failure ReviewPub Date : 2021-12-06eCollection Date: 2021-03-01DOI: 10.15420/cfr.2021.06
Sigrid L Johannesen, Colin M Barker, Melissa M Levack
{"title":"Adjunctive Techniques for Repair of Ischaemic Mitral Regurgitation.","authors":"Sigrid L Johannesen, Colin M Barker, Melissa M Levack","doi":"10.15420/cfr.2021.06","DOIUrl":"https://doi.org/10.15420/cfr.2021.06","url":null,"abstract":"<p><p>Ischaemic mitral regurgitation is a complex process with debate in the literature as to the optimal treatment pathway. Multiple therapies are available to alleviate mitral regurgitation including medical management, transcatheter edge-to-edge repair, mitral valve repair and mitral valve replacement. Medical management with goal-directed therapy should be utilised in patients with heart failure and mild-to-moderate regurgitation. Transcatheter approaches are typically used in patients with prohibitive operative risk, although their use is expanding, especially in those with functional mitral regurgitation who are not responding to goal-directed medical therapy. It is generally accepted that patients with mild-to-moderate disease can avoid valve intervention if successful revascularisation is performed. A higher consideration should be given to valve replacement over repair in patients with severe mitral regurgitation in the setting of myocardial ischaemia. Operative course must be personalised to each patient, and continues to develop with improving technologies and ongoing research into optimal treatment.</p>","PeriodicalId":33741,"journal":{"name":"Cardiac Failure Review","volume":"7 ","pages":"e20"},"PeriodicalIF":0.0,"publicationDate":"2021-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e0/3d/cfr-07-e20.PMC8674630.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39872160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardiac Failure ReviewPub Date : 2021-12-06eCollection Date: 2021-03-01DOI: 10.15420/cfr.2021.24
Abhishek Dattani, Rachana Prasad
{"title":"Isolated Left Ventricular Apical Hypoplasia.","authors":"Abhishek Dattani, Rachana Prasad","doi":"10.15420/cfr.2021.24","DOIUrl":"https://doi.org/10.15420/cfr.2021.24","url":null,"abstract":"In 2006, a 64-year-old Caucasian woman presented to the Emergency Department with breathlessness. She was an ex-smoker with a medical history of hypertension, hypercholesterolaemia and asthma. There was no family history of cardiac disease. Initial investigations, including chest radiograph, showed pulmonary oedema, which was treated with IV diuretics and continuous positive airway pressure non-invasive ventilation.","PeriodicalId":33741,"journal":{"name":"Cardiac Failure Review","volume":"7 ","pages":"e21"},"PeriodicalIF":0.0,"publicationDate":"2021-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d3/98/cfr-07-e21.PMC8728883.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39816338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardiac Failure ReviewPub Date : 2021-11-26eCollection Date: 2021-03-01DOI: 10.15420/cfr.2021.18
Nicholas K Brownell, Boback Ziaeian, Gregg C Fonarow
{"title":"The Gap to Fill: Rationale for Rapid Initiation and Optimal Titration of Comprehensive Disease-modifying Medical Therapy for Heart Failure with Reduced Ejection Fraction.","authors":"Nicholas K Brownell, Boback Ziaeian, Gregg C Fonarow","doi":"10.15420/cfr.2021.18","DOIUrl":"https://doi.org/10.15420/cfr.2021.18","url":null,"abstract":"<p><p>There are gaps in the use of therapies that save lives and improve quality of life for patients with heart failure with reduced ejection fraction, both in the US and abroad. The evidence is clear that initiation and titration of guideline-directed medical therapy (GDMT) and comprehensive disease-modifying medical therapy (CDMMT) to maximally tolerated doses improves patient-focused outcomes, yet observational data suggest this does not happen. The purpose of this review is to describe the gap in the use of optimal treatment worldwide and discuss the benefits of newer heart failure therapies including angiotensin receptor-neprilysin inhibitors and sodium-glucose cotransporter 2 inhibitors. It will also cover the efficacy and safety of such treatments and provide potential pathways for the initiation and rapid titration of GDMT/CDMMT.</p>","PeriodicalId":33741,"journal":{"name":"Cardiac Failure Review","volume":"7 ","pages":"e18"},"PeriodicalIF":0.0,"publicationDate":"2021-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/02/bc/cfr-07-e18.PMC8674626.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39636574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardiac Failure ReviewPub Date : 2021-11-22eCollection Date: 2021-03-01DOI: 10.15420/cfr.2021.16
Gerard T Giblin, Laura Murphy, Garrick C Stewart, Akshay S Desai, Marcelo F Di Carli, Ron Blankstein, Michael M Givertz, Usha B Tedrow, William H Sauer, Gary M Hunninghake, Paul F Dellaripa, Sanjay Divakaran, Neal K Lakdawala
{"title":"Cardiac Sarcoidosis: When and How to Treat Inflammation.","authors":"Gerard T Giblin, Laura Murphy, Garrick C Stewart, Akshay S Desai, Marcelo F Di Carli, Ron Blankstein, Michael M Givertz, Usha B Tedrow, William H Sauer, Gary M Hunninghake, Paul F Dellaripa, Sanjay Divakaran, Neal K Lakdawala","doi":"10.15420/cfr.2021.16","DOIUrl":"https://doi.org/10.15420/cfr.2021.16","url":null,"abstract":"<p><p>Sarcoidosis is a complex, multisystem inflammatory disease with a heterogeneous clinical spectrum. Approximately 25% of patients with systemic sarcoidosis will have cardiac involvement that portends a poorer outcome. The diagnosis, particularly of isolated cardiac sarcoidosis, can be challenging. A paucity of randomised data exist on who, when and how to treat myocardial inflammation in cardiac sarcoidosis. Despite this, corticosteroids continue to be the mainstay of therapy for the inflammatory phase, with an evolving role for steroid-sparing and biological agents. This review explores the immunopathogenesis of inflammation in sarcoidosis, current evidence-based treatment indications and commonly used immunosuppression agents. It explores a multidisciplinary treatment and monitoring approach to myocardial inflammation and outlines current gaps in our understanding of this condition, emerging research and future directions in this field.</p>","PeriodicalId":33741,"journal":{"name":"Cardiac Failure Review","volume":"7 ","pages":"e17"},"PeriodicalIF":0.0,"publicationDate":"2021-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ba/e7/cfr-07-e17.PMC8674699.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39636573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardiac Failure ReviewPub Date : 2021-11-22eCollection Date: 2021-03-01DOI: 10.15420/cfr.2021.17
Erez Marcusohn, Ofer Kobo, Maria Postnikov, Danny Epstein, Yoram Agmon, Lior Gepstein, Yaron Hellman, Robert Zukermann
{"title":"Left Ventricular Systolic Dysfunction Due to Atrial Fibrillation: Clinical and Echocardiographic Predictors.","authors":"Erez Marcusohn, Ofer Kobo, Maria Postnikov, Danny Epstein, Yoram Agmon, Lior Gepstein, Yaron Hellman, Robert Zukermann","doi":"10.15420/cfr.2021.17","DOIUrl":"https://doi.org/10.15420/cfr.2021.17","url":null,"abstract":"<p><p><b>Background:</b> Diagnosis of AF-induced cardiomyopathy can be challenging and relies on ruling out other causes of cardiomyopathy and, after restoration of sinus rhythm, recovery of left ventricular (LV) function. The aim of this study was to identify clinical and echocardiographic predictors for developing cardiomyopathy with systolic dysfunction in patients with atrial tachyarrhythmia. <b>Methods:</b> This retrospective study was conducted in a large tertiary care centre and compared patients who experienced deterioration of LV ejection fraction (EF) during paroxysmal AF, demonstrated by precardioversion transoesophageal echocardiography with patients with preserved LV function during AF. All patients had documented preserved LVEF at baseline (EF >50%) while in sinus rhythm. <b>Results:</b> Of 482 patients included in the final analysis, 80 (17%) had reduced and 402 (83%) had preserved LV function during the precardioversion transoesophageal echocardiography. Patients with reduced LVEF were more likely to be men and to have a more rapid ventricular response during AF or atrial flutter (AFL). A history of prosthetic valves was also identified as a risk factor for reduced LVEF. Patients with reduced LVEF also had higher incidence of tricuspid regurgitation and right ventricular dysfunction. <b>Conclusion:</b> In 'real-world' experience, male patients with rapid ventricular response during paroxysmal AF or AFL are more prone to LVEF reduction. Patients with prosthetic valves are also at risk for LVEF reduction during AF/AFL. Finally, tricuspid regurgitation and right ventricular dysfunction may indicate relatively long-standing AF with an associated reduction in LVEF.</p>","PeriodicalId":33741,"journal":{"name":"Cardiac Failure Review","volume":"7 ","pages":"e16"},"PeriodicalIF":0.0,"publicationDate":"2021-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/89/3a/cfr-07-e16.PMC8674700.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39636571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardiac Failure ReviewPub Date : 2021-11-12eCollection Date: 2021-03-01DOI: 10.15420/cfr.2021.07
Tracey M Ellimuttil, Kimberly Harrison, Allman T Rollins, Irene D Feurer, Scott A Rega, Jennifer Gray, Jonathan N Menachem
{"title":"Effect of Statin Intensity on the Progression of Cardiac Allograft Vasculopathy.","authors":"Tracey M Ellimuttil, Kimberly Harrison, Allman T Rollins, Irene D Feurer, Scott A Rega, Jennifer Gray, Jonathan N Menachem","doi":"10.15420/cfr.2021.07","DOIUrl":"10.15420/cfr.2021.07","url":null,"abstract":"<p><p><b>Background</b>: In the non-transplant population, hyperlipidaemia has shifted from targeting LDL goals to statin intensity-based treatment. It is unknown whether this strategy is also beneficial in cardiac transplantation. <b>Methods</b>: This single-centre retrospective study evaluated the effect of statin use and intensity on time to cardiac allograft vasculopathy (CAV) after cardiac transplantation. Kaplan-Meier and Cox proportional hazards regression survival methods were used to assess the association of statin intensity and median post-transplant LDL on CAV-free survival. <b>Results</b>: The study involved 143 adults (71% men, average follow-up of 25 ± 14 months) who underwent transplant between 2013 and 2017. Mean CAV-free survival was 47.5 months (95% CI [43.1-51.8]), with 29 patients having CAV grade 1 or greater. Median LDL was not associated with time to CAV (p=0.790). CAV-free survival did not differ between intensity groups (p=0.435). <b>Conclusion</b>: Given the non-statistically significant difference in time to CAV with higher intensity statins, the data suggest that advancing moderate- or high-intensity statin after cardiac transplantation may not provide additional long-term clinical benefit. <b>Trial registration</b>: Not applicable.</p>","PeriodicalId":33741,"journal":{"name":"Cardiac Failure Review","volume":"7 ","pages":"e15"},"PeriodicalIF":4.2,"publicationDate":"2021-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7d/e6/cfr-07-e15.PMC8609416.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39636569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"How to Implant His Bundle and Left Bundle Pacing Leads: Tips and Pearls.","authors":"Shunmuga Sundaram Ponnusamy, Pugazhendhi Vijayaraman","doi":"10.15420/cfr.2021.04","DOIUrl":"https://doi.org/10.15420/cfr.2021.04","url":null,"abstract":"<p><p>Cardiac pacing is the treatment of choice for the management of patients with bradycardia. Although right ventricular apical pacing is the standard therapy, it is associated with an increased risk of pacing-induced cardiomyopathy and heart failure. Physiological pacing using His bundle pacing and left bundle branch pacing has recently evolved as the preferred alternative pacing option. Both His bundle pacing and left bundle branch pacing have also demonstrated significant efficacy in correcting left bundle branch block and achieving cardiac resynchronisation therapy. In this article, the authors review the implantation tools and techniques to perform conduction system pacing.</p>","PeriodicalId":33741,"journal":{"name":"Cardiac Failure Review","volume":"7 ","pages":"e13"},"PeriodicalIF":0.0,"publicationDate":"2021-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f6/6b/cfr-07-e13.PMC8383140.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39371866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardiac Failure ReviewPub Date : 2021-08-06eCollection Date: 2021-03-01DOI: 10.15420/cfr.2021.09
Aniket S Rali, Angela Weingarten, Emily Sandhaus, Richa Gupta, Allman Rollins, David Bichell, Nhue Do, D Marshall Brinkley, Kelly H Schlendorf, Daniel Freno, Keki Balsara, Jonathan N Menachem
{"title":"Unknown Risks of Transplantation in Adults with Congenital Heart Disease.","authors":"Aniket S Rali, Angela Weingarten, Emily Sandhaus, Richa Gupta, Allman Rollins, David Bichell, Nhue Do, D Marshall Brinkley, Kelly H Schlendorf, Daniel Freno, Keki Balsara, Jonathan N Menachem","doi":"10.15420/cfr.2021.09","DOIUrl":"https://doi.org/10.15420/cfr.2021.09","url":null,"abstract":"","PeriodicalId":33741,"journal":{"name":"Cardiac Failure Review","volume":"7 ","pages":"e14"},"PeriodicalIF":0.0,"publicationDate":"2021-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e8/8f/cfr-07-e14.PMC8383139.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39371867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}