D. Padmanabhan, S. Shankar, Avinash Chandrashekharaiah, S. Deshpande
{"title":"Strategies to Reduce Radiation Exposure in Electrophysiology and Interventional Cardiology","authors":"D. Padmanabhan, S. Shankar, Avinash Chandrashekharaiah, S. Deshpande","doi":"10.15420/usc.2019.21.2","DOIUrl":"https://doi.org/10.15420/usc.2019.21.2","url":null,"abstract":"Clinical diagnosis sometimes involves the use of medical instruments that employ ionizing radiation. However, ionizing radiation exposure is a workplace hazard that goes undetected and is detrimental to patients and staff in the catheterization laboratory. Every possible effort should be made to reduce the amount of radiation, including scattered radiation. Implementing radiation dose feedback may have a role in reducing exposure. In medicine, it is important to estimate the potential biologic effects on, and the risk to, an individual. In general, implantation of cardiac resynchronization devices is associated with one of the highest operator exposure doses due to the proximity of the operator to the radiation source. All physicians should work on the principle of as low as reasonably achievable. Methods for reducing radiation exposure must be implemented in the catheterization laboratory. In this article, we review the available tools to lower the radiation exposure dose to the operator during diagnostic, interventional, and electrophysiological cardiac procedures.","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45285215","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}
{"title":"Single-Ventricle Physiology","authors":"Lydia Taranto, Tabitha Moe","doi":"10.15420/usc.2019.20.2","DOIUrl":"https://doi.org/10.15420/usc.2019.20.2","url":null,"abstract":"Single-ventricle physiology occurs in patients with hypoplastic ventricular heart defects, either on the right or left, who have undergone stepwise palliation surgeries ending with the Fontan procedure. After Fontan completion, these patients are dependent on passive venous return to the pulmonary circulation. The implications of passive flow are potentially devastating to the patient. We discuss some of the basic changes to the patient’s experience after a Fontan procedure, as well as the common complications. We also touch on some of the emerging management strategies for the common complications.","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45591248","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}
{"title":"Artificial Intelligence in Cardiac Imaging","authors":"K. Seetharam, S. Shrestha, P. Sengupta","doi":"10.15420/usc.2019.19.2","DOIUrl":"https://doi.org/10.15420/usc.2019.19.2","url":null,"abstract":"Machine learning (ML), a subset of artificial intelligence, is showing promising results in cardiology, especially in cardiac imaging. ML algorithms are allowing cardiologists to explore new opportunities and make discoveries not seen with conventional approaches. This offers new opportunities to enhance patient care and open new gateways in medical decision-making. This review highlights the role of ML in cardiac imaging for precision phenotyping and prognostication of cardiac disorders.","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46178366","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}
Deepak L. Bhatt, A. M. D. Kristensen, M. Pareek, M. Olsen
{"title":"Baroreflex Activation Therapy for Resistant Hypertension and Heart Failure","authors":"Deepak L. Bhatt, A. M. D. Kristensen, M. Pareek, M. Olsen","doi":"10.15420/usc.2019.13.2","DOIUrl":"https://doi.org/10.15420/usc.2019.13.2","url":null,"abstract":"Hypertension and heart failure are important contributors to global morbidity and mortality. Despite therapeutic lifestyle and pharmacological measures, a significant proportion of people with hypertension do not reach treatment targets. Patients with resistant or poorly controlled hypertension are at significantly increased risk of cardiovascular events, including heart failure. Since dysfunction of the sympathetic nervous system appears to play a key role in the development and progression of both hypertension and heart failure, these patients may benefit from treatment modalities aimed at reducing sympathetic function. The purpose of this paper is to provide an overview of baroreflex activation therapy as a potential treatment strategy in patients with resistant hypertension or heart failure.","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46936259","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}
{"title":"Clinical Features and Outcomes of Patients with Chemotherapy-induced Takotsubo Syndrome","authors":"K. Storey, S. Sharkey","doi":"10.15420/usc.2019.10.1","DOIUrl":"https://doi.org/10.15420/usc.2019.10.1","url":null,"abstract":"Chemotherapy treatment of malignancy accounts for 1–2% of takotsubo syndrome (TS) triggers. Women comprise 60–70% of patients with chemotherapy-associated TS, a distinctly lower prevalence than the 90% female prevalence in TS overall. Fluorouracil is the most commonly reported TS-triggering chemotherapeutic agent, although this must be interpreted in the context of the frequency of worldwide use of this agent. The onset of TS relative to chemotherapy initiation is quite variable, ranging from the initial administration to subsequent chemotherapy cycles several weeks beyond initiation. Limited information suggests chemotherapy can be safely reinitiated once the patient has recovered from the initial TS event. Having a TS event in the setting of chemotherapy treatment for malignancy is associated with substantial mortality.","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48540859","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}
{"title":"Effect of the Extent of Cardiac Damage on Transcatheter Aortic Valve Replacement Outcome: A New Aortic Stenosis Staging System","authors":"M. Fukui, J. Cavalcante","doi":"10.15420/usc.2019.9.1","DOIUrl":"https://doi.org/10.15420/usc.2019.9.1","url":null,"abstract":"Severe aortic stenosis (AS) causes chronic pressure overload of the left ventricle (LV), resulting in progressive cardiac change that can extend beyond the LV. A new AS staging classification has been recently proposed encompassing the extent of cardiac changes in AS. The AS staging classification has important prognostic implications for clinical outcomes after aortic valve replacement. This article introduces the AS staging system and demonstrates the association of the extent of cardiac change with outcomes after transcatheter aortic valve replacement.","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41939980","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}
{"title":"Can Early Management of Hypertension by General Practitioners Improve Outcome?","authors":"Deborah L. Nadler, A. Poppas","doi":"10.15420/USC.2019.5.1","DOIUrl":"https://doi.org/10.15420/USC.2019.5.1","url":null,"abstract":"Hypertension and its cardiovascular sequelae remain one of the major causes of death and disability worldwide, and the prevalence of hypertension in the US and Europe is high. Hypertension is a leading modifiable risk factor for cardiovascular events. Pharmacological approaches and lifestyle modification to treat hypertension early have been consistently shown to improve cardiovascular outcomes in primary and secondary prevention. Recent guidelines recommend initiating treatment at lower blood pressure levels, with normal blood pressure being defined as <120/80 mmHg. Calculating risk using a score such as the Atherosclerotic Cardiovascular Disease Risk Calculator is important to enable the general practitioner to give appropriate, individualized care.","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47530152","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}
Marc P Allard-Ratick, P. Sandesara, A. Quyyumi, L. Sperling
{"title":"Everything in Moderation: Investigating the U-Shaped Link Between HDL Cholesterol and Adverse Outcomes","authors":"Marc P Allard-Ratick, P. Sandesara, A. Quyyumi, L. Sperling","doi":"10.15420/USC.2019.3.2","DOIUrl":"https://doi.org/10.15420/USC.2019.3.2","url":null,"abstract":"Despite historical evidence suggesting an inverse association between HDL cholesterol (HDL-C) and adverse cardiovascular events, pharmacological efforts to increase HDL-C and improve outcomes have not been successful. Recently, a U-shaped association between HDL-C and adverse events has been demonstrated in several population cohorts, further complicating our understanding of the clinical significance of HDL. Potential explanations for this finding include genetic mutations linked to very high HDL-C, impaired HDL function at high HDL-C levels, and residual confounding. However, our understanding of this association remains premature and needs further investigation.","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46545891","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}
{"title":"Role of Drug-coated Balloons in Small-vessel Coronary Artery Disease","authors":"M. Megaly, M. Saad, E. Brilakis","doi":"10.15420/USC.2019.4.1","DOIUrl":"https://doi.org/10.15420/USC.2019.4.1","url":null,"abstract":"Percutaneous coronary intervention of small-vessel coronary artery disease (SVD) remains challenging due to difficulties with device delivery and high restenosis rate, even with the use of newer-generation drug-eluting stents. Drug-coated balloons represent an attractive emerging percutaneous coronary intervention option in patients with SVD. Potential advantages of drug-coated balloons in SVD include enhanced deliverability because of their small profile, avoidance of foreign-body implantation, and shorter duration of dual antiplatelet therapy.","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46835148","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}