Current Opinion in Cardiology最新文献_第7页

Prevention and treatment of hypertensive left ventricular hypertrophy. 预防和治疗高血压左心室肥厚。

IF 2.3 4区医学

Current Opinion in Cardiology Pub Date : 2024-03-05 DOI: 10.1097/hco.0000000000001135

Manvita Tatavarthy, John Stathopoulos, Ahmet Afşin Oktay

引用次数: 0

Worsening heart failure: a concept in evolution. 心力衰竭恶化：演变中的概念。

IF 2.3 4区医学

Current Opinion in Cardiology Pub Date : 2024-03-01 Epub Date: 2023-12-18 DOI: 10.1097/HCO.0000000000001108

Max Puthenpura, Jennifer Wilcox, W H Wilson Tang

引用次数: 0

Heart transplant donation after circulatory death: current status and implications. 循环死亡后的心脏移植捐赠：现状与影响。

IF 2.3 4区医学

Current Opinion in Cardiology Pub Date : 2024-03-01 Epub Date: 2023-12-18 DOI: 10.1097/HCO.0000000000001109

Savitri Fedson

{"title":"Heart transplant donation after circulatory death: current status and implications.","authors":"Savitri Fedson","doi":"10.1097/HCO.0000000000001109","DOIUrl":"10.1097/HCO.0000000000001109","url":null,"abstract":"Purpose of review: The use of cardiac transplantation following circulatory death (DCD) has been limited worldwide. Concerns about cardiac function after warm ischemia and the potential for decreased graft function have been important considerations in this hesitancy. In addition, ethical and legal questions about the two widely used organ procurement methods have led to discussions and public education in many countries.Recent findings: Publication of a US randomized trial of cardiac transplantation following DCD has shown that it is both feasible and has similar short-term outcomes compared with cardiac transplantation following brain death (DBD). These data support those from both Australia and the UK who have largest experience to date.Summary: The adoption of cardiac transplantation following circulatory death has increased overall cardiac transplantation in those transplant centers who have incorporated these donors. Short term outcomes for DCD organ procurement methods are similar to those outcomes using DBD hearts. Continued study and standardization of warm ischemic times will allow for better comparisons of organ procurement techniques and organ optimization. The ethical concerns about procurement methods, in addition to a discussion of procurement costs and feasibility will need to be addressed further in the efforts to expand the organ pool and increase overall cardiac transplantation numbers.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138813775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Obesity/cardiometabolic phenotype of heart failure with preserved ejection fraction: mechanisms to recent trials. 肥胖/心脏代谢表型的射血分数持续性心力衰竭：近期试验的机制。

IF 2.3 4区医学

Current Opinion in Cardiology Pub Date : 2024-03-01 Epub Date: 2024-01-25 DOI: 10.1097/HCO.0000000000001113

Raj Verma, Nitish K Dhingra, Kim A Connelly

{"title":"Obesity/cardiometabolic phenotype of heart failure with preserved ejection fraction: mechanisms to recent trials.","authors":"Raj Verma, Nitish K Dhingra, Kim A Connelly","doi":"10.1097/HCO.0000000000001113","DOIUrl":"10.1097/HCO.0000000000001113","url":null,"abstract":"Purpose of review: Heart failure with preserved ejection fraction (HFpEF) is a leading and growing cause of morbidity and mortality globally. Of the various phenotypes identified, the obesity (or cardiometabolic) phenotype appears to be most common. The purpose of this review is to provide the clinician with an abridged understanding of recent developments that have elucidated obesity/visceral adiposity as a central mechanism linking inflammation/immune dysregulation to the development of the HFpEF syndrome. Recent clinical trials examining the efficacy of pharmacological treatments that target obesity in HFpEF will also be discussed.Recent findings: Recent data indicate that visceral adiposity and insulin resistance in HFpEF serve as key mechanisms driving inflammation and immune dysregulation, which play a critical role in the development of cardiac stiffness, diastolic dysfunction and fibrosis in HFpEF. In obesity, alterations in macrophage polarization, changes in innate and adaptive immune systems and altered myocardial energetics promote metabolic inflammation in HFpEF. Finally, emerging data suggest that inflammatory biomarkers, specifically, IL-6, may provide useful information about HFpEF severity and symptom burden in obesity.Summary: The obesity phenotype of HFpEF is seen in upward of 80% with HFpEF. Obesity is not just a bystander, but plays an essential role in the pathobiology and clinical course of HFpEF. Targeting overweight/obesity in HFpEF with GLP-1 receptor agonists holds promise in these patients.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139643452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Considerations & challenges of mitral valve repair in females: diagnosis, pathology, and intervention. 女性二尖瓣修复的注意事项和挑战：诊断、病理和干预。

IF 2.3 4区医学

Current Opinion in Cardiology Pub Date : 2024-03-01 Epub Date: 2023-12-06 DOI: 10.1097/HCO.0000000000001107

Mimi Xiaoming Deng, Batol Barodi, Malak Elbatarny, Terrence M Yau

{"title":"Considerations & challenges of mitral valve repair in females: diagnosis, pathology, and intervention.","authors":"Mimi Xiaoming Deng, Batol Barodi, Malak Elbatarny, Terrence M Yau","doi":"10.1097/HCO.0000000000001107","DOIUrl":"10.1097/HCO.0000000000001107","url":null,"abstract":"Purpose of review: Disparities in mitral valve (MV) repair outcomes exist between men and women. This review highlights sex-specific differences in MV disease aetiology, diagnosis, as well as timing and type of intervention.Recent findings: Females present with more complicated disease: anterior or bileaflet prolapse, leaflet dysplasia/thickening, mitral annular calcification, and mixed mitral lesions. The absence of indexed echocardiographic mitral regurgitation (MR) severity parameters contributes to delayed intervention in women, resulting in more severe symptom burden at time of surgery. The sequelae of chronic MR also necessitate concomitant procedures (e.g. tricuspid repair, arrhythmia surgery) at the time of mitral surgery. Complex MV pathology, greater patient acuity, and more complicated procedures collectively pose challenges to successful MV repair and postoperative recovery. As a consequence, women receive disproportionately more MV replacement than men. In-hospital mortality after MV repair is also greater in women than men. Long-term outcomes of MV repair are comparable after risk-adjustment for preoperative status; however, women experience a greater incidence of postoperative heart failure.Summary: To address the inequity in MV repair outcomes between sexes, indexed diagnostic measurements, diligent surveillance of asymptomatic MR, increased recruitment of women in large clinical trials, and mandatory reporting of sex-based subgroup analyses are recommended.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138813771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Wellness and burnout in cardiac surgery: not black and white. 心脏外科的健康与职业倦怠：非黑即白。

IF 2.3 4区医学

Current Opinion in Cardiology Pub Date : 2024-03-01 Epub Date: 2023-12-20 DOI: 10.1097/HCO.0000000000001112

Aliya Izumi, Akachukwu Nwakoby, Raj Verma, Bobby Yanagawa

{"title":"Wellness and burnout in cardiac surgery: not black and white.","authors":"Aliya Izumi, Akachukwu Nwakoby, Raj Verma, Bobby Yanagawa","doi":"10.1097/HCO.0000000000001112","DOIUrl":"10.1097/HCO.0000000000001112","url":null,"abstract":"Purpose of review: Despite a growing emphasis on burnout in medicine, there remains a paucity of data in cardiac surgery. Herein, we summarize recent data on cardiac surgeon well being and identify factors for consideration in future burnout inquiries and management.Recent findings: Overall, 70-90% of cardiothoracic surgeons report job satisfaction in the United States. However, 35-60% still endorse burnout symptoms, and the specialty reports some of the highest rates of depression (35-40%) and suicidal ideation (7%). Such negative experiences are greater among early-stage and female surgeons and may be addressed through targeted, program-specific wellness policies. Canada's single-payer healthcare system might exacerbate surgeon burnout due to lower financial compensation and job autonomy.Summary: Cardiothoracic surgeons appear simultaneously burnt out and professionally fulfilled. They report a high incidence of depression and clock in the most hours, yet the majority would choose this specialty again. These findings reveal a more nuanced state of well being than previously appreciated and speak to ambiguities in how burnout is conceived and measured. A broader examination across surgical and social contexts highlights the hierarchical nature of burnout factors and potential ways forward. Collectively, these insights can inform assessments of burnout in Canadian cardiac surgery that remain absent to date.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138813778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A comprehensive overview of surgical and transcatheter therapies to treat tricuspid regurgitation in patients with heart failure. 全面概述治疗心力衰竭患者三尖瓣反流的手术和经导管疗法。

IF 2.3 4区医学

Current Opinion in Cardiology Pub Date : 2024-03-01 Epub Date: 2023-12-18 DOI: 10.1097/HCO.0000000000001110

Vincent Chen, Omar Abdul-Jawad Altisent, Rishi Puri

{"title":"A comprehensive overview of surgical and transcatheter therapies to treat tricuspid regurgitation in patients with heart failure.","authors":"Vincent Chen, Omar Abdul-Jawad Altisent, Rishi Puri","doi":"10.1097/HCO.0000000000001110","DOIUrl":"10.1097/HCO.0000000000001110","url":null,"abstract":"Purpose of review: The unique pathophysiologic considerations of severe tricuspid regurgitation (TR) have led to advancements in surgical and transcatheter treatments. The purpose of this review is to highlight the current surgical and transcatheter tricuspid valve interventions (TTVI) to functional TR.Recent findings: Surgical repair with ring annuloplasty consistently demonstrates better outcomes than surgical replacement or other repair approaches. However, surgical uptake of TR correction remains relatively low, and operative mortality rates are still high owing to multiple comorbidities and advanced tricuspid valve disease/right ventricular dysfunction at time of referral. Pivotal trials for tricuspid transcatheter edge-to-edge repair (T-TEER) and transcatheter TV replacement (TTVR) indicate improved quality of life compared to medical therapy alone for high-surgical-risk patients with severe symptomatic TR. Trials are underway to assess caval valve implantation (CAVI), which holds hope for many severe TR patients who are not ideal candidates for T-TEER or orthotopic TTVR. Peri-procedural optimization of right ventricular function remains critical to promote both device success and patient outcomes.Summary: Clinical outcomes after surgical TV intervention are poor, often due to intervening late in the disease course of TR. TTVI covers a treatment gap for patients deemed inoperable or high-surgical-risk, but earlier referral for TV interventions is still important prior to patients developing multiorgan dysfunction from chronic untreated TR.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138813766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Which lesions are not amenable to tricuspid clipping? 哪些病变不能进行三尖瓣修剪？

IF 2.3 4区医学

Current Opinion in Cardiology Pub Date : 2024-03-01 Epub Date: 2023-11-29 DOI: 10.1097/HCO.0000000000001105

Shahrukh N Bakar, Neil P Fam

{"title":"Which lesions are not amenable to tricuspid clipping?","authors":"Shahrukh N Bakar, Neil P Fam","doi":"10.1097/HCO.0000000000001105","DOIUrl":"10.1097/HCO.0000000000001105","url":null,"abstract":"Purpose of review: Tricuspid transcatheter edge-to-edge repair (T-TEER) has emerged as a well tolerated and effective therapeutic option for many patients with symptomatic severe tricuspid regurgitation at prohibitive surgical risk. However, there remain several important limitations to clip-based technology in the context of other rapidly emerging percutaneous treatment options for tricuspid regurgitation.Recent findings: Tricuspid lesions pose unique challenges to treatment with the current toolbox of transcatheter clip-based technologies. This review will explore key issues related to patient factors, anatomical factors, and imaging factors that may render lesions to be unsuitable for treatment with T-TEER.Summary: Selection for T-TEER must include a detailed clinical evaluation in the context of a 'heart team' approach involving multiple subspecialists, with screening for patient/lesion characteristics that make T-TEER suboptimal with current clip-based technologies. Future directions for research include patient-specific 3D modeling techniques, leaflet grasping techniques, clip deployment strategies, and personalized device sizing to increase the spectrum of lesions that may be treated with T-TEER within the context of other emerging transcatheter treatment options.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138813783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A review of the contemporary use of inotropes in patients with heart failure. 心力衰竭患者肌注药物的当代使用回顾。

IF 2.3 4区医学

Current Opinion in Cardiology Pub Date : 2024-03-01 Epub Date: 2023-12-26 DOI: 10.1097/HCO.0000000000001115

Radhika Neicheril, David Snipelisky

{"title":"A review of the contemporary use of inotropes in patients with heart failure.","authors":"Radhika Neicheril, David Snipelisky","doi":"10.1097/HCO.0000000000001115","DOIUrl":"10.1097/HCO.0000000000001115","url":null,"abstract":"Purpose of review: The role of inotropes has evolved with its use now expanding over multiple indications including cardiogenic shock, low cardiac output states, bridging therapy to transplant or mechanical support, and palliative care. There remains no consensus as to the recommended inotrope for the failing heart. We aim to provide an overview of the recent literature related to inotrope therapy and its application in patients with advanced heart failure and hemodynamic compromise.Recent findings: In this review, we outline various clinical scenarios that warrant the use of inotrope therapy and the associated recommendations. There remains no mortality benefit with inotrope use. Per American Heart Association recommendations, the choice of the inotropic agent should be guided by parameters such as blood pressure, concurrent arrhythmias, and availability of the medication. Outcome variability remains a heightened concern with inpatient inotropic use in both hemodynamically stable and unstable patients. Finally, inotropic use in palliative care continues to be a recommendation for symptom control and improvement in functional status when the appropriate social support is present for the patient.Summary: In summary, the ideal inotropic agent remains at the discretion of the clinical provider. Different clinical scenarios may favor one agent over another based on the type of cardiogenic shock and mechanism of action of the inotrope. A future shift towards characterizing inotrope use based on subgroup cardiogenic shock profiles may be seen, however further studies are needed to better understand these phenotypes. Inotrope therapy remains a keystone to bridging to advanced therapies and palliative care.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139089459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Simulating mitral repair: lessons learned. 模拟二尖瓣修复：经验教训。

IF 2.3 4区医学

Current Opinion in Cardiology Pub Date : 2024-02-03 DOI: 10.1097/hco.0000000000001106

Abigail White, Anna Zarzycki, Gianluigi Bisleri

引用次数: 0