Current Opinion in Cardiology最新文献_第8页

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":" ","pages":"104-109"},"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

Radiofrequency lesion formation prediction with contact force versus local impedance. 接触力与局部阻抗的射频损伤形成预测。

IF 2.3 4区医学

Current Opinion in Cardiology Pub Date : 2024-01-01 Epub Date: 2023-10-09 DOI: 10.1097/HCO.0000000000001095

Ziad F Issa

引用次数: 0

2023 Update on equity, diversity, and inclusion in Canadian cardiac surgery. 2023加拿大心脏外科的公平性、多样性和包容性更新。

IF 2.3 4区医学

Current Opinion in Cardiology Pub Date : 2024-01-01 Epub Date: 2023-11-07 DOI: 10.1097/HCO.0000000000001101

Lina A Elfaki, Rosalind Groenewoud, Akachukwu Nwakoby, Areeba Zubair, Raj Verma, Bobby Yanagawa

{"title":"2023 Update on equity, diversity, and inclusion in Canadian cardiac surgery.","authors":"Lina A Elfaki, Rosalind Groenewoud, Akachukwu Nwakoby, Areeba Zubair, Raj Verma, Bobby Yanagawa","doi":"10.1097/HCO.0000000000001101","DOIUrl":"10.1097/HCO.0000000000001101","url":null,"abstract":"Purpose of review: Despite efforts to diversify the medical field, cardiac surgery remains amongst the least diverse specialties. Specifically, the percentage of women and racial minorities has remained low in past few decades. This may impact prospective trainee recruitment and surgical care. This paper highlights recent efforts that aim to promote diversity and inclusion of the Canadian cardiac surgical workforce.Recent findings: Formal programs have been established to support students at different stages of training. In 2022, the Canadian Society for Cardiac Surgery has released an equity, diversity, and inclusion statement to summarize the current state and the strategic goals to accomplish a more just working environment. At the local level, the University of Toronto Next Surgeon high school pilot program, provided low-income, women, and racial minority students mentorship and experiential exposure to our field. Also, the University of Toronto, scholarships funded summer research with cardiac surgeons for women, as well as Black and Indigenous medical students.Summary: Tangible efforts that target high school, undergraduate, and medical students are underway to promote equity and diversity of cardiac surgeons in Canada. Future studies that evaluate the gaps and identify bottlenecks could better guide interventions at institutions across the country.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"68-71"},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71489194","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

Advances in cardiac pacing with leadless pacemakers and conduction system pacing. 无引线起搏器心脏起搏和传导系统起搏的进展。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2024-01-01 Epub Date: 2023-09-21 DOI: 10.1097/HCO.0000000000001092

Sulaiman Somani, Albert J Rogers

{"title":"Advances in cardiac pacing with leadless pacemakers and conduction system pacing.","authors":"Sulaiman Somani, Albert J Rogers","doi":"10.1097/HCO.0000000000001092","DOIUrl":"10.1097/HCO.0000000000001092","url":null,"abstract":"Purpose of review: The field of cardiac pacing has undergone significant evolution with the introduction and adoption of conduction system pacing (CSP) and leadless pacemakers (LLPMs). These innovations provide benefits over conventional pacing methods including avoiding lead related complications and achieving more physiological cardiac activation. This review critically assesses the latest advancements in CSP and LLPMs, including their benefits, challenges, and potential for future growth.Recent findings: CSP, especially of the left bundle branch area, enhances ventricular depolarization and cardiac mechanics. Recent studies show CSP to be favorable over traditional pacing in various patient populations, with an increase in its global adoption. Nevertheless, challenges related to lead placement and long-term maintenance persist. Meanwhile, LLPMs have emerged in response to complications from conventional pacemaker leads. Two main types, Aveir and Micra, have demonstrated improved outcomes and adoption over time. The incorporation of new technologies allows LLPMs to cater to broader patient groups, and their integration with CSP techniques offers exciting potential.Summary: The advancements in CSP and LLPMs present a transformative shift in cardiac pacing, with evidence pointing towards enhanced clinical outcomes and reduced complications. Future innovations and research are likely to further elevate the clinical impact of these technologies, ensuring improved patient care for those with conduction system disorders.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"1-5"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41154163","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

Left atrial appendage closure: the journey today and tomorrow. 左心耳封堵术：今天和明天的旅程。

IF 2.3 4区医学

Current Opinion in Cardiology Pub Date : 2024-01-01 Epub Date: 2023-10-20 DOI: 10.1097/HCO.0000000000001091

Marvin Louis Roy Lu, David Bowers De Lurgio

引用次数: 0

Neurologic impact of atrial fibrillation. 心房颤动对神经系统的影响。

IF 2.3 4区医学

Current Opinion in Cardiology Pub Date : 2024-01-01 Epub Date: 2023-09-07 DOI: 10.1097/HCO.0000000000001093

Daniel R Feldman, Emily P Zeitler

{"title":"Neurologic impact of atrial fibrillation.","authors":"Daniel R Feldman, Emily P Zeitler","doi":"10.1097/HCO.0000000000001093","DOIUrl":"10.1097/HCO.0000000000001093","url":null,"abstract":"Purpose of review: Cognitive dysfunction is a complex condition that is becoming increasingly more prevalent. There has been growing acknowledgement that individuals with atrial fibrillation are at an increased risk of cognitive dysfunction beyond the association of age with both disorders. The purpose of this review is to explore the potential underlying mechanisms connecting atrial fibrillation and cognitive dysfunction and to examine the existing evidence for potential treatment options.Recent findings: Many mechanisms have been proposed for the association between cognitive dysfunction and atrial fibrillation. These include cerebral infarction (both micro and macro embolic events), cerebral microbleeds including those secondary to therapeutic anticoagulation, an increased inflammatory state, cerebral hypoperfusion, and a genetic predisposition to both diseases. Treatments designed to target each of these mechanisms have led to mixed results and there are no specific interventions that have definitively led to a reduction in the incidence of cognitive dysfunction.Summary: The relationship between cognitive dysfunction and atrial fibrillation remains poorly understood. Standard of care currently focuses on reducing risk factors, managing stroke risk, and maintaining sinus rhythm in appropriately selected patients. Further work needs to be conducted in this area to limit the progression of cognitive dysfunction in patients with atrial fibrillation.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"33-38"},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10184569","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

Low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol and apolipoprotein B for cardiovascular care. 用于心血管护理的低密度脂蛋白胆固醇、非高密度脂蛋白蛋白胆固醇和载脂蛋白B。

IF 2.3 4区医学

Current Opinion in Cardiology Pub Date : 2024-01-01 Epub Date: 2023-11-06 DOI: 10.1097/HCO.0000000000001100

Selin Bilgic, Allan D Sniderman

{"title":"Low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol and apolipoprotein B for cardiovascular care.","authors":"Selin Bilgic, Allan D Sniderman","doi":"10.1097/HCO.0000000000001100","DOIUrl":"10.1097/HCO.0000000000001100","url":null,"abstract":"Purpose of review: Some experts and consensus groups continue to argue that apolipoprotein B (apoB) should not be introduced broadly into clinical care. But, too often, the present approach to clinical care is not succeeding. An important reason for this failure, we believe, is that the conventional approach limits what the expert clinician can accomplish and is too complex, confusing, and contradictory for primary care physicians to apply effectively in their practise.Recent findings: There are four major reasons that apoB should be measured routinely in clinical care. First, apoB is a more accurate marker of cardiovascular risk than LDL-C or non-HDL-C. Second, the measurement of apoB is standardized whereas the measurements of LDL-C and non-HDL-C are not. Third, with apoB and a conventional lipid panel, all the lipid phenotypes can be simply and accurately distinguished. This will improve the care of the expert. Fourth, apoB, as the single measure to evaluate the success of therapy, would simplify the process of care for primary care physicians.Summary: By introducing apoB broadly into clinical care, the process of care will be improved for both the expert and the primary care physician, and this will improve the outcomes of care.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"49-53"},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71489195","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

Perspectives on pulsed field ablation: how to judge endpoints. 脉冲场消融的视角：如何判断终点。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2024-01-01 Epub Date: 2023-09-11 DOI: 10.1097/HCO.0000000000001094

Valeria Anglesio, Atul Verma

{"title":"Perspectives on pulsed field ablation: how to judge endpoints.","authors":"Valeria Anglesio, Atul Verma","doi":"10.1097/HCO.0000000000001094","DOIUrl":"10.1097/HCO.0000000000001094","url":null,"abstract":"Purpose of review: This review highlights pulse field ablation's (PFA) significance in treating atrial fibrillation. PFA uses short-pulsed electrical fields, offering safety advantages over thermal methods. Multicenter studies' findings on PFA's safety, efficiency, and efficacy, compared with thermal techniques, are discussed.Recent findings: The review encompasses major PFA systems utilized in multicenter studies: penta-spline, circular, and lattice catheters. These studies affirm PFA's safety, with minimal complications like esophageal injury, phrenic nerve complications, and pulmonary vein stenosis. PFA also demonstrates procedural efficiency benefits because of rapid pulse delivery. However, PFA's efficacy appears on par with thermal ablation, showing similar rates of atrial arrhythmia recurrence during follow-up periods. The studies explore diverse postablation monitoring strategies, underscoring the necessity for standardized monitoring or consistent transformation of arrhythmia data.Summary: In conclusion, PFA marks a promising era for atrial fibrillation treatment with improved safety and efficiency. Efficacy is comparable to thermal methods, though technology advancements could alter this. PFA's potential as a safer and faster alternative positions it as a dominant atrial fibrillation ablation technology. Careful analysis and standardized monitoring are vital to assess PFA's potential and clinical implications.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"27-32"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10609986","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

Reconsideration of the definition of blanking period and significance of early recurrences after catheter ablation of atrial fibrillation. 心房颤动导管消融术后空白期定义及早期复发意义的再思考。

IF 2.3 4区医学

Current Opinion in Cardiology Pub Date : 2024-01-01 Epub Date: 2023-09-18 DOI: 10.1097/HCO.0000000000001096

Songnan Wen, Yu Liao, Tejas S Khurana, Rong Bai

{"title":"Reconsideration of the definition of blanking period and significance of early recurrences after catheter ablation of atrial fibrillation.","authors":"Songnan Wen, Yu Liao, Tejas S Khurana, Rong Bai","doi":"10.1097/HCO.0000000000001096","DOIUrl":"10.1097/HCO.0000000000001096","url":null,"abstract":"Purpose of review: Early recurrence of atrial tachyarrhythmia (ERAT) during blanking period (BP) is not uncommon after catheter ablation of AF. Current guidelines and consensus statements recommend conservative treatment of ERAT. This review summarized recent studies, underlying mechanism and clinical managements of ERAT, and proposed a reconsideration of the definition and clinical significance of BP.Recent findings: Recent studies have shown that the entity of ERAT in the very early phase of BP (i.e., first 4 weeks of the 3-month period) is different from those ERATs occurring late which is strongly associated with the late recurrence of atrial tachyarrhythmia. The optimal BP duration suggested by clinical observation ranges from 21 to 58 days. Using antiarrhythmic drugs and early electrical cardioversion are the effective management for ERAT, whereas re-ablation is a reasonable strategy although remains controversial.Summary: The definition of BP with a shorter duration, that is, 1 month instead of 3 months post AF ablation, is supported by the observations of latest clinical studies. Recurrent atrial tachyarrhythmia beyond the 1-month time frame is associated with higher risk of late recurrence and may warrant repeat ablation. A revisit to the guideline recommendation on management of ERAT is needed to change clinical practice.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"15-19"},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41141513","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