Cardiology in Review最新文献

{"title":"Managing Heart Failure in Complex Adult Congenital Heart Disease.","authors":"Tzvi Fishkin, Ashish Tripathi, Muhammad Furqan, Matthew McMaster, William Frishman, Wilbert S Aronow","doi":"10.1097/CRD.0000000000000946","DOIUrl":"10.1097/CRD.0000000000000946","url":null,"abstract":"<p><p>The management of complex congenital heart disease has advanced over the years. While certain complex congenital heart diseases are not compatible with life, palliative surgeries have developed to allow these children to survive into adulthood. Consequently, there are more children surviving into adulthood who have previously undergone complex palliative surgeries and have complex anatomy and physiology. There is a high prevalence of heart failure in adults with complex congenital heart disease due to its progressive nature. Often, anatomical and physiological sequelae of the disease itself or its surgical palliation lead to heart failure signs and symptoms over time. The nature of heart failure in this population is different than that of normal adults, and so management strategies must be adjusted based on the unique anatomy and physiology of these patients. While there are guidelines for monitoring and managing adults with complex congenital heart disease, there are limited data for medical therapies that improve symptom burden and mortality. Once these patients have worsening or decompensated heart failure, they often must be considered for advanced therapies, mechanical circulatory support, and transplant. There is still a need for further research and highly powered trials to elucidate how to optimally treat heart failure in adults with complex congenital heart disease.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989995","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}

{"title":"Chemotherapy-Induced Cardiomyopathy: A Focus on the Utility of Statins.","authors":"Sanjana Arsha, Ashish Tripathi, John Kangarlu, Bilal Rehman, William H Frishman, Wilbert S Aronow","doi":"10.1097/CRD.0000000000000942","DOIUrl":"https://doi.org/10.1097/CRD.0000000000000942","url":null,"abstract":"<p><p>Chemotherapy-induced cardiomyopathy (CICM) is a critical adverse consequence associated with chemotherapeutic treatments such as anthracyclines, taxanes, and alkylating agents. Cardiac dysfunction, characterized by left ventricular systolic dysfunction, is the primary effect found in these patients. This may result in heart failure, with heart failure related to chemotherapy resulting in a 3.5-fold increased risk of mortality compared with idiopathic cardiomyopathy alone. Multiple factors, including oxidative stress, inflammation, and disruption of key cellular pathways, are involved in cardiomyocyte damage and influence CICM pathophysiology. So far, dexrazoxane is the sole FDA-approved preventive therapy, but alternative interventions, such as beta-blockers, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, and statins, have been studied for their cardioprotective potential. Statins, beyond their cholesterol-lowering capabilities, stand out for their pleiotropic effects, including antioxidant, anti-inflammatory, and endothelial-protective actions, which counteract inflammatory effects. Multiple studies and meta-analyses suggest that statin therapy may decrease both the incidence and severity of chemotherapy-related cardiotoxicity (CTX), as evidenced by smaller declines in left ventricular ejection fraction and lower rates of heart failure in statin-treated patients. However, not all investigations confirm these protective benefits; for instance, some trials, including SPARE-HF, reported no significant differences in cardiac outcomes. While these conflicting findings underscore the need for larger randomized trials, they also reflect the heterogeneity of cancer types, chemotherapy regimens, and patient profiles. Statins show promise as a cardioprotective strategy for individuals at risk of CICM. Enhancing patient selection and specifying the timing and duration of statin therapy are essential steps for incorporating these agents into standard care. Optimizing these parameters may reduce chemotherapy-related cardiac damage, improve long-term cardiac function, and enhance overall survival in cancer survivors.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977376","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}

{"title":"Navigating Bleeding, Thrombosis, and Antithrombotic Management in Transcatheter Aortic Valve Replacement.","authors":"Jude Elsaygh, Manish A Parikh, William H Frishman, Stephen J Peterson","doi":"10.1097/CRD.0000000000000908","DOIUrl":"https://doi.org/10.1097/CRD.0000000000000908","url":null,"abstract":"<p><p>Transcatheter aortic valve replacement (TAVR) has revolutionized the treatment of aortic stenosis, providing a less invasive alternative to surgical valve replacement. However, post-TAVR management remains complex, particularly concerning antithrombotic strategies, as patients face competing risks of bleeding and thrombosis. This review explores the evolving landscape of anticoagulation and antiplatelet therapy in TAVR patients, examining current American and European guidelines, clinical trial data, and the role of direct oral anticoagulants. We also highlight the interplay between atrial fibrillation, coronary artery disease, and antithrombotic therapy, emphasizing personalized approaches to patient management. Finally, we discuss complications such as stroke, subclinical leaflet thrombosis, and major bleeding, offering insights into mitigation strategies. As the field continues to evolve, ongoing research will shape future recommendations to optimize outcomes for patients undergoing TAVR.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954011","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}

{"title":"Curbside Consult Torsemide versus Furosemide: Pharmacological Distinctions and Clinical Implications.","authors":"Siddharth Pravin Agrawal, Sobia Mansoor, Bhanu Maturi, Ritu Chandra Prakash Tated, Darshilkumar Maheta, Rakendu Jayasree Rajendran, Palak Patel, Rachna Jairaj Vashi, William H Frishman, Wilbert S Aronow","doi":"10.1097/CRD.0000000000000948","DOIUrl":"https://doi.org/10.1097/CRD.0000000000000948","url":null,"abstract":"<p><p>Furosemide and torsemide are both loop diuretics that have widespread use to manage fluid excess in heart failure (HF), chronic kidney disease, and secondary conditions. These drugs work through inhibition of the Na+-K+-2Cl- cotransporter in the Henle's loop, thus bringing about diuresis and symptomatic relief. Torsemide is different from furosemide pharmacokinetically and mechanism-wise-with higher oral bioavailability, longer half-life, and potential anti-aldosterone effect-and these differences have prompted studies of whether it offers superior clinical outcomes. Herein, furosemide and torsemide are contrasted in mechanisms of action, clinical application, efficacy (diuretic effectiveness and results in HF and chronic kidney disease), safety profile, and price. Current evidence from meta-analyses and clinical trials indicates that both medications offer equivalent volume control and clinical outcomes in HF, with no major differences in hospitalization or mortality rates.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964776","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}

{"title":"Advancing Diabetes Management and Glycemic Control While Exploring CagriSema's Impact on Obesity Management.","authors":"Somar Hadid, William H Frishman, Wilbert S Aronow","doi":"10.1097/CRD.0000000000000940","DOIUrl":"https://doi.org/10.1097/CRD.0000000000000940","url":null,"abstract":"<p><p>Diabetes is a complex metabolic disorder affecting over 37 million people in the United States. Without proper management, diabetes can lead to a myriad of complications, including cardiovascular disease, kidney failure, and vision loss. Obesity is a major contributor to type 2 diabetes, but genetic and physiological factors make weight loss difficult, necessitating medication management for both conditions. Government-approved weight loss medications, including glucagon-like peptide-1 agonists and amylin analogs, have proven to be effective for both conditions. However, intensive glycemic control involving antidiabetic medications, while beneficial for reducing diabetic complications, can often precipitate hypoglycemic events, which are characterized by cardiac arrhythmias, coma, confusion, and even mortality. A new drug under investigation, CagriSema, combines cagrilintide, an amylin analog, with semaglutide, a glucagon-like peptide-1 agonist. This drug is being marketed as a safe and potentially superior medication to lower both Hemoglobin A1c and body weight. In this article, the pathophysiology, current guidelines, and management of diabetes will be reviewed, with an emphasis on the clinical evidence for tight glucose control and avoiding hypoglycemic events. Following this, an overview of recent trials on antidiabetic medications, including those involving CagriSema, will be presented, along with prospects for future trials in this promising area of research.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976022","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}

{"title":"Efficacy of Beta-Blockers in Acute Management and Prevention of Recurrence in Takotsubo Syndrome.","authors":"Ranjit K Nair, Manish A Parikh, William H Frishman, Stephen J Peterson","doi":"10.1097/CRD.0000000000000926","DOIUrl":"https://doi.org/10.1097/CRD.0000000000000926","url":null,"abstract":"<p><p>Takotsubo cardiomyopathy is a nonischemic cardiomyopathy characterized by a transient ballooning of the apical cardiac wall secondary to stress. Since its discovery and diagnosis in Japan in 1990, Takotsubo cardiomyopathy has been known as a disease with a generally favorable prognosis due to the transient nature of its apical wall abnormalities. However, complications, including arrhythmia, hemodynamic instability, heart failure, intracardiac thrombus, and rupture, have all been reported in the literature, requiring flexible management of this unique pathology. Although therapy is guided by inciting factors and complication management, beta-blockers are a widely accepted acute and long-term treatment modality. We review the current literature describing the pathogenesis, medical evaluation, and treatment options for Takotsubo cardiomyopathy. This article aims to provide a greater understanding of the pathophysiology and further evaluate the efficacy of beta-blocker therapy when considering acute and long-term treatment and prevention of Takotsubo cardiomyopathy.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966704","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}

{"title":"Untangling the Wire: Exploring the Overuse of Continuous Telemetry on Regular Nursing Floors.","authors":"F N U Varnika, Siri Vummaneni, Parth Munjal, Benjamin Philip Walters, Vasu Gupta, Rohit Jain","doi":"10.1097/CRD.0000000000000828","DOIUrl":"https://doi.org/10.1097/CRD.0000000000000828","url":null,"abstract":"<p><p>Continuous telemetry is a widely used, or overutilized, practice on regular nursing floors despite many patients not having the proper indications for this intensive cardiac surveillance. Some of the factors driving this problem come under the broad category of \"defensive medicine,\" fueled by clinical inertia and fear of missing critical arrhythmias, the incidence of which might not be that significant. The available evidence in the literature insinuates some benefit of this while also adding to unnecessary alarm fatigue, healthcare costs, logistic issues such as understaffing or insufficient bed capacity, and potential harm from false alarms, which strains the resources and may harm patients. Addressing this issue through electronic medical record-based interventions, clinician education, standardization of continuous telemetry initiation and discontinuation criteria, and shared decision-making involving the healthcare team and the patients can lead to improved outcomes and proper resource utilization for continuous telemetry. Ultimately, reevaluating telemetry utilization on regular nursing floors is crucial to ensure judicious use, mitigate risks, and enhance patient care.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963647","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}

{"title":"Is Giant Cell Arteritis Associated with Increased Risk of Cardiovascular Disease? A Meta-Analysis.","authors":"Hritvik Jain, Maryam Shahzad, Nandan Patel, Siddhant Passey, Jagjot Singh, Rozi Khan, Rahul Patel, Roopeessh Vempati, Shrey Gole, Raheel Ahmed","doi":"10.1097/CRD.0000000000000928","DOIUrl":"https://doi.org/10.1097/CRD.0000000000000928","url":null,"abstract":"<p><p>Giant cell arteritis (GCA) is the most common form of vasculitis in individuals aged >50 years. While it has been hypothesized that GCA increases the risk of adverse cardiovascular events, existing literature presents conflicting findings. This meta-analysis aims to examine the risks of myocardial infarction (MI), stroke, and peripheral arterial disease (PAD) in patients with GCA. A comprehensive search of major bibliographic databases, including PubMed, EMBASE, Google Scholar, SCOPUS, and Web of Science, was conducted to identify studies on cardiovascular risks in GCA patients up to November 1, 2024. The RevMan (version 5.4) software was used with a random-effects model to calculate pooled hazard ratios (HR) with 95% confidence intervals (CI), using Der-Simonian and Laird's inverse-variance random-effects method. The meta-analysis included 10 studies with 518,402 participants (28,707 GCA patients and 489,695 controls). GCA was associated with a significantly increased risk of MI (HR, 1.74; 95% CI, 1.34-2.25; P < 0.0001), stroke (HR, 1.43; 95% CI, 1.33-1.54; P < 0.00001), and PAD (HR, 1.98; 95% CI, 1.53-2.57; P < 0.00001). This meta-analysis shows that GCA patients are at a significantly higher risk of MI, stroke, and PAD compared with controls. Further prospective studies are needed to confirm these findings, as early cardiovascular risk management could reduce the risk of major adverse cardiovascular events.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954900","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}

{"title":"Asthma and Cardiovascular Diseases: Uncovering Common Ground in Risk Factors and Pathogenesis.","authors":"Kanishk Aggarwal, Vasu Bansal, Ramsha Mahmood, Sai Gautham Kanagala, Rohit Jain","doi":"10.1097/CRD.0000000000000600","DOIUrl":"10.1097/CRD.0000000000000600","url":null,"abstract":"<p><p>Asthma and cardiovascular diseases (CVDs) are the 2 common and complex health problems with a substantial global impact. Epidemiological studies indicate that asthma and CVDs are common, with evidence supporting their cooccurrence. Inflammation, oxidative stress, obesity, metabolic syndrome, smoking, secondhand smoke exposure, physical inactivity, and environmental exposures are all risk factors for asthma and CVDs. In addition, inflammatory and immunological pathways, autonomic dysfunction, endothelial dysfunction, thrombosis, coagulation, and common genetic risk factors contribute to the asthma-CVD relationship. Asthmatic individuals have higher morbidity and mortality rates related to CVDs and high-risk factors. Techniques such as screening for CVDs in asthma patients, pharmaceutical therapy, and lifestyle changes are critical for effectively managing these comorbid illnesses. Understanding the link between asthma and CVD is necessary for integrated and clinical management approaches to enhance patient outcomes and lessen the burden of these related diseases.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":"219-226"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10396771","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}

{"title":"Lead Extraction-Indications, Procedure, and Future Directions.","authors":"Sumit Khurana, Subrat Das, William H Frishman, Wilbert S Aronow, Daniel Frenkel","doi":"10.1097/CRD.0000000000000610","DOIUrl":"10.1097/CRD.0000000000000610","url":null,"abstract":"<p><p>Cardiac implantable electronic device (CIED) implantation has steadily increased in the United States owing to increased life expectancy, better access to health care, and the adoption of updated guidelines. Transvenous lead extraction (TLE) is an invasive technique for the removal of CIED devices, and the most common indications include device infections, lead failures, and venous occlusion. Although in-hospital and procedure-related deaths for patients undergoing TLE are low, the long-term mortality remains high with 10-year survival reported close to 50% after TLE. This is likely demonstrative of the increased burden of comorbidities with aging. There are guidelines provided by various professional societies, including the Heart Rhythm Society, regarding indications for lead extraction and management of these patients. In this paper, we will review the indications for CIED extraction, procedural considerations, and management of these patients based upon the latest guidelines.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":"212-218"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41105781","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}