1,969 results match your criteria Cardiology Clinics[Journal]


Adult Congenital Heart Disease: A Population that Has Come of Age.

Authors:
Curt J Daniels

Cardiol Clin 2020 Aug 6;38(3):xiii. Epub 2020 Jun 6.

The Ohio State University College of Medicine, Nationwide Children's Hospital, Davis Heart and Lung Research Institute, 2nd Floor Cardiology Division, 473 West 12th Avenue, Columbus, OH 43210, USA. Electronic address:

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http://dx.doi.org/10.1016/j.ccl.2020.05.001DOI Listing

Heart Failure in Adult Congenital Heart Disease.

Cardiol Clin 2020 Aug;38(3):457-469

Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA 98195, USA.

As the population of adult congenital heart disease patients ages and grows, so too does the burden of heart failure in this population. Despite the advances in medical and surgical therapies over the last decades, heart failure in adult congenital heart disease remains a formidable complication with high morbidity and mortality. This review focuses on the challenges in determining the true burden and management of heart failure in adult congenital heart disease. Read More

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http://dx.doi.org/10.1016/j.ccl.2020.04.010DOI Listing

Congenital Heart Disease and Pulmonary Hypertension.

Cardiol Clin 2020 Aug 8;38(3):445-456. Epub 2020 Jun 8.

Department of Pediatrics, The Heart Institute, Cincinnati Children's Hospital, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA.

Pulmonary hypertension (PH) is common in adults with congenital heart disease and carries fundamental implications for management and prognosis. A high index of suspicion, combined with knowledge of the pathogenesis and pathophysiology of PH, is required to achieve a timely, accurate diagnosis, and appropriate classification and treatment. This article provides a guide on how to approach the adult with congenital heart disease and suspected PH of different types, including current management. Read More

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http://dx.doi.org/10.1016/j.ccl.2020.04.008DOI Listing

Surgery for Adult Congenital Heart Disease.

Cardiol Clin 2020 Aug 10;38(3):435-443. Epub 2020 Jun 10.

The Division of Cardiothoracic Surgery, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA; Division of Cardiothoracic Surgery, Children's Hospital of Philadelphia, The Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA.

Technical and medical improvements for congenital cardiac disease in children have contributed to an increasing population of patients who survive into adulthood. These patients may be prone to progression of their native palliated disease or suffer from sequelae of their childhood repair that requires repeat surgical intervention. Surgery for adult congenital cardiac disease poses unique challenges and risks. Read More

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http://dx.doi.org/10.1016/j.ccl.2020.04.013DOI Listing

Adults with Congenital Heart Disease and Arrhythmia Management.

Cardiol Clin 2020 Aug 7;38(3):417-434. Epub 2020 Jun 7.

Electrophysiology Service and Adult Congenital Heart Disease Center; Department of Medicine, Montreal Heart Institute, Université de Montréal, 5000 Bélanger Street, Montreal, Quebec H1T 1C8, Canada.

Arrhythmia management in adult congenital heart disease (ACHD) encompasses a wide range of problems from bradyarrhythmia to tachyarrhythmia, sudden death, and heart failure-related electrical dyssynchrony. Major advances in the understanding of the pathophysiology and treatments of these problems over the past decade have resulted in improved therapeutic strategies and outcomes. This article attempts to define these problems and review contemporary management for the patient with ACHD presenting with cardiac arrhythmia. Read More

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http://dx.doi.org/10.1016/j.ccl.2020.04.006DOI Listing

Transcatheter Interventions in Adult Congenital Heart Disease.

Cardiol Clin 2020 Aug 6;38(3):403-416. Epub 2020 Jun 6.

Sidra Heart Center, Sidra Medicine, Al Gharrafa Street, Ar-Rayyan, Doha, Qatar; Weill Cornell Medicine, Cornell University, 525 East 68th Street, New York, NY 10065, USA.

This article provides a detailed review of the current practices and future directions of transcatheter interventions in adults with congenital heart disease. This includes indications for intervention, risks, and potential complications, as well as a review of available devices and their performance. Read More

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http://dx.doi.org/10.1016/j.ccl.2020.04.005DOI Listing

The Adult Patient with a Fontan.

Cardiol Clin 2020 Aug;38(3):379-401

Adult Congenital Heart Disease, Heart Centre, King Faisal Specialist Hospital and Research Centre, Zahrawi Street, Al Maather, Al Maazer, Riyadh 12713, Saudi Arabia. Electronic address:

The authors summarize the most important anatomic and physiologic substrates of Fontan circulation. Common anatomic substrates include hypoplastic left heart syndrome, tricuspid atresia, double inlet left ventricle, and unbalanced atrioventricular septal defects. After the Fontan operation exercise capacity is limited and the key hemodynamic drivers is limited preload due to a relatively fixed pulmonary vascular resistance. Read More

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http://dx.doi.org/10.1016/j.ccl.2020.05.002DOI Listing

Tetralogy of Fallot.

Cardiol Clin 2020 Aug 10;38(3):365-377. Epub 2020 Jun 10.

Department of Cardiology, Boston Children's Hospital, Division of Cardiology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Bader 208, Boston, MA 02115, USA. Electronic address:

Repaired tetralogy of Fallot is one of the most common conditions managed by adult congenital heart disease providers. Recent comprehensive review articles and book chapters are devoted to this topic. The purpose of this article is to address several common clinical questions encountered in the management of patients with repaired tetralogy of Fallot. Read More

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http://dx.doi.org/10.1016/j.ccl.2020.04.009DOI Listing

Ebstein Anomaly in the Adult Patient.

Cardiol Clin 2020 Aug 6;38(3):353-363. Epub 2020 Jun 6.

Department of Cardiovascular Medicine, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA.

Ebstein anomaly is a congenital malformation involving primarily the tricuspid valve, with failure of delamination from the underlying myocardium and right ventricular myopathy. Echocardiography is diagnostic in most patients and demonstrates apical displacement of the septal leaflet and variable tethering of leaflet tissue to the right ventricular myocardium. Operative intervention is considered for exertional symptoms, progressive right ventricular enlargement, or right ventricular dysfunction. Read More

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http://dx.doi.org/10.1016/j.ccl.2020.04.004DOI Listing

Aortic Coarctation.

Cardiol Clin 2020 Aug 31;38(3):337-351. Epub 2020 May 31.

Adult Congenital Heart Disease Program, Congenital Heart Center, Helen DeVos Children's Hospital, Frederik Meijer Heart & Vascular Institute, Pediatrics and Human Development, Michigan State University, 25 Michigan Street NE Suite 4200, Grand Rapids, MI 49503, USA.

Aortic coarctation is a discrete narrowing of the thoracic aorta. In addition to anatomic obstruction, it can be considered an aortopathy with abnormal vascular properties characterized by stiffness and impaired relaxation. There are surgical and transcatheter techniques to address the obstruction but, despite relief, patients with aortic coarctation are at risk for hypertension, aortic complications, and abnormalities with left ventricular performance. Read More

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http://dx.doi.org/10.1016/j.ccl.2020.04.003DOI Listing

Aortopathy in Congenital Heart Disease.

Cardiol Clin 2020 Aug 3;38(3):325-336. Epub 2020 Jun 3.

Pediatrics, Aortopathy Program, University of Nebraska Medical Center, Children's Hospital & Medical Center, and Nebraska Medicine, 8200 Dodge Street, Omaha, NE 68114, USA; Medicine, Aortopathy Program, University of Nebraska Medical Center, Children's Hospital & Medical Center, and Nebraska Medicine, 8200 Dodge Street, Omaha, NE 68114, USA.

Aortic dilatation is common in patients with congenital heart disease and is seen in patients with bicuspid aortic valve and those with conotruncal congenital heart defects. It is important to identify patients with bicuspid aortic valve at high risk for aortic dissection. High-risk patients include those with the aortic root phenotype and those with syndromic or familial aortopathies including Marfan syndrome, Loeys-Dietz syndrome, and Turner syndrome. Read More

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http://dx.doi.org/10.1016/j.ccl.2020.04.002DOI Listing

Atrial Septal Defect.

Cardiol Clin 2020 Aug 6;38(3):317-324. Epub 2020 Jun 6.

Mount Sinai Cardiovascular Institute, The Children's Heart Center, Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, 1190 5th Avenue, Box 1030, New York, NY 10029, USA. Electronic address: https://twitter.com/AliZaidi%20MD.

Atrial septal defects are common congenital heart defects, characterized by insufficient/absent tissue at the interatrial septum. An unrepaired defect may be associated with right heart volume overload, atrial arrhythmia or pulmonary arterial hypertension. The 3 major types of atrial septal defect are: ostium secundum defect, ostium primum defect, and sinus venosus. Read More

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http://dx.doi.org/10.1016/j.ccl.2020.04.001DOI Listing

Psychological Needs, Assessment, and Treatment in the Care of Adults with Congenital Heart Disease.

Cardiol Clin 2020 Aug 10;38(3):305-316. Epub 2020 Jun 10.

Oregon Health and Science University, Knight Cardiovascular Institute, 3181 Southwest Sam Jackson Park Road, UHN-62, Portland, OR 97239, USA.

Although the majority of congenital heart disease survivors are thriving, many are at risk for declining emotional well-being as they age. Emotional distress is a risk factor for poorer health outcomes and must be addressed. Primary care and cardiology teams may be the first line of defense in identifying and providing referral resources for symptoms of depression, anxiety, and medical trauma. Read More

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http://dx.doi.org/10.1016/j.ccl.2020.04.007DOI Listing

Access and Delivery of Adult Congenital Heart Disease Care in the United States: Quality-Driven Team-Based Care.

Cardiol Clin 2020 Aug 7;38(3):295-304. Epub 2020 Jun 7.

Columbus Ohio Adult Congenital Heart Disease Program, Department of Internal Medicine and Pediatrics, The Ohio State University, Nationwide Children's Hospital, 451 West 10th Avenue, Columbus, OH 43210, USA.

The landscape of congenital heart disease has changed rapidly over the past few decades. The shift from pediatric to adult congenital heart disease care has stretched resources and the ability to provide high-quality access and delivery of care for the more than 1.5 million adults with congenital heart disease in the United States. Read More

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http://dx.doi.org/10.1016/j.ccl.2020.04.012DOI Listing

Adult Congenital Heart Disease-Preparing for the Changing Work Force Demand.

Cardiol Clin 2020 Aug 10;38(3):283-294. Epub 2020 Jun 10.

McGill Adult Unit for Congenital Heart Disease Excellence (MAUDE Unit), Division of Cardiology, McGill University, RVH/Glen Site, D055108, 1001 Decarie Boulevard, Montreal, Quebec H4A3J1, Canada. Electronic address:

This volume is dedicated to advances in the care of adults with congenital heart disease (CHD). In this chapter the authors review the data cornerstone to the growing workforce needs.This first chapter serves as a backdrop to the second chapter that applies these observations to the planning of health care services delivery in the United States accounting for the definition and organization of multisystem expertise and centers for adults with CHD at a health systems level. Read More

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http://dx.doi.org/10.1016/j.ccl.2020.04.011DOI Listing

Right Heart Failure: Underlying Pathophysiology, Causes, Diagnostic, and Treatment Considerations.

Cardiol Clin 2020 05;38(2):ix-x

Department of Cardiovascular Medicine, Cleveland Clinic Sydell and Arnold Miller Family Heart, Vascular and Thoracic Institute Kaufman Center for Heart Failure, Treatment and Recovery, Cleveland Clinic, 9500 Euclid Avenue Desk J3-4, Cleveland, OH 44122, USA. Electronic address:

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http://dx.doi.org/10.1016/j.ccl.2020.03.001DOI Listing

Pulmonary Hypertension and Right Ventricular Failure: Lung Transplant Versus Heart-Lung Transplant.

Cardiol Clin 2020 May 28;38(2):269-281. Epub 2020 Feb 28.

Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, 1161 21st Avenue South, T1218 MCN, Nashville, TN, USA.

Pulmonary arterial hypertension is a highly morbid disease with limited treatment options that improve survival and currently the only curative treatment is transplantation. There is a small body of literature comparing the efficacy of lung and heart-lung transplantation in this population. The bulk of evidence suggests that most patients with severe right ventricular failure undergoing transplant will have recovery of right ventricular function after lung transplantation. Read More

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http://dx.doi.org/10.1016/j.ccl.2020.01.002DOI Listing

Surgical and Percutaneous Interventions for Chronic Thromboembolic Pulmonary Hypertension.

Authors:
William R Auger

Cardiol Clin 2020 May 5;38(2):257-268. Epub 2020 Mar 5.

Pulmonary Hypertension and CTEPH Research Program, Temple Heart and Vascular Institute, Temple University, Lewis Katz School of Medicine, 3401 North Broad Street, Philadelphia, PA 19140, USA. Electronic address:

The treatment of chronic thromboembolic pulmonary hypertension has expanded considerably. The ability to endarterectomize chronic thromboembolic material, the availability of pulmonary hypertension medical therapy to treat inoperable chronic thromboembolic pulmonary hypertension and/or residual pulmonary hypertension, and the rebirth of pulmonary balloon angioplasty have changed the management landscape. Patient selection requires a multidisciplinary evaluation at an experienced center. Read More

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http://dx.doi.org/10.1016/j.ccl.2020.01.003DOI Listing

Right Heart Failure in Pulmonary Hypertension.

Cardiol Clin 2020 May;38(2):243-255

Division of Cardiovascular Medicine, Department of Medicine, University of Maryland School of Medicine, 110 South Paca Street, 7th Floor, Baltimore, MD 21201, USA. Electronic address:

Right heart failure is a major cause of morbidity and mortality in pulmonary hypertension. Its pathophysiology is complex and involves both adaptive and maladaptive patterns of right ventricular change. In addition to the gold standard of right heart catheterization, noninvasive imaging such as echocardiography is useful in diagnosis and risk assessment. Read More

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http://dx.doi.org/10.1016/j.ccl.2020.02.001DOI Listing

Right Ventricular Failure and Congenital Heart Disease.

Cardiol Clin 2020 May;38(2):239-242

Division of Cardiovascular Medicine, Duke University Medical Center, Box 2819, Durham, NC 27710, USA.

Survivorship into adulthood of patients with congenital heart disease is due to improvements in prenatal detection, novel surgeries, and specialized adult congenital heart disease care. As patients survive further into adulthood, long-term complications of congenital and repaired physiology have been more clearly elucidated. The overall mortality of patients with adult congenital heart disease with heart failure is around 4%. Read More

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http://dx.doi.org/10.1016/j.ccl.2020.02.002DOI Listing

Right Heart Failure After Left Ventricular Assist Device Placement: Medical and Surgical Management Considerations.

Authors:
Francis D Pagani

Cardiol Clin 2020 May 28;38(2):227-238. Epub 2020 Feb 28.

Department of Cardiac Surgery, Center for Circulatory Support, Frankel Cardiovascular Center, University of Michigan, 5161 Cardiovascular Center, SPC 5864, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA. Electronic address:

Durable left ventricular assist device therapy is an increasingly accepted surgical therapy for advanced heart failure refractory to guideline-directed medical therapy. Right heart failure is a known and frequent complication after durable left ventricular assist device implantation and remains an important clinical challenge. Medical management of right heart failure after left ventricular assist device therapy focuses on improving right ventricular contractility and optimizing right ventricular preload and afterload. Read More

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http://dx.doi.org/10.1016/j.ccl.2020.01.005DOI Listing

Right Ventricular Failure After Left Ventricular Assist Device.

Cardiol Clin 2020 May;38(2):219-225

Department of Surgery, Division of Cardiothoracic Surgery, University of Minnesota, 425 E River Parkway, 347, Minneapolis, MN 55455, USA.

Right ventricular failure after left ventricular assist device (LVAD) implantation remains common in the contemporary, continuous-flow era. Clinically meaningful, reproducible, and consensus definitions of both early and late right ventricular failure after LVAD are needed for progress in advanced heart failure. Right ventricular failure after LVAD implantation and post-LVAD vasoplegia share similar risk factors and physiology. Read More

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http://dx.doi.org/10.1016/j.ccl.2020.01.007DOI Listing

The Role of Multimodality Imaging in Right Ventricular Failure.

Cardiol Clin 2020 May 3;38(2):203-217. Epub 2020 Mar 3.

Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Desk J1-5, 9500 Euclid Avenue, Cleveland, OH 44195, USA. Electronic address:

Right ventricular dysfunction is increasingly being recognized as a marker of poor prognosis in a variety of cardiovascular diseases. Hence, identification and accurate quantification of the degree of impairment is crucial. Although echocardiography remains the mainstay for right ventricular evaluation, multimodality noninvasive cardiac imaging provides additional useful corroborative assessment. Read More

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http://dx.doi.org/10.1016/j.ccl.2020.01.006DOI Listing

Right Heart Failure and Cardiorenal Syndrome.

Cardiol Clin 2020 May 2;38(2):185-202. Epub 2020 Mar 2.

Kaufman Center for Heart Failure Treatment and Recovery, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, 9500 Euclid Avenue, Desk J3-4, Cleveland, OH 44195, USA; Department of Cardiovascular Medicine, Cleveland Clinic, 9500 Euclid Avenue, Desk J3-4, Cleveland, OH 44195, USA. Electronic address:

Cardiorenal syndrome is a complex interplay of dysregulated heart and kidney interaction that leads to multiorgan system dysfunction, which is not an uncommon occurrence in the setting of right heart failure. The traditional concept of impaired perfusion and forward flow recently has been modified to include the recognition of systemic venous congestion as a contributor, with direct and indirect mechanisms, including elevated renal venous pressure, reduced renal perfusion pressure, increased renal interstitial pressure, tubular dysfunction, splanchnic congestion, and neurohormonal and inflammatory activation. Treatment options beyond diuretics and vasoactive drugs remain limited and lack supportive evidence. Read More

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http://dx.doi.org/10.1016/j.ccl.2020.01.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7160202PMC

Right Heart Failure: Causes and Clinical Epidemiology.

Cardiol Clin 2020 May;38(2):175-183

Department of Cardiovascular Diseases, Mayo Clinic, 13737 North 92nd Street, Scottsdale, AZ 85260, USA.

Right heart failure is a complex and diverse syndrome with unique causes and pathophysiology. The right heart is being recognized as a structurally discrete and functionally independent predictor of mortality. Renewed interest in the right heart has led to efforts to consolidate definitions of right heart failure in an effort to standardize nomenclature and unify epidemiologic studies. Read More

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http://dx.doi.org/10.1016/j.ccl.2020.01.008DOI Listing

Right Heart Failure: A Hemodynamic Review.

Cardiol Clin 2020 May 20;38(2):161-173. Epub 2020 Feb 20.

Department of Medicine, Division of Cardiology, Medical University of South Carolina, 30 Courtenay Drive, MSC592/BM215, Charleston, SC 29425-6230, USA. Electronic address:

For many years, the importance of the right heart was neglected, and the right ventricle was viewed as merely a conduit for transmitting blood to the lungs. However, the realization that right ventricular function is a key determinant of prognosis in left heart failure, pulmonary hypertension, and after implantation of left ventricular assist devices renewed interest in accurate quantification of right ventricular function. This article reviews traditional and gold-standard hemodynamic assessments of the right ventricle in health and disease. Read More

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http://dx.doi.org/10.1016/j.ccl.2020.01.001DOI Listing

Pathophysiology of Acute and Chronic Right Heart Failure.

Cardiol Clin 2020 May 5;38(2):149-160. Epub 2020 Mar 5.

Houston Methodist DeBakey Heart & Vascular Center, 6550 Fannin Street, Houston, TX 77030, USA. Electronic address:

Right-sided heart failure (RHF) occurs from impaired contractility of the right ventricle caused by pressure, volume overload, or intrinsic myocardial contractile dysfunction. The development of subclinical right ventricle (RV) dysfunction or overt RHF is a negative prognostic indicator. Recent attention has focused on RV-specific inflammatory growth factors and mediators of myocardial fibrosis to elucidate the mechanisms leading to RHF and potentially guide the development of novel therapeutics. Read More

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http://dx.doi.org/10.1016/j.ccl.2020.01.009DOI Listing

A Decade of Revolutions in Calcific Aortic Stenosis.

Cardiol Clin 2020 Feb;38(1):xiii-xiv

Full Professor at Faculté de Médecine, Université Laval, Canada Research Chair in Valvular Heart Disease, Head of Cardiology Research, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec Heart and Lung Institute, 2725 Chemin Sainte Foy #A-2039, Québec, G1V4G5, Canada. Electronic address:

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http://dx.doi.org/10.1016/j.ccl.2019.10.001DOI Listing
February 2020

Procedures and Outcomes of Surgical Aortic Valve Replacement in Adults.

Cardiol Clin 2020 Feb;38(1):89-102

Division of Cardiac Surgery, Montreal Heart Institute, Université de Montréal, 5000 Belanger Street East, Montreal, Quebec H1T 1C8, Canada. Electronic address:

The ideal aortic valve substitute remains elusive. Bioprosthetic valves are the replacement option of choice in elderly patients undergoing aortic valve replacement (AVR). When implanted in young and middle-aged adults, both bioprosthetic and mechanical valves are associated with excess mortality compared with the age- and sex-matched general population. Read More

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http://dx.doi.org/10.1016/j.ccl.2019.09.012DOI Listing
February 2020

Prevalence and Prognostic Implications of Frailty in Transcatheter Aortic Valve Replacement.

Cardiol Clin 2020 Feb;38(1):75-87

Centre for Clinical Epidemiology, Jewish General Hospital, McGill University, 3755 Cote Ste Catherine, H-411, Montreal, Quebec H3T1E2, Canada; Division of Cardiology, Geriatric Cardiology Fellowship Program, Jewish General Hospital, McGill University, 3755 Cote Ste Catherine Road, E-222, Montreal, Quebec H3T 1E2, Canada. Electronic address:

Assessment of frailty has become engrained in the preprocedural evaluation of older adults referred for transcatheter aortic valve replacement. Addition of frailty and disability to clinical risk scores results in improved discrimination for short- and midterm mortality and identifies patients less likely to be discharged home and more likely to report worsening quality of life over the ensuing 6 to 12 months. In clinical practice, frailty can be evaluated by a tiered approach starting with a brief screening tool such as the Essential Frailty Toolset. Read More

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http://dx.doi.org/10.1016/j.ccl.2019.09.011DOI Listing
February 2020

Heart Valve Clinics, Centers, and Networks.

Cardiol Clin 2020 Feb 1;38(1):65-74. Epub 2019 Nov 1.

Department of Cardiology, Heart Valve Clinic, CHU Sart Tilman, Rue de l'hôpital 1, 4000 Liège, Belgium.

There is consensus on important aspects of managing heart valve disease. Despite this, many patients are managed by general physicians or cardiologists without specialist competencies in valve disease, which leads to suboptimal outcomes. Multidisciplinary heart valve clinics bring together cardiologists, surgeons, nurses, and in some countries scientists to deliver expert guidelines and experience-driven optimal care. Read More

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http://dx.doi.org/10.1016/j.ccl.2019.09.006DOI Listing
February 2020

Aortic Stenosis: Guidelines and Evidence Gaps.

Cardiol Clin 2020 Feb 1;38(1):55-63. Epub 2019 Nov 1.

Department of Medicine, Division of Cardiology, University of Washington, 1959 Northeast Pacific Street, Box 356422, Seattle, WA 98195, USA. Electronic address:

Current guidelines for management of adults with aortic stenosis recommend aortic valve replacement for patients with clinical consequences due to hemodynamically severe valve obstruction. However, advances in surgical and transcatheter techniques, and improved valve design have led to decreased procedural risk and improved long-term outcomes. Transcatheter aortic valve replacement (TAVR) is recommended for patients with prohibitive surgical risk and is reasonable in intermediate and high-risk patients. Read More

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http://dx.doi.org/10.1016/j.ccl.2019.09.003DOI Listing
February 2020

Biomarkers Associated with Aortic Stenosis and Structural Bioprosthesis Dysfunction.

Cardiol Clin 2020 Feb;38(1):47-54

Institut universitaire de cardiologie et de Pneumologie de Québec, 2725, Chemin Sainte-Foy, A-2047, Québec, Québec G1V 4G5, Canada.

Prediction of patients at risk of aortic valve stenosis (AS), AS progression rate, and aortic bioprosthesis dysfunction are of major importance for clinical management and/or prevention. Many imaging modalities may be used; however, they may not be conclusive or available for all patients. Circulating biomarkers are easily available and may be related to a disease or process such as aortic valve calcification or associated with a risk factor of the disease. Read More

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http://dx.doi.org/10.1016/j.ccl.2019.09.005DOI Listing
February 2020

Aortic Stenosis with Other Concomitant Valvular Disease: Aortic Regurgitation, Mitral Regurgitation, Mitral Stenosis, or Tricuspid Regurgitation.

Cardiol Clin 2020 Feb 1;38(1):33-46. Epub 2019 Nov 1.

Department of Cardiology, Amiens University Hospital, Jules Verne University of Picardie, 1 rue du Professeur Christian Cabrol, 80000 Amiens, France.

Aortic stenosis presenting as part of a multiple valve disease scenario or as mixed valve disease is frequent. These scenarios induce hemodynamic interactions that may result in diagnostic pitfalls. Echocardiography is the cornerstone technique for diagnosis of valve disorders, but other modalities may be useful. Read More

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http://dx.doi.org/10.1016/j.ccl.2019.09.002DOI Listing
February 2020

Assessment of Cardiac Damage in Aortic Stenosis.

Cardiol Clin 2020 Feb;38(1):23-31

Minneapolis Heart Institute Foundation, Cardiovascular Imaging Research and Valve Science Centers, 920 East 28th Street, Suite 620, Minneapolis, MN 55407, USA; Minneapolis Heart Institute, Abbott Northwestern Hospital, 800 East 28th Street, Suite 300, Minneapolis, MN 55407, USA. Electronic address:

Severe aortic stenosis (AS) causes chronic pressure overload of the left ventricle (LV), resulting in the progressive cardiac damage, which extends beyond the LV. Several previous studies have shown a relationship of the cardiac damage to AS, rather than the stenosis severity, with adverse events after aortic valve replacement (AVR) in patients with severe AS. A new staging system for AS patients has important prognostic implications for clinical outcomes after AVR. Read More

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http://dx.doi.org/10.1016/j.ccl.2019.09.001DOI Listing
February 2020

Aortic Stenosis: What Risks Do the Stresses of Noncardiac Surgery or Pregnancy Pose and How Should They Be Managed?

Cardiol Clin 2020 Feb;38(1):139-148

Department of Cardiology, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK.

Studies suggest that patients with aortic stenosis have increased risk in pregnancy and delivery and during anesthesia and surgery, although there are significant degrees of uncertainty as to the exact risks and best way to manage such patients. This article reviews current literature regarding impact of aortic stenosis on pregnancy and anesthesia during noncardiac surgery. There are shortcomings in the scientific evidence. Read More

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http://dx.doi.org/10.1016/j.ccl.2019.09.009DOI Listing
February 2020

Assessment of Aortic Stenosis Severity: A Multimodality Approach.

Cardiol Clin 2020 Feb;38(1):13-22

Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec Heart and Lung Institute, Université Laval, 2725 Chemin Sainte-Foy, Québec City, Québec G1V-4G5, Canada.

Severe aortic stenosis (AS) is associated with a progressive cardiac remodeling that ultimately leads to heart failure and death if the valve is not replaced. The confirmation of AS severity is therefore crucial to adequately manage patients with AS. Transthoracic echocardiography is the first-line examination to confirm AS severity, but it may be inconclusive in discordant cases. Read More

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http://dx.doi.org/10.1016/j.ccl.2019.09.004DOI Listing
February 2020

Sex Differences in the Pathophysiology, Diagnosis, and Management of Aortic Stenosis.

Cardiol Clin 2020 Feb 1;38(1):129-138. Epub 2019 Nov 1.

Institut Universitaire de Cardiologie et de Pneumologie de Québec (IUCPQ) - Université Laval, Québec Heart & Lung Institute, 2725 Chemin Sainte-Foy, Québec City, Québec G1V-4G5, Canada. Electronic address:

For years, calcific aortic stenosis (AS) was considered to be similar in men and women, and the underrepresentation of women in research studies prevented any alternate conclusions. With new sex-specific studies and data, the landscape of AS is evolving and recently important sex-disparities were revealed. These sex-specific discrepancies are of utmost importance to stratify and personalize treatment according to sex. Read More

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http://dx.doi.org/10.1016/j.ccl.2019.09.008DOI Listing
February 2020

Transcatheter Aortic Valve Replacement: Procedure and Outcomes.

Cardiol Clin 2020 Feb;38(1):115-128

Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec Heart & Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Québec, Québec G1V-4G5, Canada.

Initially, transcatheter aortic valve replacement (TAVR) was only used in patients with severe symptomatic aortic stenosis and prohibitive risk for surgical aortic valve replacement. Subsequently, TAVR was extended to patients with high and intermediate surgical risk. Recently, the results of randomized trials in low-surgical-risk patients showed superiority or noninferiority of TAVR versus surgical aortic valve replacement in this population. Read More

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http://dx.doi.org/10.1016/j.ccl.2019.09.007DOI Listing
February 2020

Planning for Success: Pre-procedural Evaluation for Transcatheter Aortic Valve Replacement.

Cardiol Clin 2020 Feb;38(1):103-113

Division of Cardiology, Columbia University Medical Center, NewYork-Presbyterian Hospital, 177 Fort Washington Avenue, 5th Floor, Room 5C-501, New York, NY 10032, USA. Electronic address:

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http://dx.doi.org/10.1016/j.ccl.2019.09.013DOI Listing
February 2020
1.064 Impact Factor

Pathophysiology of Aortic Stenosis and Future Perspectives for Medical Therapy.

Cardiol Clin 2020 Feb 1;38(1):1-12. Epub 2019 Nov 1.

British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, The Chancellor's Building, Little France Crescent, Midlothian, Edinburgh EH26 0NL, UK. Electronic address:

Calcific aortic valve stenosis is the commonest form of heart valve disease in high-income countries and set to become a major health care burden. Currently, there are no medical therapies that have proved to slow down or halt disease progression. The only available treatment is aortic valve replacement, of which the optimal timing is unknown and to which not all patients are suited. Read More

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http://dx.doi.org/10.1016/j.ccl.2019.09.010DOI Listing
February 2020

Implementing a Cardio-oncology Center of Excellence: Nuts and Bolts, Including Coding and Billing.

Cardiol Clin 2019 Nov;37(4):545-557

Cardiovascular Management of Illinois, 900 South Frontage Road, Suite 325, Woodridge, IL 60517, USA.

Cardio-oncology is rapidly expanding as part of cancer therapy in both the acute phase and later stages after treatment. The shifting paradigm of cancer becoming a chronic disease requires long-term follow-up for ongoing cardiac toxicity. As more cancer patients enter the survivorship phase, there needs to be identification of those at risk and strategies for how best to monitor long-term cancer therapy-related cardiac disease. Read More

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http://dx.doi.org/10.1016/j.ccl.2019.07.016DOI Listing
November 2019

Cardiovascular Toxicities in Pediatric Cancer Survivors.

Cardiol Clin 2019 Nov;37(4):533-544

Department of Pediatrics, Division of Pediatric Cardiology, Monroe Carell Jr. Children's Hospital at Vanderbilt, 2200 Children's Way, Suite 5230 DOT, Nashville, TN 37232, USA.

Advances in cancer therapies have significantly improved patient outcomes. However, with improvements in survival, the toxicities associated with cancer therapy have become of paramount importance and oncologists are faced with the challenge of establishing therapeutic efficacy while minimizing toxicity. Cardiovascular disease represents a significant risk to survivors of childhood cancer and is a major cause of morbidity and mortality. Read More

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http://dx.doi.org/10.1016/j.ccl.2019.07.002DOI Listing
November 2019

Approach to Surgery for Cardiac Tumors: Primary Simple, Primary Complex, and Secondary.

Cardiol Clin 2019 Nov 27;37(4):525-531. Epub 2019 Aug 27.

Department of Cardiovascular Surgery, Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, 6550 Fannin Street, Suite 1401, Houston, TX 77030, USA. Electronic address:

Cardiac tumors are rare. Most surgeons will encounter few primary cardiac tumors outside of myxomas. This article offers the authors' approach to simple and complex primary and secondary cardiac tumors. Read More

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http://dx.doi.org/10.1016/j.ccl.2019.07.001DOI Listing
November 2019

Role of Cardiovascular Biomarkers in the Risk Stratification, Monitoring, and Management of Patients with Cancer.

Cardiol Clin 2019 Nov;37(4):505-523

Division of Cardiology, Department of Medicine, University of Michigan, University of Michigan Frankel Cardiovascular Center, 1500 East Medical Center Drive, CVC #2709, Ann Arbor, MI 48109, USA. Electronic address:

Cardiovascular effects of cancer therapies are of concern. Prediction, diagnosis, and management of cardiotoxicity is a challenge. Cardiovascular biomarkers are being studied in relationship to cancer therapy, showing promise in detection and prevention of cardiotoxicity. Read More

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http://dx.doi.org/10.1016/j.ccl.2019.07.015DOI Listing
November 2019
1.064 Impact Factor

Carcinoid Heart Disease: A Guide for Clinicians.

Cardiol Clin 2019 Nov;37(4):497-503

Division of Cardiology, Department of Medicine, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA. Electronic address:

Carcinoid heart disease is the collective term for all cardiac manifestations that develop in patients with carcinoid. The cardiac manifestations of carcinoid tumors are attributed to the paraneoplastic effects of vasoactive substances released by the malignant cells. The clinical manifestations of carcinoid heart disease include valvular destruction leading to valvular regurgitation and stenosis, right-sided heart failure, and metastatic carcinoid disease. Read More

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http://dx.doi.org/10.1016/j.ccl.2019.07.014DOI Listing
November 2019
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Diagnosis and Treatment of Cardiac Amyloidosis Related to Plasma Cell Dyscrasias.

Cardiol Clin 2019 Nov;37(4):487-495

Division of Cardiovascular Medicine, Stanford Amyloid Center, Stanford University School of Medicine, 300 Pasteur Drive, Lane #158, Stanford, CA 94305, USA. Electronic address:

Light chain amyloidosis is a deadly disease in which a monoclonal plasma cell dyscrasia produces misfolded immunoglobulin light chains (AL) that aggregate and form rigid amyloid fibrils. The amyloid deposits infiltrate one or more organs, leading to injury and severe dysfunction. The degree of cardiac involvement is a major driver of morbidity and mortality. Read More

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http://dx.doi.org/10.1016/j.ccl.2019.07.013DOI Listing
November 2019
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Cardiac Interventional Procedures in Cardio-Oncology Patients.

Cardiol Clin 2019 Nov;37(4):469-486

Department of Cardiology, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Unit 1451, Houston, TX 77030, USA. Electronic address:

Comorbidities specific to the cardio-oncology population contribute to the challenges in the interventional management of patients with cancer and cardiovascular disease (CVD). Patients with cancer have generally been excluded from cardiovascular randomized clinical trials. Endovascular procedures may represent a valid option in patients with cancer with a range of CVDs because of their minimally invasive nature. Read More

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http://dx.doi.org/10.1016/j.ccl.2019.07.012DOI Listing
November 2019
1.064 Impact Factor

Arrhythmogenic Anticancer Drugs in Cardio-Oncology.

Cardiol Clin 2019 Nov;37(4):459-468

Division of Cardiovascular Medicine, Morsani College of Medicine, University of South Florida, 2 Tampa General Circle, Tampa, FL 33606, USA; Cardio-Oncology Program, Moffitt Cancer Center, Tampa, FL 33612, USA. Electronic address:

Multiple cancer therapies are associated with cardiac arrhythmias through a variety of pathophysiologic mechanisms. Atrial fibrillation and atrial flutter are common during cancer therapy but should rarely limit continued delivery of therapy. Ventricular arrhythmias are not common during cancer therapy and are more often secondary to other cardiac pathologies. Read More

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http://dx.doi.org/10.1016/j.ccl.2019.07.011DOI Listing
November 2019
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Cardiotoxicity Related to Radiation Therapy.

Cardiol Clin 2019 Nov;37(4):449-458

University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA. Electronic address:

With increasing survival from cancer, the incidence of cardiovascular diseases is increasing as a chronic side effect of radiation therapy. Prevention, early recognition, and prompt intervention should be the major focus in the care of these patients. Read More

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http://dx.doi.org/10.1016/j.ccl.2019.07.010DOI Listing
November 2019