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    946 results match your criteria Cardiology in review[Journal]

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    A Nonsurgical Approach to Mesenteric Vascular Disease.
    Cardiol Rev 2018 Mar/Apr;26(2):99-106
    Mesenteric ischemia is a rare disorder, with considerably high morbidity and mortality rates. It can manifest in several ways, including acute mesenteric ischemia, chronic mesenteric ischemia, nonocclusive mesenteric ischemia, mesenteric venous thrombosis, and colonic ischemia. Of these, acute mesenteric ischemia is the most severe form of intestinal ischemia, with a high mortality rate. Read More

    Acupuncture and Cardiovascular Disease: Focus on Heart Failure.
    Cardiol Rev 2018 Mar/Apr;26(2):93-98
    From the Department of Medicine, Cedars Sinai Medical Center, Los Angeles, CA and New York Medical College/Westchester Medical Center, Valhalla, NY.
    Symptomatic heart failure is managed with interdisciplinary approaches to reduce acute exacerbations and to improve mortality. Acupuncture is a standardized treatment of Traditional Chinese Medicine that has been shown to have beneficial effects on the cardiovascular system via a neurohumoral pathway known as the long-loop pathway. This article serves to examine recent evidence supporting the long-loop pathway as the physiologic mechanism of acupuncture and the sympatholytic, vasodilatory, and cardioprotective effects of acupuncture that could specifically improve cardiac function and quality of life measures in the management of congestive heart failure. Read More

    Impact of Improved Survival in Congenital Heart Disease on Incidence of Disease.
    Cardiol Rev 2018 Mar/Apr;26(2):82-85
    Survival rates and life expectancies for patients with congenital heart disease (CHD) have dramatically increased, and these patients are now reaching reproductive age. As they reproduce, questions pertaining to recurrent risk of disease and the impact on incidence rates have emerged. Recurrence rates for CHD have been estimated at 3% to 5%, although, due to the complex genetics underlying CHD, this range may represent an underestimation of the true risk. Read More

    Implications of the New National Guidelines for Hypertension.
    Cardiol Rev 2018 Mar/Apr;26(2):55-61
    From the Department of Medicine, Cardiology Division, Westchester Medical Center and New York Medical College, Valhalla, NY.
    Automated validated devices should be used for measuring blood pressure (BP). A systolic BP between 120 and 129 mm Hg with a diastolic BP < 80 mm Hg should be treated by lifestyle measures. Lifestyle measures plus BP lowering drugs should be used for secondary prevention of recurrent cardiovascular disease (CVD) events in persons with clinical CVD (coronary heart disease, congestive heart failure, and stroke) and an average systolic BP of ≥130 mm Hg or an average diastolic BP ≥ 80 mm Hg. Read More

    Was the Enalapril Dose Too Low in the PARADIGM-HF Trial?
    Cardiol Rev 2018 Jan 24. Epub 2018 Jan 24.
    Heart failure (HF) is a common clinical syndrome associated with significant morbidity and mortality, and there remains a clear need for innovative therapies that can modify disease progression. Sacubitril/valsartan (LCZ696) is a novel complex that combines simultaneous neprilysin inhibition and angiotensin II receptor blockade, that has demonstrated significant cardiovascular death or HF hospitalization reduction in the Prospective Comparison of Angiotensin Receptor/Neprilysin Inhibitor (ARNI) with Angiotensin-Converting Enzyme (ACE) Inhibitors to Determine Impact on Global Mortality and Morbidity in Heart Failure (PARADIGM-HF) trial when compared to evidence-based doses of the gold-standard ACE inhibitor enalapril. In this comprehensive review, the authors discuss historical trials that have investigated clinical outcomes utilizing variable dosing levels of ACE inhibitors or angiotensin receptor blockers in patients with heart failure with reduced ejection fraction. Read More

    Predictors of Outcomes in Myocardial Infarction and Cardiogenic Shock.
    Cardiol Rev 2018 Jan 3. Epub 2018 Jan 3.
    Section of Advanced Heart Failure, Mechanical Circulatory Support, and Pulmonary Vascular disease, University of Alabama at Birmingham, Birmingham, AL.
    Myocardial infarction (MI) complicated by cardiogenic shock (CS) is a major cause of cardiovascular morbidity and mortality. Predictors of outcomes in AMI-CS include clinical, laboratory, radiologic variables, as well as management strategies. This article reviews the existing literature on short- and long-term predictors and risk stratification in MI complicated by CS. Read More

    Acute Coronary Artery Dissection: A Review of the Literature and Current Evidence.
    Cardiol Rev 2017 Dec 12. Epub 2017 Dec 12.
    DIO/Associate CMO for Medical Education, Department of Medicine-Rochester Regional Health System, Rochester, New York.
    Acute coronary artery dissection is a rare, complex disease occurring particularly in young women without traditional cardiovascular risk factors. The pathophysiology and treatment are different from acute coronary syndrome caused by plaque rupture or erosion. Its clinical presentation may vary from unstable angina to sudden cardiac death. Read More

    Switching From Ticagrelor or Prasugrel to Clopidogrel.
    Cardiol Rev 2018 Mar/Apr;26(2):107-111
    From the University of New Mexico College of Pharmacy and University of New Mexico Hospitals, Albuquerque, NM.
    Ticagrelor and prasugrel are newer antiplatelet drugs which, like clopidogrel, block the P2Y12 platelet receptor to inhibit platelet aggregation. Compared with clopidogrel, both ticagrelor and prasugrel have greater clinical efficacy but also have a higher risk of bleeding and are much more costly. Therefore, some institutions and providers switch patients from ticagrelor or prasugrel to clopidogrel in an effort to lower bleeding risk, stem costs, or otherwise ensure that patients can safely adhere to long-term P2Y12 inhibitor therapy. Read More

    Mitral Valve and Subvalvular Repair for Secondary Mitral Regurgitation: Rationale and Clinical Outcomes of the Papillary Muscle Sling.
    Cardiol Rev 2018 Jan/Feb;26(1):22-28
    Secondary mitral regurgitation (MR) is a common finding in patients with dilated cardiomyopathy, and it is associated with poor outcomes. It is the result of incomplete systolic closure of the mitral valve (MV) as a consequence of left ventricular dilatation, papillary muscle displacement with impaired systolic shortening, and mitral leaflet tethering. MV surgery may be performed in cases of significant secondary MR despite guideline-directed medical therapy. Read More

    Cardiosphere-Derived Cells and Ischemic Heart Failure.
    Cardiol Rev 2018 Jan/Feb;26(1):8-21
    After a myocardial infarction, heart tissue becomes irreversibly damaged, leading to scar formation and inevitably ischemic heart failure. Of the many available interventions after a myocardial infarction, such as percutaneous intervention or pharmacological optimization, none can reverse the ischemic insult on the heart and restore cardiac function. Thus, the only available cure for patients with scarred myocardium is allogeneic heart transplantation, which comes with extensive costs, risks, and complications. Read More

    Aorto-Atrial Fistulas - A Contemporary Review.
    Cardiol Rev 2017 Oct 25. Epub 2017 Oct 25.
    1Touro College of Osteopathic Medicine, New York, NY; 2 Department of Anaesthesia, Deenanath Mangeshkar Hospital & Research Center, Pune, Maharashtra, India; 3 Department of Pulmonary, Critical Care and Sleep Medicine, Hofstra Northwell School of Medicine - Northwell Health System, New Hyde Park, NY; 4 Division of Cardiology, Hartford Hospital, Hartford, CT; 5 Department of Cardiology, Bieganski Hospital - Medical University of Lodz, Łódź, Poland.
    Aorto-atrial fistulas are a relatively rare, but potentially life-threatening condition, where an anomalous connection forms between the aortic structures and the cardiac atria. Aorto-atrial fistulas are most often the result of an underlying condition concerning the cardiac structures. It may be congenital, secondary to conditions such as aortic dissection, infective endocarditis, or valve replacement, or iatrogenic in nature. Read More

    Cardiovascular Complications of Proteasome Inhibitors Used in Multiple Myeloma.
    Cardiol Rev 2017 Dec 5. Epub 2017 Dec 5.
    From the Departments of Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY and New York Medical College/Westchester Medical Center, Valhalla, NY.
    The use of proteasome inhibitors (PI) as targeted chemotherapeutics have significantly improved survival in patients with multiple myeloma (MM). However, rare and serious cardiovascular complications have occurred as a result of their use, most commonly congestive heart failure, hypertension, and arrhythmias. MM occurs in an aged population with many concurrent cardiovascular risk factors. Read More

    Sex-Specific Outcomes After Transcatheter Aortic Valve Replacement: A Review of the Literature.
    Cardiol Rev 2018 Mar/Apr;26(2):73-81
    From the US Food and Drug Administration, Silver Spring, MD.
    Transcatheter aortic valve replacement (TAVR) is a safe and effective therapy for aortic valve replacement in patients ineligible for or at high risk for surgery. However, outcomes after TAVR based on an individual's sex remain to be fully elucidated. We searched PUBMED and EMBASE using the keywords: "transcatheter aortic valve replacement," "transcatheter aortic valve implantation," "sex differences," "gender," "sex characteristics" and collected information on baseline features, procedural characteristics, and postprocedural outcomes in women. Read More

    Devices for Autonomic Regulation Therapy in Heart Failure With Reduced Ejection Fraction.
    Cardiol Rev 2018 Jan/Feb;26(1):43-49
    Heart failure (HF) is associated with significant morbidity and mortality and an increasing economic burden. The persistence of HF's risk factors, coupled with an aging population, also leads to an increase in its incidence and prevalence. It is well established that sympathetic hyperactivity and parasympathetic withdrawal are instrumental in the development and worsening of HF. Read More

    The Prognostic Implications of Two-Dimensional Speckle Tracking Echocardiography in Hypertrophic Cardiomyopathy: Current and Future Perspectives.
    Cardiol Rev 2017 Oct 17. Epub 2017 Oct 17.
    From the 1st Cardiology department, AHEPA University Hospital, Thessaloniki, Greece.
    Two-dimensional (2D) speckle tracking echocardiography represents a novel, simple and reproducible technique for the estimation of left ventricular myocardial deformation (strain) and the evaluation of left ventricular twist mechanics. During the last few years, its clinical and prognostic implications in cardiomyopathies and hypertrophic cardiomyopathy (HCM) in particular have been rapidly increasing. Reduced global longitudinal strain is associated with more severe disease and confers an increased risk for major cardiac events, independently of other clinical and echocardiographic risk factors. Read More

    Genetic Origins of Tetralogy of Fallot.
    Cardiol Rev 2018 Mar/Apr;26(2):86-92
    Due to improved survival and clinical outcomes, congenital heart disease (CHD) is an area of growing importance within the medical community. As these patients reach adulthood and have children, there has been a growing appreciation for the increased risk of CHD among their offspring, strongly implying a genetic element. Given the growing wealth of genetic data available and these clinical implications, this review serves to reexamine the role of genetics within CHD, using Tetralogy of Fallot as a model pathology. Read More

    Effects of Anti-Inflammatory Medications in Patients with Coronary Artery Disease: A Focus on Losmapimod.
    Cardiol Rev 2017 Oct 17. Epub 2017 Oct 17.
    1Department of Medicine, Boston University Medical Center, Boston, MA. and 2Department of Medicine, New York Medical College/Westchester Medical Center, Valhalla, NY.
    Inflammation plays an integral role in atherogenesis and the pathogenesis of coronary artery disease (CAD). The question remains as to whether targeted inhibition of specific pathways of inflammation will have any clinical benefits in CAD. In this article we will review p38 mitogen-activated protein kinase (p38 MAPK), one of the key sensors of cellular stress that plays an important role in the inflammatory cascade. Read More

    Yosprala: A Fixed Dose Combination of Aspirin and Omeprazole.
    Cardiol Rev 2018 Jan/Feb;26(1):50-53
    From the Department of Pharmacy Practice, Touro College of Pharmacy, New York, NY; and Department of Pharmacy, Montefiore Medical Center, Bronx, NY.
    Cardiovascular disease is the leading cause of morbidity and mortality in the United States. Patients who survive a primary cerebrovascular or cardiovascular event are at increased risk of a subsequent occurrence. Antiplatelet therapy plays an essential role for secondary prevention in individuals with stroke, transient ischemic attack, acute or chronic artery disease, or peripheral arterial disease. Read More

    Ability of Nonstrain Diastolic Parameters to Predict Doxorubicin-Induced Cardiomyopathy: A Systematic Review With Meta-Analysis.
    Cardiol Rev 2018 Jan/Feb;26(1):29-34
    Doxorubicin is an important cause of chemotherapy-induced cardiomyopathy. Prior studies have found conflicting results of whether nonstrain diastolic parameters can predict doxorubicin-induced cardiotoxicity. We performed a systematic review of English written publications using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Read More

    Milrinone Dosing and a Culture of Caution in Clinical Practice.
    Cardiol Rev 2018 Jan/Feb;26(1):35-42
    Milrinone is an invaluable agent in the treatment of end-stage heart failure patients who are refractory to optimal medical therapy. In addition to its use in acute decompensated heart failure, milrinone can also be employed as a home infusion therapy or a bridge to cardiac transplant. Concerns about its adverse effects, such as an increased risk of arrhythmias and hypotension, often limit the doses of milrinone used in clinical practice. Read More

    Early Coronary Angiography for Survivors of Out-of-Hospital Cardiac Arrests Without ST Elevation.
    Cardiol Rev 2017 Nov/Dec;25(6):331-335
    From the *Divisions of Cardiology and Pulmonary and Critical Care, Cedars-Sinai Medical Center, Los Angeles, CA; and †Division of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA.
    There are over 300,000 out-of-hospital cardiac arrests (OOHCA) in the United States each year, and the long-term survival rate is less than 10%. Despite improvements in postarrest management, the greatest drop-off in survival occurs during hospitalization, mostly due to myocardial dysfunction and neurological injury. Coronary artery disease is common in postcardiac arrest patients, with an incidence of approximately 60-80%. Read More

    Neprilysin Inhibition and the Treatment of Heart Failure: Recent Steps in the Right Direction.
    Cardiol Rev 2017 Nov/Dec;25(6):315-320
    From the *Departments of Medicine, University of Rochester/Strong Memorial Hospital, Rochester, NY; and †New York Medical College/Westchester Medical Center, Valhalla, NY.
    Numerous investigators have attempted to target the natriuretic peptide system in the treatment of heart failure since it was first described over 30 years ago. The history of neprilysin inhibition as a treatment for heart failure has been characterized by numerous setbacks. Recently, the PARADIGM-HF trial has shown favorable results, which may bring neprilysin inhibition into the mainstream of clinical practice. Read More

    Vitamins for Cardiovascular Diseases: Is the Expense Justified?
    Cardiol Rev 2017 Nov/Dec;25(6):298-308
    From the *Center for Integrative Research on Cardiovascular Aging (CIRCA), Aurora University of Wisconsin Medical Group, Aurora Sinai/Aurora St. Luke's Medical Centers, Milwaukee, WI; †Cardiology Division, Banner University Medical Center, Phoenix, AZ, ‡College of Engineering, University of Wisconsin-Madison, Madison, WI; §Division of Cardiovascular Diseases, Mayo Clinic Arizona, Phoenix, AZ; and ‖Aurora Cardiovascular Services, Aurora Sinai/Aurora St. Luke's Medical Centers, Milwaukee, WI.
    Despite the knowledge that a well-balanced diet provides most of the nutritional requirements, the use of supplemental vitamins is widespread among adults in the United States. Evidence from large randomized controlled trials over the last 2 decades does not support vitamin supplementation for the reduction of cardiovascular risk factors or clinical outcomes. Many of the vitamins used in common practice likely are safe when consumed in small doses, but long-term consumption of megadoses is not only expensive but has the potential to cause adverse effects. Read More

    Brain-Heart Interactions in Traumatic Brain Injury.
    Cardiol Rev 2017 Nov/Dec;25(6):279-288
    From the *Department of Surgery, Clinical Research, Westchester Medical Center, Valhalla, NY; †Clinical Medicine, Weill Cornell Medical College, Doha, Qatar; ‡Department of Medicine, New York Medical College/Westchester Medical Center, Valhalla, NY; §Department of Surgery, New York Medical College/Westchester Medical Center, Valhalla, NY; and ¶Department of Surgery, Trauma & Vascular Surgery, Hamad General Hospital, Qatar.
    The cardiovascular manifestations associated with nontraumatic head disorders are commonly known. Similar manifestations have been reported in patients with traumatic brain injury (TBI); however, the underlying mechanisms and impact on the patient's clinical outcomes are not well explored. The neurocardiac axis theory and neurogenic stunned myocardium phenomenon could partly explain the brain-heart link and interactions and can thus pave the way to a better understanding and management of TBI. Read More

    Ascending Aortic Aneurysm Is an Inherited Disease: A Contemporary Literature Review Based on Hill's Criteria of Specificity, Strength of Association, and Biological Coherence.
    Cardiol Rev 2017 Nov/Dec;25(6):268-278
    From *Aurora Cardiovascular Services, Aurora Sinai/Aurora St. Luke's Medical Centers, University of Wisconsin School of Medicine and Public Health, Milwaukee, WI; and †Department of Medicine, Division of Cardiology, University of Florida Health, Jacksonville, FL.
    There is growing evidence of a differential etiological basis for thoracic aortic aneurysms (TAA), with ascending (As) TAAs being genetically mediated and descending (Des) TAAs more strongly related to acquired pathologies. A comprehensive literature review of this hypothesis has not been carried out. We carried out a systematic literature review based on the latest guidelines on TAA endorsed by the American Heart Association. Read More

    Contemporary Diagnosis and Management of Atrial Flutter: A Continuum of Atrial Fibrillation and Vice Versa?
    Cardiol Rev 2017 Nov/Dec;25(6):289-297
    From the Third Department of Cardiology, Athens University School of Medicine, Athens, Greece.
    Atrial flutter (AFlu) is usually a fast (>240 bpm) and regular right atrial macroreentrant tachycardia, with a constrained critical region of the reentry circuit located at the cavotricuspid isthmus (CTI; typical CTI-dependent AFlu). However, a variety of right and left atrial tachycardias, resulting from different mechanisms, can also present as AFlu (atypical non-CTI-dependent AFlu). The electrocardiogram can provide clues to its origin and location; however, additional entrainment and more sophisticated electroanatomical mapping techniques may be required to identify its mechanism, location, and target area for a successful ablation. Read More

    Chronic Thromboembolic Pulmonary Hypertension: Epidemiology, Diagnosis, and Management.
    Cardiol Rev 2018 Mar/Apr;26(2):62-72
    Chronic thromboembolic pulmonary hypertension (CTEPH), classified as World Health Organization (WHO) group 4 pulmonary hypertension (PH), is an interesting and rare pulmonary vascular disorder secondary to mechanical obstruction of the pulmonary vasculature from thromboembolism resulting in PH. The pathophysiology is complex, beginning with mechanical obstruction of the pulmonary arteries, which eventually leads to arteriopathic changes and vascular remodeling in the nonoccluded arteries and in the distal segments of the occluded arteries mediated by thrombus nonresolution, abnormal angiogenesis, endothelial dysfunction, and various local growth factors. Based on available data, CTEPH is a rare disease entity occurring in a small proportion (0. Read More

    Pregnancy in Patients With Congenital Heart Disease: A Contemporary Challenge.
    Cardiol Rev 2017 Nov/Dec;25(6):326-330
    From the 1st Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece.
    The majority of female patients with congenital heart disease (CHD) survives into childbearing age and require evidence-based counseling regarding pregnancy options. Even though most of them will have an uneventful pregnancy, they may be at high risk of cardiac, obstetric, and fetal complications. Predictive factors for these complications have been previously identified in numerous studies and with the use of specific scores [CARdiac disease in PREGnancy, Zwangerschap bij Aangeboren HARtAfwijkingen, and World Health Organization (WHO) risk stratification. Read More

    Cardiovascular Manifestations of Pheochromocytoma.
    Cardiol Rev 2017 Sep/Oct;25(5):215-222
    From the Department of Medicine, Division of Endocrinology, New York Medical College/Westchester Medical Center, Valhalla, NY.
    Pheochromocytomas are rare endocrine tumors that can have a significant impact on a variety of organ systems, including the cardiovascular system. Although the pathophysiology is not completely understood, pheochromocytomas exert their effects through high levels of catecholamines, mainly epinephrine and norepinephrine, which stimulate adrenergic receptors, including those within the cardiovascular system. Although the most common cardiovascular manifestation is hypertension, patients with pheochromocytoma can present with arrhythmia, hypotension, shock, myocardial ischemia, cardiomyopathy, aortic dissection, and peripheral ischemia. Read More

    Carotid Stenosis and Impaired Cognition: The Effect of Intervention.
    Cardiol Rev 2017 Sep/Oct;25(5):211-214
    From the *Stony Brook University School of Medicine, Stony Brook, NY; †Division of Vascular Surgery, Winthrop University Hospital, Mineola, NY.
    There is a clear association between carotid artery stenosis and cognitive impairment. However, there is no consensus as to how to interpret this association, and what, if any, impact this connection should have on the management of carotid stenosis. A review of the relevant literature suggests that although an intervention to relieve carotid stenosis in patients without clinically significant cognitive impairment does not improve cognition, there may be a cognitive benefit with intervention for carotid stenosis in those patients with clinically significant cognitive disorders. Read More

    Cardiac Auscultation in the Modern Era: Premature Requiem or Phoenix Rising?
    Cardiol Rev 2017 Sep/Oct;25(5):205-210
    From the *Morsani School of Medicine, University of South Florida, Tampa, FL; †Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada; and ‡Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.
    Competent cardiac auscultation remains a most important skill for the detection of heart disease. Currently it is poorly taught and often ignored or poorly performed, resulting in inaccurate and inefficient patient assessments. This review documents that teaching can be over 90% effective with new, proven teaching methods emphasizing repetition and normal-abnormal comparisons of sounds, using computer-aided and online resources. Read More

    Echocardiography in the Evaluation of Pulmonary Embolism.
    Cardiol Rev 2017 Nov/Dec;25(6):309-314
    From the Cardiology Division, Department of Medicine, New York Medical College/Westchester Medical Center, Valhalla, NY.
    Pulmonary embolism is a major cause of mortality. Acute pulmonary embolism also encompasses a wide clinical spectrum of severity, ranging from asymptomatic silent disease to hemodynamic instability and shock. Echocardiography is a useful modality to improve treatment strategies for pulmonary embolus. Read More

    Neuroendovascular Surgery for the Treatment of Ischemic Stroke.
    Cardiol Rev 2017 Nov/Dec;25(6):262-267
    From the *Department of Neurosurgery, New York Medical College/Westchester Medical Center, Valhalla, NY.
    This review discusses modern therapeutic interventions for acute ischemic stroke with a focus on endovascular therapy. In 2015, the American Heart Association made major changes to the guidelines for the endovascular treatment of acute ischemic stroke. The Class IA indications for endovascular therapy of stroke patients include symptom onset within 6 h, proven large vessel occlusion of an artery in the anterior circulation, and the use of a stent retriever as part of the mechanical thrombectomy. Read More

    Is Swimming Safe in Heart Failure? A Systematic Review.
    Cardiol Rev 2017 Nov/Dec;25(6):321-325
    From the *Department of Cardiology, Hull York Medical School, Hull and East Yorkshire Medical Research and Teaching Centre, Castle Hill Hospital, Cottingham, Kingston upon Hull, United Kingdom.
    It is not clear whether swimming is safe in patients with chronic heart failure. Ten studies examining the hemodynamic effects of acute water immersion (WI) (155 patients; average age 60 years; 86% male; mean left ventricular ejection fraction (LVEF) 29%) and 6 randomized controlled trials of rehabilitation comparing swimming with either medical treatment only (n = 3) or cycling (n = 1) or aerobic exercise (n = 2), (136 patients, average age 59 years; 84% male, mean LVEF 31%) were considered. In 7 studies of warm WI (30-35°C): heart rate (HR) fell (2% to -15%), and both cardiac output (CO) (7-37%) and stroke volume (SV) increased (13-41%). Read More

    Celiprolol: A Unique Selective Adrenoceptor Modulator.
    Cardiol Rev 2017 Sep/Oct;25(5):247-253
    From the *College of Pharmacy, University of New Mexico, Albuquerque, NM; †Department of Clinical Pharmacy, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY; and ‡Department of Medicine, New York Medical College/Westchester Medical Center, Valhalla, NY.
    Celiprolol is a β-blocker with a unique pharmacologic profile: it is a β1-andrenoceptor antagonist with partial β2 agonist activity. Given this combination of effects, celiprolol may be better described as a selective adrenoreceptor modulator. It has antihypertensive and antianginal properties and is indicated for those uses in various countries around the world. Read More

    Trial of Time: Review of Frailty and Cardiovascular Disease.
    Cardiol Rev 2017 Sep/Oct;25(5):236-240
    From the *Departments of Medicine, New York Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY, †Beth Israel Deaconess Medical Center, Harvard Medical College, Boston, MA; and ‡New York Medical College, Westchester Medical Center, Valhalla, New York.
    Frailty has become more frequently recognized as an indicator of predisability. It has been shown to have an association with cardiovascular disease (CVD), just as CVD has an association with frailty, and is a predictor of hospitalization and mortality. The ability to identify this population provides a measure to more accurately assess risk and prognosis which can help the early detection of disease and dictate intervention. Read More

    Epicardial Fat: Pathophysiology and Clinical Significance.
    Cardiol Rev 2017 Sep/Oct;25(5):230-235
    From the *Department of Medicine, Weill-Cornell Medical Center, New York, NY; †Department of Internal Medicine, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA; and ‡Department of Medicine, Westchester Medical Center, New York Medical College, Valhalla, NY.
    Over the last decade and a half there has been much interest in understanding the role of epicardial adipose tissue (EAT) in cardiac pathology. EAT is a visceral adipose deposit with putative paracrine function. In the nondiseased state, EAT releases cardioprotective cytokines and chemokines to the coronary vasculature. Read More

    Novel Oral Anticoagulants in the Peri-Endoscopic Period.
    Cardiol Rev 2017 Sep/Oct;25(5):223-229
    From the *Department of Medicine, Stanford University School of Medicine, Palo Alto, CA; †Department of Medicine, New York Medical College/Westchester Medical Center, Valhalla, NY; and ‡Department of Medicine, Division of Gastroenterology and Hepato-Biliary Diseases, New York Medical College/Westchester Medical Center, Valhalla, NY.
    Millions of patients in the United States are currently prescribed some form of anticoagulation therapy. Recently, novel oral anticoagulants (NOACs), including direct thrombin inhibitors and direct factor Xa inhibitors, have begun to replace warfarin as the drugs of choice for anticoagulation. As the use of these medications becomes more widespread, it is increasingly important for gastroenterologists to understand the risks associated with performing endoscopic procedures on patients who are taking NOACs. Read More

    Droxidopa for Symptomatic Neurogenic Hypotension.
    Cardiol Rev 2017 Sep/Oct;25(5):241-246
    From the *Department of Pharmacy, Weiler Hospital of Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY.
    Droxidopa is a first-in-class, orally available, synthetic amino acid precursor of norepinephrine that received accelerated Food and Drug Administration approval in February 2014 after Orphan Drug status for a debilitating condition known as symptomatic neurogenic orthostatic hypotension. Neurogenic disorders often lead to postural hypotension as a result of poor norepinephrine release from its storage sites. Clinical data suggest increases in standing systolic blood pressure and improvements in many other markers for subjective relief in patients with symptomatic neurogenic hypotension who received droxidopa therapy over 1-2 weeks. Read More

    Vitamin D Deficiency and Supplementation in Cardiovascular Disorders.
    Cardiol Rev 2017 Jul/Aug;25(4):189-196
    From the *Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA; †The Department of Internal Medicine, Mount Sinai Medical Center, Miami Beach, FL; and ‡Cardiology Department, Columbia University Division of Cardiology, Mount Sinai Heart Institute, Miami Beach, FL.
    Cardiovascular disease (CVD) is the leading cause of death in developed countries. Similarly, the frequency of vitamin D deficiency is increasing, and a number of epidemiologic and clinical studies have suggested that there is an increased risk of CVD among people with depletion of this vitamin. This has raised much interest in the potential pathogenic and therapeutic role of vitamin D in CVD. Read More

    Coronary Microcirculatory Dysfunction in Human Cardiomyopathies: A Pathologic and Pathophysiologic Review.
    Cardiol Rev 2017 Jul/Aug;25(4):165-178
    From the *Department for Cardiovascular Diseases, Osijek University Hospital, Osijek, Croatia; †Department of Internal Medicine, Family Medicine and History of Medicine, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; ‡Department of Physiology and Immunology, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; §Department of Pathophysiology, Semmelweis University, Budapest, Hungary; ¶Institute of Natural Sciences, University of Physical Education, Budapest, Hungary; and ‖Department of Physiology, New York Medical College, Valhalla, NY.
    Cardiomyopathies are a heterogeneous group of diseases of the myocardium. The term cardiomyopathy involves a wide range of pathogenic mechanisms that affect the structural and functional states of cardiomyocytes, extravascular tissues, and coronary vasculature, including both epicardial coronary arteries and the microcirculation. In the developed phase, cardiomyopathies present with various clinical symptoms: dyspnea, chest pain, palpitations, swelling of the extremities, arrhythmias, and sudden cardiac death. Read More

    Genetic Insights Into Bicuspid Aortic Valve Disease.
    Cardiol Rev 2017 Jul/Aug;25(4):158-164
    From the *Leicester Cardiovascular Biomedical Research Unit, Department of Cardiovascular Sciences, University of Leicester, Glenfield General Hospital, Leicester, United Kingdom; †Department of Cardiology, University of Leicester, Northhampton General Hospital, Northhampton, United Kingdom; and ‡Department of Cardiovascular Sciences, University of Leicester, East Midlands Congenital Heart Centre, Glenfield General Hospital, Leicester, United Kingdom.
    Bicuspid aortic valve (BAV) is the most common valvular congenital heart defect in the general population. BAV is commonly associated with the presence of other congenital cardiovascular malformations, which leads to cardiovascular complications requiring surgery in around 27% of cases. Familial clustering of BAV is well-recognized, and international guidelines advocate that first-degree relatives of patients with BAV be screened. Read More

    PFO Closure for Cryptogenic Stroke: A Review and Clinical Treatment Algorithm.
    Cardiol Rev 2017 Jul/Aug;25(4):147-157
    *Division of Cardiology, Departments of Medicine and Pediatrics, Weill Cornell Medicine, New York Presbyterian Hospital, Cornell Center for Adult Congenital Heart Disease, New York, NY; and †Division of Cardiology, Department of Medicine, New York Medical College, Westchester Medical Center, Valhalla, NY.
    With a high prevalence in the general population of approximately 25%, and a prevalence in the cryptogenic stroke population approaching 40%, the propensity of a patent foramen ovale (PFO) to precipitate or enable stroke, especially in young, otherwise healthy individuals, has been the subject of much debate. With proof of concept achieved via imaging modalities documenting thrombus-in-transit, and the development of minimally-invasive percutaneous approaches to closure, multiple observational studies and, more recently, several completed randomized controlled trials have sought to answer the question of when and in whom PFO closure should occur. We describe the historical context of PFO closure and review the observational and randomized control trial evidence in this field, culminating in the recent Food and Drug Administration approval of the first dedicated closure device for PFO. Read More

    Inhaled Insulin: A Clinical and Historical Review.
    Cardiol Rev 2017 May/Jun;25(3):140-146
    From the Department of Pharmacy, Montefiore Medical Center, Bronx, NY.
    Insulin is the most effective blood glucose lowering agent and remains one of the cornerstones of diabetes management. However, many individuals with diabetes are either reluctant to initiate or are nonadherent to their insulin therapy for various reasons, including fear of frequent injections. Technosphere Insulin (TI) is a novel inhaled insulin powder that is approved by the United States Food and Drug Administration for the management of diabetes. Read More

    Cangrelor: A New Route for P2Y12 Inhibition.
    Cardiol Rev 2017 May/Jun;25(3):133-139
    From the College of Pharmacy, University of New Mexico, Albuquerque, NM.
    Antiplatelet therapy with a P2Y12 inhibitor is a key component of treatment for patients with acute coronary syndromes undergoing percutaneous coronary intervention. Before the development of cangrelor (Kengreal, The Medicines Company, Parsippany, NJ), only oral P2Y12 inhibitors were available. Cangrelor is a reversible P2Y12 inhibitor that is administered as an intravenous infusion, and its quick onset and offset make it an appealing option for antiplatelet therapy, particularly for patients who are unable to take oral medications. Read More

    The Utility of Teleultrasound to Guide Acute Patient Management.
    Cardiol Rev 2017 May/Jun;25(3):97-101
    From the *Center for Telemedicine & eHealth, Westchester Medical Center, Valhalla, NY; †Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, New York Medical College/Westchester Medical Center, Valhalla, NY; ‡Division of Cardiology, Department of Medicine, New York Medical College/Westchester Medical Center, Valhalla, NY; and §Department of Anesthesiology, Westchester Medical Center, Valhalla, NY.
    Ultrasound has evolved into a core bedside tool for diagnostic and management purposes for all subsets of adult and pediatric critically-ill patients. Teleintensive care unit coverage has undergone a similar rapid expansion period throughout the United States. Round-the-clock access to ultrasound equipment is very common in today's intensive care unit, but 24/7 coverage with staff trained to acquire and interpret point-of-care ultrasound in real time is lagging behind equipment availability. Read More

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