Abstract:
:Pulmonary arterial hypertension (PAH) is a progressive disorder with a poor prognosis. It is characterized by sustained elevation of pulmonary artery pressure (PAP) and pulmonary vascular resistance (PVR). It is defined hemodynamically by a mean PAP over 25 mm Hg, a pulmonary arterial wedge pressure of 15 mm Hg or less (which excludes left sided lesions), and a PVR of 3 or more Wood units (240 dyn.sec.cm-5). Patients are limited by exertional dyspnea, pre- or true syncope, chest pain, and edema/ascites when right heart failure supervenes. PAH afflicts predominantly young women and the diagnosis is often delayed. Three processes contribute to progressive arterial narrowing: vasoconstriction, vascular remodeling, and thrombosis in situ. The diagnosis of PAH must be confirmed and its etiology must be identified before appropriate therapy can be instituted. Right heart catheterization is necessary to establish the diagnosis, severity, and prognosis of PAH and to ascertain its etiology and to evaluate vasoreactivity, which guides therapy. Treatment of PAH includes vasodilators, supplemental O2, anticoagulation, diuretics, digoxin, intravenous inotropic therapy for decompensated right ventricular failure, and lung or combined heart-lung transplantation for those patients who continue to deteriorate with a poor quality of life despite pharmacologic therapy. Calcium channel blockers are beneficial in a small minority of patients. Prospective, controlled, randomized trials of approved vasodilator agents have enrolled a large proportion of women (70-85%). Agents such as the endothelin-1 receptor antagonist bosentan, the phosphodiesterase-5 inhibitor sildenafil, and the prostanoids have been shown to improve symptoms, exercise capacity, and, in most instances, delay clinical worsening. The clinical outcomes of patients with PAH have improved with the judicious use of contemporary therapies.
journal_name
Cardiol Revjournal_title
Cardiology in reviewauthors
De Marco Tdoi
10.1097/01.crd.0000240529.49704.2esubject
Has Abstractpub_date
2006-11-01 00:00:00pages
312-8issue
6eissn
1061-5377issn
1538-4683pii
00045415-200611000-00010journal_volume
14pub_type
杂志文章,评审abstract::Inappropriate sinus tachycardia (IST) is an uncommon form of arrhythmia characterized by an increased heart rate that is out of proportion to a normal physiologic demand. The etiology of IST remains ill-defined and controversial. Clinical presentation of IST is highly variable, from isolated to sustained palpitations,...
journal_title:Cardiology in review
pub_type: 杂志文章,评审
doi:10.1097/CRD.0b013e31822f0b3e
更新日期:2012-01-01 00:00:00
abstract::The literature on the relationship between work-related psychosocial factors and the development of ischemic heart disease (IHD) was systematically reviewed: 33 articles presented 51 analyses of studies involving male participants, 18 analyses involving female participants, and 8 analyses with both genders. Twenty of ...
journal_title:Cardiology in review
pub_type: 杂志文章,评审
doi:10.1097/CRD.0b013e318198c8e9
更新日期:2009-03-01 00:00:00
abstract::Cardiovascular disease is the leading cause of death in the United States, accounting for approximately 60% of total mortality in 2002. There is evidence that race and ethnicity is a risk factor for atherothrombotic events. Blacks have a greater risk of complications from coronary heart disease and unstable angina, wi...
journal_title:Cardiology in review
pub_type: 杂志文章,评审
doi:10.1097/CRD.0b013e31815685fa
更新日期:2008-03-01 00:00:00
abstract::Cardiovascular disease is the leading cause of death in women in most developed countries of the world. Even though cardiovascular deaths of men in the United States have been declining, until recently the number of cardiovascular deaths in US women was on the rise, with 1 in 3 women dying from heart disease. Over the...
journal_title:Cardiology in review
pub_type: 杂志文章,评审
doi:10.1097/CRD.0b013e31815cb185
更新日期:2008-01-01 00:00:00
abstract::Magnesium, the fourth most abundant cation in the human body, is involved in several essential physiological, biochemical, and cellular processes regulating cardiovascular function. It plays a critical role in modulating vascular smooth muscle tone, endothelial cell function, and myocardial excitability and is thus ce...
journal_title:Cardiology in review
pub_type: 杂志文章,评审
doi:10.1097/CRD.0000000000000003
更新日期:2014-07-01 00:00:00
abstract::Cholesterol metabolism and transport has been a major focus in cardiovascular disease risk modification over the past several decades. Hydroxymethylglutaryl-CoA reductase inhibitors (statins) have been the most commonly used agents, with the greatest benefit in reducing both the primary and secondary risks of cardiova...
journal_title:Cardiology in review
pub_type: 杂志文章,评审
doi:10.1097/CRD.0000000000000245
更新日期:2019-09-01 00:00:00
abstract::This literature review examines the association of social and psychologic characteristics among women with a) the risk of developing coronary heart disease and b) prognosis and recovery after disease has become manifest. Studies of psychosocial risk factors are often conflicting. These divergent findings can result fr...
journal_title:Cardiology in review
pub_type: 杂志文章
doi:
更新日期:1998-05-01 00:00:00
abstract::Atrial fibrillation (AF) is a common cardiac arrhythmia with significant morbidity and public health cost. Because of limitations of efficacy and safety of conventional antiarrhythmic agents, alternative therapies for AF are needed. The potential antiarrhythmic properties of lipid-altering therapy, including the 3-hyd...
journal_title:Cardiology in review
pub_type: 杂志文章,评审
doi:10.1097/CRD.0b013e318177271d
更新日期:2008-07-01 00:00:00
abstract::Established coronary artery disease has a prevalence of 7% in adult Americans, accounting for 16 million people. As morbidity and mortality rates have risen, research efforts to identify the pathophysiologic mechanisms of systolic dysfunction have risen in parallel. The current goal is to develop new therapeutic strat...
journal_title:Cardiology in review
pub_type: 杂志文章,评审
doi:10.1097/CRD.0000000000000024
更新日期:2014-09-01 00:00:00
abstract::The effect of an ongoing educational program on the use of cardiovascular drugs in patients with coronary artery disease without contraindications to these drugs seen in an academic cardiology clinic was assessed in 100 patients seen during the 6-month period prior to the educational program and in 200 patients seen 9...
journal_title:Cardiology in review
pub_type: 杂志文章
doi:10.1097/01.crd.0000131191.57664.e7
更新日期:2005-03-01 00:00:00
abstract::The introduction of new medicines to treat pulmonary vascular disease has renewed interest in the management of children with idiopathic pulmonary arterial hypertension. We now have a practical classification of pulmonary hypertension, improved diagnostic techniques, and internationally recognized diagnostic and manag...
journal_title:Cardiology in review
pub_type: 杂志文章,评审
doi:10.1097/CRD.0b013e3181ce03df
更新日期:2010-03-01 00:00:00
abstract::Cardiac resynchronization therapy (CRT) has become a mainstay therapy to improve clinical outcomes of patients with left ventricular systolic dysfunction and a wide QRS complex, in addition to guideline-directed medical therapy. As clinical experience with CRT continues to expand, the device and lead design, along wit...
journal_title:Cardiology in review
pub_type: 杂志文章,评审
doi:10.1097/CRD.0000000000000127
更新日期:2017-01-01 00:00:00
abstract::Heart valve prostheses carry a risk for thrombosis and require an antithrombotic strategy to prevent stroke, systemic embolism, and prosthetic valve thrombosis. Contemporary randomized trials to guide the clinician on the optimal anticoagulant treatment are scarce, and the validity of the historical data for current r...
journal_title:Cardiology in review
pub_type: 杂志文章,评审
doi:10.1097/CRD.0b013e3182638578
更新日期:2013-01-01 00:00:00
abstract::Loop diuretics are central to the management of fluid overload in acute decompensated heart failure. However, a variance in the response to loop diuretics can alter a patient's clinical course and has an adverse effect on clinical outcomes. Thus, a diminished response to loop diuretics is an important clinical issue. ...
journal_title:Cardiology in review
pub_type: 杂志文章,评审
doi:10.1097/CRD.0000000000000116
更新日期:2016-09-01 00:00:00
abstract::This article provides a brief overview of several recently developed, emerging technologies and discusses their potential uses on clinical grounds. These new technologies include three-dimensional imaging, objective automated evaluation of ventricular function with acoustic quantification, assessment of regional ventr...
journal_title:Cardiology in review
pub_type: 杂志文章,评审
doi:10.1097/00045415-200105000-00008
更新日期:2001-05-01 00:00:00
abstract::Inflammatory cardiomyopathy is a broad term encompassing any disease leading to myocardial inflammation with associated cardiac dysfunction. While endomyocardial biopsy remains the gold standard for diagnosis, non-invasive imaging techniques, such as cardiac magnetic resonance imaging and positron emission tomography,...
journal_title:Cardiology in review
pub_type: 杂志文章
doi:10.1097/CRD.0000000000000369
更新日期:2020-11-02 00:00:00
abstract::Hypertension remains a major cause of cardiovascular morbidity and mortality in the United States. Disturbing trends have been reported recently and include declining rates of successful blood pressure control and increasing rates of stroke, congestive heart failure, and hypertension-associated end-stage renal disease...
journal_title:Cardiology in review
pub_type: 杂志文章
doi:10.1097/00045415-199809000-00009
更新日期:1998-10-01 00:00:00
abstract::Saphenous vein graft (SVG) disease after coronary artery bypass grafting (CABG) occurs in three phases: thrombosis, intimal hyperplasia, and atherosclerosis. Within the first month, thrombosis plays a major role. From month 1 to month 12, intimal hyperplasia occurs. Beyond 12 months, atherosclerosis becomes the primar...
journal_title:Cardiology in review
pub_type: 杂志文章,评审
doi:10.1097/CRD.0b013e3182736190
更新日期:2013-03-01 00:00:00
abstract::Care of pregnant patients with congenital heart disease requires understanding of the specific congenital defect, the nature of previous surgical correction, and the residua and sequelae. General risks and principles can be adduced in management decisions. In addition, lesion- and patient-specific details are importan...
journal_title:Cardiology in review
pub_type: 杂志文章,评审
doi:10.1097/00045415-200008030-00007
更新日期:2000-05-01 00:00:00
abstract::Intravascular ultrasound imaging is a relatively new imaging modality that uses miniaturized ultrasound transducers, which are mounted on catheter tips and introduced into the vessel lumen to provide cross-sectional images of the vascular structure in real time. It has gained popularity rapidly among interventional ca...
journal_title:Cardiology in review
pub_type: 杂志文章,评审
doi:10.1097/00045415-199909000-00014
更新日期:1999-09-01 00:00:00
abstract::The cost of medical care in the United States continues to spiral upward, partly as a result of new technological breakthroughs that promise improved length of life and quality of life for patients. But how good are these treatments in everyday practice? How do we make policies for adopting innovations that improve ou...
journal_title:Cardiology in review
pub_type: 杂志文章,评审
doi:10.1097/00045415-200008020-00006
更新日期:2000-03-01 00:00:00
abstract::Heart failure continues to be a leading cause of morbidity and mortality throughout the United States. The pathophysiology of heart failure involves the activation of complex neurohormonal pathways, many of which mediate not only hypertrophy and fibrosis within ventricular myocardium and interstitium, but also activat...
journal_title:Cardiology in review
pub_type: 杂志文章,评审
doi:10.1097/CRD.0000000000000094
更新日期:2016-09-01 00:00:00
abstract::Ayurveda is derived from 2 Sanskrit words, namely, "Ayus" and "Veda," meaning life and knowledge, respectively. It literally means science of life. Ayurveda, of which yoga is an integral part, is widely practiced in India and is gaining acceptance in many countries around the world. It is a comprehensive and a holisti...
journal_title:Cardiology in review
pub_type: 杂志文章
doi:10.1097/01.crd.0000128730.31658.36
更新日期:2004-09-01 00:00:00
abstract::The differentiation of left ventricular pseudoaneurysm from true aneurysm is sometimes difficult. Given the propensity for pseudoaneurysms to rupture leading to cardiac tamponade, shock, and death, compared with a more benign natural history for true aneurysms, accurate diagnosis of these conditions is clinically impo...
journal_title:Cardiology in review
pub_type: 杂志文章,评审
doi:10.1097/01.crd.0000233756.66532.45
更新日期:2006-11-01 00:00:00
abstract::There is growing evidence that inflammatory processes may be involved in the development of atherosclerosis and its complications. Viral and bacterial pathogens have been implicated as possible causative factors in the pathogenesis of coronary artery disease and postangioplasty restenosis. Antibiotic trials have been ...
journal_title:Cardiology in review
pub_type: 杂志文章,评审
doi:10.1097/00045415-200207000-00004
更新日期:2002-07-01 00:00:00
abstract::The physiologic effect of the sauna in human beings has been studied extensively, but only recently have there been studies to suggest sauna can be an effective therapeutic modality for patients with cardiovascular disease, especially for those with congestive heart failure. The data reported to date have been promisi...
journal_title:Cardiology in review
pub_type: 杂志文章
doi:10.1097/01.crd.0000124844.56479.05
更新日期:2004-11-01 00:00:00
abstract::Evacetrapib is a cholesteryl ester transfer protein (CETP) inhibitor that has been recently studied as a cholesterol modifying agent to reduce cardiovascular risk and mortality in high risk cardiovascular disease patients. Evacetrapib acts to decrease lipid exchange through CETP inhibition. CETP acts to transfer chole...
journal_title:Cardiology in review
pub_type: 杂志文章,评审
doi:10.1097/CRD.0000000000000137
更新日期:2017-03-01 00:00:00
abstract::The toll-like receptors (TLRs) are a class of transmembrane molecules that have important functions in both innate and acquired immunity. As part of the body's normal immune defense against microbial pathogens, stimulation of these receptors will trigger the inflammatory response cascade and the release of cytokines. ...
journal_title:Cardiology in review
pub_type: 杂志文章,评审
doi:10.1097/CRD.0b013e3181709fd8
更新日期:2008-11-01 00:00:00
abstract::Renovascular hypertension caused by renal artery stenosis accounts for a small portion of overall hypertension but remains important as the most common potentially curable form of high blood pressure. Diagnosis depends on developing an index of suspicion for renovascular hypertension based on the history and physical ...
journal_title:Cardiology in review
pub_type: 杂志文章,评审
doi:10.1097/00045415-200008010-00005
更新日期:2000-01-01 00:00:00
abstract::The human intestine contains the largest and most diverse ecosystem of microbes. The main function of the intestinal bacterial flora is to limit the growth of potentially pathogenic microorganisms. However, the intestinal microbiota is increasingly emerging as a risk factor for the development of cardiovascular diseas...
journal_title:Cardiology in review
pub_type: 杂志文章
doi:10.1097/CRD.0000000000000327
更新日期:2020-06-18 00:00:00