Abstract:
PURPOSE OF REVIEW:Cardiac transplantation is a recognized therapy for end-stage heart failure. Graft coronary artery disease is a chief determinant of long-term survival following cardiac transplantation. There are multiple purported etiologies for graft coronary artery disease including both immunologic and nonimmunologic factors. Immunologic factors include human leukocyte antigen mismatching, cytokine production, and activation of the cellular immune system. Nonimmunologic factors include diabetes, hypertension, hyperlipidemia, and cytomegalovirus infection, just to name a few. There are also donor and recipient factors including age, prior coronary artery disease in the donor heart, and mode of donor brain death. RECENT FINDINGS:The diagnosis of graft coronary artery disease is especially difficult, partially due to the de-innervated allograft, as well as to its inherent predilection to affect the medium-sized and smaller arteries in a concentric and diffuse nature. Conventional angiography can overlook this condition because of the lack of eccentric plaques in larger epicardial arteries. Intravascular ultrasonography, by contrast, is more sensitive in detecting graft coronary artery disease but is unable to visualize the entire arterial system. Treatment is challenging and often unrewarding, leading to re-transplantation. Prevention is therefore ideal and involves protection against endothelial injury before and during transplantation as well as after transplantation, with decreased ischemic time, aggressive attention to early rejection, risk factor modification, and close follow-up. SUMMARY:This review will look at the pathophysiology of graft coronary artery disease, current diagnostic and therapeutic choices, as well as existing and future directions.
journal_name
Curr Opin Cardioljournal_title
Current opinion in cardiologyauthors
Kass M,Haddad Hdoi
10.1097/01.hco.0000203184.89158.16subject
Has Abstractpub_date
2006-03-01 00:00:00pages
132-7issue
2eissn
0268-4705issn
1531-7080pii
00001573-200603000-00014journal_volume
21pub_type
杂志文章,评审abstract::Clinical work in cardiac transplantation has focused on combating the major complications of this procedure, namely graft rejection and infection. Retrospective analyses suggest that prospective HLA typing, as is done in renal transplantation, may improve patient survival. Trials using FK 506 in cardiac transplantati...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/00001573-199303000-00016
更新日期:1993-03-01 00:00:00
abstract:PURPOSE OF REVIEW:A healthy lifestyle throughout one's lifespan is the core foundation for both primary and secondary prevention of cardiovascular disease (CVD). Risk-based decisions for pharmacological therapy is added on-top of lifestyle management. Thus, understanding lifestyle-based recommendations is central to CV...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/HCO.0000000000000763
更新日期:2020-09-01 00:00:00
abstract:PURPOSE OF REVIEW:Patients with tetralogy of Fallot are subject to arrhythmic sequelae that substantially impact morbidity and mortality. This review focuses on recent advances in our understanding of the prevalence and types of arrhythmias encountered. Diagnostic and prognostic tools are considered and therapeutic opt...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/HCO.0b013e328341381a
更新日期:2011-01-01 00:00:00
abstract:PURPOSE OF REVIEW:Despite similar guidelines, remarkable global differences exist in the management of acute coronary syndromes. This review describes recent insights in global patterns of patient baseline characteristics, treatment strategies, medication use, and outcome in acute coronary syndromes. RECENT FINDINGS:R...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/01.hco.0000142063.30214.d2
更新日期:2004-11-01 00:00:00
abstract:PURPOSE:New data have emerged over the last few years about the role of fibrates in treatment of microvascular and macrovascular disease. RECENT FINDINGS:Endpoint studies have been conducted with fibrates in coronary heart disease (CHD) since 1971 and initial results were contradictory. Fibrates later showed benefits ...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/HCO.0b013e32832c0b3d
更新日期:2009-07-01 00:00:00
abstract::Implantable cardioverter defibrillators (ICDs) have become an important therapeutic modality for patients who have had a cardiac arrest or are at risk for life-threatening ventricular arrhythmias. Clinical trials have confirmed the role of the ICD for patients with sustained ventricular arrhythmias and have expanded t...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/00001573-200201000-00004
更新日期:2002-01-01 00:00:00
abstract:PURPOSE OF REVIEW:Heart failure is a worldwide epidemic. Aggressive treatment of patients at risk for heart failure is important. There are no trials targeting primary prevention of heart failure. However, there is trial data demonstrating that treatment of patients with atherosclerotic vascular disease, hypertension, ...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/HCO.0b013e3283207aee
更新日期:2009-03-01 00:00:00
abstract:PURPOSE OF REVIEW:The ability of high-density lipoprotein cholesterol to reverse atherosclerosis and reduce cardiovascular disease has been shown in several randomized controlled trials. One mechanism by which high-density lipoprotein cholesterol protects the vascular system includes hemorheology, the study of blood fl...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/01.hco.0000167722.22453.47
更新日期:2005-07-01 00:00:00
abstract:PURPOSE OF REVIEW:To provide an update on high-density lipoprotein (HDL) biology and emerging new HDL-based therapies for athero-thrombosis. RECENT FINDINGS:Atherosclerotic cardiovascular disease remains a major public health threat despite a significant decline over the past three decades. Although current medical th...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/HCO.0b013e32833f0382
更新日期:2010-11-01 00:00:00
abstract:PURPOSE OF REVIEW:Prolonged sitting (sedentary behavior) has deleterious cardiovascular and metabolic correlates; however, little is known about the associations of too much sitting with all-cause and cardiovascular mortality risk. In addition to the adverse effects of total sitting time, the manner in which it is accu...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/HCO.0b013e3283496605
更新日期:2011-09-01 00:00:00
abstract:PURPOSE OF REVIEW:Open aortic arch surgery is highly invasive and may result in significant morbidity. Recent innovations in thoracic stent-graft technology have facilitated methods of replacing the aortic arch without deep hypothermic circulatory arrest or even cardiopulmonary bypass. We present a review of the curren...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/HCO.0b013e3283317c91
更新日期:2009-11-01 00:00:00
abstract:PURPOSE OF REVIEW:The natural history of cardiogenic shock has improved significantly with the utilization of revascularization and mechanical circulatory support. Despite the interest in identifying new pharmacological agents, the medical therapy to restore perfusion is limited by their side-effects and no solid evide...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/HCO.0000000000000057
更新日期:2014-05-01 00:00:00
abstract:PURPOSE OF REVIEW:Despite progressive improvement in surgical results, hypoplastic left heart syndrome remains one of the congenital heart abnormalities with the greatest morbidity and mortality. Hybrid approaches to management, combining surgical and interventional catheterization procedures, have been introduced to m...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/HCO.0b013e328014d945
更新日期:2007-03-01 00:00:00
abstract:PURPOSE OF REVIEW:Frequent media reports of sudden cardiac arrest or death (SCA/SCD) keep alive a debate as to how best to prevent these tragedies. Several new studies in the past 2 years serve as an impetus to reframe the debate into a reasonable discussion that seeks to obtain more evidence wherever needed and to dev...
journal_title:Current opinion in cardiology
pub_type: 杂志文章
doi:10.1097/HCO.0b013e32835dd0fe
更新日期:2013-03-01 00:00:00
abstract:PURPOSE OF REVIEW:Penetrating aortic ulcer (PAU) is defined as ulceration of an aortic atherosclerotic plaque penetrating through the internal elastic lamina into the media. With the advances in imaging techniques, the differential diagnosis between PAU and other aortic ulcers remains a challenge. This review aims to s...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/HCO.0000000000000782
更新日期:2020-11-01 00:00:00
abstract::As a result of the increasing size of waiting lists and lengthening of waiting times for heart transplantation, coronary revascularization has emerged as an important therapeutic option in the management of patients with ischemic cardiomyopathy. A critical challenge is the identification of candidates with regions of ...
journal_title:Current opinion in cardiology
pub_type: 临床试验,杂志文章,评审
doi:10.1097/00001573-199605000-00008
更新日期:1996-05-01 00:00:00
abstract:PURPOSE OF REVIEW:To compare the potential of high-density lipoprotein (HDL) cholesterol and apolipoprotein (apo) A-I, the major protein in HDL particles, in predicting cardiovascular risk. Pros and cons for using these risk markers are discussed. RECENT FINDINGS:Both HDL cholesterol and apoA-I are in most clinical co...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/HCO.0b013e3281bd8849
更新日期:2007-07-01 00:00:00
abstract:PURPOSE OF REVIEW:Vascular disease often affects more than one territory. Atherosclerosis is a global disease affecting multiple organs/systems. Cardiovascular risk factors are associated with an increased risk for the development of arterial disease in all vascular beds but differ in their individual impacts for each ...
journal_title:Current opinion in cardiology
pub_type: 杂志文章
doi:10.1097/HCO.0000000000000746
更新日期:2020-07-01 00:00:00
abstract:PURPOSE OF REVIEW:Transcatheter aortic-valve implantation is a promising new treatment modality for patients with aortic-valve disease, where it may revolutionize the treatment of elderly and high-risk patients. RECENT FINDINGS:The two devices currently available, the Edwards Sapien valve and the Medtronic CoreValve s...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/HCO.0b013e328335fff4
更新日期:2010-03-01 00:00:00
abstract:PURPOSE OF REVIEW:Rheumatic heart disease (RHD) affects over 30 million people worldwide. Substantial variation exists in the surgical treatment of patients with RHD. Here, we aim to review the surgical techniques to treat RHD with a focus on rheumatic mitral valve (MV) repair. We introduce novel educational paradigms ...
journal_title:Current opinion in cardiology
pub_type: 杂志文章
doi:10.1097/HCO.0000000000000826
更新日期:2020-12-24 00:00:00
abstract:PURPOSE OF REVIEW:Studies comparing outcomes in left-sided endocarditis based on the prosthesis selected for implantation are limited and no randomized studies have been performed. The purpose of this review is to summarize the best available studies to determine what prosthesis is most appropriate when valve replaceme...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/HCO.0000000000000040
更新日期:2014-03-01 00:00:00
abstract::Because the main cause of death in patients with established coronary heart disease (CHD) is sudden cardiac death (SCD), physicians should develop specific strategy, including dietary changes, to prevent it. In the long term, reduction of the diet-dependent chronic risk factors of CHD, hypercholesterolemia, hypertensi...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/00001573-200009000-00009
更新日期:2000-09-01 00:00:00
abstract::In this paper, we review literature from June 1990 through May 1991. We discuss normal anatomy and physiology of the proximal coronary arteries, anomalous origin of the coronary arteries from an inappropriate aortic sinus, and anomalous origin of the left coronary artery from the pulmonary artery. Other topics revie...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/00001573-199112000-00011
更新日期:1991-12-01 00:00:00
abstract:PURPOSE OF REVIEW:Atrial fibrillation after cardiac surgery is associated with adverse outcomes and increased costs. Accordingly, therapy should be provided to prevent postoperative atrial fibrillation. The evaluation of therapies to do so is an area of active investigation with significant recent advances. The purpose...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/HCO.0b013e3280117cc5
更新日期:2007-01-01 00:00:00
abstract::Though tachyarrhythmias occur commonly in patients with the Wolff-Parkinson-White syndrome, many patients remain asymptomatic. Recent studies suggest that routine electrophysiologic testing in these individuals is of limited value. However, electrophysiologic testing remains very helpful in the symptomatic patient fo...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:
更新日期:1991-02-01 00:00:00
abstract::Minimally invasive cardiac surgery has evolved in response to the intrinsic irony facing cardiac surgeons: that we must injure our patients to treat them. In recent years, advances in fiberoptic imaging technology, applied to other surgical specialties, suggested the possibility that cardiac surgery might also be perf...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/00001573-199901000-00011
更新日期:1999-01-01 00:00:00
abstract:PURPOSE OF REVIEW:Arterial tortuosity is emerging as a common feature in genetically mediated thoracic aortic disease that may be prognostic. This review will summarize recent literature on arterial tortuosity in the setting of genetic arteriopathies. RECENT FINDINGS:Although arterial tortuosity has been primarily des...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/HCO.0000000000000218
更新日期:2015-11-01 00:00:00
abstract:PURPOSE OF REVIEW:Many patients requiring cardiac arrhythmia device surgery are on chronic oral anticoagulation therapy. The periprocedural management of their anticoagulation presents a dilemma to physicians, particularly in the subset of patients with moderate-to-high risk of arterial thromboembolic events. Physician...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/hco.0b013e32831bef53
更新日期:2009-01-01 00:00:00
abstract::The ECG is the most widely used noninvasive diagnostic and prognostic test administered to patients with suspected or proven coronary artery disease. When considering appropriate use of the electrocardiogram, physicians need to examine the clinical question being asked, the additional information that can be derived,...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/00001573-199208000-00008
更新日期:1992-08-01 00:00:00
abstract::The benefit of digoxin in chronic heart failure has been debated fervently for decades. In the 1970s, the use of digoxin was challenged due to the high incidences of digitalis toxicity and the lack of data on the effects of digoxin in patients with chronic heart failure. In the 1980s, interest in digoxin was renewed a...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/00001573-199705000-00004
更新日期:1997-05-01 00:00:00