Diagnosis and management of low-flow, low-gradient aortic stenosis.

Abstract:

PURPOSE OF REVIEW:The severity of low-flow, low-gradient aortic stenosis cases continue to be misunderstood because of challenging diagnosis, and treatment remains complex. We discuss current diagnostic and treatment modalities for low-flow, low-gradient aortic stenosis. RECENT FINDINGS:This article summarizes current guidelines and best practices for the management of low-flow, low-gradient aortic stenosis. SUMMARY:Low-flow, low-gradient aortic stenosis is a difficult entity to diagnose and treat. Various diagnostic modalities are needed to accurately determine the severity of aortic stenosis and potential treatment benefit. True-severe classical and paradoxical low-flow, low-gradient aortic stenosis can be distinguished from pseudo-severe aortic stenosis by dobutamine stress echocardiography and/or multidetector computed tomography. Once the distinction is made, aortic valve replacement results in better outcomes compared with conservative management. Although both surgical and transcatheter aortic valve replacement result in adequate outcomes, the decision between the two treatment strategies is based on patient characteristics, valve morphology, and other risk factors.

journal_name

Curr Opin Cardiol

authors

Salemi A,Hameed I,Khan FM,Gaudino M

doi

10.1097/HCO.0000000000000707

subject

Has Abstract

pub_date

2020-03-01 00:00:00

pages

87-94

issue

2

eissn

0268-4705

issn

1531-7080

journal_volume

35

pub_type

杂志文章
  • Long-lasting benefits of exercise for those living with a Fontan circulation.

    abstract:PURPOSE OF REVIEW:In recent decades, the physiology and late outcomes of the Fontan circulation have become better characterized and interest has turned to interventions that might improve exercise capacity and clinical sequelae. No therapy has currently been shown to be more effective for improving exercise capacity i...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0000000000000582

    authors: Cordina R,d'Udekem Y

    更新日期:2019-01-01 00:00:00

  • Exercise testing in heart failure: a contemporary discussion in an era of novel diagnostic techniques and biomarkers.

    abstract:PURPOSE OF REVIEW:The purpose of this review is to highlight recent advances in the field of exercise testing for patients with heart failure. RECENT FINDINGS:The importance of assessment of cardiorespiratory fitness (CRF) and exercise testing in heart failure is highlighted in the consensus recommendation of the Amer...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0000000000000490

    authors: Moneghetti KJ,Christle JW,Myers J,Haddad F

    更新日期:2018-03-01 00:00:00

  • Management of combined carotid and coronary artery disease.

    abstract::Although it has been the topic of intense medical and surgical attention for over 20 years, the coexistence of severe carotid artery disease in patients undergoing coronary artery bypass graft continues to be a major cause of perioperative morbidity and mortality. Refinements in diagnostic modalities, mainly by duplex...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-199609000-00012

    authors: Schepens MA,Vermeulen FE

    更新日期:1996-09-01 00:00:00

  • Global patterns of health care for acute coronary syndromes.

    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

    authors: Sinnaeve PR,Van de Werf FJ

    更新日期:2004-11-01 00:00:00

  • Predicting outcomes in cardiac surgery: risk stratification matters?

    abstract:PURPOSE OF REVIEW:To illustrate the limitations of predictive risk models in cardiac surgery, highlight the difficulty in interpreting risk-adjusted outcome analysis and discuss the challenges of making clinical decisions based on risk predictions, particularly in high-risk patients. RECENT FINDINGS:Predictive risk mo...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0b013e32831217ed

    authors: Dupuis JY

    更新日期:2008-11-01 00:00:00

  • The total artificial heart for biventricular heart failure and beyond.

    abstract:PURPOSE OF REVIEW:Treatment options for late-stage biventricular heart failure are limited but include medical therapy with intravenous inotropes, biventricular assist devices (Bi-VADs) and the total artificial heart (TAH). In this manuscript, we review the indications, surgical techniques and outcomes for the TAH. RE...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0b013e32835220c9

    authors: Kasirajan V,Tang DG,Katlaps GJ,Shah KB

    更新日期:2012-05-01 00:00:00

  • New advances in class III antiarrhythmic drug therapy.

    abstract::In the past 2 years, significant advances have been made in class III antiarrhythmic drug therapy. In patients with ventricular arrhythmias and implantable cardioverter defibrillators (ICDs), antiarrhythmic agents are increasingly being used as adjunct therapy to decrease the frequency of ICD discharges. Sotalol was r...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-200001000-00006

    authors: Sager PT

    更新日期:2000-01-01 00:00:00

  • Five decades of pediatric heart transplantation: challenges overcome, challenges remaining.

    abstract:PURPOSE OF REVIEW:Pediatric heart transplants continue to be the therapy of choice for children with end stage heart failure. The interplay of limited donor supply, improvement in ventricular assist device (VAD) technology and utilization, and a focus on optimizing long-term outcomes make it critically important for pr...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0000000000000351

    authors: Zangwill S

    更新日期:2017-01-01 00:00:00

  • Coronary artery surgical technique.

    abstract::The increased use of arterial conduits in coronary artery bypass grafting is reflected in numerous publications addressing indications, choice of conduits, and possible side-effects. Besides the internal thoracic artery, the right gastroepiploic artery is becoming established, and the inferior epigastric artery is be...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-199311000-00004

    authors: Turina M

    更新日期:1993-11-01 00:00:00

  • Advances in the field of proprotein convertase subtilisin kexin type 9 inhibitors.

    abstract:PURPOSE OF REVIEW:Proprotein convertase subtilisin kexin type 9 (PCSK9) inhibitors are promising therapies that inhibit the degradation of low-density lipoprotein (LDL) receptors in the hepatocyte and thus increase LDL cholesterol (LDL-C) uptake from the blood. This review summarizes main findings in the field of PCSK9...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0000000000000332

    authors: Eisen A,Giugliano RP

    更新日期:2016-11-01 00:00:00

  • Prevention of restenosis after coronary angioplasty.

    abstract:PURPOSE OF REVIEW:Despite numerous advances in coronary interventional techniques, the frequent occurrence of restenosis continues to plague interventional cardiology. With the widespread use of drug-eluting stents, there is a need to reexamine critically the roles of the various interventional techniques currently ava...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/01.hco.0000133658.77024.59

    authors: Karthikeyan G,Bhargava B

    更新日期:2004-09-01 00:00:00

  • Will left-ventricular assist device therapy replace heart transplantation in the foreseeable future?

    abstract:PURPOSE OF REVIEW:Implantation of circulatory assist devices as a permanent alternative to heart transplantation, so-called Destination Therapy, has become a promising new option for treatment of patients with advanced heart failure who are not candidates for heart transplantation. RECENT FINDINGS:The landmark REMATCH...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/01.hco.0000153949.42189.03

    authors: Lietz K,Miller LW

    更新日期:2005-03-01 00:00:00

  • Transcatheter device closure of atrial septal defects: more to think about than just closing the hole.

    abstract:PURPOSE OF REVIEW:To review current controversies in the transcatheter device closure of ostium secundum atrial septal defects (ASD). RECENT FINDINGS:Transcatheter device closure of ASD (TC-ASD) has well established efficacy and safety. For most individual patients with suitable anatomy, TC-ASD is the preferred method...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0000000000000476

    authors: O'Byrne ML,Glatz AC,Gillespie MJ

    更新日期:2018-01-01 00:00:00

  • HDL-cholesterol and cardiovascular disease: rethinking our approach.

    abstract:PURPOSE OF REVIEW:A low level of plasma high density lipoprotein cholesterol (HDL-C) is a strong and independent risk factor for atherosclerotic cardiovascular disease (ASCVD). However, several large studies recently revealed that pharmacologic interventions that increase HDL-C concentration have not improved cardiovas...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0000000000000211

    authors: Siddiqi HK,Kiss D,Rader D

    更新日期:2015-09-01 00:00:00

  • Association between hematological parameters and high-density lipoprotein cholesterol.

    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

    authors: Moriarty PM,Gibson CA

    更新日期:2005-07-01 00:00:00

  • Primary tumors of the heart.

    abstract:PURPOSE OF REVIEW:Primary cardiac tumors are a rare disease, which may have severe clinical consequences. Malignant tumors may be misdiagnosed as mixomas, with improper treatment. The aim of this review is to report how to make a differential diagnosis using old and modern tools, the latest trends in tumor classificati...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0000000000000335

    authors: Lestuzzi C

    更新日期:2016-11-01 00:00:00

  • The role of antiplatelet therapy in the secondary prevention of coronary artery disease.

    abstract:PURPOSE OF REVIEW:In this study, we review the evidence for both long-standing and newer oral antiplatelet agents as secondary prevention in coronary artery disease, and give our opinion on where each agent's treatment role lies. RECENT FINDINGS:Platelets play a pathological role in acute coronary syndromes and are th...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0b013e328338f7b5

    authors: Behan MW,Chew DP,Aylward PE

    更新日期:2010-07-01 00:00:00

  • Evidence supporting secondary prevention strategies.

    abstract::Currently 14 million individuals in the United States have coronary disease. Within the next 2 decades, this number is expected to increase to 21 million persons. To minimize the excessive risk of recurrent cardiac events in these people, evidence-based, cost-effective prevention strategies must be developed. This rev...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-199907000-00005

    authors: Blazing MA,O'Connor CM

    更新日期:1999-07-01 00:00:00

  • Unusual forms of ischemic heart disease.

    abstract::Unusual forms and causes of ischemic heart disease include angina pectoris in the presence of normal coronary arteries (syndrome X), congenital coronary abnormalities, vasculitic disorders, and graft atherosclerosis after cardiac transplantation. There is now evidence that endothelial dysfunction of coronary resistanc...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:

    authors: Drexler H,Schroeder JS

    更新日期:1994-07-01 00:00:00

  • Pharmacologic therapies for acute cardiogenic shock.

    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

    authors: Nativi-Nicolau J,Selzman CH,Fang JC,Stehlik J

    更新日期:2014-05-01 00:00:00

  • Does carotid intima media thickness indicate coronary atherosclerosis?

    abstract::Increased carotid intima media thickness (IMT) is relatively simple, inexpensive, and reproducible noninvasive marker of global atherosclerotic disease. It is a frequently used experimental tool in epidemiologic studies to identify and follow cardiovascular disease. There is evidence that early detection of atheroscle...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-200209000-00013

    authors: Sinha AK,Eigenbrodt M,Mehta JL

    更新日期:2002-09-01 00:00:00

  • Fibrates in the treatment of cardiovascular risk and atherogenic dyslipidaemia.

    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

    authors: Wierzbicki AS

    更新日期:2009-07-01 00:00:00

  • Prosthetic valve selection in patients with left-sided endocarditis: bioprosthetic or mechanical valves?

    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

    authors: Moon MR

    更新日期:2014-03-01 00:00:00

  • Use of implantable pacemakers and implantable defibrillators in hypertrophic cardiomyopathy.

    abstract::Recent data have emerged to help guide the use of implantable pacemakers and implantable defibrillators in patients who have hypertrophic cardiomyopathy (HCM). Controlled studies of the use of dual chamber pacemakers to treat outflow tract obstruction in HCM have shown little benefit, and have raised the possibility t...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-200101000-00009

    authors: Freedman RA

    更新日期:2001-01-01 00:00:00

  • Subclinical bioprosthetic aortic valve thrombosis: clinical and translational implications.

    abstract:PURPOSE OF REVIEW:A recently published study has alerted the cardiovascular community to the existence of a significant and previously unrecognized risk of subclinical valve thrombosis following implantation of surgical and catheter-based bioprosthetic valves. The purpose of this article is to review our current unders...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0000000000000373

    authors: Yanagawa B,Mazine A,Bhatt DL,Clavel MA,Côté N,Cheema AN,Pibarot P,Verma S

    更新日期:2017-03-01 00:00:00

  • The use of electrocardiography as a diagnostic and prognostic tool in coronary artery disease.

    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

    authors: Al-Joundi B,Chaitman BR

    更新日期:1992-08-01 00:00:00

  • The role of tricuspid valve repair and replacement in right heart failure.

    abstract:PURPOSE OF REVIEW:The presence of tricuspid regurgitation in the setting of right ventricular dysfunction is associated with poor prognosis. The purpose of this review is to describe the pathophysiology of functional tricuspid regurgitation, summarize the current reports favoring a more aggressive approach toward tricu...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0b013e3283512051

    authors: Pinney SP

    更新日期:2012-05-01 00:00:00

  • Cybersecurity threats to cardiac implantable devices: room for improvement.

    abstract:PURPOSE OF REVIEW:For over a decade, vulnerabilities in the healthcare industry have been identified. Medical devices such as cardiovascular implantable electronic devices (CIEDs) are particularly concerning because of direct threats to patient safety and protected health information (PHI). Although these vulnerabiliti...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章

    doi:10.1097/HCO.0000000000000815

    authors: Tomaiko E,Zawaneh MS

    更新日期:2021-01-01 00:00:00

  • How to avoid inappropriate therapy.

    abstract:PURPOSE OF REVIEW:With wider indications for implantable cardioverter defibrillator therapy, more patients at lower risk for ventricular tachyarrhythmia receive this treatment. To maintain the ratio of benefit versus side-effects at an acceptable level, the risk of inappropriate implantable cardioverter defibrillator t...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0b013e3282f30436

    authors: Israel CW

    更新日期:2008-01-01 00:00:00

  • Cardiovascular implantable electronic device lead extraction: evidence, techniques, results, and future directions.

    abstract:PURPOSE OF REVIEW:Cardiovascular implantable electronic devices are widely used to treat symptomatic arrhythmias, prevent sudden cardiac death, and improve symptoms and cardiac function. Continued population growth and expanding indications have resulted in a progressive increase in the number of cardiovascular implant...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0000000000000247

    authors: Sadek MM,Goldstein W,Epstein AE,Schaller RD

    更新日期:2016-01-01 00:00:00