Entries Tagged as 'Prog Cardiovasc Dis'
Catheter-based therapies for massive pulmonary embolism.
Prog Cardiovasc Dis. 2010 Mar-Apr;52(5):429-37
Authors: Todoran TM, Sobieszczyk P
Massive pulmonary embolism carries a high mortality rate as a result of right ventricular failure. In addition to anticoagulation, systemic thrombolysis is the standard first line of therapy for patients with life-threatening massive pulmonary embolism. Surgical embolectomy is often considered in patients with contraindications to receiving systemic thrombolysis or when thrombolysis has failed. Surgical embolectomy is not without inherent risk and limitations.Although there is a paucity of large clinical trials, available data suggests catheter-based treatment of massive pulmonary embolism restores hemodynamic stability and thus is an alternative to surgical therapy.
PMID: 20226960 [PubMed - indexed for MEDLINE]
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Variables influencing heart rate.
Prog Cardiovasc Dis. 2009 Jul-Aug;52(1):11-9
Authors: Valentini M, Parati G
In both physiologic and pathological conditions, instantaneous heart rate value is the result of a rather complex interplay. It constantly varies under the influence of a number of factors: nonmodifiable and modifiable ones. Pharmacologic blockade with beta-adrenergic antagonists and/or with parasympathetic antagonists such as atropine have permitted the identification of the mechanisms of autonomic nervous regulation of heart rate in a variety of physiologic and pathological conditions. The analysis of heart rate and blood pressure variability has yielded additional information on the autonomic control of the circulation, which has proven to have diagnostic and prognostic implications in a number of clinically relevant conditions such as hypertension, acute myocardial infarction, heart failure, and predisposition to sudden cardiac death. This article will summarize, based on available epidemiologic and clinical studies, the key variables influencing heart rate and heart rate variability in view of the known association between heart rate and cardiovascular disease.
PMID: 19615488 [PubMed - indexed for MEDLINE]
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Workup of the cardiac arrest survivor: for the symposium on sudden cardiac death for progress in cardiovascular diseases.
Prog Cardiovasc Dis. 2008 Nov-Dec;51(3):195-203
Authors: Subbiah R, Gula LJ, Klein GJ, Skanes AC, White J, Yee R, Krahn AD
Sudden cardiac death is a significant cause of mortality. Survivors of sudden cardiac death pose a significant diagnostic and management challenge for the clinician. Investigation strategies are directed at elucidating a cause or mechanism of sudden cardiac death and ultimately preventing recurrence. Detailed herein is a comprehensive approach to the assessment of a sudden cardiac death survivor.
PMID: 19026854 [PubMed - indexed for MEDLINE]
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Brugada syndrome.
Prog Cardiovasc Dis. 2008 Jul-Aug;51(1):1-22
Authors: Benito B, Brugada R, Brugada J, Brugada P
Since its first description in 1992 as a new clinical entity, the Brugada syndrome has aroused great interest among physicians and basic scientists. Two consensus conferences held in 2002 and 2005 helped refine the current accepted definite diagnostic criteria for the syndrome, briefly, the characteristic ECG pattern (right bundle branch block and persistent ST segment elevation in right precordial leads) together with the susceptibility for ventricular fibrillation and sudden death. In the last years, clinical and basic research have provided very valuable knowledge on the genetic basis, the cellular mechanisms responsible for the typical ECG features and the electrical susceptibility, the clinical particularities and modulators, the diagnostic value of drug challenge, the risk stratification of sudden death (possibly the most controversial issue) and, finally, the possible therapeutic approaches for the disease. Each one of these points is discussed in this review, which intends to provide updated information supplied by recent clinical and basic studies.
PMID: 18634914 [PubMed - indexed for MEDLINE]
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Contemporary approach to the diagnosis and management of non-ST-segment elevation acute coronary syndromes.
Prog Cardiovasc Dis. 2008 Mar-Apr;50(5):311-51
Authors: Boden WE, Shah PK, Gupta V, Ohman EM
The management of patients with acute coronary syndromes (ACS) has evolved dramatically over the past decade and, in many respects, represents a rapidly moving target for the cardiologist and internist who seek to integrate these recent advances into contemporary clinical practice. Unstable angina and non-ST-segment elevation myocardial infarction (MI) comprise a growing percentage of patients with ACS and is emerging as a major public health problem worldwide, especially in Western countries, despite significant improvements and refinements in management over the past 20 years. Against this backdrop of a multitude of randomized, controlled clinical trials that have established the scientific foundation upon which evidence-based treatment strategies have emerged and become increasingly refined, the clinician is frequently confronted with panoply of choices that can create uncertainty or confusion regarding “optimal management”. While the debate about the ideal approach to the management of non-ST-segment elevation (NSTE) ACS (i.e., routine “early invasive strategy” versus an “ischemia-guided”, or “conservative”, strategy) has been ongoing for over a decade, clinical trials results provide compelling evidence that intermediate- and high-risk ACS patients derived significant reductions in both morbidity and mortality with mechanical or surgical intervention, especially when revascularization is coupled with aggressive, multifaceted (anti-platelet, antithrombin, anti-ischemic and anti-atherogenic) medical therapy along with risk factor modification. For these reasons, it seems especially timely and appropriate to present a state-of-the-art paper that reviews the latest advances in the management of NSTE ACS, mindful of the fact that even this noble effort to synthesize and integrate a prodigious amount of scientific information and cardiovascular therapeutics is destined to evolve still further as our full-scale assault on optimizing clinical outcomes by harmonizing the advances in mechanical and pharmacologic interventions continues unabated.
PMID: 18313479 [PubMed - indexed for MEDLINE]
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