Pub Date : 2016-02-14DOI: 10.17554/J.ISSN.2309-6861.2015.03.109
P. M. Martinelli, E. Camargos
Neurotrophic factors are well known for their action on the development, survival and regeneration of neurons. However, new functions have been assigned to those peptides not only during development but also throughout the postnatal life. The searches for new therapeutic strategies have highlighted the role of neurotrophic factors in various phenomena related to pathological and physiological processes. In this review will summarize the knowledge of the families of neurotrophic factors as well as other growth factors with known neurotrophic activity. We also aim to provide a synopsis of the involvement of those peptides in cardiac diseases since this knowledge undoubtedly contributes to the development of therapeutic strategies for prevention and treatment of heart diseases.
{"title":"Neurotrophic Factors and Heart Diseases","authors":"P. M. Martinelli, E. Camargos","doi":"10.17554/J.ISSN.2309-6861.2015.03.109","DOIUrl":"https://doi.org/10.17554/J.ISSN.2309-6861.2015.03.109","url":null,"abstract":"Neurotrophic factors are well known for their action on the development, survival and regeneration of neurons. However, new functions have been assigned to those peptides not only during development but also throughout the postnatal life. The searches for new therapeutic strategies have highlighted the role of neurotrophic factors in various phenomena related to pathological and physiological processes. In this review will summarize the knowledge of the families of neurotrophic factors as well as other growth factors with known neurotrophic activity. We also aim to provide a synopsis of the involvement of those peptides in cardiac diseases since this knowledge undoubtedly contributes to the development of therapeutic strategies for prevention and treatment of heart diseases.","PeriodicalId":92802,"journal":{"name":"Journal of clinical cardiology and cardiovascular therapy","volume":"32 1","pages":"483-491"},"PeriodicalIF":0.0,"publicationDate":"2016-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79839317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-02-14DOI: 10.17554/J.ISSN.2309-6861.2015.03.105
A. Berezin
Heart failure (HF) is multi factorial syndrome with high cardiovascular (CV) morbidity and mortality rates associated with an increasingly prevalence worldwide. Measuring plasma levels of cardiac biomarkers may assist in prognostication of HF. However, the role of biomarker models in prediction of death and re-admission in ambulatory HF patients is not still understood. This editorial comment explores the knowledge regarding head-to-head comparison of galectin-3 and ST2 in risk stratification among ambulatory HF individuals. The comment is indicated sST2 and galectin-3 are recommended as alternate biomarkers with defined predictive value in HF and in generally patient population at high risk of HF manifestation. Recent clinical studies do not allow solving whether sST2 is superior then galectin-3 in ambulatory patient with stable HF because the received results are not obvious, although sST2 appears to be more attractive. Probably, more investigations are required to explain the role of each alternate biomarker in HF prognostication.
{"title":"The Biomarker Utility in Risk Stratification in an Ambulatory Heart Failure: ST2 or Galectin-3?","authors":"A. Berezin","doi":"10.17554/J.ISSN.2309-6861.2015.03.105","DOIUrl":"https://doi.org/10.17554/J.ISSN.2309-6861.2015.03.105","url":null,"abstract":"Heart failure (HF) is multi factorial syndrome with high cardiovascular (CV) morbidity and mortality rates associated with an increasingly prevalence worldwide. Measuring plasma levels of cardiac biomarkers may assist in prognostication of HF. However, the role of biomarker models in prediction of death and re-admission in ambulatory HF patients is not still understood. This editorial comment explores the knowledge regarding head-to-head comparison of galectin-3 and ST2 in risk stratification among ambulatory HF individuals. The comment is indicated sST2 and galectin-3 are recommended as alternate biomarkers with defined predictive value in HF and in generally patient population at high risk of HF manifestation. Recent clinical studies do not allow solving whether sST2 is superior then galectin-3 in ambulatory patient with stable HF because the received results are not obvious, although sST2 appears to be more attractive. Probably, more investigations are required to explain the role of each alternate biomarker in HF prognostication.","PeriodicalId":92802,"journal":{"name":"Journal of clinical cardiology and cardiovascular therapy","volume":"71 1","pages":"492-494"},"PeriodicalIF":0.0,"publicationDate":"2016-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77499199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-02-14DOI: 10.17554/J.ISSN.2309-6861.2015.03.111
S. Morra, F. Bughin, K. Solecki, F. Roubille
Background: Obstructive sleep apnea (OSA) is largely recognized as an independent risk factor for coronary artery disease (CAD), its prevalence is higher in the acute phase of ischemic heart disease and the risk of developing ischemic myocardial injury is greater in presence of this syndrome. OSA seems to exacerbate ischemic nocturnal events, to impair coronary blood flow (CBF) response to myocardial energy demand, to increase myocardial vascular resistance and to negatively impact outcomes of percutaneous coronary intervention (PCI) Case report: We reported the case of 57-years-old men with multiples cardiovascular risk factors and previous history of severe CAD, who presented multiples relapses of in-stent restenosis and failure in percutaneous procedures; because of overweight, snoring and nocturnal pains referred occurring simultaneously of respiratory apneic events, he underwent to an overnight sleep screening, resulting positive for obstructive sleep apnea. Conclusions: OSA, likewise others chronic inflammatorystates, could be responsible for negative outcomes of PCI(in-stent proliferation restenosis) due to abnormal inflammatory state, coronary microvascular dysfunction secondary to vascular remodeling, and thusineffectiveness of coronary blood flow (CBF) response to myocardial work.
{"title":"A Painful Sleep Apnea","authors":"S. Morra, F. Bughin, K. Solecki, F. Roubille","doi":"10.17554/J.ISSN.2309-6861.2015.03.111","DOIUrl":"https://doi.org/10.17554/J.ISSN.2309-6861.2015.03.111","url":null,"abstract":"Background: Obstructive sleep apnea (OSA) is largely recognized as an independent risk factor for coronary artery disease (CAD), its prevalence is higher in the acute phase of ischemic heart disease and the risk of developing ischemic myocardial injury is greater in presence of this syndrome. OSA seems to exacerbate ischemic nocturnal events, to impair coronary blood flow (CBF) response to myocardial energy demand, to increase myocardial vascular resistance and to negatively impact outcomes of percutaneous coronary intervention (PCI) Case report: We reported the case of 57-years-old men with multiples cardiovascular risk factors and previous history of severe CAD, who presented multiples relapses of in-stent restenosis and failure in percutaneous procedures; because of overweight, snoring and nocturnal pains referred occurring simultaneously of respiratory apneic events, he underwent to an overnight sleep screening, resulting positive for obstructive sleep apnea. Conclusions: OSA, likewise others chronic inflammatorystates, could be responsible for negative outcomes of PCI(in-stent proliferation restenosis) due to abnormal inflammatory state, coronary microvascular dysfunction secondary to vascular remodeling, and thusineffectiveness of coronary blood flow (CBF) response to myocardial work.","PeriodicalId":92802,"journal":{"name":"Journal of clinical cardiology and cardiovascular therapy","volume":"50 1","pages":"500-503"},"PeriodicalIF":0.0,"publicationDate":"2016-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78638165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-02-14DOI: 10.17554/J.ISSN.2309-6861.2015.03.108
G. Caminiti, C. Fossati, D. Battaglia, S. Selli, Deborah Fortuna, M. Volterrani
Exercise training, as a part of a comprehensive rehabilitation program, is currently recommended in combination with pharmacological therapy in patients with chronic heart failure. Benefits of exercise training that have been evidenced by scientific literature include improvements in various aspects of physiological function, aerobic exercise capacity and quality of life. Despite exercise training has been included in European and American guidelines as class IA recommendation, at least three important aspects need to be clarified. First of all, the effectiveness of exercise training in improving long term prognosis of patients with chronic heart failure still remains a debatable point. Secondly, the majority of studies have investigated the effects of a particular modality of exercise: continuous aerobic training performed at mild to moderate intensity. On the contrary, the effects of other exercise modalities such as intermittent training, resistance training or hydrotherapy on chronic heart failure haven’t been fully understood yet. Finally, patients included in clinical trials evaluating the effects of exercise training are, almost exclusively, those with reduced ejection fraction. Consequently very few data are, until now, available with regard to subjects with heart failure with preserved ejection fraction. This article summarizes the evidences and mechanisms by which exercise training can improve symptoms of heart failure. Moreover, it underlines current limits of knowledge in the prescription of exercise training in patients with chronic heart failure.
{"title":"Exercise Training in Heart Failure, Clinical Evidences and Areas of Uncertainty","authors":"G. Caminiti, C. Fossati, D. Battaglia, S. Selli, Deborah Fortuna, M. Volterrani","doi":"10.17554/J.ISSN.2309-6861.2015.03.108","DOIUrl":"https://doi.org/10.17554/J.ISSN.2309-6861.2015.03.108","url":null,"abstract":"Exercise training, as a part of a comprehensive rehabilitation program, is currently recommended in combination with pharmacological therapy in patients with chronic heart failure. Benefits of exercise training that have been evidenced by scientific literature include improvements in various aspects of physiological function, aerobic exercise capacity and quality of life. Despite exercise training has been included in European and American guidelines as class IA recommendation, at least three important aspects need to be clarified. First of all, the effectiveness of exercise training in improving long term prognosis of patients with chronic heart failure still remains a debatable point. Secondly, the majority of studies have investigated the effects of a particular modality of exercise: continuous aerobic training performed at mild to moderate intensity. On the contrary, the effects of other exercise modalities such as intermittent training, resistance training or hydrotherapy on chronic heart failure haven’t been fully understood yet. Finally, patients included in clinical trials evaluating the effects of exercise training are, almost exclusively, those with reduced ejection fraction. Consequently very few data are, until now, available with regard to subjects with heart failure with preserved ejection fraction. This article summarizes the evidences and mechanisms by which exercise training can improve symptoms of heart failure. Moreover, it underlines current limits of knowledge in the prescription of exercise training in patients with chronic heart failure.","PeriodicalId":92802,"journal":{"name":"Journal of clinical cardiology and cardiovascular therapy","volume":"156 1","pages":"473-482"},"PeriodicalIF":0.0,"publicationDate":"2016-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91385656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-01-01DOI: 10.17554/J.ISSN.2309-6861.2016.03.101-2
Marcelle Guerra, Thabata Pidori Igreja, T. D. Carvalho, V. Valenti, L. D. Abreu, Talita Dias da Silva, D. Garner, R. Raimundo
INTRODUCTION: Heart rate variability (HRV) is a noninvasive method that analyzes fluctuations of intervals between heartbeats and it is related to the influences of the autonomic nervous system during weaning. AIM: To describe the behavior of cardiac autonomic modulation during the weaning process. METHOD: A search was conducted in PubMed. Initially 206 articles were found. After restriction search we identified 28 potentially eligible publications. TOPIC HIGHLIGHT Heart Rate Variability During Weaning Mechanical Ventilation Marcelle Guerra, Thabata Pidori Igreja, Tatiana Dias de Carvalho, Vitor Engracia Valenti, Luiz Carlos de Abreu, Talita Dias da Silva, David M. Garner, Rodrigo Daminello Raimundo 519 Journal of Cardiol Ther 2016 June; 3(3): 519-523 ISSN 2309-6861(print), ISSN 2312-122X(online) Online Submissions: http://www.ghrnet.org/index./jct/ doi:10.17554/j.issn.2309-6861.2016.03.101-2 Journal of Cardiology and Therapy aldosterone system, thermoregulation and the peripheral vasomotor tone. The LF/HF ratio reflects the absolute and relative changes between the sympathetic and parasympathetic components of the ANS, by characterizing the sympathetic-vagal balance on the heart[7,8]. Although the predictors of delayed extubation cannot be defined easily, the ability to identify high-risk patients and preand perioperative risk factors may help to develop surgical and medical modifications which will allow earlier extubation[5]. Weaning from mechanical ventilation to spontaneous breathing is associated with changes in the hemodynamic and autonomic nervous systems that are reflected by heart rate variability. Although cardiac dysrhythmias are an important manifestation of hemodynamic alterations, the impact of heart rate variability during weaning has not been specifically studied[9]. This research on HRV for weaning patients becomes important because its assessment during this process can provide information on pathophysiological imbalances reflected in the success or failure of weaning thus avoiding the re-intubation of patients. In this sense, we aimed to describe the behavior of the cardiac autonomic modulation during the weaning process.
简介:心率变异性(HRV)是一种分析心跳间隔波动的无创方法，它与断奶期间自主神经系统的影响有关。目的:探讨断奶过程中心脏自主神经调节的行为。方法:在PubMed中进行检索。最初发现了206篇文章。经过限制检索，我们确定了28篇可能符合条件的出版物。题目重点脱机机械通气期间心率变动性Marcelle Guerra, Thabata Pidori Igreja, Tatiana Dias de Carvalho, Vitor Engracia Valenti, Luiz Carlos de Abreu, Talita Dias da Silva, David M. Garner, Rodrigo Daminello Raimundo [19] Journal of Cardiol, 2016年6月;《心脏学与治疗》杂志(doi:10.17554/j.issn.2309-6861.2016.03.101-2)。醛固酮系统、体温调节与外周血管舒缩性张力。LF/HF比值通过表征心脏交感-迷走神经平衡，反映了ANS交感神经和副交感神经组分之间的绝对和相对变化[7,8]。虽然延迟拔管的预测因素不能轻易定义，但识别高危患者以及术前和围手术期危险因素的能力可能有助于制定手术和医学修改，从而允许更早地拔管[5]。从机械通气到自主呼吸的断奶与血液动力学和自主神经系统的变化有关，这些变化由心率变异性反映出来。虽然心律失常是血流动力学改变的重要表现，但尚未对断奶期间心率变异性的影响进行专门研究[9]。这项关于脱机患者HRV的研究非常重要，因为在这一过程中对HRV的评估可以提供脱机成功或失败所反映的病理生理失衡的信息，从而避免患者再次插管。在这个意义上，我们的目的是描述在断奶过程中心脏自主调节的行为。
{"title":"Heart Rate Variability During Weaning Mechanical Ventilation: Guerra M et al . Heart Rate Variability During Weaning Mechanical Ventilation","authors":"Marcelle Guerra, Thabata Pidori Igreja, T. D. Carvalho, V. Valenti, L. D. Abreu, Talita Dias da Silva, D. Garner, R. Raimundo","doi":"10.17554/J.ISSN.2309-6861.2016.03.101-2","DOIUrl":"https://doi.org/10.17554/J.ISSN.2309-6861.2016.03.101-2","url":null,"abstract":"INTRODUCTION: Heart rate variability (HRV) is a noninvasive method that analyzes fluctuations of intervals between heartbeats and it is related to the influences of the autonomic nervous system during weaning. AIM: To describe the behavior of cardiac autonomic modulation during the weaning process. METHOD: A search was conducted in PubMed. Initially 206 articles were found. After restriction search we identified 28 potentially eligible publications. TOPIC HIGHLIGHT Heart Rate Variability During Weaning Mechanical Ventilation Marcelle Guerra, Thabata Pidori Igreja, Tatiana Dias de Carvalho, Vitor Engracia Valenti, Luiz Carlos de Abreu, Talita Dias da Silva, David M. Garner, Rodrigo Daminello Raimundo 519 Journal of Cardiol Ther 2016 June; 3(3): 519-523 ISSN 2309-6861(print), ISSN 2312-122X(online) Online Submissions: http://www.ghrnet.org/index./jct/ doi:10.17554/j.issn.2309-6861.2016.03.101-2 Journal of Cardiology and Therapy aldosterone system, thermoregulation and the peripheral vasomotor tone. The LF/HF ratio reflects the absolute and relative changes between the sympathetic and parasympathetic components of the ANS, by characterizing the sympathetic-vagal balance on the heart[7,8]. Although the predictors of delayed extubation cannot be defined easily, the ability to identify high-risk patients and preand perioperative risk factors may help to develop surgical and medical modifications which will allow earlier extubation[5]. Weaning from mechanical ventilation to spontaneous breathing is associated with changes in the hemodynamic and autonomic nervous systems that are reflected by heart rate variability. Although cardiac dysrhythmias are an important manifestation of hemodynamic alterations, the impact of heart rate variability during weaning has not been specifically studied[9]. This research on HRV for weaning patients becomes important because its assessment during this process can provide information on pathophysiological imbalances reflected in the success or failure of weaning thus avoiding the re-intubation of patients. In this sense, we aimed to describe the behavior of the cardiac autonomic modulation during the weaning process.","PeriodicalId":92802,"journal":{"name":"Journal of clinical cardiology and cardiovascular therapy","volume":"208 1","pages":"519-523"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74445238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-12-10DOI: 10.17554/J.ISSN.2309-6861.2015.02.99
A. Innocenti, Chiara Giampietro, J. Fusi, F. Galetta, F. Franzoni, O. Giampietro
Over the past decades, the prevalence of the metabolic syndrome (MetS), a health condition identified by a cluster of risk factors linked to the development of cardiovascular disease, type 2 diabetes mellitus and some types of cancer, has dramatically increased in the world. The rising of MetS incidence and progression appear related to Westernization of dietary habits in the world, with a corresponding increase in the consumption of meat or meat products, snacks, baked desserts and sugar-sweetened beverages not only in the Western countries, but also in the Mediterranean region and among the Eastern populations. Otherwise epidemiological evidence suggests that a high dietary intake of fruits, vegetables, fish and whole grains can improve all the risk factors related to MetS. Particularly adherence to the Mediterranean diet seems to have positive effects on the prevalence and progression of the MetS. In this article we reviewed cohort studies, cross-sectional studies and clinical trials, showing new evidence supporting the beneficial role of adherence to the Mediterranean dietary pattern on the MetS progression. Analysis of the literature suggests that Mediterranean diet should be considered as a healthy and sustainable lifestyle playing a key role in primary and secondary prevention of MetS and its components.
{"title":"Can Mediterranean Diet Counteract Metabolic Syndrome Diffusion","authors":"A. Innocenti, Chiara Giampietro, J. Fusi, F. Galetta, F. Franzoni, O. Giampietro","doi":"10.17554/J.ISSN.2309-6861.2015.02.99","DOIUrl":"https://doi.org/10.17554/J.ISSN.2309-6861.2015.02.99","url":null,"abstract":"Over the past decades, the prevalence of the metabolic syndrome (MetS), a health condition identified by a cluster of risk factors linked to the development of cardiovascular disease, type 2 diabetes mellitus and some types of cancer, has dramatically increased in the world. The rising of MetS incidence and progression appear related to Westernization of dietary habits in the world, with a corresponding increase in the consumption of meat or meat products, snacks, baked desserts and sugar-sweetened beverages not only in the Western countries, but also in the Mediterranean region and among the Eastern populations. Otherwise epidemiological evidence suggests that a high dietary intake of fruits, vegetables, fish and whole grains can improve all the risk factors related to MetS. Particularly adherence to the Mediterranean diet seems to have positive effects on the prevalence and progression of the MetS. In this article we reviewed cohort studies, cross-sectional studies and clinical trials, showing new evidence supporting the beneficial role of adherence to the Mediterranean dietary pattern on the MetS progression. Analysis of the literature suggests that Mediterranean diet should be considered as a healthy and sustainable lifestyle playing a key role in primary and secondary prevention of MetS and its components.","PeriodicalId":92802,"journal":{"name":"Journal of clinical cardiology and cardiovascular therapy","volume":"42 1","pages":"452-455"},"PeriodicalIF":0.0,"publicationDate":"2015-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89840151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-12-10DOI: 10.17554/J.ISSN.2309-6861.2015.02.100
A. Mandal
This editorial summarizes available data on the efficacy of diuretic strategies given by bolus or as continuous infusion in congestive heart failure (CHF). Either mode of diuretic therapy helps in relieving congestion. Question remains unresolved whether continuous infusion is more efficacious compared to bolus diuretic in preserving renal function and reducing re-hospitalization rate. In author’s study continuous bumetanide infusion in CHF is very effective in producing large volume of urine, rendering symptomatic relief and preserving or even improving renal function. Long term study in a large number of patients could answer re-hospitalization rate and mortality.
{"title":"Prospect of Bumetanide Infusion in Treatment of Congestive Heart Failure","authors":"A. Mandal","doi":"10.17554/J.ISSN.2309-6861.2015.02.100","DOIUrl":"https://doi.org/10.17554/J.ISSN.2309-6861.2015.02.100","url":null,"abstract":"This editorial summarizes available data on the efficacy of diuretic strategies given by bolus or as continuous infusion in congestive heart failure (CHF). Either mode of diuretic therapy helps in relieving congestion. Question remains unresolved whether continuous infusion is more efficacious compared to bolus diuretic in preserving renal function and reducing re-hospitalization rate. In author’s study continuous bumetanide infusion in CHF is very effective in producing large volume of urine, rendering symptomatic relief and preserving or even improving renal function. Long term study in a large number of patients could answer re-hospitalization rate and mortality.","PeriodicalId":92802,"journal":{"name":"Journal of clinical cardiology and cardiovascular therapy","volume":"37 1","pages":"449-451"},"PeriodicalIF":0.0,"publicationDate":"2015-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79391709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-12-10DOI: 10.17554/J.ISSN.2309-6861.2015.02.98
K. Santo, J. Chalmers, C. Chow, J. Redfern
Coronary heart disease (CHD) is the leading cause of death worldwide. Despite the overwhelming evidence of the benefits of preventive care, many patients with CHD fail to receive and adhere to the guideline recommendations, inclufding lifestyle advice and evidence-based cardiovascular medication. Prevention programmes such as cardiac rehabilitation can improve adherence to these recommendations and therefore, reduce hospitalisation and mortality, and improve quality of life. However, such programmes are under-utilised due to a number of barriers. These barriers can be overcome with the use of mobile technologies to deliver healthcare, called mHealth. In this review, we discuss the potential use of mHealth in a variety of medical conditions and we highlight some promising applications in CHD prevention.
{"title":"m-Health in Coronary Disease Preventive Care.","authors":"K. Santo, J. Chalmers, C. Chow, J. Redfern","doi":"10.17554/J.ISSN.2309-6861.2015.02.98","DOIUrl":"https://doi.org/10.17554/J.ISSN.2309-6861.2015.02.98","url":null,"abstract":"Coronary heart disease (CHD) is the leading cause of death worldwide. Despite the overwhelming evidence of the benefits of preventive care, many patients with CHD fail to receive and adhere to the guideline recommendations, inclufding lifestyle advice and evidence-based cardiovascular medication. Prevention programmes such as cardiac rehabilitation can improve adherence to these recommendations and therefore, reduce hospitalisation and mortality, and improve quality of life. However, such programmes are under-utilised due to a number of barriers. These barriers can be overcome with the use of mobile technologies to deliver healthcare, called mHealth. In this review, we discuss the potential use of mHealth in a variety of medical conditions and we highlight some promising applications in CHD prevention.","PeriodicalId":92802,"journal":{"name":"Journal of clinical cardiology and cardiovascular therapy","volume":"76 1","pages":"459-464"},"PeriodicalIF":0.0,"publicationDate":"2015-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85402059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-12-10DOI: 10.17554/J.ISSN.2309-6861.2015.02.96
M. Vieira, T. Hussain, C. A. Figueroa
Despite major advances in the understanding of congenital heart disease, the clinical decision-making process is still based on consensus opinion of experts, small prospective and retrospective studies, or registries. Furthermore, because the decision process is mainly supported by empirical data from cohorts of patients with similar conditions, it might not reflect the individual subject nor does it allow making predictions on the outcome in response to a variety of therapeutic options. In response to this need, the new paradigm of “predictive personalized medicine” postulates the use of computational tools that integrate patient-specific medical imaging (as well as other measurements) to simulate and quantify physiologic and pathophysiologic function of the cardiovascular system. The ultimate goal is to perform a subject-specific hemodynamic assessment and, when applicable, to predict the outcome of alternative treatment plans for an individual patient. In this article, we review image-based computational modeling in congenital heart disease. We remark that closer interactions between bioengineers and clinicians, and dedicated cross-disciplinary training are crucial to bridge the gap between image-based modeling and daily clinical scenarios.
{"title":"Patient-Specific Image-Based Computational Modeling in Congenital Heart Disease: A Clinician Perspective","authors":"M. Vieira, T. Hussain, C. A. Figueroa","doi":"10.17554/J.ISSN.2309-6861.2015.02.96","DOIUrl":"https://doi.org/10.17554/J.ISSN.2309-6861.2015.02.96","url":null,"abstract":"Despite major advances in the understanding of congenital heart disease, the clinical decision-making process is still based on consensus opinion of experts, small prospective and retrospective studies, or registries. Furthermore, because the decision process is mainly supported by empirical data from cohorts of patients with similar conditions, it might not reflect the individual subject nor does it allow making predictions on the outcome in response to a variety of therapeutic options. In response to this need, the new paradigm of “predictive personalized medicine” postulates the use of computational tools that integrate patient-specific medical imaging (as well as other measurements) to simulate and quantify physiologic and pathophysiologic function of the cardiovascular system. The ultimate goal is to perform a subject-specific hemodynamic assessment and, when applicable, to predict the outcome of alternative treatment plans for an individual patient. In this article, we review image-based computational modeling in congenital heart disease. We remark that closer interactions between bioengineers and clinicians, and dedicated cross-disciplinary training are crucial to bridge the gap between image-based modeling and daily clinical scenarios.","PeriodicalId":92802,"journal":{"name":"Journal of clinical cardiology and cardiovascular therapy","volume":"17 1 1","pages":"436-448"},"PeriodicalIF":0.0,"publicationDate":"2015-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83462651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-12-10DOI: 10.17554/J.ISSN.2309-6861.2015.02.103
F. Cacciapuoti
Some epidemiological reports showed a significant association between the increased homocysteine serum levels (H-Hcy) and risk of ischemic cardiovascular disease (CVD). Acetyl-Salicylic Acid (ASA) is the drug commonly used to antagonize pro-thrombotic effect of Hcy. But, human and animal studies evidenced that ASA, given at habitual anti-ischemic dosage, may induce an incomplete inhibition of platelet (aspirin-resistance) in patients with CVD Hcy-related by several mechanisms. In these patients, doses higher than normal are requested to obtain an optimal ASA-response (aspirin-sensitivity). That happens because Hcy “per se” is a pro-aggregatory agent and acts as specific sensitizer of blood platelets with several mechanisms. On the contrary, its acetylated form (N-acetyl-homocysteine) obtained using high ASA doses, is able to reverse this effect restoring the platelets’ sensitivity. That happens with a still unknown mechanism.
{"title":"Sub-Optimal Response to ASA in Cardiovascular Ischemia Homocysteine-Related","authors":"F. Cacciapuoti","doi":"10.17554/J.ISSN.2309-6861.2015.02.103","DOIUrl":"https://doi.org/10.17554/J.ISSN.2309-6861.2015.02.103","url":null,"abstract":"Some epidemiological reports showed a significant association between the increased homocysteine serum levels (H-Hcy) and risk of ischemic cardiovascular disease (CVD). Acetyl-Salicylic Acid (ASA) is the drug commonly used to antagonize pro-thrombotic effect of Hcy. But, human and animal studies evidenced that ASA, given at habitual anti-ischemic dosage, may induce an incomplete inhibition of platelet (aspirin-resistance) in patients with CVD Hcy-related by several mechanisms. In these patients, doses higher than normal are requested to obtain an optimal ASA-response (aspirin-sensitivity). That happens because Hcy “per se” is a pro-aggregatory agent and acts as specific sensitizer of blood platelets with several mechanisms. On the contrary, its acetylated form (N-acetyl-homocysteine) obtained using high ASA doses, is able to reverse this effect restoring the platelets’ sensitivity. That happens with a still unknown mechanism.","PeriodicalId":92802,"journal":{"name":"Journal of clinical cardiology and cardiovascular therapy","volume":"7 1","pages":"456-458"},"PeriodicalIF":0.0,"publicationDate":"2015-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76744820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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