Review Articles in 2007

In this Review, Kathryn Taubert, Nathaniel Clark and Robert Smith explore the common features and risks of cardiovascular disease, cancer and diabetes—disease which together are responsible for more than 25 million deaths in the world each year. They examine the important role of cardiology health-care providers with regards to risks for other chronic conditions and occult disease.

In this instructive Therapy Insight, Dellegrottaglie et al. examine the role of magnetic resonance angiography (MRA) in the initial diagnosis and subsequent management of patients with peripheral arterial disease, comparing this technique with other diagnostic modalities. They explain, in simple terms, current MRA methodologies and ongoing technical improvements as they apply to the evaluation of lower extremity vessels.

Identifying high-risk individuals with hypertrophic cardiomyopathy is paramount as the first clinical expression is often the most devastating—sudden cardiac death. Miller and colleagues review the established or 'major' risk factors used to identify high-risk patients, and discuss the possible and future risk factors for hypertrophic cardiomyopathy-related sudden cardiac death.

Dietary quality is fundamental in the prevention of chronic disease. Here, Stephanie Chiuve and Walter Willett respond to the food guide MyPyramid, the most visible source of US nutrition policy and dietary guidance. They discuss why they feel MyPyramid fails to provide the public with clear information about healthy food choices, and assess the current evidence on diet and chronic diseases.

Rajamani and Chaturvedi examine the lessons learnt from landmark trials including NASCET and the ECST, which explored the role of carotid endarterectomy for ischemic stroke prevention in patients with symptomatic carotid artery stenosis. They go on to discuss the best perioperative medical treatment, the recommendations for patients with asymptomatic internal carotid artery stenosis, and the stroke risk after concomitant CABG surgery.

In addition to environmental factors, genetic variation exerts a sizeable, complex influence on lipoprotein phenotypes. Rebecca Pollex and Robert Hegele review recent progress on genomic variants and cholesterol metabolism, focusing on key, well-characterized genes that are determinants of plasma lipoproteins and have shown consistent results over the years, and discuss their potential utility in clinical cardiology.

Understanding the genetic basis of coronary heart disease (CHD) could refine cardiovascular risk stratification, facilitating the development of new therapies. Here Kullo and Ding focus on the genetics behind the clinical manifestations rather than the risk factors for CHD, and provide an update on the findings to date, the challenges faced and new techniques for identifying clinically relevant genetic determinants of CHD.

Hormones, growth factors, DNA-binding proteins and enzymes can all display intracrine functionality. Here Richard Re and Julia Cook examine the role intracrines have in the heart and vasculature, and argue that understanding the principles of intracrine physiology could help the development of more-effective therapeutic interventions in cardiovascular disease.

Four years on from JNC 7, William Elliott and Henry Black examine the epidemiology and attendant risks of prehypertension, and discuss the controversial issue of drug treatment for individuals with blood pressures in the prehypertensive range.

In the follow-up to their first article examining the evidence for a cardiomyopathy of obesity and the mechanisms behind this condition, Chiew Wong and Thomas Marwick evaluate possible pharmacologic and nonpharmacologic strategies for treating obesity cardiomyopathy in the context of currently understood mechanisms.

In this educational Surgery Insight, Dearani and colleagues draw on the extensive experience with septal myectomy as a surgical option for patients with obstructive hypertrophic cardiomyopathy gained at the Mayo Clinic, Rochester, MN, USA.

The causes of progression from an asymptomatic fi broatheromatous lesion to a high-risk vulnerable plaque are not fully understood, but data suggest that intraplaque hemorrhage could be critical in this process. Here, Jainet al. focus on angiogenesis and intraplaque hemorrhage in atherosclerotic lesion progression. They discuss evidence for the role of antiangiogenic agents in normalizing the immature vasculature and examine the obstacles faced in testing their hypothesis both in preclinical models and in humans.

The majority of strokes in patients with atrial fibrillation (AF) are caused by formation of thrombi in the left atrial appendage (LAA). Surgical closure the LAA orifice has emerged as a promising therapy for patients with AF at high risk of stroke, particularly those who are unable to tolerate oral anticoagulants. Here Tariqshah Syed and Jonathan Halperin discuss minimally invasive approaches to LAA occlusion and the future of these procedures in stroke prevention.

Myocardial changes associated with the obese state are increasingly recognized and, notably, are independent of hypertension, obstructive sleep apnea and coronary artery disease. In the first part of this two-part Review, Chiew Wong and Thomas Marwick examine the range of evidence supporting the existence of cardiomyopathy of obesity, and discuss the possible mechanisms.

Diagnosis and medical care of most aortic pathologies is frequently the responsibility of cardiologists. With the emergence of endovascular interventions, it is, therefore, increasingly important for cardiologists to gain confidence in managing at least the most-frequent presentations of aortic disease. Here, Hüseyin Ince and Christoph Nienaber review the etiology, pathophysiology and clinical management of patients with thoracic aortic aneurysm, in the context of the most recent literature.

Toll-like receptors are the primary innate immune receptors and could, therefore, be a key link between cardiovascular disease development and the immune system. Here, Stefan Frantz, Georg Ertl and Johann Bauersachs review this exciting field of research, and explore the evidence supporting a role for toll-like receptors in the pathophysiology of cardiovascular diseases.

Suitable vein or artery tissue is not always available for revascularization procedures. A small-diameter conduit with patency equivalent to that of native tissue is, therefore, the holy grail of vascular surgery. In this Technology Insight, L'Heureux et al. examine the evolution of tissue-engineered vascular grafts and the key challenges we face in the transition from innovation to widespread clinical use.

The RALES and EPHESUS trials have provided data demonstrating survival benefits with spironolactone and eplerenone in chronic and postinfarction heart failure, leading to more frequent and sometimes unbridled use of these drugs. Here Kalidindi et al. describe the likely mechanisms of action of aldosterone-receptor antagonists, discuss the evidence supporting their use, and provide practical advice.

The differentiation between acute ischemic stroke and intracerebral hemorrhage following cardiac surgery is critical in making appropriate treatment decisions. In this Technology Insight, Leary and Caplan examine the role of multimodal brain MRI in identifying and delineating the size and location of acute ischemic strokes and intracerebral hemorrhages.

The causes of transient ischemic attack (TIA) are identical to those for stroke; however, there are many unresolved issues regarding acute treatment for TIA. Here Mai Nguyen-Huynh and S Claiborne Johnston review the recent literature on stroke risk after TIA and the guidelines on evaluation and treatment.