Review Articles in 2014

Asian individuals have a higher risk of stroke associated with atrial fibrillation (AF) than white patients. The use of the vitamin K antagonist warfarin is low in Asian countries, owing to the challenge of controlling anticoagulation and the high-risk of haemorrhage with warfarin in Asians. The non-vitamin K antagonist, oral anticoagulant drugs offer a solution to these challenges. In this article, Sabir et al. discuss the use of these agents in the management of AF in Asian populations.

Left cardiac sympathetic denervation (LCSD) has antiarrhythmic and antifibrillatory effects that are beneficial for patients with channelopathies, such as long QT syndrome or catecholaminergic polymorphic ventricular tachycardia. In this Review, Peter Schwartz expertly summarizes the development and current indications for LCSD, including emerging evidence for a potential beneficial effect in patients with ischaemic cardiomyopathy or heart failure.

The use of multipotent stem cells to achieve regeneration in cardiovascular disease has been the subject of continuous evaluation over the past decade. Dr Behfar and colleagues review experience obtained from trials of 'first-generation' cell-based therapy, and discuss the advances that have enabled the development of 'next-generation' stem-cell-based therapies targeting cardiovascular disease.

The term 'athlete's heart' refers to the plethora of electrical, structural, and functional cardiac adaptations that occur in athletes undertaking vigorous training regimens. The manifestations of cardiac adaptation to exercise can resemble the signs of cardiac disease that precede sudden cardiac death. Differentiation between athlete's heart and cardiac pathology presents a challenge for physicians. In this Review, Sheikh and Sharma describe the impact of ethnicity on cardiac adaptation to exercise, with a focus on black athletes, and discuss the impact of ethnically mediated changes on preparticipation cardiovascular evaluation.

The prevalence of calcific aortic valve disease (CAVD) is increasing as the global population ages. In the absence of a specific drug therapy, the only treatment for CAVD is valve replacement. In this Review, Hutcheson et al. discuss the mechanisms of CAVD and identify potential therapeutic targets that warrant further investigation.

Transcatheter aortic valve implantation (TAVI) is increasingly used to treat patients with aortic stenosis for whom the risks associated with surgery are very high. In this Review, the new generation of TAVI devices are discussed, many of which have features that allow repositioning of the device and reduce paravalvular leakage.

A number of gene variants that cause hypercoagulability, and can lead to venous thromboembolism, have been identified. The two main mechanisms are loss-of-function of anticoagulant proteins and gain-of-function of procoagulants. In this Review, Ida Martinelli and colleagues discuss the main causes of inherited thrombophilia, the associated clinical manifestations, and the implications for screening and antithrombotic prophylaxis in affected individuals and their families.

Dystrophinopathies, such as Duchenne muscular dystrophy, Becker muscular dystrophy, and X linked dilated cardiomyopathy, can have cardiac sequelae. In this Review, Finsterer and Cripe discuss how the onset of cardiac involvement should be delayed in these patients, and then how it should be treated. The use of both pharmacological and nonpharmacological tools is described.

The coronary collateral circulation protects the myocardium when blood flow is reduced because of an occlusion. In this Review, Zimarino and colleagues discuss the development of collateral vessels through tissue remodelling. Collaterals and their underlying adaptative mechanisms are clinically important to modern interventional cardiology.