Review Articles

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  • After becoming established as a therapy for various anemic states, wider uses—including cardiovascular therapy—are being explored for erythropoietin. The possible mechanisms for actions in the cardiovascular and renal systems are explored in this Review, showing that the therapeutic benefits of this cytokine seem much broader than initially anticipated.

    • Danilo Fliser
    • Ferdinand H Bahlmann
    • Hermann Haller
    Review Article
  • Use of MRI to track cell migration to target tissue, such as after stem cell transplantation in heart failure, offers a potential new way to monitor treatment. Most data come from preclinical studies but suggest a role for this technique in humans. This Review discusses the suitability of various contrast agents and labelling methods.

    • Walter J Rogers
    • Craig H Meyer
    • Christopher M Kramer
    Review Article
  • A single definition for the metabolic syndrome is not forthcoming since discussion of its forms and causes is continuing. Genetic causes and onset of the syndrome in relation to triggering genetic–environment interactions have been suggested. In this Review, the currently available knowledge about the most common purported genetic causes is drawn together.

    • Rebecca L Pollex
    • Robert A Hegele
    Review Article
  • In healthy adult hearts approximately 70% of energy is obtained from fatty acids; the balance comes from lactate, pyruvate and ketones. The pattern of substrate use is altered in failing hearts. This Review discusses substrate use and the possible benefits of using metabolic agents to cause a shift away from fatty acids as the main substrate.

    • Khalid Abozguia
    • Kieran Clarke
    • Michael Frenneaux
    Review Article
  • The severity of left ventricular dilatation and remodeling represents one of the strongest predictors of mortality. Prevention, reversal, or both of left ventricular remodeling therefore constitute crucial parts of therapy in many cases. Along with pharmacologic therapies various surgical procedures are available. In this Review, the most common surgical options for left ventricular remodeling are discussed.

    • Michele De Bonis
    • Ottavio Alfieri
    Review Article
  • In the no-reflow phenomenon, blood flow to an infarcted area can be markedly reduced by destruction of the microvasculature or blockage of vessels by microemboli, despite an open infarct-related artery. Minimization of the affected area is important to improve outcomes. Data are presented in this Review on causes and therapies.

    • Hiroshi Ito
    Review Article
  • Despite LDL-cholesterol targets being lowered several times in recent years, are they low enough? New data continue to be published showing that LDL lowering should be a primary target of therapy, with the possibility of simultaneously raising HDL cholesterol. Wiviott and Cannon bring together the extensive data to provide an update.

    • Stephen D Wiviott
    • Christopher P Cannon
    Review Article
  • Many protein kinases are positioned proximal to critical proteins that mediate cell function. Since these functions can be altered by disease, attention has turned to protein kinases as therapeutic targets. In this Review, the role of protein kinases in myocardial disease, and the pharmacologic therapy possibilities they present are discussed.

    • Mark E Anderson
    • Linda S Higgins
    • Howard Schulman
    Review Article
  • In this Review, Amish Desai, Cindy Fuller, Jill Jesurum and Mark Reisman discuss the possible link between patent foramen ovale and cryptogenic stroke, treatment options for prevention of paradoxical embolism related to patent foramen ovale and the controversial association between patent foramen ovale and migraine headaches.

    • Amish J Desai
    • Cindy J Fuller
    • Mark Reisman
    Review Article
  • Although mechanical circulatory support has been used in children for many years, the development of implantable devices and improvements in extracorporeal support have provided viable options for bridging to transplantation or even to recovery. Hetzer and Stiller share their experience with the technology and techniques and discuss the decision-making processes.

    • Roland Hetzer
    • Brigitte Stiller
    Review Article
  • Clopidogrel is widely used during percutaneous coronary intervention and to treat acute coronary syndromes. Nonresponsiveness and variability in responsiveness to clopidogrel therapy have been noted in numerous studies, and could put some patients at risk of repeat thrombotic events. The possible mechanisms and ways to overcome poor response to clopidogrel are discussed here.

    • Paul A Gurbel
    • Udaya S Tantry
    Review Article
  • Since the ventricles share a common septum, interaction between them is inevitable. Performance of each ventricle is influenced by the compliance, filling volume and pressure of the other, as well as by external constraints from the pericardium. In this review, the role of direct diastolic ventricular interaction is explored in various cardiovascular disorders.

    • Lynne Williams
    • Michael Frenneaux
    Review Article
  • Despite imaging advances, diagnosis of infective endocarditis is not simple, and uncertainty about whether a surgical or nonsurgical approach is best and the timing of intervention can hamper therapy. In this Review, Saptarsi Haldar and Patrick O'Gara discuss the major features of diagnosis and therapy and make recommendations based on the available data.

    • Saptarsi M Haldar
    • Patrick T O'Gara
    Review Article
  • Improvement is still needed in the diagnosis of renal artery stenosis, which is the most common treatable cause of secondary hypertension. An accurate functional and morphological characterization of the disease might assist in management of patients. The value of magnetic resonance angiography in this setting is discussed.

    • Santo Dellegrottaglie
    • Javier Sanz
    • Sanjay Rajagopalan
    Review Article
  • More than 80% of the US elderly population dies from coronary heart disease, but the benefits of statin therapy are not realized. These drugs are frequently underprescribed to elderly patients because few relevant age-specific data are available. This Review draws together the findings from major studies and assesses the value of statin use in the elderly.

    • O Christopher Raffel
    • Harvey D White
    Review Article
  • Many changes are taking place in terms of the devices and techniques available to perform heart valve repair and replacement. Advances have meant that interest has been raised in percutaneous and minimally invasive valvular interventions. This review outlines the evolution of and possible future for this subspecialty.

    • Vasilis Babaliaros
    • Alain Cribier
    • Carla Agatiello
    Review Article
  • Atrial fibrillation is the most common cause of arrhythmia, but the reason it occurs is not always apparent. Despite many efforts, the molecular basis for atrial fibrillation is still unclear. Genetic features of the disorder are, however, being elucidated. Robert Roberts provides here an overview of the major mutation findings so far.

    • Robert Roberts
    Review Article
  • An accurate, noninvasive method of imaging the heart and coronary arteries has long been elusive. Multidetector row CT, however, seems a likely candidate to fill this gap. This modality can be safely used to obtain high-quality images in seconds. Michael Poon provides an update on the advances in the development of this technology.

    • Michael Poon
    Review Article
  • Left ventricular dyssynchrony can lead to adverse cardiac effects, particularly if left untreated. Dyssynchrony can be improved by cardiac resynchronization therapy, but accurate diagnosis of the disorder is essential to obtain good results. Here, Bleeker et al. present an overview of the causes, diagnostic techniques and management in heart failure patients.

    • Gabe B Bleeker
    • Jeroen J Bax
    • Ernst E van der Wall
    Review Article
  • Angiotensin-converting-enzyme blockade therapy is useful in many cardiovascular disorders. Since atrial fibrillation is frequently associated with such disorders, these drugs might also be beneficial in its primary and secondary prevention. The available data for these indications are, however, supportive rather than definitive. This review summarizes the major findings and calls for randomized, placebo-controlled trials.

    • Samuel Lévy
    Review Article