Review Articles

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  • Developments in the interpretation of blood pressure curves have enabled assessment of pressure-wave reflections and arterial stiffness in the vascular system. These measurements can be translated into assessment of cardiovascular risk, enabling new features of cardiovascular disease and new drug treatments to be investigated. Here, the structural and functional factors that influence arterial stiffness are discussed.

    • Jacques Blacher
    • Michel E Safar
    Review Article
  • Alterations in β-adrenergic-receptor signal transduction play a major part in the development of heart failure. Although pharmacologic and device-based therapy can lessen morbidity and mortality, better understanding of these mechanisms should improve outcomes. Much of the current understanding of β-adrenergic signaling pathways and polymorphisms is summarized in this review.

    • David S Feldman
    • Cynthia A Carnes
    • Michael R Bristow
    Review Article
  • Patients who receive most types of modern prosthetic heart valve are currently also given long-term, low-intensity anticoagulation therapy to reduce the risk of thromboembolic complications. In this review, the authors discuss the current recommendations for anticoagulation therapy and the data on which these recommendations are based.

    • Detlef Hering
    • Cornelia Piper
    • Dieter Horstkotte
    Review Article
  • Patients with systemic lupus erythematosus are at a high risk of developing premature atherosclerosis and cardiovascular disease, but the mechanisms responsible for this are not fully understood. This review discusses traditional and lupus-specific risk factors that are likely to be involved, and outlines how risk assessments should be included in effective management of this disease.

    • Sahena Haque
    • Ian N Bruce
    Review Article
  • Mutations inSCN5A, the gene encoding the α subunit of the cardiac sodium channel, are associated with a number of cardiac rhythm syndromes, including Brugada syndrome. This review discusses the genotypic and phenotypic characteristics, cellular mechanisms, diagnosis and management of Brugada syndrome.

    • Wataru Shimizu
    • Takeshi Aiba
    • Shiro Kamakura
    Review Article
  • Shear stress plays an essential part in the maintenance of healthy vessels. If risk factors for atherosclerosis are present, low shear stress can lead to abnormalities, possibly creating predilection sites for eccentric plaque growth. The role of shear stress in the development of plaque prone to rupture is explored.

    • CJ Slager
    • JJ Wentzel
    • PW Serruys
    Review Article
  • Multislice CT, with 16, 32 or 64 rows per image, can provide an image quality that has improved the noninvasive diagnosis of disorders such as atherosclerotic plaque or coronary anomalies. This review summarizes the main data available and, despite various remaining confounding factors to image quality, calls for guidelines.

    • Torsten Beck
    • Christof Burgstahler
    • Stephen Schroeder
    Review Article
  • Despite improvements in therapy, sudden cardiac death still poses a major problem for cardiovascular patients. In very high-risk patients, half of premature deaths are sudden. Certain inotropic drugs can increase the risk of death, but mechanical devices can provide prophylactic benefits. Winslowet al. sum up the major issues and challenges in this review.

    • Robert D Winslow
    • Davendra Mehta
    • Valentin Fuster
    Review Article
  • Patients with long QT syndrome can experience life-threatening arrhythmias and related mortality is high among symptomatic, untreated people. Identification of several responsible genes and their effects on ion channels has advanced understanding of this disorder. Here, Peter Schwartz reviews how these discoveries have, or have not, modified management and changed the direction of research.

    • Peter J Schwartz
    Review Article
  • Cardiovascular complications, including cardiomyopathy and cardiac arrhythmias, are frequently seen in patients with muscular dystrophies. This review discusses the pathogenesis of the main forms of muscular dystrophy and focuses on how appropriate management of these disorders can improve the function, well being and longevity of patients.

    • Elizabeth M McNally
    • Heather MacLeod
    Review Article
  • Macrophage foam cells have important roles in physiological processes, including atherogenesis and lipoprotein metabolism, but they are also fundamental for the development and progression of atherosclerosis. As we understand more about the biology of these cells, therapeutic approaches for atherosclerosis that target macrophage foam cells are becoming a reality, as discussed in this review.

    • Robin P Choudhury
    • Justin M Lee
    • David R Greaves
    Review Article
  • Cyclo-oxygenase 2 inhibitors, although offering gastrointestinal benefits, seem to have an adverse cardiovascular risk profile. The nature of this risk is still desperately underinvestigated. Given the recent withdrawals of certain agents from the US market, this review attempts to pull together the major data available so far and asks where studies should go next.

    • Gary Spektor
    • Valentin Fuster
    Review Article
  • Coronary artery bypass grafting can now be performed without the use of the cardiopulmonary bypass pump, a technique known as “off-pump” coronary bypass. Despite data from nonrandomized retrospective trials showing a benefit to the off-pump technique, skepticism remains. This review discusses the evidence to date, focusing on data from prospectively randomized studies.

    • Thoralf M Sundt
    Review Article
  • Patients with insulin resistance syndromes are at an increased risk of developing cardiovascular disease. This review discusses the relationship between insulin resistance and heart disease, and describes how aggressive risk factor management and multifactoral treatment approaches are being used to improve the clinical outcomes of these patients.

    • Stuart A Cook
    • Tim Aitman
    • Rossi P Naoumova
    Review Article
  • In children born with only one ventricle, the systemic and pulmonary venous blood mixes. The Fontan operation, by which the blood flows through the creation of a serial arrangement in which no ventricle interposes, has become the procedure of choice. The development of this therapy and the current issues associated with it are discussed here.

    • Marc R de Leval
    Review Article
  • The importance of easy bedside investigations at an early stage is undeniable. Therefore, the introduction of hand-held ultrasound devices in settings such as the primary bedside diagnosis of patients is a welcome advance. The approaches to training, best use and reimbursement to aid this technology's introduction are discussed.

    • Bruce J Kimura
    • Anthony N DeMaria
    Review Article