Review Articles

Several gene mutations in ryanodine receptors, affecting channel gating, have been associated with certain arrhythmias and cardiomyopathy. In this review, the authors highlight the role of the ryanodine receptor, a Ca2+-release channel, in the pathogenesis of fatal arrhythmia and heart failure. They discuss also the possibility of this receptor as a new therapeutic target.

Although vaccination has so far been used mainly for infectious disease, the varied roles of the immune system in atherosclerosis present the possibility of a vaccine being developed against this prevalent disease. Here, Shah and colleagues discuss some of the background and advances being made in this field.

Morbidity and mortality are high for chronic heart failure despite therapeutic advances, but the options are not exhausted. Ulf Landmesser and Helmut Drexler present an overview of heart failure therapy and summarize the major research being done to find new ways forward.

The introduction of drug-eluting stents has revolutionized interventional cardiology. The uptake of this technology has been rapid and widespread, but the long-term data are strikingly few. In this review, an overview is presented of the studies done so far and the emerging information on safety and efficacy. Future directions for this intervention are also discussed.

The relation between obesity and cardiovascular risk factors is well documented, and risks include hypertension, cardiac remodeling and lipid disturbances. The weight loss outcomes achieved with bariatric surgery can eliminate or ameliorate such cardiovascular effects. Blackburn and Mun present the evidence for cardiovascular benefits seen with this advancing therapy.

Various cardioprotective effects seen with ischemic preconditioning and postconditioning have been documented. The application of these methods in clinical practice is not, however, straightforward because of issues with timing and the need for further elucidation of mechanisms. This review discusses whether implementation in clinical practice is feasible.

This review presents an overview of MRI for assessment of the myocardium. This method is becoming popular for the study of morphology, function, perfusion and ischemia because data on various different biological parameters can be gathered from the same area within the same scanning session simply through changes to the software.

Despite ventricular septal defects being more common than atrial septal defects, fewer trials have been done of transcatheter closure. The available results do, however, suggest positive results with low complication rates. Douglas S Moodie provides in this review an overview of current applications of transcatheter closure for membranous, perimembranous and muscular ventricular septal defects.

Statins are potent inhibitors of cholesterol synthesis and can reduce the risk of cardiovascular disease and strokes in high-risk patients. As discussed here, evidence suggests that statins, in addition to their lipid-lowering capacities, have nonlipid-mediated or pleiotropic roles in stroke prevention.

The management of atrial fibrillation, the most frequent sustained arrhythmia in humans, aims to reduce symptoms and to minimize the risk of thromboembolic events, such as strokes. This review compares and contrasts the rhythm-control and the rate-control approach for treating patients with this arrhythmia.

Risk factors identified by the Framingham Heart Study are useful for assessing a person's risk of cardiovascular disease; however, additional risk factors are needed. In this review, the potential role of lipoprotein-associated phospholipase A₂as a novel inflammatory marker for cardiovascular risk assessment is discussed.

Although excessive epicardial fat increases the work of pumping, this visceral fat depot is important source of free fatty acids and various bioactive molecules, and constitutes a metabolically active organ. Iacobelliset al. discuss its role, in the context of regional fat distribution, in cardiac pathology and the assessment of cardiac disease.

As defibrillator therapy is invasive and expensive, using a defibrillator as primary prevention therapy requires risk stratification to identify suitable patients at significant risk. In this review Antonis A Armoundaset alevaluate whether clinical data support the use of microvolt T-wave alternans testing to identify patients who are unlikely to benefit from primary prevention implantable cardioverter-defibrillator therapy.

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.

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.

Shear stress plays an essential part in the maintenance of healthy blood vessels, and locations of low shear stress can create predilection sites for eccentric plaque growth. This review discusses the mechanobiologic mechanisms related to shear stress that might have a role in plaque rupture.

Anticoagulation is a necessary part of interventional cardiology, despite the associated bleeding risks. In this review, Martin T Rothman presents an overview of how the various anticoagulant drugs weigh up against one another when used in combination with percutaneous coronary intervention.

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.

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.

Revascularization is currently recommended for patients with unprotected left main coronary artery disease. In this review, Chieffo and Colombo discuss the safety and effectiveness of percutaneous interventions involving drug-eluting stents as an alternative approach for treating this disease.