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In this Review, the authors discuss the utilization of multiple, high spatial resolution contrast weightings for thein vivoassessment of carotid atherosclerotic disease. Although 'carotid MRI' is presently an established imaging tool dedicated to research, the burgeoning data from prospective studies has placed it at the precipice of translation to clinical practice.
In this Review, the authors discuss innovations in ventricular assist devices technology as an alternative therapeutic option for patients with advanced heart failure. In particular, they focus on the newer, third-generation VADs that are currently being developed for mechanical cardiac support.
The incidence of prehypertension and hypertension among children and adolescents is rising as a result of the epidemic of youth overweight and obesity. Brian McCrindle addresses this important public health problem by reviewing the evaluation and management aspects of this condition that are specific to infants, children, and adolescents.
Plaque macrophages account for the majority of leukocytes in atherosclerotic plaques, and are believed to differentiate from monocytes recruited from circulating blood. In this Review, Dr Woollard and Dr Geissmann discuss the heterogenous population of monocytes involved in the pathogenesis of atherosclerosis.
Amiodarone effectively maintains sinus rhythm in patients with atrial fibrillation, and although dronedarone is less effective it has a better safety profile. The choice of antiarrhythmic drug (or nonpharmacological strategy) depends on the ultimate goal of therapy, which should be considered in the context of the patient's clinical presentation and the treatment tailored to the individual.
The Carillon system is a percutaneously delivered, coronary-sinus-based mitral annuloplasty device. A safety and feasibility trial now demonstrates low rates of major adverse events, with improvements in quality of life. Though promising, this report raises important questions related to relative efficacy and durability compared with other relevant therapies, and related to current clinical indications.
Stroke is the leading cause of morbidity and mortality in patients with atrial fibrillation. Whereas warfarin reduces the risk of stroke, its interactions with other drugs and food, individual differences in its efficacy and the need for frequent monitoring make its use inconvenient. Dabigatran etexilate might represent a step forward in the care of patients with atrial fibrillation.
Clinical trial data, including those from MADIT-CRT, support the use of cardiac resynchronization therapy in patients with asymptomatic and mildly symptomatic heart failure and ventricular dyssynchrony. However, important questions remain about which of these patients benefit most from this therapy.
