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In this Perspectives article, Captur et al. explain the fundamental principles of fractal geometry, and summarize cardiovascular studies in which fractal methods have been used to investigate disease mechanisms. The authors propose that clinical researchers can deploy innovative fractal solutions to common cardiac problems, which might ultimately translate into advancements in patient care.
Takotsubo syndrome is often thought to be the result of catecholamine-mediated myocardial stunning triggered by emotional or physiological stress. In this Perspectives article, Kastaun and colleagues discuss the latest studies evaluating the psychoneuroendocrinological and psychosocial mechanisms underlying the pathophysiology of Takotsubo syndrome.
In this Perspectives article, Ormerod et al. propose that dynamic left ventricular systolic dysfunction provoked by obstruction in hypertrophic cardiomyopathy is a manifestation of inefficient cardiac energy utilization. This mid-systolic drop in left ventricular Doppler ejection velocities has been termed the 'lobster claw abnormality'. Energy insufficiency is also present in nonobstructive hypertrophic cardiomyopathy, and this paradigm might suggest novel therapies.
Diagnosis and treatment in patients with an aborted cardiac arrest (ACA) pose a challenge for cardiologists, because the underlying causes of ACA and the appropriate therapies are varied. In this Perspectives article, Schwartz and Dagradi offer their view on how genetics is shaping the management of survivors of ACA, and discuss the importance of genetic testing for the protection of these patients and their families.
Renal denervation for the treatment of drug-resistant hypertension has been studied extensively in the past few years. Although early trials reported dramatic reductions in blood pressure after renal denervation, later trials testing denervation against a sham procedure showed neutral results. In this Perspectives article, Gulati and colleagues suggest potential reasons why results from these early trials could not be replicated, and summarize the current available trial data, newly designed devices, and recommendations for future trial design.
