Reviews & Analysis

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  • Heart failure is increasingly thought to be a myocyte deficiency disease. Therapeutic strategies to increase the number of cardiac muscle cells by direct transplantation are being met with a mixture of enthusiasm and caution. While conceptually attractive, however, the success of this approach remains unproven. The evidence to date is discussed.

    • Noel M Caplice
    • Arjun Deb
    Review Article
  • An inverse correlation exists between the plasma concentration of HDLs and the incidence of cardiovascular disease. The harnessing of this beneficial effect has been explored as a new approach for treatment. In this review, the range of beneficial effects and the methods being developed for the delivery of therapy are explored.

    • MM Thompson
    • SC Reed
    • GW Cockerill
    Review Article
  • Chronic delayed cerebral vasospasm has a major impact on morbidity and mortality related to aneurysmal subarachnoid hemorrhage. Reduced concentrations of endothelium-derived NO, an important vasodilator, and increased levels of endothelin-1, one of the most potent vasoconstrictors, are important contributory factors. This review discusses the relevant mechanisms in cerebral vasospasm.

    • Agustinus Suhardja
    Review Article
  • Despite treatment being available for angina in the form of β-blockers and calcium-channel blockers, these drugs are contraindicated in some patients. PharmacologicalIfinhibition could prove a promising alternative for protection from angina through heart-rate slowing. This review discusses the early mechanisms and early clinical use of ivabradine as a specific bradycardic agent.

    • Jeffrey S Borer
    Review Article
  • A shortage of donors limits the use of heart transplantation. Despite various efforts to widen selection criteria and increase availability, the collective epidemiologic impact on donor-organ shortage has been relatively small. Approaches to date and possible ways forward, including a balance between organs and mechanical assistance, are discussed.

    • Jonathan M Chen
    • Yoshifumi Naka
    • Eric A Rose
  • Relationships between atrial fibrillation and obesity, sleep apnea and C-reactive protein have only recently been recognized. In this case, an obese patient with a history of atrial fibrillation was diagnosed with concomitant sleep apnea and elevated C-reactive protein. Having exhausted various possibilities of cardiological intervention and seemingly destined for catheter-based pulmonary vein isolation, the patient finally achieved rhythm control through weight loss. This study illustrates linkage of these conditions, discussing current therapeutic options and exploring possible pathophysiologic connections.

    • Mina K Chung
    • Nancy Foldvary-Schaefer
    • Paul J Wang
    Case Study
  • Interruption or blocking of renin-angiotensin-aldosterone systems can reverse cardiac fibrosis and hypertensive vascular remodeling, and improve hypertensive left-ventricular hypertrophy. Local, possibly cellular, renin-angiotensin-aldosterone systems are thought to participate in the pathogenesis of vascular disease, but their roles are not yet fully explained. This review explores the evidence of such actions.

    • Richard N Re
    Review Article
  • In Marfan's syndrome, connective-tissue alterations promote aortic aneurysm and dissection. Despite advances in understanding the causes, treatments are still based on old protocols. The pathophysiology of aneurysm formation and progression is, however, being elucidated by new genetic data, discussed here, which might aid the advancement of therapy for Marfan-related aneurysm.

    • Francesco Ramirez
    • Harry C Dietz
    Review Article
  • The underlying electrophysiological mechanisms of cardiac arrhythmias remain unclear. Consequently, therapy is difficult, and for the worst arrhythmias is frequently ineffective. This review looks at the accumulating evidence for various emerging mechanisms of cardiac arrhythmias, with focus on selected ionic currents, stretch-activated phenomena and connexins.

    • Robert F Gilmour Jr
    • Douglas P Zipes
    Review Article
  • Given the high risk of sudden death or myocardial infarction associated with atherosclerosis, frequently with no previous symptoms, techniques to better identify high-risk plaques might help lower morbidity and mortality. In this review, various biological markers are suggested as targets for imaging to aid risk assessment.

    • Michael J Lipinski
    • Valentin Fuster
    • Zahi A Fayad
    Review Article
  • A positive relationship between salt and hypertension is well documented. Salt seems also to adversely affect cardiac structure and function independently from its influence on arterial pressure. This review discusses clinical and experimental evidence for an association between increased sodium consumption and cardiac structural and functional changes and raised cardiovascular risk.

    • Edward D Frohlich
    • Jasmina Varagic
    Review Article