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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.
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.
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.
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.
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.
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.
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.
