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Cardiac transplantation research has focused on predicting risk and determining pathogenic pathways, and hence finding targets for intervention. As the Human Genome Project is now ready to provide the information required for personalized treatment, this Viewpoint discusses genetic association studies and their potential application at different stages before and after cardiac transplantation.
Many decisions about whether patients with coronary artery stenosis should undergo revascularization are made on the basis of angiography alone. Complementary diagnostic information would be useful, particularly for patients who have multivessel disease. This commentary by Bernard De Bruyne weighs the merits of fractional flow reserve to provide such information.
The role of the rennin–angiotensin system was previously thought to be restricted to the cardiovascular system, but important roles in other tissues are coming to light. This review concentrates on this system's effects on hematopoiesis and presents a discussion of the clinical relevance and possible therapeutic applications in this context.
The need for improved prevention of sudden cardiac death has led physicians to increase the use of implantable cardioverter-defibrillators. Despite data now being available from a variety of studies, how to identify patients who will benefit most from this invasive and expensive therapy is still unclear. Here, the impact of findings on clinical decision-making is explored.
The integrity of the endothelium can be damaged in various ways, making the formation of atherosclerotic lesions possible. The source of cells involved in endothelial repair and smooth-muscle accumulation in lesions has been debated, but data suggest progenitor cells as a likely origin. Their role in the pathogenesis of atherosclerosis is discussed here.
Cardiovascular disease is a major concern in elderly adults, particularly in those with age-related reductions in renal function. Physicians are often cautious when prescribing therapy because of the perceived frailty of older patients and limited understanding of adverse effects. This review tackles the issue of prescribing considerations in elderly patients with concomitant renal and cardiovascular disease.
