Health sciences articles within Nature Reviews Cardiology

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  • Review Article |

    Detection of fetal conduction system abnormalities relies upon magnetocardiographic or electrocardiographic recording techniques. Appropriate fetal treatment requires awareness of arrhythmia characteristics, mechanisms, and their potential associations. This Review discusses current and future diagnostic techniques and pharmacologic treatments for fetal arrhythmia.

    • Janette F. Strasburger
    •  & Ronald T. Wakai

  • Review Article |

    Atrial fibrillation (AF) is the most common cardiac arrhythmia. Early management of this disorder using imaging, antiarrhythmia drugs and catheter ablation is necessary to prevent the progression of AF. In this Review, the authors discuss the current status of important facets of the early management of AF and emphasize the need for a greater understanding of the underlying etiology, which will lead to novel treatment approaches and amelioration of AF.

    • Ashok J. Shah
    • , Xingpeng Liu
    •  & Michel Haïssaguerre

  • Review Article |

    Sudden cardiac death (SCD) is a serious health concern worldwide. Despite the need for risk factors that can identify high-risk individuals, there are few available owing to the complex and often asymptomatic nature of SCD. In this Review, Sumeet Chugh outlines novel risk markers and predictors of SCD that will allow more effective prevention, and suggests a framework for studies in the future for the discovery and validation of these risk markers.

    • Sumeet S. Chugh

  • Review Article |

    The number of patients undergoing implantation of a cardioverter-defibrillator (ICD) is increasing, as the indications for device therapy have broadened. Despite the mortality benefits associated with ICDs, they can also cause substantial complications. Drs. Wazni and Wilkoff explore the issues involved in managing patients with an ICD and discuss approaches for reducing these adverse effects, from prevention of infection, and the choice of lead and implantation technique, to strategies for programming and monitoring the device.

    • Oussama Wazni
    •  & Bruce L. Wilkoff

  • Review Article |

    This Review discusses the effects of intensive glycemic control on cardiovascular disease in patients with diabetes, and examines key factors in recent intervention trials that might have contributed to their disparate findings. The authors suggest that care of these patients should focus on achieving current treatment goals, rather than on changes to glycemic targets.

    • Aparna Brown
    • , L. Raymond Reynolds
    •  & Dennis Bruemmer

  • News & Views |

    A continuous-flow left ventricular assist device (LVAD) improved survival free from disabling stroke compared with a pulsatile LVAD, when used as destination therapy over a 2-year period in patients with advanced heart failure. Both devices improved patient quality of life. Continuous-flow devices are smaller, lighter, and more simple than pulsatile LVADs and have the potential to fulfill all the requirements of a permanently implanted blood pump.

    • Yukihiko Nosé

  • News & Views |

    Klersy et al. have performed a meta-analysis of remote monitoring of patients with heart failure. Programs using structured telephone support (telephone-monitoring approach) were combined with those using transmission of physiological data (technology-assisted approach) in combination with telephone communication. Results from this study may inform policy makers regarding a potential solution to reducing hospital readmissions.

    • Mary Ann McLaughlin

  • News & Views |

    Patients with structural heart disease are at risk for life-threatening ventricular tachycardias (VTs). Implantable cardioverter-defibrillators (ICDs) can terminate VT, but often at the cost of traumatic shocks, syncope, or even exacerbation of underlying heart disease. Catheter ablation for VT can reduce the need for ICD therapies and is an increasingly important adjunct to the treatment of these patients.

    • Usha B. Tedrow
    •  & William G. Stevenson

  • Review Article |

    Over the past 30 years, we have witnessed a steady improvement in life expectancy of patients with Marfan syndrome, owing to advances in various treatments. In Part 2 of a 2-part Review on Marfan syndrome, Dr. Cañadas and colleagues discuss the present the state of the art in the management of patients with this disease.

    • Victoria Cañadas
    • , Isidre Vilacosta
    •  & Valentin Fuster

  • Review Article |

    The cardiovascular manifestations of Marfan syndrome are the main cause of morbidity and mortality in patients with this disease. In Part 1 of a 2-part Review on Marfan syndrome, Dr Cañadas and colleagues discuss the pathogenesis of Marfan syndrome, our idea of which has dramatically changed in the past decade, as well as the current strategy for diagnosis.

    • Victoria Cañadas
    • , Isidre Vilacosta
    •  & Valentin Fuster

  • Opinion |

    Controversy exists as to whether the detection of myocardial edema, to quantify myocardial damage and assess myocardial salvage, is ready for clinical use or is still only practical as a research tool. In this Perspectives article, Matthias Friedrich explains his point of view on this issue—that myocardial edema imaging using magnetic resonance technology should be seen as the essential diagnostic modality of choice for patients with suspected myocardial injury by virtue of its safety, versatility, and cost-efficiency.

    • Matthias G. Friedrich

  • Review Article |

    Statin therapy has been associated with improved outcomes in patients with heart failure. However, two large prospective, controlled trials showed neutral effects with rosuvastatin. The authors of this Review highlight data from observational studies that have showed positive outcomes, and discuss how the design of the two large trials may have contributed to the neutral effects of statin therapy on the survival of patients with heart failure.

    • W. H. Wilson Tang
    •  & Gary S. Francis

  • Review Article |

    Imaging techniques that assess myocardial perfusion and coronary anatomy obtain complementary information. Simultaneous dual-modality or sequential multimodal imaging techniques facilitate integration of this information, and thus have the potential to improve diagnostic and prognostic evaluations, as well as care of patients. This Review discusses the clinical utility and future directions of hybrid imaging.

    • Ron Blankstein
    •  & Marcelo F. Di Carli

  • Review Article |

    Stress cardiomyopathy, or Takotsubo syndrome, is a transient and reversible disorder that occurs suddenly after emotional or physical stress. It displays symptoms similar to acute myocardial infarction and is found predominantly in postmenopausal women. The underlying cause is still unknown. In this Review, the authors describe the published data relating to stress cardiomyopathy and discuss the possible mechanisms of this cardiac entity.

    • Holger M. Nef
    • , Helge Möllmann
    •  & Christian W. Hamm

  • Review Article |

    The introduction of drug-eluting stents (DES) has greatly reduced in-stent restenosis. Improvements to this technology are required, however, as safety and efficacy are still a problem. This Review describes current DES and the methods that are being used to optimize the performance of these stents. The author also suggests the direction of DES in the future, including tailored therapy to improve patient outcomes.

    • Rainer Wessely

  • News & Views |

    Inflammation might be involved in the pathophysiology of atrial fibrillation. Glucocorticoid use can attenuate inflammation and might be an effective therapy for atrial fibrillation. However, some population-based studies have reported an increased risk of atrial fibrillation associated with glucocorticoid use. Whether this link results from a direct effect of glucocorticoids or from the underlying inflammatory disease remains to be elucidated.

    • Michiel Rienstra
    •  & Isabelle C. Van Gelder

  • News & Views |

    Aldosterone antagonists decrease the mortality of patients with heart failure, but an observational study by Albert and colleagues has found that a surprisingly low number of patients receive aldosterone antagonists before discharge from hospital. This article highlights potential reasons for why there is such an underuse of efficient drugs in heart failure.

    • Jane-Lise Samuel
    •  & Claude Delcayre

  • News & Views |

    A novel three-catheter radiofrequency ablation system has been reported to reduce procedure time, but maintain ablation success rates, in patients with persistent atrial fibrillation. The findings are promising; however, important limitations and concerns must be overcome before use of this system can be considered the standard-of-care for catheter treatment of persistent atrial fibrillation.

    • Vivek Reddy

  • News & Views |

    The two CHAMPION trials failed to show superiority of cangrelor (a rapid-acting, reversible intravenous platelet P2Y12 adenosine receptor antagonist) versus clopidogrel in patients with acute coronary syndromes undergoing percutaneous coronary intervention. The CHAMPION PCI trial, however, did show a significant reduction in death and stent thrombosis suggesting benefit in those without clopidogrel pretreatment.

    • David P. Faxon

  • Review Article |

    Although currently available anticoagulants, such as warfarin, can prevent stroke in patients with atrial fibrillation, the drug-related bleeding risk remains unacceptably high, and therapy could be contraindicated if the risk exceeds that for stroke. In this Review, Freek Verheugt assesses the performance of new anticoagulants that directly inhibit different stages of the coagulation cascade.

    • Freek W. A. Verheugt

  • Review Article |

    As part of our focus issue on atrial fibrillation, Dewire and Calkins review current strategies and emerging technologies for catheter ablation of patients with this arrhythmia. The authors also discuss the current clinical role of AF ablation in various high-risk groups of patients, such as the elderly and those with concomitant heart failure.

    • Jane Dewire
    •  & Hugh Calkins

  • Review Article |

    Atrial fibrillation (AF) has multifactorial intracardiac and extracardiac causes. Current development of anti-AF agents is focused on modulation of ion channel activity as well as on upstream therapies that reduce structural substrates. In this Review, Burashnikov and Antzelevitch examine new and emerging pharmacological approaches to rhythm control in patients with AF and summarize the available data on these drugs.

    • Alexander Burashnikov
    •  & Charles Antzelevitch

  • Review Article |

    Cell therapy could improve cardiac function in patients with coronary heart disease. In this article, the authors provide an overview of the clinical trials in this field and highlight the limitations of cardiac cell therapy. They also discuss how these issues are being addressed and what the future may hold for this therapy.

    • Kai C. Wollert
    •  & Helmut Drexler

  • Review Article |

    Sudden cardiac arrest causes more than 60% of all deaths from cardiovascular disease. In this Review, Adabag and colleagues discuss trends in the incidence of sudden cardiac death (SCD), and the risk factors and triggers of this devastating event. The authors also highlight the lack of a concise definition for SCD and suggest that prospective community surveillance programs, using multiple sources to identify cases, would enable more accurate determination of SCD burden. They also review the growing evidence for the role of public-access defibrillators in improving survival after sudden cardiac arrest.

    • A. Selcuk Adabag
    • , Russell V. Luepker
    •  & Bernard J. Gersh

  • News & Views |

    Defibrillators, with or without cardiac resynchronization therapy, can reduce the rate of sudden death. However, shocks are unpleasant, often unnecessary, and can damage myocardium or defibrillator leads, thereby increasing morbidity and mortality and detracting from the benefits of this therapy. Conservative programming of devices may reduce such risks.

    • John G. F. Cleland
    •  & Laszlo Buga

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