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Advances in Cardiology
Kanu Chatterjee, Phillip A Horwitz
1:
Advances in Understanding of Pathophysiology and Management of Diastolic Heart Failure
INTRODUCTION
Definition of Diastolic Heart Failure
CLINICAL DEFINITION
How Common is Diastolic Heart Failure?
THE RISK FACTORS
PATHOPHYSIOLOGY
DIAGNOSIS
MANAGEMENT
CONCLUSION
2:
Cardiovascular Pharmacogenetics
INTRODUCTION
PRINCIPLES OF PHARMACOGENETICS
HMG-CoA REDUCTASE INHIBITORS
Low-Density Lipoprotein Cholesterol Lowering
ABCB1
ABCG2
HMGCR
APOE
Other Loci
Reduction in Cardiovascular Events
Musculoskeletal Side Effects
SLCO1B1
Adherence to Statin Therapy
Clinical Implications
THIENOPYRIDINES
Laboratory Response to Clopidogrel
CYP2C219
ABCB1
P2RY12
CYP2C9
CES1
Clinical Response to Clopidogrel
CYP2C19
Additional Loci: ABCB1, P2RY12, CES1
Clinical Implications
ASPIRIN
WARFARIN
Laboratory Response to Warfarin
CYP2C9
VKORC1
CYP4F2
Other Loci
Clinical Response to Warfarin
Clinical Implications
DIURETICS
Blood Pressure-Lowering Response
Clinical Outcomes
BETA-BLOCKERS
Heart Rate/Blood Pressure Reduction, Improvement in Ventricular Function
CYP2D6
ADRB1
ADRB2
GRK5
Clinical Benefit in Patients with Cardiovascular Disease
ADRB1
ADRB2
GRK5
Adverse Events
Clinical Implications
ANTIARRHYTHMIC DRUGS
Digoxin and Calcium-Channel Blockers
Procainamide
Propafenone
Clinical Implications
CONCLUSION AND FUTURE DIRECTIONS
3:
Advances in Clinical Lipidology
INTRODUCTION
GENETICS
LIPID METABOLISM
EPIDEMIOLOGY
RISK ASSESSMENT AND BIOMARKERS
C-Reactive Protein
Low-Density Lipoprotein Cholesterol and Lipoprotein (a)
Advanced Lipid Testing
High-Density Lipoprotein Cholesterol
Other Biomarkers
RISK ASSESSMENT AND IMAGING FOR SUBCLINICAL ATHEROSCLEROSIS
Carotid Intima-Medial Thickness
Coronary Artery Calcium
CURRENT THERAPIES
Diet
Statins
Ezetimibe
Niacin
Fibrates
Omega-3 Fatty Acids
Pioglitazone
EMERGING THERAPIES
Lomitapide
Mipomersen
Monoclonal Antibody to PCSK9 (AMG 145 and REGN727)
Cholesteryl Ester Transfer Protein Inhibitors
Apo A-I Inducers
SUMMARY
4:
Advances in Peripheral Arterial and Aortic Diseases
INTRODUCTION
LOWER EXTREMITY PERIPHERAL ARTERY DISEASE
Epidemiology
Pathophysiology
Diagnosis
Medical Treatment
Risk Factor Modification
Antiplatelet Therapy
Symptomatic Relief of Claudication
Exercise Therapy
Treatment of Acute Limb Ischemia
Treatment of Critical Limb Ischemia
Advances in Endovascular Treatment of Peripheral Artery Disease
Aortoiliac Disease
Femoropopliteal Disease
Infrapopliteal Disease
Chronic Total Occlusions and Calcified Lesions
Biological Therapy for Peripheral Artery Disease
SUBCLAVIAN ARTERY DISEASE
CEREBROVASCULAR DISEASE
Revascularization for Extracranial Carotid Disease
Carotid Artery Stenting versus Carotid Endarterectomy
Vertebral Artery Disease
RENAL ARTERIAL DISEASE
Renal Artery Stenting versus Medical Treatment
Renal Denervation for Resistant Hypertension
MESENTERIC ISCHEMIA
Chronic Mesenteric Ischemia
Acute Mesenteric Ischemia
AORTIC ANEURYSM AND DISSECTION
Abdominal Aortic Aneurysm
Endovascular versus Open Surgical Repair
New Endovascular Techniques for Challenging Anatomy
Thoracic and Thoracoabdominal Aortic Aneurysms
Endovascular versus Open Surgical Repair of Descending Thoracic and Thoracoabdominal Aortic Aneurysms
Preserving Perfusion of Aortic Branches During TEVAR
Aortic Dissection
CONCLUSION
ACKNOWLEDGMENTS
5:
Stem Cell and Gene Therapy in Cardiology
ABSTRACT
INTRODUCTION
TYPES OF STEM CELLS
Embryonic Stem Cells
Induced Pluripotent Stem Cells
Skeletal Myoblasts
Bone Marrow-derived Stem Cells
Mesenchymal Stem Cells
Cardiac Stem Cells
STEM CELL CLINICAL TRIALS
Bone Marrow-derived Mononuclear Stem Cell Clinical Trials
Acute Myocardial Infarction
Chronic Heart Failure and Ischemic Cardiomyopathy
Refractory Angina
Mesenchymal Stem Cell Clinical Trials
Acute Myocardial Infarction
Chronic Heart Failure and Ischemic Cardiomyopathy
Cardiac Stem Cell Clinical Trials
Acute Myocardial Infarction
Chronic Heart Failure and Ischemic Cardiomyopathy
ROUTES OF ADMINISTRATION
MECHANISMS OF ACTION
CONCLUSION
MECHANISM OF ACTION
LIMITATIONS OF VIRAL DELIVERY VECTORS
Nonimmune Response Limitations
Immune Response Limitations
POTENTIAL CLINICAL TARGETS
NOVEL APPROACHES
CONCLUSION
6:
Endovascular Treatment of Acute Stroke: Advances and Disappointments
INTRODUCTION
LIMITATIONS OF INTRAVENOUS TISSUE PLASMINOGEN ACTIVATOR
TECHNIQUES OF ENDOVASCULAR RECANALIZATION IN ACUTE STROKE
CLINICAL BENEFIT, BRAIN AT RISK AND TIME TO REPERFUSION
INTRA-ARTERIAL PHARMACOLOGIC THROMBOLYSIS
FIRST GENERATION THROMBECTOMY DEVICES
CLINICAL IMPACT OF ISCHEMIC PENUMBRA IMAGING AND ENDOVASCULAR INTERVENTION STUDIES
SECOND GENERATION THROMBECTOMY DEVICES: STENT RETRIEVERS
RANDOMIZED TRIALS OF ENDOVASCULAR THERAPY FOR ACUTE STROKE
Endovascular Therapy versus Intravenous Tissue Plasminogen Activator in Tissue Plasminogen Activator Eligible Patients
Intravenous Tissue Plasminogen Activator versus Intravenous Tissue Plasminogen Activator and Endovascular Treatment
Imaging Ischemic Penumbra and Outcomes with Thrombectomy versus Standard Care
LIMITATIONS OF ENDOVASCULAR THERAPY TRIALS AND LESSONS LEARNED
7:
Recent Advances in Percutaneous Structural Heart Interventions
INTRODUCTION
ADVANCES IN VALVULAR HEART DISEASE MANAGEMENT
Transcatheter Aortic Valve Replacement for Aortic Stenosis
Transcatheter Aortic Valve Replacement in Nonsurgical Patients
Transcatheter Aortic Valve Replacement versus Surgery in High-risk Patients
Valve-in-valve Transcatheter Aortic Valve Replacement
Percutaneous Pulmonary Valve Replacement
Percutaneous Therapies for Mitral Regurgitation
Direct Percutaneous Mitral Valve Repair
Percutaneous Mitral Valve Annuloplasty
Transcatheter Mitral Valve Replacement
ADVANCES IN NONVALVULAR STRUCTURAL HEART DISEASE
Percutaneous Patent Foramen Ovale Closure
Patent Foramen Ovale Closure for Cryptogenic Stroke
Patent Foramen Ovale Closure for Migraine Headache
Patent Foramen Ovale Closure for Other Indications
Left Atrial Appendage Closure for Stroke Prevention
Percutaneous Left Ventricular Volume Reduction
SUMMARY
8:
Advances in Catheter-Based Treatment of Coronary Artery Disease
INTRODUCTION
ADVANCES IN STENT TECHNOLOGY
Newer Generation Stents
ADVANCES IN PHARMACOTHERAPY
Anti-Platelet Therapy
Clopidogrel Resistance
Newer Anti-Platelet Agents
Anti-Thrombotic Therapy
ADVANCES IN CORONARY LESION ASSESSMENT
Intravascular Ultrasound and Virtual Histology
Optical Coherence Tomography
Fractional Flow Reserve
ADVANCES IN APPLICATIONS OF PCI
Multi-vessel CAD
Unprotected Left Main PCI
Bifurcation Lesions
Saphenous Vein Grafts
Chronic Total Occlusions
ST-Elevation Myocardial Infarction
APPROPRIATENESS OF PCI
CONCLUSION
9:
Cardiac Computed Tomography: Technical Advancements and Future Applications
INTRODUCTION
ENGINEERING AND POSTPROCESSING IMPROVEMENTS
RADIATION
ANATOMICAL VERSUS FUNCTIONAL DIAGNOSIS OF CORONARY DISEASE
CARDIAC CT PERFUSION IMAGING
CARDIAC CT AND RISK STRATIFICATION OF ACUTE CHEST PAIN
CARDIAC CT IN RISK STRATIFICATION OF STABLE CHEST PAIN
CARDIAC CT AND DIASTOLIC DYSFUNCTION
CARDIAC CT AND SYSTOLIC DYSFUNCTION
CARDIAC CT AND CORONARY ALLOGRAFT VASCULOPATHY
CARDIAC CT AND EVALUATION OF VALVE DISEASE
CONCLUSION
10:
Advances in the Treatment of Arrhythmias
ADVANCES IN IMPLANTABLE CARDIAC DEVICES
Cardiac Pacing
Pacing Mode Selection
Sinus Node Dysfunction
Atrioventricular Block
Alternative Ventricular Pacing Sites
Cardiac Resynchronization Therapy
Future Developments in Cardiac Pacing
Implantable Cardioverter-Defibrillator Therapy
Magnetic Resonance Imaging Compatible Devices
Remote Monitoring
ATRIAL FIBRILLATION
Catheter Ablation
Key Mechanistic Considerations that Define Current Atrial Fibrillation Ablation Strategies
Ablation Strategies
New Ablation Technologies
Efficacy and Safety of Atrial Fibrillation Ablation
Current Recommendations
Pharmacological Rhythm and Rate Control
Novel Oral Anticoagulants
INDEX
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