Cardiovascular disease is the leading cause of death in women. Decades of grassroots campaigns have helped to raise awareness about the impact of cardiovascular disease in women, and positive changes ...affecting women and their health have gained momentum. Despite these efforts, there has been stagnation in the overall reduction of cardiovascular disease burden for women in the past decade. Cardiovascular disease in women remains understudied, under-recognised, underdiagnosed, and undertreated. This Commission summarises existing evidence and identifies knowledge gaps in research, prevention, treatment, and access to care for women. Recommendations from an international team of experts and leaders in the field have been generated with a clear focus to reduce the global burden of cardiovascular disease in women by 2030. This Commission represents the first effort of its kind to connect stakeholders, to ignite global awareness of sex-related and gender-related disparities in cardiovascular disease, and to provide a springboard for future research.
The Topic Collection opens up with a systematic review and meta-analysis from Suebsaicharoen et al entitled ‘Comparative cardiovascular outcomes of novel drugs as an addition to conventional triple ...therapy for heart failure with reduced ejection fraction (HFrEF): a network meta-analysis of randomized controlled trials’.4 The researchers compared the effects of different combinations of conventional HF therapies BB, MRA, ACEI/ARBs and novel agents, ARNI, SGLT-2is, soluble guanylate cyclase, omecamtiv mecarbil and ivabradine, on time to occurrence of the primary endpoint of cardiovascular death or HF hospitalisation to define an optimal combination. ...the Topic Collection includes the editorial from Carolyn Thomas, ‘Heart failure: it’s time to finally change the F-word’, which represents the patient’s voice and addresses the problem of patients’ perception of the term heart failure. AHA/ACC/HFSA guideline for the management of heart failure: a report of the American college of cardiology/American heart Association joint committee on clinical practice guidelines.
La enfermedad cardiovascular constituye la principal causa de muerte en el mundo; a su vez, la preeclampsia es la principal causa de muerte materna en el mundo. Los trastornos hipertensivos del ...embarazo enmarcados por la preeclampsia, se traducen en consecuencias que pueden ser inmediatas, como incremento en la morbilidad y mortalidad materna y perinatal; sin embargo, sus implicaciones van más allá y se estima que su presentación contribuye al desarrollo posterior de enfermedad cardiovascular incluso años después del embarazo. En ese orden, se debe considerar la preeclampsia como una alerta para la salud de la mujer, implementar herramientas de prevención que impacten en factores de riesgo modificables y recomendar la adquisición de estilos de vida saludable con el objetivo de evitar la aparición de enfermedad cardiovascular a futuro y la mortalidad por esta causa. En este artículo se revisará la asociación entre preeclampsia y enfermedad cardiovascular a la luz de la evidencia actual.
Patients with heart failure with reduced ejection fraction (HFrEF) have a high residual risk of adverse outcomes, even when treated with optimal guideline‐directed medical therapy and in a clinically ...stable state. Soluble guanylate cyclase (sGC) stimulators have the potential to lower this risk by modifying the nitric oxide–sGC–cyclic guanosine monophosphate cascade – a pathophysiological pathway that has been targeted with limited success in HFrEF previously. Vericiguat, an sGC stimulator, was shown to improve outcomes in patients with HFrEF in the VICTORIA (Vericiguat Global Study in Subjects with Heart Failure with Reduced Ejection Fraction) trial. However, this trial included patients with recently worsening disease. In this brief review, we discuss the rationale of evaluating sGC stimulators in lower‐risk HFrEF patients. First, all key HFrEF medications have been evaluated in both higher‐ and lower‐risk populations, and the treatment effect is not always consistent across the risk spectrum. Second, pre‐clinical studies and post‐hoc studies of the VICTORIA trial have suggested that sGC stimulators may have cardioprotective effects – these effects may be more apparent when the medication is initiated earlier in the disease process. Third, the effect of vericiguat on cardiovascular mortality remains uncertain and a trial with a longer follow‐up in a lower‐risk population may allow better assessment of its effect on cardiovascular mortality. Therefore, there is a pertinent need to investigate the effects of vericiguat in optimally treated, low‐risk HFrEF patients (i.e. those without recently worsening heart failure).
Rationale to evaluate the efficacy of soluble guanylate cyclase (sGC) stimulators in heart failure with reduced ejection fraction (HFrEF) without recent worsening. CV, cardiovascular; VICTORIA, Vericiguat Global Study in Subjects with Heart Failure with Reduced Ejection Fraction.
Tuberculosis and the Heart López-López, José Patricio; Posada-Martínez, Edith L; Saldarriaga, Clara ...
Journal of the American Heart Association,
04/2021, Letnik:
10, Številka:
7
Journal Article
Recenzirano
Odprti dostop
Acquired tuberculosis continues to be a challenge worldwide. Although tuberculosis has been considered a global public health emergency, it remains poorly controlled in many countries. Despite being ...primarily a pulmonary disease, tuberculosis could involve the heart. This systematic review is part of the "Neglected Tropical Diseases and Other Infectious Diseases Involving the Heart" (the NET-Heart Project) initiative from the Interamerican Society of Cardiology. This project aims to review the cardiovascular involvement of these heterogeneous diseases, advancing original algorithms to help healthcare providers diagnose and manage cardiovascular complications. In tuberculosis, pericardium involvement is relatively common, especially in AIDS, and tuberculosis is the most common cause of constrictive pericarditis in endemic countries. Myocarditis and aortitis by tuberculosis are rare. Clinical manifestations of cardiovascular involvement by tuberculosis differ from those typically found for bacteria or viruses. Prevailing systemic symptoms and the pericarditis diagnostic index should be taken into account. An echocardiogram is the first step for diagnosing cardiovascular involvement; however, several image modalities can be used, depending on the suspected site of infection. Adenosine deaminase levels, gamma interferon, or polymerase chain reaction testing could be used to confirm tuberculosis infection; each has a high diagnostic performance. Antituberculosis chemotherapy and corticosteroids are treatment mainstays that significantly reduce mortality, constriction, and hospitalizations, especially in patients with HIV. In conclusion, tuberculosis cardiac involvement is frequent and could lead to heart failure, constrictive pericarditis, or death. Early detection of complications should be a cornerstone of overall management.
Resumen El registro RECOLFACA es la primera aproximación que se realiza en Colombia sobre el perfil clínico y demográfico de los pacientes con falla cardiaca, e incluye instituciones de gran parte ...del territorio nacional. Esta información es de gran relevancia ya que permitirá caracterizar la población y servir como base para diseñar políticas públicas que ofrezcan una mejor atención en salud a esta población. Este importante proyecto epidemiológico, llevado a cabo por el Capítulo de Falla Cardíaca, Trasplantes e Hipertensión Pulmonar de la Sociedad Colombiana de Cardiología y Cirugía Cardiovascular, es pionero en la evaluación de las enfermedades cardiovasculares en Colombia y, adicionalmente, servirá como modelo para la evaluación de otras enfermedades.
Insuficiencia cardiaca en la mujer Saldarriaga, Clara I
Revista colombiana de cardiología (Bogotá, Colombia : 1989),
January 2018, Letnik:
25
Journal Article
Recenzirano
Odprti dostop
Resumen Introducción la insuficiencia cardiaca es una enfermedad de alta prevalencia; se estima que el 50% de los casos que se presentan en el mundo corresponden a mujeres. Objetivos revisar los ...conceptos actuales que señalan las diferencias en la epidemiología, la presentación clínica, el tratamiento y el pronóstico de la insuficiencia cardiaca en la mujer. Metodología: se realizó una revisión sistemática de la literatura mediante las bases de datos PUBMED, EMBASE y SciELO. Resultados las mujeres presentan con mayor frecuencia cardiopatía no isquémica; la cardiopatía periparto surge como una etiología única del sexo femenino, en la que las mujeres se clasifican comúnmente en clase funcional avanzada y tienen peor calidad de vida a pesar de una menor mortalidad. Conclusiones la insuficiencia cardiaca en la mujer representa un reto para los sistemas de salud. Tradicionalmente la mujer ha tenido una representación pobre en los ensayos clínicos y existen barreras para acceder a la atención en salud.
Neglected tropical diseases (NTDs) are a group of infections that are prevalent in many of the tropical and sub-tropical developing countries where poverty is rampant. NTDs have remained largely ...unnoticed in the global health agenda. There is a substantial gap between the burden of disease for NTDs in cardiovascular diseases (CVD) and research devoted to the affected populations. We created a Latin-American initiative with emerging leaders (EL) from the Interamerican Society of Cardiology (IASC) with the objective to perform multiple systematic reviews of NTDs and other infectious diseases affecting the heart: The NET-Heart Project.
To describe the rationale and design considerations of the NET-Heart project.
The NET-Heart Project is a collaborative work of the IASC EL program. The main objective of the NET-Heart project is to systematically evaluate the available evidence of NTDs and other infectious diseases and their cardiovascular involvement. As a secondary objective, this initiative aims to offer recommendations and potential diagnostic and therapeutic algorithms that can aid the management of cardiovascular complications of these infectious diseases. After an expert discussion 17 initial infectious diseases were selected, for each disease we created one working group. The project was structured in different phases: Systematic review, brainstorming workshops, analysis and results, manuscript writing and recommendations and evaluation of clinical implications.
The NET-Heart project is an innovative collaborative initiative created to assess burden and impact of NTDs and other infectious diseases in CVD. NTDs can no longer be ignored and must be prioritised on the health and research agenda. This project aims to review in depth the evidence regarding cardiac compromise of these serious conditions and to propose strategies to overcome barriers for efficient diagnosis and treatment of cardiovascular complications.
MitraClip implantation has been reported in severe mitral regurgitation following ischemic papillary muscle rupture in surgically high-risk patients with cardiogenic shock. Here we present a case of ...a 68-year-old female patient who suffered an ischemic papillary muscle rupture resulting in severe mitral prolapse and had a MitraClip implanted. Three months later, due to progressive symptoms, she was taken to surgery and had an elective minimally invasive mitral valve replacement. Informed consent was given and ethics board approval was obtained.
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