Can low-carbohydrate diets be recommended for reducing cardiovascular risk?

Purpose Of Review: This review provides a rationale for implementing carbohydrate restriction as a dietary therapy to improve biomarkers of cardiovascular health and suggests that this will require a paradigm shift away from what is currently promulgated as a 'heart-healthy' diet.

Recent Findings: Type 2 diabetes mellitus (T2DM), metabolic syndrome, and related co-morbidities are major risk factors for cardiovascular disease (CVD). Ideally, then, a diet intended to support cardiovascular health should be one that improves or reverses these underlying risk factors.

An unusual case of infective endocarditis involving a right coronary artery to superior vena cava fistula.

Coronary artery fistulas (CAFs) are rare and mostly congenital anomalous connections between a coronary artery and a cardiac chamber or great vessel. Most CAFs are small, asymptomatic, and found incidentally during cardiac imaging. However, they can lead to serious complications including myocardial infarction, congestive heart failure, arrhythmias, or fistula rupture.

Aortic dissection and pericardial tamponade causing compression of the pulmonary arteries in a patient with prior cardiac surgery.

A patient with prior aortic valve surgery presented with aortic dissection and pericardial tamponade, with subsequent compression of the pulmonary arteries. While both expanding pericardial effusions and aortic dissections have been reported to cause compression of other adjacent structures, compression of the pulmonary artery vasculature in a patient with prior cardiac surgery has never been described. In this case report, we highlight this situation, which may have occurred because of alterations in the pericardial and mediastinal spaces.

Computed tomography assessment of valvular morphology, function, and disease.

Recent advancement in computed tomography angiography (CTA) has enabled the noninvasive delineation of cardiac valves using this method. Although echocardiography is the current standard, CTA is a valuable complementary imaging method to evaluate valvular morphology and function. In addition, CTA may contribute to the assessment of both congenital and acquired valvular heart disease, infectious endocarditis, and postsurgical complications of valve replacement.

Frequency and cause of cardiac troponin T elevation in chronic hemodialysis patients from study of cardiovascular magnetic resonance.

Cardiac troponin T level predicts a gradient risk for death in patients using hemodialysis. We used cardiovascular magnetic resonance (CMR) to determine whether an asymptomatic increase of troponin T in patients using hemodialysis is associated with subclinical myocardial infarction (MI). Twenty-six patients using long-term hemodialysis (49 +/- 12 years of age, 19 men, 8 diabetics) with left ventricular (LV) ejection fraction >40% and no known coronary artery disease were selected based on a low-risk troponin T level View Article and Find Full Text PDF

Echocardiography in the cardiac transplant recipient.

Despite the widespread use of echocardiography in the cardiac allograft recipient, the clinical usefulness of this practice is not well defined. In this article, the authors review the spectrum of echocardiographic findings in the adult heart transplant patient. Appreciation of typical alterations from "normal" allows the transplant physician to identify clinically significant changes and to avoid unnecessary invasive procedures based on misinterpretation of these differences.

Pregnancy-associated plasma protein-A: an emerging cardiac biomarker.

Pregnancy associated plasma protein-A (PAPP-A), originally discovered as a glycoprotein found in the serum of pregnant women, is emerging as a potential biomarker of plaque instability. It is produced by the syncytiotrophoblasts of the placenta and circulates in the form of an approximately 500 kDa heterotetramer. In addition, PAPP-A is present in the sera of men and non-pregnant women at much lower levels in the form of a homodimer, and is produced by a number of different non-placental cell types, including fibroblasts, vascular endothelial cells, and vascular smooth muscle cells.

Unrecognized drug-drug interactions: a cause of intraoperative cardiac arrest?

Many physicians overlook, or are unaware of, most drug-drug interactions. In our patient, the local anesthetic used for an axillary block may have been the precipitating drug in a cascade of drug-drug interactions that resulted in a cardiac arrest. The combination of multiple preoperative drug-drug interactions prevented the return of a stable native cardiac rhythm for almost 24 h.