Mechanical circulatory support devices in advanced heart failure: 2020 and beyond.

Substantial progress in the field of mechanical circulatory support (MCS) has expanded the treatment options for patients with advanced-stage heart failure (HF). Currently available MCS devices can be implanted percutaneously or surgically. They can also be configured to support the left, right, or both ventricles, offering varying levels of circulatory support.

Weight Loss in Underserved Patients - A Cluster-Randomized Trial.

Background: Evidence of the effectiveness of treatment for obesity delivered in primary care settings in underserved populations is lacking.

Methods: We conducted a cluster-randomized trial to test the effectiveness of a high-intensity, lifestyle-based program for obesity treatment delivered in primary care clinics in which a high percentage of the patients were from low-income populations. We randomly assigned 18 clinics to provide patients with either an intensive lifestyle intervention, which focused on reduced caloric intake and increased physical activity, or usual care.

Coronary Artery Bypass Grafting in Cancer Patients: Prevalence and Outcomes in the United States.

Objective: To characterize the contemporary efficacy and utilization patterns of coronary artery bypass grafting (CABG) in specific cancer types.

Methods: We leveraged the data from the National Inpatient Sample and plotted trends of utilization and outcomes of isolated CABG (with no other additional surgeries during the same hospitalization) procedures from January 1, 2003, through September 1, 2015. Propensity score matching was used to assess for potential differences in outcomes by type of cancer status among contemporary (2012-2015) patients.

Cardiovascular Effects of ADHD Therapies: JACC Review Topic of the Week.

Although the prevalence of attention-deficit/hyperactivity disorder (ADHD) has been stable over the past 3 decades, prescriptions of sympathomimetic stimulants have steadily increased in the United States. This study consisted of a systematic review of PubMed articles screened for ADHD medications and potential cardiovascular toxicity as well as nondrug strategies for managing ADHD. The cumulative body of data showed that ADHD medications cause modest elevations in resting heart rate and blood pressure.

Heart failure with preserved ejection fraction diagnosis and treatment: An updated review of the evidence.

Over the last several decades, clinicians and clinical scientists have had growing interest in heart failure (HF) diagnosis and treatment. While HF with reduced ejection fraction (EF) is a well-known clinical entity with several therapeutic strategies proven to be successful, HF with preserved ejection fraction is a more heterogenous syndrome with a prevalence that has increased in the last two decades, without effective therapeutic strategies. Great strides have been made in the detection of predisposing risk factors and pathological mechanisms; however, pharmacological therapies have shown to be ineffective in reducing cardiovascular mortality in the HF with preserved EF (HFpEF) population, opening the way to the necessity of developing new precision medicine based approaches.

Association of Muscular Strength and Incidence of Type 2 Diabetes.

Objective: To examine the association between muscular strength and incident type 2 diabetes, independent of cardiorespiratory fitness (CRF).

Patients And Methods: A total of 4681 adults aged 20 to 100 years who had no type 2 diabetes at baseline were included in the current prospective cohort study. Participants underwent muscular strength tests and maximal treadmill exercise tests between January 1, 1981, and December 31, 2006.

An Update on the Role of Cardiorespiratory Fitness, Structured Exercise and Lifestyle Physical Activity in Preventing Cardiovascular Disease and Health Risk.

The cardiovascular disease (CVD) pandemic has placed considerable strain on healthcare systems, quality of life, and physical function, while remaining the leading cause of death globally. Decades of scientific investigations have fortified the protective effects of cardiorespiratory fitness (CRF), exercise training, and physical activity (PA) against the development of CVD. This review will summarize recent efforts that have made significant strides in; 1) the application of novel analytic techniques to increase the predictive utility of CRF; 2) understanding the protective effects of long-term compliance to PA recommendations through large cohort studies with multiple points of assessment; 3) and understanding the potential harms associated with extreme volumes of PA.

The role of diet for prevention and management of hypertension.

Purpose Of Review: Regular consumption of a diet high in sodium, energy dense foods, fat content, refined carbohydrates, added sugar and low in fruits and vegetables contributes to an increased risk of developing hypertension (HTN) and cardiovascular disease. This review aims to provide a synopsis of evidence-based dietary approaches that have been effective in lowering blood pressure (BP) in pre-HTN and individuals with HTN.

Recent Findings: Recent dietary recommendations have emphasized overall dietary patterns and its relation between food and BP.

Changes in parameters of right ventricular function with cardiac resynchronization therapy.

Background: Studies have shown that cardiac resynchronization therapy (CRT) significantly improves right ventricle (RV) size and function in patients with heart failure (HF).

Hypothesis: CRT does not lead to improvement in RV function independent of baseline clinical variables.

Methods: A systematic search of studies published between 1966 to August 31, 2015 was conducted using Pub Med, CINAHL, Cochrane CENTRAL and the Web of Science databases.

Management of cardiovascular diseases in patients with obesity.

The management of cardiovascular diseases (CVD) in patients with obesity presents numerous challenges. Obesity has a negative effect on almost all of the major CVD risk factors, and adversely influences cardiovascular structure and function. Patients who are overweight or obese have a higher incidence of almost all CVDs compared with patients who are of normal weight.

Association of Resistance Exercise, Independent of and Combined With Aerobic Exercise, With the Incidence of Metabolic Syndrome.

Objective: To determine the association of resistance exercise, independent of and combined with aerobic exercise, with the risk of development of metabolic syndrome (MetS).

Patients And Methods: The study cohort included adults (mean ± SD age, 46±9.5 years) who received comprehensive medical examinations at the Cooper Clinic in Dallas, Texas, between January 1, 1987, and December, 31, 2006.