Subjects -> MEDICAL SCIENCES (Total: 8359 journals)
    - ANAESTHESIOLOGY (119 journals)
    - CARDIOVASCULAR DISEASES (329 journals)
    - DENTISTRY (288 journals)
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    - FORENSIC SCIENCES (41 journals)
    - HEMATOLOGY (153 journals)
    - HYPNOSIS (4 journals)
    - INTERNAL MEDICINE (164 journals)
    - MEDICAL GENETICS (58 journals)
    - MEDICAL SCIENCES (2268 journals)
    - NURSES AND NURSING (356 journals)
    - OBSTETRICS AND GYNECOLOGY (202 journals)
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    - PATHOLOGY (96 journals)
    - PEDIATRICS (270 journals)
    - PSYCHIATRY AND NEUROLOGY (813 journals)
    - RESPIRATORY DISEASES (102 journals)
    - RHEUMATOLOGY (76 journals)
    - SPORTS MEDICINE (78 journals)
    - SURGERY (393 journals)

CARDIOVASCULAR DISEASES (329 journals)                  1 2 | Last

Showing 1 - 200 of 329 Journals sorted alphabetically
Acta Angiologica     Open Access   (Followers: 5)
Acta Cardiologica     Hybrid Journal   (Followers: 2)
Acute Cardiac Care     Hybrid Journal   (Followers: 7)
Adipositas - Ursachen, Folgeerkrankungen, Therapie     Hybrid Journal  
AJP Heart and Circulatory Physiology     Hybrid Journal   (Followers: 12)
Aktuelle Kardiologie     Hybrid Journal   (Followers: 1)
American Heart Journal     Hybrid Journal   (Followers: 58)
American Journal of Cardiology     Hybrid Journal   (Followers: 67)
American Journal of Cardiovascular Drugs     Hybrid Journal   (Followers: 17)
American Journal of Hypertension     Hybrid Journal   (Followers: 28)
Anales de Cirugia Vascular     Full-text available via subscription   (Followers: 1)
Anatolian Journal of Cardiology     Open Access   (Followers: 6)
Angiología     Full-text available via subscription  
Angiologia e Cirurgia Vascular     Open Access   (Followers: 1)
Angiology     Hybrid Journal   (Followers: 3)
Annales de Cardiologie et d'Angéiologie     Full-text available via subscription   (Followers: 1)
Annals of Noninvasive Electrocardiology     Hybrid Journal   (Followers: 1)
Annals of Pediatric Cardiology     Open Access   (Followers: 12)
AORTA     Open Access  
Archives of Cardiovascular Diseases     Full-text available via subscription   (Followers: 5)
Archives of Cardiovascular Diseases Supplements     Full-text available via subscription   (Followers: 3)
Archives of Cardiovascular Imaging     Open Access   (Followers: 2)
Archivos de cardiología de México     Open Access   (Followers: 1)
Argentine Journal of Cardiology (English edition)     Open Access   (Followers: 2)
Arquivos Brasileiros de Cardiologia     Open Access   (Followers: 1)
Arteriosclerosis, Thrombosis and Vascular Biology     Full-text available via subscription   (Followers: 32)
Artery Research     Hybrid Journal   (Followers: 4)
ARYA Atherosclerosis     Open Access  
ASAIO Journal     Hybrid Journal   (Followers: 3)
ASEAN Heart Journal     Open Access   (Followers: 2)
Asian Cardiovascular and Thoracic Annals     Hybrid Journal   (Followers: 2)
Aswan Heart Centre Science & Practice Services     Open Access   (Followers: 1)
Atherosclerosis : X     Open Access  
Bangladesh Heart Journal     Open Access   (Followers: 3)
Basic Research in Cardiology     Hybrid Journal   (Followers: 10)
BMC Cardiovascular Disorders     Open Access   (Followers: 22)
Brain Circulation     Open Access   (Followers: 1)
British Journal of Cardiology     Full-text available via subscription   (Followers: 16)
Canadian Journal of Cardiology     Hybrid Journal   (Followers: 18)
Cardiac Cath Lab Director     Full-text available via subscription  
Cardiac Electrophysiology Review     Hybrid Journal   (Followers: 2)
Cardiocore     Full-text available via subscription   (Followers: 1)
Cardiogenetics     Open Access   (Followers: 3)
Cardiology     Full-text available via subscription   (Followers: 20)
Cardiology and Angiology: An International Journal     Open Access   (Followers: 1)
Cardiology and Therapy     Open Access   (Followers: 12)
Cardiology Clinics     Full-text available via subscription   (Followers: 14)
Cardiology in Review     Hybrid Journal   (Followers: 8)
Cardiology in the Young     Hybrid Journal   (Followers: 34)
Cardiology Journal     Open Access   (Followers: 6)
Cardiology Plus     Open Access   (Followers: 1)
Cardiology Research     Open Access   (Followers: 15)
Cardiology Research and Practice     Open Access   (Followers: 10)
Cardiopulmonary Physical Therapy Journal     Hybrid Journal   (Followers: 7)
Cardiorenal Medicine     Full-text available via subscription   (Followers: 1)
Cardiothoracic Surgeon     Open Access   (Followers: 1)
CardioVasc     Full-text available via subscription   (Followers: 1)
Cardiovascular & Haematological Disorders - Drug Targets     Hybrid Journal   (Followers: 1)
Cardiovascular & Hematological Agents in Medicinal Chemistry     Hybrid Journal   (Followers: 2)
CardioVascular and Interventional Radiology     Hybrid Journal   (Followers: 15)
Cardiovascular and Thoracic Open     Open Access  
Cardiovascular Diabetology     Open Access   (Followers: 10)
Cardiovascular Drugs and Therapy     Hybrid Journal   (Followers: 14)
Cardiovascular Endocrinology & Metabolism     Hybrid Journal   (Followers: 1)
Cardiovascular Engineering     Hybrid Journal   (Followers: 1)
Cardiovascular Engineering and Technology     Hybrid Journal   (Followers: 1)
Cardiovascular Intervention and Therapeutics     Hybrid Journal   (Followers: 5)
Cardiovascular Journal     Open Access   (Followers: 6)
Cardiovascular Journal of Africa     Full-text available via subscription   (Followers: 5)
Cardiovascular Journal of South Africa     Full-text available via subscription   (Followers: 1)
Cardiovascular Medicine in General Practice     Full-text available via subscription   (Followers: 7)
Cardiovascular Pathology     Hybrid Journal   (Followers: 4)
Cardiovascular Regenerative Medicine     Open Access  
Cardiovascular Research     Hybrid Journal   (Followers: 15)
Cardiovascular Revascularization Medicine     Hybrid Journal   (Followers: 1)
Cardiovascular System     Open Access  
Cardiovascular Therapeutics     Open Access   (Followers: 1)
Cardiovascular Toxicology     Hybrid Journal   (Followers: 6)
Cardiovascular Ultrasound     Open Access   (Followers: 5)
Case Reports in Cardiology     Open Access   (Followers: 7)
Catheterization and Cardiovascular Interventions     Hybrid Journal   (Followers: 3)
Cerebrovascular Diseases     Full-text available via subscription   (Followers: 3)
Cerebrovascular Diseases Extra     Open Access  
Chest     Full-text available via subscription   (Followers: 100)
Choroby Serca i Naczyń     Open Access   (Followers: 1)
Circulation     Hybrid Journal   (Followers: 247)
Circulation : Cardiovascular Imaging     Hybrid Journal   (Followers: 15)
Circulation : Cardiovascular Interventions     Hybrid Journal   (Followers: 17)
Circulation : Cardiovascular Quality and Outcomes     Hybrid Journal   (Followers: 11)
Circulation : Genomic and Precision Medicine     Hybrid Journal   (Followers: 15)
Circulation : Heart Failure     Hybrid Journal   (Followers: 26)
Circulation Research     Hybrid Journal   (Followers: 36)
Cirugía Cardiovascular     Open Access  
Clínica e Investigación en Arteriosclerosis     Full-text available via subscription  
Clínica e Investigación en arteriosclerosis (English Edition)     Hybrid Journal  
Clinical and Experimental Hypertension     Hybrid Journal   (Followers: 3)
Clinical Cardiology     Hybrid Journal   (Followers: 11)
Clinical Hypertension     Open Access   (Followers: 5)
Clinical Medicine Insights : Cardiology     Open Access   (Followers: 6)
Clinical Research in Cardiology     Hybrid Journal   (Followers: 6)
Clinical Research in Cardiology Supplements     Hybrid Journal  
Clinical Trials and Regulatory Science in Cardiology     Open Access   (Followers: 4)
Congenital Heart Disease     Hybrid Journal   (Followers: 6)
Congestive Heart Failure     Hybrid Journal   (Followers: 4)
Cor et Vasa     Full-text available via subscription   (Followers: 1)
Coronary Artery Disease     Hybrid Journal   (Followers: 2)
CorSalud     Open Access  
Critical Pathways in Cardiology     Hybrid Journal   (Followers: 4)
Current Cardiology Reports     Hybrid Journal   (Followers: 7)
Current Cardiology Reviews     Hybrid Journal   (Followers: 4)
Current Cardiovascular Imaging Reports     Hybrid Journal   (Followers: 1)
Current Cardiovascular Risk Reports     Hybrid Journal  
Current Heart Failure Reports     Hybrid Journal   (Followers: 5)
Current Hypertension Reports     Hybrid Journal   (Followers: 6)
Current Hypertension Reviews     Hybrid Journal   (Followers: 6)
Current Opinion in Cardiology     Hybrid Journal   (Followers: 14)
Current Problems in Cardiology     Hybrid Journal   (Followers: 3)
Current Research : Cardiology     Full-text available via subscription   (Followers: 1)
Current Treatment Options in Cardiovascular Medicine     Hybrid Journal   (Followers: 1)
Current Vascular Pharmacology     Hybrid Journal   (Followers: 5)
CVIR Endovascular     Open Access   (Followers: 1)
Der Kardiologe     Hybrid Journal   (Followers: 2)
Echo Research and Practice     Open Access   (Followers: 2)
Echocardiography     Hybrid Journal   (Followers: 4)
Egyptian Heart Journal     Open Access   (Followers: 2)
Egyptian Journal of Cardiothoracic Anesthesia     Open Access  
ESC Heart Failure     Open Access   (Followers: 4)
European Heart Journal     Hybrid Journal   (Followers: 67)
European Heart Journal - Cardiovascular Imaging     Hybrid Journal   (Followers: 10)
European Heart Journal - Cardiovascular Pharmacotherapy     Full-text available via subscription   (Followers: 3)
European Heart Journal - Quality of Care and Clinical Outcomes     Hybrid Journal  
European Heart Journal : Acute Cardiovascular Care     Hybrid Journal   (Followers: 1)
European Heart Journal : Case Reports     Open Access   (Followers: 1)
European Heart Journal Supplements     Hybrid Journal   (Followers: 8)
European Journal of Cardio-Thoracic Surgery     Hybrid Journal   (Followers: 9)
European Journal of Cardio-Thoracic Surgery Supplements     Full-text available via subscription   (Followers: 2)
European Journal of Cardiovascular Nursing     Hybrid Journal   (Followers: 5)
European Journal of Heart Failure     Hybrid Journal   (Followers: 14)
European Journal of Preventive Cardiology.     Hybrid Journal   (Followers: 6)
European Stroke Organisation     Hybrid Journal   (Followers: 3)
Experimental & Translational Stroke Medicine     Open Access   (Followers: 8)
Expert Review of Cardiovascular Therapy     Full-text available via subscription   (Followers: 3)
Folia Cardiologica     Open Access  
Forum Zaburzeń Metabolicznych     Hybrid Journal  
Frontiers in Cardiovascular Medicine     Open Access   (Followers: 1)
Future Cardiology     Hybrid Journal   (Followers: 6)
General Thoracic and Cardiovascular Surgery     Hybrid Journal   (Followers: 3)
Global Cardiology Science and Practice     Open Access   (Followers: 5)
Global Heart     Hybrid Journal   (Followers: 3)
Heart     Hybrid Journal   (Followers: 48)
Heart and Mind     Open Access  
Heart and Vessels     Hybrid Journal  
Heart Failure Clinics     Full-text available via subscription   (Followers: 2)
Heart Failure Reviews     Hybrid Journal   (Followers: 3)
Heart India     Open Access   (Followers: 2)
Heart International     Full-text available via subscription  
Heart Rhythm     Hybrid Journal   (Followers: 11)
Heart Views     Open Access   (Followers: 2)
HeartRhythm Case Reports     Open Access  
Hellenic Journal of Cardiology     Open Access   (Followers: 1)
Herz     Hybrid Journal   (Followers: 3)
High Blood Pressure & Cardiovascular Prevention     Full-text available via subscription   (Followers: 2)
Hypertension     Full-text available via subscription   (Followers: 23)
Hypertension in Pregnancy     Hybrid Journal   (Followers: 9)
Hypertension Research     Hybrid Journal   (Followers: 5)
Ibrahim Cardiac Medical Journal     Open Access  
IJC Heart & Vessels     Open Access   (Followers: 1)
IJC Heart & Vasculature     Open Access   (Followers: 1)
IJC Metabolic & Endocrine     Open Access   (Followers: 1)
Indian Heart Journal     Open Access   (Followers: 5)
Indian Journal of Cardiovascular Disease in Women WINCARS     Open Access  
Indian Journal of Thoracic and Cardiovascular Surgery     Hybrid Journal  
Indian Pacing and Electrophysiology Journal     Open Access   (Followers: 1)
Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery     Hybrid Journal   (Followers: 1)
Insuficiencia Cardíaca     Open Access  
Interactive CardioVascular and Thoracic Surgery     Hybrid Journal   (Followers: 7)
International Cardiovascular Forum Journal     Open Access  
International Journal of Angiology     Hybrid Journal   (Followers: 2)
International Journal of Cardiology     Hybrid Journal   (Followers: 18)
International Journal of Cardiovascular and Cerebrovascular Disease     Open Access   (Followers: 2)
International Journal of Cardiovascular Imaging     Hybrid Journal   (Followers: 2)
International Journal of Cardiovascular Research     Hybrid Journal   (Followers: 6)
International Journal of Heart Rhythm     Open Access  
International Journal of Hypertension     Open Access   (Followers: 8)
International Journal of Hyperthermia     Open Access  
International Journal of Stroke     Hybrid Journal   (Followers: 30)
International Journal of the Cardiovascular Academy     Open Access  
Interventional Cardiology Clinics     Full-text available via subscription   (Followers: 2)
Interventional Cardiology Review     Full-text available via subscription  
JACC : Basic to Translational Science     Open Access   (Followers: 5)
JACC : Cardiovascular Imaging     Hybrid Journal   (Followers: 18)
JACC : Cardiovascular Interventions     Hybrid Journal   (Followers: 17)
JACC : Heart Failure     Full-text available via subscription   (Followers: 14)
JAMA Cardiology     Hybrid Journal   (Followers: 28)
JMIR Cardio     Open Access  
Jornal Vascular Brasileiro     Open Access  
Journal of Clinical & Experimental Cardiology     Open Access   (Followers: 5)
Journal of Arrhythmia     Open Access  
Journal of Cardiac Critical Care TSS     Open Access   (Followers: 1)
Journal of Cardiac Failure     Hybrid Journal   (Followers: 1)

        1 2 | Last

Similar Journals
Journal Cover
Heart Failure Reviews
Journal Prestige (SJR): 1.887
Citation Impact (citeScore): 4
Number of Followers: 3  
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1573-7322 - ISSN (Online) 1382-4147
Published by Springer-Verlag Homepage  [2570 journals]
  • The role of mechanotransduction in heart failure pathobiology—a
           concise review
    • Abstract: Abstract This review evaluates the role of mechanotransduction (MT) in heart failure (HF) pathobiology. Cardiac functional and structural modifications are regulated by biomechanical forces. Exposing cardiomyocytes and the myocardial tissue to altered biomechanical stress precipitates changes in the end-diastolic wall stress (EDWS). Thereby various interconnected biomolecular pathways, essentially mediated and orchestrated by MT, are launched and jointly contribute to adapt and remodel the myocardium. This cardiac MT-mediated feedback decisively determines the primary cardiac cellular and tissue response, the sort (concentric or eccentric) of hypertrophy/remodeling, to mechanical and/or hemodynamic alterations. Moreover, the altered EDWS affects the diastolic myocardial properties independent of the systolic function, and elevated EDWS causes diastolic dysfunction. The close interconnection between MT pathways and the cell nucleus, the genetic endowment, principally allows for the wide variety of phenotypic appearances. However, demographic, environmental features, comorbidities, and also the genetic make-up may modulate the phenotypic result. Cardiac MT takes a fundamental and superordinate position in the myocardial adaptation and remodeling processes in all HF categories and phenotypes. Therefore, the effects of MT should be integrated in all our scientific, clinical, and therapeutic considerations.
      PubDate: 2020-01-22
  • Assessment and management of heart failure in the systemic right ventricle
    • Abstract: Abstract Transposition of the great arteries (TGA) is a common congenital cardiac malformation, in which many patients survive into adulthood. From the 1960s through much of the 1980s, the majority of those with D-TGA were repaired with an atrial switch procedure, in which the right ventricle (RV) remains the systemic ventricle. Congenitally corrected TGA patients often remain with a systemic RV. In these patients, heart failure risks result from residual sequelae of childhood repair, which often include tricuspid regurgitation, RV failure, and atrial and ventricular arrhythmias. Imaging techniques, including echocardiography, cardiac magnetic resonance imaging, multi-detector computed tomography, and radionuclide ventriculography focus on evaluation of anatomy and function as both diagnostic and prognostic tools. Biomarkers are used for risk stratification. Structural and surgical interventions are targeted for palliation and prevention of further decompensation in conjunction with pharmacologic, ablative, and device-based therapies for acute and chronic management of heart failure.
      PubDate: 2020-01-22
  • Insulin resistance and heart failure during treatment with sodium glucose
           cotransporter 2 inhibitors: proposed role of ketone utilization
    • Abstract: Abstract Sodium glucose cotransporter 2 (SGLT2) inhibitors reduce the rate of hospitalization for heart failure in individuals with type 2 diabetes, but the underlying mechanisms remain elusive. Modestly elevated circulating β-hydroxybutyrate (βOHB) during treatment with SGLT2 inhibitors causes different beneficial effects on organs and cells, depending on succinyl-CoA:3-ketoacid CoA transferase (SCOT) levels. In the heart, in which SCOT is highly expressed/up-regulated, βOHB may be an alternative energy source apart from fat and glucose oxidation. The type 2 diabetic failing heart may be energy inefficient. In skeletal muscle, in which SCOT is not highly expressed/down-regulated, βOHB may cause antioxidant effects, resulting in amelioration of insulin resistance, which could lead to improvement in cardiac insulin resistance with metabolic, endocrine, and cytokine alterations. Although various mechanisms have been suggested, we postulate that the potential impact of SGLT2 inhibitors on heart failure lies in fuel energetics and amelioration of insulin resistance with ketone utilization depending upon SCOT levels.
      PubDate: 2020-01-20
  • Malignancy predicts outcome of Takotsubo syndrome: a systematic review and
    • Abstract: Abstract Over the recent years, studies have emerged reporting on a strong relationship between the occurrence of malignancy and Takotsubo syndrome. The aim of this systematic review and meta-analysis is to evaluate the predictive value of malignancy for prognosis of Takotsubo syndrome patients. PubMed, EMBASE, Cochrane Library, Web of science, and Scopus were searched until 4 September 2019 for articles concerning association of malignancy with the prognosis of Takotsubo syndrome. A total of ten studies were finally included in this meta-analysis, demonstrating that malignancy was associated with higher mortality in Takotsubo syndrome patients (RR 2.23, 95% CI 1.64–3.03, Z = 5.10, P < 0.00001). Differences between individual studies were significant, which were due to sample size and percentage of malignant patients in each study indicated by meta-regression and then verified by sensitivity analysis. Subgroup analysis demonstrated that the predictive value of malignancy in mortality risk of Takotsubo syndrome patients was significant for both in-hospital death (RR 2.26, 95% CI 1.34–3.82, Z = 3.06, P = 0.002) and follow-up death (RR 2.04, 95% CI 1.63–2.55, Z = 6.21, P < 0.00001). Further analysis of other in-hospital outcomes demonstrated increased incidence of mechanical ventilation in cancer patients. Our meta-analysis suggested that malignancy plays a significant role in predicting the mortality of Takotsubo syndrome patients whether in the short term or long term.
      PubDate: 2020-01-20
  • Echocardiographic tissue imaging evaluation of myocardial characteristics
           and function in cardiomyopathies
    • Abstract: Abstract Current echocardiography techniques have allowed more precise assessment of cardiac structure and function of the several types of cardiomyopathies. Parameters derived from echocardiographic tissue imaging (ETI)—tissue Doppler, strain, strain rate, and others—are extensively used to provide a framework in the evaluation and management of cardiomyopathies. Generally, myocardial function assessed by ETI is depressed in all types of cardiomyopathies, non-ischemic dilated cardiomyopathy (DCM) in particular. In hypertrophic cardiomyopathy (HCM), ETI is useful to identify subclinical disease in family members of HCM, to differentiate HCM from other conditions causing cardiac hypertrophy and to predict cardiac events. ETI also for HCM allows addressing the mechanism behind left ventricular outflow tract obstruction and its improvement after therapeutic options. ETI provides cardiac amyloidosis with unique and specific findings such as “apical sparing.” Nevertheless, ETI does not seem to provide as much information amenable to histological findings as recently emerging techniques of cardiac magnetic resonance imaging. This review introduces usefulness of ETI and some other ultrasound techniques for detecting clinical and subclinical characteristics of cardiomyopathies, focusing on DCM, HCM, and cardiac amyloidosis.
      PubDate: 2020-01-16
  • Inflammatory cardiomyopathies: short- and long-term outcomes after heart
           transplantation—a protocol for a systematic review and meta-analysis
    • Abstract: Abstract Heart transplantation (HTx) for patients with “giant cell myocarditis” (GCM) or “cardiac sarcoidosis” (CS) is still controversial. However, no single center has accumulated enough experience to investigate post-HTx outcome. The primary aim of this systematic review is to identify, appraise, and synthesize existing literature investigating whether patients who have undergone HTx because of GCM or CS have worse outcomes as compared with patients transplanted because of other etiologies. A systematic and comprehensive search will be performed using PubMed, Scopus, Web of Science, EMBASE, and Google Scholar, for studies published up to December 2019. Observational and interventional population-based studies will be eligible for inclusion. The quality of observational studies will be assessed using the Newcastle–Ottawa scale, while the interventional studies will be assessed using the Cochrane Effective Practice Organization of Care tool. The collected evidence will be narratively synthesized; in addition, we will perform a meta-analysis to pool estimates from studies considered to be homogenous. Reporting of the systematic review and meta-analysis will be in accordance with the Meta-analysis of Observational Studies in Epidemiology Preferred Reporting Items for Systematic reviews and Meta-Analysis guidelines. To our knowledge, this will be the first synthesis of outcomes, including survival, acute cellular rejection, and disease recurrence, in patients with either GCM or CS treated with HTx. Reviewing the suitability of HTx in this population and highlighting areas for further research will benefit both patients and healthcare providers. Trial registration: CRD42019140574.
      PubDate: 2020-01-14
  • Heart failure in adult congenital heart disease: tetralogy of Fallot
    • Abstract: Abstract The number of rTOF patients who survive into adulthood is steadily rising, with currently more than 90% reaching the third decade of life. However, rTOF patients are not cured, but rather have a lifelong increased risk for cardiac and non-cardiac complications. Heart failure is recognized as a significant complication. Its occurrence is strongly associated with adverse outcome. Unfortunately, conventional concepts of heart failure may not be directly applicable in this patient group. This article presents a review of the current knowledge on HF in rTOF patients, including incidence and prevalence, the most common mechanisms of heart failure, i.e., valvular pathologies, shunt lesions, left atrial hypertension, primary left heart and right heart failure, arrhythmias, and coronary artery disease. In addition, we will review information regarding extracardiac complications, risk factors for the development of heart failure, clinical impact and prognosis, and assessment possibilities, particularly of the right ventricle, as well as management strategies. We explore potential future concepts that may stimulate further research into this field.
      PubDate: 2020-01-10
  • Palliative care in chronic heart failure: a theoretically guided,
           qualitative meta-synthesis of decision-making
    • Abstract: Abstract International clinical practice guidelines recommend that patients with chronic heart failure receive timely and high-quality palliative care. However, integrating palliative care is highly variable and dependent on decision-making and care models. This meta-synthesis aimed to examine health care professionals’ decision-making processes and explore factors impacting decisions to refer or deliver palliative care in chronic heart failure. The electronic databases SCOPUS, CINAHL, and Medline were searched. Included studies were those that reported health care professionals’ perceptions of palliative care in chronic heart failure through qualitative data collection, were written in English, and were peer-reviewed articles. Included articles were analysed using Thomas and Harden’s approach. The dual-process theory was used and applied a priori to organise the findings. The perception of palliative care as a transition and active treatment failure fit within the intuitive system of thinking in the dual-process theory. The theme that overlapped into both intuitive and analytical systems of thinking was acquiring patient and illness information themes reflecting the analytical system of thinking were professional role and experience, pre-existing decision pathways, and balancing viewpoints. This meta-synthesis identified factors influencing the decision-making process in referring patients with chronic heart failure to palliative care. The findings from this review highlight the need for further development of decision-making tools or facilitate guidelines to assist health care professionals’ shared decision-making to improve patient outcomes.
      PubDate: 2020-01-03
  • Effects of angiotensin-converting enzyme inhibitor/angiotensin receptor
           blocker use on cancer therapy-related cardiac dysfunction: a meta-analysis
           of randomized controlled trials
    • Abstract: Abstract Angiotensin-converting enzyme inhibitor (ACEI) and angiotensin receptor blocker (ARB) may attenuate cancer therapy–related cardiac dysfunction (CTRCD). However, results of the previous studies were not consistent. We performed a meta-analysis to evaluate the influence of ACEI/ARB on CTRCD. Randomized controlled trials (RCTs) were obtained by searching of PubMed, Embase, and Cochrane’s Library databases. A random-effect model was used to pool the results. Nine RCTs with 1095 cancer patients that underwent chemotherapy with anthracycline and/or trastuzumab were included. Using of ACEI/ARB significantly preserved left ventricular ejection fraction (LVEF, weighed mean difference = 4.24%, p = 0.002) compared with controls. Subgroup analyses showed that the benefits of ACEI/ARB on LVEF following chemotherapy were consistent and independent of study characteristics including study design, sample size, cancer type, chemotherapy protocols, preventative medications of ACEI or ARB, methods for LVEF measurement, and follow-up durations. The benefits on LVEF following chemotherapy were more remarkable in studies using ACEI and followed ≤ 12 months (p for subgroup difference = 0.04 and 0.02). Use of ACEI/ARB did not significantly reduce the risk of cardiotoxicity events (risk ratio [RR] = 0.63, p = 0.22) but increased the risk of hypotension in these patients (RR = 3.94, p = 0.008). These results indicated that using of ACEI/ARB may moderately attenuate CTRCD following chemotherapy with anthracycline and/or trastuzumab. Large-scale RCTs are needed to evaluate whether the benefits of ACEI/ARB on LVEF are clinically relevant.
      PubDate: 2020-01-03
  • Readmission-free period and in-hospital mortality at the time of first
           readmission in acute heart failure patients—NRD-based analysis of 40,000
           heart failure readmissions
    • Abstract: Abstract The 30-day readmission rates, predictors, and outcomes for acute heart failure (AHF) patients are well published, but data beyond 30 days and the association between readmission-free period (RFP) and in-hospital readmission-related mortality remain unknown. We queried the National Readmission Database to analyze comparative outcomes of AHF. Patients were divided into three groups based on their RFP: group 1 (1–30 days), group 2 (31–90 days), and group 3 (91–275 days). AHF cases and clinical variables were identified using ICD-9 codes. The primary outcome was in-hospital mortality at the time of readmission. A total of 39,237 unplanned readmissions occurred within 275 days; 15,181 within group 1, 11,925 within group 2, and 12,131 within group 3. In-hospital mortality in groups 1, 2, and 3 were 7.4%, 5.1%, and 4.1% (p < 0.001). Group 1 had higher percentages of patients with cardiogenic shock (1.3% vs. 0.9% vs. 0.9%; p < 0.001), acute kidney injury (30.2% vs. 25.9% vs. 24.0%; p < 0.001), dialysis use (8.6% vs. 7.5% vs. 6.9%; p < 0.001), and non-ST elevation myocardial infarction (4.4% vs. 3.8% vs. 3.6%; p < 0.001), but there was no statistical difference among the three groups for ST-elevation myocardial infarction, percutaneous coronary intervention (PCI), or ventricular assist device use at the time of index admission. However, group 3 had higher PCI (1.7%) compared with groups 1 and 2 (p < 0.001). In multivariable logistic regression, groups 2 and 3 had odd ratio of 0.70 and 0.55, respectively, for in-hospital mortality compared with group 1. Longer RFP is associated with decreased risk of in-hospital mortality at the time of first readmission.
      PubDate: 2020-01-02
  • Circular RNAs as potential theranostics in the cardiac fibrosis
    • Abstract: Abstract Circular RNAs (circRNAs) are a type of single-stranded RNA molecules that normally do not encode proteins. circRNAs are involved in many physiological processes as well as the pathogenesis of diseases. Cardiac fibrosis is increasingly recognized as a pathological force in advanced heart diseases. A growing number of studies have reported that the occurrence and development of cardiac fibrosis is closely associated with the regulation of circRNAs. This review summarizes the current understanding of circRNA biogenesis and function and will highlight the recent updates regarding the involvement of circRNAs in cardiac fibrosis, and their potential as emerging biomarkers and therapeutic targets.
      PubDate: 2020-01-02
  • Heart and anorexia nervosa
    • Abstract: Abstract Anorexia nervosa, one of the more frequent and severe eating disorders, is a chronic psychiatric disease with potentially serious somatic consequences. This behavioral symptomatology leads to weight loss, undernutrition, and more or less severe—potentially life-threatening—somatic complications including respiratory, hepatic, digestive and cardiac features, electrolyte disturbances, endocrine and bone impairment, immunodepression, and related opportunistic infections. In this review, the authors report an overview of cardiac diseases in this disease.
      PubDate: 2019-12-24
  • Heart failure with reduced and preserved ejection fraction in adult
           congenital heart disease
    • Abstract: Abstract Heart failure with reduced ejection fraction (HFrEF) is common in patients with adult congenital heart disease. Many of the most common congenital defects have a high prevalence of HFrEF, including left-sided obstructive lesions (aortic stenosis, coarctation of the aorta, Shone complex), tetralogy of Fallot, Ebstein anomaly, lesions in which there is a systemic right ventricle, and lesions palliated with a Fontan circulation. However, heart failure with preserved ejection fraction (HFpEF) is also prevalent in all these lesions. Comprehensive evaluation includes physical exam, biomarkers, echocardiography and advanced imaging, exercise stress testing, and, in some cases, invasive hemodynamics. Guideline-directed medical therapy for HFrEF can be applied to left-sided lesions and may be considered on an individual basis for systemic right ventricle and single-ventricle patients. Medical therapy is limited for HFpEF. However, in both HFrEF and HFpEF, ventricular dyssynchrony and arrhythmias play an important role, and medications for rhythm control, ablation, and cardiac resynchronization therapy should be considered. Finally, aggressive management of cardiovascular risk factors and comorbidities, including, but not limited to, hypertension, obesity, diabetes, dyslipidemia, and obstructive sleep apnea, cannot be overemphasized.
      PubDate: 2019-12-24
  • Rationale for targeted self-management strategies for breathlessness in
           heart failure
    • Abstract: Abstract To provide a conceptual rationale for targeted self-management strategies for breathlessness in chronic heart failure. Breathlessness is a defining symptom of chronic heart failure and is the primary cause for hospital readmissions and emergency room visits, resulting in extensive health care utilization. Chronic breathlessness, punctuated by acute physiological decompensation, is a sentinel symptom of the heart failure syndrome and often intensifies towards the end of life. Drawing upon evidence-based guidelines, physiological mechanisms and existing conceptual models for the management of breathlessness is proposed. Key elements of this model include adherence to evidence-based approaches (pharmacological and non-pharmacological management to optimize heart failure treatment), self-monitoring of symptoms, identification of modifiable factors (such as fluid overload), and targeted strategies for breathlessness including distraction and gas flow. Self-management is an essential component in heart failure management which could positively influences health outcomes and quality of life. Refining programs to focus on breathlessness may have the potential to reduce symptom burden and improve quality of life.
      PubDate: 2019-12-24
  • Cardiovascular complications in patients with idiopathic inflammatory
           myopathies: does heart matter in idiopathic inflammatory myopathies'
    • Abstract: Abstract This review presents a detailed study of original researches and previously published reviews concerning cardiovascular involvement in idiopathic inflammatory myopathies (IIM). We aimed to summarize the current knowledge on the cardiac involvement in IIM, evaluate its impact on mortality and indicate areas still awaiting to be investigated. We searched MEDLINE database (until January 2019) and the reference lists of articles. Selection criteria included only published data, available in English, both original researches and reviews. Articles related to cardiovascular involvement in IIM were selected and analysed. The references were also screened, and relevant articles were included. Cardiovascular involvement is frequent in IIM but typically remains subclinical. Among far less prevalent symptomatic forms, congestive heart failure is the most common. Myocardium and conduction system seems to be predominantly affected. High rate of left ventricular diastolic dysfunction was observed. Non-specific changes of ST-T segment were the most common abnormalities in electrocardiography. Patients with IIM were more frequently affected by atrial fibrillation as compared with other autoimmune diseases. Increased risk of myocardial infarction was observed; furthermore, patients often develop comorbidities that enhance cardiovascular risk. Since cardiovascular disorders remain one of the major causes of death and subclinical involvement is frequent, active screening is justified. Growing availability of the novel imaging techniques may facilitate diagnosis. Correlation between myocardial involvement and the type of autoantibodies and impact of different therapeutic options on the progression of cardiovascular lesions require further studies.
      PubDate: 2019-12-23
  • Mechanisms for heart failure in systemic right ventricle
    • Abstract: Abstract There are two predominant scenarios where the right ventricle acts as the systemic ventricle, namely congenitally corrected transposition of the great arteries (CC-TGA) and patients with D-transposition of the great arteries (D-TGA) who have undergone an atrial switch operation. There is evidence that having a right ventricle in the systemic position predisposes to the development of heart failure. In this review, we aim to explore the proposed mechanisms and pathophysiology for heart failure in patients with a systemic right ventricle in these two subsets of patients.
      PubDate: 2019-12-19
  • Association between evidence-based medication at discharge and outcomes in
           patients with heart failure: a systematic review and meta-analysis
    • Abstract: Abstract To conduct a meta-analysis of observational studies assessing the association between dispensing evidence-based medications (EBMs) at discharge and outcomes, we extracted published studies in English from PubMed, Medline, and EMBASE from 2007 to early 2019. The EBMs included renin-angiotensin system inhibitors (RASIs), β-blockers, and mineralocorticoid receptor antagonists (MRAs). The main outcomes of interest were all-cause death and heart failure (HF) readmission. Pooled hazard ratios (HRs) were calculated using random effect model from the adjusted HRs or relative risks (RRs) extracted from individual studies, stratified by HF patients with reduced ejection fraction (HFrEF), and preserved ejection fraction (HFpEF). Forty-three studies including a total number of 295,060 patients with an average follow-up time of 2.3 years were identified for systematic review. Dispensing RASI at discharge was independently associated with 30% and 25% lower risks of all-cause death and HF readmission respectively in HFrEF but has a moderate effect on reducing all-cause deaths (HR = 0.88, 95% CI: 0.81–0.95) in HFpEF. By contrast, dispensing β-blockers at discharge was associated with 35% lower risk of all-cause deaths in HFrEF and has a weak association with borderline statistical significance on improving overall survival in HFpEF. Dispensing MRA at discharge was associated with 5% lower risk of all-cause death in HFrEF. This meta-analysis provides evidence to support RASIs and β-blockers as primary pharmacotherapies for HF patients. Our findings suggest that the health professionals maintain use of RASIs and β-blockers at discharge for potential survival improvement.
      PubDate: 2019-12-17
  • Pulmonary vasodilator therapy after the Fontan procedure: a meta-analysis
    • Abstract: Abstract We aimed to assess the efficacy and safety of pulmonary vasodilators in patients after the Fontan procedure. The PubMed, EMBASE, and Cochrane Library databases were searched through November 2019 for studies comparing pulmonary vasodilators and controls in Fontan patients. The variables assessed included change in pulmonary resistance, heart function, exercise capacity, quality of life, mortality, and adverse events after drug administration. A random/fixed effects model was used to assess the mean difference (MD)/risk ratio (RR) with 95% confidence intervals (CIs). Subgroup analysis was stratified by drug category. In total, 449 Fontan patients from 13 studies were included. Pooled estimates of the change in pulmonary arterial pressure (MD, − 1.07; 95% CI, − 2.75 to 0.60; p = 0.21), New York Heart Association class (MD, − 0.57; 95% CI, − 1.41 to 0.28; p = 0.19), peak oxygen consumption (MD, 1.46; 95% CI, 0.01 to 2.90; p = 0.05), Short Form 36 (MD, 1.39; 95% CI, − 0.62 to 3.39; p = 0.17), mortality (RR, 0.37; 95% CI, 0.08 to 1.65; p = 0.19), and any adverse event (RR, 0.94; 95% CI, 0.71 to 1.24; p = 0.64) were not significantly different between the drug and control groups. Likewise, most results of the subgroup analysis revealed no significant between-group differences. Pulmonary vasodilator therapy appears to be safe, but not beneficial, in the categories of pulmonary resistance, heart function, or quality of life in patients who have undergone a Fontan procedure. No significant evidence was found to confirm that most pulmonary vasodilators could improve exercise capacity in Fontan patients.
      PubDate: 2019-12-16
  • A miRNA’s insight into the regenerating heart: a concise descriptive
    • Abstract: Abstract Manipulation of microRNA (miRNA) expression has been shown to induce cardiac regeneration, consolidating their therapeutic potential. However, studies often validate only a few miRNA targets in each experiment and hold these targets entirely accountable for the miRNAs’ action, ignoring the other potential molecular and cellular events involved. In this report, experimentally validated miRNAs are used as a window of discovery for the possible genes and signaling pathways that are implicated in cardiac regeneration. A thorough evidence search was conducted, and identified miRNAs were submitted for in silico dissection using reliable bioinformatics tools. A total of 46 miRNAs were retrieved from existing literature. Shared targets between miRNAs included well-recognized genes such as BCL-2, CCND1, and PTEN. Transcription factors that are possibly involved in the regeneration process such as SP1, CTCF, and ZNF263 were also identified. The analysis confirmed well-established signaling pathways involved in cardiac regeneration such as Hippo, MAPK, and AKT signaling, and revealed new pathways such as ECM-receptor interaction, and FoxO signaling on top of hormonal pathways such as thyroid, adrenergic, and estrogen signaling pathways. Additionally, a set of differentially expressed miRNAs were identified as potential future experimental candidates.
      PubDate: 2019-12-14
  • Cost-effectiveness analysis of PCSK9 inhibitors in cardiovascular
           diseases: a systematic review
    • Abstract: Aims To assess the cost-effectiveness of pro-protein convertase subtilisin/kexin type 9 (PCSK9) inhibitors in cardiovascular disease. Methods and results We performed a comprehensive search strategy in electronic databases from January 2015 to January 2019. Out of 475 articles, 16 were entered into the study. Quality-adjusted life year, life years gained (LYG), annual cost, and the incremental cost-effectiveness ratio (ICER) regarding the use of PCSK9 inhibitors were considered as the key outcomes. The cost-effectiveness threshold varied from $45,000 in Spain to $150,000 in the USA. The annual cost of PCSK9 inhibitors for studies undertaken in the USA was in the range of $14,000 to $15,000, while it was about $7000 for other developed countries. The results showed that reduction in the price of PCSK9 inhibitors changed from 20 to 88%. The means of QALY were 0.65 and 0.67 in the Markov and Cardiovascular Disease Policy Modeling (CVDPM) models; also, the ICER means were $197,707 and $625,555 for the Markov and CVDPM model, respectively. Conclusion According to the current study, the effectiveness of PCSK9 inhibitors is well documented, although all studies pointed out a higher cost of these inhibitors. Trial registration This study was registered within the International Prospective Register of Systematic Reviews (PROSPERO) database of the University of York (CRD42018088472).
      PubDate: 2019-12-13
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
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