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The cardiovascular diseases affecting the people have at their core atherosclerosis and hypertension, both of which are profoundly affected by diet and can be approached at least in part from a nutritional point of view as can the increasing epidemic of obesity. Diet is a multi-component mixture of many nutrients, which may interact with one another. The definitive study of nutrients and their impact on cardiovascular disease can be a daunting enterprise. Many dietary risk factors contribute to these diseases in various environmental and ethnic settings. These risk factors are often in evidence in youth so that preventive measures must be initiated early in life. Most of the information about nutritional risk factors and cardiovascular disease derives from studies in the developed world.
Unlike cardiovascular disease, which describes problems with the blood vessels and circulatory system as well as the heart, heart disease refers only issues and deformities in the heart itself. Heart disease refers to various types of conditions that can affect heart function. These include coronary artery (atherosclerotic) heart disease that affects the arteries to the heart; valvular heart disease that affects how the valves function to regulate blood flow in and out of the heart; cardiomyopathy that affects how the heart muscle squeezes; heart rhythm disturbances (arrhythmias) that affect the electrical conduction; heart infections where the heart has structural problems that develop before birth; coronary artery disease is the most common type of heart disease in the US; coronary arteries supply blood to the heart muscle and coronary artery disease occurs when there is a buildup of cholesterol plaque inside the artery walls. A heart attack occurs when a plaque ruptures and forms a clot in the artery causing a complete blockage. That part of the heart muscle that is denied blood supply starts to die. According to the Centers for Disease Control (CDC), heart disease is the leading cause of death in the United Kingdom, United States, Canada, and Australia. One in every four deaths in the U.S. occurs as a result of heart disease.
Interventional cardiologists rank among the world's foremost authorities on cardiovascular disease and its treatment. They perform large number of procedures on the heart by catheterization. This most commonly involves the insertion of a sheath into the femoral artery but in practice, any large peripheral artery or vein and cannulating the heart under X-ray visualization most commonly fluoroscopy. This approach offers several advantages including the accessibility of the artery in most patients, the easy control of bleeding even in anticoagulated patients, the enhancement of comfort because patients are capable of sitting up and walking immediately following the procedure, and the near absence of clinically significant sequelae in patients with a normal Allen test. Downsides to this approach include spasm of the artery and pain, inability to use larger catheters needed in some procedures, and more radiation exposure.
Pediatric and Neonatal Cardiology deal with evaluates fetuses of mothers with health conditions such as diabetes, lupus and Sjögren syndrome, which can affect heart development. They treat a wide range of fetal and neonatal heart conditions, which include congenital heart defects ranging from septal defects to hypoplastic left heart syndrome; irregular heart rhythms (arrhythmia); prenatal heart failure (hydrops). The diagnosis includes specialized ultrasound imaging of the heart during pregnancy or fetal echocardiography. The pediatric cardiologist is able to provide immediate results to the mother at the time of the scan. Neonatal cardiology provides complete heart care for expectant mothers and their babies as well as newborn infants.
Cardiovascular Pharmacology is concerned with the treatment of cardiovascular disease. It emphasizes the biophysical, biochemical, and cellular basis for drug therapy with a thorough understanding of not only general pharmacologic principles and mechanisms of action of cardiovascular drugs, but more importantly, with an understanding of the rationale for drug use.
Cardiovascular Pharmacology deals with treatment of cardiovascular disease which requires administration of numerous medications for longer periods of time to patients likely to be old and suffering from a range of comorbid conditions. Rational prescribing informed by clinical pharmadeals with cology is essential if the right drug is to be administered to the right patient, at the right time, and for the right price. This requires an appreciation of the key principles of clinical pharmacology, and specific knowledge of individual therapies. Knowledge of polypharmacy and drug interactions is crucial, and the pharmacokinetic and pharmacodynamic challenges associated with advanced patient age, comorbidity, and sometimes frailty must be addressed and overcome. Long-term preventive medication raises issues concerning safety, adherence, and cost to healthcare providers. A basic familiarity with the principles of pharmaco-vigilance, pharmaco-epidemiology, and pharmaco-economics may therefore be of some value to practitioners. The environmental and genetic determinants of variability in response to treatment are increasingly well understood, and new biomarkers and pharmacogenetic techniques provide the foundations of the emerging discipline of personalized medicine.
Cardiovascular Toxicology deals with the adverse effects on the heart or blood systems which result from exposure to toxic chemicals. It describes safety data of detrimental effects of new cardiovascular drugs.
The Molecular Cardiology is concerned with the study of the molecular mechanisms of cardiovascular biology of great interest for human cardiovascular diseases. It focuses on discovery and study of the novel pathways that regulate cardiac hypertrophy, aging and metabolic diseases with specific attention to translating bench findings to new bedside approaches and strategies. Using a broad variety of techniques in genomics, stem cell biology, molecular biology, gene therapy, transgenic models and parabiosis, it approaches cardiovascular problems relevant to human diseases to develop solutions that we validate by performing in vivo studies. A great interest of the laboratory is the identification of novel circulating factors that regulate cardiac biology including aging and hypertrophy. An important example is the demonstration that using the parabiosis surgical technique, age-related cardiac hypertrophy can be reversed by exposure to a young circulatory environment.
The vascular network consists of both small and large vessels specifically designed to accommodate varying levels of blood flow and pressure, depending upon the location within the body such as large conduit vessels versus small microvessels within the capillary beds in tissues. In addition layered within the vascular tissue is a diverse population of cell types including endothelial cells, smooth muscle cells, pericytes, fibroblasts, and other connective tissue cell types. The combination of these cell types make up the vascular tissue and form tight junctions or connections, which allow for permeability for both passive and active transport across the vessel wall. The endothelial cells found within the vascular tissue are also involved in other activities critical to maintaining normal growth and function; providing an inner lining to the heart and blood vessels; secretion of bioactive molecules to affect local cellular environments; mediate angiogenesis and normal microvascular growth; transport molecules from the blood to the interstitial fluid; interact with adjacent smooth muscle cells during growth and disease. Endothelial cells also play a critical role in normal tissue maintenance and growth. However, aberrant or uncontrolled vascular cell growth can also be associated with diseases and processes such as angiogenesis, diabetic retinopathy, and other developmental conditions that are currently the focus of many research efforts today.
Clinical Cardiology is concerned with research that allows cardiologists to do clinical research on cardiology. The clinical cardiology research include cardiology disorders, treatment related to disorders, techniques to find out any particular disorders etc in this discipline and helps to create a platform for other researchers to contribute towards this field. A clinical cardiology deals with diagnosing and treating conditions that affect the heart and surrounding blood vessels. Cardiologists require specialized education and training that teaches them how to prevent and treat diseases affecting the heart. These may include heart attacks, stroke, coronary artery disease and related conditions. According to the U.S. Bureau of Labor Statistics, employment growth for clinical cardiologists is good with opportunities expected to increase by as much as 24 percent through 2020, which is faster than average for all occupations.
Cardiometabolic syndrome is a constellation of metabolic dysfunction characterized by insulin resistance and impaired glucose tolerance, atherogenic dyslipidemia, hypertension and intra-abdominal adiposity (IAA). Other names used for cardiometabolic syndrome are insulin resistance syndrome, syndrome X, Reavan's syndrome, Beer belly syndrome, etc. Cardiometabolic syndrome is now recognized as a disease entity by the American Society of Endocrinology, National Cholesterol Education Program (NCEP), and World Health Organization. Around 25% of the world's adults are suffering from cardiometabolic syndrome. People with cardiometabolic syndrome are two times more likely to die from coronary heart disease and three times more likely to have heart attack and stroke. Visceral fat is metabolically active tissue that produces various pro-inflammatory and prothrombotic cytokines. Both fatty liver and abdominal visceral adipose tissue are independent correlates of cardiometabolic risk, but the association is stronger for VAT than fatty liver.
Cardiac toxicity is harmful chemicals that damage the heart. As part of the treatment, you may be given toxins or drugs to kill cancer cells. A side effect is that the normal cells in and around your heart can also be killed. Besides cell death, other types of cardiac toxicity from cancer treatment include cardiomyopathy is when heart muscle becomes weakened, enlarged, thickened, or stiff; Myocarditis is inflammation (swelling) of the heart; Pericarditis is inflammation or swelling of the sac surrounding the heart; acute coronary syndromes caused by blood vessel damage reduces blood flow to the heart; congestive heart failure is when the heart is unable to pump enough blood throughout the body. Chemotherapy can cause mild or severe damage to the heart. The chemotherapy drugs that most commonly cause heart damage are anthracyclines. Anthracyclines are used to treat many types of cancers which include some types of leukemia, lymphoma, sarcomas as well as bladder, bone, breast, head and neck, kidney, skin, stomach, and other cancers.
Echocardiography is referred to a cardiac echo or simply an echo is a sonogram of the heart. Electrocardiogram is abbreviated as ECG. Echocardiography uses standard two-dimensional, three-dimensional, and Doppler ultrasound to create images of the heart. Echocardiography has become routinely used in the diagnosis, management, and follow-up of patients with any suspected or known heart diseases. It is one of the most widely used diagnostic tests in cardiology. It can provide a wealth of helpful information including the size and shape of the heart internal chamber size quantification, pumping capacity, and the location and extent of any tissue damage. An echocardiogram can also give physicians other estimates of heart function, such as a calculation of the cardiac output, ejection fraction, and diastolic function that shows how well the heart relaxes.
Cardiomyopathy is a group of diseases that affect the heart muscle. Early on there may be few or no symptoms. Some people may have shortness of breath, feel tired, or have swelling of the legs due to heart failure. An irregular heart beat may occur as well as fainting. Those affected are at an increased risk of sudden cardiac death. Types of cardiomyopathy include hypertrophic cardiomyopathy, dilated cardiomyopathy, restrictive cardiomyopathy, arrhythmogenic right ventricular dysplasia, and takotsubo cardiomyopathy broken heart syndrome. In hypertrophic cardiomyopathy the heart muscle enlarges and thickens. In dilated cardiomyopathy the ventricles enlarge and weaken. In restrictive cardiomyopathy the ventricle stiffens. The cause is frequently unknown. Hypertrophic cardiomyopathy usually is inherited, while dilated cardiomyopathy is inherited in a third of cases. Dilated cardiomyopathy may also result from alcohol, heavy metals, coronary heart disease, cocaine use, and viral infections.
When the heart's electrical system malfunctions, the normal rhythm of the heart is affected. Depending upon the abnormality, the heart may begin to beat too fast, too slow, irregularly, or not at all. Heart rhythm disorders are often referred to as cardiac arrhythmias. But this is technically incorrect, since in most cases there is a heart rhythm, but it is abnormal. Cardiac dysrhythmia might be a better term. Dysrhythmias may occur because of problems directly associated with the electrical wiring, the SA node, the AV node, or ventricular conducting system. The issue may also be due to influences on the conducting system from outside the heart. These can include electrolyte abnormalities in the bloodstream, abnormal hormone levels for example thyroid function that is too high or too low, and medication or drug ingestions. Any abnormality of the electrical cycle within the heart that generates an abnormal beat, whether it is too fast, too slow, skipped, or irregular is considered a dysrhythmia.
Hypertensive heart disease includes a number of complications of high blood pressure that affect the heart. While there are several definitions of hypertensive heart disease in the medical literature, the term is most widely used in the context of the International Classification of Diseases (ICD) coding categories. The definition includes heart failure and other cardiac complications of hypertension when a causal relationship between the heart disease and hypertension is stated or implied on the death certificate. Since high blood pressure is a risk factor for atherosclerosis and ischemic heart disease death rates from hypertensive heart disease provide an incomplete measure of the burden of disease due to high blood pressure. The symptoms and signs of hypertensive heart disease will depend on whether or not it is accompanied by heart failure. In the absence of heart failure, hypertension, with or without enlargement of the heart left ventricular hypertrophy is usually symptomless.
Cardiology breakthroughs couldn’t come soon enough because heart disease is the No. 1 killer of men and women in the U.S. About 610,000 Americans die of heart disease per year, and an additional 735,000 Americans suffer from a heart attack. Risk prevention, electrophysiology, imaging, heart failure, percutaneous coronary intervention, and acute cardiac care are some of the recent advances made in cardiology. In clinical context the new trial findings regarding anticoagulation or dabigatran; antiplatelet therapy such as ticagrelor, clopidogrel, prasugrel and aspirin; percutaneous coronary management like thrombectomy, multivessel / left main disease and biodegradable polymers; medical therapy for coronary disease ivabradine and rosuvastatin; and management of heart failure beta-blocker strategy; atrial fibrillation and resynchronization therapy.
Cardiac remodeling or Ventricular Remodeling refers to changes in the size, shape, structure, and function of the heart. This can happen as a result of exercise physiological remodeling or after injury to the heart muscle pathological remodeling. The injury is typically due to acute myocardial infarction usually transmural or ST segment elevation infarction, but may be from a number of causes that result in increased pressure or volume, causing pressure overload or volume overload or forms of strain on the heart. Chronic hypertension, congenital heart disease with intracardiac shunting and valvular heart disease may also lead to remodeling. After the insult occur a series of histopathological and structural changes occur in the left ventricular myocardium that lead to progressive decline in left ventricular performance. Ultimately ventricular remodeling may result in diminished contractile (systolic) function and reduced stroke volume.
Cardiovascular Engineering and Technology (CVET) presents a wide spectrum of research, from basic to translational in all aspects of cardiovascular physiology and medical treatment. It offers academic and industrial investigators a forum for the dissemination of research that utilizes engineering principles and methods to advance fundamental knowledge and technological solutions related to the cardiovascular system. It focuses on research from subcellular to systems-level to implantable medical devices, hemodynamics and tissue biomechanics, functional imaging, surgical devices, electrophysiology, tissue engineering and regenerative medicine, diagnostic instruments, transport and delivery of biologics, and sensors. Cardiovascular disease is the number one cause of death in many countries around the world. Cardiovascular Engineering encompasses a multi-disciplinary effort to improve an understanding of cardiovascular disease and to develop better therapies. Cardiovascular engineering seeks to develop new methods to study, diagnose and treat cardiovascular diseases. The study includes the understanding of how molecules control the heartbeat, imaging the electrical potential at the surface of the heart.
Palliative surgery for congenital heart disease has allowed patients with previously lethal heart malformations to survive and in most cases to thrive. However, these procedures often place pressure and volume loads on the heart and over time, these chronic loads can cause heart failure. Surmounting the heart regeneration barrier it transforms the treatment of congenital as well as acquired heart disease and likewise would enable development of personalized, in vitro cardiac disease models. Although these remain distant goals, studies of heart development are illuminating the path forward and suggest unique opportunities for heart regeneration particularly in fetal and neonatal periods. Many of the more complex forms of congenital heart disease still cannot be physiologically corrected; rather, patients are surgically palliated, permitting survival but leaving significant residual cardiac pressure and volume loads. Over time these patients are at risk for heart failure, and some ultimately require heart transplantation.
Evaluation of 2082 patients who were treated with drug-eluting stent for bifurcation lesions and were event free or no death, myocardial infarction [MI], cerebrovascular accident, stent thrombosis, or any revascularization at 12 months after the index procedure. Patients were divided into 2 groups: DAPT ≥12-month group (n=1776) and DAPT <12-month group (n=306). Primary outcome was all-cause death or MI. At 4 years after the index procedure, death or MI occurred less frequently in the DAPT ≥12-month group than the DAPT <12-month group (2.8% versus 12.3%; adjusted hazard ratio, 0.21; 95% confidence interval, 0.13–0.35; P<0.001). After propensity score matching, incidence of death or MI was still lower in the DAPT ≥12-month group than the DAPT <12-month group (2.6% versus 12.3%; adjusted hazard ratio, 0.22; 95% confidence interval, 0.12–0.38; P<0.001). In subgroup analysis, the treatment effect of prolonged DAPT was consistent across subgroups regardless of lesion location, stenting technique, or type of used drug-eluting stent. The risk of all-cause death or MI was significantly lower in the ≥12-month DAPT group than the <12-month DAPT group after percutaneous coronary intervention for bifurcation lesion using drug-eluting stent. Our results suggest that prolonged DAPT may improve long-term clinical outcomes after percutaneous coronary intervention for bifurcation lesions.
Coronary Heart Disease (CAD) also known as ischemic heart disease (IHD), refers to a group of diseases which includes stable angina, unstable angina, myocardial infarction, and sudden cardiac death. It is within the group of cardiovascular diseases of which it is the most common type. A common symptom is chest pain or discomfort which may travel into the shoulder, arm, back, neck, or jaw. Occasionally, it may feel like heartburn. Usually symptoms occur with exercise or emotional stress, last less than a few minutes, and improve with rest. Shortness of breath may also occur and sometimes no symptoms are present. In many cases, the first sign is a heart attack. Other complications include heart failure or an abnormal heartbeat. Risk factors include high blood pressure, smoking, diabetes, lack of exercise, obesity, high blood cholesterol, poor diet, depression, and excessive alcohol. The underlying mechanism involves reduction of blood flow and oxygen to the heart muscle due to atherosclerosis of the arteries of the heart. A number of tests may help with diagnoses including electrocardiogram, cardiac stress testing, coronary computed tomographic angiography, and coronary angiogram, among others.
Cardiac disease in the pregnant patient can present challenges in cardiovascular and maternal-fetal management. It is important to understand that even in normal patients, pregnancy imposes some dramatic physiologic changes upon the cardiovascular system. These include an increase in plasma volume by 50%, an increase in resting pulse by 17%, and an increase in cardiac output by 50%. After delivery, the heart rate normalizes within 10 days; by 3 months postpartum, stroke volume, cardiac output, and systemic vascular resistance return to the pre-pregnancy state. Acute coronary syndromes and myocardial infarction are rare in pregnancy, which is 1–2 per 35,000 deliveries but can occur in all stages. The usual coronary risk factors apply and additional risk factors include advanced maternal age, thrombocytosis, blood transfusion, and preeclampsia. Cardiac catheterization is permissible in pregnant patients with appropriate abdominal lead coverage for the mother and fluoroscopy time minimized. Thrombolytic agents can be given but the guidelines for percutaneous coronary intervention should be followed. Direct-current cardioversion is also safe in pregnancy. Supraventricular and ventricular tachycardia should be treated by both nonpharmacologic and pharmacologic means, as in the non-pregnant patient. However amiodarone should be avoided because it crosses the placenta and can have toxic effects on the fetus.
Myocardial infarction (MI) known as a heart attack occurs when blood flow decreases or stops to a part of the heart, causing damage to the heart muscle. The most common symptom is chest pain or discomfort which may travel into the shoulder, arm, back, neck, or jaw. Often it occurs in the center or left side of the chest and lasts for more than a few minutes. The discomfort may occasionally feel like heartburn. Other symptoms may include shortness of breath, nausea, feeling faint, a cold sweat, or feeling tired. About 30% of people have atypical symptoms. Women more often have atypical symptoms than men. Among those over 75 years old, about 5% have had an MI with little or no history of symptoms. An MI may cause heart failure, an irregular heartbeat, cardiogenic shock, or cardiac arrest. Most MIs occur due to coronary artery disease. Risk factors include high blood pressure, smoking, diabetes, lack of exercise, obesity, high blood cholesterol, poor diet, and excessive alcohol intake etc.
Cardiac arrhythmia can be defined as a problem of heart rhythm. In this condition, the heart beats either too quick, too slow, or in an irregular pattern. When the heart beats more rapidly than normal, it is called tachycardia and when it beats too slowly, it is called bradycardia. Factors which can affect heart's rhythm are few heart diseases, smoking, congenital heart defects, and stress.
Heart disease is the leading cause of death in the western world. Each year in the U.S.A, more than 500,000 men and women die from coronary artery disease. During the past two decades, major strides have been made in the diagnosis and treatment of heart disease. Nuclear Cardiology has played a pivotal role in establishing the diagnosis of heart disease and in the assessment of disease extent and the prediction of outcomes in the setting of coronary artery disease. Nuclear cardiology studies use noninvasive techniques to assess myocardial blood flow, evaluate the pumping function of the heart as well as visualize the size and location of a heart attack. Among the techniques of nuclear cardiology, myocardial perfusion imaging is the most widely used.
Noninvasive cardiac imaging can be used for the diagnostic and prognostic assessment of patients with suspected or known coronary artery disease. It is central to the treatment of patients with myocardial infarction, coronary artery disease, or acute coronary syndromes with or without angina. Radionuclide cardiac imaging; echocardiography; and, increasingly, cardiac computed tomography and cardiac magnetic resonance imaging techniques play an important role in the diagnosis of coronary artery disease