Cardiovascular Medicine

8 pages, 10249 KB

Open AccessReview

Obstructive Sleep Apnoea and Heart Failure

by Micha T. Maeder, Otto D. Schoch, Marc Buser, Peter Ammann and Hans Rickli

Cardiovasc. Med. 2017, 20(1), 9; https://doi.org/10.4414/cvm.2017.00452 (registering DOI) - 18 Jan 2017

Cited by 4 | Viewed by 73

There are multiple lines of evidence of a strong link between obstructive sleep apnoea and heart failure. First, obstructive sleep apnoea is associated with cardiovascular risk factors (hypertension and diabetes) and cardiovascular diseases (coronary artery disease, atrial fibrillation) which predispose to the development of heart failure. Second, obstructive sleep apnoea per se is associated with changes in cardiac structure and function. Third, the presence of obstructive sleep apnoea is related to an increased incidence of heart failure. Fourth, in patients with established heart failure with reduced ejection fraction (HFrEF), the presence of obstructive sleep apnoea is associated with worse outcomes. And fifth, mechanistic proof-of-concept studies have shown that treatment with continuous positive airway pressure (CPAP) not only successfully treats the obstructive sleep apnoea but also has the potential to reverse or at least to attenuate cardiac dysfunction in subjects with obstructive sleep apnoea without heart failure, as well as in patients with HFrEF and obstructive sleep apnoea. However, there are no randomized studies showing that treatment of obstructive sleep apnoea with CPAP improves clinical outcomes in patients with heart failure. In the present review, we summarise the current knowledge on the role of obstructive sleep apnoea as a risk factor predisposing to the development of heart failure, its role in patients with heart failure, the effects of CPAP on cardiac function in patients with and without heart failure, and the potential role of obstructive sleep apnoea as a disease modifier and therapeutic target in patients with heart failure. Full article

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6 pages, 278 KB

Open AccessReview

Vorhofflimmern und Antikoagulation—Update 2016

by Alexander Breitenstein and Jan Steffel

Cardiovasc. Med. 2017, 20(1), 3; https://doi.org/10.4414/cvm.2017.00455 - 18 Jan 2017

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Abstract

Non-vitamin K-dependent oral anticoagulants have replaced vitamin K antagonists in thromboembolism prevention in the case of non-valvular atrial fibrillations as a first choice treatment, based on studies with 4 different substances with tens of thousands of patients, which prove the safety, above all, but also the efficacy of the substances. This is being increasingly reinforced by “real world data”, which, despite numerous important limitations, are able to show an overall consistent effect with the large randomized clinical trials. Even in special situations, such as renal failure, fragility and other high-risk groups, NOACs appear to be superior to vitamin K antagonists. Meanwhile, a direct effective antidote to Dabigatran is available; approval for the antidote for the FXa inhibitor is expected for 2018. In the case of patients with absolute contraindications for anticoagulation, the interventional left atrial appendage occlusion may represent a good alternative option. Full article

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1 pages, 147 KB

Open AccessInteresting Images

Gunshot Reversed the Tako-Tsubo

by Nils Perrin, Jean-Christophe Stauffer, Laurent Froidevaux and Jean-Jacques Goy

Cardiovasc. Med. 2017, 20(1), 24; https://doi.org/10.4414/cvm.2017.00454 - 18 Jan 2017

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Abstract

A-year-old man without any past medical history was shot with a gun in the legs and underwent an urgent haemostatic surgical procedure without complications[...] Full article

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2 pages, 109 KB

Open AccessCase Report

Multiple Mitral Valve Repairs in Relapsing Endocarditis

by Tiziano Torre, Giorgio Franciosi and Stefanos Demertzis

Cardiovasc. Med. 2017, 20(1), 22; https://doi.org/10.4414/cvm.2017.00453 - 18 Jan 2017

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Abstract

We present the case of a young woman with a history of drug abuse, who was treated for mitral valve endocarditis. Six months after a successful mitral valvuloplasty, the patient returned to hospital with relapsing endocarditis, which was treated once again with mitral repair. The strategy in this case was preferentially driven by the childbearing age of the patient. In cases of extensive destruction, it could be reasonable to proceed to a valve replacement, especially when a satisfactory repair is not achievable. Full article

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5 pages, 112 KB

Open AccessReview

The Good and Bad of Exercise

by Baris Gencer and Philippe Meyer

Cardiovasc. Med. 2017, 20(1), 17; https://doi.org/10.4414/cvm.2017.00456 - 18 Jan 2017

Viewed by 102

Abstract

The 2016 European Society of Cardiology guidelines on cardiovascular disease prevention in clinical practice have been recently published, with a large section addressing the benefits of physical activity on general health and control of cardiovascular risk factors. Regular physical activity remains the cornerstone of cardiovascular prevention and is recommended for the entire population. At least of 30 min a day of moderate activity 5 days a week or 20 min of intensive activity 3 days a week is recommended for the overall cardiovascular health, which is in line with the American Heart Association prevention guidelines. The prescription of physical activity is one of the most cost-effective treatments in medicine. Full article

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Cardiovasc. Med., Volume 20, Issue 1 (01 2017) – 5 articles

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