Cardiovascular Research is to learn the basic, translational, and clinical research of cardiovascular diseases. Cardiovascular diseases, including Heart Rhythm and Arrhythmias, HIV and Heart Disease, Imaging, Interventional Cardiology, Myocardial Biology/Heart Failure, Preventive Cardiology, Women and Heart Disease, congestive heart failure, hypertension, atherosclerosis, stroke, aneurysms, and vascular auto-immune diseases are the most common cause of death and disability in the United States, and account for approximately 30% of deaths and health care costs annually in this country and developed societies. The mission of Cardiovascular Research is to support interdisciplinary research in basic, translational and clinical cardiovascular sciences, including cardiovascular development, function, pathophysiology, pharmacology, genetics, genomics, and proteomics, and to apply this knowledge to better understand the causes of cardiovascular diseases and to pioneer development of new innovative therapies and approaches to prevent or treat them.
Cardiovascular surgeons perform many different types of operations, including heart valve repair and replacement, heart defect repair, coronary artery bypass, aneurysm repair, trans myocardial laser revascularization, and heart transplantation, heart failure surgery, surgery to treat congenital heart defects in children and congenital heart disease in adults, trans catheter aortic valve replacement and implantation of ventricular assist devices, and total artificial hearts.. They also perform operations on the blood vessels in your body, including the aorta—the body’s main blood supplier. Heart surgery today may also include the use or implantation of ventricular assist devices (VADs), mechanical devices that “assist” the failing heart by helping it pump blood throughout the body.
Cardiac nurses possess a high level of education and experience that allows them to diagnose, treat, and manage conditions that affect the complex cardiovascular system. They work to promote optimal cardiovascular health among clients through preventative measures that involve health counselling, screening, and stress tests, as well as disease prevention and management strategies. They also provide care to patients with coronary heart disease, providing post-operative care to those recovering from bypass surgery or heart transplant.
Although cardiac nurses are traditionally employed in hospital cardiology units, cardiovascular interventional units, and cardiothoracic surgical units, the need for cardiac nurses in diagnostic, rehabilitative, and long-term care settings is also on the rise. Cardiac nurses also serve vital roles in a number of cardiology specific medical settings:
Congenital heart defects, or diseases, are problems with the heart’s structure that are present at birth. They may change the normal flow of blood through the heart. Congenital heart defects are the most common type of birth defect. There are many types of congenital heart defects. The most common defects involve the inside walls of the heart, the valves of the heart, or the large blood vessels that carry blood to and from the heart. Some defects require no treatment, but some require treatment soon after birth. Because diagnosis and treatment of congenital heart defects has improved, more babies are surviving and now many adults are living with congenital heart defects. Types:
Cardiovascular diseases (CVDs) are a group of disorders of the heart and blood vessels and they include:
Heart attacks and strokes are usually acute events and are mainly caused by a blockage that prevents blood from flowing to the heart or brain. The most common reason for this is a build-up of fatty deposits on the inner walls of the blood vessels that supply the heart or brain. Strokes can also be caused by bleeding from a blood vessel in the brain or from blood clots. The cause of heart attacks and strokes are usually the presence of a combination of risk factors, such as tobacco use, unhealthy diet and obesity, physical inactivity and harmful use of alcohol, hypertension, diabetes and hyperlipidaemia.
Interventional cardiology is a branch of cardiology that deals specifically with the catheter based treatment of structural heart diseases. Interventional cardiology is a non-surgical option which uses a catheter – a small, flexible tube – to repair damaged or weakened vessels, narrowed arteries, or other affected parts of the heart structure. A large number of procedures can be performed on the heart by catheterization. The main advantages of using the interventional cardiology or radiology approach are the avoidance of the scars and pain, and long post-operative recovery. Additionally, interventional cardiology procedure of primary angioplasty is now the gold standard of care for an acute myocardial infarction.
Pulmonary hypertension is a sort of hypertension that influences the arteries in lungs and the right side of heart. In one type of pulmonary hypertension, tiny arteries in your lungs, called pulmonary arterioles, and capillaries become narrowed, blocked or devastated. This makes it harder for blood to move through your lungs, and raises pressure inside your lungs' courses. As the pressure builds, your heart's lower right chamber (right ventricle) must work harder to pump blood through your lungs, in the long run causing your heart muscle to debilitate and fail. In spite of the fact that a few kinds of pulmonary hypertension are not curable, treatment can help decrease symptoms and enhance quality of life.
The future holds dramatic advances that will transform the cardiac surgeon, in part, into an intervention list with new skills in diagnostic and therapeutic approaches to structural heart disease. The cardiovascular surgery has achieved great progress both on scale and technology though development over the past thirty years. However, the technical predominance of cardiovascular surgery in therapies for some diseases has been weakened, along with developments of new drugs and interventional technology. Currently, cardiovascular surgeons should practice the "patient first" principle, carry out individual customized treatment and precision therapy, absorb the advantages of other subjects like intervention and imaging in order to achieve technological breakthroughs, create new treatment technologies and models with smaller trauma and better outcome, establish heart team to provide patient oriented treatment. Besides, cardiovascular surgeons should improve knowledge system by learning related technology and science, become hybrid doctors of research. Cardiovascular surgeons should pay high attention to critical effect of research on the disciplinary development, change the medical practice by virtue of research achievements, direct the treatment for cardiovascular diseases, and finally provide better health service and rebuild the predominance of cardiovascular surgery.
Obesity and diabetes, are independently associated with post-ischemic stroke outcomes (e.g., functional disability and all-cause mortality). The association between total or abdominal obesity and risk for recurrent stroke or survival has been examined in only a few studies. These have not demonstrated an association between obesity and risk for recurrence. Paradoxically, poststroke mortality, as well as the composite outcome of major cardiovascular events (i.e, stroke, myocardial infarction, or vascular death), may be lower among some stroke survivors who are overweight or obese compared with those of normal weight. Age seems to modify this effect such that obesity is associated with increased mortality among young stroke survivors and reduced mortality among older survivors. The relationship between central obesity and stroke is inconsistent in diabetic and non-diabetic populations. This indicates an interaction between diabetes and central obesity on stroke risk. Stroke is an important cause of morbidity and mortality, and is an economic burden. Diabetes and obesity are two important modifiable risk factors for stroke. Patients with diabetes have a higher incidence of stroke and a poorer prognosis after stroke. Risk-factor modification is the most important aspect of prevention of stroke in diabetes and obesity. This includes lifestyle modifications and different therapeutic modalities to control conditions, such as diabetes, hypertension, dyslipidemia and arrhythmia.
New tests are constantly being developed to further the understanding of disease, injury, and congenital (present at birth) or acquired abnormalities of the heart. These are just a few of the tests that have been used to diagnose heart and blood vessel disease (cardiovascular).
Cardiac regeneration is well documented in lower vertebrates and in developing mammals. After we are born, however, human heart regeneration becomes limited. the evidence for cardiomyocyte turnover in humans, and current experimental strategies to remuscularize the injured heart using adult and pluripotent stem cells, cellular reprogramming and tissue engineering. Current therapeutic options for initial surgery and chronic heart failure that results from failed palliation are limited, in part, by the mammalian heart’s low inherent capacity to form new cardiomyocytes. Surmounting the heart regeneration barrier would transform the treatment of congenital, as well as acquired, heart disease and likewise would enable development of personalized, in vitro cardiac disease models.
Cardiac Anaesthesiology is a multi-faceted division dedicated to perioperative cardiovascular care, education and research. Approximately 1,500 open-heart procedures per year require anaesthesia. These procedures include coronary artery bypass, valve replacement , heart transplant, pulmonary thromboendarterectomy, and mechanical circulatory assist devices(artificial heart and left ventricular assist device). Clinical anaesthesia is also provided for a growing number and variety of pacemaker and implantable cardioverter-defibrillator (ICD), percutaneous aortic valve and arrhythmia procedures. The cardiovascular anaesthesiologist stays in the operating room as a vital part of the surgical team. He or she makes decisions about how to protect and regulate any of your organ systems by using advanced technology to monitor not only your body functions but also the appropriate anaesthetic medicines. After surgery, the anaesthesiology team monitors how you wake from the anaesthesia and follows your postoperative progress.
Cardiovascular disease is a major cause of morbidity and mortality throughout the world. Most cardiovascular diseases, such as ischemic heart disease and cardiomyopathy, are associated with loss of functional cardiomyocytes. Unfortunately, the heart has a limited regenerative capacity and is not able to replace these cardiomyocytes once lost. In recent years, stem cells have been put forward as a potential source for cardiac regeneration. Stem cell-derived cardiac cells should resemble original cardiac cell types and be able to integrate in the damaged heart. Integration requires administration of stem cell-derived cardiac cells at the right time using the right mode of delivery. Once delivered, transplanted cells need vascularization, electrophysiological coupling with the injured heart, and prevention of immunological rejection. Finally, stem cell therapy needs to be safe, reproducible, and affordable. Heart regeneration via stem cell therapy could improve the functional outcome for millions of patients. A goal of cardiac stem cell research is to foster the engraftment of new, beating cardiac cells into the ischemic region of the heart after a myocardial infarction. After decades of believing the heart loses the ability to regenerate soon after birth, numerous studies are now reporting that the adult heart may indeed be capable of regeneration, although the magnitude of new cardiac myocyte formation varies greatly. While this debate has energized the field of cardiac regeneration and led to a dramatic increase in our understanding of cardiac growth and repair, it has left much confusion in the field as to the prospects of regenerating the heart.
Pediatric cardiology is outgrowing from the shadows of adult cardiology and cardiac surgery. It promises to be an attractive and sought-after subspeciality of Pediatrics, dealing with not only congenital cardiac diseases but also metabolic, rheumatic and host of other cardiac diseases. The new government policy shall provide more training avenues for the budding pediatric cardiologists, pediatric cardiac surgeons, pediatric anesthetists, pediatric cardiac intensivists, neonatologists and a host of supportive workforce. Neonatal heart conditions mainly includes heart defects associated with other types of disease, such as diaphragmatic hernia, heart muscle disease (cardiomyopathy) or infection (myocarditis), Heart problems due to lung masses, etc. Congenital heart disease (CHD) is the most common, congenital disorder in newborns. A neonatal cardiologist is a pediatrician who has received extensive training in diagnosing and treating babies cardiac problems.
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. Cardiovascular pharmacology manages the drug of heart illnesses. The Cardiac Drugs are utilized to treat states of the heart or the circulatory or vascular framework. Many classes of cardiovascular operators are accessible to treat the different cardiovascular conditions. Pharmacology of vascular endothelium deals with alterations of endothelial cells and the vasculature play a central role in the pathogenesis of a broad spectrum of the most dreadful of human diseases, as endothelial cells have the key function of participating in the maintenance of patent and functional capillaries.
Structural heart diseases are structural defects in the heart which may be present from the initial stages of birth, which need to be rectified by surgical interventions. Transcatheter techniques applied for treating non-coronary heart diseases are known as structural heart interventions. New opportunities continue to unfold in the field of treating structural heart interventions. The Present day structural heart intervention training programmes include both valvular and non-valvular techniques concentrating on a wide range of adult primary congenital heart defects and complex surgical residual defects infant population. Many cardiologists prefer a new branch of percutaneous treatment which targets congenital and acquired diseases that were not addressed or were treated in another complex manner. Percutaneous structural heart interventions require a multi-axle approach involving cardiac imaging specialists, clinical cardiologists, interventional cardiologists, paediatricians and expert cardiac surgeons. A thorough assessment on patient procure compatibility has to be made. Continuous enhancement of knowledge and training in materials and devices to be used individual specific procedures is a prerequisite. The catheterization lab in the hospital must be equipped to perform hybrid procedures.
The following structural conditions are grouped together.
Molecular Cardiology is the study of genetic heart disorders. Major goal is to reduce human disease through the integration of basic science research and clinical cardiology. The Molecular Cardiology main purpose is the study of the molecular mechanisms of cardiovascular biology of great interest for human cardiovascular diseases. In particular, focuses on discovering and studying 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, we approach cardiovascular problems relevant to human diseases.
Evolution in the technology used in the cardiac catheterization laboratory has permitted a migration from the femoral to radial artery access for many interventional procedures while concurrently improving outcomes. As a disruptive technology, transradial access has been associated with several controversies including a dichotomous relationship with femoral access. coronary artery disease are common and complex, with an aggressive progression of atherosclerosis, increased rate of stent complications, and increased rates of incomplete revascularization in multivessel disease compared to non-diabetic patients. Percutaneous coronary intervention (PCI) has become a key modality of therapy of patients with coronary artery disease. However, with the exception of acute coronary syndromes, there is as yet no conclusive evidence from randomized controlled trials that PCI improves survival and outcome compared with optimal medical therapy. Randomized trials comparing PCI and coronary artery bypass grafting in patients with stable coronary artery disease conducted before stenting showed superiority of the surgical approach.
Advanced cardiac imaging, using cardiac magnetic resonance imaging (MRI) and multi detector computed tomography (CT), is increasingly used in the work-up of athletes with suspected abnormalities on screening. Both imaging modalities produce highly accurate and reproducible structural and functional cardiac information. Cardiac MRI has the advantage of imaging without radiation exposure or the use of iodine-containing contrast agents, but is sometimes not possible due to claustrophobia or other contraindications. Although cardiac MRI can rule out coronary artery anomalies, multi detector CT is superior to cardiac MRI for visualising the full extent of the coronary arteries and atherosclerotic coronary artery disease. Echocardiography remains the most advanced tool for noninvasive cardiac imaging because of its applicability for most cardiac disorders and its exquisite spatial resolution. Two-dimensional systems produce real time, dynamic, qualitative assessments of cardiac chamber morphology, size, thickness, and performance. The development of transesophageal echocardiography has brought this imaging power into the operating room for use by anesthesiologists. Recently developed quantitative and color-coded Doppler techniques will reveal intracardiac flow patterns and their alterations by anesthetics and surgery. These advantages are partially offset by inherent difficulties in quantifying echocardiographic data, and the need for highly trained operators for image reproduction. Nuclear cardiology and echocardiology are highly complementary. The scintigraphic methods identify myocardium at risk for infarction, confirm infarction when present, and produce quantitative, highly reproducible estimates of ventricular filling and performance. Time required to obtain data can be very brief for first-pass techniques, and these data are ideally suited for computer processing.
Cardiology case reports give an appropriate assemblage for all cardiologists by rendering their important clinical cases of late occurrence. Studying from medical cases provides valuable experience for clinicians, students and paramedical staff -members. Rare medical reports and conditions discovered through the latest methods of examination are reinforced. Furthermore, studying diagnostic methods from medical cases and interpretation of symptoms is significant to train and increase the processes which are being used in the clinical field.
Pathogenesis is a mural thrombus formation on a ruptured or eroded atherosclerotic plaque. However, any process that acutely changes the supply-demand ratio (decreased supply or increased demand in the presence of a decrease in supply) can precipitate the clinical presentation of unstable angina. Standard acute antithrombotic drug therapy is effective in decreasing progression to infarction. Newer agents (low-molecular-weight heparin and platelet glycoprotein IIb/IIIa inhibitors) are more effective, and their use is evolving. Percutaneous intervention and bypass surgery can reduce symptoms and multiple hospitalizations, in most cases without a decrease in the long-term mortality rate.
Coronary artery disease (CAD) is one of the most common causes of death worldwide. In the last decade, significant advancements in CAD treatment have been made. The existing treatment is medical, surgical or a combination of both depending on the extent, severity and clinical presentation of CAD. The collaboration between different science disciplines such as biotechnology and tissue engineering has led to the development of novel therapeutic strategies such as stem cells, nanotechnology, robotic surgery and other advancements (3-D printing and drugs). These treatment modalities show promising effects in managing CAD and associated conditions. Research on stem cells focuses on studying the potential for cardiac regeneration, while nanotechnology research investigates nano-drug delivery and percutaneous coronary interventions including stent modifications and coatings.
Research advances have contributed to improved outcomes across all specialties, but the rate of advancement in cardiology has been exceptional. Concurrently, the population of patients with cardiac conditions continues to grow and greater public awareness has increased patients' expectations of new drugs and devices. Future Cardiology (ISSN 1479-6678) reflects this new era of cardiology and highlights the new molecular approach to advancing cardiovascular therapy. Coverage will also reflect the major technological advances in bioengineering in cardiology in terms of advanced and robust devices, miniaturization, imaging, system modelling and information management issues. We also take a new approach to the way information is structured and delivered, so that its value is maximized to the reader. Accessible 'at-a-glance' formats are important in an increasingly time-constrained clinical community.
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