HEART INTERNATIONAL – VOLUME 17, ISSUE 1 – 2023

Welcome to the latest issue of Heart International. This edition includes a range of articles on topics showcasing the latest advances in our understanding and treatment of cardiovascular disease. We begin with focus on the hereditary cardiac disorder, hypertrophic cardiomyopathy, which previously had a limited treatment options. However, with the approval of the myosin inhibitor, […]

Hypertrophic cardiomyopathy (HCM) is a genetic cardiovascular disease affecting 1 in 500 individuals worldwide.1 The disease pathogenesis of HCM is characterized by hypertrophy and myocyte disarray, along with muscle fibrosis on histopathology and intramural hyperplasia of the coronary arteries.2 HCM is diagnosed in patients with left ventricular hypertrophy having a maximum left ventricular wall thickness ≥15 mm […]

Palliative care (PC) is recommended as a standard of practice for all patients with heart failure (HF) and is supported by evidence of improved patient outcomes (e.g. reduction in symptoms refractory to cardiovascular therapies and improved shared decision-making).1 PC also addresses the persistent disparity in care experienced by patients from disenfranchised groups.2 PC is often a consultative […]

The global prevalence of aortic stenosis (AS) has steadily increased over the past several decades.1 In high-income countries, degenerative calcific aortic valve disease is the primary aetiology for AS, whereas chronic rheumatic valve disease and infective endocarditis remain more common causes worldwide.2 Population-wide trends in developed countries suggest a strong relationship between advanced age and incidence of […]

The prevalence of aortic stenosis (AS) has grown over the last few decades, as life expectancy has increased. AS is the most common valvular disease in the developed world and is found in up to 9.8% of individuals aged ≥75.1–3 The wide range of ages, and the wide variability in the general health status in the […]

Mitral valve (MV) disease includes either mitral regurgitation or mitral stenosis or both. The incidence and prevalence of valvular heart disease is increasing with the increasing population age. Degenerative MV disease poses a global burden with a prevalence of 18.1 million cases in 2017. Further, its global prevalence increased by 94% from 1990 to 2017.1 Surgery is the gold standard of […]

The systemic amyloidoses are a group of heterogenous diseases, which are characterized by the deposition of insoluble amyloid fibrils within the extracellular matrix of multiple organs throughout the body. Amyloid fibrils are formed from the misfolding of amyloid precursor proteins (APPs) into insoluble, beta-pleated sheets that are resistant to proteolysis. They are histologically characterized by […]

Heart failure (HF) is a common clinical diagnosis often requiring hospitalization secondary to patient decompensation associated with clinically determined ‘dry’ or ‘wet’ volume states. However, fluid overload is the more common basis for clinical deterioration accounting for the majority of hospitalizations.1–4 There is often a cycle of decompensation, compensation following intervention and then a recurrence of volume overload […]

The American Diabetes Association (ADA) defines prediabetes as glycated haemoglobin (HbA1c) 5.7–6.4% or fasting plasma glucose (FPG) 100–125 mg/dL or 5.6–6.9 mmol/L.1 Patients with prediabetes have up to a 70% chance of developing diabetes and a two-fold higher risk of cardiovascular disease than normoglycaemic patients. Studies show results varying from no association to a strong association […]

A significant proportion of patients with atrial fibrillation (AF) who have a high stroke risk are currently being treated with oral anticoagulation (OAC), including direct oral anticoagulants (DOACs) and vitamin K inhibitors (VKAs).1 It is well known that the increased risk of thromboembolic stroke in patients with AF is primarily due to left atrial appendage (LAA) […]

Bradycardia, renal failure, atrioventricular nodal blockade, shock and hyperkalemia (BRASH) syndrome is a rare, often unrecognized but potentially life-threatening clinical entity that is characterized by the pentad of symptoms after which it is named. BRASH syndrome is seen most commonly in the setting of atrioventricular nodal-blocking medications such as beta-blockers and calcium channel blockers.1,2 The synergistic interplay of […]