Dietary Sodium Intake: Perceptions of an Urban Heart Failure Population

Background: Dietary sodium restriction is a mainstay of disease management and self-care in heart failure (HF). Heart failure education programs that include recommendations on limiting sodium intake are fairly variable across centers and populations. A clear assessment is lacking on efficacy of such programs in enhancing levels of patient understanding regarding recommendations on sodium intake and knowledge of sodium content in commonly consumed food items. This pilot study was designed to assess the knowledge pertaining to sodium-restricted diets in underserved, at-risk patients with chronic, stable HF at an urban, academic center. Methods: Adult English-speaking patients with either stable, chronic HF reduced ejection fraction (HFREF) or HF preserved ejection fraction (HFPEF) were included. Baseline characteristics such as demographics, knowledge of HF self-care including understanding of sodium intake and related health implications were collected. Subsequently, a pictorial survey was administered that asked participants to categorize food items into high-, medium- or low-sodium based on the FDA-recommended daily sodium intake of 2.4g. Unordered Pearson chi-square tests were performed for differences between each group. Results: A total of 24 participants (mean age 57.3, 58.3% male, 75% HFREF) participated in the survey. Seventy-five percent of participants had a high-school or equivalent level education and 25% had an advanced degree. Participants were able to accurately categorize foods into high-, moderate-, or low-sodium categories 74%, 36% and 63% of the time, respectively (respective 95% confidence intervals 0.69-0.79, 0.29-0.43, 0.56-0.63). These percentages differed significantly from each other (p Conclusions: Understanding of dietary sodium intake varies significantly among HF patients. Despite intensive HF education, patients were not able to accurately identify sodium content in appropriate categories. Further research is needed on barriers to understanding of dietary education and its effect on outcomes

Rheumatological Disease from Cardiac Point of View: A Systematic Review

Objectives Rheumatic diseases are associated with an increased risks of premature cardiovascular mortality. The aim of our study was to conduct a systematic review of the literature regarding the cardiovascular involvement in various rheumatic diseases. Commonly used treatments for rheumatic disease and their cardiovascular side effects were studied as well. Methods Online databases (Pubmed and Medline) were searched from inception to January 2016. Search terms included: “systemic lupus erythematosus”, “rheumatoid arthritis”, “cardiovascular diseases”, “cardiovascular mortality”, “sudden cardiac death”, and “atherosclerosis”. Studies meeting the following criteria were included: (a) Articles are written in English language, (b) Reference to the cardiac involvement in rheumatic diseases, and (c) Articles where full text available. Results We identified 12,336 citations. After screening retrieved citations, 160 articles were included based on the predetermined criteria. Overall, pericarditis was considered the most common finding in rheumatic disease (50 %). In addition, myocarditis was more prevalent in Churg-Strauss syndrome (30%), Takayasu\u27s disease (45%), and systemic sclerosis (25%), and coronary angiitis was more common in polyarteritis nodosa (40%), Takayasu\u27s disease (40%), and Behcet disease (17%). Accelerated atherosclerosis has been increasingly reported especially due to chronic systemic inflammation associated with rheumatic disease. As expected, the cardiac side effects of systemic glucocorticoids are well documented and frequently seen in the management of rheumatic diseases (12%). Followed by epoprostenole (11%) and rituximab (11%). Conclusions Cardiovascular diseases are commonly encountered in rheumatic disease. The current systematic review was useful in describing the prevalence of cardiovascular involvement in each of the rheumatic disease. Close collaboration is needed between cardiologists and rheumatologists in managing this group of patients for overlapping conditions. Further research is needed to understand the impact of cardiovascular diseases on morbidity and mortality in rheumatic diseases

Diagnosis of acute coronary syndrome

Acute coronary syndrome, a spectrum extending from unstable angina to acute myocardial infarction, is a key manifestation of coronary artery disease. With coronary artery disease being the leading cause of death in the United States, it is essential to understand the basic pathophysiology and spectrum of presentation prior to making an effort to identify it. © 2009 Springer-Verlag London

Monitoring chemotherapy-induced cardiotoxicity: Role of cardiac nuclear imaging

Cardiotoxicity may result from a range of chemotherapeutic agents. The prevalence of cardiotoxicity from certain cytotoxic agents is reported to be significantly high. In addition to serious side effects and increased long-lasting morbidity and mortality, dose limitation and suboptimal usage is an important adverse effect. Nuclear cardiac imaging has played a quintessential and important role in identifying patients at risk and in the prevention and reduction of cardiac injury resulting from cytotoxic agents. Despite exploring a number of other diagnostic imaging or biochemical tools for identification of cardiac injury, nuclear cardiac imaging in the form of radionuclide angiocardiography continues to be the most suitable and cost-effective tool for reducing the prevalence of cases of cardiac dysfunction resulting from chemotherapy. This article reviews the prevalence, mechanisms, and prevention strategies for cardiotoxicity associated with some of the commonly known cytotoxic agents and the role of nuclear cardiac imaging in its monitoring and prevention, along with recent advances in this area. © 2006 American Society of Nuclear Cardiology