Peter A McCullough

..This issue is important because if we can overcome barriers to the utilization of beneficial treatments, then clinical outcomes should improve over time...

..Thus, this agent holds the hope of being a bona fide antiatherosclerotic therapy that can be gauged through blood measurement of LpPLA2 activity...

..The goal of this article is to highlight the importance of these topics in improving cardiovascular outcomes and use of appropriate treatment in CKD...

..This paper will review the core concepts of prevention of CRS with practical applications to be considered in today's practice...

..These data suggest the careful clinical exam with attention to traditional cardiac auscultation using a stethoscope in a quiet room should remain the gold standard...

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..Coronary artery disease (CAD) identifies the need for intensive treatment of risk factors among individuals with chronic kidney disease (CKD), a high-risk, complex cardiovascular risk state...

..Attention will be given to selected micronutrients which may call for novel assessments and intervention for optimal cardiorenal outcomes...

..The impact of marathon running on kidney function has not been previously described...

..e., iodixanol) to those reported with various low-osmolar contrast media (LOCM)...

..Coronary artery calcification (CAC) measured by computed tomography is radiographic confirmation of atherosclerosis, predicts cardiovascular events, and has been evaluated as a surrogate measure in randomized trials...

..Conflicting data exist regarding the effects of obstructive sleep apnea syndrome (OSAS) on cardiorespiratory fitness in morbidly obese individuals with normal resting left ventricular function...

..Chronic kidney disease (CKD) is a worldwide public health problem. Systolic blood pressure as an associated feature of CKD has not been fully explored in community volunteer and nationally representative samples of the US population...

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..This analysis aims to assess whether serum intact parathyroid hormone (PTH) level is an independent risk factor for CVD in patients with CKD stages 3 and 4...

..We hypothesized that each of these chronic kidney disease-related measures would have an independent relationship with CVD...

..2% and 13.0% for those with diastolic and systolic HF, respectively (p=0.001). In a large, racially mixed, urban HF population, those with diastolic HF predominate and enjoy better-adjusted survival than counterparts with systolic HF...

..The determinants of bundle block patterns and their relationship to mortality in heart failure patients is not completely understood...

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..We evaluated the degree of residual angina on the outcomes of enhanced external counterpulsation (EECP) therapy for chronic stable angina...

..These schemes are potentially valuable, but at present the most practical approach to risk prediction is based on a simple model incorporating renal function and diabetes mellitus...

..Conclusions: On the basis of participant preference, both group obesity treatment and exercise are associated with greater weight loss and improvement in more cardiovascular risk factors than an individual intervention and no exercise...

..The relationship between complications after bariatric surgery and preoperative cardiorespiratory fitness has not been previously studied...

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..Late referral to a nephrologist may lead to suboptimal pre-end stage renal disease care and greater mortality. It is not known whether current postgraduate training adequately prepares a future internist in this aspect of CKD management...

..These data suggest that more aggressive energy expenditure and caloric restriction targets for long periods of time are needed to result in significant weight loss in this population...

..Bariatric surgery has become a common treatment for morbid obesity. The relative changes in body tissue that comprise the substantial weight loss over time are not completely understood...

..Obstructive sleep apnea (OSA) is associated with hypertension, obesity and metabolic syndrome that are risk factors for cardiovascular and chronic kidney disease. Few data are available regarding renal parameters in patients with OSA...

..These findings are consistent with overall higher expected mortality in morbidly obese persons...

..Improved treatment of congestive heart failure (CHF) can slow disease progression, promote clinical stability, and prolong survival...

..These data suggest substantial and sustained weight loss after bariatric surgery may be a powerful intervention to decrease future rates of myocardial infarction and death in the morbidly obese...

..In conclusion, our data show that obese patients with AMI have a lower risk for in-hospital, 6-month, and 12-month mortality and cardiovascular events than patients with a normal BMI...

..While clinical studies have demonstrated the usefulness of EECP in selected patients, these guidelines permit recommendations for the extended application of this important treatment to subsets of patients excluded from clinical trials...

..Chronic kidney disease (CKD) is recognized as an independent cardiovascular disease risk state. The relationship between CKD and cardiovascular disease in volunteer and general populations has not been explored...

..The BNPRR correlated with the volume removed, change in body weight, and Kt/V. Future research with the BNPRR as a potential marker of the adequacy of volume removal in HD is warranted...

..Thus, weight reduction is a key strategy for simultaneous improvement in global cardiovascular risk, with anticipated improvements in survival and quality of life...

..Percutaneous coronary revascularization was associated with superior long-term survival. In conclusion, patients with severe CKD and ACS had improved long-term survival when treated with percutaneous coronary revascularization...

..The relationship between CKD and CVD in younger and middle-aged adults has not been fully explored...

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..We investigated, at a weight control center in a community hospital setting, the relation between degree of surgical weight loss and reduction in the cardiovascular risk markers, albuminuria and hs-CRP...

..It is not known whether current postgraduate training adequately prepares a future internist in CKD management...

..This case review highlights use of advanced biomarkers and imaging to assess atherosclerotic disease activity in a 49-year-old asymptomatic woman who presents for evaluation after the death of her father from MI...

..A brief description of each sleep disorder, the pathophysiology, its epidemiology and its implications for cardiorespiratory fitness are provided. Finally, we discuss therapy for each disorder and its effect on the cardiovascular system...

..001, p = 0.994). Pre- and postoperative vitamin D levels were inversely correlated with BMI. Secondary hyperparathyroidism was observed in 33% of patients postoperatively; however, this did not correlate with vitamin D...

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..Recombinant, human BNP (nesiritide) is an approved intravenous treatment for acute, decompensated HF. This paper reviews the literature concerning the use of this peptide as a diagnostic test and as an intravenous therapy...

..To evaluate the individual components of a cardiac multimarker panel in the detection of acute myocardial infarction (AMI) in patients with chest pain across a spectrum of renal dysfunction...

..59) with increasing BMI quintiles. The VE/VCO2 slope is an effort-independent measure that is also independent of BMI and may serve as an adjunctive cardiorespiratory variable when evaluating morbidly obese men and women...

..Overt diabetes is a risk factor for development of chronic kidney disease (CKD), but GDM alone, without subsequent development of overt diabetes, may also pose a risk for CKD...

..Future, similar analyses other databases should control for the duration of illness to avoid lead-time bias in AA with CHF...

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..However, the prognostic significance of larger increases in BNP during STEMI has not been reported...

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..Because obesity is potentially one of the most modifiable mediators of cardiovascular morbidity and mortality, effective treatment and prevention interventions should have a profound and favorable impact on public health...

..Sedentary lifestyles and poor physical fitness are major contributors to the current obesity and cardiovascular disease pandemic...

..Treatment of hypertension is difficult in chronic kidney disease (CKD), and blood pressure goals remain controversial. The association between each blood pressure component and end-stage renal disease (ESRD) risk is less well known...

..Future clinical studies are needed to assess if proteinuria reduction should be a target of treatment to reduce the burden of end-stage renal disease, cardiovascular disease, and improve survival in this high-risk population...

..In addition, studies suggest that there are higher adverse drug effects with statins in CKD...

..This article summarizes major advancements in the integrative use of multiple blood biomarkers and cardiovascular imaging in the diagnosis, prognosis, and management of ACS...

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..Behavior influences are believed to play a modulating role in this problem. Accordingly, we sought to identify these predictors in patients with extreme obesity after Roux-en-Y gastric bypass (RYGB)...

..Recently, new therapeutic classes have become available for treatment. This review will examine the new therapeutic classes of incretin mimetics and enhancers in the treatment of type 2 diabetes...

..Heart failure, asthma, and chronic obstructive pulmonary disease (COPD) are syndromes where dyspnea and wheezing are overlapping signs, and hence, these syndromes are often difficult to differentiate...

..Future research is needed to describe the clinical course and risks and benefits of bariatric surgery in the CKD population...

..This suggests that these measures may assess different aspects of heart failure severity, and that physiologic measures do not reflect patients' perceptions of the impact of heart failure on their health status...

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..Perceptions of cardiovascular risk among adolescents have not been studied recently. The rise in unattended risk factors and the obesity pandemic have created calculable cardiovascular disease risk in the adolescent population...

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..The purpose of this study is to evaluate factors associated with decisions to reject patients from medical intensive care unit (MICU) admission and assess the outcome of these patients...

..In this article, we review the role of ischemia and development of fibrosis in the epidemiology, pathophysiology, and evaluation of patients with diastolic dysfunction and diastolic heart failure...

..In this population, 5.2 +/- 3.4 patients/hospital/year were rejected for being over the weight limit. In conclusion, these results provide useful information for the future management of this growing population...

..Cardiovascular disease accounts for the majority of morbidity and mortality in patients with chronic kidney disease (CKD). This review therefore concentrates on CKD from the viewpoint of the cardiologist...

..The goal of an ideal clinical trial would be ESRD prevention; however, pragmatic objectives such as a greater understanding of therapeutic toxicities should also be explored in this population...

..This article reviews a common strategy for prevention of both cardiac and kidney endpoints in patients with early nephropathy...

..0001); African Americans (p=0.05). These data suggest that modestly overweight young adults can have excessive weight gains during adult life, resulting in morbid obesity and high rates of obesity-related comorbidities...

..Morbidly obese persons (body mass index [BMI; in kg/m(2)] >or= 40) have an increased risk of cardiovascular morbidity and mortality but have reduced accuracy with conventional cardiac testing and coronary CT angiography (CCTA)...

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..Without treatment, the survival rate for malignant hypertension is 10% to 35%. With appropriate treatment, the 5-year survival rate is 75%...

..The pathogenesis of RCN goes beyond serum Cr and involves a unique vascular pathobiology that interrelates both the renal and cardiovascular disease outcomes...

..Current imaging protocols have reduced exposure to ionizing radiation and continue to improve safety...

..This article reviews the evidence for an association among CKD, anemia, and CVD...

..This article reviews the data in support of altering the natural history of CAC with lipid modification...

..This article will review clinical trials on the effects of weight loss and pharmacotherapy on obesity associated inflammatory and thrombotic markers linked with cardiovascular disease...

..These improvements include prevention of cardiovascular events, management of acute coronary syndromes and heart failure, and the prevention of sudden death...

..This paper explores the intradialytic complications of hemodialysis as they relate to the cardiovascular system and highlights opportunities for research and improved quality of care...

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..In general, a BNP level <100 pg/mL excludes acutely decompensated heart failure. This article sorts out the literature concerning the practical use of BNP in a variety of clinical scenarios...

..Chronic kidney disease (CKD) and end-stage renal disease (ESRD) are conditions associated with metabolic disorders related to soft tissue calcification...