From the Editor's Desk: Ochsner Journal Focus Issue: Cardiovascular Diseases

Cardiovascular disease (CVD) remains the leading cause of death in the United States and globally.¹ The impact of CVD continues to grow despite advances in the understanding and treatment of cardiovascular conditions. Part of this growth is attributable to the increase in average life expectancy, allowing CVD to take its course. A related contributor is the advances in infectious disease prevention and management in developing communities that have made infection no longer the number one killer worldwide. Now, more than ever, having a strong understanding of the pathophysiology of various CVDs and of the management of these conditions is vital.

We are proud that Ochsner Medical Center's Cardiovascular Diseases Department remains at the forefront in the field of CVD. In this edition of the Ochsner Journal, our cardiovascular specialists present advances in the understanding and treatment of CVD. Our physicians are helping to lead the way in cardiovascular health by establishing specialty clinics, serving as a regional center for treatment of conditions both complex and straightforward, and advancing research in cardiovascular disease.

Congestive heart failure (HF) is among the oldest known CVDs, first described in the Ebers papyrus in the year 1550 BCE.² Since then, the many advances in HF treatment have improved the symptoms and increased the longevity for individuals with this chronic syndrome, and Ochsner physicians provide modern and innovative treatment for these patients. In this issue, Dr Englert et al describe the history of left ventricular assist devices (LVADs) for the treatment of the failing heart, as well as recent progress in this therapy. Meanwhile, Dr Ergle et al describe a novel approach to HF management: percutaneous LVADs. Dr Bansal et al further expand on the topic by discussing a novel approach for the use of the Impella percutaneous support device as a bridge to decision in decompensated HF.

Beyond management of these classic cardiac conditions, Ochsner Medical Center is also making advances in new fields in cardiology. Dr Mandras et al discuss the barriers to early referral to specialty clinics for individuals with pulmonary hypertension, a population often in desperate need of optimal therapy. Next, Dr Domercant et al and Dr Shum et al provide insight into the developing field of cardio-oncology. Their contributions discuss how to monitor and manage the potential cardiotoxicity of chemotherapy and also provide new insights into cardiovascular risk stratification of women with prior breast cancer. Ochsner Medical Center is one of few centers in the Gulf South that provides subspecialized cardiovascular care to individuals with a history of cancer.

Ochsner Medical Center has a long history of being at the forefront of both procedural techniques and prevention, and this legacy continues today. Dr Stewart et al describe the evolution of catheter-based mitral valve repair for the management of severe mitral regurgitation, while Dr Bernard discusses the new and exciting leadless cardiac pacemakers recently introduced for the treatment of significant bradycardia. Dr Abdelghani et al discuss various surface electrocardiogram techniques for the stratification of sudden death risk, Dr Qamruddin expounds upon the clinical dilemmas surrounding the topic of false-positive stress testing, and Dr Parto et al discuss the relationship between optimal cardiovascular fitness achieved through sufficient (although not too much) exercise and improved outcomes. Finally, we are excited to present a metaanalysis by Dr Deichmann et al regarding interventions designed to improve adherence to lipid-lowering medications, as cholesterol control remains an important part of our strategy for decreasing heart attacks and strokes.

As apparent from this theme issue of the Ochsner Journal, cardiovascular care at Ochsner is led by clinician-scientists who are not only providing excellent care to our patients with CVD, but who are also leaders in developing the next set of advances in such care.

• © Academic Division of Ochsner Clinic Foundation