Prediction and prognosis of ventricular tachycardia recurrence after catheter ablation with remote magnetic navigation for electrical storm in patients with ischemic cardiomyopathy
BackgroundVentricular tachycardia (VT) recurrence after catheter ablation for electrical storm is commonly seen in patients with ischemic cardiomyopathy (ICM). HypothesisWe hypothesized that VT recurrence can be predicted and be related to the all‐cause death after VT storm ablation guided by remote magnetic navigation (RMN) in patients with ICM. MethodsA total of 54 ICM patients (87% male; mean age, 65 ± 7.1 years) presenting with VT storm undergoing acute ablation using RMN were enrolled. Acute complete ablation success was defined as noninducibility of any sustained monomorphic VT at the en...
Source: Clinical Cardiology - August 1, 2017 Category: Cardiology Authors: Qi Jin, Peter Karl Jacobsen, Steen Pehrson, Xu Chen Tags: CLINICAL INVESTIGATIONS Source Type: research

Stroke or left atrial thrombus prediction using antithrombin III and mean platelet volume in patients with nonvalvular atrial fibrillation
BackgroundCHADS2 (congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, stroke) and CHA2DS2‐VASc (congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, stroke, vascular disease, age 65 to 74 years, sex category) scores showed just moderate discrimination ability in predicting thromboembolic complications in patients with nonvalvular atrial fibrillation (AF). HypothesisTo determine the association of antithrombin III (AT‐III) deficiency and mean platelet volume (MPV) with the development of stroke or left atrial (LA) thrombus in patients with AF. MethodsAT‐III and MPV we...
Source: Clinical Cardiology - August 1, 2017 Category: Cardiology Authors: Seo ‐Won Choi, Bo‐Bae Kim, Dong‐Hyun Choi, Geon Park, Byung Chul Shin, Heesang Song, DongHun Kim, Dong‐Min Kim Tags: CLINICAL INVESTIGATIONS Source Type: research

Atrial fibrillation variability on long ‐term monitoring of implantable cardiac rhythm management devices
The objective of this study was to determine temporal changes in AF burden as detected by continuous monitoring. HypothesisAF burden changes over time when detected by continuous monitoring. MethodsA post hoc analysis of patients enrolled in the TRENDS (A Prospective Study of the Clinical Significance of Atrial Arrhythmias Detected by Implanted Device Diagnostics) study with ≥1 stroke risk factor(s) who were implanted with a dual‐chamber cardiac rhythm management device (CRMD) and had AF burden data available for ≥2 years was performed. AF burden was defined as no AF, low AF (
Source: Clinical Cardiology - August 1, 2017 Category: Cardiology Authors: Rachel M. Kaplan, Paul D. Ziegler, Jodi Koehler, Taya V. Glotzer, Rod S. Passman Tags: CLINICAL INVESTIGATIONS Source Type: research

Left atrial appendage occlusion for stroke prevention in patients with atrial fibrillation
Atrial fibrillation (AF) is a commonly sustained atrial arrhythmia with associated morbidity and mortality. AF is associated with increased risk of thromboembolism and stroke, requiring use of anticoagulation. Anticoagulation decreases the risk of stroke but is associated with a higher risk of bleeding, necessitating discontinuation in some patients. The left atrial appendage is the likely source of thrombus in the majority of patients with AF. This has led to the development of left atrial appendage occlusion as a means to reduce stroke risk in patients who have a contraindication to long‐term anticoagulation. Multiple ...
Source: Clinical Cardiology - July 27, 2017 Category: Cardiology Authors: Rizma Jalees Bajwa, Lara Kovell, Jon R. Resar, Armin Arbab ‐Zadeh, Kaushik Mandal, Hugh Calkins, Ronald D. Berger Tags: REVIEW Source Type: research

The 2017 American Society for Preventive Cardiology Congress and Experts Course
(Source: Clinical Cardiology)
Source: Clinical Cardiology - July 24, 2017 Category: Cardiology Authors: Seth J. Baum Tags: EDITORIAL Source Type: research

Issue Information
(Source: Clinical Cardiology)
Source: Clinical Cardiology - July 13, 2017 Category: Cardiology Tags: ISSUE INFORMATION Source Type: research

Prognostic implications of Q waves at presentation in patients with ST ‐segment elevation myocardial infarction undergoing primary percutaneous coronary intervention: An analysis of the HORIZONS‐AMI study
ConclusionsPresence of Q waves on the presenting ECG in patients undergoing primary percutaneous coronary intervention due to STEMI is an independent predictor of mortality and adds prognostic value, regardless of sex or rapidity of revascularization. (Source: Clinical Cardiology)
Source: Clinical Cardiology - July 11, 2017 Category: Cardiology Authors: Ioanna Kosmidou, Bj örn Redfors, Aaron Crowley, Bernard Gersh, Shmuel Chen, José M. Dizon, Monica Embacher, Roxana Mehran, Ori Ben‐Yehuda, Gary S. Mintz, Gregg W. Stone Tags: CLINICAL INVESTIGATIONS Source Type: research

Decreased pulmonary arterial proportional pulse pressure is associated with increased mortality in group 1 pulmonary hypertension
This study evaluated the utility of a novel index, pulmonary arterial (PA) proportional pulse pressure (PAPP; range 0–1, defined as [PA systolic pressure – PA diastolic pressure] / PA systolic pressure), in predicting mortality in patients with World Health Organization group 1 pulmonary hypertension (PH). HypothesisLow PAPP is associated with increased 5‐year mortality independent of a validated contemporary risk‐prediction equation (Pulmonary Hypertension Connection [PHC] equation). MethodsIn a group of 262 patients in the National Institutes of Health Primary Pulmonary Hypertension (NIH‐PPH) Registry, ...
Source: Clinical Cardiology - July 10, 2017 Category: Cardiology Authors: Hunter Mwansa, Kenneth C. Bilchick, Alex M. Parker, William Harding, Benjamin Ruth, Jamie L. W. Kennedy, Manu Mysore, Younghoon Kwon, Andrew Mihalek, Sula Mazimba Tags: CLINICAL INVESTIGATIONS Source Type: research

Pulmonary embolism in a morbidly obese patient receiving dabigatran
(Source: Clinical Cardiology)
Source: Clinical Cardiology - July 10, 2017 Category: Cardiology Authors: Usama Nasir Tags: LETTER TO THE EDITOR Source Type: research

Vitamin K antagonists with or without long ‐term antiplatelet therapy in outpatients with stable coronary artery disease and atrial fibrillation: Association with ischemic and bleeding events
BackgroundIt remains uncertain whether patients with atrial fibrillation (AF) requiring long‐term oral anticoagulation (OAC) and with stable coronary artery disease (CAD) should receive antiplatelet therapy (APT) in addition to OAC. HypothesisAPT in addition to OAC would be more effective than OAC alone in preventing ischaemic events in such patients. MethodsIn the international REduction of Atherothrombosis for Continued Health (REACH) Registry including 68 236 outpatients with or at risk for atherothrombosis, we identified 2347 patients with stable CAD and AF receiving vitamin K antagonists (VKA). Using propensity scor...
Source: Clinical Cardiology - July 10, 2017 Category: Cardiology Authors: Gilles Lemesle, Gregory Ducrocq, Yedid Elbez, Eric Van Belle, Shinya Goto, Christopher P. Cannon, Christophe Bauters, Deepak L. Bhatt, Philippe Gabriel Steg, Tags: CLINICAL INVESTIGATIONS Source Type: research

Determination of ideal target exercise heart rate for cardiac patients suitable for rehabilitation
BackgroundExercise prescription for patients with cardiovascular disease remains a challenge. The concept of exercising at an intensity equivalent to one's anaerobic threshold has been well studied and highly recommended in the fitness industry for other populations. For this concept to be applicable to patients with cardiovascular disease, the level and intensity of activity must not trigger myocardial ischemia. HypothesisWe hypothesized that the heart rate at ventilatory anaerobic threshold (HRVAT) will not exceed heart rate at ischemic threshold (HRIT) (ie, HRVAT ≤ HRIT in a majority [>50%] of patients). MethodsIn...
Source: Clinical Cardiology - July 6, 2017 Category: Cardiology Authors: Shih Jia Janice Tan, John Carson Allen, Swee Yaw Tan Tags: CLINICAL INVESTIGATIONS Source Type: research

Psychiatric conditions as predictors of rehospitalization among African American patients hospitalized with heart failure
This study aims to determine the prevalence and relationship of common psychiatric conditions to outcomes of patients hospitalized with HF. HypothesisPsychiatric conditions lead to worse outcomes in HF patients. MethodsThis single‐center retrospective study enrolled 611 AA patients admitted to an urban teaching community hospital for HF from 2010 to 2013. Patient demographics, clinical variables, and history of psychiatric disorders were obtained. Cox proportional hazards regression was used to assess impact of psychiatric disorders on readmission rates and mortality. ResultsThe mean age was 66 ± 15&...
Source: Clinical Cardiology - July 1, 2017 Category: Cardiology Authors: Marvin Louis Roy Lu, Toni Anne De Venecia, Abhinav Goyal, Mary Rodriguez Ziccardi, Napatt Kanjanahattakij, Mahek Kishor Shah, Carlos D. Davila, Vincent M. Figueredo Tags: CLINICAL INVESTIGATIONS Source Type: research

Early segmental relaxation abnormalities in hypertrophic cardiomyopathy for differential diagnostic of patients with left ventricular hypertrophy
BackgroundHypertrophic cardiomyopathy (HCM) is characterized by asymmetric left ventricular hypertrophy (LVH). However, clinical signs can be subtle and differentiation from other causes of LVH is challenging. HypothesisAs diastolic dysfunction (DD) is an early sign in HCM, we aimed to find regional changes in relaxation pattern for differentiation from other entities of LVH. MethodsIn 148 patients (81 HCM, 55 arterial hypertension (AHT), 12 Fabry disease) and 63 healthy controls, relaxation patterns were assessed using regional tissue Doppler imaging. In 42 HCM patients, myocardial mass and fibrosis were quantified by car...
Source: Clinical Cardiology - July 1, 2017 Category: Cardiology Authors: Christian Voigt, Julia M ünch, Maxim Avanesov, Anna Suling, Katrin Witzel, Gunnar Lund, Monica Patten Tags: CLINICAL INVESTIGATIONS Source Type: research

Handheld echocardiography during hospitalization for acute myocardial infarction
ConclusionsIn patients with AMI, HHE and standard TTE demonstrate good correlation for LV function and wall motion. Agreement was less robust for structural abnormalities and specific wall segments. In experienced hands, HHE can provide a focused assessment of LV function in patients hospitalized with AMI; however, HHE should not substitute for comprehensive TTE. (Source: Clinical Cardiology)
Source: Clinical Cardiology - July 1, 2017 Category: Cardiology Authors: Michael W. Cullen, Jeffrey B. Geske, Nandan S. Anavekar, J. Wells Askew, Bradley R. Lewis, Jae K. Oh Tags: CLINICAL INVESTIGATIONS Source Type: research

Frailty is an independent prognostic marker in elderly patients with myocardial infarction
ConclusionsFrailty phenotype at admission is common among elderly patients with ACS and is an independent predictor for severe adverse events. It should be considered in future risk‐stratification models. (Source: Clinical Cardiology)
Source: Clinical Cardiology - July 1, 2017 Category: Cardiology Authors: Gonzalo Luis Alonso Salinas, Marcelo Sanmartin, Marina Pascual Izco, Luis Miguel Rincon, Pablo Pastor Pueyo, Alvaro Marco del Castillo, Alberto Garcia Guerrero, Pedro Caravaca Perez, Alejandro Recio ‐Mayoral, Asuncion Camino, Manuel Jimenez‐Mena, Jos Tags: CLINICAL INVESTIGATIONS Source Type: research

Rationale and design of a randomized trial of apixaban vs warfarin to evaluate atherosclerotic calcification and vulnerable plaque progression
This study is a single‐center, prospective, randomized, open‐label study. From May 2014 to December 2015, 66 patients with nonvalvular AF who experienced VKA therapy were enrolled. Patients were randomized into either warfarin or apixaban cohorts and followed for 52 weeks. The primary objective is to compare the rate of change in coronary artery calcification (CAC) from baseline to follow‐up in apixaban vs warfarin cohorts. The key secondary objective is to compare the rate of incident plaques and quantitative changes in plaque types between patients randomized to either warfarin or apixaban cohorts using serial coro...
Source: Clinical Cardiology - July 1, 2017 Category: Cardiology Authors: Kazuhiro Osawa, Rine Nakanishi, Theingi Tiffany Win, Dong Li, Sina Rahmani, Negin Nezarat, Nasim Sheidaee, Matthew J. Budoff Tags: TRIAL DESIGNS Source Type: research

Issue Information
(Source: Clinical Cardiology)
Source: Clinical Cardiology - June 26, 2017 Category: Cardiology Tags: ISSUE INFORMATION Source Type: research

Population ‐based values and abnormalities of the electrocardiogram in the general Dutch population: The LifeLines Cohort Study
ConclusionsOur study provides an overview of average values and ECG abnormalities and confirms data of previous smaller studies. In addition, we evaluate the age‐ and sex‐dependent normal limits of the P wave and QRS duration and confirm in detail the frontal plane QRS‐T angle on the ECG. (Source: Clinical Cardiology)
Source: Clinical Cardiology - June 12, 2017 Category: Cardiology Authors: M. Yldau van der Ende, Joylene E. Siland, Harold Snieder, Pim van der Harst, Michiel Rienstra Tags: CLINICAL INVESTIGATIONS Source Type: research

Cardiovascular adverse events in the drug ‐development program of bupropion for smoking cessation: A systematic retrospective adjudication effort
Conclusions CV events in bupropion clinical trials for smoking cessation were uncommon, with no observed increase among subjects assigned to bupropion vs placebo. However, this effort was limited by a paucity of quality data. (Source: Clinical Cardiology)
Source: Clinical Cardiology - June 12, 2017 Category: Cardiology Authors: Jessie Kittle, Renato D. Lopes, Mingyan Huang, Marsha L. Marquess, Matthew D. Wilson, John Ascher, Alok Krishen, Vic Hasselblad, Brad J. Kolls, Matthew T. Roe, Darren K. McGuire, Stuart D. Russell, Kenneth W. Mahaffey Tags: CLINICAL INVESTIGATIONS Source Type: research

Socioeconomic status and the development of atrial fibrillation in Hispanics, African Americans and non ‐Hispanic whites
BackgroundAtrial fibrillation (AF) is the most common arrhythmia and is associated with significant morbidity and mortality. Despite having a higher burden of traditional AF risk factors, African American and Hispanic minorities have a lower incidence of AF when compared to non‐Hispanic whites, referred to as the “racial paradox.” HypothesisLower SES among Hispanics and African Americans may help to explain the lower incidence rates of AF compared to non‐Hispanic whites. MethodsAn electrocardiogram/electronic medical records database in New York State was interrogated for individuals free of AF for developm...
Source: Clinical Cardiology - June 9, 2017 Category: Cardiology Authors: Eric Shulman, Faraj Kargoli, Philip Aagaard, Ethan Hoch, Luigi Di Biase, John Fisher, Jay Gross, Soo Kim, Kevin J. Ferrick, Andrew Krumerman Tags: CLINICAL INVESTIGATIONS Source Type: research

Relative efficacy and safety of ticagelor vs clopidogrel as a function of time to invasive management in non –ST‐segment elevation acute coronary syndrome in the PLATO trial
Abstract BackgroundGuidelines suggest that “upstream” P2Y12 receptor antagonists should be considered in patients with non–ST‐segment elevation acute coronary syndromes (NSTE‐ACS). HypothesisEarly use of ticagrelor in patients managed with an invasive strategy would be more effective than clopidogrel because of its more rapid onset of action and greater potency. MethodsIn the PLATO trial, 6792 NSTE‐ACS patients were randomized to ticagrelor or clopidogrel (started prior to angiography) and underwent angiography within 72 hours of randomization. We compared efficacy and safety outcomes of ticagrelor ...
Source: Clinical Cardiology - June 9, 2017 Category: Cardiology Authors: Charles V. Pollack, Farideh Davoudi, Deborah B. Diercks, Richard C. Becker, Stefan K. James, Soo Teik Lim, Phillip J. Schulte, Jindrich Spinar, Philippe Gabriel Steg, Robert F. Storey, Anders Himmelmann, Lars Wallentin, Christopher P. Cannon, Tags: CLINICAL INVESTIGATIONS Source Type: research

The association of QRS duration with atrial fibrillation in a heart failure with preserved ejection fraction population: a pilot study
ConclusionsSimilar to results in patients with systolic dysfunction, patients with preserved EF may have an association between a prolonged QRSd and AF. (Source: Clinical Cardiology)
Source: Clinical Cardiology - June 6, 2017 Category: Cardiology Authors: Joseph N. Gigliotti, Mandeep S. Sidhu, Alina M. Robert, Jonathan S. Zipursky, Jeremiah R. Brown, Salvatore P. Costa, Robert T. Palac, David A. Steckman, David J. Malenka, Alan T. Kono, Mark L. Greenberg Tags: CLINICAL INVESTIGATIONS Source Type: research

Does education modify the effect of ethnicity in the expression of ideal cardiovascular health? The Baptist Health South Florida Employee Study
ConclusionsHigher educational attainment had variable associations with achieved levels of ideal CVH across race/ethnic groups. Interventions to improve CVH should be tailored to meet the needs of target communities. (Source: Clinical Cardiology)
Source: Clinical Cardiology - June 1, 2017 Category: Cardiology Authors: Oluseye Ogunmoroti, Ovie A. Utuama, Erin D. Michos, Javier Valero ‐Elizondo, Victor Okunrintemi, Ziyad Ben Taleb, Raed Bahelah, Sankalp Das, Maribeth Rouseff, Don Parris, Arthur Agatston, Theodore Feldman, Emir Veledar, Wasim Maziak, Khurram Nasir Tags: CLINICAL INVESTIGATIONS Source Type: research

Current trends in admissions and outcomes of cardiac diseases in Ghana
Cardiovascular diseases (CVDs) pose a major burden in Africa, but data on temporal trends in disease burden are lacking. We assessed trends in CVD admissions and outcomes in central Ghana using a retrospective analysis of data from January 2004 to December 2015 among patients admitted to the medical wards of a tertiary medical center in Kumasi, Ghana. Rates of admissions and mortality were expressed as CVD admissions and deaths divided by the total number of medical admissions and deaths, respectively. Case fatality rates per specific cardiac disease diagnosis were also computed. Over the period, there were 4226 CVD admiss...
Source: Clinical Cardiology - June 1, 2017 Category: Cardiology Authors: Lambert T. Appiah, Fred S. Sarfo, Charles Agyemang, Humphrey O. Tweneboah, Nana Akua B.A. Appiah, George Bedu ‐Addo, Ohene Opare‐Sem Tags: QUALITY AND OUTCOMES Source Type: research

Cost ‐effectiveness analysis of 30‐month vs 12‐month dual antiplatelet therapy with clopidogrel and aspirin after drug‐eluting stents in patients with acute coronary syndrome
Continuation of dual antiplatelet therapy (DAPT) beyond 1 year reduces late stent thrombosis and ischemic events after drug‐eluting stents (DES) but increases risk of bleeding. We hypothesized that extending DAPT from 12 months to 30 months in patients with acute coronary syndrome (ACS) after DES is cost‐effective. A lifelong decision‐analytic model was designed to simulate 2 antiplatelet strategies in event‐free ACS patients who had completed 12‐month DAPT after DES: aspirin monotherapy (75–162 mg daily) and continuation of DAPT (clopidogrel 75 mg daily plus aspirin 75–162 mg daily) for 18 months. Cl...
Source: Clinical Cardiology - June 1, 2017 Category: Cardiology Authors: Minghuan Jiang, Joyce H.S. You Tags: QUALITY AND OUTCOMES Source Type: research

Clinical, scintigraphic, and angiographic predictors of oxygen pulse abnormality in patients undergoing cardiopulmonary exercise testing
ConclusionsFemale sex, increasing body mass index, and myocardial fibrosis were significant predictors of abnormal O2 pulse curves. Myocardial ischemia and the presence and extent of CAD were not associated with the abnormal patterns of the O2 pulse curve. (Source: Clinical Cardiology)
Source: Clinical Cardiology - June 1, 2017 Category: Cardiology Authors: Andrea De Lorenzo, Carlito Lessa da Silva, Fernando Cesar Castro Souza, Salvador Serra, Pablo Marino, Ronaldo SL Lima Tags: CLINICAL INVESTIGATIONS Source Type: research

Association between insomnia and atrial fibrillation in a Chinese population: A cross ‐sectional study
BackgroundInsomnia is the most prevalent sleep disorder; however, little research has explored the link between insomnia and atrial fibrillation (AF). HypothesisInsomnia is associated with increased risk of AF in a Chinese population. MethodsA total of 8371 Chinese participants (4314 males; mean age, 42.4 ± 13.1 years) were enrolled in this cross‐sectional study to investigate the association between insomnia and AF. AF was assessed in a standard supine resting position with a 10‐s 12‐lead electrocardiograph (ECG) or by self‐reported history. Insomnia was assessed using the Athens Insomn...
Source: Clinical Cardiology - May 31, 2017 Category: Cardiology Authors: Xu Han, Yiheng Yang, Yue Chen, Lianjun Gao, Xiaomeng Yin, Huihua Li, Jing Qiu, Youxin Wang, Yong Zhou, Yunlong Xia Tags: CLINICAL INVESTIGATIONS Source Type: research

Safety and efficacy of DOACs vs acenocoumarol in patients undergoing catheter ablation of atrial fibrillation
BackgroundThromboembolic complications can be life‐threatening during atrial fibrillation (AF) catheter ablation. The aim of our study was to evaluate the safety and efficacy of continuous treatment using direct oral anticoagulants (DOACs) as an alternative to uninterrupted acenocoumarol for periprocedural anticoagulation. HypothesisContinuous treatment with DOACs has similar safety and efficacy compared to acenocoumarol. MethodsWe enrolled 474 patients (mean age, 58 years; 68.4% male) undergoing AF catheter ablation between June 2013 and December 2016. All patients were equally assigned to take acenocoumarol (group 1, 1...
Source: Clinical Cardiology - May 31, 2017 Category: Cardiology Authors: Konstantinos Vlachos, Michael Efremidis, George Bazoukis, Konstantinos P. Letsas, Athanasios Saplaouras, Stamatis Georgopoulos, Nikolaos Karamichalakis, Aikaterini Rokiza, Antigoni Sakellaropoulou, Angelos Michail Kolokathis, Theodoros Efremidis, Dimitrio Tags: CLINICAL INVESTIGATIONS Source Type: research

Predictive value of inflammatory factors on contrast ‐induced acute kidney injury in patients who underwent an emergency percutaneous coronary intervention
BackgroundContrast‐induced acute kidney injury (CI‐AKI) is one of the most serious complications in patients who undergo percutaneous coronary intervention (PCI), especially in those with acute coronary syndrome. It has been shown that inflammation may play an important role in the pathophysiology of CI‐AKI. HypothesisInflammatory factors may play a predominant role in the prediction of CI‐AKI in patients who undergo emergency PCI. MethodsPatients who underwent emergency PCI from 2013 to 2015 were consecutively enrolled and were divided into CI‐AKI and non–CI‐AKI groups. Logistic analysis was used to iden...
Source: Clinical Cardiology - May 19, 2017 Category: Cardiology Authors: Ying Yuan, Hong Qiu, Xiaoying Hu, Tong Luo, Xiaojin Gao, Xueyan Zhao, Jun Zhang, Yuan Wu, Shubin Qiao, Yuejin Yang, Runlin Gao Tags: CLINICAL INVESTIGATIONS Source Type: research

Issue Information
(Source: Clinical Cardiology)
Source: Clinical Cardiology - May 18, 2017 Category: Cardiology Tags: ISSUE INFORMATION Source Type: research

Geographic variation and risk factors for systemic and limb ischemic events in patients with symptomatic peripheral artery disease: Insights from the REACH Registry
BackgroundPatients with symptomatic peripheral artery disease (PAD) are at high risk of ischemic events. However, data about predictors of this risk are limited. HypothesisWe analyzed baseline characteristics and 4‐year follow‐up of patients enrolled in the international REduction of Atherothrombosis for Continued Health (REACH) Registry with symptomatic PAD and no history of stroke/transient ischemic attack to describe annual rates of recurrent ischemic events globally and geographically. MethodsThe primary outcome was systemic ischemic events (composite of cardiovascular death, myocardial infarction, or stroke) at 4 ...
Source: Clinical Cardiology - May 18, 2017 Category: Cardiology Authors: J érémie Abtan, Deepak L. Bhatt, Yedid Elbez, Emmanuel Sorbets, Kim Eagle, Christopher M. Reid, Iris Baumgartner, David Wu, Mary E. Hanson, Hakima Hannachi, Puneet K. Singhal, Philippe Gabriel Steg, Gregory Ducrocq, Tags: CLINICAL INVESTIGATIONS Source Type: research

Centers for Medicare and Medicaid Services ’ readmission reports inaccurately describe an institution's decompensated heart failure admissions
Hospitals typically use Center for Medicare and Medicaid Services’ (CMS) Hospital Readmission Reduction Program (HRRP) administrative reports as the standard of heart failure (HF) admission quantification. We aimed to evaluate the HF admission population identified by CMS HRRP definition of HF hospital admissions compared with a clinically based HF definition. We evaluated all hospital admissions at an academic medical center over 16 months in patients with Medicare fee‐for service benefits and age ≥65 years. We compared the CMS HRRP HF definition against an electronic HF identification algorithm. Admissi...
Source: Clinical Cardiology - May 4, 2017 Category: Cardiology Authors: Zachary L. Cox, Pikki Lai, Connie M. Lewis, Daniel J. Lenihan Tags: QUALITY AND OUTCOMES Source Type: research

Assessment of subtle cardiac dysfunction in patients with frequent premature ventricular complexes by real ‐time three‐dimensional speckle tracking echocardiography
BackgroundTo evaluate subtle and early premature ventricular complex (PVC)–induced ventricular impairment in patients with frequent PVCs and without structural heart disease by real‐time 3‐dimensional (3D) speckle tracking echocardiography (RT3D‐STE). HypothesisPatients with frequent premature ventricular complexes with normal left ventricular ejection fraction have subtle left ventricular dysfunction. MethodsForty patients (22 male) with a single source of frequent PVCs and 40 healthy controls (24 male) underwent assessment by conventional 2‐dimensional (2D) echocardiography and RT3D‐STE. Left ventricular ...
Source: Clinical Cardiology - May 4, 2017 Category: Cardiology Authors: Yunlong Ling, Quan Wan, Qingxing Chen, Wenqing Zhu Tags: CLINICAL INVESTIGATIONS Source Type: research

Sustained apnea induces endothelial activation
ConclusionsEven a single maximal breath‐hold induces acute endothelial activation and should be performed with great caution by subjects with preexisting vascular diseases. Voluntary apnea might be used as a model to simulate changes in endothelial function caused by hypoxia in humans. (Source: Clinical Cardiology)
Source: Clinical Cardiology - May 2, 2017 Category: Cardiology Authors: Lars Eichhorn, Ramona Dolscheid ‐Pommerich, Felix Erdfelder, Muhammad Ajmal Ayub, Theresa Schmitz, Nikos Werner, Felix Jansen Tags: CLINICAL INVESTIGATIONS Source Type: research

Repeated procedures at the generator pocket are a determinant of implantable cardioverter ‐defibrillator infection
BackgroundRates of cardiac‐device infections have increased in recent years, but the current incidence and risk factors for infection in patients with implantable cardioverter‐defibrillators (ICDs) are not well known. HypothesisThe increasing number of ICD infections is related to accumulated pocket manipulations over time. MethodsThis single‐center, prospective study included patients that underwent ICD implantation from 2008 to 2015. The endpoint was time to infection. Multivariate analysis was performed to identify independent risk factors related to infection. ResultsThe study included a total of 570 patients, of...
Source: Clinical Cardiology - May 1, 2017 Category: Cardiology Authors: Eduardo Arana ‐Rueda, Alonso Pedrote, Manuel Frutos‐López, Juan Acosta, Beatriz Jauregui, Lorena García‐Riesco, Álvaro Arce‐León, Federico Gómez‐Pulido, Juan A. Sánchez‐Brotons, Encarnación Gutiérrez‐Carretero, Arístides de Alarcón Tags: CLINICAL INVESTIGATIONS Source Type: research

The value of electrocardiography in prognosticating clinical deterioration and mortality in acute pulmonary embolism: A systematic review and meta ‐analysis
The role of electrocardiography (ECG) in prognosticating pulmonary embolism (PE) is increasingly recognized. ECG is quickly interpretable, noninvasive, inexpensive, and available in remote areas. We hypothesized that ECG can provide useful information about PE prognostication. We searched MEDLINE, EMBASE, Google Scholar, Web of Science, abstracts, conference proceedings, and reference lists through February 2017. Eligible studies used ECG to prognosticate for the main outcomes of death and clinical deterioration or escalation of therapy. Two authors independently selected studies; disagreement was resolved by consensus. Ad...
Source: Clinical Cardiology - May 1, 2017 Category: Cardiology Authors: Amro Qaddoura, Genevi ève C. Digby, Conrad Kabali, Piotr Kukla, Zhong‐Qun Zhan, Adrian M. Baranchuk Tags: REVIEW Source Type: research

ESC sudden ‐death risk model in hypertrophic cardiomyopathy: Incremental value of quantitative contrast‐enhanced CMR in intermediate‐risk patients
This study aimed to establish the relation between myocardial fibrosis (late gadolinium enhancement [LGE] extension) and the novel SCD risk‐prediction model in a real population of HCM to evaluate its potential additional value in the different risk groups. HypothesisThere is a significant association between LGE extension and the novel SCD risk calculator that may help conflicting ICD decisions. MethodsSeventy‐seven patients with HCM underwent routine clinical evaluation, echocardiography, and cardiac magnetic resonance study. Their SCD risk at 5 years was calculated using the new model. ResultsExtension of LGE positi...
Source: Clinical Cardiology - May 1, 2017 Category: Cardiology Authors: Rocio Hinojar, Jos é Luis Zamorano, Ariana Gonzalez Gómez, Maria Plaza Martin, Amparo Esteban, Luis Miguel Rincón, Juan Carlos Portugal, José Julio Jimenez Nácher, Covadonga Fernández‐Golfín Tags: CLINICAL INVESTIGATIONS Source Type: research

An association between volumes of the cardiac chambers and troponin levels in individuals submitted to cardiac coronary computed tomography
ConclusionsUsing the technology of automatic volumetric analysis in individuals undergoing CCTA, an association between larger right and left cardiac chambers and higher levels of troponin concentration was shown. (Source: Clinical Cardiology)
Source: Clinical Cardiology - May 1, 2017 Category: Cardiology Authors: Zach Rozenbaum, Yaron Arbel, Yoav Granot, Dotan Cohen, Haim Shmilovich, Tomer Ziv ‐Baran, Ehud Chorin, Ofer Havakuk, Merav Cohen, Shlomo Berliner, Yan Topilsky, Galit Aviram Tags: CLINICAL INVESTIGATIONS Source Type: research

Typical angina is associated with greater coronary endothelial dysfunction but not abnormal vasodilatory reserve
BackgroundTypical angina (TA) is defined as substernal chest pain precipitated by physical exertion or emotional stress and relieved with rest or nitroglycerin. Women and elderly patients are usually have atypical symptoms both at rest and during stress, often in the setting of nonobstructive coronary artery disease (CAD). HypothesisTo further understand this, we performed subgroup analysis comparing subjects who presented with TA vs nontypical angina (NTA) using baseline data of patients with nonobstructive CAD and coronary microvascular dysfunction (CMD) enrolled in a clinical trial. Methods155 subjects from the RWISE st...
Source: Clinical Cardiology - May 1, 2017 Category: Cardiology Authors: Ahmed AlBadri, Derek Leong, C. Noel Bairey Merz, Janet Wei, Eileen M. Handberg, Chrisandra L. Shufelt, Puja K. Mehta, Michael D. Nelson, Louise E. Thomson, Daniel S. Berman, Leslee J. Shaw, Galen Cook ‐Wiens, Carl J. Pepine Tags: CLINICAL INVESTIGATIONS Source Type: research

Heart failure in patients admitted for acute coronary syndromes: A report from a large national registry
BackgroundData on temporal trends of heart failure (HF) in acute coronary syndrome (ACS) are scarce. HypothesisImproved treatment options may have led to lower case‐fatality rates (CFRs) during the last years in ACS complicated by HF. MethodsPatients of the nationwide Acute Myocardial Infarction in Switzerland (AMIS)–Plus ACS registry were analyzed from 2000 to 2014. ResultsOf 36 366 ACS patients, 3376 (9.3%) had acute or chronic HF, 2111 (5.8%) de novo acute HF (AHF), 964 (2.7%) chronic HF (CHF), and 301 (0.8%) acute decompensated CHF (ADCHF). In‐hospital CFRs were highest in patients with ADCHF (32.6%) a...
Source: Clinical Cardiology - May 1, 2017 Category: Cardiology Authors: Raban V. Jeger, Otmar Pfister, Dragana Radovanovic, Franz R. Eberli, Hans Rickli, Philip Urban, Giovanni Pedrazzini, Jean ‐Christophe Stauffer, Jörg Nossen, Paul Erne, Tags: CLINICAL INVESTIGATIONS Source Type: research

Navigating air travel and cardiovascular concerns: Is the sky the limit?
As the population ages and our ability to care for patients with cardiac disease improves, an increasing number of passengers with cardiovascular conditions will be traveling long distances. Many have had cardiac symptoms, recent interventions, devices, or surgery. Air travel is safe for most individuals with stable cardiovascular disease. However, a thorough understanding of the physiologic changes during air travel is essential given the potential impact on cardiovascular health and the risk of complications in passengers with preexisting cardiac conditions. It is important for clinicians to be aware of the current recom...
Source: Clinical Cardiology - May 1, 2017 Category: Cardiology Authors: Muhammad Hammadah, Bryan R. Kindya, Marc P. Allard ‐Ratick, Sammer Jazbeh, Danny Eapen, W.H. Wilson Tang, Laurence Sperling Tags: Review Source Type: research

Obstructive sleep apnea is associated with increased readmission in heart failure patients
BackgroundHeart failure (HF) readmission rates have become an increasingly important quality metric since the advent of the Hospital Readmissions Reduction Program. Despite many well‐intentioned efforts to reduce readmissions, clinicians continue to struggle with the problem of high HF readmission rates. HypothesisHF patients with obstructive sleep apnea (OSA) will have higher burden of rehospitalization and mortality than HF patients without OSA. MethodsOur study included 344 patient encounters (among 271 unique patients) with a diagnosis of HF from September 2014 through September 2015. Our primary endpoints were all...
Source: Clinical Cardiology - May 1, 2017 Category: Cardiology Authors: Alex Sommerfeld, Andrew D. Althouse, Jennifer Prince, Charles W. Atwood, Suresh R. Mulukutla, Gavin W. Hickey Tags: CLINICAL INVESTIGATIONS Source Type: research

Rationale, design, and baseline characteristics of the CLARIFY registry of outpatients with stable coronary artery disease
Conclusion CLARIFY will provide a useful resource for understanding the current epidemiology of stable CAD. (Source: Clinical Cardiology)
Source: Clinical Cardiology - May 1, 2017 Category: Cardiology Authors: Emmanuel Sorbets, Nicola Greenlaw, Roberto Ferrari, Ian Ford, Kim M. Fox, Jean ‐Claude Tardif, Michal Tendera, Philippe Gabriel Steg, Tags: TRIAL DESIGNS Source Type: research

Design of the Magnetic Resonance Imaging Evaluation of Mineralocorticoid Receptor Antagonism in Diabetic Atherosclerosis (MAGMA) Trial
Mineralocorticoid receptor (MR) activation plays an essential role in promoting inflammation, fibrosis, and target organ damage. Currently, no studies are investigating MR antagonism in patients with type 2 diabetes mellitus (T2DM) with chronic kidney disease, at high risk for cardiovascular complications, who are otherwise not candidates for MR antagonism by virtue of heart failure. Further, there is limited information on candidate therapies that may demonstrate differential benefit from this therapy. We hypothesized that MR antagonism may provide additional protection from atherosclerosis progression in higher‐risk pa...
Source: Clinical Cardiology - May 1, 2017 Category: Cardiology Authors: Sanjay Rajagopalan, M. Amer Alaiti, Kylene Broadwater, Aditya Goud, Juan Gaztanaga, Kim Connelly, Anas Fares, Shayan Shirazian, Catherine Kreatsoulas, Michael Farkouh, Mirela Dobre, Jeffrey C. Fink, Matthew R. Weir Tags: TRIAL DESIGNS Source Type: research

Relationship between carotid atherosclerosis and coronary artery calcification in asymptomatic diabetic patients: A prospective multicenter study
BackgroundThe value of screening sub‐clinical atherosclerosis in asymptomatic patients with type 2 diabetes mellitus (T2DM) remains controversial. HypothesisAn integrated model incorporating carotid intima‐media thickness (CIMT) and carotid plaque with traditional risk factors can be used to predict prevalence and severity of coronary artery calcification in asymptomatic T2DM patients. MethodsA cohort of 262 asymptomatic T2DM patients were prospectively studied with carotid ultrasound to evaluate CIMT and carotid plaque and also a computed tomography coronary artery calcium (CT‐CAC) scan. ResultsCarotid plaque was de...
Source: Clinical Cardiology - May 1, 2017 Category: Cardiology Authors: Anand Jeevarethinam, Shreenidhi Venuraju, Alain Dumo, Sherezade Ruano, Vishal S. Mehta, Miranda Rosenthal, Devaki Nair, Mark Cohen, Daniel Darko, Avijit Lahiri, Roby Rakhit Tags: CLINICAL INVESTIGATIONS Source Type: research

Low ‐flow/low‐gradient aortic stenosis—Still a diagnostic and therapeutic challenge
Aortic stenosis (AS) is the most frequently observed valvular heart disease. During the symptomatic stage, the rate of death increases dramatically, so that a precise diagnostic approach is taken to guide therapeutic options. Of patients with severe AS, 30% to 50% present with low‐flow/low‐gradient AS (LF/LGAS) status. This review focuses on LF/LGAS and the best diagnostic and therapeutic management in either classic LF/LGAS with reduced left ventricular ejection fraction (LVEF) or paradoxical LF/LGAS with preserved LVEF. Current literature demonstrates that in classic LF/LGAS it is crucial to rule out a pseudo‐sever...
Source: Clinical Cardiology - May 1, 2017 Category: Cardiology Authors: Anja Vogelgesang, Gerd Hasenfuss, Claudius Jacobshagen Tags: Review Source Type: research

“Real life” longevity of implantable cardioverter‐defibrillator devices
Conclusions ICDs continue to have limited longevity of 4.9 ± 1.6 years, and 8% demonstrate premature battery depletion by 3 years. CRT devices have the shortest longevity (mean, 3.8 years) by 13 to 17 months, compared with other ICD devices. These findings have important implications, particularly in view of the high expense involved with this type of electrical therapy. (Source: Clinical Cardiology)
Source: Clinical Cardiology - May 1, 2017 Category: Cardiology Authors: Antonis S. Manolis, Themistoklis Maounis, Spyridon Koulouris, Vassilios Vassilikos Tags: CLINICAL INVESTIGATIONS Source Type: research

Oral anticoagulation management in patients with atrial fibrillation undergoing cardiac implantable electronic device implantation
ConclusionsManagement of anticoagulation among AF patients undergoing CIED implantation is highly variable, with OAC being interrupted in more than half of both warfarin‐ and NOAC‐treated patients. Bleeding and stroke events were infrequent in both warfarin and NOAC‐treated patients. (Source: Clinical Cardiology)
Source: Clinical Cardiology - May 1, 2017 Category: Cardiology Authors: Eric Black ‐Maier, Sunghee Kim, Benjamin A. Steinberg, Gregg C. Fonarow, James V. Freeman, Peter R. Kowey, Jack Ansell, Bernard J. Gersh, Kenneth W. Mahaffey, Gerald Naccarelli, Elaine M. Hylek, Alan S. Go, Eric D. Peterson, Jonathan P. Piccini, Tags: CLINICAL INVESTIGATIONS Source Type: research

Aspirin and the risk of cardiovascular events in atherosclerosis patients with and without prior ischemic events
ConclusionsIn this observational analysis of outpatients with stable atherosclerosis, aspirin was marginally beneficial among patients with a prior ischemic event; however, there was no apparent benefit among those with no prior ischemic event. (Source: Clinical Cardiology)
Source: Clinical Cardiology - May 1, 2017 Category: Cardiology Authors: Anthony A. Bavry, Islam Y. Elgendy, Yedid Elbez, Ahmed N. Mahmoud, Emmanuel Sorbets, Philippe Gabriel Steg, Deepak L. Bhatt, Tags: CLINICAL INVESTIGATIONS Source Type: research

Correlation between genetic polymorphisms within the MAPK1/HIF ‐1/HO‐1 signaling pathway and risk or prognosis of perimenopausal coronary artery disease
BackgroundMitogen‐activated protein kinase‐1 (MAPK1), as well as its downstream factors of hypoxia‐inducible factor‐1 (HIF‐1) and heme oxygenase‐1 (HO‐1), have been documented to be involved in modulating development of coronary artery disease (CAD). HypothesisGenetic mutations within the MAPK1/HIF‐1/HO‐1 signaling pathway could alter the risk of perimenopausal CAD in Chinese patients. MethodsPeripheral blood samples were gathered from 589 CAD patients and 860 healthy controls, and 12 potential single‐nucleotide polymorphisms (SNPs) were obtained from HapMap database and previously published studies. Ge...
Source: Clinical Cardiology - April 26, 2017 Category: Cardiology Authors: Nan Guo, Nan Zhang, Liqiu Yan, Xufen Cao, Jiawang Wang, Yunfei Wang Tags: CLINICAL INVESTIGATIONS Source Type: research