Echocardiographic evaluation of the right ventricle: Clinical implications
Interest in evaluation of the right ventricle (RV) has increased recently. With the growth of new echocardiographic techniques and technology, there has been a corresponding increase in the ability to evaluate the RV, both qualitatively and quantitatively. Older echocardiographic techniques, such as right ventricular fractional area of change, tricuspid annular plane systolic excursion, and tissue S′, and newer echocardiographic techniques including 3‐dimensional evaluation and global longitudinal strain, can improve our evaluation of RV function. These techniques provide both diagnostic and prognostic data on a la...
Source: Clinical Cardiology - January 31, 2017 Category: Cardiology Authors: Tanya Dutta, Wilbert S. Aronow Tags: REVIEW Source Type: research

The role of thyroid hormones in acute coronary syndromes: Prognostic value of alterations in thyroid hormones
The prognosis of acute coronary syndromes (ACS) is affected by many factors. Normal thyroid homeostasis is known to alter during various critical illnesses, a condition that has been shown to correlate with the severity of the disease and increased mortality. The purpose of this article is to review literature to emphasize the considerable association of thyroid function with the cardiovascular system and summarize all existing evidence with regard to the role of thyroid hormones alterations during ACS. The electronic databases of PubMed, Medline, Scopus, and Cochrane were searched for relevant literature and studies. Alte...
Source: Clinical Cardiology - January 31, 2017 Category: Cardiology Authors: Vasileios Lamprou, Dimitrios Varvarousis, Kali Polytarchou, Giolanda Varvarousi, Theodoros Xanthos Tags: REVIEWS Source Type: research

Transcatheter aortic valve implantation improves carotid and vertebral arterial blood flow in patients with severe aortic stenosis: practical role of orthostatic stress test
BackgroundThere are no data on the impact of transcatheter aortic valve implantation (TAVI) on carotid and vertebral arterial blood flow. Our aim was to assess the effects of the orthostatic stress test on carotid and vertebral artery blood flow in patients with severe aortic stenosis (AS) undergoing TAVI. HypothesisTAVI may have beneficial effect on carotid and vertebral artery flow in patients with severe aortic stenosis. MethodsThirty carefully selected patients with severe AS undergoing TAVI were enrolled. Peak systolic blood‐flow velocity and end‐diastolic velocity in the common carotid artery, internal carotid ar...
Source: Clinical Cardiology - January 31, 2017 Category: Cardiology Authors: Pawel Kleczy ński, Pawel Petkow Dimitrow, Artur Dziewierz, Andrzej Surdacki, Dariusz Dudek Tags: CLINICAL INVESTIGATION Source Type: research

Cost ‐Effectiveness of Remote Cardiac Monitoring With the CardioMEMS Heart Failure System
The objective of this study was to estimate the cost‐effectiveness of this remote monitoring technology compared to standard of care treatment for HF. A Markov cohort model relying on the CHAMPION (CardioMEMS Heart Sensor Allows Monitoring of Pressure to Improve Outcomes in NYHA Class III Heart Failure Patients) clinical trial for mortality and hospitalization data, published sources for cost data, and a mix of CHAMPION data and published sources for utility data, was developed. The model compares outcomes over 5 years for implanted vs standard of care patients, allowing patients to accrue costs and utilities while they ...
Source: Clinical Cardiology - January 31, 2017 Category: Cardiology Authors: Jordana K. Schmier, Kevin L. Ong, Gregg C. Fonarow Tags: QUALITY AND OUTCOMES Source Type: research

Echocardiography fails to detect left ventricular noncompaction in a cohort of patients with noncompaction on cardiac magnetic resonance imaging
BackgroundLeft ventricular noncompaction (LVNC) is a rare disorder characterized by increased left ventricular trabeculation, deep intertrabecular recesses, and a thin compacted myocardial layer with associated clinical sequelae. Cardiac imaging with echocardiogram and cardiac magnetic resonance (CMRI) can detect variable myocardial morphology including excessive trabeculations. Multiple CMRI and echocardiographic criteria have been offered that attempt to identify LVNC morphology. The aim of this study was to assess the utility of echocardiogram in identifying LVNC in a cohort of patients with LVNC detected on CMRI. Hypot...
Source: Clinical Cardiology - January 31, 2017 Category: Cardiology Authors: Sachin Diwadkar, Leelakrishna Nallamshetty, Carlos Rojas, Alexia Athienitis, Chris Declue, Chad Cox, Aarti Patel, Sanders H. Chae Tags: CLINICAL INVESTIGATIONS Source Type: research

Fragmented QRS complex predicts contrast ‐induced nephropathy and in‐hospital mortality after primary percutaneous coronary intervention in patients with ST‐segment elevation myocardial infarction
ConclusionsThe fQRS is an independent predictor of postprocedural CIN and in‐hospital mortality in STEMI patients. (Source: Clinical Cardiology)
Source: Clinical Cardiology - January 31, 2017 Category: Cardiology Authors: Alparslan Kurtul, Mustafa Duran Tags: CLINICAL INVESTIGATIONS Source Type: research

Commentary on Electrocardiographic Time to Intrinsicoid Deflection and Heart Failure: the Multi ‐Ethnic Study of Atherosclerosis
(Source: Clinical Cardiology)
Source: Clinical Cardiology - January 31, 2017 Category: Cardiology Authors: E. Harvey Estes Tags: Commentary Source Type: research

The American Society for Preventive Cardiology: “The Times they are a Changing”
(Source: Clinical Cardiology)
Source: Clinical Cardiology - January 31, 2017 Category: Cardiology Tags: Editorial Source Type: research

Issue Information
(Source: Clinical Cardiology)
Source: Clinical Cardiology - January 31, 2017 Category: Cardiology Tags: Issue Information Source Type: research

Long ‐term follow‐up of arrhythmogenic right ventricular cardiomyopathy patients with an implantable cardioverter‐defibrillator for prevention of sudden cardiac death
ConclusionsRecurrence of sustained ventricular tachycardia/ventricular fibrillation is frequentin high‐risk patients with ARVC. The prognosis is favorable for ARVC patients treated with anICD for prevention of SCD. (Source: Clinical Cardiology)
Source: Clinical Cardiology - January 30, 2017 Category: Cardiology Authors: Kang Yin, Ligang Ding, Yuqiu Li, Wei Hua Tags: CLINICAL INVESTIGATIONS Source Type: research

Short and long term radiation induced cardiovascular disease in patients with cancer
Radiation‐induced cardiovascular disease is well described as a late effect in cancer patients treated with radiation therapy. Advancements in surgery, radiotherapy, and chemotherapy have led to an increasing number of cancer survivors with resultant long‐term side effects related to their cancer treatments. In this review, we describe the short‐ and long‐term cardiovascular consequences of mediastinal radiotherapy and discuss the optimal cardiovascular assessments and diagnostic tools in asymptomatic and symptomatic patients. (Source: Clinical Cardiology)
Source: Clinical Cardiology - January 30, 2017 Category: Cardiology Authors: Kirsten Melgaard Nielsen, Birgitte Vrou Offersen, Hanne Melgaard Nielsen, Merete Vaage ‐Nilsen, Syed Wamique Yusuf Tags: REVIEW Source Type: research

Very short/short ‐term benefit of inpatient/outpatient cardiac rehabilitation programs after coronary artery bypass grafting surgery
BackgroundExercise‐based rehabilitation is an important part of treatment patients following coronary artery bypass graft (CABG) surgery. HypothesisTo evaluate effect of very short/short‐term exercise training on cardiopulmonary exercise testing (CPET) parameters. MethodsWe studied 54 consecutive patients with myocardial infarction (MI) treated with CABG surgery referred for rehabilitation. The study population consisted of 50 men and 4 women (age 57.72 ± 7.61 years, left ventricular ejection fraction 55% ± 5.81%), who participated in a 3‐week clinical and 6‐month ou...
Source: Clinical Cardiology - January 10, 2017 Category: Cardiology Authors: Dejan Spiroski, Mojsije Andji ć, Olivera Ilić Stojanović, Milica Lazović, Ana Djordjević Dikić, Miodrag Ostojić, Branko Beleslin, Snežana Kostić, Marija Zdravković, Dragan Lović Tags: CLINICAL INVESTIGATIONS Source Type: research

Long ‐term outcome following remote ischemic postconditioning during percutaneous coronary interventions—the RIP‐PCI trial long‐term follow‐up
The clinical value of ischemic conditioning during percutaneous coronary intervention (PCI) and mode of administration is controversial. Our aim was to assess the long‐term effect of remote ischemic postconditioning among patients undergoing PCI. We randomized 360 patients undergoing PCI who presented with a negative troponin T at baseline into 3 groups: 2 groups received remote ischemic postconditioning (with ischemia applied to the arm in 1 group and to the thigh in the other group), and the third group acted as a control group. Remote ischemic postconditioning was applied during PCI immediately following stent deploym...
Source: Clinical Cardiology - January 10, 2017 Category: Cardiology Authors: Shahar Lavi, Nour Abu ‐Romeh, Sabrina Wall, Mistre Alemayehu, Ronit Lavi Tags: CLINICAL TRIAL UPDATES Source Type: research

Changes in left ventricular function after spontaneous coronary artery dissection
BackgroundSpontaneous healing of spontaneous coronary artery dissection (SCAD) and left ventricular ejection fraction (LVEF) recovery is frequently observed clinically. However, LVEF on presentation and follow‐up imaging has not been described. HypothesisWe hypothesize that LV dysfunction improves at follow‐up after initial SCAD presentation. MethodsWe included patients with nonatherosclerotic SCAD prospectively followed at Vancouver General Hospital, who had baseline assessment of LVEF and wall‐motion abnormality (WMA) during their index presentation. A subset of these patients had repeat assessment of their ventric...
Source: Clinical Cardiology - December 31, 2016 Category: Cardiology Authors: Christopher Franco, Andrew Starovoytov, Milad Heydari, G.B. John Mancini, Eve Aymong, Jacqueline Saw Tags: CLINICAL INVESTIGATIONS Source Type: research

Plasma oxidative stress and inflammatory biomarkers are associated with the sizes of the left atrium and pulmonary vein in atrial fibrillation patients
ConclusionsOxidative stress, inflammatory biomarkers and the sizes of the LA and PVs were significantly increased in AF patients. Hs‐CRP, ox‐LDL, RSPV CsA, LIPV CsA and LAV were associated with AF persistence. (Source: Clinical Cardiology)
Source: Clinical Cardiology - December 31, 2016 Category: Cardiology Authors: Jin ‐yi Li, Yan He, Hong‐hong Ke, Yu Jin, Zhi‐yuan Jiang, Guo‐qiang Zhong Tags: CLINICAL INVESTIGATIONS Source Type: research

Anthropometric parameters and the incidence of atrial fibrillation in older people: the PRO.V.A study
In this study, we examined the association between baseline anthropometric parameters with the incidence of AF in older people, hypothesizing that body size could impact the onset of AF more than fat distribution. MethodsOur study included 1764 participants with a mean age of 74.3 ± 6.9 years and no AF at baseline. Body mass index (BMI), body height, body surface area (BSA), waist and hip circumference, waist‐to‐stature ratio, waist‐to‐hip ratio, and mid–upper arm circumference (MUAC) were measured by trained physicians. AF was assessed after a 4.4‐year follow‐up. ResultsThere were 11...
Source: Clinical Cardiology - December 31, 2016 Category: Cardiology Authors: Caterina Trevisan, Stefania Maggi, Chiara Curreri, Giovanni Nante, Marianna Noale, Marina De Rui, Egle Perissinotto, Leonardo Sartori, Sabina Zambon, Gaetano Crepaldi, Enzo Manzato, Giuseppe Sergi Tags: CLINICAL INVESTIGATIONS Source Type: research

Voltage combined with pace mapping is simple and effective for ablation of noninducible premature ventricular contractions originating from the right ventricular outflow tract
ConclusionsVoltage mapping combined with pace mapping is effective and safe for patients with noninducible RVOT‐PVCs determined by conventional methods. (Source: Clinical Cardiology)
Source: Clinical Cardiology - December 26, 2016 Category: Cardiology Authors: Zefeng Wang, Heping Zhang, Hui Peng, Xuhua Shen, Zhijun Sun, Can Zhao, Ruiqing Dong, Huikuan Gao, Yongquan Wu Tags: Clinical Investigations Source Type: research

Antianginal medications and long ‐term outcomes after elective catheterization in patients with coronary artery disease
ConclusionsAntianginal medications are not universally prescribed among obstructive CAD patients; nonuse was associated with higher mortality. For CAD patients with or without prior myocardial infarction, β‐blockers were associated with improved long‐term survival. (Source: Clinical Cardiology)
Source: Clinical Cardiology - December 26, 2016 Category: Cardiology Authors: Lan Shen, John P. Vavalle, Samuel Broderick, Linda K. Shaw, Pamela S. Douglas Tags: Clinical Investigations Source Type: research

Issue Information
(Source: Clinical Cardiology)
Source: Clinical Cardiology - December 26, 2016 Category: Cardiology Tags: Issue Information Source Type: research

Patterns and predictors of lipid ‐lowering therapy in patients with atherosclerotic cardiovascular disease and/or diabetes mellitus in 2014: Insights from a large US managed‐care population
ConclusionsIn 2014, only 49% of patients with ASCVD and 40% with only DM had evidence for a filled statin prescription. Those with indications of ischemic stroke, PAD, and DM were less likely to receive statins than those with coronary conditions. Other characteristics such as advanced age, female sex, and noncardiac conditions predicted less statin utilization, thereby representing good targets for quality improvement. (Source: Clinical Cardiology)
Source: Clinical Cardiology - December 26, 2016 Category: Cardiology Authors: Dylan L. Steen, Irfan Khan, Laura Becker, JoAnne M. Foody, Katherine Gorcyca, Robert J. Sanchez, Robert P. Giugliano Tags: CLINICAL INVESTIGATIONS Source Type: research

The contemporary value of peak creatine kinase ‐MB after ST‐segment elevation myocardial infarction above other clinical and angiographic characteristics in predicting infarct size, left ventricular ejection fraction, and mortality
BackgroundComplex multimarker approaches to predict outcome after ST‐elevation myocardial infarction (STEMI) have only considered a single baseline sample, while neglecting easily obtainable peak creatine kinase and creatine kinase‐MB (CK‐MB) values during hospitalization. MethodsWe studied 476 patients undergoing primary percutaneous coronary intervention for STEMI and cardiac magnetic resonance imaging (CMRI) at 4‐6 months after STEMI. We determined the association with cardiac biomarkers (peak CK‐MB, peak troponin T, N‐terminal pro‐brain natriuretic peptide), clinical and angiographic characteristics with ...
Source: Clinical Cardiology - December 26, 2016 Category: Cardiology Authors: Minke H. T. Hartman, Ruben N. Eppinga, Pieter J. J. Vlaar, Chris P. H. Lexis, Erik Lipsic, Joost D. E. Haeck, Dirk J. van Veldhuisen, Iwan C. C. van der Horst, Pim van der Harst Tags: CLINICAL INVESTIGATIONS Source Type: research

Evaluation of left ventricular diastolic function profile in patients with pulmonary hypertension due to heart failure with preserved ejection fraction
ConclusionsThe profile of LV diastolic dysfunction by conventional echocardiography is highly variable in patients with PH‐HFpEF and has no significant impact on long‐term survival. A more severe RV function and higher right ventricle systolic pressure were associated with worse survival. (Source: Clinical Cardiology)
Source: Clinical Cardiology - December 26, 2016 Category: Cardiology Authors: Pejman Raeisi ‐Giglou, Louis Lam, Balaji K. Tamarappoo, Jennie Newman, Raed A. Dweik, Adriano R. Tonelli Tags: CLINICAL INVESTIGATIONS Source Type: research

Impact of diabetes on mortality in peripheral artery disease: a meta ‐analysis
BackgroundThere are accumulating studies showing the association between diabetes and all‐cause mortality in peripheral vascular disease. However, the results in these studies are conflicting regarding the impact of diabetes on outcome. HypothesisDiabetes is associated with increased risk of mortality in peripheral artery disease. MethodsUsing MEDLINE and Scopus, we searched for studies published before January 2016. Additionally, studies were identified by manual search of references of original articles or review studies on this topic. Of the 1072 initially identified records, 21 studies with 15,857 patients were inclu...
Source: Clinical Cardiology - December 26, 2016 Category: Cardiology Authors: Mislav Vrsalovic, Ksenija Vucur, Ana Vrsalovic Presecki, Damir Fabijanic, Milan Milosevic Tags: CLINICAL INVESTIGATIONS Source Type: research

Direct oral anticoagulant use in nonvalvular atrial fibrillation with valvular heart disease: a systematic review
In conclusion, subanalyses of DOAC landmark AF trials revealed that dabigatran, rivaroxaban, and apixaban may be safely used in AF patients with certain types of VHD: aortic stenosis, aortic regurgitation, and mitral regurgitation. More evidence is needed before routinely recommending these agents for patients with bioprosthetic valves or mild mitral stenosis. Patients with moderate to severe mitral stenosis or mechanical valves should continue to receive warfarin, as these patients were excluded from all landmark AF trials. (Source: Clinical Cardiology)
Source: Clinical Cardiology - December 21, 2016 Category: Cardiology Authors: Ryan E. Owens, Rajesh Kabra, Carrie S. Oliphant Tags: Reviews Source Type: research

Issue Information
(Source: Clinical Cardiology)
Source: Clinical Cardiology - December 11, 2016 Category: Cardiology Tags: Issue Information Source Type: research

Personalized, assessment ‐based, and tiered medical education curriculum integrating treatment guidelines for atrial fibrillation
BackgroundThis continuing medical education (CME) curriculum utilizes the Learner Assessment Platform (LAP), providing learners with personalized educational pathways related to atrial fibrillation treatment. HypothesisThere are improvements in knowledge among physician learners after CME, especially among LAP learners. MethodsIn this LAP‐based curriculum, an evaluation of learner deficits on designated learning objectives was conducted in tier 1 and used to direct learners to individualized tier 2 activities. Performance was assessed across learner tracks from baseline to learners’ final intervention. Retention da...
Source: Clinical Cardiology - November 30, 2016 Category: Cardiology Authors: Brian C. Lee, Karyn D. Ruiz ‐Cordell, Steven M. Haimowitz, Cara Williams, Bruce S. Stambler, Anthia Mandarakas Tags: CLINICAL INVESTIGATIONS Source Type: research

Impact of rotor temperospatial stability on acute and one ‐year atrial fibrillation ablation outcomes
ConclusionsAcute and intermediate results did not change with protocolized mapping designed to identify temperospatially stable rotors. Outcomes at 12 months were similar in both groups. (Source: Clinical Cardiology)
Source: Clinical Cardiology - November 30, 2016 Category: Cardiology Authors: Muhammad Balouch, Esra Gucuk Ipek, Jonathan Chrispin, Rizma J. Bajwa, Tarek Zghaib, Ronald D. Berger, Hiroshi Ashikaga, Saman Nazarian, Joseph E. Marine, Hugh Calkins, David D. Spragg Tags: CLINICAL INVESTIGATIONS Source Type: research

Correlation between cardiac rhythm, left atrial appendage flow velocity, and CHA2DS2 ‐VASc score: Study based on transesophageal echocardiography and 2‐dimensional speckle tracking
This study aimed to explore the effects of AF rhythm and CHA2DS2‐VASc score in the development of thrombogenesis and their potential correlation with LAA‐FV and LA strain. Hypothesis AF rhythm and high CHA2DS2‐VASc score correlate independently with decreased LAA‐FV, which can be predicted by LA strain. MethodsIn 98 AF patients, LAA‐FV was measured by transesophageal echocardiography and LA strain was measured by transthoracic echocardiography. Results LAA‐FV decreased sharply in the AF rhythm group (26.22 vs 61.87 mm/s; P
Source: Clinical Cardiology - November 30, 2016 Category: Cardiology Authors: Kun Zuo, Lanlan Sun, Xinchun Yang, Xiuzhang Lyu, Kuibao Li Tags: CLINICAL INVESTIGATIONS Source Type: research

Expression of programmed cell death ‐1 and its ligand B7 homolog 1 in peripheral blood lymphocytes from patients with peripartum cardiomyopathy
ConclusionsThis study provided the first findings that PD‐1 and B7‐H1 expression were decreased, which might impair functional regulation of negative costimulation on immune response that may work in the etiopathogenesis of PPCM. (Source: Clinical Cardiology)
Source: Clinical Cardiology - November 30, 2016 Category: Cardiology Authors: Guozhi Xia, Xiaopu Zheng, Xinye Yao, Xiaowei Yao, Zhongwei Liu, Junkui Wang Tags: Clinical Investigations Source Type: research

Effect of treatment with 5 ‐lipoxygenase inhibitor VIA‐2291 (atreleuton) on coronary plaque progression: a serial CT angiography study
In this study, a selective 5‐LO inhibitor will slow plaque progression using serial cardiac computed tomographic angiography (CCTA). MethodsPatients with recent acute coronary syndrome (ACS) were prospectively assigned to one of 3 VIA‐2291 doses (25 mg, 50 mg, 100 mg) or placebo by oral administration. All groups underwent CCTA at baseline and at 6 months’ follow‐up. Plaque types such as low‐attenuation plaque (LAP), fibro‐fatty tissue (FF), fibro‐calcified plaque (FC), and dense calcium plaque (DC) were measured based upon predefined density threshold, and changes from baseline CCTA ...
Source: Clinical Cardiology - November 23, 2016 Category: Cardiology Authors: Suguru Matsumoto, Reda Ibrahim, Jean C. Gr égoire, Philippe L. L'Allier, Josephine Pressacco, Jean‐Claude Tardif, Matthew J. Budoff Tags: Clinical Investigations Source Type: research

Impact of prior permanent pacemaker on long ‐term clinical outcomes of patients undergoing percutaneous coronary intervention
Conclusions PPM has no effect on all‐cause mortality in patients undergoing first PCI but significantly increases the HF‐associated hospitalization rate, especially in ACS patients. (Source: Clinical Cardiology)
Source: Clinical Cardiology - November 22, 2016 Category: Cardiology Authors: Yan ‐Jie Li, Wei‐Wei Zhang, Xiao‐Xiao Yang, Ning Li, Xing‐Biao Qiu, Xin‐Kai Qu, Wei‐Yi Fang, Yi‐Qing Yang, Ruo‐Gu Li Tags: Clinical Investigations Source Type: research

Hemodynamic ‐guided heart‐failure management using a wireless implantable sensor: Infrastructure, methods, and results in a community heart failure disease‐management program
BackgroundThe real‐world impact of remote pulmonary artery pressure (PAP) monitoring on New York Heart Association (NYHA) class improvement and heart failure (HF) hospitalization rate is presented here from a single center. Hypothesis MethodsSeventy‐seven previously hospitalized outpatients with NYHA class III HF were offered PAP monitoring via device implantation in a multidisciplinary HF‐management program. Prospective effectiveness analyses compared outcomes in 34 hemodynamically monitored patients to a group of similar patients (n = 32) who did not undergo device implantation but received usual care. NYHA class a...
Source: Clinical Cardiology - November 22, 2016 Category: Cardiology Authors: Rita Jermyn, Amit Alam, Jessica Kvasic, Omar Saeed, Ulrich Jorde Tags: Clinical Investigations Source Type: research

Guideline ‐based statin/lipid‐lowering therapy eligibility for primary prevention and accuracy of coronary artery calcium and clinical cardiovascular events: The Multi‐Ethnic Study of Atherosclerosis (MESA)
ConclusionsDespite the increased in SN of statin eligibility by the ACC/AHA, it has similar NPV and PPV for CAC/future CVD events. The ACC/AHA class I indications for statin may be a superior screening tool for subclinical and clinical CVD. (Source: Clinical Cardiology)
Source: Clinical Cardiology - November 11, 2016 Category: Cardiology Authors: Peter Flueckiger, Waqas Qureshi, Erin D. Michos, Michael Blaha, Gregory Burke, Veit Sandfort, David Herrington, Joseph Yeboah Tags: Clinical Investigations Source Type: research

Cardiopulmonary exercise testing improves diagnostic specificity in patients with echocardiography ‐suspected pulmonary hypertension
BackgroundDoppler echocardiography is usually the first diagnostic investigation for patients suspected with pulmonary hypertension (PH), but it is often inaccurate when used alone, especially in mild PH. HypothesisCardiopulmonary exercise testing (CPET) may serve as a complementary tool to improve diagnostic accuracy in echocardiography‐suspected “PH possible” patients. MethodsEighty‐eight consecutive patients with suspected PH (referred to as “PH possible” hereafter) based on echocardiography were included in the study. CPET was assessed subsequently and PH was confirmed by right‐heart cathe...
Source: Clinical Cardiology - November 1, 2016 Category: Cardiology Authors: Qin ‐Hua Zhao, Lan Wang, Bigyan Pudasaini, Rong Jiang, Ping Yuan, Su‐Gang Gong, Jian Guo, Qiang Xiao, Hui Liu, Cheng Wu, Zhi‐Cheng Jing, Jin‐Ming Liu Tags: Clinical Investigations Source Type: research

Exercise test predictors of severe coronary artery disease: Role of ST ‐segment elevation in lead aVR
Conclusions EST‐induced STE in lead aVR does not significantly increase the prediction of severe CAD compared with severity and extension of STD as assessed in the other electrocardiographic leads. (Source: Clinical Cardiology)
Source: Clinical Cardiology - November 1, 2016 Category: Cardiology Authors: Giulio Russo, Salvatore Emanuele Ravenna, Antonio De Vita, Cristina Aurigemma, Priscilla Lamendola, Gaetano Antonio Lanza, Filippo Crea Tags: Clinical Investigations Source Type: research

Long ‐term cardiovascular mortality after radiotherapy for breast cancer: A systematic review and meta‐analysis
BackgroundRadiotherapy (RT) is frequently associated with late cardiovascular (CV) complications. The mean cardiac dose from irradiation of a left‐sided breast cancer is much higher than that for a right‐sided breast cancer. However, data is limited on the long‐term risks of RT on CV mortality. Hypothesis RT for breast cancer is associated with long term CV mortality and left sided RT carries a greater mortality than right sided RT. MethodsWe searched PubMed, Cochrane Central, Embase, EBSCO, Web of Science, and CINAHL databases from inception through December 2015. Studies reporting CV mortality with RT for left‐ v...
Source: Clinical Cardiology - November 1, 2016 Category: Cardiology Authors: Partha Sardar, Amartya Kundu, Saurav Chatterjee, Anju Nohria, Ramez Nairooz, Sripal Bangalore, Debabrata Mukherjee, Wilbert S. Aronow, Carl J Lavie Tags: Clinical Investigations Source Type: research

Myocardial tissue deformation is reduced in subjects with coronary microvascular dysfunction but not rescued by treatment with ranolazine
BackgroundPatients with coronary microvascular dysfunction (CMD) often have diastolic dysfunction, representing an important therapeutic target. Ranolazine—a late sodium current inhibitor—improves diastolic function in animal models and subjects with obstructive coronary artery disease (CAD). HypothesisWe hypothesized that ranolazine would beneficially alter diastolic function in CMD. MethodsTo test this hypothesis, we performed retrospective tissue tracking analysis to evaluate systolic/diastolic strain, using cardiac magnetic resonance imaging cine images acquired in a recently completed, randomized, double...
Source: Clinical Cardiology - October 31, 2016 Category: Cardiology Authors: Michael D. Nelson, Behzad Sharif, Jaime L. Shaw, Galen Cook ‐Wiens, Janet Wei, Chrisandra Shufelt, Puja K. Mehta, Louise E. J. Thomson, Daniel S. Berman, Richard B. Thompson, Eileen M. Handberg, Carl J. Pepine, Debiao Li, C. Noel Bairey Merz Tags: CLINICAL INVESTIGATIONS Source Type: research

Cryoballoon ablation of atrial fibrillation: a practical and effective approach
Medical management of atrial fibrillation (AF), the most common arrhythmia in the general population, has had modest efficacy in controlling symptoms and restoring and maintaining sinus rhythm. Since the seminal observation in 1998 that pulmonary veins host the triggers of AF in the majority of cases, electrical isolation of all pulmonary veins constitutes the cornerstone of ablation in patients with symptomatic AF. However, due to the elaborate and tedious technique of the conventional point‐by‐point method with radiofrequency ablation guided by electroanatomical mapping, newer, more versatile single‐shot techniques...
Source: Clinical Cardiology - October 31, 2016 Category: Cardiology Authors: George Georgiopoulos, Dimitris Tsiachris, Antonis S. Manolis Tags: Review Source Type: research

Erratum
(Source: Clinical Cardiology)
Source: Clinical Cardiology - October 26, 2016 Category: Cardiology Tags: Erratum Source Type: research

Prasugrel Use Following PCI and Associated Patient Outcomes: Insights From the National VA CART Program
ABSTRACT BackgroundPrasugrel is more effective than clopidogrel in preventing thrombotic complications after percutaneous coronary intervention (PCI) among patients with acute coronary syndromes (ACS), but it increases the risk of bleeding in subgroups of patients. There is limited data on whether prasugrel use in routine practice is targeted to clinical settings with greatest anticipated patient benefit. MethodsIn a national cohort of 11 617 veterans who underwent PCI between 2010 and 2013 at Veterans Administration hospitals nationwide, we assessed overall trends in the use of prasugrel and the frequency of prasugrel use...
Source: Clinical Cardiology - October 26, 2016 Category: Cardiology Authors: Vikas Aggarwal, Ehrin J. Armstrong, Wenhui Liu, Thomas M. Maddox, P. Michael Ho, Evan Carey, Tracy Wang, Matthew Sherwood, Thomas T. Tsai, John S. Rumsfeld, Steven M. Bradley Tags: Clinical Investigations Source Type: research

Issue Information
(Source: Clinical Cardiology)
Source: Clinical Cardiology - October 26, 2016 Category: Cardiology Tags: Issue Information Source Type: research

Management of newly treated diabetes in Medicare beneficiaries with and without heart failure
BackgroundSeveral diabetes mellitus (DM) therapies are associated with worse heart failure (HF) outcomes, yet limited data exist characterizing routine DM management based on HF status. HypothesisDM medications prescribed for patients with HF will differ in meaningful ways from patients without HF, and co‐morbidities will impact the choice of medications prescribed. MethodsUsing Medicare fee‐for‐service claims data, we identified patients with newly treated DM between 2008 and 2011 and used multivariable logistic regression to assess associations between baseline HF status and DM medication use. We used the cumulativ...
Source: Clinical Cardiology - October 25, 2016 Category: Cardiology Authors: Lauren B. Cooper, Xiaojuan Mi, Robert J. Mentz, Jennifer B. Green, Kevin J. Anstrom, Adrian F. Hernandez, Lesley H. Curtis Tags: Clinical Investigations Source Type: research

The American Society for Preventive Cardiology: Our 30 ‐year legacy
(Source: Clinical Cardiology)
Source: Clinical Cardiology - October 25, 2016 Category: Cardiology Authors: Nathan D. Wong, Laurence S. Sperling, Seth J. Baum Tags: Commentary Source Type: research

Cardiogenic Shock Predicts Long ‐term Mortality in Hospital Survivors of STEMI Treated With Primary Percutaneous Coronary Intervention
Background ST‐segment elevation myocardial infarction (STEMI) complicated by cardiogenic shock (CS) has a poor prognosis. Recently published data suggested, however, that CS does not affect long‐term mortality in hospital survivors of STEMI. We investigated whether this could be confirmed in a larger cohort. HypothesisSTEMI complicated by CS leads to worse long‐term survival. MethodsA prospective cohort study was performed in 7412 consecutive patients with STEMI treated by primary percutaneous coronary intervention (angioplasty). The predictive value of CS on long‐term mortality was assessed in hospital survivors. ...
Source: Clinical Cardiology - October 23, 2016 Category: Cardiology Authors: Veemal V. Hemradj, Jan Paul Ottervanger, Arnoud W. 't Hof, Jan Henk Dambrink, Marcel Gosselink, Elvin Kedhi, Harry Suryapranata, Tags: Clinical Investigations Source Type: research

Higher copeptin levels are associated with worse outcome in patients with hypertrophic cardiomyopathy
In this study, we aimed to investigate the prognostic value of copeptin levels in patients with hypertrophic cardiomyopathy (HCM). Methods HCM was defined as presence of left ventricular wall thickness ≥15 mm in a subject without any concomitant disease that may cause left ventricular hypertrophy. Levels of copeptin and plasma N‐terminal probrain natriuretic peptide (NT‐proBNP) were evaluated prospectively in 24 obstructive HCM patients, 36 nonobstructive HCM patients, and 36 age‐ and sex‐matched control subjects. Blood samples were collected in the morning between 7 and 9 am after overnight fastin...
Source: Clinical Cardiology - October 20, 2016 Category: Cardiology Authors: Irfan Sahin, Baris Gungor, Berk Ozkaynak, Fatih Uzun, Suat Hayri K üçük, Ilhan Iker Avci, Ender Ozal, Burak Ayça, Sukru Cetın, Ertugrul Okuyan, Mustafa Hakan Dinckal Tags: Clinical Investigations Source Type: research

Sudden death and its risk factors after atrioventricular junction ablation and pacemaker implantation in patients with atrial fibrillation
ConclusionsDilated cardiomyopathy, mitral stenosis, and baseline QRS morphology should be examined as potential risk factors for SD after AVJ ablation and pacemaker implantation. (Source: Clinical Cardiology)
Source: Clinical Cardiology - October 16, 2016 Category: Cardiology Authors: Ru ‐Xing Wang, Hon‐Chi Lee, Jia‐Ping Li, David O. Hodge, Yong‐Mei Cha, Paul A. Friedman, Thomas M. Munger, Komandoor Srivathsan, Behzad B. Pavri, Win‐Kuang Shen Tags: Clinical Investigation Source Type: research

Direct oral anticoagulants in patients with atrial fibrillation and renal impairment, extremes in weight, or advanced age
A growing number of patients with an indication for stroke prevention in atrial fibrillation have kidney‐, age‐, or weight‐related alterations in pharmacokinetics that affect dosing of direct oral anticoagulants. Because these patients were excluded from or comprised a small number of patients in clinical trials, there is a lack of evidence to guide clinicians. As a consequence, many patients do not receive oral anticoagulation despite a high risk for atrial fibrillation–related stroke. Here, we present a review of direct oral anticoagulant pharmacokinetics and a review of the available clinical evidence in pat...
Source: Clinical Cardiology - October 6, 2016 Category: Cardiology Authors: Leo F. Buckley, Eva Rybak, Ahmed Aldemerdash, Judy W.M. Cheng, John Fanikos Tags: Review Source Type: research

Bone mineral density is associated with left ventricular diastolic function in women
ConclusionsOsteoporosis is independently associated with LV diastolic dysfunction in women. A prospective study is needed to elucidate the effects of BMD on cardiac function in women. (Source: Clinical Cardiology)
Source: Clinical Cardiology - October 6, 2016 Category: Cardiology Authors: Rui ‐tao Wang, Xue‐song Li, Ji‐rong Zhang, Yuxiang Sun, Kai‐jiang Yu, Tiemin Liu Tags: Clinical Investigation Source Type: research

New Oral Anticoagulants in Nonvalvular Atrial Fibrillation
The choice of an oral anticoagulant (OAC) for patients with nonvalvular atrial fibrillation (NVAF) is a major and complex clinical decision taking into account the individual risk‐benefit ratio and bearing in mind the chronicity of therapy. This review focuses on the safety and efficacy of new oral anticoagulants (NOACs) compared with conventional vitamin K antagonists (VKA) in patients with NVAF. Current data suggest that NOACs are at least as effective and safe as VKAs for most NVAF subjects. The NOACs do not mandate dietary restrictions and regular pharmacodynamic monitoring, and they seem to have lesser incidence of ...
Source: Clinical Cardiology - October 6, 2016 Category: Cardiology Authors: Fatima Urooj, Abhishek Kulkarni, Dwight Stapleton, Edo Kaluski Tags: Review Source Type: research

Left ventricular stiffness estimated by diastolic wall strain is associated with paroxysmal atrial fibrillation in structurally normal hearts
This study included 328 consecutive subjects with structurally normal hearts: 164 paroxysmal AF patients and 164 age‐ and sex‐matched (1:1) controls. We calculated the DWS from the M‐mode echocardiographic measurements of the LV posterior wall thickness at end‐systole and end‐diastole during sinus rhythm. ResultsThe DWS was lower in the AF patients (0.35 ± 0.07) than in the controls (0.41 ± 0.06; P
Source: Clinical Cardiology - October 6, 2016 Category: Cardiology Authors: Shunsuke Uetake, Mitsunori Maruyama, Teppei Yamamoto, Katsuhito Kato, Yasushi Miyauchi, Yoshihiko Seino, Wataru Shimizu Tags: Clinical Investigation Source Type: research