Rate control in atrial fibrillation, calcium channel blockers versus beta-blockers
Conclusion
In patients with non-permanent AF, calcium channel blockers instituted for rate control were associated with less bradycardia during sinus rhythm compared with beta-blockers. (Source: Heart)
Source: Heart - November 10, 2023 Category: Cardiology Authors: Koldenhof, T., Van Gelder, I. C., Crijns, H. J., Rienstra, M., Tieleman, R. G. Tags: Arrhythmias and sudden death Source Type: research
Phenotyping of atrial fibrillation with cluster analysis and external validation
Conclusions
Machine learning-based cluster analysis identified five different phenotypes of AF with unique clinical characteristics and different clinical outcomes. The use of these phenotypes may help identify high-risk patients with AF. (Source: Heart)
Source: Heart - November 10, 2023 Category: Cardiology Authors: Saito, Y., Omae, Y., Nagashima, K., Miyauchi, K., Nishizaki, Y., Miyazaki, S., Hayashi, H., Nojiri, S., Daida, H., Minamino, T., Okumura, Y. Tags: Open access, Editor's choice Arrhythmias and sudden death Source Type: research
Transcatheter closure of atrial septal defect in the elderly: a systematic review and meta-analysis
Conclusions
Transcatheter ASD closure is beneficial for the elderly population since it improves functional capacity, biventricular dimensions, pulmonary pressures, TR severity and BNP. However, the incidence of atrial arrhythmias did not change significantly after the intervention.
PROSPERO registration number
CRD42022378574. (Source: Heart)
Source: Heart - November 10, 2023 Category: Cardiology Authors: Baroutidou, A., Arvanitaki, A., Farmakis, I. T., Patsiou, V., Giannopoulos, A., Efthimiadis, G., Ziakas, A., Giannakoulas, G. Tags: Open access Systematic review Source Type: research
Dyspnoea and murmur in a young adult
Clinical introduction A quadragenarian patient presented with functional class II dyspnoea for 6 months. Clinical examination revealed cardiomegaly, left ventricular S3 with 4/6 systolic murmur at cardiac apex, radiating towards the base of the heart. The mitral inflow continuous Doppler and lateral mitral annular tissue Doppler imaging are shown in figure 1A,B. Figure 1(A) Transthoracic 2D echocardiogram showing mitral inflow continuous wave Doppler; (B) lateral mitral annular tissue Doppler imaging. Question What is the most likely aetiology of the patient’s murmur? Rheumatic mitral valve disease, Systolic anterio...
Source: Heart - November 10, 2023 Category: Cardiology Authors: Mondal, S., Garikapati, V., Banerjee, S. Tags: Image challenges Source Type: research
Update on advanced interventional neuromodulatory approaches to lower blood pressure
Herein, we review interventional peripheral neuromodulatory approaches to reduce blood pressure (BP), specifically focusing on catheter-based renal denervation (RDN), as well as the latest data from recent clinical trials underpinning its clinical use. Given the apparent failure of established lifestyle measures and pharmacologic BP-lowering approaches to improve hypertension (HTN) control rates, the past decade has seen remarkable scientific efforts to explore the utility of interventional strategies for BP management. Experimental studies and human clinical trials have demonstrated the crucial role of the sympathetic ner...
Source: Heart - November 10, 2023 Category: Cardiology Authors: Kiuchi, M. G., Carnagarin, R., Schultz, C., Shetty, S., Ward, N. C., Santos, C. E., Schlaich, M. P. Tags: Review articles Reviews Source Type: research
Right-sided mechanical valve prostheses in adults with congenital heart disease
Congenital heart disease (CHD) commonly includes right-sided valvular heart disease. Patients with CHD may require multiple sternotomies and interventions in their lifetime. The longevity of their replaced valve will be one of the most important factors determining freedom from re-intervention and overall prognosis. The European Society of Cardiology Guidelines for the management of adults with CHD have recommendations as to the indications and timing of pulmonary and tricuspid valve intervention1; however, whether to use a bioprosthetic or mechanical valve is not specifically outlined. The guidelines acknowledge that ther...
Source: Heart - November 10, 2023 Category: Cardiology Authors: Galligan, J., Brida, M. Tags: Editorials Source Type: research
Transcatheter atrial septal defect closure in the elderly: the decisive role of balloon testing
Atrial septal defect (ASD), one of the most common types of congenital heart disease, can be diagnosed and treated early in life but frequently remains undetected until adulthood.1 Over time, the haemodynamic complications of a simple ASD depend on the size of the defect, right and left ventricular compliance, and right and left atrial pressures. A clinically significant ASD with chronic left-to-right shunting often leads to arrhythmias, right-sided heart failure and/or pulmonary arterial hypertension. In addition, as highlighted almost 60 years ago in Dexter’s classic essay, patients with ASD and long-standing shunt...
Source: Heart - November 10, 2023 Category: Cardiology Authors: Drakopoulou, M., Tsioufis, C., Toutouzas, K. Tags: Editorials Source Type: research
Atrial fibrillation phenotypes: the route to personalised care?
Atrial fibrillation (AF) is the most common arrhythmia in adults and is responsible for significant morbidity and mortality. Recent data support the move towards personalisation of care in AF, which is of particular importance given the multiple, complex, management decisions that need to be made. Paradigms in AF care have also changed significantly recently due to the results of EAST-AFNET 41 that demonstrated the benefits of rhythm control for the reduction in adverse cardiovascular outcomes. Catheter ablation is used increasingly in AF for the improvement of symptoms and potentially the reduction of adverse events in ce...
Source: Heart - November 10, 2023 Category: Cardiology Authors: Sau, A., Pastika, L., Ng, F. S. Tags: Editorials Source Type: research
Heartbeat: atrial fibrillation phenotyping identifies patients at high risk of adverse events
Atrial fibrillation (AF) is primarily classified based on duration of the arrhythmia and the risk of stroke. However, the heterogenous pathophysiology of AF is either not considered or is only factored into clinical management on an individual basis. Saito and colleagues1 hypothesised that more precise phenotyping of patients with atrial fibrillation would better predict clinical outcomes. In derivation cohort of 3055 patient in the SAKURA AF registry (Real World Survey of Atrial Fibrillation Patients Treated with Warfarin and Non-vitamin K Antagonist Oral Anticoagulants), cluster analysis identified five distinct AF pheno...
Source: Heart - November 10, 2023 Category: Cardiology Authors: Otto, C. M. Tags: Highlights from this issue Source Type: research
Launching a career as an academic medical educator
A career in medical education is not just for those who aspire to be program directors (PDs) or associate program directors (APDs). There are in fact many possible paths that can make for a rewarding and fulfilling career in this space. Across all the organisation levels within a school of medicine or within graduate medical education, there are a myriad of opportunities to impact learners and improve ways medical knowledge is imparted to future generations. Charting this career path as a cardiologist can sometimes seem daunting, but it has become more established in recent years, especially as the number or cardiologists ...
Source: Heart - October 26, 2023 Category: Cardiology Authors: Sabanayagam, A., Qasim, A. Tags: Cardiology in Focus Source Type: research
Coronary artery calcium: from risk prediction to treatment allocation and clinical trials
Coronary artery calcium (CAC) is a direct measure of an individual’s coronary atherosclerotic burden. Higher levels of CAC are strongly associated with an increased risk of cardiovascular disease (CVD) events and individuals with very high CAC levels have a CVD risk similar to stable persons with a prior CVD event. Conversely, the absence of CAC (CAC=0) is associated with a low long-term risk of CVD, even among groups classified as high risk based on traditional risk factors. Accordingly, the guideline-based role of CAC in allocation of CVD prevention therapies has expanded to include both statin and non-statin medic...
Source: Heart - October 26, 2023 Category: Cardiology Authors: Whelton, S. P., Blaha, M. J. Tags: Education in Heart Source Type: research
Direct oral anticoagulants versus vitamin K antagonist after transcatheter aortic valve implantation
Conclusions
This study supports evidence of the efficacy of DOAC use after TAVI in patients with an indication for oral anticoagulation. (Source: Heart)
Source: Heart - October 26, 2023 Category: Cardiology Authors: Hohmann, C., Pfister, R., Frerker, C., Beckmann, A., Walther, T., Bleiziffer, S., Ensminger, S., Bekeredjian, R., Seiffert, M., Sinning, J.-M., Möllmann, H., Beyersdorf, F., Baldus, S., Böning, A., Herrmann, E., Balaban, U., Kuhn, E., for Tags: Valvular heart disease Source Type: research
Cost-effectiveness of ultra-low-dose quadruple combination therapy for high blood pressure
Conclusion(s)
Quadpill in comparison with monotherapy is comparably cost-effective for short-term BP lowering. In the long-term, quadpill therapy is likely to be cost-effective.
Trial registration number
ANZCTRN12616001144404. (Source: Heart)
Source: Heart - October 26, 2023 Category: Cardiology Authors: Atkins, E. R., Chye, A., Lung, T., Nolde, J. M., Billot, L., Burke, M., Chalmers, J., Figtree, G. A., Hay, P., Hillis, G. S., Jansen, S., Marschner, S., Neal, B., Nelson, M. R., Reid, C. M., Usherwood, T., Schlaich, M., Chow, C. K., Rodgers, A. Tags: Healthcare delivery, economics and global health Source Type: research
Independent external validation of the QRISK3 cardiovascular disease risk prediction model using UK Biobank
Conclusions
QRISK3 had moderate overall discrimination in UK Biobank, which was best in younger participants. The observed CVD risk for UK Biobank participants was lower than that predicted by QRISK3, particularly for older participants. It may be necessary to recalibrate QRISK3 or use an alternate model in studies that require accurate CVD risk prediction in UK Biobank. (Source: Heart)
Source: Heart - October 26, 2023 Category: Cardiology Authors: Parsons, R. E., Liu, X., Collister, J. A., Clifton, D. A., Cairns, B. J., Clifton, L. Tags: Open access Cardiac risk factors and prevention Source Type: research
Associations of dietary patterns, ultra-processed food and nutrient intake with incident atrial fibrillation
Conclusion
With the possible exception of reducing ultra-processed food consumption, these findings suggest that attention to other modifiable risk factors, particularly obesity, may be more important than specific dietary patterns for the primary prevention of AF. (Source: Heart)
Source: Heart - October 26, 2023 Category: Cardiology Authors: Tu, S. J., Gallagher, C., Elliott, A. D., Bradbury, K. E., Marcus, G. M., Linz, D., Pitman, B. M., Middeldorp, M. E., Hendriks, J. M., Lau, D. H., Sanders, P., Wong, C. X. Tags: Editor's choice Arrhythmias and sudden death Source Type: research
