Tolerability and beneficial effects of sacubitril/valsartan on systemic right ventricular failure
Conclusions
Treatment with sacubitril/valsartan was associated with a low rate of adverse effects in this adult sRV cohort. Persisting improvement in 6-minute walking test distance, NT-proBNP levels and echocardiographic parameters of sRV function was observed in an on-treatment analysis and showed no differential response based on sex or anatomy. (Source: Heart)
Source: Heart - September 28, 2023 Category: Cardiology Authors: Nederend, M., Kies, P., Regeer, M. V., Vliegen, H. W., Mertens, B. J., Robbers-Visser, D., Bouma, B. J., Tops, L. F., Schalij, M. J., Jongbloed, M. R. M., Egorova, A. D. Tags: Congenital heart disease Source Type: research
Chest pain symptoms during myocardial infarction in patients with and without diabetes: a systematic review and meta-analysis
Conclusion
In patients with an MI, patients with DM are less likely than those without to have presentations with CP recorded. Clinicians should consider an MI diagnosis when patients with DM present with atypical symptoms and treatment protocols should reflect this, alongside an increased patient awareness on this issue.
PROSPERO registration number
CRD42017058223. (Source: Heart)
Source: Heart - September 28, 2023 Category: Cardiology Authors: Kumar, A., Sanghera, A., Sanghera, B., Mohamed, T., Midgen, A., Pattison, S., Marston, L., Jones, M. M. Tags: Cardiac risk factors and prevention Source Type: research
Paradoxical worsening of an arrhythmia due to antiarrhythmics
Clinical introduction A man in his 50s presented to the emergency room with palpitations. He had recently been diagnosed with supraventricular tachycardia (VT) and had started taking propafenone 150 mg orally two times per day 2 weeks prior, as prescribed. Initial vital signs showed a heart rate of 215 bpm without haemodynamic instability. The initial 12-lead ECG (figure 1) revealed a regular wide QRS tachycardia; therefore, it was decided to administer 300 mg of amiodarone. Figure 1ECG Question Based on this ECG, what is the most likely diagnosis? Monomorphic ventricular tachycardia Aberrant atrioventricular reentrant ta...
Source: Heart - September 28, 2023 Category: Cardiology Authors: Lopez-Lizarraga, M. A., Sanchez-Amaya, D. J., Godinez-Cordova, L. B. Tags: Image challenges Source Type: research
Transcatheter aortic valve intervention in patients with cancer
The prevalence of concurrent cancer and severe aortic stenosis (AS) is increasing due to an ageing population. In addition to shared traditional risk factors for AS and cancer, patients with cancer may be at increased risk for AS due to off-target effects of cancer-related therapy, such as mediastinal radiation therapy (XRT), as well as shared non-traditional pathophysiological mechanisms. Compared with surgical aortic valve replacement, major adverse events are generally lower in patients with cancer undergoing transcatheter aortic valve intervention (TAVI), especially in those with history of mediastinal XRT. Similar pro...
Source: Heart - September 28, 2023 Category: Cardiology Authors: Leedy, D., Elison, D. M., Farias, F., Cheng, R., McCabe, J. M. Tags: Review articles Reviews Source Type: research
Obesity paradox is still alive in heart failure
Certainly, substantial evidence indicates that obesity is reaching epidemic levels worldwide, including in the USA, Europe and most of the Westernised world. In fact, in the USA alone, using body mass index (BMI) criteria, 75% of US adults are either overweight or have obesity, with 42% meeting criteria for obesity with BMI ≥30 kg/m2.1 Even more alarmingly, however, is the fact that class III, or severe obesity (BMI ≥40 kg/m2), is now present in ~9% of US adults,1 clearly placing an extremely ‘heavy’ burden on the US healthcare system, which is likely similar, although somewhat less, worldwide. Clearly, o...
Source: Heart - September 28, 2023 Category: Cardiology Authors: Lavie, C. J., Kokkinos, P., Lin, G.-M. Tags: Editorials Source Type: research
Type 2 myocardial infarction: the need to operationalise diagnostic criteria and shift towards clinical trials
Type 2 myocardial infarction due to an imbalance in myocardial oxygen supply and demand that is unrelated to coronary atherothrombosis is a complex and heterogeneous condition that occurs most commonly from non-coronary aetiologies, but can also occur from acute coronary conditions, as well as in patients with normal or stable non-obstructive or obstructive atherosclerotic coronary artery disease (CAD).1 While it is a frequent and prognostic condition, there are no evidence-based guidelines or randomised trials to inform the management of these patients.1 It is also clear from clinical practice as well as research studies ...
Source: Heart - September 28, 2023 Category: Cardiology Authors: Sandoval, Y. Tags: Editorials Source Type: research
Heart failure management in adults with congenital heart disease: are we on the 'right path?
Heart failure (HF) epidemic in congenital heart disease and systemic right ventricle (sRV) In recent years, surgical advances in the treatment of congenital heart disease (CHD) ensured a huge survival benefit. Therefore, the ageing population of adults with CHD is now frequently exposed to the long-term complications of living a long life with a deranged haemodynamics. Some groups of CHD constitute unique pathophysiological conditions, being predisposed to a wide array of undesired events in the long-term. That is the case of adults with a sRV, such as those with congenitally corrected transposition of the great arteries o...
Source: Heart - September 28, 2023 Category: Cardiology Authors: Fusco, F., Scognamiglio, G. Tags: Editorials Source Type: research
Heartbeat: cardiopulmonary fitness as an explanation for the apparent obesity paradox in heart failure mortality risk
People with obesity are at increased risk of cardiovascular disease (CVD) and have a twofold higher risk of heart failure (HF) compared with people with a healthy body mass index (BMI). Paradoxically, in patients with HF a higher BMI is associated with a lower risk of all-cause mortality. In order to better understand the association between BMI, HF and survival in a large primary care cohort, Jones and colleagues1 analysed data on 47 531 participants (mean age 78 years, 45.6% female) with HF in the Clinical Practice Research Datalink (2000–2017). Compared with healthy weight participants, the risk of death was highe...
Source: Heart - September 28, 2023 Category: Cardiology Authors: Otto, C. M. Tags: Highlights from this issue Source Type: research
Cardiology training in the USA
Introduction Modern medical education in the USA is a competitive, highly regulated and highly regimented process.1 In order to specialise in cardiovascular diseases, aspiring cardiologists must at minimum complete a college (bachelor’s) degree, medical school (MD or DO), internal medicine residency and cardiology fellowship. The required length of training in cardiology has significantly increased in parallel with the proliferation of subspecialties and rapid expansion of medical knowledge,2 such that the typical minimum length of training following high school graduation is now 14 years (figure 1). Figure 1Timeline...
Source: Heart - September 13, 2023 Category: Cardiology Authors: Mayfield, J. J. Tags: Cardiology in Focus Source Type: research
Familial hypercholesterolaemia and emerging therapeutics
Learning objectives To review prevalence, genetics and current guidelines for the diagnosis and treatment of familial hypercholesterolaemia. To assess cardiac and extracardiac complication of familial hypercholesterolaemia. To understand the management of familial hypercholesterolaemia including emerging pharmacological and non-pharmacological therapies. Introduction Familial hypercholesterolaemia (FH) is an inherited lipid disorder which dramatically increases the risk of premature atherosclerotic cardiovascular disease (ASCVD). FH is caused by one or more mutations affecting the low-density lipoprotein (LDL) receptor or ...
Source: Heart - September 13, 2023 Category: Cardiology Authors: Farias, F. I., Kim, S. M., Shapiro, M. D. Tags: Education in Heart Source Type: research
Clinical outcomes after aortic valve replacement with severe stenosis of trileaflet aortic valve and low valve calcium score
Conclusions
Patients with low AVC exhibit distinct clinical characteristics and a higher risk of long-term mortality compared with those with high AVC. (Source: Heart)
Source: Heart - September 13, 2023 Category: Cardiology Authors: Choi, Y., Ahn, J.-M., Yang, D. H., Koo, H. J., Lee, S.-A., Kang, D.-Y., Kim, J. B., Park, D.-W., Kim, D.-H., Choo, S. J., Park, S.-J. Tags: Valvular heart disease Source Type: research
Mortality trends of aortic stenosis in high-income countries from 2000 to 2020
Conclusions
While crude mortality rates increased in the eight countries, shifts towards decreasing trends were identified in age-standardised mortality rates in three countries and in the elderly aged ≥80 years in the eight countries. Further multidimensional observation is warranted to clarify the mortality trends. (Source: Heart)
Source: Heart - September 13, 2023 Category: Cardiology Authors: Hibino, M., Pandey, A. K., Hibino, H., Verma, R., Aune, D., Yanagawa, B., Takami, Y., Bhatt, D. L., Attizzani, G. F., Pelletier, M. P., Verma, S. Tags: Valvular heart disease, Editor's choice Source Type: research
Reliability of major bleeding events in UK routine data versus clinical trial adjudicated follow-up data
Conclusions
Analyses of the ASCEND randomised trial found that major bleeding events ascertained via UK routine data sources provided relative and absolute treatment effects similar to adjudicated follow-up.
Trial registration number
ISRCTN60635500; NCT00135226. (Source: Heart)
Source: Heart - September 13, 2023 Category: Cardiology Authors: Harper, C., Mafham, M., Herrington, W., Staplin, N., Stevens, W., Wallendszus, K., Haynes, R., Landray, M. J., Parish, S., Bowman, L., Armitage, J. Tags: Open access Study design Source Type: research
Evaluation of hospital readmission rates as a quality metric in adult cardiac surgery
Conclusion
Our findings suggest that readmissions following adult cardiac surgery may not be an ideal quality measure as hospital factors do not appear to influence this outcome. (Source: Heart)
Source: Heart - September 13, 2023 Category: Cardiology Authors: Ebrahimian, S., Bakhtiyar, S. S., Verma, A., Williamson, C., Sakowitz, S., Ali, K., Chervu, N. L., Sanaiha, Y., Benharash, P. Tags: Healthcare delivery, economics and global health Source Type: research
Prevalence of angina pectoris and association with coronary atherosclerosis in a general population
Conclusion
Angina pectoris symptoms are common (3.5%) among middle-aged individuals of the general population of Sweden, though with low association to obstructive coronary atherosclerosis. Sociodemographic and psychological factors are highly associated with angina symptoms, irrespective of degree of coronary atherosclerosis. (Source: Heart)
Source: Heart - September 13, 2023 Category: Cardiology Authors: Welen Schef, K., Tornvall, P., Alfredsson, J., Hagström, E., Ravn-Fischer, A., Soderberg, S., Yndigegn, T., Jernberg, T. Tags: Open access Coronary artery disease Source Type: research
