Augmenting reality in echocardiography
Echocardiography is a vital first-line imaging tool for the diagnosis and management of many cardiovascular diseases. Its availability and low cost have encouraged widespread use by clinicians for the diagnosis and management of patients with heart failure.1 Visual estimation is widely used to assess ejection fraction (EF), the percentage of blood the left ventricle pumps out during a contraction. Accurately determining the EF in patients with heart failure is crucial for the implementation of timely guideline-directed medical treatment. There is a substantial need for high-fidelity determination of EF in emergency setting...
Source: Heart - February 23, 2024 Category: Cardiology Authors: Sangha, V. Tags: Editorials Source Type: research
Prehospital triage in suspected myocardial infarction: a calculated risk?
In the prehospital setting, accurate decision-making is of paramount importance in the management of cardiac emergencies. For life-threatening events involving complete occlusion of a coronary artery, the activation of ST-elevation myocardial infarction protocols instructs the emergency services to provide immediate treatment and liaise directly with cardiac centres regarding invasive management, in turn, reducing morbidity and saving lives. Yet, when the coronary artery is only partially occluded in the context of non-ST-elevation acute coronary syndrome (NSTE-ACS), the prehospital diagnostic work-up and subsequent invasi...
Source: Heart - February 23, 2024 Category: Cardiology Authors: Kite, T. A., Ladwiniec, A., Moss, A. J. Tags: Editorials Source Type: research
Correspondence on 'Echocardiographic estimation of pulmonary pressure in patients with severe tricuspid regurgitation by Lemarchand et al
Lemarchand et al1 address an everyday question in the echocardiography laboratories about the reliability of systolic pulmonary artery pressure (sPAP) estimation in cases of severe tricuspid regurgitation (TR). It is concluded that sPAP is underestimated in cases of massive or torrential TR (TR-V), high right atrial (RA) pressure and ‘V-wave cut-off’sign on echocardiography. The applicability of the simplified Bernoulli equation in patients with TR-V for sPAP estimation is unclear and has not been adequately studied. While some authors alert that sPAP may be underestimated,2 others argue against its use in case...
Source: Heart - February 12, 2024 Category: Cardiology Authors: Gual-Capllonch, F., Pericas, P. Tags: Correspondence Source Type: research
Exercise training in heart failure
Learning objectives To understand the importance of exercise and physical activity in the general management and well-being of people with heart failure (HF). To understand the key principles of exercise training prescription in people with HF. To be familiar with the specific considerations of exercise training prescription in specific HF population groups including HF with preserved ejection fraction. To be aware of needs and requirements of remote delivery (home and digital supported) models of exercise training for people with HF. Introduction Management of heart failure (HF) requires multidisciplinary, pharmacological...
Source: Heart - February 12, 2024 Category: Cardiology Authors: Dibben, G. O., Hannay, J. R., Taylor, R. S. Tags: Education in Heart Source Type: research
Echocardiographic estimation of pulmonary pressure in patients with severe tricuspid regurgitation
Conclusion
The reliability of the estimation of sPAP in patients with severe TR could be altered by high RAP which cannot be estimated with current thresholds. (Source: Heart)
Source: Heart - February 12, 2024 Category: Cardiology Authors: Lemarchand, L., Auffret, V., Le Breton, H., Bedossa, M., Boulmier, D., Galli, E., Donal, E., Leurent, G. Tags: Valvular heart disease Source Type: research
Rationale and design of the United Kingdom Heart Failure with Preserved Ejection Fraction Registry
Conclusions
UK HFpEF will develop a rich, multimodal data resource to enable the identification of disease endotypes and develop more effective diagnostic strategies, precise risk stratification and targeted therapeutics.
Trial registration number
NCT05441839. (Source: Heart)
Source: Heart - February 12, 2024 Category: Cardiology Authors: UK HFpEF Collaborative Group, Miller, Al-Mohammad, Beezer, Columbine, Cotterell, Fisher, Hartshorne-Evans, Humphreys-Davies, Hyland, Lumbers, McCann, Paton, Petrie, Robinson, Sudlow, Cleverley, Smith, Wardle, Worsnop, Manisty, Moon, Petersen, Balakrishnan Tags: Open access Heart failure and cardiomyopathies Source Type: research
Peak oxygen consumption by smartwatches compared with cardiopulmonary exercise test in complex congenital heart disease
Conclusion
Both absolute values and changes over time in pVO2 as measured by smartwatches and CPETs correlate well in patients with complex ACHD. (Source: Heart)
Source: Heart - February 12, 2024 Category: Cardiology Authors: Tran, T., Steiner, J. M., Venkateswaran, A., Buber, J. Tags: Congenital heart disease Source Type: research
Triple vasodilator therapy in pulmonary arterial hypertension associated with congenital heart disease
Conclusions
Triple therapy with prostanoids is safe and effective for patients with PAH-CHD, improving FC, 6MWTD and NT-proBNP levels over 2 years. The treatment is particularly beneficial for patients with pre-tricuspid defects and non-Eisenmenger PAH-CHD. (Source: Heart)
Source: Heart - February 12, 2024 Category: Cardiology Authors: Luna-Lopez, R., Segura de la Cal, T., Sarnago Cebada, F., Martin de Miguel, I., Hinojosa, W., Cruz-Utrilla, A., Velazquez, M. T., Delgado, J. F., Mendoza, A., Arribas Ynsaurriaga, F., Escribano-Subias, P. Tags: Congenital heart disease Source Type: research
Associations between air pollution and the risk of first admission and multiple readmissions for cardiovascular diseases
Conclusion
This study provides evidence that ambient air pollutants might play an important role in both first admission and readmission for cardiovascular events. In addition, patients with pre-existing CVDs may be more vulnerable to air pollution compared with healthy population. (Source: Heart)
Source: Heart - February 12, 2024 Category: Cardiology Authors: Zhang, S., Chen, L., Qian, Z., Li, D., Cai, M., Wang, C., Zhang, Z., Vaughn, M. G., Keith, A. E., Li, H., Lin, H. Tags: Editor's choice Cardiac risk factors and prevention Source Type: research
Temporal trends in mortality of aortic dissection and rupture in the UK, Japan, the USA and Canada
Conclusions
Trends in mortality from aortic rupture are decreasing; however, mortality from aortic dissection is increasing in Japan, the USA and Canada. Further study to explain these trends is warranted. (Source: Heart)
Source: Heart - February 12, 2024 Category: Cardiology Authors: Hibino, M., Verma, S., Jarret, C. M., Shimamura, J., Verma, R., Hibino, H., Baeza, C. R., Aune, D., Yanagawa, B., Usui, A., Nienaber, C. A., Pelletier, M. P. Tags: Aortic and vascular disease Source Type: research
Optimal antiplatelet strategy following coronary artery bypass grafting: a meta-analysis
Conclusion
In patients with CABG, DAPT compared with SAPT and DAPT-T/P compared with DAPT-C were associated with reduction in all-cause and cardiovascular mortality, especially in patients with acute coronary syndrome. Additionally, DAPT was associated with reduction in MACCE, but higher rates of major and minor bleeding. An individualised approach to choosing antiplatelet regimen is necessary for patients with CABG based on ischaemic and bleeding risks. (Source: Heart)
Source: Heart - February 12, 2024 Category: Cardiology Authors: Agrawal, A., Kumar, A., Majid, M., Badwan, O., Arockiam, A. D., El Dahdah, J., Syed, A. B., Schleicher, M., Reed, G. W., Cremer, P. C., Griffin, B. P., Menon, V., Wang, T. K. M. Tags: Systematic review Source Type: research
Young adult with left ventricular dysfunction
Clinical introduction A patient in their 30s had been diagnosed with peripartum cardiomyopathy, pulmonary oedema, with severe left ventricular dysfunction at the seventh month of gestation in the third pregnancy in their late 20s. The patient had pregnancy-induced hypertension and hypothyroidism and was treated accordingly. The patient was managed medically and was referred to us in view of worsening symptoms with severe left ventricular dysfunction and moderate aortic regurgitation. Echocardiogram, CT aortogram and late gadolinium imaging of the aorta have been shown in figure 1. The coronary angiogram was normal. C react...
Source: Heart - February 12, 2024 Category: Cardiology Authors: Mondal, S., Raj, R. R., Gaddamedi, S. K. Tags: Image challenges Source Type: research
Review of the National Institute for Health and Care Excellence guidelines on the management of atrial and ventricular arrhythmias
The National Institute for Health and Care Excellence (NICE) guidelines present a synopsis of extensive internal evidence and technology reviews, with a particular focus on clinical efficacy and cost-effectiveness within the NHS in England. This approach has delivered a novel perspective on arrhythmia management, with important distinctions from other policymakers’ recommendations. For example, when compared with the European Society of Cardiology (ESC) and the American Heart Association (AHA)/Heart Rhythm Society (HRS)/American College of Cardiology (ACC) guidelines on atrial fibrillation (AF), NICE advocates unique...
Source: Heart - February 12, 2024 Category: Cardiology Authors: Lambiase, P. D., Maclean, E. Tags: Review articles Reviews Source Type: research
Right atrial pressure, not Doppler jet velocity, is the problem in estimating pulmonary pressure when tricuspid regurgitation is severe
Echocardiography allows estimation of right ventricular (RV) systolic pressure by adding the estimated right atrial pressure (RAP) to the systolic pressure gradient between the RV and right atrium (RA) calculated from the tricuspid regurgitant (TR) Doppler velocity. RV systolic pressure is equivalent to pulmonary artery systolic pressure (PASP) in the absence of pulmonic valve stenosis. Some degree of TR is present in about 80% of patients undergoing echocardiography, often only a trace or mild amount but just enough to allow PASP estimation which is now a standard echocardiographic reporting element. Non-invasive estimate...
Source: Heart - February 12, 2024 Category: Cardiology Authors: Otto, C. M., Bartkowiak, J., Hahn, R. T. Tags: Editorials Source Type: research
Raising the bar: triple therapy for pulmonary arterial hypertension associated with congenital heart disease
Pulmonary arterial hypertension related to congenital heart disease as a paradigm of complexity Pulmonary arterial hypertension related to congenital heart disease (PAH-CHD) really represents a paradigm of complexity. As such, some patients develop PAH-CHD during the infancy, usually as a result of a large post-tricuspid shunt, with pulmonary arterial pressures which may never drop after birth. In others, PAH may persist after late repair or develop later in life. Again, in rare cases, PAH-CHD may develop after a timely repair of the congenital defect, in the absence of any significant residual haemodynamic lesions or in t...
Source: Heart - February 12, 2024 Category: Cardiology Authors: D'Alto, M., Bassareo, P. P. Tags: Editorials Source Type: research
