Winning the battle but losing the war: increased population-based mortality from aortic dissection
We read with great interest ‘Temporal Trends in Mortality of Aortic Dissection and Rupture in the UK, Japan, the USA, and Canada’. In their study, Hibino and colleagues1 performed a retrospective database analysis examining trends in mortality from aortic dissection and rupture across four countries over a 19-year time-period. The main outcome was age-standardised mortality rates and annual percentage change of mortality over the study period, with a comparison between trends in aortic dissection versus aortic rupture. Their hypothesis was that given improved surgical mortality and the uptick of endovascular ma...
Source: Heart - February 12, 2024 Category: Cardiology Authors: Hamilton, B. C. S., Eagle, K. A. Tags: Editorials Source Type: research
Role of lipoprotein(a) concentrations in bioprosthetic aortic valve degeneration
Conclusions
High serum Lp(a) is associated with bAV degeneration. Prospective studies are needed to confirm these findings and to investigate whether lowering Lp(a) levels could slow bioprostheses degradation. (Source: Heart)
Source: Heart - January 29, 2024 Category: Cardiology Authors: Farina, J. M., Chao, C.-J., Pereyra, M., Roarke, M., Said, E. F., Barry, T., Alsidawi, S., Sell-Dottin, K., Sweeney, J. P., Fortuin, D. F., Ayoub, C., Lester, S. J., Oh, J. K., Arsanjani, R., Marcotte, F. Tags: Editor's choice Valvular heart disease Source Type: research
Aetiology, ejection fraction and mortality in chronic heart failure: a mediation analysis
Conclusions
The direct effect of aetiology on mortality dominates the indirect effect through LVEF. Therefore, clarification of aetiology is as important as measurement of LVEF. (Source: Heart)
Source: Heart - January 29, 2024 Category: Cardiology Authors: Fritz, J., Belovari, K., Ulmer, H., Zaruba, M.-M., Messner, M., Ungericht, M., Siebert, U., Ruschitzka, F., Bauer, A., Poelzl, G. Tags: Heart failure and cardiomyopathies Source Type: research
Widening ethnic inequities in heart failure incidence in New Zealand
Conclusion
Ethnic inequities in incident HF hospitalisation have widened in NZ over the past 13 years. Urgent action is required to address the predisposing factors that lead to development of HF in Maori and Pacific people. (Source: Heart)
Source: Heart - January 29, 2024 Category: Cardiology Authors: Chan, D. Z., Grey, C., Doughty, R. N., Lund, M., Lee, M. A. W., Poppe, K., Harwood, M., Kerr, A. Tags: Heart failure and cardiomyopathies Source Type: research
Coronary physiology thresholds associated with microvascular obstruction in myocardial infarction
Conclusions
IMR and CFR are associated with the presence of microvascular obstruction in STEMI. Patients with an IMR>31 units and a CFR≤1.25 have higher prevalence of microvascular obstruction, lower left ventricular ejection fraction, larger infarct size and area at risk.
Trial registration number
NCT04677257. (Source: Heart)
Source: Heart - January 29, 2024 Category: Cardiology Authors: Benenati, S., Montorfano, M., Pica, S., Crimi, G., Ancona, M., Montone, R. A., Rinaldi, R., Gramegna, M., Esposito, A., Palmisano, A., Tavano, D., Monizzi, G., Bartorelli, A., Porto, I., Ambrosio, G., Camici, P. G. Tags: Coronary artery disease Source Type: research
Exercise electrocardiography for pre-test assessment of the likelihood of coronary artery disease
Conclusions
ExECG incorporated into a clinical likelihood model improves reclassification of patients to a very low clinical likelihood group with very low prevalence of obstructive CAD and favourable prognosis. (Source: Heart)
Source: Heart - January 29, 2024 Category: Cardiology Authors: Rasmussen, L. D., Schmidt, S. E., Knuuti, J., Newby, D. E., Singh, T., Nieman, K., Galema, T. W., Vrints, C., Bottcher, M., Winther, S. Tags: Coronary artery disease Source Type: research
Long-term cardiac follow-up of athletes infected with SARS-CoV-2 after resumption of elite-level sports
Conclusions
This prospective study demonstrates the safety of resuming elite-level sports after SARS-CoV-2 infection. The medium-term risks associated with SARS-CoV-2 infection and elite-level sports appear low, as the resumption of elite sports did not lead to detrimental cardiac effects or increases in clinical events, even in the four elite athletes with SARS-CoV-2 associated myocardial involvement. (Source: Heart)
Source: Heart - January 29, 2024 Category: Cardiology Authors: van Hattum, J. C., Daems, J. J. N., Verwijs, S. M., Wismans, L. V., van Diepen, M. A., Groenink, M., Boekholdt, S. M., Planken, R. N., van Randen, A., Hirsch, A., Moen, M. H., Pinto, Y. M., Wilde, A. A. M., Jorstad, H. T. Tags: Open access, COVID-19 Cardiac risk factors and prevention Source Type: research
Left atrial appendage closure in very elderly patients in the French National Registry
Conclusion
Despite a higher mean CHA2DS2-VASc score in octogenarians, the rate of thromboembolic events after LAAC in this age group was similar to that in patients aged <80 years.
Trial registration number
ClinicalTrials.gov Registry (NCT03434015). (Source: Heart)
Source: Heart - January 29, 2024 Category: Cardiology Authors: Teiger, E., Eschalier, R., Amabile, N., Rioufol, G., Ducrocq, G., Garot, P., Lepillier, A., Bille, J., Elbaz, M., Defaye, P., Audureau, E., Le Corvoisier, P., French Left Atrial Appendage Closure-2 registry (FLAAC-2) investigators, Abi-Khalil, Amabile, Ar Tags: Arrhythmias and sudden death Source Type: research
Ebsteins anomaly in children and adults: multidisciplinary insights into imaging and therapy
Although survival has significantly improved in the last four decades, the diagnosis of Ebstein’s anomaly is still associated with a 20-fold increased risk of mortality, which generally drops after neonatal period and increases subtly thereafter. With increasing age of presentation, appropriate timing of intervention is challenged by a wide spectrum of disease and paucity of data on patient-tailored interventional strategies. The present review sought to shed light on the wide grey zone of post-neonatal Ebstein’s manifestations, highlighting current gaps and achievements in knowledge for adequate risk assessmen...
Source: Heart - January 29, 2024 Category: Cardiology Authors: Pasqualin, G., Boccellino, A., Chessa, M., Ciconte, G., Marcolin, C., Micaglio, E., Pappone, C., Sturla, F., Giamberti, A. Tags: Open access, Review articles Reviews Source Type: research
Acute chest pain in a young man with low cardiovascular risk profile
Clinical introductionVignette A man in his 40s presented to our emergency department with sudden onset of severe central chest pain radiating to his left arm. He was sweaty, clammy and had accompanying breathlessness. There was no antecedent angina. His cardiovascular risk profile was low except for being a smoker (15 cigarettes per day). There was no medical history and he was not on any medical treatment. The 12-lead ECG showed sinus rhythm with hyperacute T waves in leads V3 and V4. Coronary angiography was performed using right radial access. The right coronary artery was small and free of disease. The left system show...
Source: Heart - January 29, 2024 Category: Cardiology Authors: Boeddinghaus, J., Chapman, A. R., Henriksen, P. A. Tags: Image challenges Source Type: research
Comprehensive imaging in patients with suspected pulmonary arterial hypertension
Currently, several imaging techniques are being used for a comprehensive evaluation of patients with suspected pulmonary hypertension (PH), in order to provide information that may clarify the presence and identify the aetiology of this complex pathology. The current paper is focused on recent updates regarding the importance of comprehensive imaging techniques for patients with suspected PH. Transthoracic echocardiography that can mainly detect right ventricle pressure overload and dysfunction is the cornerstone of imaging evaluation, while right heart catheterisation remains the gold standard assessment method. Chest rad...
Source: Heart - January 29, 2024 Category: Cardiology Authors: Crisan, S., Baghina, R.-M., Luca, S. A., Cozlac, A.-R., Negru, A.-G., Vacarescu, C., Lazar, M.-A., Luca, C.-T., Gaita, D. Tags: Review articles Reviews Source Type: research
Synopsis of JBS recommendations for magnetic resonance imaging in patients with cardiac implantable electronic devices
Over the last several decades, magnetic resonance (MR) imaging has become the diagnostic modality of choice for several conditions, cardiac and non-cardiac. However, MR uses a static magnetic field, gradient magnetic fields and pulsed radiofrequency energy, all of which may interact with metallic and electronic components within the field. As such, patients with cardiac implantable electronic devices (CIEDs) have traditionally been precluded from MR imaging given the potential harm from mechanical force and torque, heating and tissue damage, unwanted myocardial stimulation or electrical reset. Necessity, therefore, drove r...
Source: Heart - January 29, 2024 Category: Cardiology Authors: Zghaib, T., Nazarian, S. Tags: Guideline summary Source Type: research
Understanding the driving mechanisms of bioprosthetic valve degeneration
Over the last decade, it has become increasingly clear that different mechanisms drive the development of native aortic stenosis. Most patients who develop native aortic stenosis have hypertension, and some have increased cholesterol. However, male sex, body mass index, smoking, metabolic syndrome, renal failure and genetic factors (eg, bicuspid aortic valve) have been identified in epidemiological studies as risk factors for developing native aortic stenosis. These studies have led to a series of clinical variables, which provide the foundation for understanding the mechanisms. The low-density lipoprotein (LDL) radius the...
Source: Heart - January 29, 2024 Category: Cardiology Authors: Wachtell, K. Tags: Editorials Source Type: research
Utility of exercise ECG testing in clinical practice: back to the future?
Assessment of patients presenting for the first time with suspected coronary artery disease (CAD) remains cumbersome with multiple diagnostic options. Likelihood of CAD can be estimated based on symptoms and risk factors, and an abnormal ECG may also be helpful. Patients with moderate/high probability of CAD are usually referred for further tests including angiography (CT or invasive) or isotope-based myocardial perfusion scans.1 2 The exercise ECG, once the stalwart of chest pain evaluation, has lost favour over the last two decades in most heart centres due to its relatively poor discriminatory ability and reliance on pa...
Source: Heart - January 29, 2024 Category: Cardiology Authors: Flather, M., Talukder, S. Tags: Editorials Source Type: research
Joint British Society consensus recommendations for magnetic resonance imaging for patients with cardiac implantable electronic devices
Magnetic Resonance Imaging (MRI) is increasingly a fundamental component of the diagnostic pathway across a range of conditions. Historically, the presence of a cardiac implantable electronic device (CIED) has been a contraindication for MRI, however, development of MR Conditional devices that can be scanned under strict protocols has facilitated the provision of MRI for patients. Additionally, there is growing safety data to support MR scanning in patients with CIEDs that do not have MR safety labelling or with MR Conditional CIEDs where certain conditions are not met, where the clinical justification is robust. This mean...
Source: Heart - January 29, 2024 Category: Cardiology Authors: Bhuva, A., Charles-Edwards, G., Ashmore, J., Lipton, A., Benbow, M., Grainger, D., Lobban, T., Gopalan, D., Slade, A., Roditi, G., Manisty, C. Tags: Consensus statement Source Type: research
