Effects of ticagrelor and prasugrel on coronary microcirculation in elective percutaneous coronary intervention
Conclusions
In patients with stable CAD undergoing PCI, pretreatment with a loading dose of ticagrelor compared with prasugrel improves post-procedural coronary flow and microvascular function and seems to reduce the related myocardial injury. (Source: Heart)
Source: Heart - December 20, 2023 Category: Cardiology Authors: Mangiacapra, F., Colaiori, I., Di Gioia, G., Pellicano, M., Heyse, A., Paolucci, L., Peace, A., Bartunek, J., de Bruyne, B., Barbato, E. Tags: Coronary artery disease Source Type: research
Association between high-sensitivity cardiac troponin I and fall-related hospitalisation in women aged over 70 years
Conclusion
Elevated level of hs-cTnI was associated with slower TUG performance and increased fall-related hospitalisation risk. This indicates subclinical level of hs-cTnI can identify clinically relevant falls, emphasising the need to consider cardiac health during fall assessment in women aged over 70 years.
Trial registration number
ACTRN12617000640303. (Source: Heart)
Source: Heart - December 20, 2023 Category: Cardiology Authors: Gebre, A. K., Sim, M., Dalla Via, J., Smith, C., Rodriguez, A. J., Hodgson, J. M., Bondonno, C. P., Lim, W., Byrnes, E., Thompson, P. R., Prince, R. L., Lewis, J. R. Tags: Cardiac risk factors and prevention Source Type: research
Unusual cause of syncope
Clinical introduction A man in his 50s was admitted for recurrent syncope over 4 months. ECG demonstrated sinus rhythm, peripheral low voltage and T wave inversions in V3–V6 (figure 1A). Holter ambulatory monitoring showed normal sinus rhythm with atrial and ventricular premature beats. Electroencephalogram was normal. N-terminal pro-brain natriuretic peptide was elevated at 4631 ng/L, and troponin-T was elevated at 105 ng/L. Coronary angiography showed no obstructive disease. Transthoracic echocardiogram displayed increased wall thickness, dilated atria and decreased ejection fraction (48%) (figure 1B). Cardiac MRI ...
Source: Heart - December 20, 2023 Category: Cardiology Authors: Bi, K., Wan, K., Chen, Y. Tags: Image challenges Source Type: research
Metabolic syndrome and ischaemic stroke in non-anticoagulated atrial fibrillation with low CHA2DS2-VASc scores
Conclusion
Among AF patients with CHA2DS2-VASc scores of 0 and 1 with no anticoagulation, MetS is associated with an increased risk of ischaemic stroke. Given the linear incremental association between metabolic burden and ischaemic stroke, the integrated management of metabolic derangements in AF is required. (Source: Heart)
Source: Heart - December 20, 2023 Category: Cardiology Authors: Ahn, H.-J., Lee, S.-R., Choi, E.-K., Lee, S.-W., Han, K.-D., Kwon, S., Oh, S., Lip, G. Y. H. Tags: Arrhythmias and sudden death Source Type: research
Factors influencing blood pressure control in patients with atrial fibrillation and hypertension in Australian primary care
Conclusions
Uncontrolled BP was more likely in women and adults ≥75 years. Patients who had frequent GP visits with the same clinician were more likely to have BP controlled and receive guideline-recommended antihypertensive treatment. This suggests that targeting these primary care factors could potentially improve BP control and subsequently reduce stroke risk in patients with AF. (Source: Heart)
Source: Heart - December 20, 2023 Category: Cardiology Authors: Trivedi, R., Marschner, S., Shaw, T., Min, H., Yue, J., Kazi, S., Nguyen, T. N., Laranjo, L., Chow, C. K. Tags: Open access, Editor's choice Arrhythmias and sudden death Source Type: research
Antithrombotic therapy after heart valve intervention: review of mechanisms, evidence and current guidance
As the population ages and treatment options for heart valve disease increase, the number of patients with intracardiac valve prostheses is growing rapidly. Although all devices have the potential to cause thrombus formation, the propensity depends on the type of prosthesis as well as risk of the individual patient. Mechanical valve prostheses carry the highest (and persistent) risk of thromboembolism, and these patients require anticoagulation with vitamin K antagonists (warfarin). Required international normalised ratio levels are dependent on the location of the valve (mitral>aortic), type of valve (ball and cage vs ...
Source: Heart - December 20, 2023 Category: Cardiology Authors: Cheng, A., Malkin, C., Briffa, N. P. Tags: Review articles Reviews Source Type: research
Clinically significant myocardial bridging
Myocardial bridging is a common anatomical variant in which a major epicardial coronary artery takes an intramyocardial course, leading to dynamic systolic compression. Because coronary perfusion occurs primarily during diastole, most patients with this anatomical variant have no associated perfusion abnormalities or symptoms. Despite this, there is a subset of patients with myocardial bridging who experience ischaemic symptoms. Determining which anatomical variants are benign and which are clinically relevant remains a challenge. Further complicating the picture, functional factors such as diastolic dysfunction and corona...
Source: Heart - December 20, 2023 Category: Cardiology Authors: Danek, B. A., Kearney, K., Steinberg, Z. L. Tags: Review articles Reviews Source Type: research
Carcinoid heart disease: another step into the knowledge of a rare disease
With an incidence of 1/100 000 in the general population, carcinoid tumours are rare neuroendocrine malignancies (NETs). Mostly originating from the enterochromaffin cells of the gastrointestinal tract, they usually grow slowly over the years, secreting large amounts of vasoactive substances (ie, serotonins such as 5-hydroxytryptamine, tachykinins and prostaglandins). Carcinoid syndromes (CS) occur in 20–30% of patients and are associated with the presence of liver metastases with the consequent release of vasoactive amines into the systemic circulation. At this stage, patients may become symptomatic with cutaneous f...
Source: Heart - December 20, 2023 Category: Cardiology Authors: Pavon, A. G., Guglielmo, M. Tags: Editorials Source Type: research
Ticagrelor in stable coronary disease
Interventional cardiology luxuriously bathes in a pool of oral P2Y12 antiplatelet medications: ticlopidine, clopidogrel, prasugrel and ticagrelor. In the coming years, all of these agents will be available generically at modest cost to healthcare systems and patients. Once price no longer distinguishes among them, two factors will drive clinical selection. First, logistical practicalities differ such as side effects (hence the near abandonment of ticlopidine), drug interactions (for example, when transitioning off intravenous cangrelor) and administration (two times per day maintenance dosing of ticagrelor instead of once ...
Source: Heart - December 20, 2023 Category: Cardiology Authors: van Nunen, L. X., Johnson, N. P. Tags: Editorials Source Type: research
Better blood pressure control in patients with atrial fibrillation: overcoming barriers to improve outcomes
Hypertension is the single most important risk factor for development of atrial fibrillation (AF), which may be considered as a cardiac manifestation of hypertensive target organ damage. Furthermore, coexistence of hypertension and AF mutually amplifies the risk of complications, such as heart failure and stroke.1 Hypertension results in structural changes in the heart, facilitated by the haemodynamic disturbances, autonomic dysregulation, atrial myocardial cellular injury with apoptosis and activation of profibrotic signalling pathways. These structural changes occur and progress as a result of prolonged exposure to risk ...
Source: Heart - December 20, 2023 Category: Cardiology Authors: Dzeshka, M. S., Shantsila, A., Shantsila, E., Lip, G. Y. H. Tags: Editorials Source Type: research
Correction: Rheumatic heart disease mortality in Indigenous and non-Indigenous Australians between 2010 and 2017
This article has been corrected since it was first published. A typographical error in the title has been corrected; the years should have been between 2013 and 2017. (Source: Heart)
Source: Heart - December 20, 2023 Category: Cardiology Tags: Corrections Source Type: research
Correction: Transition to rilonacept monotherapy from oral therapies in patients with recurrent pericarditis
This article has been corrected since it was first published. A sentence in the Results section incorrectly stated "patients receiving colchicine and glucocorticoids at baseline demonstrated comparable transition to rilonacept monotherapy". This has now been corrected to "patients receiving colchicine and NSAIDs at baseline demonstrated comparable transition to rilonacept monotherapy". (Source: Heart)
Source: Heart - December 20, 2023 Category: Cardiology Tags: Open access Corrections Source Type: research
Primary prevention implantable cardioverter defibrillators for patients with heart failure
This article reviews the historical trial evidence as a route to understanding contemporary ICD decision making. Practical considerations and potential future developments are discussed. Although obviously associated issues,... (Source: Heart)
Source: Heart - December 15, 2023 Category: Cardiology Authors: Beggs, S. A. S., Wright, G. A., Gardner, R. S. Tags: Education in Heart Source Type: research
Traditional and novel risk factors for incident aortic stenosis in community-dwelling older adults
Conclusion
This comprehensive evaluation of risk factors for long-term incidence of AS identified associations for diabetes and prevalent CHD, LpPLA2 activity, sCD14 and IL-6, and eGFRcr. These factors may hold clues to biology, preventive efforts and potential therapeutics for those at highest risk. (Source: Heart)
Source: Heart - December 15, 2023 Category: Cardiology Authors: Massera, D., Bartz, T. M., Biggs, M. L., Sotoodehnia, N., Reiner, A. P., Semba, R. D., Gottdiener, J. S., Psaty, B. M., Owens, D. S., Kizer, J. R. Tags: Valvular heart disease Source Type: research
Parameters associated with improvement of systolic function in patients with heart failure
Conclusion
In this outpatient HFrEF cohort, most patients improved systolic function. Heart failure aetiology, comorbidities and echocardiographic measures of heart structure and function were significantly, independently associated with future LVEF improvement. Greater LVEF improvement was significantly associated with lower mortality. (Source: Heart)
Source: Heart - December 15, 2023 Category: Cardiology Authors: Schöps, L. B., Sengelov, M., Modin, D., Jorgensen, P. G., Bruun, N. E., Fritz-Hansen, T., Gislason, G., Wolsk, E., Schou, M., Biering-Sorensen, T. Tags: Heart failure and cardiomyopathies Source Type: research
