Predictive Factors and Safety of Non-Invasive Mechanical Ventilation in Combination With Propofol Deep Sedation in Left Atrial Ablation Procedures
Catheter ablation is nowadays the core treatment of atrial fibrillation (AF). Propofol infusion sedation is an accepted safety strategy, however respiratory depression with respiratory variations are frequent. Noninvasive mechanical ventilation (NIV) added to deep sedation could improve procedural safety and success. We sought to assess the predictive factors and safety of NIV in combination to Propofol deep sedation in left atrial ablation procedures. Procedural data from 252 consecutive patients undergoing left atrial ablation (166 (66%) persistent, 86 (34%) for paroxysmal AF were analyzed. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - April 25, 2019 Category: Cardiology Authors: Aneida Vevecka, Carolina Schwab, Mathias Forkmann, Steffi Butz, Ajmi Issam, Oliver Turschner, Christian Mahnkopf, Johannes Brachmann, Sonia Busch Source Type: research

Investing 101: How to Achieve Financial Security
From WW II until the end of the century, the savings rate in the US was about 10%. As those who remembered the true hardships of the 30s and 40s have died off, to be replaced by those who have experienced only prosperity and good times, the savings rate in the US has fallen to less than 3%. People can't even save 3 cents from a buck. No matter how much you make, if you spend it all, you will have no money in the bank. Thrift creates wealth. To quote Peter Lynch1 (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - April 25, 2019 Category: Cardiology Authors: By Robert M. Doroghazi Source Type: research

Diagnostic Accuracy of Microcatheter Derived Fractional Flow Reserve
Microcatheter derived fractional flow reserve (FFRMC) system has an increased profile compared to pressure-wire derived fractional flow reserve (FFRW). Consequently, the FFRMC system itself may increase the degree of coronary artery stenosis and lower the measured FFR value. This can affect the diagnostic accuracy of the FFRMC system and inadvertently result in erroneous therapy for patients. Our aim was to evaluate the diagnostic accuracy FFRMC measurements and provide a means for clinicians to interpret individual FFRMC results with respect to FFRW. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - April 25, 2019 Category: Cardiology Authors: Ozan M. Demir, Satoru Mitomo, Antonio Mangieri, Marco B. Ancona, Damiano Regazzoli, Giuseppe Lanzillo, Francesco Giannini, Luca Testa, William Wijns, Antonio Colombo, Azeem Latib Source Type: research

Echocardiographic Predictors of Long-Term Mortality in Patients Presenting With Acute Pulmonary Embolism
Pulmonary embolism (PE) is associated with a high mortality; whether echocardiographic evaluation at presentation predicts long-term adverse outcomes is of importance. We sought to determine if a composite of routinely obtained echocardiographic parameters could determine long-term adverse events in PE patients. Right ventricular (RV) size and function and right atrial (RA) size were retrospectively evaluated in 233 consecutive PE patients with an inpatient echocardiogram, and compared with 70 healthy controls; mortality at 3 years was confirmed. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - April 25, 2019 Category: Cardiology Authors: Andrew D Terluk, Siddharth J Trivedi, Leonard Kritharides, Vincent Chow, Ee-May Chia, Karen Byth, Christian J Mussap, Austin C.C. Ng, Liza Thomas Source Type: research

Understanding by General Providers of the Echocardiogram Report
Echocardiograms are the second most frequently utilized cardiac test after electrocardiograms and are most commonly ordered by non-cardiology providers. Echocardiogram reports are designed to communicate a comprehensive interpretation of cardiac function; however, it is not known how well these reports are understood by ordering providers. In order to identify gaps in understanding and target potential areas for improvement, we developed a questionnaire testing various topics reported on a standard transthoracic echocardiogram (TTE) report. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - April 24, 2019 Category: Cardiology Authors: Amanda Trang, June Kampangkaew, Robin Fernandes, Jasleen Tiwana, Arunima Misra, Ihab Hamzeh, Alvin Blaustein, David Aguilar, Tina Shah, Christie Ballantyne, Miguel Quinones, Sherif F. Nagueh, Hisham Dokanish, Salim S. Virani, Anita Deswal, James N. Kirkpa Source Type: research

Thromboembolism In The Absence Of Atrial Fibrillation
Atrial fibrillation (AF) is associated with thrombus formation in the left atrial appendage (LAA) and systemic embolic events including ischemic stroke. Cardiogenic thromboembolism can also occur in the absence of clinical AF as a result of various pathological conditions affecting the endocardium. The inconsistent temporal relation between AF and ischemic events has stimulated exploration for factors other than clinical AF that contribute to thromboembolism. These include sub-clinical AF, a thrombogenic atrial cardiomyopathy, LAA dysfunction and embolism from other sources. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - April 24, 2019 Category: Cardiology Authors: Jeffrey Smietana, Anna Plitt, Jonathan L. Halperin Source Type: research

Meta-Analysis of Atrial Fibrillation in Patients with Various Cardiomyopathies
Patients with cardiomyopathy are at risk of developing atrial fibrillation (AF) which is a strong risk factor for thromboembolic events, progression to heart failure and mortality or heart transplantation. This systematic review and meta-analysis sought to estimate the prevalence of AF in a global population with cardiomyopathy. PubMed and EMBASE were searched from inception until June 30, 2017 for published articles on AF and major cardiomyopathies without language restrictions. Eligible papers were independently assessed for methodological qualities. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - April 24, 2019 Category: Cardiology Authors: Jean Jacques Noubiap, Jean Joel Bigna, Valirie N. Agbor, Clarence Mbanga, Aude Laetitia Ndoadoumgue, Jan Ren é Nkeck, Arnaud Kamguia, Ulrich Flore Nyaga, Ntobeko A.B. Ntusi Source Type: research

Some Thoughts about the Different Ballooning Patterns in Patients with Recurrent Takotsubo Syndrome from the Ones during Their Index Takotsubo Episode
Perusal of the 4,204 articles, published in PubMed from its inception to 2/23/19, accessed in response to MeSH term “takotsubo”, reveals that takotsubo syndrome (TTS) occasionally recurs in some patients, and such recurrence emerges within days, weeks or years (sometimes>10), after the index TTS episode.1-3 A parallel observation deriving from the same source is that the ballooning pattern affecting the left and/or right ventricle(s) displays different “regionality” in the index and the recurrent TTS episodes. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - April 24, 2019 Category: Cardiology Authors: John E. Madias Source Type: research

Shared Decision Making in Femoral vs. Radial Cardiac Catheterization
Shared decision making (SDM) is a strategy to assist with patient involvement in medical decisions. One of its pillars is patient knowledge and understanding, e.g. of the risks and benefits associated with specific procedures. We studied patient knowledge about transradial (TRA) and transfemoral (TFA) cardiac catheterization. A prospective study was conducted in 100 patients hospitalized following diagnostic and therapeutic cardiac catheterization - TRA in 71% of patients and remaining TFA. All patients were presented a standard balanced informed consent outlining risks and benefits. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - April 23, 2019 Category: Cardiology Authors: Logan Schwarzman, Talya Miron-Shatz, Katherine Maki, Leon Hsueh, Eden Liu, Danit Tarashandegan, Felipe Mendez, Mladen I. Vidovich Source Type: research

Comparative Effectiveness and Safety of Polymer-Free Biolimus-Eluting Stent and Durable Polymer Everolimus-Eluting Stent in All-Comer Patients Undergoing Percutaneous Coronary Interventions
We aim to compare Polymer-Free Biolimus-Eluting Stent (PF-BES) with Durable Polymer-Everolimus-Eluting stent (DP-EES) in unselected patients. PF-BES showed a favorable profile in high bleeding risk patients undergoing PCI. Limited data are available on PF-BES compared with second generation durable polymer-coated drug-eluting stents in patients eligible for standard dual antiplatelet therapy. A total of 848 consecutive patients were enrolled: 306 patients were treated with PF-BES and 542 with DP-EES. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - April 23, 2019 Category: Cardiology Authors: Martino Pepe, Giuseppe Biondi-Zoccai, Nicola Corcione, Palma Luisa Nestola, Paolo Ferraro, Alberto Morello, Sirio Conte, Francesco Prati, Francesco Paolo Bianchi, Alessandro Santo Bortone, Arturo Giordano Source Type: research

Correlation of Circulating miR-765, miR-93-5p and miR-433-3p to Obstructive Coronary Heart Disease Evaluated by Cardiac Computed Tomography
Epigenetic-sensitive mechanisms may be correlated both to pathogenesis and prognosis of coronary heart disease (CHD). We prospectively investigated some plasma circulating microRNA (miRNA) levels in patients undergoing Cardiac Computed Tomography (CCT) for suspected CHD (n=95).We show that let-7c-5p, miR-765, miR-483-5p, miR-31-5p and miR-206 were upregulated in CHD patients (n=66) vs healthy subjects HS (n=29); moreover, let-7c-5p, miR-765, miR- 483-5p showed higher expression in obstructive CHD (n=36) compared to no obstructive CHD patients (n=66). (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - April 23, 2019 Category: Cardiology Authors: Teresa Infante, Ernesto Forte, Bruna Punzo, Filippo Cademartiri, Carlo Cavaliere, Andrea Soricelli, Marco Salvatore, Claudio Napoli Source Type: research

Adherence to Blood Cholesterol Treatment Guidelines Among Physicians Managing Patients with Atherosclerotic Cardiovascular Disease
The ACC/AHA blood cholesterol treatment guidelines recommend statin therapy for all patients after experiencing an acute cardiovascular event. Previous analyses have shown that physicians have been slow to adopt guidelines, and many patients remain untreated or undertreated with statins after a cardiovascular event. However, reasons for this remain unknown. This analysis used EMR and patient chart data from Reliant Medical Group (Worcester, Massachusetts, USA) to evaluate physician adherence to the 2013 ACC/AHA blood cholesterol guidelines when treating patients with evidence of acute atherosclerotic cardiovascular disease...
Source: The American Journal of Cardiology - April 23, 2019 Category: Cardiology Authors: Eddison Ramsaran, Peggy Preusse, Devi Sundaresan, Stefan DiMario, Jeetvan Patel, David Harrison, Michael Munsell, Joseph Menzin Source Type: research

Readmissions Following Isolated Coronary Artery Bypass Graft Surgery in the US (from the Nationwide Readmissions Database 2010-2014)
Readmission following cardiac surgery is associated with poor outcomes and increased healthcare expenditure. However, a nationwide understanding of the incidence, cost, causes, and predictors of 30-day readmission following coronary artery bypass grafting is limited. The Nationwide Readmissions Database was used to identify all adult patients who underwent isolated coronary artery bypass grafting (CABG) with no other concomitant surgery between 2010 and 2014. The primary outcome was all-cause readmission within 30 days of discharge after surgery. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - April 23, 2019 Category: Cardiology Authors: Habib Khoury, Yas Sanaiha, Sarah E Rudasill, Alexandra L Mardock, Sohail Sareh, Peyman Benharash Source Type: research

Sinus Node sparing novel Hybrid Approach for treatment of Inappropriate Sinus Tachycardia/Postural orthostatic sinus tachycardia with new electrophysiological finding
We describe our first experience of 50 consecutive patients (41 females, 22.83 ± 3.91 years) having undergone a novel hybrid thoracoscopic ablation for drug resistant IST (n=39, 78%) or POTS (n=11, 22%). (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - April 23, 2019 Category: Cardiology Authors: Carlo de Asmundis, Gian-Battista Chierchia, Juan Sieira, Erwin Str öker, Vincent Umbrain, Jan Poelaert, Pedro Brugada, Mark La Meir Source Type: research

Relation of Marital Status and QT Interval Prolongation (From the Third National Health and Nutrition Examination Survey)
Although the link between marital status and mortality is well-established, the pathophysiological basis is unclear. An investigation of the association of marital status with prolonged QT interval may highlight the underlying mechanism for poor outcomes associated with being unmarried. This analysis included 6,562 participants (mean age 58.6 years, 52% women, 50.1% Non-Hispanic Whites) without a history of cardiovascular disease (CVD) from the Third National Health and Nutrition Examination Survey. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - April 23, 2019 Category: Cardiology Authors: Muhammad Imtiaz Ahmad, Chaudry Nasir Majeed, Dipendra Chaudhary, Abhishek Dutta, Hanumantha R. Jogu, Elsayed Z. Soliman Source Type: research

Incremental Prognostic Value of Exercise Stress Testing in Primary Prevention
In primary prevention, addition of C-reactive protein (CRP) and family history to standard risk factor assessment (Reynolds Risk Score or RRS) provides superior risk stratification for future cardiovascular (CV) events. We sought to assess whether addition of functional capacity to RRS provided incremental prognostic value. This was a prospective observational cohort study of 3964 consecutive asymptomatic adults without documented CVD (mean age 51 years, 78% men) evaluated between 2005-13, who underwent clinical and treadmill stress testing at baseline. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - April 23, 2019 Category: Cardiology Authors: Alaa Alashi, Haris Riaz, Richard Lang, Raul Seballos, Steven Feinleib, Roxanne Sukol, Leslie Cho, Paul Cremer, Wael Jaber, Brian P Griffin, Milind Y Desai Source Type: research

Comparison of left ventricular mass calculation methods via two-dimensional echocardiogram in children, adolescents, and young adults with systemic hypertension
This study retrospectively reviewed 200 consecutive, initial echocardiograms for the indication of hypertension. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - April 23, 2019 Category: Cardiology Authors: Sean M. Lang, Benjamin R. Ittleman, Eunice Hahn, Ryan A. Moore, Philip R. Khoury, Nicholas J. Ollberding, Thomas R. Kimball, Christopher J. Statile Source Type: research

Inferior Vena Cava Filters in Stable Patients with Pulmonary Embolism and Heart Failure
Mortality according to the use inferior vena cava (IVC) filters in patients with pulmonary embolism (PE) and heart failure (HF) has been sparsely studied. In the present investigation, we assess whether IVC filters in stable patients with PE and HF reduce mortality. This is a retrospective cohort study of administrative data from the Premier Healthcare Database, 2009-2015. Patients aged ≥18 years hospitalized with a primary diagnosis of PE and a discharge diagnosis of heart failure (HF) were identified by International Classification of Diseases-Ninth Revision-Clinical Modification (ICD-9-CM) Codes. (Source: The Ameri...
Source: The American Journal of Cardiology - April 23, 2019 Category: Cardiology Authors: Paul D. Stein, Fadi Matta, Mary J Hughes Tags: Original Investigation Source Type: research

Significance of Coronary Artery Calcium Found on Non-Electrocardiogram-Gated Computed Tomography During Pre-Operative Evaluation for Liver Transplant
Guidelines to evaluate patients for coronary artery disease (CAD) during pre-operative evaluation for orthotopic liver transplantation (OLT) are conflicting. Cardiac catheterization is not without risk in patients with end-stage liver disease. No study to date has looked at the utility of non-electrocardiogram (ECG)-gated chest computed tomography (CT) in the pre-liver transplant population. Our hypothesis was that coronary artery calcium scores (CACS) from chest CT scans ordered during the liver transplant workup, can identify patients who would benefit from invasive angiography. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - April 23, 2019 Category: Cardiology Authors: Brian H. West, Christopher G. Low, Biraj B. Bista, Eric H. Yang, Gabriel Vorobiof, Ronald W. Busuttil, Matthew J. Budoff, David Elashoff, Jonathan M. Tobis, Henry M. Honda Source Type: research

Cardiovascular Health and Disease Among Asian-Americans (From the National Health and Nutrition Examination Survey)
Variable propensity towards cardiovascular disease amongst the different ethnicities in the United States has been reported. We aimed to characterize the prevalence trends of cardiovascular health (as defined by the American Heart Association's Life's Simple 7 metrics) and cardiovascular diseases, amongst Asian-Americans. We used the National Health and Examination Nutrition Survey (NHANES) from 2011 to 2016 capture self-identified American-born Asian-Americans and foreign-born Asian-Americans. The prevalence trends of cardiovascular health metrics and diseases were evaluated amongst Asian-Americans and also compared betwe...
Source: The American Journal of Cardiology - April 23, 2019 Category: Cardiology Authors: Rajat Kalra, Nirav Patel, Pankaj Arora, Garima Arora Source Type: research

Usefulness of Longitudinal Strain to Assess Remodeling of Right and Left Cardiac Chambers Following Transcatheter Aortic Valve Implantation
Remodeling after transcatheter aortic valve implantation (TAVI) has been well-characterized for the left ventricle (LV) but not for the other cardiac chambers. We aimed to describe conventional indices of cardiac remodeling and novel longitudinal strain (LS) in all four cardiac chambers post-TAVI and to explore gender remodeling disparities. Consecutive patients with significant aortic stenosis who underwent TAVI were included if echocardiograms in sinus rhythm before and 1-year post-procedure were available. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - April 23, 2019 Category: Cardiology Authors: Diego Medvedofsky, Edward Koifman, Tatsuya Miyoshi, Toby Rogers, Zuyue Wang, Steven A. Goldstein, Itsik Ben-Dor, Lowell F. Satler, Rebecca Torguson, Ron Waksman, Federico M. Asch Source Type: research

Relation of Isolated Systolic Hypertension and Pulse Pressure to High Sensitivity Cardiac Troponin-T and N-terminal pro-B-type natriuretic peptide in Older Adults (From the Atherosclerosis Risk in Communities Study)
Isolated systolic hypertension (ISH) and elevated pulse pressure (PP) are common blood pressure (BP) abnormalities in older adults, reflect poor vascular compliance, and can signify risk for cardiovascular outcomes. We sought to characterize the associations of ISH and widened PP with hs-cTnT (a marker of myocardial damage) and NT-proBNP (a marker of hemodynamic stress) levels among older adults. We performed a cross-sectional analysis of 5,251 Atherosclerosis Risk in Communities (ARIC) Study participants without heart failure who attended visit 5 (2011-2013). (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - April 23, 2019 Category: Cardiology Authors: Nidhi Madan, Alexandra K. Lee, Kunihiro Matsushita, Ron C. Hoogeveen, Christie M. Ballantyne, Elizabeth Selvin, John W. McEvoy Source Type: research

Subclinical Hypothyroidism and the Risk of Cardiovascular Disease
We highly appreciated the long term study by Moon et al. on the substantial increased risk of ischemic cerebrovascular and cardiac events among individuals younger than 65 years old with subclinical hypothyroidism (SCH)1. We wish to draw the attention to a curable mechanism driving this association, i.e. the infection by pathogenic strains of Helicobacter pylori. Such organisms are marked by the production of the cytotoxin-associated gene A protein (CagA) and are endowed with an increased inflammatory potential. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - April 23, 2019 Category: Cardiology Authors: Antonio Ponzetto, Gaetano De Ferrari Source Type: research

Familial Spontaneous Coronary Artery Dissection and the SMAD-3 Mutation
We describe a family with a SMAD3 gene mutation and LDS presenting with recurrent SCAD episodes. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - April 23, 2019 Category: Cardiology Authors: Amir Solomonica, Rodrigo Bagur, Tawfiq Choudhury, Shahar Lavi Source Type: research

Characteristics, Outcomes and Predictors of Significant Pericardial Complications in Patients Undergoing Transcatheter Aortic Valve Implantation (TAVI)
This study describes characteristics, outcomes and predictors of patients who develop significant pericardial complications related to TAVR. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - April 23, 2019 Category: Cardiology Authors: Gbolahan O Ogunbayo, Naoki Misumida, Elliott Goodwin, Robert Pecha, Ayman Elbadawi, Claude S Elayi, Ahmed Abdel-Latif, John Gurley, Adrian W Messerli, Khaled Ziada Source Type: research

Prognosis is Different than Treatment Effect
We have concerns with the publication, “Relation of Obesity to Outcomes of Hospitalizations for Atrial Fibrillation”1 (AF). We found it to be another example in which the rules of logic are ignored to produce findings that appear paradoxical and surprising, but are really predictable and mundane. This analysis and others like it misi nterpret associations seen in observational evidence, and ultimately serve as a source of confusion to those aiming to practice evidence-based medicine. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - April 23, 2019 Category: Cardiology Authors: Steven D. Stovitz, John Mandrola Source Type: research

Hemodynamic Performances and Clinical Outcomes In Patients Undergoing Valve-in-valve Versus Native Transcatheter Aortic Valve Implantation
Valve-in-valve (ViV) trans catheter aortic valve implantation (TAVI) emerged has a less invasive treatment than surgery for patients with degenerated bioprosthesis. However, few data are currently available regarding results of ViV vs. TAVI in native aortic valve. We aimed to compare hemodynamic performances and 1-year outcomes between patients undergoing ViV procedure and patients undergoing non-ViV TAVI. This bicentric study included all patients undergoing aortic ViV procedure for surgical bioprosthetic aortic failure between 2013 and 2017. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - April 18, 2019 Category: Cardiology Authors: Mariama Akodad, Alexandra Meilhac, Thierry Lef èvre, Guillaume Cayla, Benoit Lattuca, Cécile Autissier, Claire Duflos, Thomas Gandet, Jean-Christophe Macia, Delphine Delseny, Francois Roubille, Eric Maupas, Laurent Schmutz, Christophe Piot, Frédéric T Source Type: research

Temporal Pattern of Growth Differentiation Factor-15 Protein After Acute Coronary Syndrome (From the BIOMArCS Study)
Growth differentiation factor-15 (GDF-15) has appeared as a promising biomarker with strong predictive abilities in acute coronary syndrome (ACS). However, studies are solely based on single measurements in the acute phase of an ACS event. The way GDF-15 patterns in post ACS patients behave on the long term is largely unknown. We conducted a nested case-control study within our multicenter, prospective, observational biomarker study (BIOMArCS) of 844 ACS patients. Following an index ACS event, high-frequency blood sampling was performed during 1-year of follow-up. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - April 18, 2019 Category: Cardiology Authors: Nermina Buljubasic, Maxime M. Vroegindewey, Rohit M. Oemrawsingh, Folkert W. Asselbergs, Etienne Cramer, Anho Liem, Pim van der Harst, Arthur Maas, Eelko Ronner, Carl Schotborgh, Alexander J. Wardeh, K. Martijn Akkerhuis, Eric Boersma, for the BIOMArCS in Source Type: research

Proceedings of the Editorial Board Meeting of The American Journal of Cardiology on March 17, 2019, in New Orleans, Louisiana
The annual editorial board meeting of The American Journal of Cardiology (AJC) was held on March 17, 2019, at the time of the Annual Scientific Sessions of the American College of Cardiology. The major purpose of the meeting is to thank the editorial board members for their considerable help during the previous year in reviewing manuscripts and to seek their suggestions for improving the journal. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - April 17, 2019 Category: Cardiology Authors: William C. Roberts Tags: FROM THE EDITOR Source Type: research

Some Math All Investors Should Know
I have listed 6 numbers or math concepts, knowledge of which will make you a better investor. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - April 10, 2019 Category: Cardiology Authors: Robert M. Doroghazi Source Type: research

“Some Math All Investors Should Know”
I have listed 6 numbers or math concepts, knowledge of which will make you a better investor. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - April 10, 2019 Category: Cardiology Authors: Robert M. Doroghazi Source Type: research

Heterogeneity of periodic limb movements associated with central sleep apnea in Heart Failure patients
We read with great interest the paper published in the American Journal of Cardiology1 concerning “The effect of Adaptive Servo-Ventilation on Periodic Limb Movements in Sleep in patients with Heart Failure”. Jang and his co-authors concluded that Periodic Limb Movements in Sleep (PLMS) are more frequent in central sleep apnea (CSA) patients with Heart Failure (HF) than those without. Furthe rmore a paradoxical increase in PLMS is observed in HF patients treated with Adaptive Servo-Ventilation (ASV) despite reduction of breathing events. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - April 10, 2019 Category: Cardiology Authors: Doctor Maher Abouda Source Type: research

Propensity Matched Analysis Comparing Conscious Sedation Versus General Anesthesia in Transcatheter Aortic Valve Implantation
Conscious sedation (CS) has been increasingly utilized in transcatheter aortic valve implantation (TAVI). We aim to compare safety, efficacy, efficiency and direct cost outcomes of patients who underwent TAVI with general anesthesia (GA) to those with CS. Records for all adult patients undergoing transfemoral TAVI at our institution between February 2012 to September 2018 were retrospectively screened. Patients were grouped by anesthesia treatment (GA or CS) and propensity matched. Safety (in-hospital and 30-day mortality, in-hospital and 30-day stroke, cardiac arrest, need for permanent pacemaker, composite bleed/vascular...
Source: The American Journal of Cardiology - April 10, 2019 Category: Cardiology Authors: Wassim Mosleh, Jeffrey F. Mather, Mostafa R. Amer, Brett Hiendlmayr, Francis J. Kiernan, Raymond G. McKay Source Type: research

Computed Tomographic Angiography-Derived Risk Factors for Vascular Complications in Percutaneous Transfemoral Transcatheter Aortic Valve Implantation
Transfemoral aortic valve implantation (TAVI) has become a viable alternative to surgical valve implantation, particularly for higher risk patients; however, VCs remain a concern in transfemoral TAVI. We aimed to determine clinical and computed tomographic angiography (CTA)-derived risk factors associated with Valve Academic Research Consortium (VARC)-2 criteria vascular complications (VCs) in patients undergoing TAVI. From 2011 to 2017, 481 patients underwent percutaneous transfemoral TAVI at the Minneapolis Heart Institute and were screened for procedural and post-procedural access-related VC according to VARC-2 criteria...
Source: The American Journal of Cardiology - April 10, 2019 Category: Cardiology Authors: Jonathan Urbach, Cody R. Hou, John R. Lesser, Larissa I. Stanberry, Ross F. Garberich, David Caye, Paul Sorajja, Mario G össl Source Type: research

Surveillance of Congenital Heart Defects among Adolescents at Three U.S. Sites
The prevalence, comorbidities, and healthcare utilization among adolescents with congenital heart defects (CHDs) is not well understood. Adolescents (11-19 years old) with a healthcare encounter between 1/1/2008 (1/1/2009 for MA) and 12/31/2010 with a CHD diagnosis code were identified from multiple administrative data sources compiled at three U.S. sites: Emory University, Atlanta, Georgia (EU); Massachusetts Department of Public Health (MA); and New York State Department of Health (NY). The estimated prevalence for any CHD was 4.77 (EU), 17.29 (MA), and 4.22 (NY) and for severe CHDs was 1.34 (EU), 3.04 (MA), and 0.88 (NY...
Source: The American Journal of Cardiology - April 10, 2019 Category: Cardiology Authors: George K. Lui, Claire McGarry, Ami Bhatt, Wendy Book, Tiffany J. Riehle-Colarusso, Julie E. Dunn, Jill Glidewell, Michelle Gurvitz, Trenton Hoffman, Carol J. Hogue, Daphne Hsu, Stan Obenhaus, Cheryl Raskind-Hood, Fred H. Rodriguez, Ali Zaidi, Alissa R. Va Source Type: research

Effect of High Influenza Activity on Risk of Ventricular Arrhythmias Requiring Therapy in Patients with Implantable Cardiac Defibrillators and Cardiac Resynchronization Therapy Defibrillators
Influenza is associated with an increased risk of cardiovascular events. Influenza's association with ventricular arrhythmias (VAs) has not been adequately studied. We investigated the relation of seasonal influenza activity with the incidence of VAs requiring therapy in patients with an implantable cardiac defibrillator (ICD) or cardiac resynchronization therapy defibrillator (CRT-D). We retrospectively studied 163,831 patients with an ICD or CRT-D who were enrolled in the Abbott Medical Merlin.net remote-monitoring network between January 2009 and December 2015. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - April 10, 2019 Category: Cardiology Authors: Mohammad Madjid, Allison T. Connolly, Yelena Nabutovsky, Payam Safavi-Naeini, Mehdi Razavi, Charles C. Miller Source Type: research

Relation of Hospital Volume With In-Hospital and 90-Day Outcomes After Transcatheter Mitral Valve Repair Using MitraClip
This study sought to examine the association between hospital volume and outcomes after transcatheter mitral valve repair using the MitraClip device. Using the Nationwide Readmissions Database, we identified all patients who underwent a MitraClip procedure and categorized hospitals into tertiles based on their annual procedure volume: low ( ≤3 procedures/year), medium (4 to 13/year), and high (≥14/year) volume centers. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - April 9, 2019 Category: Cardiology Authors: Ilhwan Yeo, Luke K. Kim, S. Chiu Wong, Jim W. Cheung, Shinobu Itagaki, Joanna Chikwe, Natalia N. Egorova Source Type: research

The Effect of Obstructive Sleep Apnea on 3-Year Outcomes in Patients Who Underwent Orthotopic Heart Transplantation
Despite the well-known association between obstructive sleep apnea (OSA) and cardiovascular disease, there is a paucity of data regarding OSA in orthotopic heart transplant (OHT) recipients and its effect on clinical outcomes. Hence, we sought to determine the association between OSA, as detected by polysomnography, and late graft dysfunction (LGD) after OHT. In this retrospective review of consecutive OHT recipients from 2012 to 2014 at our center, we examined LGD, i.e., graft failure>1 year after OHT, through competing risks analysis. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - April 9, 2019 Category: Cardiology Authors: Aasim Afzal, Kristen M. Tecson, Aayla K. Jamil, Joost Felius, Puneet S. Garcha, Shelley A. Hall, Sandra A. Carey Source Type: research

Reader's Comments: Beyond Atrial Fibrillation Patterns as Contributors to Risk of Thromboembolism
I read with great interest the paper by Zhang et al1 in which the authors reported that the incidence of stroke and systemic embolism and overall mortality were lower in paroxysmal atrial fibrillation (AF) than in persistent or permanent AF while annualized major bleeding rates were similar across AF types. In truth, this is not a new observation. Ganesan et al2 reported essentially the same findings in 2016, as have others.3 Importantly, Zhang et al1 noted that both the CHADS2 and CHA2DS2-VASc risk scoring systems do not consider the type of AF, which may be a significant limitation in their utility if AF type is truly im...
Source: The American Journal of Cardiology - April 9, 2019 Category: Cardiology Authors: James A. Reiffel Source Type: research

Use of Ventilatory Efficiency Slope as a Marker for Increased Mortality in Wild-Type Transthyretin Cardiac Amyloidosis
Wild-type transthyretin amyloidosis (ATTRwt) results in an infiltrative cardiomyopathy often culminating in symptomatic heart failure (HF). The use of cardiopulmonary exercise testing (CPET) in determining outcomes in ATTRwt cardiac amyloidosis is unknown. Given the emergence of novel therapies to treat transthyretin amyloidosis, we sought to investigate the utility of CPET on outcomes in patients with ATTRwt cardiomyopathy. Fifty-six patients, with biopsy and immunohistochemically-proven ATTRwt, were enrolled between 2005-2015, as part of an NIH ATTRwt substudy at the Boston University Amyloidosis Center. (Source: The Ame...
Source: The American Journal of Cardiology - April 9, 2019 Category: Cardiology Authors: Adil Yunis, Gheorge Doros, Ivan Luptak, Lawreen H. Connors, Flora Sam Source Type: research

Impact of Effective Management Strategies on Patients with the Most Extreme Phenotypic Expression of Hypertrophic Cardiomyopathy
Advances in treatment options for hypertrophic cardiomyopathy (HC) patients have proven effective in many patients for promoting favorable long-term outcomes. Whether this expectation is similar for patients with the most extreme expression of massive LV hypertrophy, a particularly aggressive form of the disease is unresolved. Of 1766 consecutive HC patients presenting to Tufts HC Institute (2004 to 2015), 92 were identified with extreme LV wall thickness (30-48 mm), and compared to 1674 HC patients with less marked hypertrophy (13mm-29 mm). (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - April 9, 2019 Category: Cardiology Authors: Ethan J. Rowin, Barry J. Maron, Mikhail Romashko, Wendy Wang, Hassan Rastegar, Mark S. Link, Martin S. Maron Source Type: research

National Trends, Sex, Management and Outcomes of Patients Hospitalized for Myocarditis
Myocarditis is a major cause of acute and chronic cardiomyopathy. Data on patient characteristics, utilization of healthcare and outcomes of myocarditis related hospitalizations is limited. We sought to analyze the outcomes of patients hospitalized with myocarditis from a large diverse, multicentric, nationwide cohort using Nationwide Inpatient Sample (NIS) database. A total of 27129 hospitalizations involving adult patients (age ≥ 18 years) with the primary discharge diagnosis of myocarditis from years 2007 through 2014 were included and patients who had diagnosis of myocardial infarction or coronary syndromes (includi...
Source: The American Journal of Cardiology - April 9, 2019 Category: Cardiology Authors: Zubair Shah, Moghniuddin Mohammed, Venkat Vuddanda, Mohammed Waseem Ansari, Reza Masoomi, Kamal Gupta Source Type: research

Meta-Analysis of the Effect of Preoperative Atrial Fibrillation on Outcomes After Left Ventricular Assist Device Implantation
The effect of preoperative atrial fibrillation (AF) on clinical outcomes after left ventricular assist device (LVAD) implantation remains uncertain. We sought to conduct a meta-analysis to assess the safety and efficacy of LVAD implantation in AF patients. Medline and Scopus were searched for studies that assessed the effect of pre-operative AF on clinical outcomes in patients undergoing LVAD implantation. Outcomes of interest included all-cause mortality, thromboembolic events and bleeding. Estimates were combined using random effects model to calculate risk ratios (RRs) with 95% confidence intervals (CIs). (Source: The A...
Source: The American Journal of Cardiology - April 9, 2019 Category: Cardiology Authors: Muhammad Shariq Usman, Saba Ahmed, Naser Yamani, Tauseef Akhtar, Nisar Asmi, Tariq Jamal Siddiqi, Safi U. Khan, Rami Doukky, Muhammad Shahzeb Khan Source Type: research

Beyond Atrial Fibrillation Patterns as Contributors to Risk of Thromboembolism
I read with great interest the paper by Zhang and colleagues1 in which the authors reported that the incidence of stroke and systemic embolism and overall mortality were lower in paroxysmal atrial fibrillation (AF) than in persistent or permanent AF while annualized major bleeding rates were similar across AF types. In truth, this is not a new observation. Ganesan et al.2 reported essentially the same findings in 2016, as have others.3 Importantly, Zhang et al.1 noted that both the CHADS2 and CHA2DS2-VASc risk scoring systems do not consider the type of AF, which may be a significant limitation in their utility if AF type ...
Source: The American Journal of Cardiology - April 9, 2019 Category: Cardiology Authors: James A. Reiffel Tags: Reader's Comments Source Type: research

Perceived Health Mediates Effects of Physical Activity on Quality of Life in Patients with a Fontan Circulation
This study aimed to describe self-reported physical activity in adult Fontan patients and examine associations between physical activity, perceived health status and QOL. The sample consisted of 177 Fontan patients (Mage=27.5 ± 7.6 years, 52% male) who reported their physical activity, perceived health status, and QOL as part of the cross-sectional Assessment of Patterns of Patient-Reported Outcomes in Adults with Congenital Heart disease – International Study (APPROACH-IS). (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - April 9, 2019 Category: Cardiology Authors: Christina E. Holbein, Gruschen R. Veldtman, Philip Moons, Adrienne H. Kovacs, Koen Luyckx, Silke Apers, Shanti Chidambarathanu, Alexandra Soufi, Katrine Eriksen, Jamie L. Jackson, Junko Enomoto, Susan M. Fernandes, Bengt Johansson, Luis Alday, Mikael Dell Source Type: research

Relation of Fontan Baffle Stroke Volume to Fontan Failure and Lower Exercise Capacity in Patients With an Atriopulmonary Fontan
Fontan failure remains a significant problem, especially in patients with an atriopulmonary Fontan. Fontan baffle volume change during the cardiac cycle (Fontan baffle stroke volume) may affect outcomes in Fontan circulation. Assuming that increased Fontan baffle stroke volume is associated with increased energy loss in the baffle, we hypothesized that higher baffle stroke volume is associated with worse exercise capacity and increased incidence of Fontan failure. Patients from 6 centers with an atriopulmonary or lateral tunnel Fontan operation were included if they had a cardiac magnetic resonance (CMR) study and an adequ...
Source: The American Journal of Cardiology - April 9, 2019 Category: Cardiology Authors: Tarek Alsaied, Jelle P.G. van der Ven, Saeed Juggan, Lynn A. Sleeper, Nina Azcue, Lucia J Kroft, Andrew J. Powell, Willem A. Helbing, Rahul H. Rathod Source Type: research

The Effect of Obstructive Sleep Apnea on Three Year Outcomes in Patients who Underwent Orthotopic Heart Transplantation
Despite the well-known association between obstructive sleep apnea (OSA) and cardiovascular disease, there is a paucity of data regarding OSA in orthotopic heart transplant (OHT) recipients and its effect on clinical outcomes. Hence, we sought to determine the association between OSA, as detected by polysomnography, and late graft dysfunction (LGD) following OHT. In this retrospective review of consecutive OHT recipients from 2012-2014 at our center, we examined LGD, i.e. graft failure> 1 year following OHT, via competing risks analysis. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - April 9, 2019 Category: Cardiology Authors: Aasim Afzal, Kristen M. Tecson, Aayla K. Jamil, Joost Felius, Puneet S. Garcha, Shelley A. Hall, Sandra A. Carey Source Type: research

Prognosis and Risk Stratification of Patients with Advanced Heart Failure (From PROBE)
In recent years, many prognostic scores have been developed for advanced chronic heart failure (CHF), but none of them is comprised of first and second level echocardiographic indexes. The aim was to create a new prognostic echocardiographic score for patients with advanced CHF. Patients with advanced CHF were analyzed by standard, 3D and speckle tracking echocardiography and followed prospectively for 2 ±0.7 years recording major adverse cardiac events (MACE): cardiovascular death, hospitalization for HF, emergency heart transplantation and left ventricular assist device or intra-aortic balloon pump implantation. (...
Source: The American Journal of Cardiology - April 9, 2019 Category: Cardiology Authors: Matteo Cameli, M. Concetta Pastore, Giulia E. Mandoli, Dan Nistor, Edoardo Lisi, Özge Ö. Tok, Luna Cavigli, Andrea Romano, Sergio Mondillo Source Type: research

Relation of Hospital Volume with In-Hospital and Ninety-Day Outcomes after Transcatheter Mitral Valve Repair Using MitraClip
This study sought to examine the association between hospital volume and outcomes after transcatheter mitral valve repair using the MitraClip device. Using the Nationwide Readmissions Database, we identified all patients who underwent a MitraClip procedure and categorized hospitals into tertiles based on their annual procedure volume: low ( ≤3 procedures/year), medium (4-13/year), and high (≥14 /year) volume centers. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - April 9, 2019 Category: Cardiology Authors: Ilhwan Yeo, Luke K. Kim, S. Chiu Wong, Jim W. Cheung, Shinobu Itagaki, Joanna Chikwe, Natalia N. Egorova Source Type: research

Effect of Aortic Regurgitation by Cardiovascular Magnetic Resonance After Transcatheter Aortic Valve Implantation
The objective of this study was to evaluate the impact of AR as determined by CMR on clinical outcomes (mortality, heart failure [HF] hospitalization) post-TAVI. A total of 448 TAVI recipients from 2 centers (mean age: 80 ±7 years, mean STS: 5.8±5.4%) who survived the periprocedural period with no pacemaker implantation were included. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - April 9, 2019 Category: Cardiology Authors: Alfredo Nunes Ferreira-Neto, Constanze Merten, Hans-Wilko Beurich, Dirk Zachow, Gert Richardt, Eric Larose, Leonardo Guimaraes, Philippe Pibarot, Emilie Pelletier-Beaumont, Josep Rod és-Cabau, Mohamed Abdel-Wahab Source Type: research