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Specialty: Cardiology
Source: Heart

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Total 262 results found since Jan 2013.

The positive predictive value of ct-proAVP (copeptin) in patients with STEMI
Recently Reinstadler et al reported on a study in n=54 patients diagnosed with STEMI who underwent copeptin sampling 2 (1–3) days after the index event and Cardiac Magnetic Resonance (CMR) on the same day. A follow-up CMR study was done after 4 months in n=47 patients. The authors found a strong and significant correlation between day 2 copeptin and ejection fraction, end systolic volume, stroke volume and per cent infarct mass. Additionally, using optimised cutoffs, adverse remodelling could be excluded by the combination of copeptin with NT-proBNP.1 Copeptin is a stable glycopeptide comprising the C-terminal p...
Source: Heart - September 20, 2013 Category: Cardiology Authors: Mockel, M., Searle, J. Tags: Drugs: cardiovascular system, Hypertension, Interventional cardiology, Acute coronary syndromes, Clinical diagnostic tests Editorials Source Type: research

Ethnicity and prediction of cardiovascular disease: performance of QRISK2 and Framingham scores in a UK tri-ethnic prospective cohort study (SABRE--Southall And Brent REvisited)
Conclusions Neither score performed consistently well in all ethnic groups. Further validation of QRISK2 in other multi-ethnic datasets, and better methods for identifying high risk African Caribbeans and South Asian women, are required.
Source: Heart - December 6, 2013 Category: Cardiology Authors: Tillin, T., Hughes, A. D., Whincup, P., Mayet, J., Sattar, N., McKeigue, P. M., Chaturvedi, N., On behalf of the SABRE Study Group, Chaturvedi, Baker, Beauchamp, Coady, Collins, Forouhi, Gedroyc, Godsland, Hattersley, Heasman, Hughes, Key, Majeed, March, Tags: Open access, Drugs: cardiovascular system, Acute coronary syndromes, Epidemiology Source Type: research

Cardiovascular highlights from non-cardiology journals
This study included randomised trials of drugs to lower blood pressure that were compared with placebo or other drugs with at least 1000 patient years of follow-up in each treatment arm. The primary outcome was major CV events (the composite of stroke, myocardial infarction, heart failure or CV death), with secondary outcomes of each element of the composite outcome as well as all-cause mortality. These 26 trials included 152 290 patients, of which 30 295 had impaired renal function (estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73 m2). Meta-analysis according to baseline kidney fu...
Source: Heart - December 6, 2013 Category: Cardiology Authors: Bradley, S. M. Tags: Journal scan Source Type: research

Progress: the ROPAC multinational registry advances our understanding of an important outcome in pregnant women with heart disease
When caring for women with structural heart disease (SHD), clinicians face an apparent paradox: most women with SHD are able to complete a pregnancy without complication; however, compared with the general population, maternal risk is increased and SHD remains a major source of maternal morbidity and mortality and poor fetal outcomes.1–4 Identifying those women with SHD who are at increased risk for meaningful complications during pregnancy is critical. During pregnancy, intravascular volume, stroke volume, heart rate and cardiac output increase, while systemic vascular resistance decreases. During pregnancy, women w...
Source: Heart - January 3, 2014 Category: Cardiology Authors: Krieger, E. V., Stout, K. K. Tags: Congenital heart disease, Drugs: cardiovascular system, Hypertension, Acute coronary syndromes, Epidemiology Editorials Source Type: research

Heartbeat: Highlights from the issue
In this issue of Heart, Dr. Bouri and colleagues (see page 456) reexamined the issue of the perioperative use of beta blockers in patients with an intermediate or high cardiovascular risk who are undergoing major non cardiac surgery. Unfortunately, the evidence base for current recommendations has been called into question because of allegations of research fraud in some of the main studies, which are excluded from this new meta-analysis of the relevant randomized controlled clinical trials. They found that although beta-blockers decreased the risk of non-fatal myocardial infarction, they increased the risk of stroke and h...
Source: Heart - February 19, 2014 Category: Cardiology Authors: Otto, C. M. Tags: Drugs: cardiovascular system, Interventional cardiology, Acute coronary syndromes, Epidemiology Heartbeat Source Type: research

Cardiac MRI assessment of atrial fibrosis in atrial fibrillation: implications for diagnosis and therapy
Atrial fibrillation (AF) is the most commonly encountered cardiac arrhythmia in clinical practice, with a prevalence of 0.4–1% in the US population.w1 AF is a potent risk factor, increasing the risk of stroke fivefold and accounting for approximately 15% of all strokes in the USA.w2 AF also significantly increases the risk of mortality from heart failure.w3–7 Many therapies, including pharmacological approaches and direct current cardioversion, have been tried to treat this malignant arrhythmia, but were not found to be that effective.1 w8–w11 Catheter ablation of AF has provided better outcomes compared ...
Source: Heart - March 5, 2014 Category: Cardiology Authors: Higuchi, K., Akkaya, M., Akoum, N., Marrouche, N. F. Tags: Tachyarrhythmias, Atrial fibrillation, Education in Heart, Dilated cardiomyopathy, Hypertrophic cardiomyopathy, Drugs: cardiovascular system, Echocardiography, Heart failure, Acute coronary syndromes, Clinical diagnostic tests, Epidemiology Source Type: research

Heartbeat: Highlights from the issue
This issue of Heart has a group of articles about hypertrophic cardiomyopathy with two of these studies addressing exercise capacity. In a study from The Heart Hospital in London (See page 644 and figure 1) cardiopulmonary exercise testing showed a reduced peak oxygen consumption and cardiac index in 70 patients with hypertrophic cardiomyopathy compared to normal volunteers. Left ventricular outflow tract obstruction was present in 31% of patients at rest and an additional 14% had obstruction provoked by exercise. Compared to patients without obstruction, outflow obstruction at all levels of exercise was associated with an...
Source: Heart - March 21, 2014 Category: Cardiology Authors: Otto, C. M. Tags: Hypertrophic cardiomyopathy, Drugs: cardiovascular system, Echocardiography, Interventional cardiology, Clinical diagnostic tests Heartbeat Source Type: research

Cardiac output response and peripheral oxygen extraction during exercise among symptomatic hypertrophic cardiomyopathy patients with and without left ventricular outflow tract obstruction
Conclusions Cardiac reserve is reduced in HCM because of failure of SV augmentation. LVOTO exacerbates this abnormal response, but haemodynamic responses vary significantly. Non-invasive exercise haemodynamic assessment may improve understanding of symptoms and help tailor therapy.
Source: Heart - March 21, 2014 Category: Cardiology Authors: Critoph, C. H., Patel, V., Mist, B., Elliott, P. M. Tags: Hypertrophic cardiomyopathy, Drugs: cardiovascular system, Hypertension Heart failure and cardiomyopathies Source Type: research

Cardiovascular highlights from non-cardiology journals
Stenting of atherosclerotic renal artery disease fails to improve outcomes Atherosclerotic renal-artery stenosis is common among patients with cardiovascular disease and the condition may contribute to hypertension. The impact of renal artery angioplasty or stenting on the risk of clinical events among patients with atherosclerotic renal disease remains poorly defined. In the Cardiovascular Outcomes in Renal Atherosclerotic Lesions (CORAL) study, 947 patients atherosclerotic renal-artery stenosis and hypertension and/or chronic kidney disease were randomized to medical therapy alone or medical therapy plus renal artery ste...
Source: Heart - April 16, 2014 Category: Cardiology Authors: Bradley, S. M. Tags: Journal scan Source Type: research

Resistant hypertension: resistance to treatment or resistance to taking treatment?
The treatment of hypertension has been a therapeutic success. A generation or more of effective drugs deserves considerable credit for their contribution to the substantial decline in age-related incidence of stroke, ischaemic heart disease and heart failure. And because almost all the drugs are long-since off patent, the cost of success comes cheaply. Indeed, National Institute of Health and Care Excellence (NICE) has branded treatment of hypertension as not only cost effective but cost saving.1 Yet not all patients achieve their blood pressure target and are labelled as ‘resistant hypertension’. A contentious...
Source: Heart - May 8, 2014 Category: Cardiology Authors: Brown, M. J. Tags: Drugs: cardiovascular system, Hypertension, Interventional cardiology, Epidemiology Editorials Source Type: research

Cardiovascular highlights from non-cardiology journals
Estrogen formulations have differing cardiovascular risk profile Ever since the publication of the Women's Health Initiative randomized trial that demonstrated clinical harm associated with use of conjugated equine estrogens, providers have been left in a challenging position in balancing the risk of these therapies against their benefit in treatment of menopausal symptoms. In the present study, the authors examined cardiac safety of oral conjugated equine estrogen vs. oral estradiol in a population-based case control study of post-menopausal women. Cases of venous thrombosis (n=68), myocardial infarction (n=67) or ischemi...
Source: Heart - May 19, 2014 Category: Cardiology Authors: Bradley, S. M. Tags: Journal scan Source Type: research

Short-term effects of air pollution on a range of cardiovascular events in England and Wales: case-crossover analysis of the MINAP database, hospital admissions and mortality
Conclusions This study found no clear evidence for pollution effects on STEMIs and stroke, which ultimately represent thrombogenic processes, though it did for pulmonary embolism. The strongest associations with air pollution were observed with selected non-MI outcomes.
Source: Heart - June 21, 2014 Category: Cardiology Authors: Milojevic, A., Wilkinson, P., Armstrong, B., Bhaskaran, K., Smeeth, L., Hajat, S. Tags: Open access, Drugs: cardiovascular system, Acute coronary syndromes, Venous thromboembolism, Epidemiology Cardiac risk factors and prevention Source Type: research

Predominance of normal left ventricular geometry in the male 'athlete's heart'
Conclusions In this comprehensive evaluation of the male athlete's heart (AH), normal LV geometry was predominant in both athlete groups. In the ET, 30% demonstrated an eccentric hypertrophy with no concentric hypertrophy in RT. Cardiac data in RT require further evaluation, and any interpretation of LV size should appropriately index for differences in body size.
Source: Heart - July 21, 2014 Category: Cardiology Authors: Utomi, V., Oxborough, D., Ashley, E., Lord, R., Fletcher, S., Stembridge, M., Shave, R., Hoffman, M. D., Whyte, G., Somauroo, J., Sharma, S., George, K. Tags: Echocardiography, Clinical diagnostic tests Special populations Source Type: research

Asymptomatic adults with mild/moderate isolated native pulmonary valve stenosis are in need of treatment... but not the kind you are thinking of!
As new treatment strategies are developed which outperform previous approaches in terms of safety, efficacy and long-term results, a reappraisal of old therapeutic dogmas is warranted, including lowering the threshold for intervention. Pulmonary valvuloplasty was introduced in 1982 to treat children and adults with significant isolated pulmonary valve stenosis (PS) and provided a very reliable tool to treat the problem avoiding cardiac surgery, with very good long-term results in terms of reinterventions as well as functional outcomes.1 2 Besides the neonate with critical PS, the same technique has been used to treat older...
Source: Heart - August 6, 2014 Category: Cardiology Authors: Giardini, A., Cervi, E. Tags: Congenital heart disease, Drugs: cardiovascular system, Hypertension, Interventional cardiology, Right sided valvular heart disease Editorials Source Type: research