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Total 151 results found since Jan 2013.
Developing and validating a cardiovascular risk score for patients in the community with prior cardiovascular disease
Conclusions The PREDICT-CVD secondary prevention score uses routine measurements from clinical practice that enable it to be implemented in a primary care setting. The score will facilitate risk communication between primary care practitioners and patients with prior CVD, particularly as a resource to show the benefit of risk factor modification.
Source: Heart - May 31, 2017 Category: Cardiology Authors: Poppe, K. K., Doughty, R. N., Wells, S., Gentles, D., Hemingway, H., Jackson, R., Kerr, A. J. Tags: Cardiac risk factors and prevention Source Type: research
Cochrane corner: self-monitoring and self-management of oral anticoagulation
Background Use of oral anticoagulants such as warfarin is increasing. Part of the reason for this is the rising prevalence of atrial fibrillation, an ageing population and the widening indications for treatment based on evidence of benefit in reducing risk of stroke. A meta-analysis of 29 randomised trials including 28 044 participants with atrial fibrillation found that warfarin decreased the absolute risk of stroke by 2.7% per year (the number needed to treat (NNT) 37) compared with placebo or no treatment and by 0.7% per year (NNT=143) compared with aspirin.1 Management of warfarin, however, is challenging bec...
Source: Heart - May 31, 2017 Category: Cardiology Authors: Heneghan, C. J., Spencer, E. A., Mahtani, K. R. Tags: Editorials Source Type: research
Oral anticoagulation in end-stage renal disease and atrial fibrillation: is it time to just say no to drugs?
Atrial fibrillation (AF) frequently complicates the management of chronic kidney disease, especially in patients with end-stage renal disease (ESRD). AF occurs in approximately one in five of the 650 000 patients with ESRD in the USA.1 ESRD confers increased risk for AF, while AF hastens progression to ESRD. The presence of chronic kidney disease in patients with AF is associated with an increased risk for ischaemic stroke independent of traditional risk factors. In addition, chronic kidney disease and particularly ESRD are associated with an increased risk of bleeding. Little is understood about how to safely reduce ...
Source: Heart - May 10, 2017 Category: Cardiology Authors: Black-Maier, E., Piccini, J. P. Tags: Editorials Source Type: research
Tea consumption and risk of ischaemic heart disease
Conclusions In this large prospective study, daily tea consumption was associated with a reduced risk of IHD.
Source: Heart - April 26, 2017 Category: Cardiology Authors: Li, X., Yu, C., Guo, Y., Bian, Z., Si, J., Yang, L., Chen, Y., Ren, X., Jiang, G., Chen, J., Chen, Z., Lv, J., Li, L., on behalf of the China Kadoorie Biobank Collaborative Group Tags: Open access Cardiac risk factors and prevention Source Type: research
Long-term prognostic impact of left atrial volumes and emptying fraction in a community-based cohort
Conclusions In this community-based cohort, LAEF was a powerful predictor of incident cardiovascular events and its predictive ability was stronger than for LA volumes. Our findings suggest that LA dysfunction may represent a more advanced state of LA remodelling than LA enlargement.
Source: Heart - April 10, 2017 Category: Cardiology Authors: Hedberg, P., Selmeryd, J., Leppert, J., Henriksen, E. Tags: Drugs: cardiovascular system, Echocardiography, Acute coronary syndromes, Clinical diagnostic tests Heart failure and cardiomyopathies Source Type: research
How heavy is the load? The ventricular mechanics of mitral regurgitation revisited in the era of percutaneous therapies
The impact of mitral regurgitation (MR) on left ventricular (LV) function and remodelling has been typically described in terms of a pure volume overload. In fact, LV afterload in MR is sometimes believed to be below normal ‘because the regurgitant orifice allows blood to exit the ventricle with little opposition’. Moreover, this argument sometimes is followed by the idea that a low-afterload leads to overestimate intrinsic LV systolic function in MR. Remarkably, despite a number of authors have emphasised that afterload is not reduced in chronic MR,1 2 the idea is still prevalent. Describing MR merely as a vol...
Source: Heart - March 28, 2017 Category: Cardiology Authors: Martinez-Legazpi, P., Yotti, R., Bermejo, J. Tags: Drugs: cardiovascular system, Hypertension, Mitral valve disease, Right sided valvular heart disease Editorials Source Type: research
A tragedy of modern cardiology: using ejection fraction to gauge left ventricular function in mitral regurgitation
Mechanics The normal mitral valve provides unidirectional flow from left atrium (LA) to left ventricle (LV) in a smooth and efficient fashion. Mitral incompetence allows backward flow into the LA, requiring the LV to pump additional volume to compensate for that lost to regurgitation (MR). In its compensated state, even severe chronic MR is remarkably well tolerated at least for short periods of time. Patients are often totally asymptomatic, and many can achieve normal results during cardiopulmonary stress testing, objective proof that symptom absence is based upon true physiological compensation for the existing pathologi...
Source: Heart - March 28, 2017 Category: Cardiology Authors: Carabello, B. A. Tags: Editorials Source Type: research
Non-major bleeding with apixaban versus warfarin in patients with atrial fibrillation
Conclusions In ARISTOTLE, non-major bleeding was common and substantially less frequent with apixaban than with warfarin. CRNM bleeding was independently associated with a higher risk of death and subsequent major bleeding. Our results highlight the importance of any severity of bleeding in patients with AF treated with anticoagulation therapy and suggest that non-major bleeding, including minor bleeding, might not be minor. Trial registration number NCT00412984; post-results.
Source: Heart - March 28, 2017 Category: Cardiology Authors: Bahit, M. C., Lopes, R. D., Wojdyla, D. M., Held, C., Hanna, M., Vinereanu, D., Hylek, E. M., Verheugt, F., Goto, S., Alexander, J. H., Wallentin, L., Granger, C. B. Tags: Open access, Drugs: cardiovascular system Arrhythmias and sudden death Source Type: research
Cautious anticoagulation strategy in patients with dialysis-requiring end-stage kidney disease
To the Editor: We read with interest this manuscript which demonstrated in a large clinical registry that patients with chronic kidney disease with indications for anticoagulation were often treated subtherapeutically.1 A more aggressive approach was, therefore, advocated. We would like to point out that, while this study should be commended for including a large number of patients, it did not show data on the key clinical outcomes of stroke or bleeding. We feel, therefore, that a clear association cannot be made between low time in the therapeutic range (TTR) and any negative clinical outcome. In fact, paradoxically,...
Source: Heart - March 28, 2017 Category: Cardiology Authors: Behar, J. M., Forbes, S. H., Wragg, A., Sporton, S. Tags: Correspondence Source Type: research
Cardiovascular highlights from non-cardiology journals
Continuous positive airway pressure fails to improve cardiovascular outcomes in obstructive sleep apnea Obstructive sleep apnea (OSA) is associated with increased cardiovascular events in observational studies. Randomized trials have demonstrated continuous positive airway pressure (CPAP) therapy reduces blood pressure, markers of oxidative stress and insulin insensitivity. Yet, it remains unclear whether treatment with CPAP reduces cardiovascular events. In the largest study of its kind, 2717 patients aged 45 to 75 years with moderate-to-severe OSA and coronary or cerebrovascular disease were randomized in open-label fash...
Source: Heart - March 13, 2017 Category: Cardiology Authors: McCabe, J. M. Tags: Journal scan Source Type: research
Dipeptidyl peptidase-4 inhibitors and cardiovascular risks in patients with pre-existing heart failure
Conclusions In this nationwide T2DM cohort, the risks of mortality and the combination of MI and ischaemic stroke were lower for patients receiving DPP-4 inhibitors than for those who did not receive such treatment. DPP-4 inhibitor use was not associated with a higher risk of hospitalisation for HF even in patients with pre-existing HF.
Source: Heart - February 27, 2017 Category: Cardiology Authors: Ou, S.-M., Chen, H.-T., Kuo, S.-C., Chen, T.-J., Shih, C.-J., Chen, Y.-T. Tags: Health policy, Drugs: cardiovascular system, Acute coronary syndromes, Epidemiology, Diabetes, Metabolic disorders Heart failure and cardiomyopathies Source Type: research
Coronary bypass surgery versus stenting in multivessel disease involving the proximal left anterior descending coronary artery
Conclusions In patients with multivessel disease with proximal LAD involvement, CABG is associated with lower rates of the safety composite endpoint of death, MI or stroke as compared with PCI with drug-eluting stents at 5 years of follow-up (number needed to treat=21). Trial registration number PRECOMBAT clinicaltrials.gov NCT00997828; SYNTAX: clinicaltrials.gov identifier: NCT00114972 NCT00114972.
Source: Heart - February 27, 2017 Category: Cardiology Authors: Cavalcante, R., Sotomi, Y., Zeng, Y., Lee, C. W., Ahn, J.-M., Collet, C., Tenekecioglu, E., Suwannasom, P., Onuma, Y., Park, S.-J., Serruys, P. W. Tags: Drugs: cardiovascular system, Interventional cardiology, Acute coronary syndromes, Percutaneous intervention, Epidemiology Coronary artery disease Source Type: research
Stop vasodepressor drugs in reflex syncope: a randomised controlled trial
Conclusions Recurrence of syncope and presyncope can be reduced by discontinuing/reducing vasoactive therapy in most elderly patients affected by reflex vasodepressor syncope. Trial registration number NCT01509534; EudraCT2013-004364-63; Results.
Source: Heart - February 27, 2017 Category: Cardiology Authors: Solari, D., Tesi, F., Unterhuber, M., Gaggioli, G., Ungar, A., Tomaino, M., Brignole, M. Tags: Drugs: cardiovascular system, Hypertension, Acute coronary syndromes, Epidemiology Special populations Source Type: research
Pre-procedural dual antiplatelet therapy in patients undergoing transcatheter aortic valve implantation increases risk of bleeding
Conclusions The current study demonstrated that DAPT before TF-TAVI increased the risk of bleeding compared with single or no antiplatelet therapy. Lower intensity antiplatelet therapy was not associated with thrombotic events. In modern practice, it might be reasonable to perform TAVI using single or no pre-procedural antiplatelet therapy with an expectation of no increase of adverse events. Trial registration number UMIN-ID; 000020423; Results.
Source: Heart - February 16, 2017 Category: Cardiology Authors: Hioki, H., Watanabe, Y., Kozuma, K., Nara, Y., Kawashima, H., Kataoka, A., Yamamoto, M., Takagi, K., Araki, M., Tada, N., Shirai, S., Yamanaka, F., Hayashida, K., And on behalf of OCEAN-TAVI investigators Tags: Valvular heart disease Source Type: research
Relationship between aetiology and left ventricular systolic dysfunction in hypertrophic cardiomyopathy
Conclusions In adults with HCM, LV systolic dysfunction is more frequent in those with rare phenocopies. When combined with age at presentation, it is a marker for specific aetiologies and is associated with poorer long-term survival.
Source: Heart - January 27, 2017 Category: Cardiology Authors: Rosmini, S., Biagini, E., O'Mahony, C., Bulluck, H., Ruozi, N., Lopes, L. R., Guttmann, O., Reant, P., Quarta, C. C., Pantazis, A., Tome-Esteban, M., Mckenna, W. J., Rapezzi, C., Elliott, P. M. Tags: Hypertrophic cardiomyopathy, Drugs: cardiovascular system, Echocardiography, Interventional cardiology, Clinical diagnostic tests, Epidemiology, Metabolic disorders Heart failure and cardiomyopathies Source Type: research
Net clinical benefit of warfarin in individuals with atrial fibrillation across stroke risk and across primary and secondary care
Conclusions CHA2DS2-VASc accurately stratifies IS risk in individuals with AF across both primary and secondary care. However, the incidence rate of ischaemic stroke at CHA2DS2-VASc=1 are lower than previously reported, which may change the decision to start anticoagulation with warfarin in these individuals.
Source: Heart - January 13, 2017 Category: Cardiology Authors: Allan, V., Banerjee, A., Shah, A. D., Patel, R., Denaxas, S., Casas, J.-P., Hemingway, H. Tags: Open access, Drugs: cardiovascular system, Epidemiology Arrhythmias and sudden death Source Type: research
Heartbeat: Left atrial appendage occlusion for stroke prevention
Stroke prevention is the primary goal of therapy in patients with atrial fibrillation (AF).1 Heart has published numerous papers on early AF detection,2 approaches for restoring normal sinus rhythm, risk scores for determining which AF patients benefit most from anti-thrombotic therapy, and transcatheter occlusion of the left atrial appendage (LAA) to prevent thrombus formation.3–6 Early studies of LAA occlusion compared this procedure to vitamin K antagonist (VKA) therapy for stroke prevention. Now, direct oral anticoagulants (DOACs) have replaced VKA therapy in many AF patients due to an improved risk/benefit profi...
Source: Heart - January 5, 2017 Category: Cardiology Authors: Otto, C. M. Tags: Heartbeat Source Type: research
To occlude or not? Left atrial appendage occlusion for stroke prevention in atrial fibrillation
The cornerstone of atrial fibrillation (AF) management is effective stroke prevention, which by now remains the only proven method of improved survival in patients with AF. Oral anticoagulation with the use of vitamin K antagonists (eg, warfarin) or non-vitamin K antagonist oral anticoagulants (NOACs) has been shown to substantially reduce the risk of AF-related strokes and thus is presently the standard of care for stroke prevention in non-valvular AF. Approximately 90% of thrombi being formed in AF are localised in left atrial appendage (LAA).1 Thus, LAA exclusion seems a tempting method of prophylaxis against stroke, pa...
Source: Heart - January 5, 2017 Category: Cardiology Authors: Mazurek, M., Lip, G. Y. H. Tags: Drugs: cardiovascular system, Epidemiology Editorials Source Type: research
Efficacy and safety of left atrial appendage closure versus medical treatment in atrial fibrillation: a network meta-analysis from randomised trials
Conclusions The findings of this meta-analysis suggest that LAAC is superior to placebo and APT, and comparable to NOAC for preventing mortality and stroke or SE, with similar bleeding risk in patients with non-valvular AF. However, these results should be interpreted with caution and more studies are needed to further substantiate this advantage, in view of the wide CIs with some variables in the current meta-analysis.
Source: Heart - January 5, 2017 Category: Cardiology Authors: Sahay, S., Nombela-Franco, L., Rodes-Cabau, J., Jimenez-Quevedo, P., Salinas, P., Biagioni, C., Nunez-Gil, I., Gonzalo, N., de Agustin, J. A., del Trigo, M., Perez de Isla, L., Fernandez-Ortiz, A., Escaned, J., Macaya, C. Tags: Editor's choice, Drugs: cardiovascular system, Epidemiology Arrhythmias and sudden death Source Type: research
Why should we screen for atrial fibrillation?
Atrial fibrillation (AF) constitutes an increasing challenge to the medical community and healthcare providers. With a prevalence of almost 3% in the adult Swedish population1 and a forecasted twofold or threefold increase by 2050 in the USA, we are facing a diagnosis with epidemic proportions. Apart from increased mortality, AF also increases the risk of heart failure, hospitalisations and ischaemic stroke.2 Of these complications, ischaemic stroke gives a particularly heavy burden on patients, their family and society. Ischaemic stroke is the most common reason for permanent neurological disability in the adult Western p...
Source: Heart - December 9, 2016 Category: Cardiology Authors: Svennberg, E., Engdahl, J. Tags: Press releases, Drugs: cardiovascular system, Epidemiology Editorials Source Type: research
Screening for atrial fibrillation in 13 122 Hong Kong citizens with smartphone electrocardiogram
Conclusion Community screening for AF with SL-ECG was feasible and it identified a significant proportion of citizens with newly diagnosed AF. The prevalence of AF in a Chinese population in Hong Kong was comparable with that of contemporary Western counterparts. Apart from age and sex, different anthropometric parameters and cardiovascular comorbid conditions were identified as independent predictors of AF.
Source: Heart - December 9, 2016 Category: Cardiology Authors: Chan, N.-y., Choy, C.-c. Tags: Editor's choice, Press releases, Drugs: cardiovascular system, Heart failure, Hypertension, Epidemiology, Metabolic disorders Arrhythmias and sudden death Source Type: research
Atrial appendage occlusion for stroke prevention in patients with atrial fibrillation
In the developed countries, stroke is an important cause of mortality and disability. Cardioembolism is the most frequent cause of ischaemic stroke, in the presence of atrial fibrillation (AF).1 AF is the most common cardiac arrhythmia in the general population and its prevalence increases with age; the lifetime risk of AF development is 25% in people over 40 years old.2 Anticoagulation has been established as an effective treatment strategy for stroke prevention in patients with AF and risk factors for stroke.3 The new oral anticoagulants (NOACs) seem to be similarly efficacious compared with vitamin K antagonists (V...
Source: Heart - November 25, 2016 Category: Cardiology Authors: Swaans, M. J., Boersma, L. V. A. Tags: Drugs: cardiovascular system, Echocardiography, Hypertension, Interventional cardiology, Clinical diagnostic tests, Epidemiology Editorials Source Type: research
Trends in the epidemiology of cardiovascular disease in the UK
Cardiovascular disease (CVD) mortality in the UK is declining; however, CVD burden comes not only from deaths, but also from those living with the disease. This review uses national datasets with multiple years of data to present secular trends in mortality, morbidity, and treatment for all CVD and specific subtypes within the UK. We produced all-ages and premature age-standardised mortality rates by gender, standardised to the 2013 European Standard Population, using data from the national statistics agencies of the UK. We obtained data on hospital admissions from the National Health Service records, using the main diagno...
Source: Heart - November 25, 2016 Category: Cardiology Authors: Bhatnagar, P., Wickramasinghe, K., Wilkins, E., Townsend, N. Tags: Open access, Press releases, Review articles Reviews Source Type: research
Left atrial appendage occlusion in high-risk patients with non-valvular atrial fibrillation
Conclusions Our data suggest LAA occlusion in high-risk patients with NVAF not suitable for OACs is feasible and associated with low complication rates as well as low rates of stroke and major bleeding at long-term follow-up.
Source: Heart - November 25, 2016 Category: Cardiology Authors: Berti, S., Pastormerlo, L. E., Rezzaghi, M., Trianni, G., Paradossi, U., Cerone, E., Ravani, M., De Caterina, A. R., Rizza, A., Palmieri, C. Tags: Drugs: cardiovascular system, Echocardiography, Clinical diagnostic tests Cardiac risk factors and prevention Source Type: research
Loneliness and social isolation and increased risk of coronary heart disease and stroke: clinical implications
To the Editor The recent meta-analysis published in Heart by Valtorta et al1 showed that loneliness and social isolation are associated with increased incidence of coronary heart disease (CHD) and stroke in 16 large longitudinal studies conducted in high-income countries. This finding is not surprising given the extensive literature documenting such harmful consequences of social isolation, including a study my research group published in 19922 showing in a large sample of CHD patients that those who were not married and did not have a confident—and hence likely to be lonely and socially isolated—had a 5-year m...
Source: Heart - November 25, 2016 Category: Cardiology Authors: Williams, R. B. Tags: PostScript Source Type: research
Antithrombotic drug use: scientific breakthroughs, biological limits and physician behaviour
During the past 25 years, there has been a dramatic surge in the use of antithrombotic drugs as documented in the Heart paper by Adelborg et al.1 The authors derived their findings from the Danish drug utilisation database, which is unique in its comprehensiveness and ability to capture over-the-counter aspirin. The increased prescription of antithrombotic drugs is fuelled by a better understanding of disease and risk, population growth, ageing societies, improved methods of detection, and rising global rates of obesity, a recognised risk factor for atrial fibrillation (AF), venous thromboembolic (VTE) disease, and ca...
Source: Heart - November 11, 2016 Category: Cardiology Authors: Hylek, E. M. Tags: Drugs: cardiovascular system, Venous thromboembolism, Epidemiology Editorials Source Type: research
Stroke and death in elderly patients with atrial fibrillation in Japan compared with the United Kingdom
Conclusions Elderly (age ≥75 years) patients with AF in both Japan and the UK are at similarly high risk of stroke and death, with OAC still underused in both populations. Ethnicity was not independently associated with the risk of stroke, regardless of OAC use or non-use.
Source: Heart - November 11, 2016 Category: Cardiology Authors: Senoo, K., An, Y., Ogawa, H., Lane, D. A., Wolff, A., Shantsila, E., Akao, M., Lip, G. Y. H. Tags: Drugs: cardiovascular system, Heart failure, Hypertension, Epidemiology, Diabetes, Metabolic disorders Health care delivery, economics and global health care Source Type: research
New perspectives on atrial fibrillation and stroke
Atrial fibrillation (AF) is directly implicated in embolic stroke and suspected in a large proportion of cryptogenic stroke. The current stroke-prevention strategy in embolic and cryptogenic stroke starts with arrhythmia detection, followed by risk stratification and treatment for those deemed to be at increased risk. This approach is practical and widespread; however, more recent findings have questioned its validity. Arrhythmia detection is dependent on the length and fidelity of monitoring. Long-term monitoring using implanted recorders improves arrhythmia detection in patients with cryptogenic stroke. A large proportio...
Source: Heart - October 26, 2016 Category: Cardiology Authors: Akoum, N. Tags: Review articles Reviews Source Type: research
Hypertrophic cardiomyopathy and the potential influence of etomidate on postoperative outcomes
This study showed no difference in what they defined as ‘hard outcomes’ such as myocardial infarction, stroke and death. They did however show an increased incidence of composite end points (10%; p=0.03) such as postoperative congestive heart failure (1%) and readmission rates (7%). One interesting point that we would like to raise is the significantly higher use of etomidate in the HCM cohort (p=0.002). Understandably, etomidate was chosen in many cases for its rapid onset and stable haemodynamic properties. This was likely reflected in the significantly lower incidence of intraoperative tachycardia and hypote...
Source: Heart - October 26, 2016 Category: Cardiology Authors: White, L. D., Vlok, R., Chong, C., Melhuish, T. M. Tags: PostScript Source Type: research
On the use of genetic risk scores to predict cardiovascular disease in the general population
Using genetic information to predict the risk of common diseases has been the holy grail of several groups working in genetics of common human diseases.1 Results up to now have been contradictory and subject to widely different interpretations: from sheer enthusiasm to deep pessimism. While great success has been obtained in the identification of several hundreds of genetic markers robustly and consistently associated with a wide range of human quantitative phenotypes, for the majority of these genetic variants, no clear translation into a better prediction capacity has been shown. In their Heart publication, Morris et al2...
Source: Heart - September 27, 2016 Category: Cardiology Authors: Pereira, A. C. Tags: Drugs: cardiovascular system, Hypertension, Epidemiology Editorials Source Type: research
Management of supraventricular arrhythmias in adults with congenital heart disease
Supraventricular arrhythmias are a frequent complication in adults with congenital heart disease (ACHD). The prevalence increases with time since surgery, complexity of the underlying defect, type of repair and older age at surgery. Arrhythmias are the most frequent reason for hospital admission and along with heart failure the leading cause of death. The arrhythmia-associated increase in morbidity and mortality makes their management a key task in patients with ACHD. Intra-atrial re-entry is the most frequent arrhythmia mechanism. Less common arrhythmia mechanisms are supraventricular tachycardias in the presence of an ac...
Source: Heart - September 27, 2016 Category: Cardiology Authors: Wasmer, K., Eckardt, L. Tags: Review articles Reviews Source Type: research
Direct oral anticoagulants: unique properties and practical approaches to management
Since 2009, four direct oral anticoagulants (DOACs) have been introduced for treatment of venous thromboembolism and stroke prevention in non-valvular atrial fibrillation. While they are currently first-line therapy for a majority of patients, there are a number of clinical situations where warfarin is preferable. In both randomised trials and real-world populations, use of DOACs significantly reduces the risk of intracranial haemorrhage as compared with warfarin. While drug-specific reversal agents are currently only available for dabigatran, andexanet alpha is pending approval for reversal of factor Xa inhibitors, reduci...
Source: Heart - September 27, 2016 Category: Cardiology Authors: Barnes, G. D., Kurtz, B. Tags: Review articles Reviews Source Type: research
Perioperative outcomes of patients with hypertrophic cardiomyopathy undergoing non-cardiac surgery
Conclusions Patients with HCM undergoing high-risk and intermediate-risk non-cardiac surgeries have a low perioperative event rate, at an experienced centre. However, they have a higher risk of composite events versus matched patients without HCM.
Source: Heart - September 27, 2016 Category: Cardiology Authors: Dhillon, A., Khanna, A., Randhawa, M. S., Cywinski, J., Saager, L., Thamilarasan, M., Lever, H. M., Desai, M. Y. Tags: Hypertrophic cardiomyopathy, Drugs: cardiovascular system, Heart failure, Acute coronary syndromes, Clinical diagnostic tests, Epidemiology Heart failure and cardiomyopathies Source Type: research
Catheter ablation for atrial fibrillation in hypertrophic cardiomyopathy: a systematic review and meta-analysis
Conclusions The observed complication rate of catheter ablation of AF in patients with HCM was low. Even though the risk of relapse is twofold higher, catheter ablation can be effective in patients with HCM and AF, particularly in patients with paroxysmal AF and smaller atria.
Source: Heart - September 13, 2016 Category: Cardiology Authors: Providencia, R., Elliott, P., Patel, K., McCready, J., Babu, G., Srinivasan, N., Bronis, K., Papageorgiou, N., Chow, A., Rowland, E., Lowe, M., Segal, O. R., Lambiase, P. D. Tags: Tachyarrhythmias, Editor's choice, Hypertrophic cardiomyopathy, Drugs: cardiovascular system, Clinical diagnostic tests Heart failure and cardiomyopathy Source Type: research
Histology of debris captured by a cerebral protection system during transcatheter valve-in-valve implantation
Conclusions Transcatheter VIV procedures were associated with the release of particulate debris into the cerebral circulation in all patients. The type of debris suggests that debris originates predominantly from arterial and valvular passage of the THV.
Source: Heart - September 13, 2016 Category: Cardiology Authors: Schmidt, T., Schlüter, M., Alessandrini, H., Akdag, O., Schewel, D., Schewel, J., Thielsen, T., Kreidel, F., Bader, R., Romero, M., Ladich, E., Virmani, R., Schäfer, U., Kuck, K.-H., Frerker, C. Tags: Aortic and vascular disease Source Type: research
Cardiovascular events and all-cause mortality with insulin versus glucagon-like peptide-1 analogue in type 2 diabetes
Conclusions In this cohort of obese people with T2DM, intensification of dual oral therapy by adding GLP-1ar analogue is associated with a lower MACE outcome in routine clinical practice, compared with adding insulin therapy as the third glucose-lowering agent.
Source: Heart - September 13, 2016 Category: Cardiology Authors: Anyanwagu, U., Mamza, J., Mehta, R., Donnelly, R., Idris, I. Tags: Drugs: cardiovascular system, Acute coronary syndromes, Epidemiology, Diabetes, Metabolic disorders Healthcare delivery, economics and global health Source Type: research
Cardiovascular highlights from non-cardiology journals
Cholesterol Lowering in Intermediate-risk Persons without Cardiovascular Disease Implementation of statin therapy in practice for primary prevention of cardiovascular disease is controversial due to concerns over costs and side-effects with broader use and uncertainty regarding LDL goals in the primary prevention population. Previous primary prevention trials suggest a reduction in cardiovascular outcomes in largely white patients with significant risk factors for coronary disease. The HOPE-3 trial randomized a diverse population of 12,000 individuals over 55 years of age (women over 60) with 1–2 relatively modest ri...
Source: Heart - September 13, 2016 Category: Cardiology Authors: Kearney, K., McCabe, J. M. Tags: Journal scan Source Type: research
Contemporary evaluation and management of lower extremity peripheral artery disease
Peripheral artery disease (PAD) includes atherosclerosis of the aorta and lower extremities. Affecting a large segment of the population, PAD is associated with impaired functional capacity and reduced quality of life as well as an increased risk of stroke, myocardial infarction and cardiovascular death. The evaluation of PAD begins with the physical examination, incorporating non-invasive testing such as ankle-brachial indices to confirm the diagnosis. Therapeutic interventions are aimed at alleviating symptoms while preserving limb integrity and reducing overall cardiovascular risk. With this in mind, risk factor modific...
Source: Heart - August 24, 2016 Category: Cardiology Authors: Foley, T. R., Armstrong, E. J., Waldo, S. W. Tags: Review articles Reviews Source Type: research
Obesity and atrial fibrillation: can adipokines help to solve this puzzle
Obesity is a major public health problem increasing risk for hypertension, diabetes mellitus, cardiovascular diseases, heart failure, stroke, left atrial enlargement and obstructive sleep apnoea. Conventionally, body mass index (BMI) is used in many studies to diagnose and classify obesity. However, epidemiological studies have shown that waist:hip ratio is a better predictor for myocardial infarction and sudden cardiac death compared with BMI. Nevertheless, some subjects who have ‘healthy obese phenotype’ have a benign cardiometabolic profile due to greater deposition of the fat tissue in the subcutaneous area...
Source: Heart - August 11, 2016 Category: Cardiology Authors: Güngör, B. Tags: Drugs: cardiovascular system, Hypertension, Acute coronary syndromes, Epidemiology, Diabetes, Metabolic disorders Editorials Source Type: research
Loneliness and social isolation as risk factors for coronary heart disease and stroke: systematic review and meta-analysis of longitudinal observational studies
Conclusions Our findings suggest that deficiencies in social relationships are associated with an increased risk of developing CHD and stroke. Future studies are needed to investigate whether interventions targeting loneliness and social isolation can help to prevent two of the leading causes of death and disability in high-income countries. Study registration number CRD42014010225.
Source: Heart - June 10, 2016 Category: Cardiology Authors: Valtorta, N. K., Kanaan, M., Gilbody, S., Ronzi, S., Hanratty, B. Tags: Open access, Editor's choice, Press releases, Drugs: cardiovascular system, Epidemiology Cardiac risk factors and prevention Source Type: research
Risk of death and stroke associated with anticoagulation therapy after mitral valve repair
Conclusion VKA treatment after mitral valve repair is associated with a markedly lower risk of adverse events as stroke or death without excess major bleeding risk during the first 3 months following surgery.
Source: Heart - April 12, 2016 Category: Cardiology Authors: Valeur, N., Merie, C., Hansen, M. L., Torp-Pedersen, C., Gislason, G. H., Kober, L. Tags: Drugs: cardiovascular system, Interventional cardiology, Epidemiology Valvular heart disease Source Type: research
Early detection of occult atrial fibrillation and stroke prevention
Atrial fibrillation (AF) is a very common arrhythmia and significantly increases stroke risk. This risk can be mitigated with oral anticoagulation, but AF is often asymptomatic, or occult, preventing timely detection and treatment. Accordingly, occult AF may cause stroke before it is clinically diagnosed. Currently, guidelines for the early detection and treatment of occult AF are limited. This review addresses recent advancements in occult AF detection methods, identification of populations at high risk for occult AF, the treatment of occult AF with oral anticoagulation, as well as ongoing trials that may answer criticall...
Source: Heart - June 25, 2015 Category: Cardiology Authors: Keach, J. W., Bradley, S. M., Turakhia, M. P., Maddox, T. M. Tags: Review articles Reviews Source Type: research
Atrial fibrillation and stroke in adult patients with atrial septal defect and the long-term effect of closure
Conclusions Patients with ASD had a higher risk of first-time AF after closure than the comparison cohort. There was no effect of closure on the use of AF-related medicine in patients with prevalent AF.
Source: Heart - April 9, 2015 Category: Cardiology Authors: Nyboe, C., Olsen, M. S., Nielsen-Kudsk, J. E., Hjortdal, V. E. Tags: Congenital heart disease in adult patients, Congenital heart disease, Drugs: cardiovascular system, Epidemiology Source Type: research
Survival by stroke volume index in patients with low-gradient normal EF severe aortic stenosis
Conclusions Lower SVI is incrementally associated with mortality in LG severe AS with preserved EF. These findings have implications for classification of AS severity, identification of high-risk groups and subsequent management.
Source: Heart - December 12, 2014 Category: Cardiology Authors: Eleid, M. F., Sorajja, P., Michelena, H. I., Malouf, J. F., Scott, C. G., Pellikka, P. A. Tags: Editor's choice, Drugs: cardiovascular system, Echocardiography, Aortic valve disease, Clinical diagnostic tests, Epidemiology Valvular heart disease Source Type: research
Survival by stroke volume index in low-gradient normal EF severe aortic stenosis: insights into myocardial systolic dysfunction
To the Editor, We read with interest the recent article on survival by stroke volume index (SVI) in patients with low-gradient normal EF severe aortic stenosis, which demonstrated lower SVI is incrementally associated with mortality.1 The authors discuss a putative mechanism of low stroke volume (SV) secondary to concentric remodelling which results in reduced LV cavity size. This impedes LV diastolic filling culminating in diminished systolic function despite normal EF. The authors quote evidence of systolic impairment, for example reduced longitudinal strain, in similar cohorts with preserved EF.2 In the current study, t...
Source: Heart - December 12, 2014 Category: Cardiology Authors: Rodrigues, J. C. L., Dastidar, A. G., Rohan, S., MacIver, D. H. Tags: PostScript Source Type: research
Prediction of stroke in patients without atrial fibrillation using the CHADS2 and CHA2DS2-VASc scores: a justification for more widespread thromboprophylaxis?
The CHADS2 (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, previous stroke/transient ischaemic attack (TIA) (double)) and more recently, the CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years (double score), diabetes mellitus, previous stroke/TIA (double score), vascular disease, age 65–74 years, sex category (female)) scores are validated clinical prediction tools commonly used to estimate the stroke risk in atrial fibrillation (AF) patients. More recently, the focus has been on initially identifying those patients at ‘low risk’ (ie, CHA2DS...
Source: Heart - September 9, 2014 Category: Cardiology Authors: Senoo, K., Lip, G. Y. H. Tags: Drugs: cardiovascular system, Heart failure, Hypertension, Epidemiology, Diabetes, Metabolic disorders Editorials Source Type: research
Prediction of stroke or TIA in patients without atrial fibrillation using CHADS2 and CHA2DS2-VASc scores
Conclusions In patients with ACS but no AF, the CHADS2 and CHA2DS2-VASc scores predict ischaemic stroke/TIA events with similar accuracy to that observed in historical populations with non-valvular AF, but with lower absolute event rates. Further study of the utility of the CHADS2 and CHA2DS2-VASc scores for the assessment of thromboembolic risk and selection of antithrombotic therapy in patients without AF is warranted.
Source: Heart - September 9, 2014 Category: Cardiology Authors: Mitchell, L. B., Southern, D. A., Galbraith, D., Ghali, W. A., Knudtson, M., Wilton, S. B., for the APPROACH investigators Tags: Drugs: cardiovascular system, Epidemiology Coronary artery disease Source Type: research
Right ventricular stroke work in children with pulmonary arterial hypertension: a promising approach
To the Editor, We read with great interest the article by Di Maria et al,1 describing the importance of RV performance, especially RV stroke work (RVSW), in children with pulmonary arterial hypertension (PAH). The authors investigated the relation between echocardiographic measurements of RV function and the ‘gold standard’ of right heart catheterisation in children and found that RVSW strongly correlates with non-invasive data of RV function.1 The authors concluded that RVSW correlates with outcome parameters, for example, abnormal WHO class, and mortality, in children with PAH. We completely agree with the fi...
Source: Heart - August 6, 2014 Category: Cardiology Authors: Pansy, J., Koestenberger, M. Tags: PostScript Source Type: research
RV stroke work in children with pulmonary arterial hypertension: estimation based on invasive haemodynamic assessment and correlation with outcomes
Conclusions RVSW can be estimated in children with PAH, and is significantly associated with abnormal WHO class, the need for septostomy, as well as mortality. Indices accounting for RV performance as well as ventricular-vascular coupling may be useful in the prognosis and, hence, management of children with PAH.
Source: Heart - August 6, 2014 Category: Cardiology Authors: Di Maria, M. V., Younoszai, A. K., Mertens, L., Landeck, B. F., Ivy, D. D., Hunter, K. S., Friedberg, M. K. Tags: Congenital heart disease, Drugs: cardiovascular system, Echocardiography, Hypertension, Clinical diagnostic tests, Epidemiology Pulmonary vascular disease Source Type: research
Allopurinol reduces brachial and central blood pressure, and carotid intima-media thickness progression after ischaemic stroke and transient ischaemic attack: a randomised controlled trial
Conclusions Allopurinol lowered CBP and reduced CIMT progression at 1 year compared with placebo in patients with recent ischaemic stroke and TIA. This extends the evidence of sustained beneficial effects of allopurinol to these prognostically significant outcomes and to the stroke population, highlighting the potential for reduction in cardiovascular events with this treatment strategy. Trial registration number ISRCTN11970568.
Source: Heart - June 21, 2014 Category: Cardiology Authors: Higgins, P., Walters, M. R., Murray, H. M., McArthur, K., McConnachie, A., Lees, K. R., Dawson, J. Tags: Hypertension, Epidemiology Cardiac risk factors and prevention Source Type: research