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Total 262 results found since Jan 2013.

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

Diabetes, incretin hormones and cardioprotection
The diabetes pandemic In 2012 an estimated 371 million people had diabetes and of those about a half were undiagnosed. That number is set to expand to 552 million by 2030. Type 2 diabetes mellitus (T2DM) constitutes 85–95% of all diabetes in high income nations and may account for an even greater proportion in their low and middle income counterparts (figure 1). As a global pandemic, diabetes claimed the lives of 4.8 million people in 2012, half of whom were below the age of 60 years.w1 The predominant cause of morbidity and mortality in diabetes is cardiovascular disease, with at least a twofold excess risk of ...
Source: Heart - September 9, 2014 Category: Cardiology Authors: Myat, A., Redwood, S. R., Gersh, B. J., Yellon, D. M., Marber, M. S. Tags: Diabetic heart disease, Education in Heart, Drugs: cardiovascular system, Epidemiology, Diabetes, Metabolic disorders Source Type: research

Two (or more) sides of a coin
There has been a lot of controversy concerning the prognostic role of obesity on cardiovascular morbidity and mortality. Several studies with cardiovascular patients (heart failure, coronary, cerebrovascular and peripheral artery diseases, hypertension and atrial fibrillation) have reported better or similar risk of cardiovascular events and mortality among overweight and obese individuals as compared to lean ones.1 Since obesity is an independent risk factor for cardiovascular diseases, these findings initially surprised researchers, who coined the term ‘obesity paradox’. The increasingly debated ‘metabo...
Source: Heart - August 21, 2014 Category: Cardiology Authors: Beleigoli, A., Diniz, M. d. F. Tags: Drugs: cardiovascular system, Hypertension, Acute coronary syndromes, Epidemiology Editorials Source Type: research

Brain MRI to personalise atrial fibrillation therapy: current evidence and perspectives
Advances in the access to and in the performance of brain MRI have led to an increased detection of asymptomatic abnormalities in the brain of patients with cardiovascular diseases. These may have prognostic impact and could influence management in the future. In this review, we summarise the main findings of brain MRI in patients with atrial fibrillation (AF) and explore the available evidence to better quantify the risk for intracerebral haemorrhage and (recurrent) ischaemic stroke based on brain MRI findings. Treatment decisions in the majority of patients with AF should still be based on data from established validated...
Source: Heart - August 21, 2014 Category: Cardiology Authors: Haeusler, K. G., Wilson, D., Fiebach, J. B., Kirchhof, P., Werring, D. J. Tags: Reviews Source Type: research

Increased risk of coronary heart disease in patients with chronic osteomyelitis: a population-based study in a cohort of 23 million
Conclusions This study demonstrates that COM is an independent risk factor for CHD, particularly in the younger population. Further studies are necessary to explore the underlying mechanisms linking COM and CHD.
Source: Heart - August 21, 2014 Category: Cardiology Authors: Hsiao, L.-C., Muo, C.-H., Chen, Y.-C., Chou, C.-Y., Tseng, C.-H., Chang, K.-C. Tags: Health policy, Drugs: cardiovascular system, Hypertension, Epidemiology, Metabolic disorders Coronary artery disease Source Type: research

Molecular imaging of atherosclerosis: clinical state-of-the-art
Physicians depend greatly on imaging techniques that help them make clinical decisions. However, when a diagnosis is made on the basis of anatomical imaging alone, the disease process has often advanced beyond the point where preventative therapy can be applied. In many cardiovascular diseases, it is vital to detect pathological and normal processes at an early, subclinical stage, to enable early and improved diagnosis, prediction and treatment (figure 1A). This is particularly relevant to atherosclerosis, which can be clinically silent for decades and then manifest suddenly as an acute myocardial infarction (MI) or stroke...
Source: Heart - August 21, 2014 Category: Cardiology Authors: Jaffer, F. A., Verjans, J. W. Tags: Non-invasive imaging, Education in Heart, Drugs: cardiovascular system, Acute coronary syndromes, Clinical diagnostic tests Source Type: research

Cardiovascular highlights from non-cardiology journals
Cryptogenic stroke due to undetected atrial fibrillation—longer ECG monitoring may be the key Up to 40% of ischemic strokes remain unexplained after routine evaluation and thus are considered cryptogenic. However, a number of these strokes may be due to an undetected episode of paroxysmal atrial fibrillation (AF) where anticoagulation can reduce the risk of subsequent ischemic stokes. Although a minimum of 24 hours of ECG monitoring is guideline recommended in the evaluation of ischemic stroke to identify AF, the optimal duration of monitoring remains undetermined. Among patients with cryptogenic stroke, two concurre...
Source: Heart - August 21, 2014 Category: Cardiology Authors: Bradley, S. M. Tags: Journal scan 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

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

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

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

Biomarkers and atrial fibrillation: is it prime time yet?
Atrial fibrillation (AF) is a global epidemic with increasing burden on healthcare systems.1 AF is associated with increased risk of thromboembolic stroke, heart failure, cognitive dysfunction and mortality. In improving prognosis, the focus of management revolves around stroke prevention with clinical scores developed to identify people with increased stroke risk. The CHADS2 and CHA2DS2-VASc scores are the most commonly used scores, with the latter being better able to discriminate low-risk subjects.2 However, both the risk scores have a modest predictive value for identifying high-risk subjects for stroke with C statisti...
Source: Heart - July 3, 2014 Category: Cardiology Authors: Mahajan, R., Lau, D. H., Sanders, P. Tags: Drugs: cardiovascular system, Echocardiography, Clinical diagnostic tests, Epidemiology Editorials Source Type: research

Importance of persistent elevation of cardiac biomarkers in atrial fibrillation: a RE-LY substudy
Conclusions Persistent elevation of troponin and NT-proBNP indicates a worse prognosis than transient elevations or no elevations of either marker. Prognostication of stroke, death and thromboembolic events is improved by the use of repeated determinations of cardiac biomarkers. Trial registration number: http://www.clinicaltrials.gov, NCT00262600
Source: Heart - July 3, 2014 Category: Cardiology Authors: Hijazi, Z., Oldgren, J., Andersson, U., Connolly, S. J., Ezekowitz, M. D., Hohnloser, S. H., Reilly, P. A., Siegbahn, A., Yusuf, S., Wallentin, L. Tags: Drugs: cardiovascular system, Epidemiology Arrhythmias and sudden death 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

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