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Source: Journal of the American College of Cardiology
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Total 269 results found since Jan 2013.
Interventional Cryoablation Therapy of Paroxysmal Atrial Fibrillation in Young Patients With Low CHADS2 Score: Worth the Risk of Periprocedural and Long-Term Adverse Events?
In this study the long-term effectiveness in the cryoablation group was reported as 69.9% after 12 months, with a mean fluoroscopy exposure time of 63 min. Regarding the adverse events during follow-up, only 1 adverse event (1.2%) occurred in the drug therapy arm (transfusion because of hemorrhage) compared with 32 adverse events (14.2%) in the cryoablation group, not regarding the 24 patients who suffered temporary phrenic nerve palsy. Five strokes, 4 transient ischemic attacks, 2 cases of tamponades, 2 myocardial infarctions, 3 transfusions, 2 atriovenous fistulas, 2 pseudoaneurysms, 4 cases of persistent phrenic nerve...
Source: Journal of the American College of Cardiology - July 26, 2013 Category: Cardiology Authors: Silke D. Braun Tags: Letters to the Editor Source Type: research
President's Page: An Urgent Call to Action: Graduate Medical Education Funding and the Future of Health Care
Cardiovascular medicine is experiencing a confluence of events that pose a significant threat to the future health of the nation. By 2030, it is predicted that more than 40% of adult Americans will have some form of cardiovascular disease. In addition, current projections indicate a 25% increase in the prevalence of both heart failure and stroke over the next 20 years—a result of an aging U.S. population . To make matters more complicated, an additional 30 million Americans will be seeking healthcare services beginning as early as next year as a result of the Affordable Care Act .
Source: Journal of the American College of Cardiology - October 2, 2013 Category: Cardiology Authors: John Gordon Harold, Patrick T. O'Gara, Joseph A. Hill, Marvin A. Konstam Tags: FROM THE ACC Source Type: research
Invasive Hemodynamic Assessment of “Paradoxical” Low-Flow Severe Aortic Stenosis
We read with interest the paper by Lauten et al. discussing the invasive hemodynamic characteristics of low-gradient, severe aortic stenosis (AS) despite preserved ejection fraction. The authors' main finding was that low-gradient, severe AS despite preserved ejection fraction was not merely the result of a systematic bias in the echocardiographic calculation of the aortic valve area (AVA) as a result of measurement error and so forth, but was in fact a real entity as confirmed by invasively derived hemodynamic data using both the thermodilution and the oxygen consumption methods for stroke volume, cardiac output, and AVA...
Source: Journal of the American College of Cardiology - July 26, 2013 Category: Cardiology Authors: Crochan J. O'Sullivan, Stefan Stortecky, Peter Wenaweser Tags: Letters to the Editor Source Type: research
Relationship of Lipoproteins to Cardiovascular Events: The AIM-HIGH Trial (Atherothrombosis Intervention in Metabolic Syndrome With Low HDL/High Triglycerides and Impact on Global Health Outcomes)
This study sought to examine the relationship between niacin treatment, lipoproteins, and cardiovascular (CV) outcomes in this secondary analysis of the AIM-HIGH (Atherothrombosis Intervention in Metabolic Syndrome With Low HDL/High Triglycerides and Impact on Global Health Outcomes) trial.Background: During a 3-year follow-up in 3,414 patients with established CV disease and low high-density lipoprotein cholesterol (HDL-C) levels, combined niacin + low-density lipoprotein cholesterol (LDL-C)–lowering therapy did not reduce CV events compared with LDL-C–lowering therapy alone.Methods: Subjects taking simvastatin and/o...
Source: Journal of the American College of Cardiology - August 2, 2013 Category: Cardiology Authors: John R. Guyton, April E. Slee, Todd Anderson, Jerome L. Fleg, Ronald B. Goldberg, Moti L. Kashyap, Santica M. Marcovina, Stephen D. Nash, Kevin D. O'Brien, William S. Weintraub, Ping Xu, Xue-Qiao Zhao, William E. Boden Tags: Cardiometabolic Risk Source Type: research
Long-Term Cardiovascular Risk in Women Prescribed Fertility Therapy
Objectives: The purpose of the study was to investigate whether fertility therapy might contribute to subsequent cardiovascular disease.Background: Fertility medications are used for 1% of births yet may also lead to endothelial injury with long-term adverse consequences for the mother.Methods: A population-based cohort analysis was performed of women who gave birth in Ontario, Canada, between July 1, 1993, and March 31, 2010, distinguishing those who did and did not receive fertility therapy in the 2 years before delivery. Cox proportional models were derived to estimate hazard ratios with and without adjustment for basel...
Source: Journal of the American College of Cardiology - August 2, 2013 Category: Cardiology Authors: Jacob A. Udell, Hong Lu, Donald A. Redelmeier Tags: Pregnancy and Heart Disease Source Type: research
Low High-Density Lipoprotein Cholesterol Is Not a Risk Factor for Recurrent Vascular Events in Patients With Vascular Disease on Intensive Lipid-Lowering Medication
Conclusions: In patients with clinically manifest vascular disease using no or usual dose lipid-lowering medication, low plasma HDL-C levels are related to increased vascular risk, whereas in patients using intensive lipid-lowering medication, HDL-C levels are not related to vascular risk.
Source: Journal of the American College of Cardiology - August 14, 2013 Category: Cardiology Authors: Anton P. van de Woestijne, Yolanda van der Graaf, An-Ho Liem, Maarten J.M. Cramer, Jan Westerink, Frank L.J. Visseren, SMART Study Group Tags: Cardiometabolic Risk Source Type: research
Selective Heart Rate Reduction With Ivabradine Unloads the Left Ventricle in Heart Failure Patients
Objectives: The study aimed to determine whether isolated heart rate (HR) reduction with ivabradine reduces afterload of patients with systolic heart failure.Background: The effective arterial elastance (Ea) represents resistive and pulsatile afterload of the heart derived from the pressure volume relation. HR modulates Ea, and, therefore, afterload burden.Methods: Among the patients with systolic heart failure (ejection fraction ≤35%) randomized to either placebo or ivabradine in the SHIFT (Systolic Heart Failure Treatment With the If Inhibitor Ivabradine Trial), 275 patients (n = 132, placebo; n = 143, ivabradine 7...
Source: Journal of the American College of Cardiology - August 9, 2013 Category: Cardiology Authors: Jan-Christian Reil, Jean-Claude Tardif, Ian Ford, Suzanne M. Lloyd, Eileen O'Meara, Michel Komajda, Jeffrey S. Borer, Luigi Tavazzi, Karl Swedberg, Michael Böhm Tags: Heart Failure Source Type: research
Prevalence of Silent Cerebral Ischemia in Paroxysmal and Persistent Atrial Fibrillation and Correlation With Cognitive Function
Objectives: The aim of this study was to compare the prevalence of silent cerebral ischemia (SCI) and cognitive performance in patients with paroxysmal and persistent atrial fibrillation (AF) and controls in sinus rhythm.Background: Large registries have reported a similar risk for symptomatic stroke in both paroxysmal and persistent AF. The relationship among paroxysmal and persistent AF, SCI, and cognitive impairment has remained uncharted.Methods: Two hundred seventy subjects were enrolled: 180 patients with AF (50% paroxysmal and 50% persistent) and 90 controls. All subjects underwent clinical assessment, neurologic...
Source: Journal of the American College of Cardiology - July 12, 2013 Category: Cardiology Authors: Fiorenzo Gaita, Laura Corsinovi, Matteo Anselmino, Cristina Raimondo, Martina Pianelli, Elisabetta Toso, Laura Bergamasco, Carlo Boffano, Maria Consuelo Valentini, Federico Cesarani, Marco Scaglione Tags: Heart Rhythm Disorders Source Type: research
Atrial Fibrillation, Silent Cerebral Ischemia, and Cognitive Function∗
In this issue of the Journal, Gaita et al. report findings from 270 patients, of whom 180 had atrial fibrillation and 90 with similar demographic and clinical characteristics did not have atrial fibrillation. All were free of clinical stroke at the time of the study, and all underwent brain magnetic resonance imaging (MRI). Silent cerebral ischemia (SCI) was defined as a focal, sharply demarcated area on MRI of hyperintensity on T2-weighted fluid-attenuated inversion recovery or isointensity on T1-weighted imaging. The numbers of SCI lesions, and the areas of the brain in which they were observed, were determined. A st...
Source: Journal of the American College of Cardiology - July 12, 2013 Category: Cardiology Authors: Steven Shea, Marco Di Tullio Tags: Heart Rhythm Disorders: Editorial Comment Source Type: research
Prevalence of Peripheral Artery Disease by Abnormal Ankle-Brachial Index in Atrial Fibrillation: Implications for Risk and Therapy
Nonvalvular atrial fibrillation (NVAF) is the most common sustained arrhythmia encountered in clinical practice and is associated with a 5-fold increased risk for stroke . Moreover, patients with NVAF often suffer from atherosclerotic complications such as acute myocardial infarction (AMI) . Peripheral artery disease (PAD) is an established marker of systemic atherosclerosis but its prevalence in NVAF is still unclear. We reasoned that inclusion of ankle-brachial index (ABI), which is an established tool for diagnosis of PAD , in the CHA2DS2-VASc score would better define the prevalence of vascular disease.
Source: Journal of the American College of Cardiology - August 16, 2013 Category: Cardiology Authors: Francesco Violi, Giovanni Daví, William Hiatt, Gregory Y.H. Lip, Gino R. Corazza, Francesco Perticone, Marco Proietti, Pasquale Pignatelli, Anna R. Vestri, Stefania Basili, ARAPACIS Study Investigators Tags: Research Correspondence Source Type: research
Antithrombotic Treatment in Transcatheter Aortic Valve Implantation: Insights for Cerebrovascular and Bleeding Events
Transcatheter aortic valve implantation (TAVI) has emerged as a therapeutic alternative for patients with symptomatic aortic stenosis at high or prohibitive surgical risk. However, patients undergoing TAVI are also at high risk for both bleeding and stroke complications, and specific mechanical aspects of the procedure itself can increase the risk of these complications. The mechanisms of periprocedural bleeding complications seem to relate mainly to vascular/access site complications (related to the use of large catheters in a very old and frail elderly population), whereas the pathophysiology of cerebrovascular events re...
Source: Journal of the American College of Cardiology - April 12, 2013 Category: Cardiology Authors: Josep Rodés-Cabau, Harold L. Dauerman, Mauricio G. Cohen, Roxana Mehran, Eric M. Small, Susan S. Smyth, Marco A. Costa, Jessica L. Mega, Michelle L. O'Donoghue, E. Magnus Ohman, Richard C. Becker Tags: STATE-OF-THE-ART PAPER Source Type: research
Effect of Percutaneous Closure of Patent Foramen Ovale on Post-Procedural Arrhythmias
Atrial arrhythmias after percutaneous patent foramen ovale (PFO) closure, including atrial fibrillation (AF), has been consistently reported in different series suggesting a causal link between mechanical closure of PFO and the new onset of post-procedural arrhythmias . We have systematically assessed the effect of percutaneous PFO closure upon the development of post-procedural arrhythmias in 221 consecutive patients (144 women; mean age 48 ± 13 years) undergoing percutaneous PFO closure. At clinical evaluation, no patient had symptoms indicative or suggestive of arrhythmias. Indications for closure were the presence of ...
Source: Journal of the American College of Cardiology - September 13, 2013 Category: Cardiology Authors: Achille Gaspardone, Arianna Giardina, Maria Iamele, Gaetano Gioffrè, Mauro Polzoni, Filippo Lamberti, Romolo Remoli, Gregory A. Sgueglia, Marco Papa, Cesare Iani Tags: Research Correspondence Source Type: research
Early High-Dose Rosuvastatin for Contrast-Induced Nephropathy Prevention in Acute Coronary Syndrome: Results From the PRATO-ACS Study (Protective Effect of Rosuvastatin and Antiplatelet Therapy On Contrast-Induced Acute Kidney Injury and Myocardial Damage in Patients With Acute Coronary Syndrome)
Conclusions: High-dose rosuvastatin given on admission to statin-naïve patients with ACS who are scheduled for an early invasive procedure can prevent CI-AKI and improve short-term clinical outcome. (Statin Contrast Induced Nephropathy Prevention [PRATO-ACS]; NCT01185938)
Source: Journal of the American College of Cardiology - September 27, 2013 Category: Cardiology Authors: Mario Leoncini, Anna Toso, Mauro Maioli, Francesco Tropeano, Simona Villani, Francesco Bellandi Tags: Cardiac Imaging Source Type: research
President's Page: Heart Month and the American College of Cardiology: A Lesson in Partnerships, Member Values, and Patient Education
The global statistics surrounding cardiovascular disease speak for themselves. Not only is cardiovascular disease the number 1 cause of death globally, but this trend is also expected to continue well into the future. According to the World Health Organization, the number of deaths from cardiovascular diseases, mainly from heart disease and stroke, is expected to reach 23.3 million by 2030 .
Source: Journal of the American College of Cardiology - February 3, 2014 Category: Cardiology Authors: John Gordon Harold Tags: FROM THE ACC Source Type: research
Patent Foramen Ovale Closure Challenged by Left Atrial Chord
In a 22-year-old woman suffering from ischemic stroke affecting the posterior cerebral artery, clinical work-up ruled out cardiovascular and neurological pathologies except patent foramen ovale (PFO) with septal aneurysm and complete bubble filling of the left atrium as demonstrated by echocardiography. The patient was scheduled for transcatheter PFO closure. Peri-interventional 3-dimensional transesophageal echocardiography revealed a PFO tunnel and a left atrial chord keeping the PFO open, with consequent continuous left to right shunting (A to C; Online Video 1). Balloon sizing demonstrated a tunnel diameter of 16 mm (D...
Source: Journal of the American College of Cardiology - December 2, 2013 Category: Cardiology Authors: Smita R. Jategaonkar, Nikola Bogunovic, Dieter Horstkotte, Werner Scholtz Tags: IMAGES IN CARDIOLOGY Source Type: research
