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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 24, 2016 Category: Cardiology Authors: Bhatnagar, P., Wickramasinghe, K., Wilkins, E., Townsend, N. Tags: Open access, Press releases, Review articles Reviews 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 26, 2016 Category: Cardiology Authors: Wasmer, K., Eckardt, L. Tags: Review articles Reviews Source Type: research

Carotid artery stenting outcomes in dataset registries: a cause of concern or an opportunity for improvement?
Dear Editor, Roffi et al1 report that contemporary outcomes following carotid stenting (CAS) in large-scale registries were comparable to carotid endarterectomy (CEA). They also concluded that, over time, complication rates following CAS had decreased.1 We recently reviewed outcomes after >1 500 000 procedures in 21 administrative dataset registries where procedural death/stroke rates were reported for both CEA and CAS.2 One key finding was that CAS was associated with in-hospital/30-day death/stroke rates that exceeded the 3% American Heart Association (AHA) risk threshold for asymptomatic patients in 9/21 re...
Source: Heart - June 9, 2016 Category: Cardiology Authors: Paraskevas, K. I., Naylor, A. R. Tags: Review articles PostScript Source Type: research

Cardiovascular highlights from non-cardiology journals
Long-Term Outcomes of Transcatheter Aortic Valve Replacement The Placement of Aortic Transcatheter Valves (PARTNER) trial demonstrated that transcatheter aortic valve replacement (TAVR) for high-risk patients with aortic stenosis resulted in similar outcomes at 1, 2 and 3 years compared with surgical aortic valve replacement (SAVR). The present study reports the 5-year outcomes of this trial. The study enrolled 699 patients who were randomized to SAVR or TAVR (via a transfemoral or transapical approach). Overall, mean age was 84.1 years, 94% were NYHA Class 3 or 4, and the mean Society of Thoracic Surgeons Predicted Risk o...
Source: Heart - May 25, 2015 Category: Cardiology Authors: Bradley, S. M. Tags: Journal scan Source Type: research

Infective endocarditis: old problem, new guidelines and still much to learn
Despite major advances in treating valvular heart disease, the in-hospital mortality (15–20%) and 1-year mortality (~=40%) for infective endocarditis (IE) has not improved even with modern antibiotics and surgical therapy. Further, stroke (17%), embolisation other than stroke (23%), heart failure (HF) (32%) and other complications remain common; therefore, all precautions to help prevent IE should be employed where indicated. In underdeveloped countries, IE is most often associated with rheumatic heart disease. In developed countries, IE is increasingly associated with prosthetic valves and intracardiac devices, with...
Source: Heart - June 9, 2014 Category: Cardiology Authors: Erwin, J. P., Otto, C. M. Tags: Drugs: cardiovascular system, Echocardiography, Clinical diagnostic tests, Epidemiology, Diabetes, Metabolic disorders Editorials 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