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Percutaneous management of acute ischaemic stroke
Learning objectives To understand both the rationale and principles behind percutaneous management of stroke. To be aware of the evidence base for this treatment. To appreciate the current logistical challenges and how they might be overcome. Introduction In principle, the similarity between opening an occluded cerebral artery and an occluded coronary artery, when the perfusion to that organ is acutely compromised, is inescapable: to re-establish antegrade flow as quickly as possible to minimise downstream damage. There are, of course, important differences between an acute myocardial infarction (MI) and an acute ischaemic...
Source: Heart - April 25, 2023 Category: Cardiology Authors: Routledge, H., Curzen, N. Tags: Education in Heart Source Type: research

Prediction of incident atrial fibrillation in community-based electronic health records: a systematic review with meta-analysis
Conclusions Models externally validated for prediction of incident AF in community-based EHR demonstrate moderate predictive ability and high risk of bias. Novel methods may provide stronger discriminative performance. Systematic review registration PROSPERO CRD42021245093.
Source: Heart - June 10, 2022 Category: Cardiology Authors: Nadarajah, R., Alsaeed, E., Hurdus, B., Aktaa, S., Hogg, D., Bates, M. G. D., Cowan, C., Wu, J., Gale, C. P. Tags: Open access Arrhythmias and sudden death 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

Patent foramen ovale: the current state of play
Learning objectives Understand the anatomy and embryology of the interatrial septum and patent foramen ovale (PFO). Develop an overview of the many clinical associations of a PFO. Appraise the clinical evidence for and against closure of PFO. Introduction Patent foramen ovale (PFO) is a common finding, occurring in up to 25% of people.1 2 An association between PFO and stroke has consistently been seen in up to 50% of patients without an identifiable cause, that is, the so-called cryptogenic stroke (CS) and only in 20% with an identified cause.3 4 Many studies have been published testing the hypothesis that paradoxical emb...
Source: Heart - November 12, 2015 Category: Cardiology Authors: Asrress, K. N., Marciniak, M., Marciniak, A., Rajani, R., Clapp, B. Tags: Education in Heart, Echocardiography, Clinical diagnostic tests Source Type: research

Non-vitamin K antagonist oral anticoagulants (NOACs) for the management of venous thromboembolism
Learning objectives Understand the importance of venous thrombosis in cardiovascular medicine. Appreciate the mode of action of different oral anticoagulants. Recall the uses, risks and benefits of each non-vitamin K antagonist oral anticoagulants. Introduction Thrombosis is the common pathophysiology responsible for ischaemic heart disease, ischaemic stroke and venous thromboembolism (VTE), and a major contributor to the global disease burden.1 This effect is markedly more pronounced by considering the view that cancer is also a thrombotic disease.2 3 Cardiovascular disease (CVD, manifesting as acute coronary syndromes, m...
Source: Heart - June 5, 2016 Category: Cardiology Authors: Blann, A. D., Lip, G. Y. H. Tags: Education in Heart, Drugs: cardiovascular system, Acute coronary syndromes, Venous thromboembolism, Epidemiology Source Type: research

Carotid artery stenting
Learning objectives After reading this article the reader should:Know the appropriate diagnostic workup for patients with carotid artery disease. Be able to put in perspective, based on strengths and limitations, the results of randomised trials comparing carotid artery stenting and carotid endarterectomy. Be able to identify patients that may benefit from carotid artery stenting. Introduction In western countries, stroke is the fourth leading cause of death, after heart disease, cancer and chronic respiratory diseases.1 Carotid artery disease may be responsible for 10–15% of all ischaemic strokes.2 Randomised contro...
Source: Heart - June 9, 2016 Category: Cardiology Authors: Roffi, M., Kulcsar, Z., Carrera, E., Cremonesi, A. Tags: Education in Heart, Drugs: cardiovascular system, Interventional cardiology, Epidemiology, Tobacco use Source Type: research

Contemporary management of persistent atrial fibrillation
Learning objectives Develop a basic understanding of the underlying mechanisms of atrial fibrillation and classification of the disease. Review the main principles in contemporary management of atrial fibrillation with a focus on persistent atrial fibrillation. Discuss catheter ablation in the context of atrial fibrillation. Introduction Atrial fibrillation (AF) is a multisystemic disorder that is associated with an excess risk of stroke, heart failure and mortality.1 It remains the most common sustained arrhythmia and its significance should not be underestimated. Research focused on unveiling the mechanisms of AF began o...
Source: Heart - December 22, 2021 Category: Cardiology Authors: Gupta, D., Ding, W. Y. Tags: Education in Heart Source Type: research

Proteomics profiling reveals a distinct high-risk molecular subtype of hypertrophic cardiomyopathy
Conclusions Our prospective plasma proteomics study not only exhibited the presence of HCM molecular subtypes but also identified pathobiological mechanisms associated with a distinct high-risk subtype of HCM.
Source: Heart - October 28, 2022 Category: Cardiology Authors: Liang, L. W., Raita, Y., Hasegawa, K., Fifer, M. A., Maurer, M. S., Reilly, M. P., Shimada, Y. J. Tags: Heart failure and cardiomyopathies Source Type: research

Not to be sneezed at: cardiovascular disease after COVID-19 infection
COVID-19 has changed our way of life since it was first identified in December of 2019. While our understanding of the manifestations and outcomes of the immediate acute illness has improved, we are still learning about the medium to long-term impact of this diagnosis on patients’ health. For some time, it has been suggested that COVID-19 may be associated with incident cardiovascular events such as venous thromboembolism, stroke and myocardial infarction.1 However, the absolute risk of these events and whether an excess risk is present are challenging to determine without a contemporary reference population. This is...
Source: Heart - December 22, 2022 Category: Cardiology Authors: Bularga, A., Newby, D. E., Chapman, A. R. Tags: Press releases, COVID-19 Editorials Source Type: research

Prediction of short-term atrial fibrillation risk using primary care electronic health records
Conclusions FIND-AF, a machine learning algorithm applicable at scale in routinely collected primary care data, identifies people at higher risk of short-term AF.
Source: Heart - June 26, 2023 Category: Cardiology Authors: Nadarajah, R., Wu, J., Hogg, D., Raveendra, K., Nakao, Y. M., Nakao, K., Arbel, R., Haim, M., Zahger, D., Parry, J., Bates, C., Cowan, C., Gale, C. P. Tags: Open access, Editor's choice Arrhythmias and sudden death Source Type: research

Systolic blood pressure, chronic obstructive pulmonary disease and cardiovascular risk
Conclusion Using deep learning for modelling EHR, we identified a monotonic association between SBP and risk of cardiovascular events in patients with COPD.
Source: Heart - July 27, 2023 Category: Cardiology Authors: Rao, S., Nazarzadeh, M., Li, Y., Canoy, D., Mamouei, M., Salimi-Khorshidi, G., Rahimi, K. Tags: Open access Cardiac risk factors and prevention Source Type: research