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Total 262 results found since Jan 2013.

The key role of the RV in the pathogenesis of acute pulmonary oedema
Dear Editor, The article entitled ‘The pathophysiology of hypertensive acute heart failure’1 provides an excellent contemporary review of mechanisms involved in the development of acute pulmonary oedema (APO). We wish to highlight the potential important role of the RV in the pathogenesis of APO.2 APO is often thought to result from backward pressure where a disease of the LV causes the LV end-diastolic pressure (LVEDP) to rise, resulting in elevated pulmonary venous pressure and, hence, pulmonary capillary hydrostatic pressure. However, an increase in a given pressure can only occur if pressure energy is added...
Source: Heart - November 12, 2015 Category: Cardiology Authors: MacIver, D. H., Clark, A. L. Tags: PostScript Source Type: research

Cost-effectiveness of percutaneous coronary intervention versus bypass surgery from a Dutch perspective
Conclusions For the broad population with three-vessel or left main disease who are candidates for either CABG or PCI, we found that CABG is a clinically and economically attractive revascularisation strategy compared with DES-PCI from a Dutch healthcare perspective. The cost-effectiveness of CABG versus PCI differed according to several anatomic factors, however. The newly developed SYNTAX Score II provides enhanced prognostic discrimination in this population, and may be a useful tool to guide resource allocation as well. Trial registration number Clinical trial unique identifier: NCT00114972 (http://www.clinical-trials.gov)
Source: Heart - November 26, 2015 Category: Cardiology Authors: Osnabrugge, R. L., Magnuson, E. A., Serruys, P. W., Campos, C. M., Wang, K., van Klaveren, D., Farooq, V., Abdallah, M. S., Li, H., Vilain, K. A., Steyerberg, E. W., Morice, M.-C., Dawkins, K. D., Mohr, F. W., Kappetein, A. P., Cohen, D. J., on behalf of Tags: Health policy, Drugs: cardiovascular system, Interventional cardiology, Acute coronary syndromes, Percutaneous intervention, Epidemiology Coronary artery disease Source Type: research

Ischaemic stroke after ST-elevation myocardial infarction
Clinical introduction A 67-year-old Hispanic man presented with 5-h history of typical chest pain and an ECG consistent with inferior ST-elevation myocardial infarction (STEMI). Coronary angiography revealed an occluded proximal right coronary artery, and a percutaneous intervention with drug eluting stent was performed. He was started on aspirin and clopidogrel. Two weeks later, he was admitted with loss of consciousness, tonic-clonic seizure and urinary incontinence. On physical examination, he was unresponsive to tactile stimuli. Cardiac examination revealed a prominent left ventricular heave. Neurological examination s...
Source: Heart - December 11, 2015 Category: Cardiology Authors: Al-Ansari, Y., Otalvaro, L., Damluji, A. A. Tags: Drugs: cardiovascular system, Echocardiography, Image challenges, Acute coronary syndromes, Clinical diagnostic tests Source Type: research

Inflammatory biomarkers in atrial fibrillation: are they linked to future outcomes?
Atrial fibrillation (AF), the most common arrhythmia in the elderly, is an independent risk factor for stroke and death. There is increasing evidence that inflammation contributes to the pathogenesis of AF. Association between high-sensitivity C-reactive protein (hs-CRP) and AF has been well described, both experimentally and clinically, and studies have shown that hs-CRP and interleukin 6 (IL-6) levels are higher in patients with AF than in control patients.1–3 Incremental elevation of hs-CRP has been observed in both paroxysmal and persistent AF.1–3 Furthermore, levels of both inflammatory CRP and IL-6 have b...
Source: Heart - March 11, 2016 Category: Cardiology Authors: Okumura, Y. Tags: Drugs: cardiovascular system, Acute coronary syndromes, Epidemiology Editorials Source Type: research

Safety and efficacy of ticagrelor and clopidogrel in primary percutaneous coronary intervention
Conclusions In the subset of patients with STEMI treated with primary PCI, ticagrelor compared with clopidogrel was safe, and efficacy outcomes were consistent with the overall PLATO trial. Trial registration number NCT00391872; Results.
Source: Heart - March 22, 2016 Category: Cardiology Authors: Velders, M. A., Abtan, J., Angiolillo, D. J., Ardissino, D., Harrington, R. A., Hellkamp, A., Himmelmann, A., Husted, S., Katus, H. A., Meier, B., Schulte, P. J., Storey, R. F., Wallentin, L., Gabriel Steg, P., James, S. K., on behalf of the PLATO Investi Tags: Drugs: cardiovascular system, Interventional cardiology, Acute coronary syndromes, Percutaneous intervention, Venous thromboembolism Coronary artery disease Source Type: research

Global longitudinal strain is associated with heart failure outcomes in hypertrophic cardiomyopathy
Conclusions In patients with HCM, reduced GLS is an independent factor associated with poor cardiac outcomes, and particularly HF outcomes.
Source: Heart - April 24, 2016 Category: Cardiology Authors: Reant, P., Mirabel, M., Lloyd, G., Peyrou, J., Lopez Ayala, J.-M., Dickie, S., Bulluck, H., Captur, G., Rosmini, S., Guttmann, O., Demetrescu, C., Pantazis, A., Tome-Esteban, M., Moon, J. C., Lafitte, S., McKenna, W. J. Tags: Hypertrophic cardiomyopathy, Drugs: cardiovascular system, Echocardiography, Clinical diagnostic tests Heart failure and cardiomyopathies Source Type: research

Using electronic health records to predict costs and outcomes in stable coronary artery disease
Conclusions Existing EHRs may be used to estimate lifetime healthcare costs and outcomes of patients with stable-CAD. The stable-CAD model developed in this study lends itself to informing decisions about commissioning, pricing and reimbursement. At current prices, to be cost-effective some established as well as future stable-CAD treatments may require stratification by patient risk.
Source: Heart - April 24, 2016 Category: Cardiology Authors: Asaria, M., Walker, S., Palmer, S., Gale, C. P., Shah, A. D., Abrams, K. R., Crowther, M., Manca, A., Timmis, A., Hemingway, H., Sculpher, M. Tags: Health policy, Open access, Drugs: cardiovascular system, Acute coronary syndromes Coronary artery disease Source Type: research

Ticagrelor and aspirin for the prevention of cardiovascular events after coronary artery bypass graft surgery
Conclusions Ticagrelor added to aspirin after CABG reduced the proportion of patients with graft occlusion, and was a significant univariate and multivariable predictor of graft occlusion. These results are hypothesis-generating and should be confirmed in larger studies. Trial registration number NCT01373411: Results.
Source: Heart - April 24, 2016 Category: Cardiology Authors: Saw, J., Wong, G. C., Mayo, J., Bernstein, V., Mancini, G. B. J., Ye, J., Skarsgard, P., Starovoytov, A., Cairns, J. Tags: Drugs: cardiovascular system, Interventional cardiology, Acute coronary syndromes, Clinical diagnostic tests, Epidemiology Coronary artery disease Source Type: research

Heartbeat: Go with the flow in aortic stenosis?
Aortic valve stenosis (AS), at the simplest level, is mechanical obstruction to left ventricular (LV) outflow with severity best described by the high velocity or pressure gradient across the valve or the small valve opening area. More recently, the importance of adverse left ventricular (LV) changes in patients with aortic valve disease has led to a new classification of AS to include measures of LV function and volume flow rate as follows: (1) high gradient severe AS with a transvalvular velocity ≥4 m/s or mean gradient ≥40 mm Hg, (2) low-flow low-gradient severe AS with reduced ejection fraction (<50%), an...
Source: Heart - June 5, 2016 Category: Cardiology Authors: Otto, C. M. Tags: Drugs: cardiovascular system, Echocardiography, Aortic valve disease, Clinical diagnostic tests, Epidemiology Heartbeat Source Type: research

Echocardiographic predictors of outcomes in adults with aortic stenosis
Conclusions The most powerful echocardiographic predictors of mortality are low LVEF and low flow, whereas AS severity parameters predict valve-related events but not overall mortality. Hence, low flow should be integrated in the risk stratification and therapeutic decision-making in patients with AS.
Source: Heart - June 5, 2016 Category: Cardiology Authors: Capoulade, R., Le Ven, F., Clavel, M.-A., Dumesnil, J. G., Dahou, A., Thebault, C., Arsenault, M., O'Connor, K., Bedard, E., Beaudoin, J., Senechal, M., Bernier, M., Pibarot, P. Tags: Editor's choice, Drugs: cardiovascular system, Echocardiography, Aortic valve disease, Clinical diagnostic tests, Epidemiology Valvular heart disease Source Type: research

Heartbeat: Lonely Hearts
Loneliness and social isolation are associated with an increased risk of premature mortality. This association is related to several factors including behaviors (such as smoking or physical inactivity), reduced psychological well-being, and adverse physiological changes (such as altered immune function and hypertension). In order to better define the magnitude of risk for incident cardiovascular disease attributable to loneliness and social isolation, Valtorta and colleagues (see page 1009) performed a meta-analysis of 16 longitudinal databases with a total of 4628 coronary heart disease (CHD) events and 3002 strokes over ...
Source: Heart - June 9, 2016 Category: Cardiology Authors: Otto, C. M. Tags: Drugs: cardiovascular system, Hypertension, Acute coronary syndromes, Epidemiology, Tobacco use Heartbeat Source Type: research

Loneliness and social isolation as risk factors for CVD: implications for evidence-based patient care and scientific inquiry
Loneliness and social isolation as risk factors for CVD A recent meta-analysis has shown that loneliness and social isolation are risk factors for coronary heart disease and stroke.1 These latest findings, specific to cardiovascular outcomes, are consistent with substantial research indicating broad health risks (eg, immune functioning, cardiovascular functioning, cognitive decline) associated with the quantity and quality of social relationships—including several meta-analyses documenting mortality risk.2 3 In the most comprehensive of these,3 the overall odds for mortality was 1.50, similar to the risk from light s...
Source: Heart - June 9, 2016 Category: Cardiology Authors: Holt-Lunstad, J., Smith, T. B. Tags: Open access, Press releases, Drugs: cardiovascular system, Hypertension, Epidemiology, Tobacco use Editorials 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

Cardiovascular highlights from non-cardiology journals
Transcatheter aortic valve implantation in intermediate risk patients Transcatheter aortic valve implantation (TAVI) has had a major impact on both morbidity and mortality in high-risk and inoperable patients with severe aortic stenosis. Robust evidence has supported widespread adoption in this patient group but uncertainty exists as to whether TAVI may also achieve clinical equipoise with surgical aortic valve replacement (AVR) in lower risk groups. In the industry sponsored PARTNER 2 trial, patients deemed at intermediate surgical risk (generally with an STS score between 4 and 8) were randomized to either TAVI with the ...
Source: Heart - July 25, 2016 Category: Cardiology Authors: McCabe, J. M. Tags: Journal scan 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 10, 2016 Category: Cardiology Authors: Güngör, B. Tags: Drugs: cardiovascular system, Hypertension, Acute coronary syndromes, Epidemiology, Diabetes, Metabolic disorders Editorials Source Type: research