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Total 262 results found since Jan 2013.

Contemporary evaluation and management of lower extremity peripheral artery disease
Peripheral artery disease (PAD) includes atherosclerosis of the aorta and lower extremities. Affecting a large segment of the population, PAD is associated with impaired functional capacity and reduced quality of life as well as an increased risk of stroke, myocardial infarction and cardiovascular death. The evaluation of PAD begins with the physical examination, incorporating non-invasive testing such as ankle-brachial indices to confirm the diagnosis. Therapeutic interventions are aimed at alleviating symptoms while preserving limb integrity and reducing overall cardiovascular risk. With this in mind, risk factor modific...
Source: Heart - August 23, 2016 Category: Cardiology Authors: Foley, T. R., Armstrong, E. J., Waldo, S. W. Tags: Review articles Reviews Source Type: research

Catheter ablation for atrial fibrillation in hypertrophic cardiomyopathy: a systematic review and meta-analysis
Conclusions The observed complication rate of catheter ablation of AF in patients with HCM was low. Even though the risk of relapse is twofold higher, catheter ablation can be effective in patients with HCM and AF, particularly in patients with paroxysmal AF and smaller atria.
Source: Heart - September 12, 2016 Category: Cardiology Authors: Providencia, R., Elliott, P., Patel, K., McCready, J., Babu, G., Srinivasan, N., Bronis, K., Papageorgiou, N., Chow, A., Rowland, E., Lowe, M., Segal, O. R., Lambiase, P. D. Tags: Tachyarrhythmias, Editor's choice, Hypertrophic cardiomyopathy, Drugs: cardiovascular system, Clinical diagnostic tests Heart failure and cardiomyopathy Source Type: research

Histology of debris captured by a cerebral protection system during transcatheter valve-in-valve implantation
Conclusions Transcatheter VIV procedures were associated with the release of particulate debris into the cerebral circulation in all patients. The type of debris suggests that debris originates predominantly from arterial and valvular passage of the THV.
Source: Heart - September 12, 2016 Category: Cardiology Authors: Schmidt, T., Schlüter, M., Alessandrini, H., Akdag, O., Schewel, D., Schewel, J., Thielsen, T., Kreidel, F., Bader, R., Romero, M., Ladich, E., Virmani, R., Schäfer, U., Kuck, K.-H., Frerker, C. Tags: Aortic and vascular disease Source Type: research

Cardiovascular events and all-cause mortality with insulin versus glucagon-like peptide-1 analogue in type 2 diabetes
Conclusions In this cohort of obese people with T2DM, intensification of dual oral therapy by adding GLP-1ar analogue is associated with a lower MACE outcome in routine clinical practice, compared with adding insulin therapy as the third glucose-lowering agent.
Source: Heart - September 12, 2016 Category: Cardiology Authors: Anyanwagu, U., Mamza, J., Mehta, R., Donnelly, R., Idris, I. Tags: Drugs: cardiovascular system, Acute coronary syndromes, Epidemiology, Diabetes, Metabolic disorders Healthcare delivery, economics and global health Source Type: research

Cardiovascular highlights from non-cardiology journals
Cholesterol Lowering in Intermediate-risk Persons without Cardiovascular Disease Implementation of statin therapy in practice for primary prevention of cardiovascular disease is controversial due to concerns over costs and side-effects with broader use and uncertainty regarding LDL goals in the primary prevention population. Previous primary prevention trials suggest a reduction in cardiovascular outcomes in largely white patients with significant risk factors for coronary disease. The HOPE-3 trial randomized a diverse population of 12,000 individuals over 55 years of age (women over 60) with 1–2 relatively modest ri...
Source: Heart - September 12, 2016 Category: Cardiology Authors: Kearney, K., McCabe, J. M. Tags: Journal scan Source Type: research

On the use of genetic risk scores to predict cardiovascular disease in the general population
Using genetic information to predict the risk of common diseases has been the holy grail of several groups working in genetics of common human diseases.1 Results up to now have been contradictory and subject to widely different interpretations: from sheer enthusiasm to deep pessimism. While great success has been obtained in the identification of several hundreds of genetic markers robustly and consistently associated with a wide range of human quantitative phenotypes, for the majority of these genetic variants, no clear translation into a better prediction capacity has been shown. In their Heart publication, Morris et al2...
Source: Heart - September 26, 2016 Category: Cardiology Authors: Pereira, A. C. Tags: Drugs: cardiovascular system, Hypertension, Epidemiology Editorials 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

Direct oral anticoagulants: unique properties and practical approaches to management
Since 2009, four direct oral anticoagulants (DOACs) have been introduced for treatment of venous thromboembolism and stroke prevention in non-valvular atrial fibrillation. While they are currently first-line therapy for a majority of patients, there are a number of clinical situations where warfarin is preferable. In both randomised trials and real-world populations, use of DOACs significantly reduces the risk of intracranial haemorrhage as compared with warfarin. While drug-specific reversal agents are currently only available for dabigatran, andexanet alpha is pending approval for reversal of factor Xa inhibitors, reduci...
Source: Heart - September 26, 2016 Category: Cardiology Authors: Barnes, G. D., Kurtz, B. Tags: Review articles Reviews Source Type: research

Hypertrophic cardiomyopathy and the potential influence of etomidate on postoperative outcomes
This study showed no difference in what they defined as ‘hard outcomes’ such as myocardial infarction, stroke and death. They did however show an increased incidence of composite end points (10%; p=0.03) such as postoperative congestive heart failure (1%) and readmission rates (7%). One interesting point that we would like to raise is the significantly higher use of etomidate in the HCM cohort (p=0.002). Understandably, etomidate was chosen in many cases for its rapid onset and stable haemodynamic properties. This was likely reflected in the significantly lower incidence of intraoperative tachycardia and hypote...
Source: Heart - October 25, 2016 Category: Cardiology Authors: White, L. D., Vlok, R., Chong, C., Melhuish, T. M. Tags: PostScript Source Type: research

Antithrombotic drug use: scientific breakthroughs, biological limits and physician behaviour
During the past 25 years, there has been a dramatic surge in the use of antithrombotic drugs as documented in the Heart paper by Adelborg et al.1 The authors derived their findings from the Danish drug utilisation database, which is unique in its comprehensiveness and ability to capture over-the-counter aspirin. The increased prescription of antithrombotic drugs is fuelled by a better understanding of disease and risk, population growth, ageing societies, improved methods of detection, and rising global rates of obesity, a recognised risk factor for atrial fibrillation (AF), venous thromboembolic (VTE) disease, and ca...
Source: Heart - November 10, 2016 Category: Cardiology Authors: Hylek, E. M. Tags: Drugs: cardiovascular system, Venous thromboembolism, Epidemiology Editorials Source Type: research

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

Relationship between aetiology and left ventricular systolic dysfunction in hypertrophic cardiomyopathy
Conclusions In adults with HCM, LV systolic dysfunction is more frequent in those with rare phenocopies. When combined with age at presentation, it is a marker for specific aetiologies and is associated with poorer long-term survival.
Source: Heart - January 26, 2017 Category: Cardiology Authors: Rosmini, S., Biagini, E., O'Mahony, C., Bulluck, H., Ruozi, N., Lopes, L. R., Guttmann, O., Reant, P., Quarta, C. C., Pantazis, A., Tome-Esteban, M., Mckenna, W. J., Rapezzi, C., Elliott, P. M. Tags: Hypertrophic cardiomyopathy, Drugs: cardiovascular system, Echocardiography, Interventional cardiology, Clinical diagnostic tests, Epidemiology, Metabolic disorders Heart failure and cardiomyopathies Source Type: research

Pre-procedural dual antiplatelet therapy in patients undergoing transcatheter aortic valve implantation increases risk of bleeding
Conclusions The current study demonstrated that DAPT before TF-TAVI increased the risk of bleeding compared with single or no antiplatelet therapy. Lower intensity antiplatelet therapy was not associated with thrombotic events. In modern practice, it might be reasonable to perform TAVI using single or no pre-procedural antiplatelet therapy with an expectation of no increase of adverse events. Trial registration number UMIN-ID; 000020423; Results.
Source: Heart - February 15, 2017 Category: Cardiology Authors: Hioki, H., Watanabe, Y., Kozuma, K., Nara, Y., Kawashima, H., Kataoka, A., Yamamoto, M., Takagi, K., Araki, M., Tada, N., Shirai, S., Yamanaka, F., Hayashida, K., And on behalf of OCEAN-TAVI investigators Tags: Valvular heart disease Source Type: research

Stop vasodepressor drugs in reflex syncope: a randomised controlled trial
Conclusions Recurrence of syncope and presyncope can be reduced by discontinuing/reducing vasoactive therapy in most elderly patients affected by reflex vasodepressor syncope. Trial registration number NCT01509534; EudraCT2013-004364-63; Results.
Source: Heart - February 26, 2017 Category: Cardiology Authors: Solari, D., Tesi, F., Unterhuber, M., Gaggioli, G., Ungar, A., Tomaino, M., Brignole, M. Tags: Drugs: cardiovascular system, Hypertension, Acute coronary syndromes, Epidemiology Special populations Source Type: research

Cardiovascular highlights from non-cardiology journals
Continuous positive airway pressure fails to improve cardiovascular outcomes in obstructive sleep apnea Obstructive sleep apnea (OSA) is associated with increased cardiovascular events in observational studies. Randomized trials have demonstrated continuous positive airway pressure (CPAP) therapy reduces blood pressure, markers of oxidative stress and insulin insensitivity. Yet, it remains unclear whether treatment with CPAP reduces cardiovascular events. In the largest study of its kind, 2717 patients aged 45 to 75 years with moderate-to-severe OSA and coronary or cerebrovascular disease were randomized in open-label fash...
Source: Heart - March 12, 2017 Category: Cardiology Authors: McCabe, J. M. Tags: Journal scan Source Type: research