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Total 262 results found since Jan 2013.

Allopurinol reduces brachial and central blood pressure, and carotid intima-media thickness progression after ischaemic stroke and transient ischaemic attack: a randomised controlled trial
Conclusions Allopurinol lowered CBP and reduced CIMT progression at 1 year compared with placebo in patients with recent ischaemic stroke and TIA. This extends the evidence of sustained beneficial effects of allopurinol to these prognostically significant outcomes and to the stroke population, highlighting the potential for reduction in cardiovascular events with this treatment strategy. Trial registration number ISRCTN11970568.
Source: Heart - June 21, 2014 Category: Cardiology Authors: Higgins, P., Walters, M. R., Murray, H. M., McArthur, K., McConnachie, A., Lees, K. R., Dawson, J. Tags: Hypertension, Epidemiology Cardiac risk factors and prevention Source Type: research

Risk of left atrial appendage thrombus and stroke in patients with atrial fibrillation and mitral regurgitation
Conclusions Among patients with NVAF, the presence or severity of MR was not associated with a decreased risk of LAAT or stroke.
Source: Heart - December 10, 2021 Category: Cardiology Authors: Melduni, R., Nkomo, V. T., Wysokinski, W., Gersh, B. J., Deshmukh, A., Padang, R., Greene, E. L., Oh, J. K., Lee, H.-C. Tags: Arrhythmias and sudden death Source Type: research

Rivaroxaban and other novel anticoagulants for stroke prevention in atrial fibrillation: time to embrace the future
Atrial fibrillation (AF) is now said to be at epidemic proportions.1 Although symptoms and heart failure are two of the main reasons that patients with AF suffer from reduced quality of life, thromboembolic complications, particularly stroke, remain the major determinant of significant morbidity and mortality.2 Importantly, the risk of thromboembolism (TE) is completely irrespective of symptoms, and hence the sad fact that people continue to present with catastrophic stroke in AF with no prior history of its detection.3 Appropriate anticoagulation is imperative to reduce the TE/stroke risk. Numerous large scale studies hav...
Source: Heart - February 18, 2013 Category: Cardiology Authors: Rajappan, K. Tags: Drugs: cardiovascular system, Epidemiology Editorials Source Type: research

RV stroke work in children with pulmonary arterial hypertension: estimation based on invasive haemodynamic assessment and correlation with outcomes
Conclusions RVSW can be estimated in children with PAH, and is significantly associated with abnormal WHO class, the need for septostomy, as well as mortality. Indices accounting for RV performance as well as ventricular-vascular coupling may be useful in the prognosis and, hence, management of children with PAH.
Source: Heart - August 6, 2014 Category: Cardiology Authors: Di Maria, M. V., Younoszai, A. K., Mertens, L., Landeck, B. F., Ivy, D. D., Hunter, K. S., Friedberg, M. K. Tags: Congenital heart disease, Drugs: cardiovascular system, Echocardiography, Hypertension, Clinical diagnostic tests, Epidemiology Pulmonary vascular disease Source Type: research

To occlude or not? Left atrial appendage occlusion for stroke prevention in atrial fibrillation
The cornerstone of atrial fibrillation (AF) management is effective stroke prevention, which by now remains the only proven method of improved survival in patients with AF. Oral anticoagulation with the use of vitamin K antagonists (eg, warfarin) or non-vitamin K antagonist oral anticoagulants (NOACs) has been shown to substantially reduce the risk of AF-related strokes and thus is presently the standard of care for stroke prevention in non-valvular AF. Approximately 90% of thrombi being formed in AF are localised in left atrial appendage (LAA).1 Thus, LAA exclusion seems a tempting method of prophylaxis against stroke, pa...
Source: Heart - January 4, 2017 Category: Cardiology Authors: Mazurek, M., Lip, G. Y. H. Tags: Drugs: cardiovascular system, Epidemiology Editorials Source Type: research

Net clinical benefit of warfarin in individuals with atrial fibrillation across stroke risk and across primary and secondary care
Conclusions CHA2DS2-VASc accurately stratifies IS risk in individuals with AF across both primary and secondary care. However, the incidence rate of ischaemic stroke at CHA2DS2-VASc=1 are lower than previously reported, which may change the decision to start anticoagulation with warfarin in these individuals.
Source: Heart - January 12, 2017 Category: Cardiology Authors: Allan, V., Banerjee, A., Shah, A. D., Patel, R., Denaxas, S., Casas, J.-P., Hemingway, H. Tags: Open access, Drugs: cardiovascular system, Epidemiology Arrhythmias and sudden death Source Type: research

Dual potential embolic source detected in left atrium during hyperacute stroke
Clinical introduction A woman in her late 60s with a medical history of hypertension presented to the emergency department with symptoms of a stroke which began 40 min prior. Brain MRI was performed (figure 1A). Hyperacute CT angiography of the head and neck did not find any atherosclerosis. ECG is shown (figure 1B), and subsequent transthoracic echocardiography showed left atrium enlargement and left-to-right flow at the region of the fossa ovalis (figure 1C). Figure 1Brain MRI of diffusion-weighted image sequence (A), ECG (B), and transthoracic echocardiogram (C). Question Which of the following is the most likely mechan...
Source: Heart - September 13, 2023 Category: Cardiology Authors: Fu, Z., Xu, C., Gao, L. Tags: Image challenges Source Type: research

Recent advances in the epidemiology, outcome, and prevention of myocardial infarction and stroke in sub-Saharan Africa
The early part of the new millennium witnessed reports of a growing burden of cardiovascular disease in Sub-Saharan Africa (SSA). However the contribution of ischemic heart disease and stroke to this increasing burden relative to that caused by hypertensive heart disease, cardiomyopathy and rheumatic heart disease was not clear. Over the last decade, data from the continent has begun to clarify this issue and suggests three main points. The burden of ischemic heart disease relative to other causes of heart disease remains low particularly in the black Africans majority. Stroke caused predominantly by hypertension is now a ...
Source: Heart - August 2, 2013 Category: Cardiology Authors: Ntsekhe, M., Damasceno, A. Tags: Drugs: cardiovascular system, Hypertension, Acute coronary syndromes, Epidemiology Global burden of cardiovascular disease Source Type: research

Preserved stroke volume late after tetralogy repair, despite severe right ventricular dilatation
The Authors’ reply We would like to thank Drs Masutani and Senzaki for their comments1 and Heart for the opportunity to respond. As stated in our study2, we did not find a significant difference in left ventricular (LV) volumes or function in patients with repaired tetralogy of Fallot (TOF) either above or below an indexed right ventricular (RV) end-diastolic volume of 150 mL/m2. We observed that as the RV became more dilated, the progressive increase in RV stroke volume was associated with lower RV ejection fraction in the more dilated group but was largely explained by increased indexed RV end-systolic volume....
Source: Heart - November 20, 2013 Category: Cardiology Authors: O'Meagher, S., Celermajer, D. S., Puranik, R. Tags: PostScript Source Type: research

Survival by stroke volume index in patients with low-gradient normal EF severe aortic stenosis
Conclusions Lower SVI is incrementally associated with mortality in LG severe AS with preserved EF. These findings have implications for classification of AS severity, identification of high-risk groups and subsequent management.
Source: Heart - December 12, 2014 Category: Cardiology Authors: Eleid, M. F., Sorajja, P., Michelena, H. I., Malouf, J. F., Scott, C. G., Pellikka, P. A. Tags: Editor's choice, Drugs: cardiovascular system, Echocardiography, Aortic valve disease, Clinical diagnostic tests, Epidemiology Valvular heart disease Source Type: research

Survival by stroke volume index in low-gradient normal EF severe aortic stenosis: insights into myocardial systolic dysfunction
To the Editor, We read with interest the recent article on survival by stroke volume index (SVI) in patients with low-gradient normal EF severe aortic stenosis, which demonstrated lower SVI is incrementally associated with mortality.1 The authors discuss a putative mechanism of low stroke volume (SV) secondary to concentric remodelling which results in reduced LV cavity size. This impedes LV diastolic filling culminating in diminished systolic function despite normal EF. The authors quote evidence of systolic impairment, for example reduced longitudinal strain, in similar cohorts with preserved EF.2 In the current study, t...
Source: Heart - December 12, 2014 Category: Cardiology Authors: Rodrigues, J. C. L., Dastidar, A. G., Rohan, S., MacIver, D. H. Tags: PostScript Source Type: research

Early detection of occult atrial fibrillation and stroke prevention
Atrial fibrillation (AF) is a very common arrhythmia and significantly increases stroke risk. This risk can be mitigated with oral anticoagulation, but AF is often asymptomatic, or occult, preventing timely detection and treatment. Accordingly, occult AF may cause stroke before it is clinically diagnosed. Currently, guidelines for the early detection and treatment of occult AF are limited. This review addresses recent advancements in occult AF detection methods, identification of populations at high risk for occult AF, the treatment of occult AF with oral anticoagulation, as well as ongoing trials that may answer criticall...
Source: Heart - June 25, 2015 Category: Cardiology Authors: Keach, J. W., Bradley, S. M., Turakhia, M. P., Maddox, T. M. Tags: Review articles Reviews Source Type: research

Heartbeat: Left atrial appendage occlusion for stroke prevention
Stroke prevention is the primary goal of therapy in patients with atrial fibrillation (AF).1 Heart has published numerous papers on early AF detection,2 approaches for restoring normal sinus rhythm, risk scores for determining which AF patients benefit most from anti-thrombotic therapy, and transcatheter occlusion of the left atrial appendage (LAA) to prevent thrombus formation.3–6 Early studies of LAA occlusion compared this procedure to vitamin K antagonist (VKA) therapy for stroke prevention. Now, direct oral anticoagulants (DOACs) have replaced VKA therapy in many AF patients due to an improved risk/benefit profi...
Source: Heart - January 4, 2017 Category: Cardiology Authors: Otto, C. M. Tags: Heartbeat Source Type: research

Heartbeat: sex disparities in stroke, heart failure and all-cause mortality in adults with coronary heart disease
Research on sex disparities in patients with coronary heart disease (CHD) largely has focused on events directly related to the coronary arteries themselves—recurrent myocardial infarction, revascularisation and cardiovascular death—rather than the wider consequences of atherosclerotic vascular disease. In contrast, Akyea and colleagues1 evaluated sex disparities across a broader range of major adverse cardiovascular events (MACE) including not only recurrent CHD, but also stroke, peripheral vascular disease, heart failure and all-cause mortality in a population-based cohort of 143 702 adults (median age 73 yea...
Source: Heart - December 10, 2021 Category: Cardiology Authors: Otto, C. M. Tags: Heartbeat Source Type: research

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