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Circulation

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https://www.readbyqxmd.com/read/28082387/high-intensity-interval-training-in-heart-failure-patients-with-reduced-ejection-fraction
#1
Øyvind Ellingsen, Martin Halle, Viviane M Conraads, Asbjørn Støylen, Håvard Dalen, Charles Delagardelle, Alf-Inge Larsen, Torstein Hole, Alessandro Mezzani, Emeline M Van Craenenbroeck, Vibeke Videm, Paul J Beckers, Jeffrey W Christle, Ephraim B Winzer, Norman Mangner, Felix Woitek, Robert Höllriegel, Axel P Pressler, Tea Monk-Hansen, Martin Snoer, Patrick Feiereisen, Torstein Valborgland, John K Kjekshus, Rainer Hambrecht, Stephan Gielen, Trine Karlsen, Eva B Prescott, Axel Linke
BACKGROUND: -Small studies have suggested that high intensity interval training (HIIT) is superior to moderate continuous training (MCT) in reversing cardiac remodeling and increasing aerobic capacity in heart failure patients with reduced ejection fraction (HFrEF). The present multicenter trial compared 12 weeks supervised interventions of HIIT, MCT, or a recommendation of regular exercise (RRE). METHODS: -261 patients with LVEF ≤35% and NYHA II-III were randomly assigned to HIIT at 90-95% of maximal heart rate (HRmax), MCT at 60-70% of HRmax or RRE...
January 12, 2017: Circulation
https://www.readbyqxmd.com/read/28082386/population-based-long-term-cardiac-specific-mortality-among-34-489-five-year-survivors-of-childhood-cancer-in-great-britain
#2
Miranda M Fidler, Raoul C Reulen, Katherine E Henson, Julie Kelly, David Cutter, Gill A Levitt, Clare Frobisher, David L Winter, Michael M Hawkins
BACKGROUND: -Increased risks of cardiac morbidity and mortality among childhood cancer survivors have been described previously. However, little is known about the very long-term risks of cardiac mortality and whether the risk has decreased among those more recently diagnosed. We investigated the risk of long-term cardiac mortality among survivors within the recently extended British Childhood Cancer Survivor Study. METHODS: -The British Childhood Cancer Survivor Study is a population-based cohort of 34,489 five-year survivors of childhood cancer diagnosed from 1940-2006 and followed up until February 28, 2014, and is the largest cohort to date to assess late cardiac mortality...
January 12, 2017: Circulation
https://www.readbyqxmd.com/read/28082385/management-of-pregnancy-in-patients-with-complex-congenital-heart-disease-a-scientific-statement-for-healthcare-professionals-from-the-american-heart-association
#3
Mary M Canobbio, Carole A Warnes, Jamil Aboulhosn, Heidi M Connolly, Amber Khanna, Brian J Koos, Seema Mital, Carl Rose, Candice Silversides, Karen Stout
Today, most female children born with congenital heart disease will reach childbearing age. For many women with complex congenital heart disease, carrying a pregnancy carries a moderate to high risk for both the mother and her fetus. Many such women, however, do not have access to adult congenital heart disease tertiary centers with experienced reproductive programs. Therefore, it is important that all practitioners who will be managing these women have current information not only on preconception counseling and diagnostic evaluation to determine maternal and fetal risk but also on how to manage them once they are pregnant and when to refer them to a regional center with expertise in pregnancy management...
January 12, 2017: Circulation
https://www.readbyqxmd.com/read/28073805/sheet-like-remodeling-of-the-transverse-tubular-system-in-human-heart-failure-impairs-excitation-contraction-coupling-and-functional-recovery-by-mechanical-unloading
#4
Thomas Seidel, Sutip Navankasattusas, Azmi A Ahmad, Nikolaos A Diakos, Weining D Xu, Martin Tristani-Firouzi, Michael Bonios, Iosif Taleb, Dean Y Li, Craig H Selzman, Stavros G Drakos, Frank B Sachse
BACKGROUND: -Cardiac recovery in response to mechanical unloading by left ventricular assist devices (LVADs) has been demonstrated in subgroups of chronic heart failure (HF) patients. Hallmarks of HF are depletion and disorganization of the transverse tubular system (t-system) in cardiomyocytes. Here, we investigated remodeling of the t-system in human end-stage HF and its role in cardiac recovery. METHODS: -Left ventricular biopsies were obtained from 5 donors (CTRL) and 26 chronic HF patients undergoing implantation of LVADs...
January 10, 2017: Circulation
https://www.readbyqxmd.com/read/28052979/prevalence-incidence-and-mortality-of-stroke-in-china-results-from-a-nationwide-population-based-survey-of-480-687-adults
#5
Wenzhi Wang, Bin Jiang, Haixin Sun, Xiaojuan Ru, Dongling Sun, Linhong Wang, Limin Wang, Yong Jiang, Yichong Li, Yilong Wang, Zhenghong Chen, Shengping Wu, Yazhuo Zhang, David Wang, Yongjun Wang, Valery L Feigin
BACKGROUND: -China bears the biggest stroke burden in the world. However, little is known about the current prevalence, incidence, and mortality of stroke at the national level, and the trend in the last 30 years. METHODS: -In 2013 a nationally-representative door-to-door survey was conducted in 155 urban and rural centres in 31 provinces in China, totalling 480,687 adults aged ≥20 years. All stroke survivors were considered as prevalent stroke cases at the prevalent time (August 31, 2013)...
January 4, 2017: Circulation
https://www.readbyqxmd.com/read/28052978/the-diabetic-hfpef-phenotype-is-it-real-and-is-it-worth-targeting-therapeutically
#6
Brian R Lindman
For investigators, physicians, and patients, the inability to identify therapies to improve clinical outcomes, particularly mortality, in patients with heart failure with preserved ejection fraction (HFpEF) has been particularly vexing and stands in stark contrast to the progress made in the treatment of patients with heart failure with reduced ejection fraction (HFrEF). This has prompted a return to the proverbial drawing board, forcing a reconsideration of long-held assumptions and paradigms. Despite different underlying etiologies, patients with HFrEF are generally responsive to several classes of medications that target the neurohormonal axis...
January 4, 2017: Circulation
https://www.readbyqxmd.com/read/28052977/clinical-and-echocardiographic-characteristics-and-cardiovascular-outcomes-according-to-diabetes-status-in-patients-with-heart-failure-and-preserved-ejection-fraction-a-report-from-the-irbesartan-in-heart-failure-with-preserved-ejection-fraction-trial-i-preserve
#7
Søren L Kristensen, Ulrik M Mogensen, Pardeep S Jhund, Mark C Petrie, David Preiss, Sithu Win, Lars Køber, Robert S McKelvie, Michael R Zile, Inder S Anand, Michel Komajda, John S Gottdiener, Peter E Carson, John J V McMurray
BACKGROUND: -In patients with HF and preserved ejection fraction (HFpEF), little is known about the characteristics of and outcomes in those with and without diabetes. METHODS: -We examined clinical and echocardiographic characteristics and outcomes in the Irbesartan in Heart Failure with Preserved Ejection Fraction trial (I-Preserve), according to history of diabetes. Cox regression models were used to estimate hazard ratios (HR) for cardiovascular outcomes adjusted for known predictors, including age, sex, natriuretic peptides, and comorbidity...
January 4, 2017: Circulation
https://www.readbyqxmd.com/read/28039229/the-role-of-diastolic-stress-testing-in-the-evaluation-for-hfpef-a-simultaneous-invasive-echocardiographic-study
#8
Masaru Obokata, Garvan C Kane, Yogesh N V Reddy, Thomas P Olson, Vojtech Melenovsky, Barry A Borlaug
BACKGROUND: -Diagnosis of heart failure (HF) with preserved ejection fraction (HFpEF) is challenging and relies largely on demonstration of elevated cardiac filling pressures (pulmonary capillary wedge pressure, PCWP). Current guidelines recommend use of natriuretic peptides (NT-proBNP) and rest/exercise echocardiography (E/e' ratio) to make this determination. Data to support this practice is conflicting. METHODS: -Simultaneous echocardiographic-catheterization studies were prospectively conducted at rest and during exercise in subjects with invasively-proven HFpEF (n=50) and participants with dyspnea but no identifiable cardiac pathology (n=24)...
December 30, 2016: Circulation
https://www.readbyqxmd.com/read/28034902/risk-factors-for-coarctation-of-the-aorta-on-prenatal-ultrasound-a-systematic-review-and-meta-analysis
#9
Alessandra Familiari, Maddalena Morlando, Asma A Khalil, Sonesson Sven-Erik, Carolina Scala, Giuseppe Rizzo, Gelsomina Del Sordo, Chiara Vassallo, Maria Elena Flacco, Lamberto Manzoli, Antonio Lanzone, Giovanni Scambia, Ganesh Acharya, Francesco D'Antonio
BACKGROUND: -Prenatal diagnosis of Coarctation of the Aorta (CoA) is still challenging and affected by high rates of false positive diagnoses. The aim of this study was to ascertain the strength of association and to quantify the diagnostic accuracy of different ultrasound signs in predicting CoA prenatally. METHODS: -Medline, Embase, CINAHL and Cochrane databases were searched. Random-effect and HSROC model meta-analyses were used to analyse the data. RESULTS: -794 articles were identified and 12 (922 fetuses at risk for CoA) were included...
December 29, 2016: Circulation
https://www.readbyqxmd.com/read/28034899/comparison-of-the-efficacy-and-safety-of-early-rule-out-pathways-for-acute-myocardial-infarction
#10
Andrew R Chapman, Atul Anand, Jasper Boeddinghaus, Amy V Ferry, Dennis Sandeman, Philip D Adamson, Jack P Andrews, Stephanie Tan, Sheun F Cheng, Michelle D'Souza, Kate Orme, Fiona E Strachan, Thomas Nestelberger, Raphael Twerenbold, Patrick Badertscher, Tobias Reichlin, Alasdair Gray, Anoop S V Shah, Christian Mueller, David E Newby, Nicholas L Mills
BACKGROUND: -High-sensitivity cardiac troponin assays enable myocardial infarction to be ruled out earlier, but the optimal approach is uncertain. We compared the European Society of Cardiology (ESC) rule-out pathway, with a pathway that incorporates lower cardiac troponin concentrations to risk stratify patients. METHODS: -Patients with suspected acute coronary syndrome (n=1,218) underwent high-sensitivity cardiac troponin I measurement at presentation, 3 and 6 or 12 hours...
December 29, 2016: Circulation
https://www.readbyqxmd.com/read/28034901/body-mass-index-and-mortality-among-adults-undergoing-cardiac-surgery-a-nationwide-study-with-a-systematic-review-and-meta-analysis
#11
Giovanni Mariscalco, Marcin J Woźniak, Alan G Dawson, Giuseppe F Serraino, Richard Porter, Mintu Nath, Catherine Klersy, Tracy Kumar, Gavin J Murphy
BACKGROUND: -In an apparent paradox morbidity and mortality are lower in obese patients undergoing cardiac surgery, although the nature of this association is unclear. We sought to determine whether the obesity paradox observed in cardiac surgery is attributable to reverse epidemiology, bias, or confounding. METHODS: -Data from the National Adult Cardiac Surgery registry for all cardiac surgical procedures performed between April 2002 and March 2013 were extracted...
December 28, 2016: Circulation
https://www.readbyqxmd.com/read/28031423/neurologic-injury-and-cerebral-blood-flow-in-single-ventricles-throughout-staged-surgical-reconstruction
#12
Mark A Fogel, Christine J Li, Okan U Elci, Tom Pawlowski, Peter J Schwab, Felice B Wilson, Susan C Nicolson, Lisa M Montenegro, Laura Diaz, Thomas L Spray, J William Gaynor, Stephanie Fuller, Christopher E Mascio, Marc S Keller, Matthew A Harris, Kevin K Whitehead, James Bethel, Arastoo Vossough, Daniel J Licht
BACKGROUND: -Single ventricle patients experience a high rate of brain injury and adverse neurodevelopmental outcome, however, the incidence of brain abnormalities throughout surgical reconstruction and its relationship with cerebral blood flow, oxygen delivery and carbon dioxide reactivity remains unknown. METHODS: -Single ventricle patients were studied with MRI scans immediately prior to bidirectional Glenn (pre-BDG), prior to Fontan and then 3-9 months after Fontan reconstruction...
December 28, 2016: Circulation
https://www.readbyqxmd.com/read/28028005/releasing-the-brakes-on-the-fibrinolytic-system-in-pulmonary-emboli-unique-effects-of-plasminogen-activation-and-%C3%AE-2-antiplasmin-inactivation
#13
Satish Singh, Aiilyan K Houng, Guy L Reed
BACKGROUND: -In patients with hemodynamically significant pulmonary embolism, physiologic fibrinolysis fails to dissolve thrombi acutely and recombinant tissue plasminogen activator (r-tPA) therapy may be required, despite its bleeding risk. To examine potential mechanisms, we analyzed the expression of key fibrinolytic molecules in experimental pulmonary emboli, assessed the contribution of α2-antiplasmin to fibrinolytic failure and compared the effects of plasminogen activation and α2-antiplasmin-inactivation on experimental thrombus dissolution and bleeding...
December 27, 2016: Circulation
https://www.readbyqxmd.com/read/27998940/recommendations-for-the-implementation-of-telehealth-in-cardiovascular-and-stroke-care-a-policy-statement-from-the-american-heart-association
#14
Lee H Schwamm, Neale Chumbler, Ed Brown, Gregg C Fonarow, David Berube, Karin Nystrom, Robert Suter, Mirian Zavala, Daniel Polsky, Kavita Radhakrishnan, Nathaniel Lacktman, Katherine Horton, Mary-Beth Malcarney, John Halamka, A Colby Tiner
The aim of this policy statement is to provide a comprehensive review of the scientific evidence evaluating the use of telemedicine in cardiovascular and stroke care and to provide consensus policy suggestions. We evaluate the effectiveness of telehealth in advancing healthcare quality, identify legal and regulatory barriers that impede telehealth adoption or delivery, propose steps to overcome these barriers, and identify areas for future research to ensure that telehealth continues to enhance the quality of cardiovascular and stroke care...
December 20, 2016: Circulation
https://www.readbyqxmd.com/read/27993908/implantable-cardioverter-defibrillator-for-non-ischemic-cardiomyopathy-an-updated-meta-analysis
#15
Harsh Golwala, Navkaranbir Singh Bajaj, Garima Arora, Pankaj Arora
Use of Implantable cardioverter-defibrillators (ICD) have been a major advancement in patients with ischemic cardiomyopathy (ICM) with reduced ejection fraction <35%.(1) While the data supporting the use of ICDs are robust in patients with ICM, limited randomized controlled clinical trial (RCT) data exist for similar benefit in patients with non-ischemic cardiomyopathy (NICM).(2) A prior meta-analysis that included both primary and secondary prevention ICD trials in 2004 by Desai et al. demonstrated a 31% reduction in all-cause mortality with ICD use in patients with NICM...
December 19, 2016: Circulation
https://www.readbyqxmd.com/read/27986651/effects-of-pcsk9-inhibition-with-alirocumab-on-lipoprotein-metabolism-in-healthy-humans
#16
Gissette Reyes-Soffer, Marianna Pavlyha, Colleen Ngai, Tiffany Thomas, Stephen Holleran, Rajasekhar Ramakrishnan, Wahida Karmally, Renu Nandakumar, Nelson Fontanez, Joseph C Obunike, Santica M Marcovina, Alice H Lichtenstein, Nirupa R Matthan, James Matta, Magali Maroccia, Frederic Becue, Franck Poitiers, Brian Swanson, Lisa Cowan, William J Sasiela, Howard K Surks, Henry N Ginsberg
BACKGROUND: -Alirocumab, a monoclonal antibody to proprotein convertase subtilisin/kexin type 9 (PCSK9), lowers plasma low density lipoprotein cholesterol (LDL-C) and apolipoprotein B100 (apoB). Although studies in mice and cells have identified increased hepatic LDL receptors as the basis for LDL lowering by PCSK9 inhibitors, there have been no human studies characterizing the effects of PCSK9 inhibitors on lipoprotein metabolism. In particular, it is not known if inhibition of PCSK9 has any effects on very low density lipoprotein (VLDL) or intermediate density lipoprotein (IDL) metabolism...
December 16, 2016: Circulation
https://www.readbyqxmd.com/read/27979875/predictors-of-death-in-contemporary-adult-patients-with-eisenmenger-syndrome-a-multicentre-study
#17
Aleksander Kempny, Cristel S Hjortshøj, Hong Gu, Wei Li, Alexander R Opotowsky, Michael Landzberg, Annette S Jensen, Lars Søndergaard, Mette-Elise Estensen, Ulf Thilén, Werner Budts, Barbara J Mulder, Ilja M Blok, Lidia Tomkiewicz-Pajak, Kamil Szostek, Michele D'Alto, Giancarlo Scognamiglio, Katja Prokšelj, Gerhard-Paul Diller, Konstantinos Dimopoulos, Stephen J Wort, Michael A Gatzoulis
BACKGROUND: -Eisenmenger syndrome (ES) is associated with substantial morbidity and mortality. There is no consensus, however, on mortality risk stratification. We aimed to investigate survival and predictors of death in a large, contemporary cohort of ES patients. METHODS: -We identified in a multicentre approach adults with ES under follow-up between 2000 and 2015. We examined survival and its association with clinical, electrocardiographic, echocardiographic and laboratory parameters...
December 15, 2016: Circulation
https://www.readbyqxmd.com/read/27974350/genetic-obesity-and-the-risk-of-atrial-fibrillation-causal-estimates-from-mendelian-randomization
#18
Neal A Chatterjee, Franco Giulianini, Bastiaan Geelhoed, Kathryn L Lunetta, Jeffrey R Misialek, Maartje N Niemeijer, Michiel Rienstra, Lynda M Rose, Albert V Smith, Dan E Arking, Patrick T Ellinor, Jan Heeringa, Honghuang Lin, Steven A Lubitz, Elsayed Z Soliman, Niek Verweij, Alvaro Alonso, Emelia J Benjamin, Vilmundur Gudnason, Bruno H Stricker, Pim van der Harst, Daniel I Chasman, Christine M Albert
BACKGROUND: -Observational studies have identified an association between body mass index (BMI) and incident atrial fibrillation (AF). Inferring causality from observational studies, however, is subject to residual confounding, reverse causation, and bias. The primary objective of this study was to evaluate the causal association between BMI and AF using genetic predictors of BMI. METHODS: -We identified 51 646 individuals of European ancestry without AF at baseline from seven prospective population-based cohorts initiated between 1987 and 2002 in the United States, Iceland, and the Netherlands with incident AF ascertained between 1987 and 2012...
December 14, 2016: Circulation
https://www.readbyqxmd.com/read/27965285/the-impact-of-ct-perfusion-imaging-on-the-response-to-tenecteplase-in-ischemic-stroke-analysis-of-two-randomized-controlled-trials
#19
Andrew Bivard, Xuya Huang, Patrick McElduff, Christopher R Levi, Bruce C V Campbell, Bharath Kumar Cheripelli, Dheeraj Kalladka, Fiona C Moreton, Ian Ford, Christopher F Bladin, Stephen M Davis, Geoffrey A Donnan, Keith W Muir, Mark W Parsons
BACKGROUND: -We pooled two clinical trials of tenecteplase compared with alteplase for the treatment of acute ischemic stroke, one demonstrating superiority of tenecteplase, while the other showed no difference between the treatments on patient clinical outcomes. We tested the hypotheses that reperfusion therapy with tenecteplase would be superior to alteplase in improving functional outcome in the group of patients with target mismatch as identified with advanced imaging. METHODS: -We investigated if tenecteplase treated patients had a different 24h reduction in the National Institutes of Health Stroke Scale (NIHSS) and a favourable odds ratio of a modified Rankin scale (mRS) of 0-1vs 2-6 compared with alteplase treated patients using linear regression to generate odds ratios (OR)...
December 13, 2016: Circulation
https://www.readbyqxmd.com/read/27941066/thrombus-aspiration-in-st-elevation-myocardial-infarction-an-individual-patient-meta-analysis
#20
Sanjit S Jolly, Stefan K James, Vladimír Džavík, John A Cairns, Karim D Mahmoud, Felix Zijlstra, Salim Yusuf, Göran K Olivecrona, Henrik Renlund, Peggy Gao, Bo Lagerqvist, Ashraf Alazzoni, Sasko Kedev, Goran Stankovic, Brandi Meeks, Ole Frøbert
BACKGROUND: -Thrombus aspiration during percutaneous coronary intervention (PCI) for the treatment of ST elevation myocardial infarction (STEMI) has been widely used; however, recent trials have questioned its value and safety. In this meta-analysis, we, the trial investigators, aimed to pool the individual patient data from these trials to determine the benefits and risks of thrombus aspiration during PCI in patients with STEMI. METHODS: -Included were large (N≥1000) randomized controlled trials comparing manual thrombectomy vs...
December 9, 2016: Circulation
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