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Joshua C Reynolds, Brian E Grunau, Jon C Rittenberger, Kelly N Sawyer, Michael C Kurz, Clifton W Callaway
BACKGROUND: -Little evidence guides the appropriate duration of resuscitation in out-of-hospital cardiac arrest (OHCA), and case features justifying longer or shorter durations are ill-defined. We estimated the impact of resuscitation duration on the probability of favorable functional outcome in OHCA using a large, multi-center cohort. METHODS: -Secondary analysis of a North American, single blind, multi-center, cluster-randomized clinical trial (ROC-PRIMED) of consecutive adults with non-traumatic, EMS-treated, OHCA...
October 19, 2016: Circulation
Daniel J Friedman, Haikun Bao, Erica S Spatz, Jeptha P Curtis, James P Daubert, Sana M Al-Khatib
BACKGROUND: -A prolonged PR interval is common among cardiac resynchronization therapy (CRT) candidates; however, the association between PR interval and outcomes is unclear, and data are conflicting. METHODS: -We conducted inverse probability weighted (IPW) analyses of 26,451 CRT eligible (EF≤35, QRS≥120ms) patients from the National Cardiovascular Data Registry ICD Registry to assess the association between a prolonged PR interval (≥230ms), receipt of CRT with defibrillator (CRT-D) versus implantable cardioverter defibrillator (ICD), and outcomes...
October 19, 2016: Circulation
Zahir H Alshehry, Piyushkumar A Mundra, Christopher K Barlow, Natalie A Mellett, Gerard Wong, Malcolm J McConville, John Simes, Andrew M Tonkin, David R Sullivan, Elizabeth H Barnes, Paul J Nestel, Bronwyn A Kingwell, Michel Marre, Bruce Neal, Neil R Poulter, Anthony Rodgers, Bryan Williams, Sophia Zoungas, Graham S Hillis, John Chalmers, Mark Woodward, Peter J Meikle
BACKGROUND: -Clinical lipid measurements do not show the full complexity of the altered lipid metabolism associated with diabetes or cardiovascular disease. Lipidomics enables the assessment of hundreds of lipid species as potential markers for disease risk. METHODS: -Plasma lipid species (310) were measured by a targeted lipidomic analysis with liquid chromatography electrospray ionisation-tandem mass spectrometry on a case-cohort (n=3,779) subset from the ADVANCE (Action in Diabetes and Vascular disease: preterAx and diamicroN-MR Controlled Evaluation) trial...
October 18, 2016: Circulation
Raimund Pechlaner, Stefan Kiechl, Manuel Mayr
Since the seminal publications from the Framingham study in the mid-sixties,(1) the measurement of lipid levels, mainly of total cholesterol, total triglycerides, and LDL and HDL cholesterol, is routine clinical practice for cardiovascular disease (CVD) and lipid-lowering therapy. A more detailed assessment of the lipid composition, that is, the molecular species that constitute the lipid classes is not widely used, mainly due to the caveats of assessing the lipidome. The human lipidome is estimated to include thousands of molecular lipid species with functional diversity...
October 18, 2016: Circulation
Catriona Syme, Simon Czajkowski, Jean Shin, Michal Abrahamowicz, Gabriel Leonard, Michel Perron, Louis Richer, Suzanne Veillette, Daniel Gaudet, Lisa Strug, Yun Wang, Hongbin Xu, Graeme Taylor, Tomáš Paus, Steffany Bennett, Zdenka Pausova
BACKGROUND: -Glycerophosphocholine (GPC) metabolites modulate atherosclerosis and thus risk for cardiovascular disease (CVD). Pre-clinical CVD may start during adolescence. Here, we used targeted serum lipidomics to identify a new panel of GPCs, and tested whether any of these GPCs are associated - in adolescence - with classical risk factors of CVD, namely excess visceral fat (VF), elevated BP, insulin resistance and atherogenic dyslipidemia. METHODS: -We studied a population-based sample of 990 adolescents (12-18 years, 48% male), as part of the Saguenay Youth Study...
October 18, 2016: Circulation
Demosthenes G Katritsis, Joseph E Marine, Fernando M Contreras, Akira Fujii, Rakesh Latchamsetty, Konstantinos C Siontis, George D Katritsis, Theodoros A Zografos, Roy M John, Laurence M Epstein, Gregory F Michaud, Elad Anter, Ali Sepahpour, Edward Rowland, Alfred E Buxton, Hugh Calkins, Fred Morady, William G Stevenson, Mark E Josephson
BACKGROUND: -Due to its low prevalence, data on atypical atrioventricular nodal reentrant tachycardia (AVNRT) are scarce, and the optimal ablation method is not established. Our study aimed at assessing the efficacy and safety of conventional slow pathway ablation, as applied for typical cases, in atypical AVNRT. METHODS: -We studied 2079 patients with AVNRT subjected to slow pathway ablation. In 113 patients, mean age 48.5±18.1 years, 68 female, atypical AVNRT or co-existent atypical and typical AVNRT without other concomitant arrhythmia was diagnosed...
October 17, 2016: Circulation
John W Pickering, Jaimi H Greenslade, Louise Cullen, Dylan Flaws, William Parsonage, Sally Aldous, Peter George, Andrew Worster, Peter A Kavsak, Martin P Than
BACKGROUND: -The European Society of Cardiology (ESC) new guidelines to rule-in and rule-out acute myocardial infarction (AMI) in the emergency department (ED) include a rapid assessment algorithm based on high-sensitivity cardiac troponin and sampling at zero and one hour. ED physicians require very high sensitivity to confidently rule-out AMI, while cardiologists aim to minimise false positive results. METHODS: -High-sensitivity troponin I (hs-cTnI) and T (hs-cTnT) assays were used to measure troponin concentrations in patients presenting with chest-pain symptoms and being investigated for possible acute coronary syndrome at hospitals in New Zealand, Australia and Canada...
October 17, 2016: Circulation
Allan S Jaffe, Harvey D White
High sensitivity cardiac troponin (hscTn) assays are used everywhere except in the United States.(1) One potential advantage of these assays is the ability to triage patients with possible ischemia more rapidly and, there is an understandable desire to find easy, facile algorithms to do this. This was the approach taken with hscTn in the evaluation of patients with possible acute myocardial infarction (AMI) using an algorithm developed by the Advantageous Predictors of Acute Coronary Syndromes Evaluation (APACE) trial...
October 17, 2016: Circulation
Barbara S Wiggins, Joseph J Saseen, Robert L Page, Brent N Reed, Kevin Sneed, John B Kostis, David Lanfear, Salim Virani, Pamela B Morris
No abstract text is available yet for this article.
October 17, 2016: Circulation
Niels B Matthiesen, Tine Henriksen, Peter Agergaard, William J Gaynor, Cathrine C Bach, Vibeke Hjortdal, John Ostergaard
BACKGROUND: -Congenital heart defects (CHD) have been associated with placental anomalies. The nature and the consequences of this association remain poorly understood. We aimed to estimate the associations between all major subtypes of CHD and placental weight at birth as well as the association between placental weight and measures of both overall and cerebral growth in fetuses with CHD. METHODS: -We included all 924,422 liveborn Danish singletons, 1997-2011. CHD was present in 7,569...
October 14, 2016: Circulation
Jia-Ling Ruan, Nathaniel L Tulloch, Maria V Razumova, Mark Saiget, Veronica Muskheli, Lil Pabon, Hans Reinecke, Michael Regnier, Charles E Murry
BACKGROUNDS: -Tissue engineering enables the generation of functional human cardiac tissue using cells derived in vitro in combination with biocompatible materials. Human induced pluripotent stem cell (hiPSC)-derived cardiomyocytes provide a cell source for cardiac tissue engineering; however, their immaturity limits their potential applications. Here we sought to study the effect of mechanical conditioning and electrical pacing on the maturation of hiPSC-derived cardiac tissues. METHODSS: -Cardiomyocytes derived from hiPSCs were used to generate collagen-based bioengineered human cardiac tissue...
October 13, 2016: Circulation
Kyle B Walsh, Daniel Woo, Padmini Sekar, Jennifer Osborne, Charles J Moomaw, Carl D Langefeld, Opeolu Adeoye
BACKGROUND: -Hypertension is a significant risk factor for intracerebral hemorrhage (ICH). While ethnic/racial disparities related to hypertension and ICH have been reported, these previous studies were limited by a lack of Hispanics and inadequate power to analyze by ICH location. In the current study, while overcoming these prior limitations, we investigated whether there was variation by ethnicity/race of treated and untreated hypertension as risk factors for ICH. METHODS: -The Ethnic/Racial Variations of ICH (ERICH) study is a prospective, multicenter, case-control study of ICH among whites, blacks, and Hispanics...
October 13, 2016: Circulation
Monika M Safford
Although it makes up only 15-20% of all strokes, intracerebral hemorrhage (ICH) is a particularly lethal form of this potentially disabling condition. A recent meta-analysis of 122 studies concluded that the 1-year survival following ICH was 46%, and the 5-year survival was only 29%.(1) Furthermore, quality of life for survivors is often very limited.(2) A thorough understanding of how to prevent these events is therefore a high priority.In this issue of Circulation, the study by Walsh and colleagues sheds light on several important findings that suggest where attention should be directed to prevent these types of strokes...
October 13, 2016: Circulation
Walter R Wilson, Thomas C Bower, Mark A Creager, Sepideh Amin-Hanjani, Patrick T O'Gara, Peter B Lockhart, Rabih O Darouiche, Basel Ramlawi, Colin P Derdeyn, Ann F Bolger, Matthew E Levison, Kathryn A Taubert, Robert S Baltimore, Larry M Baddour
No abstract text is available yet for this article.
October 13, 2016: Circulation
Davide Capodanno, Dominick J Angiolillo
Daily administration of low-dose of aspirin has proven to be beneficial in preventing recurrent cardiovascular events. However, the role of aspirin for primary prevention in patients with no overt cardiovascular disease is more controversial. In fact, in lower risk patients, the modest benefit in reducing serious vascular events can be offset by the increased risk of bleeding, including intracranial and gastrointestinal hemorrhage. Diabetes mellitus (DM) has been associated with a substantially increased risk of both first and recurrent atherothrombotic events, which makes aspirin therapy of potential value in these subjects...
October 11, 2016: Circulation
Liesl Zühlke, Ganesan Karthikeyan, Mark E Engel, Sumathy Rangarajan, Pam Mackie, Blanche Cupido, Katya Mauff, Shofiqul Islam, Rezeen Daniels, Veronica Francis, Stephen Ogendo, Bernard Gitura, Charles Mondo, Emmy Okello, Peter Lwabi, Mohammed M Al-Kebsi, Christopher Hugo-Hamman, Sahar S Sheta, Abraham Haileamlak, Wandimu Daniel, Dejuma Yadeta Goshu, Senbeta G Abdissa, Araya G Desta, Bekele A Shasho, Dufera M Begna, Ahmed ElSayed, Ahmed S Ibrahim, John Musuku, Fidelia Bode-Thomas, Christopher C Yilgwan, Ganiyu A Amusa, Olukemi Ige, Basil Okeahialam, Christopher Sutton, Rajeev Misra, Azza Abul Fadl, Neil Kennedy, Albertino Damasceno, Mahmoud U Sani, Okechukwu S Ogah, Taiwo Olunuga, Huda ElHassan, Ana Olga Mocumbi, Abiodun M Adeoye, Pindile S Mntla, Dike B Ojji, Joseph Mucumbitsi, Koon Teo, Salim Yusuf, Bongani M Mayosi
BACKGROUND: -There are few contemporary data on the mortality and morbidity associated with rheumatic heart disease (RHD) or information on their predictors. We report the two year follow-up of individuals with RHD from 14 low and middle income countries in Africa and Asia. METHODS: -Between January 2010 and November 2012, we enrolled 3343 patients from 25 centers in 14 countries and followed them for two years to assess mortality, congestive heart failure (CHF), stroke or transient ischemic attack (TIA), recurrent acute rheumatic fever (ARF), and infective endocarditis (IE)...
October 4, 2016: Circulation
Adam S Helms, Francisco J Alvarado, Jaime Yob, Vi T Tang, Francis Pagani, Mark W Russell, Héctor H Valdivia, Sharlene M Day
BACKGROUND: -Aberrant calcium signaling may contribute to arrhythmias and adverse remodeling in hypertrophic cardiomyopathy (HCM). Mutations in sarcomere genes may distinctly alter calcium handling pathways. METHODS: -We analyzed gene expression, protein levels, and functional assays for calcium regulatory pathways in human HCM surgical samples with (n=25) and without (n=10) sarcomere mutations compared with control hearts (n=8). RESULTS: -Gene expression and protein levels for calsequestrin, L-type calcium channel, sodium-calcium exchanger, phospholamban (PLN), calcineurin, and calcium/calmodulin-dependent protein kinase type II (CaMKII) were similar in HCM compared to controls...
September 29, 2016: Circulation
Sara B Seidelmann, Brian Claggett, Paco E Bravo, Ankur Gupta, Hoshang Farhad, Barbara E Klein, Ronald Klein, Marcelo F Di Carli, Scott D Solomon
BACKGROUND: -Narrower retinal arterioles and wider retinal venules have been associated with negative cardiovascular outcomes. We investigated whether retinal vessel calibers are associated with cardiovascular outcomes in long-term follow-up and provide incremental value over the 2013 American College of Cardiology/American Heart Association pooled cohort equations (PCE) in predicting Atherosclerotic Cardiovascular Disease Events (ASCVE). METHODS: -10,470 men and women without prior ASCVE or heart failure (HF) in the Atherosclerosis Risk in Communities (ARIC) study underwent retinal photography at visit 3 (1993-1995)...
September 28, 2016: Circulation
Xueli Yang, Jianxin Li, Dongsheng Hu, Jichun Chen, Ying Li, Jianfeng Huang, Xiaoqing Liu, Fangchao Liu, Jie Cao, Chong Shen, Ling Yu, Fanghong Lu, Xianping Wu, Liancheng Zhao, Xigui Wu, Dongfeng Gu
BACKGROUND: -The accurate assessment of individual risk can be of great value to guiding and facilitating prevention of atherosclerotic cardiovascular disease (ASCVD). However, prediction models in common use were primarily formulated in white populations. The project is aimed to develop and validate ten-year risk prediction equations for ASCVD from four contemporary Chinese cohorts. METHODS: -Two prospective studies followed up together with a unified protocol were used as the derivation cohort to develop 10-year ASCVD risk equations in 21 320 Chinese participants...
September 28, 2016: Circulation
Jesper K Jensen
Population ageing and improvements in survival after cardiovascular disease have contributed to worldwide increases in the number of patients with established cardiovascular disease. The importance of ischemic heart disease is attested to by the almost epidemic number of persons afflicted with more than 16 million Americans suffering from ischemic heart disease.(1) Despite a decline in the mortality, ischemic heart disease is now the leading cause of death worldwide, which according to estimates from The World Health Organization will rise to 11...
September 28, 2016: Circulation
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