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Circulation

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https://www.readbyqxmd.com/read/29792299/a-simple-evidence-based-approach-to-help-guide-diagnosis-of-heart-failure-with-preserved-ejection-fraction
#1
Yogesh N V Reddy, Rickey E Carter, Masaru Obokata, Margaret M Redfield, Barry A Borlaug
Background -Diagnosis of heart failure with preserved ejection fraction (HFpEF) is challenging in euvolemic patients with dyspnea, and no evidence-based criteria are available. We sought to develop and then validate non-invasive diagnostic criteria that could be used to estimate the likelihood that HFpEF is present among patients with unexplained dyspnea in order to guide further testing. Methods -Consecutive patients with unexplained dyspnea referred for invasive hemodynamic exercise testing were retrospectively evaluated...
May 23, 2018: Circulation
https://www.readbyqxmd.com/read/29789303/-me_who-anatomy-of-scholastic-leadership-and-social-isolation-of-underrepresented-minority-women-in-academic-medicine
#2
Michelle A Albert
In academic medicine, under-represented minority women physician-scientists (URMWP)* are uncommon, particularly in leadership positions. Data from the American Association of Medical Colleges (AAMC) show that among internal medicine chairs, there are 12 Asian males, 10 African/American (blacks; 9 men), 7 Hispanics (2 females) and 137 whites (21 females). In the top 40 ranked cardiology programs, there are no female cardiology chiefs, whereas there are at least 10, 2, 1 and 24 Asian, black, Hispanic and white males respectively...
May 22, 2018: Circulation
https://www.readbyqxmd.com/read/29789302/fractional-flow-reserve-and-instantaneous-wave-free-ratio-as-predictors-of-the-placebo-controlled-response-to-percutaneous-coronary-intervention-in-stable-single-vessel-coronary-artery-disease-physiology-stratified-analysis-of-orbita
#3
Rasha Al-Lamee, James P Howard, Matthew J Shun-Shin, David Thompson, Hakim-Moulay Dehbi, Sayan Sen, Sukhjinder Nijjer, Ricardo Petraco, John Davies, Thomas Keeble, Kare Tang, Iqbal S Malik, Christopher Cook, Yousif Ahmad, Andrew S P Sharp, Robert Gerber, Christopher Baker, Raffi Kaprielian, Suneel Talwar, Ravi Assomull, Graham Cole, Niall G Keenan, Gajen Kanaganayagam, Joban Sehmi, Roland Wensel, Frank E Harrell, Jamil Mayet, Simon A Thom, Justin E Davies, Darrel P Francis
BACKGROUND : There are no data on how fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) are associated with the placebo-controlled efficacy of percutaneous coronary intervention (PCI) in stable single-vessel coronary artery disease. METHODS : We report the association between prerandomization invasive physiology within ORBITA (Objective Randomised Blinded Investigation With Optimal Medical Therapy of Angioplasty in Stable Angina), a placebo-controlled trial of patients who have stable angina with angiographically severe single-vessel coronary disease clinically eligible for PCI...
May 22, 2018: Circulation
https://www.readbyqxmd.com/read/29789301/orbita-2-bringing-some-oxygen-back-to-pci-in-stable-ischemic-heart-disease
#4
Ajay J Kirtane
With the presentation and publication of the ORBITA trial in late 2017,1 for the first time the cardiology community had the results of a blinded randomized trial examining the efficacy of percutaneous coronary intervention (PCI) for stable ischemic heart disease (SIHD). ORBITA was a mechanistic trial, carefully examining a host of endpoints in order to determine potentially measurable effects of PCI vs. a sham comparator at 6 weeks of follow-up. The trial was performed in 200 highly committed research subjects with single vessel SIHD who were treated within a protocol that put them on an average of ~3 antianginal medications, subjected them to serial assessments of symptom status and tests for ischemia, and led to multiple cardiac catheterization procedures (2 procedures for subjects in the PCI arm and 15% of the sham arm, and 3 procedures for the 85% of subjects in the sham arm who underwent post-study treatment with PCI)...
May 22, 2018: Circulation
https://www.readbyqxmd.com/read/29773586/seafood-long-chain-n-3-polyunsaturated-fatty-acids-and-cardiovascular-disease-a-science-advisory-from-the-american-heart-association
#5
REVIEW
Eric B Rimm, Lawrence J Appel, Stephanie E Chiuve, Luc Djoussé, Mary B Engler, Penny M Kris-Etherton, Dariush Mozaffarian, David S Siscovick, Alice H Lichtenstein
Since the 2002 American Heart Association scientific statement "Fish Consumption, Fish Oil, Omega-3 Fatty Acids, and Cardiovascular Disease," evidence from observational and experimental studies and from randomized controlled trials continues to emerge to further substantiate the beneficial effects of seafood long-chain n-3 polyunsaturated fatty acids and cardiovascular disease. A recent American Heart Association science advisory addressed the specific effect of n-3 polyunsaturated fatty acid supplementation on clinical cardiovascular events...
May 17, 2018: Circulation
https://www.readbyqxmd.com/read/29764898/clinical-presentation-and-outcome-in-a-contemporary-cohort-of-patients-with-acute-myocarditis-the-multicenter-lombardy-registry
#6
Enrico Ammirati, Manlio Cipriani, Claudio Moro, Claudia Raineri, Daniela Pini, Paola Sormani, Riccardo Mantovani, Marisa Varrenti, Patrizia Pedrotti, Cristina Conca, Antonio Mafrici, Aurelia Grosu, Daniele Briguglia, Silvia Guglielmetto, Giovanni Battista Perego, Stefania Colombo, Salvatore Ivan Caico, Cristina Giannattasio, Alberto Maestroni, Valentina Carubelli, Marco Metra, Carlo Lombardi, Jeness Campodonico, Piergiuseppe Agostoni, Giovanni Peretto, Laura Scelsi, Annalisa Turco, Giuseppe Di Tano, Carlo Campana, Armando Belloni, Fabrizio Morandi, Andrea Mortara, Antonio Cirò, Michele Senni, Antonello Gavazzi, Maria Frigerio, Fabrizio Oliva, Paolo G Camici
Background -There is controversy regarding outcome of patients with acute myocarditis (AM), and lack of data on how patients admitted with suspected AM are managed. We report characteristics, in-hospital management and long-term outcome of patients with AM based on a retrospective multi-center registry from 19 Italian hospitals. Methods -A total of 684 patients with suspected AM and recent onset of symptoms (<30 days) were screened between May 2001 and February 2017. Patients >70 years and those older than 50 years without coronary angiography were excluded...
May 15, 2018: Circulation
https://www.readbyqxmd.com/read/29764897/diagnostic-yield-of-genetic-testing-in-young-athletes-with-t-wave-inversion
#7
Nabeel Sheikh, Michael Papadakis, Mathew Wilson, Aneil Malhotra, Carmen Adamuz, Tessa Homfray, Lorenzo Monserrat, Elijah R Behr, Sanjay Sharma
Background -T-wave inversion (TWI) is common in patients with cardiomyopathy. However, up to 25% of athletes of African/Afro-Caribbean descent (black athletes) and 5% of white athletes also have TWI of unclear clinical significance despite comprehensive clinical evaluation and long-term follow-up. The aim of this study was to determine the diagnostic yield from genetic testing, beyond clinical evaluation, when investigating athletes with TWI. Methods -We investigated 50 consecutive asymptomatic black and 50 white athletes aged 14-35-years-old with TWI and a normal echocardiogram who were referred to a UK tertiary center for cardiomyopathy and sports cardiology...
May 15, 2018: Circulation
https://www.readbyqxmd.com/read/29752398/device-related-thrombus-after-left-atrial-appendage-closure-incidence-predictors-and-outcomes
#8
Srinivas R Dukkipati, Saibal Kar, David R Holmes, Shephal K Doshi, Vijendra Swarup, Douglas N Gibson, Brijeshwar Maini, Nicole T Gordon, Michael L Main, Vivek Y Reddy
Background -In patients with atrial fibrillation (AF), left atrial appendage closure (LAAC) with the Watchman device prevents thromboembolism from the LAA; however, thrombus may form on the left atrial face of the device, and then potentially embolize. Herein, we studied the incidence, predictors and clinical outcome of device-related thrombus (DRT) using a large series of clinical trial cohorts of patients undergoing Watchman implantation. Methods -We studied the device arms of 4 prospective FDA trials: PROTECT-AF (n=463); PREVAIL (n=269); CAP (n=566); CAP2 (n=578)...
May 11, 2018: Circulation
https://www.readbyqxmd.com/read/29748189/pacemaker-cybersecurity-local-experience-with-a-firmware-upgrade
#9
Adrian Baranchuk, Bryce Alexander, Debra Campbell, Sohaib Haseeb, Damian Redfearn, Chris Simpson, Ben Glover
In August 2016, Muddy Waters LLC released a short-sell report outlining potential cybersecurity vulnerabilities in several St. Jude Medical (now Abbott) pacemaker models following a demonstration of a "crash attack" and a "battery drain attack" by vulnerability research firm MedSec.1 The motivation behind the release of this report does not appear to have been focused on patient safety; rather than inform Abbott or the US Food and Drug Administration (FDA) directly, the information was released to the public sector...
May 10, 2018: Circulation
https://www.readbyqxmd.com/read/29748188/factors-influencing-the-decision-to-proceed-to-firmware-upgrades-to-implanted-pacemakers-for-cybersecurity-risk-mitigation
#10
Leslie A Saxon, Niraj Varma, Laurence M Epstein, Leonard I Ganz, Andrew E Epstein
In August 2017, the first major recall for cybersecurity vulnerabilities in pacemakers capable of remote connectivity was released that impacted 465,000 United States patients.1,2 The FDA approved a firmware update designed by the manufacturer of the devices as a remediation (Abbott , formally St. Jude Medical). The recall was in response to the public disclosure of vulnerability by an investment firm and produced in a lab environment that could allow an unauthorized party in close proximity to a patient to impact the performance of the device or modify device settings via radio frequency communication...
May 10, 2018: Circulation
https://www.readbyqxmd.com/read/29748187/complete-and-partial-lcat-deficiency-are-differentially-associated-with-atherosclerosis
#11
Federico Oldoni, Damiano Baldassarre, Samuala Castelnuovo, Alice Ossoli, Mauro Amato, Julian van Capelleveen, G Kees Hovingh, Eric de Groot, Andrea Bochem, Sara Simonelli, Simone Barbieri, Fabrizio Veglia, Guido Franceschini, Jan Albert Kuivenhoven, Adriaan G Holleboom, Laura Calabresi
Background -Lecithin:cholesterol acyltransferase (LCAT) is the sole enzyme that esterifies cholesterol in plasma. Its role in the supposed protection from atherogenesis remains unclear since mutations in LCAT causing Fish-Eye Disease (FED) or Familial LCAT Deficiency (FLD) have been reported to be associated with more or instead less carotid atherosclerosis, respectively. This discrepancy may be associated with the loss of cholesterol esterification on only apolipoprotein (apo) A-I (FED) or on both apoA-I and apoB-containing lipoproteins (FLD), an aspect that has thus far not been investigated...
May 10, 2018: Circulation
https://www.readbyqxmd.com/read/29748186/dicer-in-macrophages-prevents-atherosclerosis-by-promoting-mitochondrial-oxidative-metabolism
#12
Yuanyuan Wei, Judit Corbalán-Campos, Rashmi Gurung, Lucia Natarelli, Mengyu Zhu, Nicole Exner, Florian Erhard, Franziska Greulich, Claudia Geißler, N Henriette Uhlenhaut, Ralf Zimmer, Andreas Schober
Background -Alternative macrophage activation, which relies on mitochondrial oxidative metabolism, plays a central role in resolution of inflammation and prevents atherosclerosis. Moreover, macrophages handle large amounts of cholesterol and triglycerides derived from the engulfed modified lipoproteins during atherosclerosis. Although several microRNAs regulate macrophage polarization, the role of microRNA-generating enzyme Dicer in macrophage activation during atherosclerosis is unknown. Methods -To evaluate the role of Dicer in atherosclerosis, Apoe-/- mice with or without macrophage-specific Dicer deletion were fed a high-fat diet for 12 weeks...
May 10, 2018: Circulation
https://www.readbyqxmd.com/read/29748185/promoting-risk-identification-and-reduction-of-cardiovascular-disease-in-women-through-collaboration-with-obstetricians-and-gynecologists-a-presidential-advisory-from-the-american-heart-association-and-the-american-college-of-obstetricians-and-gynecologists
#13
REVIEW
Haywood L Brown, John J Warner, Eugenia Gianos, Martha Gulati, Alexandria J Hill, Lisa M Hollier, Stacey E Rosen, Mary L Rosser, Nanette K Wenger
No abstract text is available yet for this article.
May 10, 2018: Circulation
https://www.readbyqxmd.com/read/29739755/erv1-chemr23-signaling-protects-from-atherosclerosis-by-modifying-oxldl-uptake-and-phagocytosis-in-macrophages
#14
Andres Laguna-Fernandez, Antonio Checa, Miguel Carracedo, Gonzalo Artiach, Marcelo H Petri, Roland Baumgartner, Maria J Forteza, Xintong Jiang, Teodora Andonova, Mary E Walker, Jesmond Dalli, Hildur Arnardottir, Anton Gisterå, Silke Thul, Craig E Wheelock, Gabrielle Paulsson-Berne, Daniel F J Ketelhuth, Göran K Hansson, Magnus Bäck
Background -In addition to enhanced pro-inflammatory signaling, impaired resolution of vascular inflammation plays a key role in atherosclerosis. Pro-resolving lipid mediators formed through the 12/15 lipoxygenase pathways exert protective effects against murine atherosclerosis. n-3 polyunsaturated fatty acids, including eicosapentaenoic acid (EPA), serve as the substrate for the formation of lipid mediators, which transduce potent anti-inflammatory and pro-resolving actions through their cognate G-protein-coupled receptors...
May 8, 2018: Circulation
https://www.readbyqxmd.com/read/29735485/longitudinal-associations-of-smoke-free-policies-and-incident-cardiovascular-disease-cardia-study
#15
Stephanie L Mayne, Rachel Widome, Allison J Carroll, Pamela J Schreiner, Penny Gordon-Larsen, David R Jacobs, Kiarri N Kershaw
Background -Smoke-free legislation has been associated with lower rates of cardiovascular disease hospital admissions in ecological studies. However, prior studies lacked detailed information on individual-level factors (eg, sociodemographic and clinical characteristics) that could potentially confound associations. Our objective was to estimate associations of smoke-free policies with incident cardiovascular disease in a longitudinal cohort after controlling for sociodemographics, cardiovascular disease risk factors, and policy covariates...
May 7, 2018: Circulation
https://www.readbyqxmd.com/read/29735484/effect-of-an-sirna-therapeutic-targeting-pcsk9-on-atherogenic-lipoproteins-pre-specified-secondary-end-points-in-orion-1
#16
Kausik K Ray, Robert M Stoekenbroek, David Kallend, Lawrence A Leiter, Ulf Landmesser, R Scott Wright, Peter Wijngaard, John J Kastelein
Background -The ORION-1 trial demonstrated that inclisiran, a small interfering RNA (siRNA) therapeutic that targets PCSK9 mRNA within hepatocytes, produces significant LDL-C reduction. The effects of inclisiran on other lipids are less well described. Methods -ORION-1 was a phase 2 trial assessing 6 different inclisiran dosing regimens vs placebo. Participants with elevated LDL-C despite receiving maximally tolerated statin therapy received a single- (200, 300 or 500mg) or two-dose starting regimen (100, 200 or 300mg on days 1 and 90) of inclisiran or placebo...
May 7, 2018: Circulation
https://www.readbyqxmd.com/read/29720507/comprehensive-assessment-of-coronary-artery-disease-in-sports-related-sudden-cardiac-arrest
#17
Nicole Karam, Louis Pechmajou, Florence Dumas, Wulfran Bougouin, Ardalan Sharifzadehgan, Frankie Beganton, Guillaume Bonnet, Daniel Jost, Lionel Lamhaut, Olivier Varenne, Pierre Aubry, Georgios Sideris, Christian Spaulding, Alain Cariou, Eloi Marijon, Xavier Jouven
Despite the cardiovascular benefits of regular sports, sudden cardiac arrest (SCA) risk is increased during or shortly after exercise. Association with coronary artery disease (CAD) has been described in small studies, mainly autopsic with potential bias given the high sports-related SCA survival, and focusing on young competitive athletes, whereas sports-related SCA occurs mostly in recreational athletes.1-5 Through the Paris Sudden Death Expertise Center prospective registry that includes all SCAs in Paris and suburbs since May 2011, we performed the first broad comprehensive CAD description in sports-related SCAs, with a comparison with matched non-sports-related SCAs...
May 2, 2018: Circulation
https://www.readbyqxmd.com/read/29716942/mechanosensitive-gene-regulation-by-myocardin-related-transcription-factors-is-required-for-cardiomyocyte-integrity-in-load-induced-ventricular-hypertrophy
#18
Michael A Trembley, Pearl Quijada, Esperanza Agullo-Pascual, Kevin M Tylock, Mert Colpan, Ronald A Dirkx, Jason R Myers, Deanne M Mickelsen, Karen de Mesy Bentley, Eli Rothenberg, Christine S Moravec, Jeffrey D Alexis, Carol C Gregorio, Robert T Dirksen, Mario Delmar, Eric M Small
Background -Hypertrophic cardiomyocyte (CM) growth and dysfunction accompanies various forms of heart disease. The mechanisms responsible for transcriptional changes that impact cardiac physiology and the transition to heart failure (HF) are not well understood. The intercalated disc (ID) is a specialized intercellular junction coupling CM electrical activity and force transmission, and is gaining attention as a mechanosensitive signaling hub and hotspot for causative mutations in cardiomyopathy. Methods -Transmission electron microscopy, confocal microscopy, and single-molecule localization microscopy (SMLM) were used to examine changes in ID structure and protein localization in the murine and human heart...
May 1, 2018: Circulation
https://www.readbyqxmd.com/read/29716941/increased-rtn3-leads-to-obesity-and-hypertriglyceridemia-by-interacting-with-hspa5
#19
Rong Xiang, Liang-Liang Fan, Hao Huang, Ya-Qin Chen, Wanxia He, Shuai Guo, Jing-Jing Li, Jie-Yuan Jin, Ran Du, Riqiang Yan, Kun Xia
Background -Reticulon 3 (RTN3) is an endoplasmic reticulum protein that has been previously shown to play a role in neurodegenerative diseases, but little is known about its role in lipid metabolism. Methods -Obesity patients (149), hypertriglyceridemia patients (343), and healthy controls (84) were enrolled to assess their levels of RTN3. To explore pathophysiological roles of RTN3 in the control of lipid metabolism, we utilized Tg-RTN3 and RTN3-null transgenic mouse models and multiple C. elegans strains for molecular characterization...
May 1, 2018: Circulation
https://www.readbyqxmd.com/read/29716940/residual-inflammatory-risk-on-treatment-with-pcsk9-inhibition-and-statin-therapy
#20
Aruna D Pradhan, Aaron W Aday, Lynda M Rose, Paul M Ridker
Background -The combination of statin therapy and proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibition markedly lowers low-density lipoprotein cholesterol (LDL-C) and reduces cardiovascular event rates. Whether residual inflammatory risk as measured by on-treatment high sensitivity C-reactive protein (hsCRP) remains an important clinical issue in such patients is uncertain. Methods -We evaluated residual inflammatory risk among 9,738 patients participating in the Studies of PCSK9 Inhibition and the Reduction of Vascular Events (SPIRE)-1 and -2 cardiovascular outcomes trials who were receiving both statin therapy and bococizumab, according to on-treatment levels of hsCRP (hsCRPOT ) and LDL-COT measured 14 weeks after drug initiation...
May 1, 2018: Circulation
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