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Clinical Cardiology

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https://www.readbyqxmd.com/read/28636098/repeated-procedures-at-the-generator-pocket-are-a-determinant-of-implantable-cardioverter-defibrillator-infection
#1
Eduardo Arana-Rueda, Alonso Pedrote, Manuel Frutos-López, Juan Acosta, Beatriz Jauregui, Lorena García-Riesco, Álvaro Arce-León, Federico Gómez-Pulido, Juan A Sánchez-Brotons, Encarnación Gutiérrez-Carretero, Arístides de Alarcón-González
BACKGROUND: Rates of cardiac-device infections have increased in recent years, but the current incidence and risk factors for infection in patients with implantable cardioverter-defibrillators (ICDs) are not well known. HYPOTHESIS: The increasing number of ICD infections is related to accumulated pocket manipulations over time. METHODS: This single-center, prospective study included patients that underwent ICD implantation from 2008 to 2015...
June 21, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28628222/the-value-of-electrocardiography-in-prognosticating-clinical-deterioration-and-mortality-in-acute-pulmonary-embolism-a-systematic-review-and-meta-analysis
#2
REVIEW
Amro Qaddoura, Geneviève C Digby, Conrad Kabali, Piotr Kukla, Zhong-Qun Zhan, Adrian M Baranchuk
The role of electrocardiography (ECG) in prognosticating pulmonary embolism (PE) is increasingly recognized. ECG is quickly interpretable, noninvasive, inexpensive, and available in remote areas. We hypothesized that ECG can provide useful information about PE prognostication. We searched MEDLINE, EMBASE, Google Scholar, Web of Science, abstracts, conference proceedings, and reference lists through February 2017. Eligible studies used ECG to prognosticate for the main outcomes of death and clinical deterioration or escalation of therapy...
June 19, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28614597/esc-sudden-death-risk-model-in-hypertrophic-cardiomyopathy-incremental-value-of-quantitative-contrast-enhanced-cmr-in-intermediate-risk-patients
#3
Rocio Hinojar, José Luis Zamorano, Ariana Gonzalez Gómez, Maria Plaza Martin, Amparo Esteban, Luis Miguel Rincón, Juan Carlos Portugal, José Julio Jimenez Nácher, Covadonga Fernández-Golfín
BACKGROUND: Hypertrophic cardiomyopathy (HCM) remains the most common cause of sudden cardiac death (SCD) in the young; however, current strategies do not identify all HCM patients at risk. A novel validated algorithm was proposed by the last European Society of Cardiology guidelines to guide implantable cardioverter-defibrillator (ICD) therapy. Recently, extensive myocardial fibrosis was independently associated with increased risk of SCD events. This study aimed to establish the relation between myocardial fibrosis (late gadolinium enhancement [LGE] extension) and the novel SCD risk-prediction model in a real population of HCM to evaluate its potential additional value in the different risk groups...
June 14, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28613405/an-association-between-volumes-of-the-cardiac-chambers-and-troponin-levels-in-individuals-submitted-to-cardiac-coronary-computed-tomography
#4
Zach Rozenbaum, Yaron Arbel, Yoav Granot, Dotan Cohen, Haim Shmilovich, Tomer Ziv-Baran, Ehud Chorin, Ofer Havakuk, Merav Cohen, Shlomo Berliner, Yan Topilsky, Galit Aviram
BACKGROUND: Previous echocardiographic studies have revealed an association between enlarged cardiac chamber volumes and elevated troponin concentrations. An automatic 4-chamber volumetric analysis tool was adopted to investigate this association in patients who underwent cardiac-gated computed tomography angiography (CCTA). HYPOTHESIS: We hypothesized that troponin concentration within the normal range correlates with cardiac chambers' volumes. METHODS: Serum troponin was obtained from 157 ambulatory patients before undergoing CCTA for nonacute coronary artery evaluation...
June 14, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28605043/typical-angina-is-associated-with-greater-coronary-endothelial-dysfunction-but-not-abnormal-vasodilatory-reserve
#5
Ahmed AlBadri, Derek Leong, C Noel Bairey Merz, Janet Wei, Eileen M Handberg, Chrisandra L Shufelt, Puja K Mehta, Michael D Nelson, Louise E Thomson, Daniel S Berman, Leslee J Shaw, Galen Cook-Wiens, Carl J Pepine
BACKGROUND: Typical angina (TA) is defined as substernal chest pain precipitated by physical exertion or emotional stress and relieved with rest or nitroglycerin. Women and elderly patients are usually have atypical symptoms both at rest and during stress, often in the setting of nonobstructive coronary artery disease (CAD). HYPOTHESIS: To further understand this, we performed subgroup analysis comparing subjects who presented with TA vs nontypical angina (NTA) using baseline data of patients with nonobstructive CAD and coronary microvascular dysfunction (CMD) enrolled in a clinical trial...
June 12, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28605035/cardiovascular-adverse-events-in-the-drug-development-program-of-bupropion-for-smoking-cessation-a-systematic-retrospective-adjudication-effort
#6
Jessie Kittle, Renato D Lopes, Mingyan Huang, Marsha L Marquess, Matthew D Wilson, John Ascher, Alok Krishen, Vic Hasselblad, Brad J Kolls, Matthew T Roe, Darren K McGuire, Stuart D Russell, Kenneth W Mahaffey
BACKGROUND: In 2011, the US Food and Drug Administration requested that GlaxoSmithKline perform retrospective adjudication of cardiovascular (CV) events reported in the bupropion drug-development trials for smoking cessation. HYPOTHESIS: Retrospective adjudication of clinical trial data will not increase the identification of adverse events. METHODS: We performed a comprehensive retrospective analysis of adverse events in 19 previously completed controlled US clinical trials of bupropion marketed for the treatment of smoking cessation, yielding 9479 subjects (5290 bupropion, 2927 placebo, 1018 active control [ACT], and 244 treated concurrently with bupropion and ACT)...
June 12, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28605034/population-based-values-and-abnormalities-of-the-electrocardiogram-in-the-general-dutch-population-the-lifelines-cohort-study
#7
M Yldau van der Ende, Joylene E Siland, Harold Snieder, Pim van der Harst, Michiel Rienstra
BACKGROUND: Our aim is to present average values and prevalence of electrocardiographic (ECG) abnormalities among the general Dutch population in the LifeLines Cohort. HYPOTHESIS: The ECG values previously studied in the Caucasian population of smaller cohorts will be confirmed with ECG data from LifeLines. METHODS: ECG data of 152 180 individuals age 18 to 93 years were available. Individuals with cardiovascular risk factors were excluded to analyze the healthy population...
June 12, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28598574/socioeconomic-status-and-the-development-of-atrial-fibrillation-in-hispanics-african-americans-and-non-hispanic-whites
#8
Eric Shulman, Faraj Kargoli, Philip Aagaard, Ethan Hoch, Luigi Di Biase, John Fisher, Jay Gross, Soo Kim, Kevin J Ferrick, Andrew Krumerman
BACKGROUND: Atrial fibrillation (AF) is the most common arrhythmia and is associated with significant morbidity and mortality. Despite having a higher burden of traditional AF risk factors, African American and Hispanic minorities have a lower incidence of AF when compared to non-Hispanic whites, referred to as the "racial paradox." HYPOTHESIS: Lower SES among Hispanics and African Americans may help to explain the lower incidence rates of AF compared to non-Hispanic whites...
June 9, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28598569/heart-failure-in-patients-admitted-for-acute-coronary-syndromes-a-report-from-a-large-national-registry
#9
Raban V Jeger, Otmar Pfister, Dragana Radovanovic, Franz R Eberli, Hans Rickli, Philip Urban, Giovanni Pedrazzini, Jean-Christophe Stauffer, Jörg Nossen, Paul Erne
BACKGROUND: Data on temporal trends of heart failure (HF) in acute coronary syndrome (ACS) are scarce. HYPOTHESIS: Improved treatment options may have led to lower case-fatality rates (CFRs) during the last years in ACS complicated by HF. METHODS: Patients of the nationwide Acute Myocardial Infarction in Switzerland (AMIS)-Plus ACS registry were analyzed from 2000 to 2014. RESULTS: Of 36 366 ACS patients, 3376 (9.3%) had acute or chronic HF, 2111 (5...
June 9, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28598510/relative-efficacy-and-safety-of-ticagelor-vs-clopidogrel-as-a-function-of-time-to-invasive-management-in-non-st-segment-elevation-acute-coronary-syndrome-in-the-plato-trial
#10
Charles V Pollack, Farideh Davoudi, Deborah B Diercks, Richard C Becker, Stefan K James, Soo Teik Lim, Phillip J Schulte, Jindrich Spinar, Philippe Gabriel Steg, Robert F Storey, Anders Himmelmann, Lars Wallentin, Christopher P Cannon
BACKGROUND: Guidelines suggest that "upstream" P2Y12 receptor antagonists should be considered in patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS). HYPOTHESIS: Early use of ticagrelor in patients managed with an invasive strategy would be more effective than clopidogrel because of its more rapid onset of action and greater potency. METHODS: In the PLATO trial, 6792 NSTE-ACS patients were randomized to ticagrelor or clopidogrel (started prior to angiography) and underwent angiography within 72 hours of randomization...
June 9, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28597566/navigating-air-travel-and-cardiovascular-concerns-is-the-sky-the-limit
#11
REVIEW
Muhammad Hammadah, Bryan R Kindya, Marc P Allard-Ratick, Sammer Jazbeh, Danny Eapen, W H Wilson Tang, Laurence Sperling
As the population ages and our ability to care for patients with cardiac disease improves, an increasing number of passengers with cardiovascular conditions will be traveling long distances. Many have had cardiac symptoms, recent interventions, devices, or surgery. Air travel is safe for most individuals with stable cardiovascular disease. However, a thorough understanding of the physiologic changes during air travel is essential given the potential impact on cardiovascular health and the risk of complications in passengers with preexisting cardiac conditions...
June 8, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28586100/obstructive-sleep-apnea-is-associated-with-increased-readmission-in-heart-failure-patients
#12
Alex Sommerfeld, Andrew D Althouse, Jennifer Prince, Charles W Atwood, Suresh R Mulukutla, Gavin W Hickey
BACKGROUND: Heart failure (HF) readmission rates have become an increasingly important quality metric since the advent of the Hospital Readmissions Reduction Program. Despite many well-intentioned efforts to reduce readmissions, clinicians continue to struggle with the problem of high HF readmission rates. HYPOTHESIS: HF patients with obstructive sleep apnea (OSA) will have higher burden of rehospitalization and mortality than HF patients without OSA. METHODS: Our study included 344 patient encounters (among 271 unique patients) with a diagnosis of HF from September 2014 through September 2015...
June 6, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28586090/the-association-of-qrs-duration-with-atrial-fibrillation-in-a-heart-failure-with-preserved-ejection-fraction-population-a-pilot-study
#13
Joseph N Gigliotti, Mandeep S Sidhu, Alina M Robert, Jonathan S Zipursky, Jeremiah R Brown, Salvatore P Costa, Robert T Palac, David A Steckman, David J Malenka, Alan T Kono, Mark L Greenberg
BACKGROUND: Heart failure is a significant cause of morbidity and mortality, yet patient risk stratification may be difficult. Prevention or treatment of atrial fibrillation (AF) may be an important strategy in these patients that could positively affect their outcome. It has been demonstrated that in patients with systolic dysfunction, prolonged QRS duration (QRSd), an easily measured electrocardiographic parameter, is associated with AF. HYPOTHESIS: Prolonged QRSd is associated with an increase in prevalence of AF in patients with heart failure with preserved ejection fraction(HFPEF)...
June 6, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28561986/rationale-design-and-baseline-characteristics-of-the-clarify-registry-of-outpatients-with-stable-coronary-artery-disease
#14
Emmanuel Sorbets, Nicola Greenlaw, Roberto Ferrari, Ian Ford, Kim M Fox, Jean-Claude Tardif, Michal Tendera, Philippe Gabriel Steg
BACKGROUND: Despite major advances in prevention and treatment, coronary artery disease (CAD) remains the leading cause of death worldwide. Whereas many sources of data are available on the epidemiology of acute coronary syndromes, fewer datasets reflect the contemporary management and outcomes of stable CAD patients. HYPOTHESIS: A worldwide contemporary registry would improve our knowledge about stable CAD. The main objectives are to describe the demographics, clinical profile, contemporary management and outcomes of outpatients with stable CAD; to identify gaps between evidence and treatment; and to investigate long-term prognostic determinants...
May 31, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28561951/safety-and-efficacy-of-doacs-vs-acenocoumarol-in-patients-undergoing-catheter-ablation-of-atrial-fibrillation
#15
Konstantinos Vlachos, Michael Efremidis, George Bazoukis, Konstantinos P Letsas, Athanasios Saplaouras, Stamatis Georgopoulos, Nikolaos Karamichalakis, Aikaterini Rokiza, Antigoni Sakellaropoulou, Angelos Michail Kolokathis, Theodoros Efremidis, Dimitrios Asvestas, Antonios Sideris
BACKGROUND: Thromboembolic complications can be life-threatening during atrial fibrillation (AF) catheter ablation. The aim of our study was to evaluate the safety and efficacy of continuous treatment using direct oral anticoagulants (DOACs) as an alternative to uninterrupted acenocoumarol for periprocedural anticoagulation. HYPOTHESIS: Continuous treatment with DOACs has similar safety and efficacy compared to acenocoumarol. METHODS: We enrolled 474 patients (mean age, 58 years; 68...
May 31, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28561943/association-between-insomnia-and-atrial-fibrillation-in-a-chinese-population-a-cross-sectional-study
#16
Xu Han, Yiheng Yang, Yue Chen, Lianjun Gao, Xiaomeng Yin, Huihua Li, Jing Qiu, Youxin Wang, Yong Zhou, Yunlong Xia
BACKGROUND: Insomnia is the most prevalent sleep disorder; however, little research has explored the link between insomnia and atrial fibrillation (AF). HYPOTHESIS: Insomnia is associated with increased risk of AF in a Chinese population. METHODS: A total of 8371 Chinese participants (4314 males; mean age, 42.4 ± 13.1 years) were enrolled in this cross-sectional study to investigate the association between insomnia and AF. AF was assessed in a standard supine resting position with a 10-s 12-lead electrocardiograph (ECG) or by self-reported history...
May 31, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28555959/design-of-the-magnetic-resonance-imaging-evaluation-of-mineralocorticoid-receptor-antagonism-in-diabetic-atherosclerosis-magma-trial
#17
Sanjay Rajagopalan, M Amer Alaiti, Kylene Broadwater, Aditya Goud, Juan Gaztanaga, Kim Connelly, Anas Fares, Shayan Shirazian, Catherine Kreatsoulas, Michael Farkouh, Mirela Dobre, Jeffrey C Fink, Matthew R Weir
Mineralocorticoid receptor (MR) activation plays an essential role in promoting inflammation, fibrosis, and target organ damage. Currently, no studies are investigating MR antagonism in patients with type 2 diabetes mellitus (T2DM) with chronic kidney disease, at high risk for cardiovascular complications, who are otherwise not candidates for MR antagonism by virtue of heart failure. Further, there is limited information on candidate therapies that may demonstrate differential benefit from this therapy. We hypothesized that MR antagonism may provide additional protection from atherosclerosis progression in higher-risk patients who otherwise may not be candidates for such a therapeutic approach...
May 26, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28543093/relationship-between-carotid-atherosclerosis-and-coronary-artery-calcification-in-asymptomatic-diabetic-patients-a-prospective-multicenter-study
#18
Anand Jeevarethinam, Shreenidhi Venuraju, Alain Dumo, Sherezade Ruano, Vishal S Mehta, Miranda Rosenthal, Devaki Nair, Mark Cohen, Daniel Darko, Avijit Lahiri, Roby Rakhit
BACKGROUND: The value of screening sub-clinical atherosclerosis in asymptomatic patients with type 2 diabetes mellitus (T2DM) remains controversial. HYPOTHESIS: An integrated model incorporating carotid intima-media thickness (CIMT) and carotid plaque with traditional risk factors can be used to predict prevalence and severity of coronary artery calcification in asymptomatic T2DM patients. METHODS: A cohort of 262 asymptomatic T2DM patients were prospectively studied with carotid ultrasound to evaluate CIMT and carotid plaque and also a computed tomography coronary artery calcium (CT-CAC) scan...
May 25, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28543102/low-flow-low-gradient-aortic-stenosis-still-a-diagnostic-and-therapeutic-challenge
#19
REVIEW
Anja Vogelgesang, Gerd Hasenfuss, Claudius Jacobshagen
Aortic stenosis (AS) is the most frequently observed valvular heart disease. During the symptomatic stage, the rate of death increases dramatically, so that a precise diagnostic approach is taken to guide therapeutic options. Of patients with severe AS, 30% to 50% present with low-flow/low-gradient AS (LF/LGAS) status. This review focuses on LF/LGAS and the best diagnostic and therapeutic management in either classic LF/LGAS with reduced left ventricular ejection fraction (LVEF) or paradoxical LF/LGAS with preserved LVEF...
May 23, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28543134/-real-life-longevity-of-implantable-cardioverter-defibrillator-devices
#20
Antonis S Manolis, Themistoklis Maounis, Spyridon Koulouris, Vassilios Vassilikos
BACKGROUND: Manufacturers of implantable cardioverter-defibrillators (ICDs) promise a 5- to 9-year projected longevity; however, real-life data indicate otherwise. The aim of the present study was to assess ICD longevity among 685 consecutive patients over the last 20 years. HYPOTHESIS: Real-life longevity of ICDs may differ from that stated by the manufacturers. METHODS: The study included 601 men and 84 women (mean age, 63.1 ± 13.3 years)...
May 22, 2017: Clinical Cardiology
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