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Clinical Cardiology

Alejandro Lemor, Alvaro J Ramos-Rodriguez, Ricardo de la Villa, Seyed Hamed Hosseini Dehkordi, Fernando Vazquez de Lara, Shawn Lee, Mario Rodriguez Rivera, Abel Casso Dominguez, Edgar Argulian
BACKGROUND: Takotsubo syndrome (TTS) is characterized by acute, transient systolic dysfunction of the left ventricle not attributed to coronary artery disease. We aimed at exploring the gender differences in clinical characteristics and in-hospital outcomes of patients admitted with TTS. METHODS AND RESULTS: The National Inpatient Sample database was searched for patients admitted with a principal diagnosis of TTS from 2006 to 2014 using the ICD9-CM code 429.83...
November 4, 2018: Clinical Cardiology
Yang-Yu Karen Xiao, Garth Graham
While the prevalence of cardiovascular risk factors has decreased in the United States in recent years, cardiovascular disparities by sex and race persist. Among the factors contributing to these disparities is the physical environment in which individuals live. Neighborhood characteristics, ranging from air pollution exposure to residential segregation, have been found to be related to cardiovascular health and stroke risk. Through the use of cross-sectional, longitudinal, and analytic regression modeling, we are gaining clarity about the relationship between an individual's external environment and cardiovascular health...
November 4, 2018: Clinical Cardiology
Qian Zhang, Chun-Mei Wang, Shu-Tian Shi, Hong Chen, Yu-Jie Zhou
BACKGROUND: The incidence of left ventricular thrombus (LVT) is 4% to 15% in patients with anterior acute ST-segment elevation myocardial infarction (ant-AMI) in the era of primary percutaneous coronary intervention (PPCI). And patients with LVT have higher in-hospital mortality. HYPOTHESIS: There is a relationship between LVT formation and one-year major adverse cardio-cerebrovascular events (MACCE) in patients with ant-AMI treated by PPCI. METHODS: Our study population included 1488 consecutive patients with ant-AMI...
October 27, 2018: Clinical Cardiology
Panagiota Anyfanti, Eugenia Gkaliagkousi, Eleni Gavriilaki, Areti Triantafyllou, Panagiotis Dolgyras, Vasiliki Galanopoulou, Spyros Aslanidis, Stella Douma
BACKGROUND: Galectin-3 has emerged as a promising novel biomarker of cardiovascular fibrosis in patients with cardiovascular diseases. HYPOTHESIS: We investigated whether galectin-3 correlates with markers of vascular fibrosis, subclinical atherosclerosis and cardiac function in patients with rheumatoid arthritis (RA), a disease accompanied by high cardiovascular risk. METHODS: RA and non-RA individuals underwent applanation tonometry, carotid ultrasound and impedance cardiography, to obtain markers of arterial stiffness, subclinical atherosclerosis, and myocardial function, respectively...
October 23, 2018: Clinical Cardiology
Georgia Besant, Douglas Wan, Cynthia Yeung, Crystal Blakely, Pamela Branscombe, Laiden Suarez-Fuster, Damian Redfearn, Christopher Simpson, Hoshiar Abdollah, Benedict Glover, Adrian Baranchuk
BACKGROUND: Lyme carditis (LC), an early manifestation of Lyme disease that most commonly presents as high-degree atrioventricular block (AVB), usually resolves with antibiotic treatment. When LC is not identified as the cause of AVB, a permanent pacemaker may be inappropriately implanted in a reversible cardiac conduction disorder. HYPOTHESIS: The likelihood that a patient's high-degree AVB is caused by LC can be evaluated by clinical characteristics incorporated into a risk stratification tool...
October 23, 2018: Clinical Cardiology
Ahmed Abu-Haniyeh, Nishant P Shah, Yuping Wu, Leslie Cho, Haitham M Ahmed
BACKGROUND: Cardiac rehabilitation (CR) improves cardiorespiratory fitness and has been shown to reduce cardiovascular events and death. However, data about predictors of fitness improvement during CR are limited and conflicting. The objective of this study was to determine predictors of improvement in metabolic equivalents of task (METs) based on formal exercise testing throughout phase II CR. METHODS: We retrospectively reviewed 20,671 patients enrolled in phase II CR at our center from 2006-2016...
October 23, 2018: Clinical Cardiology
Abdullah Haddad, Remy Arwani, Osama Altayar, Tarek Sawas, M Hassan Murad, Eduardo de Marchena
OBJECTIVES: This systematic review and meta-analysis sought to summarize the available evidence on the use of TAVR in patients with Native Aortic Valve Regurgitation (NAVR) and compare outcomes between first and second generation valves. BACKGROUND: Owing to the improvements in transcatheter heart valve design and procedural success, TAVR has become increasingly performed in broader aortic valve pathologies. METHOD: We searched Medline, Embase, Cochrane and Scopus databases from 2007 to 2018 and performed a systematic review on reports with at least 10 patients with aortic valve regurgitation undergoing TAVR procedure...
October 23, 2018: Clinical Cardiology
Narut Prasitlumkum, Chanavuth Kanitsoraphan, Veraprapas Kittipibul, Pattara Rattanawong, Pakawat Chongsathidkiet, Wisit Cheungpasitporn
INTRODUCTION: Atrial fibrillation (AF) is the most common arrhythmia, independently associated with significant mortality and morbidity. Recent studies suggest that AF is potentially associated with contrast-induced nephropathy (CIN) in patients with Coronary artery disease (CAD) undergoing catheterization. However, the association was not conclusive. Thus, we assessed the association between AF in patients with CAD and CIN by a systematic review of the literature and a meta-analysis...
October 17, 2018: Clinical Cardiology
Aman Kansal, Chandler A Long, Manesh R Patel, W Schuyler Jones
Peripheral artery disease (PAD) is a major health concern affecting more than 200 million people worldwide and studies have shown PAD to be a strong predictor of mortality, morbidity, and disability. The management of PAD is multi-tiered and advancements in technology have given physicians more options for endovascular revascularization if medical therapy does not result in substantial improvement. Many randomized controlled trials (RCT) have reported efficacy of various therapies including laser atherectomy, stent technology, and drug-coated balloons over standard percutaneous transluminal angioplasty; however, uncertainty regarding the best standard of care remains unclear due to a lack of head to head comparisons between novel therapies...
October 15, 2018: Clinical Cardiology
Eleni S Nakou, Maria E Marketou, Gregory I Chlouverakis, Alexandros P Patrianakos, Panos E Vardas, Fragiskos I Parthenakis
BACKGROUND: Despite robust data on the benefits of sacubitril/ valsartan (LCZ696) in patients with chronic heart failure with reduced ejection fraction (HFrEF), there is no evidence yet on prespecified predictive markers of its efficacy. HYPOTHESIS: The objective of this study was to identify potentially prognostic factors of LCZ696 treatment response. METHODS: We included 48 symptomatic patients with chronic HFrEF (LVEF ≤ 35%) and New York Heart Association (NYHA) class II/III: Group A (N =23) received LCZ696 (105 ± 30 mg twice daily), whereas it was not prescribed in group B (N = 25) according to physician's judgement...
October 15, 2018: Clinical Cardiology
Daniel Shpilsky, Claudia Bambs, Kevin Kip, Sanjay Patel, Aryan Aiyerv, Oladipupo Olafiranye, Steven E Reis, Sebhat Erqou
BACKGROUND: Ideal cardiovascular health (CVH) was defined in order to promote population health. We aimed to characterize the association between ideal CVH and markers of subclinical cardiovascular disease (CVD) METHODS: We used data from the Heart Strategies Concentrating on Risk Evaluation (Heart SCORE) study. We assigned 1 for each of the ideal CVH factor met. Endothelial function, expressed as Framingham reactive hyperemia index (fRHI), was measured using the Endo-PAT device. Coronary artery calcium (CAC) and carotid intima-media thickness (CIMT) were quantified using electron beam computed tomography and carotid ultrasonography, respectively...
October 14, 2018: Clinical Cardiology
Jesse D Ortendahl, Allison L Diamant, Peter P Toth, Dasha Cherepanov, Amanda L Harmon, Michael S Broder
AIMS: Cardiovascular disease (CVD) mortality has decreased over 60% over the past 50 years in the US, however emerging data indicate CVD incidence may be rising due to shifting demographics, increasing risk factor prevalence, and competing needs for limited resources. We projected CVD mortality from 2015 to 2040 given varying informed assumptions regarding changes in risk factor prevalence, uptake of current therapeutic options, and future innovations. METHODS: A microsimulation model was used to project US CVD mortality trends...
October 14, 2018: Clinical Cardiology
Haiyan Su, Yinghua Pei, Chunling Tian, Qing Zhang, Li Liu, Ge Meng, Zhanxin Yao, Hongmei Wu, Yang Xia, Xue Bao, Yeqing Gu, Shaomei Sun, Xing Wang, Ming Zhou, Qiyu Jia, Kun Song, Zhong Sun, Kaijun Niu
BACKGROUND: Atherosclerosis is an inflammatory disease. Many studies demonstrated that hyperglycemia not only increased inflammatory response, but also is a cause of atherosclerosis, implying that glucose metabolic status may be an important stratification factor when analyzing the relationship between inflammatory levels and subclinical carotid atherosclerosis. The aim of the present study is to assess the relationship between inflammatory levels and subclinical carotid atherosclerosis, stratified by different glucose metabolic status in a general population...
October 14, 2018: Clinical Cardiology
Constantina Aggeli, Kali Polytarchou, Dimitrios Varvarousis, Stellios Kastellanos, Dimitrios Tousoulis
Stress echocardiography (SE) is a very useful method in clinical practice, since it offers important information both for patient's functional status and hemodynamic changes during stress. Therefore, SE provides strong diagnostic and prognostic data in a wide spectrum of cardiovascular diseases. This review summarizes the clinical applications of SE in conditions beyond coronary artery disease and highlights practical recommendations and key issues for each condition that need further investigation. SE is an established method for the evaluation of symptomatic and asymptomatic patients with valvular heart disease and cardiomyopathies, and provides important information regarding prognosis and management of patients with congenital heart disease, pulmonary hypertension or diastolic dysfunction...
October 12, 2018: Clinical Cardiology
Andrés Ricardo Pérez-Riera, Raimundo Barbosa-Barros, Rodrigo Daminello-Raimundo, Luiz Carlos de Abreu, Kjell Nikus
The existence of a tetrafascicular intraventricular conduction system remains debatable. A consensus statement ended up with some discrepancies and, despite agreeing on the possible existence of an anatomical left septal fascicle, the electrocardiographic and vectorcardiographic characteristics of left septal fascicular block (LSFB) were not universally accepted. The most important criteria requested to confirm the existence of LSFB is its intermittent nature. So far, our group has published cases of transient ischemia-induced LSFB and phase 4 or bradycardia-dependent LSFB...
October 7, 2018: Clinical Cardiology
Amr Salama, Abdullah Abdullah, Abdul Wahab, George Eigbire, Ryan Hoefen, Ruth Kouides, Nathan Ritter, Hanna Mieszczanska, Richard Alweis
BACKGROUND: Obstructive sleep apnea (OSA) is a known independent risk factor for a multiple cardiovascular morbidities and mortality. The association of OSA and ventricular arrhythmias is less well understood. The aim of this analysis to study the relationship between OSA and ventricular tachyarrhythmias. HYPOTHESIS: OSA is associated with increased ventricular arrhythmias METHODS: Data from the National Inpatient Sample (NIS) 2012 - 2014, were reviewed. Discharges associated with OSA were identified as the target population using the relevant ICD-9-CM codes...
October 7, 2018: Clinical Cardiology
Marianne H Gillam, Nicole L Pratt, Maria C S Inacio, Sepehr Shakib, Prashanthan Sanders, Dennis H Lau, Elizabeth E Roughead
INTRODUCTION: A large number of older people receive pacemakers each year but broad population based studies that describe complications following pacemaker implantation in this population are lacking. METHODS: We conducted a retrospective cohort study using data from the Australian Government Department of Veterans' Affairs database. The cohort consisted of patients who received a pacemaker from 2005 to 2014. The outcomes were subsequent re-hospitalisations for infections, procedure related complications, thromboembolism, cardiovascular events (heart failure, myocardial infarction, atrial fibrillation) and re-operation of pacemaker, and mortality...
October 7, 2018: Clinical Cardiology
Yevgeniy Khariton, Krishna K Patel, Paul S Chan, Yashashwi Pokharel, Jingyan Wang, John A Spertus, David M Safley, William R Hiatt, Kim G Smolderen
AIMS: The ACC/AHA cholesterol guidelines recommend patients with peripheral artery disease (PAD) be treated with a moderate to high-intensity statin. The extent to which patients with new or worsening PAD symptoms are offered guideline therapy is unknown. METHODS AND RESULTS: In the PORTRAIT registry, patterns of statin therapy were assessed in 1144 patients at 16 PAD specialty clinics between June 2011-December 2015 before and after an evaluation for new or worsening claudication symptoms...
October 4, 2018: Clinical Cardiology
Shuaibing Wang, Rui Peng, Shuying Liang, Kaiyan Dong, Wei Nie, Qian Yang, Nan Ma, Jianying Zhang, Kaijuan Wang, Chunhua Song
BACKGROUND: To compare the efficiency of bioelectrical indices (visceral fat index, VFI; percentage body fat, PBF) and anthropometric indices (body mass index, BMI; waist circumference, WC; waist-to-height ratio, WHtR; a body shape index, ABSI) in the relation to prehypertension (120-139/80-89mmHg) among Chinese population. METHODS: Using stratified multistage random sampling method, a general population-based sample of 11,175 adults in Henan province were selected during 2013 to 2015...
October 3, 2018: Clinical Cardiology
Ahmed Subahi, Emmanuel Akintoye, Ahmed S Yassin, Hossam Abubakar, Oluwole Adegbala, Tushar Mishra, Mohamed Abdelrahman, Mohamed Shokr, Luis Afonso
BACKGROUND: Atrial fibrillation (AF) is associated with increased all-cause mortality in the general population. However, the impact of atrial fibrillation on the in-hospital outcomes of acute myocarditis patients is not well characterized. METHODS: Patients (age ≥18 years) with a primary diagnosis of acute myocarditis in the National Inpatient Sample (NIS) from 2007 to 2014 were included, using the ICD-9-CM diagnostic codes. We compared the in-hospital outcomes between the AF group and propensity score-matched control group without AF...
October 3, 2018: Clinical Cardiology
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