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Clinical Cardiology

Xiao-Xi Zhao, Ku-Lin Li, Ru-Xing Wang, Jie Zheng, Xiao-Yu Liu, Shi-Peng Dang, Zhi-Ming Yu, Chang-Ying Zhang, Xiang-Jun Yang
BACKGROUND: No data exist on comparisons of efficacy, safety and recurrence risk factors of paroxysmal and persistent atrial fibrillation (AF) ablation using robotic magnetic navigation system (MNS) respectively. METHODS: 151 AF patients were prospectively enrolled and divided into paroxysmal AF group (n=102) and persistent AF group (n=49). Circumferential pulmonary vein antrum isolation (CPVI) were performed in all patients. Linear ablation at the left atrial roof and mitral isthmus was performed in patients with persistent AF in addition to CPVI...
January 16, 2019: Clinical Cardiology
Izzah Vasim, Muhammad Imtiaz Ahmad, Morgana Mongraw-Chaffin, Elsayed Z Soliman
OBJECTIVES: As the debate continues about whether obesity in metabolically healthy individuals is associated with poor outcomes or not, investigating the association between the obesity phenotypes and markers of subclinical myocardial injury will help identify those at risk for future cardiovascular events (CVD). METHODS: This analysis included 3423 participants (57.85±13.06 years, 53.3% women) without known CVD from NHANES-III. Multivariable logistic regression models were used to examine the cross-sectional association between four obesity phenotypes (metabolically healthy non-obese (MHNO) (reference), metabolically unhealthy non-obese (MUNO), metabolically healthy obese (MHO) and metabolically unhealthy obese (MUO) with subclinical myocardial injury (SC-MI)...
January 16, 2019: Clinical Cardiology
Saurabh Gupta, Emilie P Belley-Côté, Richard P Whitlock
We read with interest the study by Johnsrud et al. The authors retrospectively examined outcomes in a cohort of patients with atrial fibrillation undergoing surgical left atrial appendage (LAA) exclusion during cardiac surgery. The authors aimed to evaluate the long-term effect of LAA exclusion on oral anticoagulation (OAC) prescription and stroke. They evaluated 91 patients who, during surgery, underwent LAA exclusion and matched them to patients who did not. The final analysis included only 62 pairs, matched on 16 pre-treatment variables, and demonstrated no significant difference in OAC prescription and stroke at discharge and at 5 years...
January 16, 2019: Clinical Cardiology
Beatriz Tose Costa Paiva, Thomas H Fischer, Johannes Brachmann, Sonia Busch
No abstract text is available yet for this article.
January 16, 2019: Clinical Cardiology
Yuxia Cui, Sufang Li, Feng Zhang, Junxian Song, Chongyou Lee, Manyan Wu, Hong Chen
BACKGROUND: Familial hypercholesterolemia (FH) is a genetic cause of premature myocardial infarction (PMI). Early diagnosis of FH is critical for prognosis. This study aimed to investigate the prevalence of FH among a cohort of Chinese patients with PMI using genetic testing, and to evaluate different diagnostic criteria. METHODS AND RESULTS: A total of 225 consecutive PMI patients were recruited. LDLR, APOB, PCSK9 and LDLRAP1 genes were detected by Sanger sequencing...
January 13, 2019: Clinical Cardiology
Israel Gotsman, Ayelet Shauer, Donna R Zwas, Ilgar Tahiroglu, Chaim Lotan, Andre Keren
BACKGROUND: Low serum albumin is common in patients with chronic heart failure (HF) and may have an impact on clinical outcome. We evaluated the effect of albumin levels on clinical outcome in a real-world cohort of patients with HF. METHODS: All patients with HF at a health maintenance organization were followed for cardiac-related hospitalizations and death. RESULTS: A total of 5,779 HF patients were included in the study; Mean follow-up was 576 days; Median serum albumin was 4...
January 13, 2019: Clinical Cardiology
Amit K Dey, Jacob Groenendyk, Nehal N Mehta, Evgenia Gourgari
Patients with type 2 diabetes have a significantly increased risk for cardiovascular disease (CVD) compared to the general population - with CVD accounting for two out of every three deaths in patients with diabetes. In 2008, the FDA suggested that CVD risk should be evaluated for any new antidiabetic therapy, leading to a multitude of large CVD outcome trials to assess CVD risk from these medications. However, several of these outcome trials with new novel anti-diabetic therapies have demonstrated a clear and definite CVD advantage at mid-term follow up in high risk patients with T2DM...
January 12, 2019: Clinical Cardiology
Wilson C Kwan, David M Shavelle, David R Laughrun
Pulmonary vascular resistance (PVR) and pulmonary vascular resistance index (PVRI) are key variables in a broad range of contexts, including prediction of outcomes in heart and liver transplantation, determining candidacy for closure of atrial or ventricular septal defects, and guiding treatment of pulmonary hypertension. Significant variability exists among the units used to report PVRI in current literature, making the interpretation of data and translation into clinical practice difficult. Here we will review the measurement and derivation of PVR and PVRI and demonstrate the extent of confusion in the literature...
January 4, 2019: Clinical Cardiology
Hyun Jun Cho, Jae Yong Yoon, Namkyun Kim, Se Yong Jang, Myung Hwan Bae, Jang Hoon Lee, Dong Heon Yang, Hun Sik Park, Yongkeun Cho, Shung Chull Chae
BACKGROUND: A fragmented QRS complex (fQRS) is caused by conduction abnormalities of the ventricle secondary to myocardial ischemia and/or scar in patients with myocardial infarction. However, the implications of the fQRS in the development of coronary artery disease with myocardial ischemia in those without a scar remain unknown. METHODS: We studied electrocardiograms (ECGs) obtained from 150 patients (60.5±8.5 years, 102 men) with myocardial ischemia, which was confirmed by performing both, a nuclear exercise stress test and coronary angiography...
December 31, 2018: Clinical Cardiology
Michael C Kontos, Christopher B Fordyce, Anita Y Chen, Karen Chiswell, Jonathan R Enriquez, James De Lemos, Matthew T Roe
BACKGROUND: Little is known about how differences in out of hospital cardiac arrest patient volume affects in-hospital myocardial infarction (MI) mortality. HYPOTHESIS: Hospitals accepting cardiac arrest transfers will have an increased hospital MI mortality. METHODS: MI patients (STEMI and NSTEMI) in the ACTION Registry were included. Hospital variation of cardiac arrest and temporal trend of the proportion of cardiac arrest MI patients were explored...
December 30, 2018: Clinical Cardiology
Francesco Vitali, Matteo Serenelli, Juhani Airaksinen, Rita Pavasini, Anna Tomaszuk-Kazberuk, Elzbieta Mlodawska, Samuli Jaakkola, Cristina Balla, Lorenzo Falsetti, Nicola Tarquinio, Roberto Ferrari, Angelo Squeri, Gianluca Campo, Matteo Bertini
BACKGROUND: Despite progresses in the treatment of the thromboembolic risk related to atrial fibrillation (AF), the management of recurrences remains a challenge. HYPOTHESIS: to assess if CHA2 DS2 -VASc score is predictive of early arrhythmia recurrence after AF cardioversion. METHODS: Systematic review and individual patient pooled meta-analysis following PRISMA guidelines. INCLUSION CRITERIA: observational trials in patients with AF undergoing cardioversion, available data on recurrence of AF and available data on CHA2 DS2 -VASc score...
December 30, 2018: Clinical Cardiology
Mohamed Ayan, Fuad Habash, Bilal Alqam, Zaid Gheith, Michael Cross, Srikanth Vallurupalli, Hakan Paydak
BACKGROUND: The effects of carvedilol and metoprolol succinate on appropriate and inappropriate implantable cardioverter defibrillator (ICD) therapy in patients with heart failure with reduced ejection fraction (HFrEF) are not fully understood. METHODS: All patients with ICD registered to a single device clinic between 1/2012 and 6/2017 (n = 569) were identified. Patients with systolic heart failure (left ventricular ejection fraction < 40%) treated with carvedilol vs metoprolol succinate were compared...
December 27, 2018: Clinical Cardiology
Adamu J Bamaiyi, Angela J Woodiwiss, Vernice Peterson, Monica Gomes, Carlos D Libhaber, Pinhas Sareli, Gavin R Norton
BACKGROUND: Although obesity-associated metabolic abnormalities (insulin resistance-IR) may not play as marked a role in determining left ventricular (LV) diastolic dysfunction (DD) as hypertension, the impact of combinations of these risk factors on DD is unknown. HYPOTHESIS: We hypothesized that IR influences the impact of hypertension on DD. METHODS: In 704 randomly selected participants from a community sample with a high prevalence of hypertension (50...
December 27, 2018: Clinical Cardiology
Nasrien E Ibrahim, Cian P McCarthy, Shreya Shrestha, Hanna K Gaggin, Renata Mukai, Craig A Magaret, Rhonda F Rhyne, James L Januzzi
BACKGROUND: Standard measures of kidney function are only modestly useful for accurate prediction of risk for acute kidney injury (AKI). HYPOTHESIS: Clinical and biomarker data can predict AKI more accurately. METHODS: Using Luminex xMAP technology, we measured 109 biomarkers in blood from 889 patients prior to undergoing coronary angiography. Procedural AKI was defined as an absolute increase in serum creatinine of ≥0.3 mg/dL, a percentage increase in serum creatinine of ≥50%, or a reduction in urine output (documented oliguria of <0...
December 23, 2018: Clinical Cardiology
Naomi Dl Fisher, Liliana E Fera, Jacqueline R Dunning, Sonali Desai, Lina Matta, Victoria Liquori, Jaclyn Pagliaro, Erika Pabo, Mary Merriam, Calum A MacRae, Benjamin M Scirica
BACKGROUND: Hypertension remains poorly controlled on the population level. National rates of control, even when defined leniently by BP<140/90 mmHg, are only ~50%. As growing healthcare costs coincide with tighter blood pressure (BP) targets, innovative management programs are needed to maximize efficiency of care delivery and optimize control. HYPOTHESIS: We aimed to develop, a remote, navigator-led hypertension innovation program that would leverage algorithmic care pathways, home BP measurements and patient coaching to allow rapid and complete medication titration...
December 23, 2018: Clinical Cardiology
Johanna P Contreras, Kimberly N Hong, Javier Castillo, Lucas N Marzec, Jonathan C Hsu, Christopher P Cannon, Song Yang, Thomas M Maddox
BACKGROUND: In non-valvular atrial fibrillation (NVAF) patients, congestive heart failure (CHF) confers an increased risk of stroke or systemic thromboembolism. This risk is present in both heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF). It is unclear if clinicians account for both types of CHF in their NVAF anticoagulation practices. Accordingly, we characterized current outpatient anticoagulation trends in NVAF patients with HFpEF compared to patients with HFrEF...
December 23, 2018: Clinical Cardiology
Barry Greenberg, Eric D Peterson, Jeffrey S Berger, François Laliberté, Qi Zhao, Guillaume Germain, Dominique Lejeune, Jennifer W Wu, Patrick Lefebvre, Gregg C Fonarow
BACKGROUND: Real-world data on the clinical outcomes of heart failure (HF) across the spectrum of ejection fraction (EF) and the prognostic value of B-type natriuretic peptide (BNP) have not been well examined. HYPOTHESIS: The real-world association between the clinical outcomes of HF and EF or BNP levels may differ across different EF or BNP values. METHODS: The Optum Integrated Claims-Clinical data (07/2009-09/2016) was used to identify adult patients with ≥1 HF diagnosis during a hospitalization or emergency room visit...
December 22, 2018: Clinical Cardiology
Falco Kosich, Katja Schumacher, Tatjana Potpara, Gregory Yh Lip, Gerhard Hindricks, Jelena Kornej
Atrial fibrillation (AF) is the most prevalent sustained cardiac arrhythmia in adults. Catheter ablation (CA) is one of the most important management strategies to reduce AF burden and AF-associated complications. In order to stratify the risk of adverse events and to predict treatment success in AF patients undergoing CA, several risk stratification scores had been developed during the last decade. The aim of this review is to provide an overview of the most important clinical risk scores predicting rhythm outcomes, electro-anatomical substrate and mortality in AF...
December 22, 2018: Clinical Cardiology
Shams Y-Hassan, Staffan Holmin, Goran Abdula, Felix Böhm
Thrombo-embolism is one of the serious complications of takotsubo syndrome (TS) in addition to heart failure, pulmonary edema, cardiogenic shock, cardiac arrest, life-threatening arrhythmias, left ventricular outlet tract obstruction, mitral regurgitation, cardiac rupture, and death. The most common cardio-embolic events in TS are cerebral, renal and peripheral embolism. Approximately one third of patients with left ventricular thrombus (LVT) in TS develop embolic complications. Cardio-embolism in TS may occur with or without the presence of detectable LVT...
December 18, 2018: Clinical Cardiology
Kimi Sato, Arnav Kumar, Amar Krishnaswamy, Stephanie Mick, Milind Y Desai, Brian P Griffin, Samir R Kapadia, Zoran B Popović
BACKGROUND: We aimed to assess longitudinal changes of B-type natriuretic peptide (BNP) in AS patients treated by transcatheter aortic valve replacement (TAVR). METHODS: From our TAVR database, we identified 193 consecutive patients with severe symptomatic AS who underwent TAVR and were prospectively followed using serial BNP levels and echocardiography. Patients were divided in subgroups according to type of left ventricular (LV) remodeling as having normal LV mass and relative wall thickness, or showing concentric remodeling (CR), concentric hypertrophy (CH), and eccentric hypertrophy (EH)...
December 18, 2018: Clinical Cardiology
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