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Canadian Journal of Cardiology

Nathaniel Moulson, Taryn Taylor, Chris S Simpson, Amer M Johri
To determine the current cardiovascular preparticipation screening practices and attitudes of team physicians for Canadian University and Major Junior Hockey Athletes, a 13-question survey was distributed to lead physicians of each organization. The response rate was 47% (48% [27 of 56] for the Canadian Interuniversity Sport and 55% [11 of 20] for the Ontario Hockey League). Ninety-two percent of physicians reported some form of preparticipation screening, with 22% currently using 12-lead electrocardiogram...
November 9, 2016: Canadian Journal of Cardiology
Sean van Diepen, Meng Lin, Justin A Ezekowitz, Finlay A McAlister, Douglas S Lee, Shaun G Goodman, Paul W Armstrong, Padma Kaul
International registries have reported a wide variation in coronary care unit (CCU) admission rates for patients hospitalized with acute coronary syndrome (ACS) or heart failure (HF). Little is known about variation in Canadian interprovincial use and outcomes. Canadian Institute of Health Information data were used to identify hospitalized patients admitted to a CCU with a primary diagnosis of ACS or HF between April 1, 2007 and March 31, 2013. We examined interprovincial differences in CCU admission rates, use of CCU restricted therapies in the first 2 days of admission, and the association between CCU admission rate and risk-adjusted in-hospital mortality at the provincial level...
October 19, 2016: Canadian Journal of Cardiology
Nayer Youssef, Richard P Whitlock
The pulmonary artery catheter (PAC) is the most common method of measuring cardiac output in cardiac surgery. However, its use has always been questioned in terms of survival benefit, specifically with regard to the accuracy of its measurements and its invasive nature, with the potential for serious complications. In this review we aimed to develop a clear understanding of the pitfalls of the use of PAC, and discuss its risks and available alternatives. We conclude that there is no indication for the routine use of PAC such that clinicians should carefully consider the clinical risks and benefits on a patient by patient basis...
October 17, 2016: Canadian Journal of Cardiology
Emmanuelle Duceppe, Joel Parlow, Paul MacDonald, Kristin Lyons, Michael McMullen, Sadeesh Srinathan, Michelle Graham, Vikas Tandon, Kim Styles, Amal Bessissow, Daniel I Sessler, Gregory Bryson, P J Devereaux
The Canadian Cardiovascular Society Guidelines Committee and key Canadian opinion leaders believed there was a need for up to date guidelines that used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system of evidence assessment for patients who undergo noncardiac surgery. Strong recommendations included: 1) measuring brain natriuretic peptide (BNP) or N-terminal fragment of proBNP (NT-proBNP) before surgery to enhance perioperative cardiac risk estimation in patients who are 65 years of age or older, are 45-64 years of age with significant cardiovascular disease, or have a Revised Cardiac Risk Index score ≥ 1; 2) against performing preoperative resting echocardiography, coronary computed tomography angiography, exercise or cardiopulmonary exercise testing, or pharmacological stress echocardiography or radionuclide imaging to enhance perioperative cardiac risk estimation; 3) against the initiation or continuation of acetylsalicylic acid for the prevention of perioperative cardiac events, except in patients with a recent coronary artery stent or who will undergo carotid endarterectomy; 4) against α2 agonist or β-blocker initiation within 24 hours before surgery; 5) withholding angiotensin-converting enzyme inhibitor and angiotensin II receptor blocker starting 24 hours before surgery; 6) facilitating smoking cessation before surgery; 7) measuring daily troponin for 48 to 72 hours after surgery in patients with an elevated NT-proBNP/BNP measurement before surgery or if there is no NT-proBNP/BNP measurement before surgery, in those who have a Revised Cardiac Risk Index score ≥1, age 45-64 years with significant cardiovascular disease, or age 65 years or older; and 8) initiating of long-term acetylsalicylic acid and statin therapy in patients who suffer myocardial injury/infarction after surgery...
October 4, 2016: Canadian Journal of Cardiology
Shubhayan Sanatani, Vann Chau, Anne Fournier, Andrew Dixon, Renée Blondin, Robert S Sheldon
Pediatric syncope is a common problem that peaks in adolescence, for which there are few data or evidence-based consensus on investigation and management. This document offers guidance for practical evaluation/management of pediatric patients (age < 19 years) with syncope encountered in the acute or primary care setting. The writing committee used the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. Most syncope is vasovagal, which is benign and does not require extensive investigation...
October 3, 2016: Canadian Journal of Cardiology
Michael Papadakis, Sanjay Sharma
No abstract text is available yet for this article.
September 27, 2016: Canadian Journal of Cardiology
Roxanne Pelletier, Jin Choi, Nicholas Winters, Mark J Eisenberg, Simon L Bacon, Jafna Cox, Stella S Daskalopoulou, Kim L Lavoie, Igor Karp, Avi Shimony, Derek So, George Thanassoulis, Louise Pilote
BACKGROUND: Over past decades, the incidence of acute coronary syndrome (ACS) has increased in young women, and greater mortality rates after discharge were observed among young women vs men. We revisited this issue with contemporary data from the Gender and Sex Determinants of Cardiovascular Disease: From Bench to Beyond Premature Acute Coronary Syndrome (GENESIS-PRAXY), a multicentre prospective cohort study. METHODS: One thousand two hundred thirteen patients were enrolled in GENESIS-PRAXY from 26 centres across Canada, the United States, and Switzerland between January 2009 and April 2013...
September 21, 2016: Canadian Journal of Cardiology
Tara L Sedlak, Mona Izadnegahdar
No abstract text is available yet for this article.
September 21, 2016: Canadian Journal of Cardiology
Fabien Picard, Philippe L L'allier, Jean-François Tanguay
Bioresorbable vascular scaffold (BVS) is a novel technology designed to overcome the long-term limitations of permanent metallic stent implantation in percutaneous coronary intervention. However, little is known about the development of coronary aneurysms after the use of BVSs, and additional experience is needed to establish the entire spectrum of complications related to the use of these emerging materials. We hereby report an unusual case of early multiple coronary artery micro aneurysms formation after BVS implantation...
September 13, 2016: Canadian Journal of Cardiology
Matthew Valdis, Gaetano DeRose, Linrui Guo, Michael W A Chu
Young patients with bicuspid aortic valve disease and aortopathy remain a clinical challenge, with many requiring multiple corrective operations throughout their lifetimes. Innovative surgical approaches are often required to address complex aortic pathologic conditions but leave patients at risk for reintervention, lifelong anticoagulation, and suboptimal hemodynamics. We describe an active 44-year-old female triathlete with recurrent bicuspid aortic stenosis, a small aortic root, a hypoplastic aortic arch and complex distal arch, and a descending aortic aneurysm, who underwent a single-stage reconstruction with a combined Ross procedure, hybrid arch, and frozen elephant trunk reconstruction...
December 2016: Canadian Journal of Cardiology
(no author information available yet)
No abstract text is available yet for this article.
December 2016: Canadian Journal of Cardiology
Ruth McPherson, Robert A Hegele
No abstract text is available yet for this article.
December 2016: Canadian Journal of Cardiology
Jeff S Healey
No abstract text is available yet for this article.
December 2016: Canadian Journal of Cardiology
Michael Khoury, Juan Pablo Sandoval, Lars Grosse-Wortmann, Edgar Jaeggi, Rajiv R Chaturvedi
A 33-day-old infant with obstructed cor triatriatum sinister and partial anomalous pulmonary venous drainage presented with respiratory distress and fever. Her suprasystemic pulmonary hypertension was relieved by opening the connection to the right atrium using balloon atrial septoplasty and septostomy, and to the inferior chamber using balloon dilation of a fenestration in the dividing membrane. This enabled extubation and discharge, with elective surgical repair at 2 months. To our knowledge, this is the youngest patient to receive a catheter intervention for obstructed cor triatriatum sinister, providing relief of pulmonary hypertension and postponement of surgical repair...
December 2016: Canadian Journal of Cardiology
Robin A Ducas, Christopher Labos, David Allen, Mehrdad Golian, Maya Jeyaraman, Justin Lys, Amrinder Mann, Leslie Copstein, Sherri Vokey, Rasheda Rabbani, Ryan Zarychanski, Ahmed M Abou-Setta, Alan H Menkis
BACKGROUND: Delays in reperfusion for patients with myocardial ischemia leads to increased morbidity and mortality. The objective of this review was to identify, evaluate, and critically appraise the evidence on whether pre-hospital electrocardiography (ECG) reduces patient mortality and improves post-ST-segment myocardial infarction patient-oriented outcomes. METHODS: We searched PubMed/MEDLINE, EMBASE, and Cochrane Library (1990-2015) for controlled clinical studies...
December 2016: Canadian Journal of Cardiology
Jonathan Beaudoin, Jagmeet P Singh, Jackie Szymonifka, Qing Zhou, Robert A Levine, James L Januzzi, Quynh A Truong
BACKGROUND: Cardiac resynchronization therapy (CRT) improves mitral regurgitation (MR) in a subset of patients. We hypothesized that biomarkers (amino-terminal pro-B type natriuretic peptide, high-sensitivity troponin I, galectin-3 [gal-3], and soluble ST2) might predict MR response after CRT. METHODS: We measured levels of biomarkers during CRT implantation in 132 patients with a subsequent 2-year follow-up. MR was graded as no-trace, mild, moderate, or severe at baseline and at 6 months...
December 2016: Canadian Journal of Cardiology
Barbara A Danek, Aris Karatasakis, Dimitri Karmpaliotis, Khaldoon Alaswad, Farouc A Jaffer, Robert W Yeh, Mitul P Patel, John Bahadorani, William L Lombardi, R Michael Wyman, J Aaron Grantham, David E Kandzari, Nicholas J Lembo, Anthony H Doing, Catalin Toma, Jeffrey W Moses, Ajay J Kirtane, Ziad A Ali, Manish Parikh, Santiago Garcia, Phuong-Khanh Nguyen-Trong, Judit Karacsonyi, Aya J Alame, Pratik Kalsaria, Craig Thompson, Subhash Banerjee, Emmanouil S Brilakis
BACKGROUND: We sought to determine the effect of lesion age on procedural techniques and outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). METHODS: We examined the characteristics and outcomes of 394 CTO PCIs with data on lesion age, performed between 2012 and 2016 at 11 experienced US centres. RESULTS: Mean patient age was 66 ± 10 years and 85.6% of the patients were men. Overall technical and procedural success rates were 90...
December 2016: Canadian Journal of Cardiology
William J Hucker, Harsimran Saini, Steven A Lubitz, Patrick T Ellinor
Atrial fibrillation (AF) is the most common sustained arrhythmia and has significant clinical impact. Over the last decade, our understanding of the genetics of AF has expanded dramatically. After a heritable predisposition for AF was identified, many investigators have in turn identified both common and rare variants associated with AF. Ongoing work is focused on translating these variants into disease pathways and novel therapeutic modalities. In this review, we focus on our understanding of the current concepts behind the genetics of AF and outline a vision for the incorporation of genetic data into clinical practice...
November 2016: Canadian Journal of Cardiology
Chaitu Cheruvu, Christopher Naoum, Philipp Blanke, Bjarne Norgaard, Jonathon Leipsic
In the treatment of stable coronary artery disease (CAD), the determination of stenosis severity by invasive coronary angiography (ICA) is a critical procedure, and for borderline lesions, the detection of ischemia through invasive fractional flow reserve (FFR) is the gold standard. With advances in computational fluid dynamics, FFR can now be calculated noninvasively using anatomic data from coronary computed tomographic angiography (CCTA). This technique is known as FFRCT. The purpose of this review is to summarize the science of FFRCT, describe its diagnostic accuracy, discuss its clinical and economic impact, and elucidate factors beyond stenosis severity that may mechanistically relate to lesion-specific ischemia...
November 2016: Canadian Journal of Cardiology
Rajat Sharma, Colleen M Norris, Gabor Gyenes, Manohara Senaratne, Kevin R Bainey
BACKGROUND: Unequivocally, cardiac rehabilitation (CR) in patients with established cardiovascular disease improves survival. However, its effect on higher-risk ethnic groups has not been explored. Accordingly, we evaluated the effect of CR on South Asian (SA) compared with European Canadians with coronary artery disease (CAD). METHODS: Using the Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease (APPROACH) registry, 26,167 patients from Edmonton, Alberta who received coronary angiography with documented CAD were reviewed (January 2002 to March 2012)...
October 2016: Canadian Journal of Cardiology
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