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Heart, Lung & Circulation

Samuel Hui, Robert Gooley, Hashrul N Rashid, Sarah Zaman
BACKGROUND: Antithrombotic recommendations following transcatheter aortic valve replacement (TAVR) are largely based on previous trial protocols. The efficacy and risk of anticoagulation has not been systematically assessed. The aim of this study was to determine the efficacy and safety of oral anticoagulation in patients with atrial fibrillation (AF) following TAVR with the Lotus Valve System (Boston Scientific, Malborough, MA, USA). METHODS: Consecutive patients with severe aortic stenosis who underwent Lotus valve implantation were prospectively recruited (n=164)...
April 4, 2018: Heart, Lung & Circulation
Taryn L Luitingh, Melissa G Y Lee, Bryn Jones, Remi Kowalski, Sofia Weskamp Aguero, Jane Koleff, Diana Zannino, Michael M H Cheung, Yves d'Udekem
BACKGROUND: Exercise-testing may be a more tolerable method of detecting hypertension in children after coarctation repair compared to gold-standard 24-hour ambulatory blood pressure (BP) monitoring (ABPM). This study aims to determine the prevalence of exercise-induced hypertension and end-organ damage in children after coarctation repair, and the effectiveness of exercise-testing compared to 24-hour ABPM in this population. METHODS: Exercise-testing (Bruce protocol), transthoracic echocardiogram, 24-hour ABPM, and pulse wave velocity were performed in 41 patients aged 8 to 18 years with previous coarctation repair...
March 27, 2018: Heart, Lung & Circulation
Nikki Molan, Sam Emmanuel, Tamra Langley, Cameron J Holloway
BACKGROUND: Cardiac rehabilitation (CR) is an important tool for the secondary prevention of cardiac disease. Despite its proven effectiveness, CR remains vastly under-utilised especially amongst the most disadvantaged patients. As an adjunct to CR, the St Vincent's Heart Health website (SVHHH) was created by the St Vincent's Hospital CR team to provide information via simplified medical text, videos and animations. We evaluated the effectiveness of the website in educating patients about their heart condition...
March 27, 2018: Heart, Lung & Circulation
Rui-Dong Qi, Jun-Ming Zhu, Yong-Min Liu, Lei Chen, Cheng-Nan Li, Xiao-Yan Xing, Nan Zhang, Li-Zhong Sun
BACKGROUND: Hybrid aortic arch repair is an invasive approach to the surgical management of distal aortic arch aneurysm. The complications associated with hybrid aortic arch repair, such as stroke and endoleaks, are not uncommon and late reintervention is frequent. We retrospectively reviewed our experience of distal aortic arch aneurysm repair using the stented elephant trunk procedure with left subclavian artery (LSCA)-left common carotid artery (LCCA) transposition in the hybrid repair era...
March 27, 2018: Heart, Lung & Circulation
Yasuhiko Kubota, Alvaro Alonso, Susan R Heckbert, Faye L Norby, Aaron R Folsom
BACKGROUND: Although many studies have investigated the association of blood homocysteine with major cardiovascular diseases such as coronary heart disease and stroke, research on its association with atrial fibrillation (AF) is scarce. METHODS: We analysed data from Atherosclerosis Risk in Communities (ARIC) Study (n=492, age 45-64 years) and Multi-Ethnic Study of Atherosclerosis (MESA) (n=6,641, age 45-84 years). RESULTS: During the 10,106 and 67,613 person-years of follow-up, we identified 85 and 351 AF events in ARIC and MESA, respectively...
March 21, 2018: Heart, Lung & Circulation
Tom J O'Donohoe, Ryan G Schrale, Suchandan Sikder, Nuzhat Surve, Donna Rudd, Natkunam Ketheesan
BACKGROUND: Anti-myosin antibodies (AMAs) are often formed in response to myocardial infarction (MI) and have been implicated in maladaptive cardiac remodelling. We aimed to: (1) compare AMA formation in patients with Non-ST-Elevation MI (NSTEMI) and ST-Elevation MI (STEMI); (2) evaluate factors predicting autoantibody formation; and, (3) explore their functional significance. METHODS: Immunoglobulin M (IgM) and Immunoglobulin G (IgG) AMA titres were determined in serum samples collected at admission, 3 and 6 months post MI...
March 21, 2018: Heart, Lung & Circulation
Nicholas Jackson, Michael McGee, Waheed Ahmed, Allan Davies, Jim Leitch, Mark Mills, Matthew Cambourn, Saad Ezad, Andrew Boyle, John Attia, Kumaraswamy Nanthakumar, Malcolm Barlow
BACKGROUND: The most frequent complications from percutaneous electrophysiology procedures relate to vascular access. We sought to perform the first randomised controlled trial for femoral venous haemostasis utilising a simple and novel purse string suture (PSS) technique. METHODS: We randomised 200 consecutive patients who were referred for electrophysiology procedures at two different hospitals to either 10minutes of manual pressure or a PSS over the femoral vein and determined the incidence of vascular access site complications...
March 20, 2018: Heart, Lung & Circulation
Sam Mirzaee, Paul M Thein, Dennis Wong, Arthur Nasis
BACKGROUND: Evolocumab is an expensive proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor which has been shown to significantly improve cardiovascular outcomes in high risk patients. METHODS: This is a case study describing a stepwise approach to "PCSK9 inhibitor non-response" in a patient with familial hypercholesterolaemia. There are a few described pathophysiological mechanisms for "PCSK9 inhibitor non-response" including homozygous LDL-C receptor-negative mutations and alteration in the binding site of PCSK9 inhibitors...
March 20, 2018: Heart, Lung & Circulation
Hunbo Shim, Ji-Won Hwang, Dong Seop Jeong, Kiick Sung, Wook Sung Kim, Pyo Won Park
BACKGROUND: Although flexible-ring annuloplasty is more inclined to increase the transmitral gradient over time, its effect on the tricuspid annulus is unknown. This study was conducted to evaluate serial changes in mean pressure gradient (mPG) across tricuspid and mitral valves after simultaneous dual implantation of flexible bands. METHODS: Seventy-one patients (median age, 61.6 years; IQR: 50.8-69.0 years) underwent simultaneous mitral/tricuspid annuloplasties using St...
March 17, 2018: Heart, Lung & Circulation
Tom Kai Ming Wang, Michael Tzu Min Wang, Peter Ruygrok
BACKGROUND: Patent foramen ovale (PFO) is a common anatomic variant associated with cryptogenic stroke. Percutaneous PFO closure in these patients to prevent recurrent neurological events has been controversial for decades, and mixed results have been reported from past and recent observational and randomised studies. This meta-analysis of randomised trials aims to compare the efficacy and safety of PFO closure with medical therapy for cryptogenic stroke patients. METHODS: Medline, PubMed, EMBASE, Scopus and Cochrane were searched from January 1980 to September 2017 by two authors independently to include original randomised trials comparing PFO closure with medical therapy for secondary stroke prevention...
March 12, 2018: Heart, Lung & Circulation
Matthew W P Jackson, Douglas F Muir, Mark A de Belder, Sonny Palmer, W Andrew Owens, Andrew Goodwin, Umair Hayat, Paul D Williams
BACKGROUND: Vascular complications from transfemoral (TF) secondary access during transcatheter aortic valve implantation (TAVI) are common. We compare our experience of transradial versus transfemoral secondary access during TAVI and describe techniques for performing iliofemoral arterial intervention from the transradial approach. METHODS: All TAVI procedures with a single secondary access were included. Demographics, procedural details and 30-day outcomes were recorded...
March 10, 2018: Heart, Lung & Circulation
Benjamin T Fitzgerald, William M Scalia, Gregory M Scalia
BACKGROUND: Exercise stress testing is a well validated cardiovascular investigation. Accuracy for treadmill stress electrocardiograph (ECG) testing has been documented at 60%. False positive stress ECGs (exercise ECG changes with non-obstructive disease on anatomical testing) are common, especially in women, limiting the effectiveness of the test. This study investigates the incidence and predictors of false positive stress ECG findings, referenced against stress echocardiography (SE) as a standard...
March 7, 2018: Heart, Lung & Circulation
Kawa Haji, Christopher X Wong, Nikhil Chandra, Helen Truong, Wendy Corkill, Alex Kaethner, Pyi Naing, Asanga Abeyaratne, Stephen J Brady, Nadarajah Kangaharan
BACKGROUND: The burden of pulmonary hypertension (PHT) in Central Australia has not been previously studied. Our aim is to characterise the prevalence, clinical classification, and long-term survival of individuals with PHT in Central Australia. METHODS: A community-based cohort study of all individuals diagnosed with PHT in Central Australia between 2005 and 2016 was undertaken. We estimated PHT prevalence using population data, describe clinical PHT classification, and characterised long-term survival using Kaplan-Meier approaches...
March 6, 2018: Heart, Lung & Circulation
Thomas J Ford, Margaret McEntegart, Colin Berry, Keith G Oldroyd
No abstract text is available yet for this article.
March 6, 2018: Heart, Lung & Circulation
Sean M Conte, Daniel S Florisson, Joshua A De Bono, Reece A Davies, Andrew E Newcomb
A best evidence topic was written to address if perioperative levosimendan improves mortality following cardiac surgery. Fourteen papers represented the best available evidence. An older meta-analysis summarising 11 of these trials concluded that there were fewer deaths in the levosimendan group compared to the control group (OR 0.41, p <0.001) however, this was driven by the results of three included trials by the same author. Three larger and more recent randomised controlled trials failed to demonstrate significant differences in mortality...
March 6, 2018: Heart, Lung & Circulation
Chenglong Zhang, Fengjuan Li, Tianyi Long, Fei Li, Liming Peng, Ke Xia, Ran Jing, Qiying Xie, Tianlun Yang
BACKGROUND: Previous studies have shown that beta 2-microglobulin (B2M) could predict all-cause mortality and cardiovascular mortality in various groups of people. However, the relationship between B2M and severity of coronary stenosis in patients with acute coronary syndrome has not been established. METHODS: We enrolled 872 consecutive patients admitted with acute coronary syndrome in our study. All participants underwent coronary angiography examination or stent implantation after admission...
March 5, 2018: Heart, Lung & Circulation
Anan Younis, Arwa Younis, Ronen Goldkorn, Ilan Goldenberg, Yael Peled, Boaz Tzur, Robert Klempfner
BACKGROUND: Limited data exist regarding the long-term association of body mass index (BMI) and all-cause mortality among patients with stable coronary artery disease (CAD). Accordingly, the aim of this study is to explore the association between BMI and long-term all-cause mortality among patients with stable CAD. METHODS: Our study included 15,357 patients with stable CAD who were enrolled in the Bezafibrate Infarction Prevention (BIP) registry between February, 1990 and October1992, and subsequently followed-up through December 2014...
March 3, 2018: Heart, Lung & Circulation
Siobhan Boyle, Mugur Nicolae, Karam Kostner, Kathy Davies, Irena Cukovski, Amanda Cunliffe, Adam Morton
BACKGROUND: Peripartum cardiomyopathy is associated with significant risks of decline in left ventricular function and adverse maternal and fetal outcome in subsequent pregnancy. The risks of pregnancy in women with dilated cardiomyopathy are unclear. We aimed to assess the outcome of pregnancy in women with dilated cardiomyopathy seen at our institution and to review the literature on this subject. METHODS: A retrospective audit of the outcomes of 14 pregnancies to 12 women with dilated cardiomyopathy...
March 2, 2018: Heart, Lung & Circulation
Diego Castini, Marco Centola, Giulia Ferrante, Sara Cazzaniga, Simone Persampieri, Stefano Lucreziotti, Diego Salerno-Uriarte, Carlo Sponzilli, Stefano Carugo
BACKGROUND: Compare the discriminative performance of two validated bleeding risk models for in-hospital bleeding events in a non-selected cohort of acute coronary syndrome (ACS) patients. METHODS: CRUSADE (Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA Guidelines) and ACUITY-HORIZONS (Acute Catheterization and Urgent Intervention Triage strategY-Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction) scores were calculated in 501 consecutive patients (median age 68 years (IQR 57-77), 31% female) admitted for ACS to the coronary care unit (CCU) of San Paolo Hospital in Milan (Italy)...
March 2, 2018: Heart, Lung & Circulation
Benjamin Auld, Lindsay Carrigan, Cameron Ward, Robert Justo, Nelson Alphonso, Ben Anderson
BACKGROUND: The approach to intervention for congenital aortic valve stenosis (AS) differs depending upon centre bias toward a primary catheter or surgical approach. We therefore investigated associations with freedom from re-intervention (FFI) in the cohort of children who underwent primary balloon aortic valvuloplasty (BAV) for congenital AS in our centre. METHODS: All patients who underwent BAV as a primary procedure in the period between 2001 and 2015 in a single service were included...
March 1, 2018: Heart, Lung & Circulation
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