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Heart, Lung & Circulation

André La Gerche, Aaron Baggish, Hein Heidbuchel, Benjamin D Levine, Dhrubo Rakhit
The field of sports cardiology has advanced significantly over recent times. It has incorporated clinical and research advances in cardiac imaging, electrophysiology and exercise physiology to enable better diagnostic and therapeutic management of our patients. One important endeavour has been to try and better differentiate athletic cardiac remodelling from inherited cardiomyopathies and other pathologies. Whilst our diagnostic tools have improved, there have also been errors resulting from assumptions that the pathological traits observed in the general population would be generalisable to athletic populations...
June 6, 2018: Heart, Lung & Circulation
Edgar Francisco Carrizales-Sepúlveda, Alejandro Ordaz-Farías, Raymundo Vera-Pineda, Ramiro Flores-Ramírez
Periodontal and cardiovascular disease are both major health issues. Poor oral health has long been associated with the development of systemic diseases, with the typical example being the risk of endocarditis posterior to dental procedures. Through the years, the association of periodontal disease with other non-infectious systemic diseases has been brought to attention. One of the most interesting associations is the one that exists with the development of cardiovascular disease. Many studies, including systematic reviews and meta-analyses, suggest an important association between periodontal disease and ischaemic heart disease, cerebrovascular disease, heart failure, atrial fibrillation and peripheral artery disease...
June 2, 2018: Heart, Lung & Circulation
Austin N May, Linda I Ping Lin, Michael Feneley
No abstract text is available yet for this article.
June 1, 2018: Heart, Lung & Circulation
Catharina Elizabeth Myburgh, Leoné Malan, Annemarie Wentzel, Jacobus De Wet Scheepers, Nicolaas Theodor Malan
BACKGROUND: Defensive coping (DefS) was associated with cardiovascular disease (CVD) susceptibility in Blacks. Whether coping strategies will associate with sub-clinical left ventricular hypertrophy (electrocardiographic-left ventricular hypertrophy [ECG-LVH] or Cornell product), cardiomyocyte injury and blood pressure (BP), is unclear. Therefore, we assessed relationships between ECG-LVH, cardiac troponin T (cTnT) and 24-hour BP in bi-ethnic groups when habitually utilising a certain coping style, and these groups when having a stress-related cTnT cut-point of 4...
May 31, 2018: Heart, Lung & Circulation
Michael McGee, David Ferreira, Olav Tvedten, Ehsan Mahmoodi, Nicholas Whitehead, David Baker, Stuart Sugito, Allan Davies, Stuart Turner, Andrew Boyle
Myocardial perfusion scanning (MPS) is commonly used to assess patients with an intermediate to high risk of coronary artery disease. Concerns have been raised about the accuracy of this test. There is little recent data regarding the specificity of the MPS in the context of current medical therapy. The primary objective of this study is to determine the specificity of MPS in diagnosing obstructive coronary artery disease. A total of 184 patients fulfilled study criteria. The overall specificity of MPS for obstructive coronary artery disease was 54%...
May 27, 2018: Heart, Lung & Circulation
Chunguang Feng, Yi Liu, Lulu Wang, Dongdong Niu, Bing Han
BACKGROUND: To determine whether nicorandil administration distal to the thrombus in the coronary artery during percutaneous coronary intervention (PCI) in acute ST-segment elevation myocardial infarction (STEMI) patients reduced the incidence of no-reflow phenomenon, reperfusion injury, and adverse events. METHODS: This randomised controlled trial involved 170 STEMI patients who underwent PCI. All patients underwent thrombectomy and tirofiban injection (10μg/kg) distal to the vascular lesion via a suction catheter, followed by nicorandil (84 patients; 2mg) or saline injection (86 patients; 2mL) at the same site...
May 22, 2018: Heart, Lung & Circulation
David Prior
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a recognised cause of sudden cardiac death during exercise in young athletes. Competitive exercise is also known to accelerate progression of ARVC and exercise restriction is an important part of disease management. Regular endurance training can induce physiological changes detectable on electrocardiography and imaging which may overlap with pathological findings caused by ARVC, thus making differentiation of athlete's heart from ARVC difficult in some cases...
May 19, 2018: Heart, Lung & Circulation
Ahmed M Selim, Lalit Wadhwani, Adam Burdorf, Eugenia Raichlin, Brian Lowes, Ronald Zolty
BACKGROUND: Pulmonary hypertension secondary to left heart disease (WHO Group 2) is a known risk factor in patients with heart failure. The favourable effect of left ventricular assist devices (LVAD) on pulmonary hypertension has been demonstrated before, although this effect has not been well-studied in advanced pulmonary arterial bed disease with a significant elevation in pulmonary vascular resistance. METHODS: We reviewed the records of 258 LVAD patients in our institution...
May 18, 2018: Heart, Lung & Circulation
Dhrubo Rakhit, David L Prior, André La Gerche
The following four cases are typical of the dilemmas faced by sports cardiologists on a regular basis. These are real-life cases and, for each, in addition to a focussed evaluation, the authors openly discuss the clinical predicament and give their personal viewpoints. The cases are designed to be engaging and informative, demonstrating the benefits of expertise in sports cardiology when confronted with athletes with cardiological conundrums.
May 18, 2018: Heart, Lung & Circulation
Michael Kosasih, Aubrey A Almeida, Julian A Smith
BACKGROUND: Sutureless aortic valve replacement (SU-AVR) offers an alternative to traditional aortic valve replacement (AVR) and is becoming widely performed in many hospitals. The aim of the current study was to evaluate the early experience in SU-AVR with the Perceval S bioprosthesis at Monash Medical Centre. METHODS: Fifty-two patients who underwent SU-AVR were retrospectively analysed (mean age: 74.8±6.5years). Data regarding preoperative and operative details, hospital stay, postoperative outcomes within 30days after surgery, re-admissions and longer term echocardiographic data were collected from the relevant hospital databases...
May 18, 2018: Heart, Lung & Circulation
Patita Sitticharoenchai, Pairoj Chattranukulchai, Suphot Srimahachota, Monravee Tumkosit, Smonporn Boonyaratavej
No abstract text is available yet for this article.
May 18, 2018: Heart, Lung & Circulation
Maria J Brosnan, Dhrubo Rakhit
In athletes who undertake a high volume of high intensity exercise, the resultant changes in cardiac structure and function which develop as a result of physiological adaptation to exercise (so called "Athlete's Heart") may overlap with some features of pathological conditions. This chapter will focus on the left side of the heart, where left ventricular cavity enlargement, increase in left ventricular wall thickness and increased left ventricular trabeculation associated with athletic remodelling may sometimes be difficult to differentiate from conditions such as dilated cardiomyopathy, hypertrophic cardiomyopathy or isolated left ventricular non-compaction...
May 16, 2018: Heart, Lung & Circulation
Malin Stenman, Ulrik Sartipy
BACKGROUND: Depression is common in patients with ischaemic heart disease and preoperative depression is a risk factor following coronary artery bypass grafting. The American Heart Association recommends depression screening in all patients with heart disease. Our aim was to assess the feasibility and results of a depression screening program in cardiac surgery patients. METHODS: We introduced a depression screening project at the cardiac surgery department at Karolinska University Hospital and included patients between 2013 and 2016...
May 16, 2018: Heart, Lung & Circulation
Zhengde Tang, Lefeng Zeng, Yanjun Lin, Zhihua Han, Jun Gu, Changqian Wang, Huili Zhang
BACKGROUND: Left atrial appendage (LAA) is gaining increasing attention in patients with atrial fibrillation (AF) in the context of cardioembolic stroke. Galectin-3 (Gal-3) is a mediator of profibrotic pathways and is associated with an increased incidence of heart failure. However, the role of Gal-3 in LAA remodelling and thrombus formation in AF has not been evaluated. METHODS: This prospective study included 153 consecutive patients with paroxysmal (n=58), persistent (n=55) or permanent (n=40) nonvalvular AF...
May 14, 2018: Heart, Lung & Circulation
Adrian D Elliott, Dominik Linz, Christian V Verdicchio, Prashanthan Sanders
Regular exercise contributes to improved cardiovascular health and reduced cardiovascular mortality. Previous studies have shown that regular physical activity and high cardiorespiratory fitness both contribute to a reduction in incident atrial fibrillation (AF). However, the risk of AF appears to be paradoxically increased by participation in endurance exercise. Although the mechanisms are not well understood, exercise-induced changes in autonomic tone alongside the development of an arrhythmogenic atrial substrate, appear to contribute to an excess of AF amongst athletes, despite an overall reduction in cardiovascular disease incidence...
May 8, 2018: Heart, Lung & Circulation
Maurizio Acampa, Pietro Enea Lazzerini, Francesca Guideri, Rossana Tassi, Andrea Lo Monaco, Giuseppe Martini
BACKGROUND: About one third of ischaemic strokes are classified as embolic strokes of undetermined source (ESUS). A silent atrial fibrillation (AF) may play a pathogenic role in these strokes and P wave dispersion (PWD), representing an electrocardiographic (ECG) predictor for paroxysmal AF, thereby a potential marker of covert cardioembolism, was found to be increased in cryptogenic stroke. Furthermore, current evidence links AF to inflammation: inflammatory markers, such as high-sensitive C-reactive protein (hsCRP), have been related to the development and persistence of AF, possibly by promoting atrial remodelling...
May 8, 2018: Heart, Lung & Circulation
Hariharan Raju, Jonathan M Kalman
Atrial fibrillation (AF) is a recognised arrhythmic risk of endurance sports participation, predominantly affecting middle-aged men who are lifelong athletes. Affected athletes were historically included in the category of lone AF, although specific pathophysiological processes apply to this condition, referred to as exercise-related AF. Younger non-endurance athletes may also present with AF, particularly when associated with co-existing cardiomyopathy or arrhythmia syndrome. Management of exercise-related AF is largely based on evidence from randomised trials in non-athletes...
May 8, 2018: Heart, Lung & Circulation
L E Couperus, H W Vliegen, B J Sorgdrager, A C den Dulk, S L M A Beeres, E Y Sarton, J Dubbeld, M J Schalij, J W Jukema, B van Hoek, R W C Scherptong
BACKGROUND: Severely increased right ventricular (RV) afterload is considered a contra-indication for orthotopic liver transplantation (OLT). This study assesses the effects of mildly increased RV afterload on long-term outcome after OLT in relation to RV function. METHODS: 139 OLT recipients (53±12years, 76% male) were included. Preoperative RV afterload was assessed invasively or, if not available, echocardiographically and categorised as normal, high-normal (mean pulmonary artery pressure [PAP] 20-25mmHg or echocardiographic systolic PAP 35-40mmHg) or mildly elevated (mean PAP 25-35mmHg or systolic PAP 40-50mmHg)...
May 8, 2018: Heart, Lung & Circulation
Si Si, Jonathan Golledge, Paul Norman, Mark Nelson, Derek Chew, Zanfina Ademi, Deepak L Bhatt, Gabriel P Steg, Christopher M Reid
BACKGROUND: Compared with other manifestations of cardiovascular disease, peripheral arterial disease (PAD) is under-diagnosed. This study aims to investigate the prevalence, risk profile and cardiovascular outcomes of undiagnosed PAD in Australian general practices. METHOD: A sub-study of the Australian Reduction of Atherothrombosis for Continued Health (REACH) Registry, a prospective cohort study of patients at high risk of atherothrombosis recruited from Australian general practices...
May 8, 2018: Heart, Lung & Circulation
Nia A Luxton, Ross MacKenzie, Patti Shih
BACKGROUND: Smoking cessation (SC) care in the perioperative period of cardiothoracic surgery is important to reduce surgical risk and help achieve long-term smoking abstinence in patients who continue to smoke. The implementation of clinical guidelines for SC care in the perioperative period has proved challenging, yet little is known of what influences the inter-disciplinary team involved in the cardiothoracic area. This qualitative study explored the views of the clinicians involved in perioperative period of cardiothoracic surgery in Australia on their SC advice and support...
May 8, 2018: Heart, Lung & Circulation
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