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Heart, Lung & Circulation

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https://www.readbyqxmd.com/read/28709919/morbidity-after-cardiac-surgery-in-patients-with-adult-congenital-heart-disease-in-comparison-with-acquired-disease
#1
Dimos Karangelis, Amine Mazine, Sreekanth Narsupalli, Shamarli Mendis, Gruschen Veldtman, Nicolas Nikolaidis
BACKGROUND: Due to the advancements in congenital cardiac surgery and interventional cardiology in the last five decades, more than 85% of congenital heart patients now survive to adulthood. METHODS: This retrospective study included 135 Adult Congenital Heart Disease (ACHD) patients, who had cardiac surgery at Southampton General Hospital over three consecutive years. We also included 42 patients with a structurally normal heart who had cardiac surgery for acquired cardiac conditions as a control group...
June 28, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28709918/unroofed-coronary-sinus-syndrome-an-easily-corrected-congenital-anomaly-but-more-diagnostic-suspicions-are-needed
#2
Changcheng Chen, Lili Xu, Yi Xu, Ping Li, Shuo Liu, Bin You
BACKGROUND: Unroofed coronary sinus syndrome (URCSS) is a spectrum of cardiac anomalies in which part (partial type) or the entire common wall (complete type) between the coronary sinus (CS) and left atrium is absent. It is commonly associated with a persistent left superior vena cava (PLSVC). The PLSVC can even anomalously connect to the left atrium in complete type anomaly. URCSS has been reported to be associated with delayed diagnosis and life-threatening cerebral injury. The purpose of the present study was to review our experience with surgical correction of this often-concealed malformation and discuss methods for reducing diagnostic omission...
June 22, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28690023/the-tyg-index-as-a-marker-of-subclinical-atherosclerosis-and-arterial-stiffness-in-lean-and-overweight-postmenopausal-women
#3
Irene Lambrinoudaki, Maria Vasiliki Kazani, Eleni Armeni, Georgios Georgiopoulos, Konstantinos Tampakis, Demetrios Rizos, Areti Augoulea, Georgios Kaparos, Andreas Alexandrou, Kimon Stamatelopoulos
BACKGROUND: The present study aims to examine the association of the metabolic syndrome (MS) as well as of the triglyceride-glucose index (TyG-Index), a novel marker of insulin resistance, with subclinical atherosclerosis in a cohort of postmenopausal women, stratified according to their body mass index. METHODS: A total of 473 informed-consenting, non-diabetic postmenopausal women, without overt cardiovascular disease, were included in this study. We aimed to compare the association between structural and functional indices of subclinical atherosclerosis (i...
June 16, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28690020/cardiac-society-of-australia-and-new-zealand-position-statement-coronary-artery-calcium-scoring
#4
LETTER
Gary Liew, Clara Chow, Niels van Pelt, John Younger, Michael Jelinek, Jonathan Chan, Christian Hamilton-Craig
Coronary Artery Calcium Scoring (CAC) is a non-invasive quantitation of coronary artery calcification using computed tomography (CT). It is a marker of atherosclerotic plaque burden and an independent predictor of future myocardial infarction and mortality. Coronary Artery Calcium Scoring provides incremental risk information beyond traditional risk calculators (eg. Framingham Risk Score). Its use for risk stratification is confined to primary prevention of cardiovascular events, and can be considered as "individualized coronary risk scoring" for those not considered to be of high or low risk...
June 16, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28716519/cost-effectiveness-of-simvastatin-plus-ezetimibe-for-cardiovascular-prevention-in-patients-with-a-history-of-acute-coronary-syndrome-analysis-of-results-of-the-improve-it-trial
#5
Ziyad S Almalki, Jeff Jianfei Guo, Abdullah Alahmari, Nawaf Alotaibi, Hilal Thaibah
BACKGROUND: Simvastatin plus ezetimibe reduced the risk of cardiovascular events in the IMProved Reduction of Outcomes: Vytorin Efficacy International (IMPROVE-IT) study. The aim of this study is to investigate the cost-effectiveness of adding ezetimibe to simvastatin treatment for patients with ACS based on the recently completed IMPROVE-IT trial. METHODS: We constructed a Markov state-transition model to evaluate the costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness (ICER) associated with co-therapy compared with simvastatin alone from a health care perspective...
June 15, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28705664/complete-atrioventricular-canal-defect-towards-a-more-physiological-repair
#6
A Boutayeb
We describe a more physiological technique of complete atrioventricular septal defect repair which restores normal heart anatomy with the offset between the insertions of the mitral and tricuspid valves. This technique overcomes the drawbacks of the previous approaches, and may improve surgical outcomes, particularly in small infants with high ventricular septal defect component or dextroposed aorta.
June 15, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28690022/absence-of-myostatin-improves-cardiac-function-following-myocardial-infarction
#7
Sarina Lim, Chris D McMahon, Kenneth G Matthews, Gerard P Devlin, Marianne S Elston, John V Conaglen
BACKGROUND: Myostatin inhibits the development of skeletal muscle and regulates the proliferation of skeletal muscle fibroblasts. However, the role of myostatin in regulating cardiac muscle or myofibroblasts, specifically in acute myocardial infarction (MI), is less clear. This study sought to determine whether absence of myostatin altered left ventricular function post-MI. METHODS: Myostatin-null mice (Mstn(-/-)) and wild-type (WT) mice underwent ligation of the left anterior descending artery to induce MI...
June 15, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28690021/transcatheter-aortic-valve-implantation-in-nonagenarians-procedural-outcome-and-mid-term-results
#8
Smita Scholtz, Zisis Dimitriadis, Marios Vlachojannis, Cornelia Piper, Dieter Horstkotte, Marcus Wiemer, Jan Gummert, Buntaro Fujita, Michael Benzinger, Stephan M Ensminger, Jochen Börgermann, Werner Scholtz
BACKGROUND: For nonagenarians with symptomatic severe aortic stenosis transcatheter aortic valve implantation (TAVI) has become a feasible therapeutic option. Therefore, the aim of this study was to evaluate the procedural outcomes and mid-term follow-up in this patient group and compare this to octogenarians. METHODS: From 1359 patients who underwent TAVI at our institution between March 2009 and February 2016, 82 patients were nonagenarians and 912 were octogenarians...
June 15, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28688832/prosthetic-valve-infective-endocarditis-with-mycobacterium-fortuitum-antibiotics-alone-can-be-curative
#9
Sonali R Gnanenthiran, Eunice Y T Liu, Michael Wilson, Tommy Chung, Thomas Gottlieb
Rapidly growing non-tuberculous mycobacteria (RGM) are a rare, often fatal cause of infective endocarditis. Although surgery has been the cornerstone of RGM endocarditis therapy, we present the first documented adult case of Mycobacterium fortuitum endocarditis cured with antibiotic therapy.
June 15, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28697936/radiofrequency-catheter-ablation-for-atrial-fibrillation-approaches-and-outcomes
#10
REVIEW
Manish Kalla, Prashanthan Sanders, Jonathan M Kalman, Geoffrey Lee
Catheter ablation is now at the forefront of the management of symptomatic atrial fibrillation (AF). Its role in paroxysmal AF is well defined with considerable data supporting its role. Catheter ablation in persistent AF has been less effective and the subject of considerable debate. Mechanistic studies have demonstrated the critical role of pulmonary vein physiology in paroxysmal AF, whereas the mechanisms that sustain persistent AF are not well understood. Additional substrate ablation in persistent AF has not improved long-term outcomes and the use of novel mapping technologies to assess rotor activity remains controversial...
June 13, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28662919/risk-factor-management-and-atrial-fibrillation-clinics-saving-the-best-for-last
#11
REVIEW
Rajiv Mahajan, Rajeev K Pathak, Anand Thiyagarajah, Dennis H Lau, Francis E Marchlinski, Sanjay Dixit, John D Day, Jeroen M L Hendriks, Melinda Carrington, Jonathan M Kalman, Prashanthan Sanders
Atrial fibrillation (AF) is a leading cause of cardiovascular morbidity and mortality worldwide. Management of AF is a complex process involving: 1) the prevention of thromboembolic complications with anticoagulation; 2) rhythm control; and 3) the detection and treatment of underlying heart disease. However, cardiometabolic risk factors, such as obesity, hypertension, diabetes mellitus, and obstructive sleep apnoea, have been proposed as contributors to the expanding epidemic of atrial fibrillation (AF). Thus, a fourth pillar of AF care would include aggressive targeting of interdependent, modifiable cardiovascular risk factors as part of an integrated care model...
June 9, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28655535/adenosine-testing-after-atrial-fibrillation-ablation-systematic-review-and-meta-analysis
#12
Nelson Wang, Steven Phan, Aran Kanagaratnam, Narendra Kumar, Kevin Phan
BACKGROUND: Adenosine can be used to reveal dormant pulmonary vein (PV) conduction after pulmonary vein isolation (PVI) for the treatment of atrial fibrillation (AF). We performed a systematic review and meta-analysis to assess the impact of adenosine administration in patients undergoing PVI for AF. METHODS: Meta-analysis of 22 studies was performed to assess the rates of freedom from AF in 1) patients with dormant PV conduction versus patients without dormant PV conduction, and 2) patients given routine adenosine post PVI versus patients not given adenosine...
June 7, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28655534/position-statement-on-the-diagnosis-and-management-of-familial-dilated-cardiomyopathy
#13
LETTER
Diane Fatkin, Renee Johnson, Julie McGaughran, Robert G Weintraub, John J Atherton
No abstract text is available yet for this article.
June 7, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28684097/an-update-on-anticoagulation-in-atrial-fibrillation
#14
REVIEW
John Amerena, Daryl Ridley
Cerebrovascular accidents related to atrial fibrillation (AF) are potentially preventable with anticoagulation. Until recently, warfarin was the only proven anticoagulant to be effective in stroke prevention, however the novel, direct acting oral anticoagulants (DOACs) are now available, triggering a paradigm shift in treatment philosophy. Today, physicians need to consider in which patients anticoagulation should not be used rather than, as in the past, deciding in which patients it should be used. Although warfarin will continue to have a place in managing some patients with AF, in the future, the DOACs should be the predominant therapy for stroke prevention in patients with non-valvular AF...
June 3, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28662918/reproducibility-of-cardiac-magnetic-resonance-imaging-cmri-derived-right-ventricular-parameters-in-repaired-tetralogy-of-fallot-tof
#15
Ganesh Kumar Gnanappa, Imran Rashid, David Celermajer, Julian Ayer, Rajesh Puranik
BACKGROUND: Quantification of right ventricular (RV) volumes is challenging owing to variable reproducibility and is especially so in congenital heart disease. Cardiac magnetic resonance (CMR) has the ability to more comprehensively survey the entire right ventricle and is currently considered the gold standard. AIMS: We aimed to determine the inter-observer reproducibility of CMR-derived RV volumes generated by two independent and experienced (SCMR Level III) observers in Tetralogy of Fallot (ToF) patients with varying degrees of RV dilatation...
June 3, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28655532/surgical-relief-of-left-ventricular-outflow-tract-obstruction-in-adults-with-congenital-aortic-stenosis-and-associated-aortic-annulus-hypoplasia-and-or-subaortic-obstruction
#16
Tanveer Ahmad, Amalan Thuraisingam, Marco Larobina, Peter Skillington
BACKGROUND: In children and adolescents, a Ross/Konno operation is commonly done to both enlarge the aortic root and provide a competent aortic valve with relief of left ventricular outflow tract obstruction (LVOTO). Optimum management is not so straightforward in adults. METHODS: Between 1995 and 2014, 16 patients of mean age 39.4 years (18-57 years) with hypoplastic aortic annulus (AA) measuring 20mm and less, and mean aortic valve/LVOT gradient of 61mmHg (30-70mmHg) presented for surgery...
June 3, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28652027/atrial-fibrillation-and-sleep-apnoea-guilt-by-association
#17
REVIEW
Zaidon Al-Falahi, Jonathan Williamson, Hany Dimitri
Atrial fibrillation (AF) and obstructive sleep apnoea (OSA) are both common, often underdiagnosed conditions with serious sequelae. An association between these two conditions has been recognised but the nature of this relationship remains a topic of active debate. Despite that lack of strong, randomised controlled trials, there is a considerable body of data indicating that not only does untreated OSA provide the substrates and triggers for AF but that OSA, itself, is also a therapeutic target for the management of cardiovascular disease in general and of AF in particular...
June 3, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28606607/state-of-the-art-review-atrial-fibrillation-in-athletes
#18
REVIEW
M Darragh Flannery, Jonathan M Kalman, Prashanthan Sanders, André La Gerche
Exercise has substantial health benefits with pleomorphic vascular, metabolic, psychological and anti-neoplastic actions resulting in improved quality of life and longevity. Despite these many benefits, numerous studies have shown that endurance athletes are more likely to develop atrial fibrillation (AF) than non-athletes. The type, intensity and amount of sport appears to influence the risk of developing AF. Several endurance sport activities have been shown to increase the risk of developing AF but an excess in AF has not been shown in non-endurance sports...
June 3, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28688833/balloon-aortic-valvuloplasty-in-the-transcatheter-valve-era-single-centre-indications-and-early-safety-data-in-a-high-risk-population
#19
Thomas J Ford, Katherine Nguyen, Joseph Brassil, Virag Kushwaha, Daniel Friedman, Roger Allan, Mark Pitney, Nigel Jepson
BACKGROUND: The introduction of transcatheter aortic valve implantation (TAVI) has generated a renewed interest in the techniques available to treat high-risk patients with severe aortic stenosis (AS). We report our single centre experience with balloon aortic valvuloplasty (BAV) focussing on indications, procedural success and 30-day outcomes. METHODS: We retrospectively reviewed all patients that underwent BAV procedures at our institution between August 2012 and August 2014...
June 2, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28655533/a-unique-hybrid-approach-to-complex-re-do-aortic-root-surgery
#20
Fiona Doig, Rishen Naidoo, Vinod Sharma, Peter Tesar
BACKGROUND: We present the case of a 23-year-old male with ventriculo-aortic dehiscence and a retrosternal false aneurysm communicating to the left ventricular outflow tract (LVOT) and ascending aorta. His history included aortic valve replacement (AVR) and mitral valve (MV) repair remotely, followed by two further operations for endocarditis and aortic root abscess. METHODS: The risk associated with the redo surgery required detailed planning and innovative techniques to allow it to be performed safely...
June 1, 2017: Heart, Lung & Circulation
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