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Heart, Lung & Circulation

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https://www.readbyqxmd.com/read/28506646/virtual-resting-pd-pa-from-coronary-angiography-and-blood-flow-modelling-diagnostic-performance-against-fractional-flow-reserve
#1
Michail I Papafaklis, Takashi Muramatsu, Yuki Ishibashi, Christos V Bourantas, Dimitrios I Fotiadis, Emmanouil S Brilakis, Héctor M Garcia-Garcia, Javier Escaned, Patrick W Serruys, Lampros K Michalis
BACKGROUND: Fractional flow reserve (FFR) has been established as a useful diagnostic tool. The distal coronary pressure to aortic pressure (Pd/Pa) ratio at rest is a simpler physiologic index but also requires the use of the pressure wire, whereas recently proposed virtual functional indices derived from coronary imaging require complex blood flow modelling and/or are time-consuming. Our aim was to test the diagnostic performance of virtual resting Pd/Pa using routine angiographic images and a simple flow model...
May 3, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28511925/total-correction-of-tetralogy-of-fallot-at-early-age-a-study-of-183-cases
#2
Mohamed Alassal, Bedir M Ibrahim, Hany M Elrakhawy, Magdy Hassenien, Sameh Sayed, Magdy Elshazly, Nabil Elsadeck
BACKGROUND: Opinions regarding the optimal time for the repair of tetralogy of Fallot vary. A debate also exists about the timing of repair for the asymptomatic infant. METHODS: This study included 183 patients with tetralogy of Fallot. All patients were subjected to clinical examination with measurement of oxygen saturation, 12-lead ECG, plain chest x-ray, and complete laboratory investigation. Echocardiography and cardiac catheterisation were indicated if there was an inability to reach diagnosis by echocardiography, suspicion of coronary anomaly, evaluation of distal pulmonary arteries or suspicion of major aorto-pulmonary collaterals...
April 27, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28506456/prevalence-of-asymptomatic-coronary-heart-disease-in-the-siblings-of-young-myocardial-infarction-patients-as-detected-by-coronary-computer-tomography-angiography-a-pilot-study
#3
Nadim Shah, Chiew Wong, Nicholas Cox, Anne-Maree Kelly, Kean Soon
BACKGROUND: There is little data on the prevalence of coronary heart disease (CHD) in the young. The study aimed to estimate the prevalence of asymptomatic CHD in siblings of young patients with myocardial infarction (MI) using coronary computed tomography angiography (CCTA). METHODS: Prospective observational data was collected on siblings of patients aged ≤55 years presenting with acute MI and having coronary stenosis ≥50% on invasive coronary angiography in at least one epicardial coronary artery...
April 27, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28506648/antegrade-versus-continuous-retrograde-del-nido-cardioplegia-in-the-david-i-operation
#4
Xuan Jiang, Tianxiang Gu, Enyi Shi, Chun Wang, Zongyi Xiu, Guangwei Zhang
BACKGROUND: The efficacy of continuous retrograde del Nido cardioplegia for myocardial protection is still controversial. We hypothesised that antegrade and retrograde cardioplegia offer equivalent safety for myocardial protection in the David I procedure. METHODS: We retrospectively reviewed 33 patients undergoing the David I operation with antegrade or retrograde del Nido solution from June 2014 to January 2016. The outcomes were compared. The follow-up was 1 month to 15 months...
April 26, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28511924/evaluation-of-the-effectiveness-of-a-phone-based-care-coordination-pilot-on-hospital-utilisation-and-costs-for-patients-with-chest-pain
#5
Peita Price, Ruth Vincent, Mark Tacey, Jane Gilchrist, Danny Liew, Leeanne Grigg, Lucio Naccarella
BACKGROUND: A small percentage of the population represents a disproportionate number of attendances at emergency departments (ED). "Frequent presenters" to ED with chest pain do not always fit into established pathways for acute myocardial events. With accelerated "rule out" protocols, patients are often discharged from the Emergency Department (ED) after short lengths of stay. This research will evaluate the effectiveness of a phone based care-coordination pilot designed to meet the needs of patients attending ED with cardiac and non-cardiac chest pain...
April 20, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28506647/acute-structural-failure-of-the-trifecta-aortic-valve-bioprosthesis
#6
Michael Z L Zhu, Mark A Newman, Pragnesh Joshi, Jurgen Passage
Advancements in bioprosthetic valve technology have greatly enhanced the haemodynamic performance and long-term durability of tissue valves. These features, along with the key advantage of avoiding lifelong anticoagulation, have made bioprosthetic valves increasingly attractive for clinicians and patients alike. The St Jude Trifecta valve is a novel, bovine pericardial bioprosthesis with promising early data for performance and safety. However, no prosthetic valve is perfect and prosthesis failure can occur with even the most reliable and well-designed devices...
April 20, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28487060/timi-risk-index-as-a-predictor-of-30-day-outcomes-in-patients-with-acute-pulmonary-embolism
#7
Marco Zuin, Luca Conte, Claudio Picariello, Gianni Pastore, Dobrin Vassiliev, Daniela Lanza, Pietro Zonzin, Giovanni Zuliani, Gianluca Rigatelli, Loris Roncon
BACKGROUND: Available studies have already identified age, heart rate (HR) and systolic blood pressure (SBP) as strong predictors of early mortality in acute pulmonary embolism (PE). MATERIAL AND METHODS: One-hundred-seventy patients, with acute PE confirmed on computed tomography angiography (CTA) were enrolled. Thrombolysis In Myocardial Infarction (TIMI) risk index (TRI) was calculated using the formula [heart rate (HR) x (AGE/102)/ systolic blood pressure (SBP)]...
April 20, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28511923/igg4-aortopathy-an-underappreciated-cause-of-non-infectious-thoracic-aortitis
#8
Victor Aguirre, Catherine Connolly, Robert Stuklis
IgG4 related thoracic aortitis is a recent addition to the differential diagnosis for inflammatory aortic disease - a condition which is often underappreciated until complications arise such as aneurysmal formation or aortic dissection. Currently, IgG4 aortitis remains a post-surgical diagnosis reliant on positive immunohistochemistry findings. Management is guided by the extent of disease involvement, which can be gauged by serum IgG4 levels and radiological findings. Options include surgical resection, corticosteroid therapy and steroid-sparing agents to prevent relapses...
April 19, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28487061/the-spectrum-of-ambulatory-electrocardiographic-monitoring
#9
REVIEW
Harry G Mond
Since its introduction as a clinical investigative tool, the 12-lead electrocardiograph (ECG) has been the gold standard for recognition of cardiac arrhythmias. The resting 12-lead ECG, however, gives only a rhythm snapshot in time, whereas arrhythmias maybe short-lived, paroxysmal and even asymptomatic making documentation in many patients very difficult. To overcome this, ambulatory ECG monitoring has been developed as a means of recording the ECG in patients over a set period of time, whether it be short-, medium- or long-term...
April 13, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28473216/transcatheter-aortic-valve-implantation-in-intermediate-surgical-risk-patients-with-severe-aortic-stenosis-a-systematic-review-and-meta-analysis
#10
Kuljit Singh, Kristin Carson, Mohammed K Rashid, Rohan Jayasinghe, Abdulrahman AlQahtani, Alexander Dick, Christopher Glover, Marino Labinaz
BACKGROUND: Recent data from randomised and observational studies have reported non-inferior outcomes for transcatheter aortic valve implantation (TAVI) compared to surgical aortic valve replacement (SAVR) in intermediate-risk patients. We performed a systematic review to evaluate the mortality of TAVI compared to SAVR in intermediate-risk patients. METHODS: A comprehensive search of four major databases (EMBASE, Ovid MEDLINE, PubMed, and Google Scholar) was performed from their inception to 29 April 2016...
April 12, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28473215/management-of-nonagenarian-patients-with-severe-aortic-stenosis-the-role-of-comorbidity
#11
Eva Bernal, Albert Ariza-Solé, Antoni Bayés-Genís, Francesc Formiga, Pablo Díez-Villanueva, Rafael Romaguera, Hugo González-Saldívar, Manuel Martínez-Sellés
BACKGROUND: The number of nonagenarian patients with aortic stenosis will likely increase due to the ageing population. We assessed the clinical characteristics, management, and outcomes of nonagenarian patients with severe aortic stenosis. METHODS: A total of 177 (117 females and 60 males) consecutive nonagenarian patients from two large contemporary registries were included in this study. Clinical characteristics, comorbidity as assessed by the Charlson Index, clinical management, and outcomes were recorded...
April 12, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28515027/early-versus-delayed-invasive-strategies-in-high-risk-non-st-elevation-acute-coronary-syndrome-patients-a-systematic-literature-review-and-meta-analysis-of-randomised-controlled-trials
#12
REVIEW
Delara Javat, Clare Heal, Stefan Buchholz, Zhihua Zhang
RATIONALE: It is unclear whether it is beneficial to perform angiography and/or percutaneous coronary intervention (PCI) as an early or delayed invasive strategy amongst high-risk non-ST elevation acute coronary syndrome (NSTEACS) patients. OBJECTIVE: To determine whether an early invasive strategy could further reduce recurrent myocardial infarction (MI) and early mortality compared to a delayed invasive strategy. METHODS AND RESULTS: We searched MEDLINE, CINAHL and SCOPUS and performed a meta-analysis of nine RCTs with a total of 5274 patients...
April 11, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28473214/diabetes-medications-and-cardiovascular-outcomes-in-type-2-diabetes
#13
REVIEW
Cecilia Chi, Jennifer Snaith, Jenny E Gunton
INTRODUCTION: Patients with type 2 diabetes have an increased risk of developing adverse cardiovascular (CV) outcomes. The evidence relating to the effects of glucose-lowering medications on CV outcomes is of variable quality and there are numerous trials ongoing. RESULTS: In this review, we summarise the available literature on CV outcomes of the following diabetes treatments: metformin, the sulfonylureas, acarbose, glucagon-like peptide 1 (GLP1) receptor agonists, dipeptidyl peptidase-4 inhibitors (DPP4i), sodium-glucose co-transporter 2 inhibitors (SGLT2i), thiazolidinediones (TZDs) and insulin...
April 10, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28456599/robotically-assisted-minimally-invasive-off-pump-coronary-artery-bypass-surgery-in-a-patient-with-permanent-tracheostomy
#14
Fabio Ramponi, Campbell D Flynn, Michael K Wilson
BACKGROUND: Patients with a permanent tracheostomy requiring coronary surgery represent a unique challenge, being at increased risk of sternal wound complications, mediastinitis and stoma necrosis. Several techniques have been described including manubrium sparing sternotomy, thoracoscopic internal mammary harvest and hybrid revascularization. HOW TO DO IT: We report a case of robotic assisted (daVinci(®)Xi™ Surgical System) total arterial off-pump revascularization in a patient with previous laryngectomy and permanent tracheostomy...
April 7, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28511922/simultaneous-transseptal-para-ring-leak-closure-and-transcatheter-mitral-valve-implantation-for-the-treatment-of-surgical-mitral-repair-failure
#15
James Roy, Mehdi Eskandari, Mark Monaghan, Olaf Wendler, Jonathan Byrne, Philip MacCarthy
Repeat cardiac surgery in patients with a previous sternotomy is associated with significant morbidity and mortality. While transcatheter aortic valve implantation in high risk surgical patients is now well established, experience with transcatheter mitral valve replacement is still at an early stage. Although many successful reports of transcatheter mitral valve replacements now exist, the predominant approach has been via a transapical approach. It is likely that, as with the evolution of favoured access routes for transcatheter aortic therapies, future directions for transcatheter mitral valves will focus on smaller delivery systems favouring the transvenous transseptal approach where possible...
April 6, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28483550/efficacy-and-safety-of-inter-atrial-shunt-devices-for-heart-failure-with-reduced-or-preserved-ejection-fraction-early-experiences
#16
Dasheng Lu, Jing Zhu, Bin Liao
BACKGROUND: Elevated left atrial (LA) pressure is thought to be the common final pathological way in decompensated heart failure (HF). We aimed to gather currently available clinical evidence to evaluate the feasibility of inter-atrial shunt devices in HF patients. METHODS: We searched PubMed and Cochrane Library databases through 23rd April 23, 2016. Data were extracted by two investigators independently. We pooled outcomes of interest in Revman 5.2 (The Cochrane Collaboration, Oxford, United Kingdom)...
April 6, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28473213/topical-ice-slush-adversely-affects-sniff-nasal-inspiratory-force-after-coronary-bypass-surgery
#17
Rakan I Nazer, Ali M Albarrati
BACKGROUND: Topical cooling with ice slush as an adjunct for myocardial protection during cardiac surgery has been shown to cause freezing injury of the phrenic nerves. This can cause diaphragmatic dysfunction and respiratory complications. METHODS: Twenty (n=20) male patients between the ages of 40 and 60 years were equally randomised to undergo elective coronary artery bypass grafting (CABG) with either cold cardioplegic arrest with topical ice slush cooling or cold cardioplegic arrest without the use of ice slush...
April 6, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28495126/recanalisation-of-bronchial-venous-plexuses-in-superior-venous-cava-occlusion
#18
Li-Ting Huang, Bo Wang, Chung-Dann Kan, Yi-Shan Tsai
No abstract text is available yet for this article.
April 5, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28501519/the-utility-of-cardiac-magnetic-resonance-imaging-in-the-diagnosis-of-cardiac-sarcoidosis
#19
Kelly M Stanton, Madhusudan Ganigara, Peter Corte, David S Celermajer, Mark A McGuire, Paul J Torzillo, Tamera J Corte, Rajesh Puranik
BACKGROUND: Autopsy reports suggest that cardiac sarcoidosis occurs in 20 to 25% of patients with pulmonary sarcoidosis, yet the clinical ante-mortem diagnosis is made in only 5% of cases. Current diagnostic algorithms are complex and lack sensitivity. Cardiac Magnetic Resonance imaging (CMR) provides an opportunity to detect myocardial involvement in sarcoidosis. The aim of this study is to determine the prevalence and clinical significance of late gadolinium enhancement (LGE) on CMR in patients with sarcoidosis...
April 4, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28522275/impact-of-continuous-positive-airway-pressure-on-left-ventricular-systolic-loading-and-coronary-flow-reserve-in-healthy-young-men
#20
Volker Schulze, Christian Meyer, Christian Eickholt, Roberto Sansone, Stefanie Keymel, Christian Heiss, Tienush Rassaf, Malte Kelm, Stephan Steiner
BACKGROUND: Increased augmentation index (AIx) is accompanied by an elevated cardiovascular risk. A reduction of AIx is known for long-term continuous positive airway pressure (CPAP) therapy. We hypothesised that acute preload and left ventricular workload effects AIx and subendocardial viability ratio (SEVR) as a marker of coronary flow reserve. METHODS: Increased augmentation index and central blood pressure parameters were measured by radial artery tonometry in 17 healthy men (32/±6years) at rest and during CPAP ventilation at pressures of 5, 10mbar and after recovery...
March 31, 2017: Heart, Lung & Circulation
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