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Clinical Medicine Insights. Cardiology

Fernando Manzur, Andrés Rico, Juan Diego Romero, Carlos E Rodriguez-Martinez
Objective: To evaluate the efficacy and safety of valsartan (V) or chlorthalidone (C) monotherapy in comparison with a fixed combination of valsartan and chlorthalidone (V + C). Methods: This 12-week multicenter randomized three-arm open-label study randomly allocated 72 patients to V or C as monotherapy or a combination of V + C. The aim was to measure changes in office systolic blood pressure (SBP) and diastolic blood pressure (DBP) and in 24-hour ambulatory blood pressure monitoring (ABPM) from baseline to week 12, in addition to medication tolerability...
2018: Clinical Medicine Insights. Cardiology
Ivan Jurić, Emir Fazlibegović, Danijel Pravdić, Boris Starčević, Ante Punda, Dražen Huić, Mustafa Hadžiomerović, Damir Rozić, Marko Martinac, Darko Markota, Mirjana Vasilj, Ivan Vasilj, Anshul Saxena
Background: Patients with stable coronary artery disease (CAD) can be evaluated for myocardial viability by examining reverse redistribution of Thallium-201 (201 TI) through cardiac scintigraphy. There is limited knowledge about association of a reverse redistribution with favorable cardiac outcomes. In this study, we hypothesized that higher left ventricular ejection fraction (LVEF), lower myocardial necrosis, fewer ischemic events, and less angina will be associated with reverse redistribution of 201 TI imaging...
2018: Clinical Medicine Insights. Cardiology
Merlin C Thomas
Heart failure is a leading cause for hospitalisation and for readmission, especially in patients over the age of 65. Diabetes is an increasingly common companion to heart failure. The presence of diabetes and its associated comorbidity increases the risk of adverse outcomes and premature mortality in patients with heart failure. In particular, patients with diabetes are more likely to be readmitted to hospital soon after discharge. This may partly reflect the greater severity of heart disease in these patients...
2018: Clinical Medicine Insights. Cardiology
Manal M Alem, Abdullah M Alshehri, Peter Mb Cahusac, Matthew R Walters
Background: The xanthine oxidase inhibitor allopurinol improves endothelial function in different populations, including patients with chronic heart failure (CHF). Its effect on arterial stiffness parameters is less clear. We investigated the effect of short-term low-dose allopurinol therapy on arterial stiffness in Saudi patients with stable mild-moderate CHF. Methods: A prospective, randomized, double-blind, placebo-controlled study was performed on 73 patients with mild-moderate CHF...
2018: Clinical Medicine Insights. Cardiology
Marc Heidorn, Tim Frodermann, Andreas Böning, Rolf Schreckenberg, Klaus-Dieter Schlüter
Background: Reperfusion or reopening of occluded vessels is the gold standard to terminate ischemia. However, early functional recovery after reperfusion is often low requiring inotropic intervention. Although catecholamines increase inotropy and chronotropy, they are not the best choice because they increase myocardial oxygen and substrate demand. As nitric oxide (NO) contributes to cardiac function, we tested the hypothesis that addition of citrulline during the onset of reperfusion improves post-ischemic recovery because citrulline can reenter arginine consumption of NO synthases (NOS) but not of arginases...
2018: Clinical Medicine Insights. Cardiology
Orawan Prasitsiriphon, Wiraporn Pothisiri
Objective: (1) To examine the associations between 3 measures of grip strength: static grip strength, change in grip strength, and the combination of grip strength and its change, with all-cause and cardiovascular mortality, and (2) to determine which measure is the most powerful predictor of all-cause and cardiovascular mortality among the European older population. Method: Data come from the first 4 waves of the Survey of Health, Ageing and Retirement in Europe (SHARE)...
2018: Clinical Medicine Insights. Cardiology
Akiko Kawano, Ayumi Oshima, Satoshi Masutani, Akio Ishiguro, Yoichi Iwamoto, Hirotaka Ishido, Mio Taketazu, Hideaki Senzaki
M-mode echocardiography has been playing an important role in the diagnosis of fetal tachyarrhythmia. We recently encountered a neonatal case of atrial flutter with 2:1 atrioventricular conduction. However, M-mode erroneously indicated 1:1 atrioventricular movement. While the movement of the atrial wall far from the atrioventricular valve was much faster than that of the ventricular wall, the atrial wall adjacent to the atrioventricular valve fully synchronized to that of the ventricular wall. Thus, to avoid this novel pitfall, it would be important to add an additional assessment focusing on the movement of the atrial wall far from the ventricle...
2018: Clinical Medicine Insights. Cardiology
Karl Sörelius, Pietro G di Summa
Objective: There is striking paucity in consensus on the terminology, definition, and diagnostic criteria of mycotic aortic aneurysms. This literature study aims to elucidate this scientific omission, discuss its consequences, and present a proposition for reporting items on this disease. Methods: A systematic literature review on PubMed and Medline using mycotic and infected aortic aneurysms between 1850 and 2017 was performed. Articles were assessed according to a protocol regarding terminology, definition, and diagnostic criteria...
2018: Clinical Medicine Insights. Cardiology
Arturo Giordano, Stefano Messina, Gennaro Maresca, Giuseppe Biondi-Zoccai
Purpose: Brachial access is occasionally used for endovascular procedures when other more established or safer ones (eg, femoral or radial) are contraindicated. Although manual compression is the standard of care after brachial arteriotomy, suboptimal compression may lead to bleeding or thrombosis. Arteriotomy closure devices have thus been proposed as an alternative means to achieve hemostasis after brachial arteriotomy. Yet, there is a paucity of evidence and a limited spectrum of devices suitable for brachial arteriotomy closure...
2018: Clinical Medicine Insights. Cardiology
Toba Kazemi, Morteza Hajihosseini, Maryam Moossavi, Mina Hemmati, Masood Ziaee
Introduction: The alteration in serum lipid profile; increase in total cholesterol (TC), triacylglycerol (TAG), and low-density lipoprotein cholesterol (LDL-C); and reduction in high-density lipoprotein cholesterol (HDL-C) are key factors in cardiovascular disease progression. The high prevalence and severity of cardiovascular diseases require new screening tools for better evaluation. Atherogenic index (AI) (LDL-C/HDL-C) and coronary risk index (CRI) (TC/HDL-C) can be strong markers for predicting the risk of atherosclerosis and coronary heart disease and disclose the presence of LDL or TAG in the serum of related patients...
2018: Clinical Medicine Insights. Cardiology
Monish Raut, Arun Maheshwari, Baryon Swain
Perioperative echocardiography, especially transesophageal echocardiography, is of paramount importance in evaluating and managing refractory hypotension, a potential cause of which is systolic anterior motion (SAM) of anterior mitral leaflet. Dynamically moving anterior mitral valve leaflet towards the left ventricular outflow tract (LVOT) is described as SAM. Although SAM was initially observed in patients with hypertrophic cardiomyopathy, it can also be seen in patients with complex dynamic anatomy of the left ventricle...
2018: Clinical Medicine Insights. Cardiology
Laure Champ-Rigot, Virginie Ferchaud, Jean-Noël Prévost, Pierre Moirot, Arnaud Pellissier, Damien Legallois, Joachim Alexandre, Patrice Scanu, Remy Morello, Eric Saloux, Paul Ursmar Milliez
Previous studies showed good agreement between pacemaker respiratory disturbance index (RDI) and polysomnography for diagnosis of severe sleep apnea (SA). The aim of this study is to investigate the diagnostic accuracy of RDI compared with apnea-hypopnea index (AHI) from a cardiorespiratory sleep study for the diagnosis of severe SA within patients requiring a pacemaker and meeting diastolic dysfunction criteria. Secondary objectives are as follows: correlation between plasma aldosterone level and SA severity, diagnostic accuracy of RDI for moderate SA, prevalence of SA among patients with diastolic dysfunction, occurrence of arrhythmias, and improvement of RDI with continuous positive airway pressure therapy...
2018: Clinical Medicine Insights. Cardiology
Shane Nanayakkara, Hitesh C Patel, David M Kaye
Heart failure is highly prevalent with more than 50% of cases being patients with a preserved ejection fraction (HFPEF), a figure that is projected to increase due to the changing risk factor landscape, in particular the ageing population. Overall mortality is similar to patients with heart failure with reduced ejection fraction (HFREF), as are the rates of hospitalisation. Patients with HFPEF have more comorbid conditions with fewer therapeutic options available. In this review, we explore the epidemiology of hospitalisation of HFPEF, the impact of current treatment modalities, and the potential of future therapies...
2018: Clinical Medicine Insights. Cardiology
Eisuke Amiya, Masanobu Taya
Exercise-based rehabilitation programs have been reported to have beneficial effects for patients with heart failure. However, there is little evidence about whether this is the case in patients with more severe heart failure. In particular, there is a question in the clinical setting whether patients with advanced heart failure and continuous inotropic infusion should be prescribed exercise training. In contrast, many studies conclude that prolonged immobility associated with heart failure profoundly impairs physical function and promotes muscle wasting that could further hasten the course of heart failure...
2018: Clinical Medicine Insights. Cardiology
Geir Arne Tangen, Frode Manstad-Hulaas, Erik Nypan, Reidar Brekken
Purpose: A prototype steerable catheter was designed for endovascular procedures. This technical pilot study reports the initial experience using the catheter for cannulation of visceral arteries. Technique: The 7F catheter was manually steerable with operator control handle for bending and rotation of the tip. The maximum bending angle was approximately 90° and full 360° rotation of the tip was supported. The study involved 1 pig with 4 designated target arteries: the left and right renal arteries, the superior mesenteric artery, and the celiac trunk...
2018: Clinical Medicine Insights. Cardiology
Hans Iv Lindgren, Håkan Pärsson, Anders Gottsäter, Stefan Bergman
Background: Intermittent claudication (IC) is traditionally managed with risk factor modification, best medical treatment (BMT), and exercise training. Comorbidities such as diabetes and ischemic heart disease affect both results of invasive treatment and health-related quality of life (HRQoL) negatively. It is unknown how chronic widespread pain (CWP) influences the results of invasive treatment. We evaluated the influence of CWP on HRQoL in patients undergoing invasive (open surgery or endovascular treatment) and noninvasive BMT of IC...
2017: Clinical Medicine Insights. Cardiology
Srilakshmi M Adhyapak, Prahlad G Menon, Kiron Varghese, Abhinav Mehra, S B Lohitashwa, Fabio Fantini
Background: Late revascularization following a myocardial infarction has questionable clinical benefit. Methods: We studied 13 patients with anterior wall myocardial infarction who underwent percutaneous coronary intervention within 2 weeks of the primary event, by quantitative analysis of 2-dimensional echocardiographic images. Endocardial segmentations of the left ventricular (LV) endocardium from the 4-chamber views were studied over time to establish cumulative wall displacements (CWDs) throughout the cardiac cycle...
2017: Clinical Medicine Insights. Cardiology
Thanawat Rattanathammethee, Adisak Tantiworawit, Ekarat Rattarittamrong, Chatree Chai-Adisaksopha, Sasinee Hantrakool, Arintaya Phrommintikul, Wanwarang Wongcharoen, Siriluck Gunaparn, Lalita Norasetthada
Background: There were some reports of peripheral artery occlusive disease (PAOD) associated with nilotinib usage in chronic myeloid leukemia (CML). These complications in other tyrosine kinase inhibitors are revealed as unknown. Materials and methods: We determined the prevalence of PAOD in patients with CML as compared with matched-control population by cross-sectional case-control study. Peripheral artery occlusive disease was screened by ankle-brachial index (ABI)...
2017: Clinical Medicine Insights. Cardiology
Christopher J Lafferty, Kristen M Lafferty, Tariq Bhat, Peter C Olson, Adam Atoot, Farshid Daneshvar, Donald A McCord
Takotsubo cardiomyopathy is a transient apical ballooning of the left ventricle typically with electrocardiographic changes and enzyme release without evidence of obstructive coronary artery disease. It typically occurs in postmenopausal women and may have a predilection for patients with anxiety disorders. The following is a case in which we believe takotsubo cardiomyopathy was induced by the tapering of antianxiety medications. We feel that health care professionals should be aware of this possibility in such a patient population especially when they have demonstrated cardiovascular symptomatology...
2017: Clinical Medicine Insights. Cardiology
Tuoyo Omasan Mene-Afejuku, Michael Olabode Balogun, Anthony Olubunmi Akintomide, Rasaaq Ayodele Adebayo, Olufemi Eyitayo Ajayi, Valentine N Amadi, Omolola Abiodun Oketona, Amanze Nkemjika Ikwu, Bamidele Mene-Afejuku, Olaniyi James Bamikole
Background: Hypertensive heart failure (HHF) is the commonest form of heart failure in Nigeria. There is paucity of data in Nigeria on 24-hour Holter electrocardiography (24-HHECG) and important predictors of arrhythmias among HHF patients. Objectives: To determine the 24-HHECG characteristics among HHF patients. To determine the clinical and echocardiographic predictors of arrhythmias detected using 24-HHECG among HHF patients. Methods: A total of 100 HHF patients as well as 50 age-matched and sex-matched apparently healthy controls were prospectively recruited over a period of 1 year...
2017: Clinical Medicine Insights. Cardiology
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