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Open Heart

Ali M Agha, Purvi Parwani, Avirup Guha, Jean B Durand, Cezar A Iliescu, Saamir Hassan, Nicolas L Palaskas, Greg Gladish, Peter Y Kim, Juan Lopez-Mattei
Cardiac amyloidosis (CA) describes the pathological process of amyloid protein deposition in the extracellular space of the myocardium. Unfortunately, the diagnosis of CA is often made late and when the disease process is advanced. However, advances in cardiovascular imaging have allowed for better prognostication and establishing diagnostic pathways with high sensitivity and specificity. This review discusses the role of echocardiography, cardiac MRI and nuclear cardiology in current clinical practice for diagnosis and prognosis of CA...
2018: Open Heart
Martijn Stefan van Mourik, Jeroen Vendrik, Mohammad Abdelghani, Floortje van Kesteren, Jose P S Henriques, Antoine H G Driessen, Joanna J Wykrzykowska, Robbert J de Winter, Jan J Piek, Jan G Tijssen, Karel T Koch, Jan Baan, M Marije Vis
Objective: Transcatheter aortic valve implantation (TAVI) provides a significant symptom relief and mortality reduction in most patients; however, a substantial group of patients does not experience the same beneficial results according to physician-determined outcomes. Methods: Single-centre prospective design; the population comprises all consecutive patients undergoing TAVI in 2012-2017. TAVI futility was defined as the combined endpoint of either no symptomatic improvement or mortality at 1 year...
2018: Open Heart
Wieneke Vlastra, Ronak Delewi, Wim J Rohling, Tineke C Wagenaar, Alexander Hirsch, Martin G Meesterman, Marije M Vis, Joanna J Wykrzykowska, Karel T Koch, Robbert J de Winter, Jan Baan, Jan J Piek, Mirjam A G Sprangers, José P S Henriques
Aims: In this study, we examined the effects of the routinely administration of benzodiazepines on reducing periprocedural anxiety versus no premedication. Methods: In this open label study, we enrolled 1683 patients undergoing diagnostic coronary angiograms (CAG) or percutaneous coronary interventions (PCI). Randomisation was simulated by systematically allocating patients in monthly rotational periods to lorazepam 1  mg/sl, oxazepam 10  mg/po, diazepam 5  mg/po, midazolam 7...
2018: Open Heart
Thor Ueland, Ola Kleveland, Annika E Michelsen, Rune Wiseth, Jan Kristian Damås, Pål Aukrust, Lars Gullestad, Bente Halvorsen, Arne Yndestad
Objective: It is unclear if activation of inflammatory pathways regulates proprotein convertase subtilisin-kexin type 9 (PCSK9) levels. Approach: We evaluated (1) the temporal course of serum PCSK9 during hospitalisation following acute coronary syndrome and associations with markers of inflammation (leucocyte counts, interleukin (IL)-6, C-reactive protein) and lipid levels and (2) the effect of inhibition of IL-6 signalling with the IL-6 receptor antibody tocilizumab on PCSK9 levels in a randomised, double-blind, placebo-controlled trial release in patients with non-ST-elevation myocardial infarction...
2018: Open Heart
Sebastian Greiner, Ferdinand Goppelt, Matthias Aurich, Hugo A Katus, Derliz Mereles
Objective: The aim of the prospective New-RV study was to evaluate a parameter for non-invasive quantification of right ventricular (RV) dysfunction in patients with precapillary pulmonary hypertension (PH) that yields prognostic information and is applicable in daily clinical routine. Methods: Sixty-five consecutive patients with precapillary PH under guideline conform therapy (43 women, 22 men) underwent clinical assessment, serological testing, as well as a comprehensive transthoracic echocardiography including strain imaging and a detailed assessment of RV haemodynamics...
2018: Open Heart
Makoto Saito, Manami Yamaoka, Mayuri Ohzawa, Emi Tominaga, Kayo Takahashi, Toru Morofuji, Takumi Sumimoto, Shinji Inaba
Objective: Mountain districts normally have tougher geographic conditions than plain districts, which might worsen heart failure (HF) conditions in patients. Also, those places frequently are associated with social problems of ageing, underpopulation and fewer medical services, which might cause delay in detection of disease progression and require more admissions. We investigated the association of residence altitude with readmission in patients with HF. Methods: We followed 452 patients with HF to determine all-cause readmissions over a median of 1...
2018: Open Heart
Takeshi Umazume, Satoshi Yamada, Takahiro Yamada, Satoshi Ishikawa, Itsuko Furuta, Hiroyuki Iwano, Daisuke Murai, Taichi Hayashi, Kazunori Okada, Mamoru Morikawa, Hiroyuki Tsutsui, Hisanori Minakami
Objective: Women with hypertensive disorders of pregnancy (HDP) show elevated risk of heart failure despite decreased circulating plasma volume compared with those with normotensive control pregnancies (NCP). This study was performed to better characterise the heart in women with HDP and determine whether high-sensitivity troponin I (hs-TnI) around childbirth predicts reduced left ventricular (LV) relaxation at 1 month postpartum. Methods: Echocardiography was performed longitudinally during the first, second and third trimesters and immediately postpartum within 1 week and 1 month postpartum in 24 women with HDP, with simultaneous determination of blood variables in comparison with 51 women with NCP...
2018: Open Heart
Atsushi Shibata, Yasuo Sugano, Akito Shimouchi, Tetsuro Yokokawa, Naoya Jinno, Hideaki Kanzaki, Keiko Ohta-Ogo, Yoshihiko Ikeda, Hideshi Okada, Takeshi Aiba, Kengo Kusano, Mikiyasu Shirai, Hatsue Ishibashi-Ueda, Satoshi Yasuda, Hisao Ogawa, Toshihisa Anzai
Objective: Hydrogen excretion is thought to be related to systemic antioxidation activity. H2 selectively reduces the hydroxyl radical of free hydrogen (·OH), a highly cytotoxic form of reactive oxygen species, in cultured cells. Methods: We investigated whether exhaled H2 decreased during night sleep, reflected ·OH production and was associated with heart failure severity. We enrolled 108 patients with chronic heart failure (CHF) and 15 control participants without CHF...
2018: Open Heart
(no author information available yet)
[This corrects the article DOI: 10.1136/openhrt-2018-000782.].
2018: Open Heart
Mohamad Alkhouli, Chalak Berzingi, Amer Kowatli, Fahad Alqahtani, Vinay Badhwar
Background: Comparative outcome data on tricuspid valve repair (TVr) versus tricuspid valve replacement (TVR) for severe secondary tricuspid regurgitation (TR) are limited. Methods: We used a national inpatient sample to assess in-hospital morbidity and mortality, length of stay and cost in patients with severe secondary TR undergoing isolated TVr versus TVR. Results: A total of 1364 patients (national estimate=6757) underwent isolated tricuspid valve surgery during the study period, of whom 569 (41...
2018: Open Heart
M Mostafa Mokhles, Sadaf Soloukey Tbalvandany, Sabrina Siregar, Michel I M Versteegh, Luc Noyez, Bart van Putte, Alexander B A Vonk, Jolien W Roos-Hesselink, Ad J J C Bogers, Johanna J M Takkenberg
Objective: The outcome of female patients after adult cardiac surgery has been reported to be less favourable compared with the outcome of male patients. This study compares men with women with respect to patient and procedural characteristics and early mortality in a contemporary national cohort of patients who underwent aortic valve (AV) and combined aortic valve/coronary (CABG/AV) surgery. Methods: All patients who underwent AV (n=8717, 56% male) or a combined CABG/AV surgery (n=5867, 67% male) in the Netherlands between January 2007 and December 2011 were included...
2018: Open Heart
Akshay Patel, Kajan Mahendran, Michael Collins, Mahmoud Abdelaziz, Saib Khogali, Heyman Luckraz
Objectives: The aim of this retrospective series is to describe the prevalence and clinical significance of the incidental findings found during pre-transcatheter aortic valve implantation (TAVI) work-up and to ascertain the clinical course of such patients. Methods: Consecutive patients undergoing TAVI from 2013 to 2015 where a TAVI CT assessment was performed (n=138) were included in the study. All incidental findings that were not expected from the patient's history were discussed at the TAVI multidisciplinary meeting in order to ascertain the clinical significance of said findings and whether they would alter the proposed course of treatment...
2018: Open Heart
Artin Entezarjou, Moman Aladdin Mohammad, Pontus Andell, Sasha Koul
Background: ST-elevation myocardial infarction (STEMI) occurs as a result of rupture of an atherosclerotic plaque in the coronary arteries. Limited data exist regarding the impact of culprit coronary vessel on hard clinical event rates. This study investigated the impact of culprit vessel on outcomes after primary percutaneous coronary intervention (PCI) of STEMI. Methods: A total of 29 832 previously cardiac healthy patients who underwent primary PCI between 2003 and 2014 were prospectively included from the Swedish Coronary Angiography and Angioplasty Registry and the Registry of Information and Knowledge about Swedish Heart Intensive care Admissions...
2018: Open Heart
Daniela Poli, Emilia Antonucci, Vittorio Pengo, Elisa Grifoni, Niccolò Maggini, Sophie Testa, Corrado Lodigiani, Antonio Insana, Francesco Marongiu, Doris Barcellona, Carmelo Paparo, Eugenio Bucherini, Pasquale Pignatelli, Gualtiero Palareti
Objective: Several factors should be considered when a prosthetic heart valve, bioprosthetic valve (BV) or mechanical valve is to be implanted: thrombogenicity, life expectancy and the risk of reoperation. Methods: We conducted an observational retrospective multicentre study among Italian Thrombosis Centers on patients with BV on long-term vitamin K antagonist (VKA) treatment to evaluate the risk of reoperation and the rate of bleeding and thrombotic events. Results: We analysed 612 patients (median age 71...
2018: Open Heart
Jonathan Ludmir, Xinggang Liu, Anuj Gupta, Gautam V Ramani, Stanley S Liu, Sammy Zakaria, Avelino C Verceles, Nirav G Shah, Michael T McCurdy, Jennifer A Dammeyer, Giora Netzer
Objective: Few data exist regarding physician attitudes and implementation of family-centred rounds (FCR) in cardiovascular care. This study aimed to assess knowledge and attitudes among cardiologists and cardiology fellows regarding barriers and benefits of FCRs. Methods: An electronic, web-based questionnaire was nationally distributed to cardiology fellows and attending cardiologists. Results: In total, 118 subjects were surveyed, comprising cardiologists (n=64, 54%) and cardiology fellows (n=54, 46%)...
2018: Open Heart
Toshiyuki Nagai, Varun Sundaram, Kieran Rothnie, Jennifer Kathleen Quint, Ahmad Shoaib, Yasuyuki Shiraishi, Shun Kohsaka, Susan Piper, Theresa A McDonagh, Suzanna Marie C Hardman, Ayumi Goda, Atsushi Mizuno, Takashi Kohno, Alan S Rigby, Tsutomu Yoshikawa, Andrew L Clark, Toshihisa Anzai, John G F Cleland
Objective: Mortality amongst patients hospitalised for heart failure (HHF) in Western and Asian countries may differ, but this has not been investigated using individual patient-level data (IPLD). We sought to remedy this through rigorous statistical analysis of HHF registries and variable selection from a systematic literature review. Methods and results: IPLD from registries of HHF in Japan (n=3781) and the UK (n=894) were obtained. A systematic literature review identified 23 models for predicting outcome of HHF...
2018: Open Heart
Per Winkel, Janus Christian Jakobsen, Jørgen Hilden, Gorm Jensen, Erik Kjøller, Ahmad Sajadieh, Jens Kastrup, Hans Jørn Kolmos, Anders Larsson, Johan Ärnlöv, Christian Gluud
Objective: To characterise the long-term prognosis of patients with stable coronary artery heart disease by means of 'standard predictors' defined as demographic, clinical and biochemical quantities routinely available in general practices and ascertained at an interview not prompted by renewed cardiac complaints. Methods: This is an observational study based on data from 2199 Copenhagen placebo patients from the 'clarithromycin for patients with stable coronary heart disease' trial of patients with stable coronary heart disease...
2018: Open Heart
James J DiNicolantonio, James H O'Keefe
No abstract text is available yet for this article.
2018: Open Heart
Jacob W Groenendyk, Nehal N Mehta
Atherogenesis has been well demonstrated to proceed in an ordinal fashion. Imaging technologies have advanced substantially in recent decades, enabling early detection of atherosclerosis. Some modalities, such as coronary CT, have seen broad clinical adaptation. In contrast, others, such as flow-mediated dilatation, remain predominantly research-based. Optimal and appropriate usage of these technologies remains an area of active investigation. We hypothesise that investigators ought to consider which stage of atherosclerosis is under investigation when choosing imaging modalities...
2018: Open Heart
Mahmoud Abdelaziz, Saib Khogali, James M Cotton, Antonella Meralgia, Maciej Matuszewski, Heyman Luckraz
Objective: Severe decompensated aortic valve stenosis is associated with noticeable reduction in survival. Until recently the options for such patients were either high-risk surgery or percutaneous balloon valvuloplasty and medical therapy which does not add any survival benefits and associated with high rate of complications. We present our experience in the use of transcatheter aortic valve implantation (TAVI) in patients with decompensated severe aortic stenosis requiring urgent intervention in the same hospital admission...
2018: Open Heart
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