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Open Heart

Alex Bottle, Dani Kim, Paul P Aylin, F Azeem Majeed, Martin R Cowie, Benedict Hayhoe
Objective: To describe associations between initial management of people presenting with heart failure (HF) symptoms in primary care, including compliance with the recommendations of the National Institute for Health and Care Excellence (NICE), and subsequent unplanned hospitalisation for HF and death. Methods: This is a retrospective cohort study using data from general practices submitting records to the Clinical Practice Research Datalink. The cohort comprised patients diagnosed with HF during 2010-2013 and presenting to their general practitioners with breathlessness, fatigue or ankle swelling...
2018: Open Heart
Sammy Elmariah, Cian McCarthy, Nasrien Ibrahim, Deborah Furman, Renata Mukai, Craig Magaret, Rhonda Rhyne, Grady Barnes, Roland R J van Kimmenade, James L Januzzi
Objective: Severe aortic valve stenosis (AS) develops via insidious processes and can be challenging to correctly diagnose. We sought to develop a circulating biomarker panel to identify patients with severe AS. Methods: We enrolled study participants undergoing coronary or peripheral angiography for a variety of cardiovascular diseases at a single academic medical centre. A panel of 109 proteins were measured in blood obtained at the time of the procedure. Statistical learning methods were used to identify biomarkers and clinical parameters that associate with severe AS...
2018: Open Heart
Louise Y Sun, Jack V Tu, Douglas S Lee, Rob S Beanlands, Marc Ruel, Peter C Austin, Anan Bader Eddeen, Peter P Liu
Objective: Heart failure (HF) impairs survival post coronary artery bypass grafting (CABG), but little is known about the postoperative quality of life (QoL) in patients with HF. We derived a patient-centred QoL surrogate and assessed the impact of different HF subtypes on this surrogate in the year post-CABG. Methods: We surveyed 3112 cardiovascular patients to derive a patient-centred disability outcome and studied this outcome in a population-based cohort. We defined preserved ejection fraction as ≥50% and reduced ejection fraction as <50%...
2018: Open Heart
Roopinder K Sandhu, Justin A Ezekowitz, Ziad Hijazi, Johan Westerbergh, Julia Aulin, John H Alexander, Christopher B Granger, Sigrun Halvorsen, Michael S Hanna, Renato D Lopes, Agneta Siegbahn, Lars Wallentin
Objective: We investigated the association between obesity and biomarkers indicating cardiac or renal dysfunction or inflammation and their interaction with obesity and outcomes. Methods: A total of 14 753 patients in the Apixaban for Reduction In STroke and Other ThromboemboLic Events in Atrial Fibrillation (ARISTOTLE) trial provided plasma samples at randomisation to apixaban or warfarin. Median follow-up was 1.9 years. Body Mass Index (BMI) was measured at baseline and categorised as normal, 18...
2018: Open Heart
Denis S Tuter, Philippe Y Kopylov, Abram L Syrkin, Oleg S Glazachev, Roman N Komarov, Andrei I Katkov, Ljudmila P Severova, Ekaterina V Ivanova, Young Zhang, Hugo Saner
Background: Although remote ischaemic preconditioning (RIP) provides protection against myocardial ischaemia and reperfusion injury during cardiac surgery, it is not widely used. Systemic intermittent hypoxic-hyperoxic training (IHHT) may be a suitable alternative. Methods: This is a prospective, single-centre, randomised controlled trial. 127 patients with ischaemic heart disease and indication for coronary artery bypass graft (CABG) surgery from the Cardiology Clinic IM Sechenov First Moscow State Medical University were randomly assigned to IHHT, IHHT-control or RIP...
2018: Open Heart
Kristina Fladseth, Andreas Kristensen, Jan Mannsverk, Thor Trovik, Henrik Schirmer
Objective: Patients referred for acute coronary angiography (CAG) with unstable angina (UA) have low mortality and low rate of obstructive coronary artery disease (CAD). Better pre-test selection criteria are warranted. We aimed to assess the current guidelines against other clinical variables as predictors of obstructive CAD in patients with UA referred for acute CAG. Methods: From 2005 to 2012, all CAGs performed at the University Hospital of North Norway, the sole provider of CAG in the region, were recorded in a registry...
2018: Open Heart
Christian Eick, Patrick Groga-Bada, Kathrin Reinhardt, Martin Duckheim, Lars Mizera, Katharina Böhm, Nina Götz, Meinrad Gawaz, Christine Zürn
Background: Patients with acute coronary syndrome (ACS) are at risk especially in the period shortly after the event. Alterations in respiratory control have been associated with adverse prognosis. The aim of our study was to assess if the nocturnal respiratory rate (NRR) is a predictor of mortality in patients with ACS presenting in the emergency department. Methods: Clinically stable consecutive patients with ACS aged ≥ 18 years were prospectively enrolled. The Global Registry of Acute Coronary Events (GRACE) score and left ventricular ejection fraction (LVEF) were assessed for all patients...
2018: Open Heart
Fernando Macaya, Pablo Salinas, Nieves Gonzalo, Antonio Fernández-Ortiz, Carlos Macaya, Javier Escaned
Spontaneous coronary artery dissection is an increasingly recognised cause of acute coronary syndromes, especially in young and middle-age women. Recognising its particularities and differences with atherosclerotic disease is central for appropriately identifying and approaching these patients. The authors review the current state of knowledge on spontaneous coronary artery dissection and provide practical recommendations for the diagnosis and management of this condition, both in the acute and convalescence phases...
2018: Open Heart
Jonathan R G Etnel, Willem A Helbing, Jolien W Roos-Hesselink, Regina The, Ad J J C Bogers, Johanna J M Takkenberg
Background: To assess the current state of patient information and decision-making in congenital aortic and pulmonary valve disease, we conducted a survey among patients, parents and physicians. Methods: A questionnaire was sent by ground mail to 157 adults and 32 parents of children who previously underwent surgery for congenital aortic or pulmonary valve disease at 0-40 years of age between January 2005 and February 2014 at the Erasmus University Medical Center and to all paediatric and adult congenital cardiologists and congenital cardiac surgeons in the Netherlands (n=88)...
2018: Open Heart
Gabriella Captur, Eloisa Arbustini, Petros Syrris, Dina Radenkovic, Ben O'Brien, William J Mckenna, James C Moon
Objective: Two LMNA genotype-phenotype cardiac correlations are reported: first, that cardiac involvement in multisystem laminopathies prevails with mutations upstream of the nuclear localisation signal (NLS); second, that worse outcomes occur with non-missense (compared with missense) mutations. We tested whether LMNA mutation DNA location and mutation subtype can predict phenotype severity in patients with lamin heart disease. Methods: We used a semantic workflow platform and manual electronic literature search to identify published LMNA mutations with cardiac-predominant phenotype...
2018: Open Heart
Tomás Barry, Ainhoa González, Niall Conroy, Paddy Watters, Siobhán Masterson, Jan Rigby, Gerard Bury
Objective: Resuscitation from out-of-hospital cardiac arrest (OHCA) is largely determined by the availability of cardiopulmonary resuscitation (CPR) and defibrillation within 5-10 min of collapse. The potential contribution of organised groups of volunteers to delivery of CPR and defibrillation in their communities has been little studied. Ireland has extensive networks of such volunteers; this study develops and tests a model to examine the potential impact at national level of these networks on early delivery of care...
2018: Open Heart
Andreas Jönsson, Artur Fedorowski, Gunnar Engström, Per Wollmer, Viktor Hamrefors
Objective: Chronic obstructive pulmonary disease (COPD) and coronary artery disease (CAD) are leading causes of global morbidity and mortality. Despite the well-known comorbidity between COPD and CAD, the presence of COPD may be overlooked in patients undergoing coronary evaluation. We aimed to assess the prevalence of undiagnosed COPD among outpatients evaluated due to suspected myocardial ischemia. Methods: Among 500 outpatients who were referred to myocardial perfusion imaging due to suspected stable myocardial ischaemia, 433 patients performed spirometry...
2018: Open Heart
Karim Tararbit, Nathalie Lelong, François Goffinet, Babak Khoshnood
Objectives: To quantify the risk of preterm birth (PTB) for newborns with congenital heart defects (CHDs) conceived following infertility treatments, and to examine the role of multiple pregnancies in the association between infertility treatments and PTB for newborns with CHD. Methods: We used data from a population-based, prospective cohort study (EPICARD EPIdémiologie des CARDiopathies congénitales) including 2190 newborns with CHD and excluding cases with atrial septal defects born to women living in the Greater Paris area between May 2005 and April 2008...
2018: Open Heart
Melissa Suzanne Burroughs Peña, Katrina Swett, Robert C Kaplan, Krista Perreira, Martha Daviglus, Mayank M Kansal, Jianwen Cai, Aida L Giachello, Marc D Gellman, Eric J Velazquez, Carlos J Rodriguez
Objective: To describe the relationship of household secondhand smoke (SHS) exposure and cardiac structure and function. Methods: Participants (n=1069; 68 % female; age 45-74 years) without history of tobacco use, coronary artery disease or severe valvular disease were included. Past childhood (starting at age <13 years), adolescent/adult and current exposure to household SHS was assessed. Survey linear regression analyses were used to model the relationship of SHS exposure and echocardiographic measures of cardiac structure and function, adjusting for covariates (age, sex, study site, alcohol use, physical activity and education)...
2018: Open Heart
Rohan Khera, Sheena CarlLee, Amy Blevins, Marin Schweizer, Saket Girotra
Background: Although acute myocardial infarction is a common cause of out-of-hospital cardiac arrest (OHCA), the role of early coronary angiography in OHCA remains uncertain. We conducted a meta-analysis of observational studies to determine the association of early coronary angiography with survival in OHCA. Methods: We searched multiple electronic databases for published studies on early coronary angiography in OHCA between 1 January 1990 and 18 January 2017. Studies were included if (1) restricted to only OHCA, (2) included an exposure group that underwent early coronary angiography within 1  day of arrest onset and a concurrent control group that did not undergo early coronary angiography, and (3) reported survival outcomes...
2018: Open Heart
Christopher J McAloon, Temo Barwari, Jimiao Hu, Thomas Hamborg, Alan Nevill, Samantha Hyndman, Valerie Ansell, Anntoniette Musa, Julie Jones, Julie Goodby, Prithwish Banerjee, Paul O'Hare, Manuel Mayr, Harpal Randeva, Faizel Osman
Aims: Cardiac resynchronisation therapy (CRT) is effective treatment for selected patients with heart failure (HF) but has ~30% non-response rate. We evaluated whether specific biomarkers can predict outcome. Methods: A prospective single-centre pilot study of consecutive unselected patients undergoing CRT for HF between November 2013 and December 2015 evaluating cardiac extracellular matrix biomarkers and micro-ribonucleic acid (miRNA) expression before and after CRT assessing ability to predict functional response and survival...
2018: Open Heart
Mylène Shen, Romain Capoulade, Lionel Tastet, Ezequiel Guzzetti, Marie-Annick Clavel, Erwan Salaun, Élisabeth Bédard, Marie Arsenault, Philippe Chetaille, Helena Tizón-Marcos, Florent Le Ven, Philippe Pibarot, Éric Larose
Objective: The aim of this study was to compare the prevalence of left ventricle non-compaction (LVNC) criteria (or hypertrabeculation) in a cohort of patients with bicuspid aortic valve (BAV) and healthy control subjects (CTL) without cardiovascular disease using cardiovascular MR (CMR). Methods: 79 patients with BAV and 85 CTL with tricuspid aortic valve and free of known cardiovascular disease underwent CMR to evaluate the presence of LVNC criteria. The left ventricle was assessed at end-systole and end-diastole, in the short-axis, two-chamber and four-chamber views and divided into the 16 standardised myocardial segments...
2018: Open Heart
James J DiNicolantonio, James H O'Keefe
No abstract text is available yet for this article.
2018: Open Heart
James J DiNicolantonio, Mark F McCarty, James H O'Keefe
No abstract text is available yet for this article.
2018: Open Heart
Gunnar Erikssen, Jamil Aboulhosn, Jeannette Lin, Knut Liestøl, Mette E Estensen, Ola Gjesdal, Helge Skulstad, Gaute Døhlen, Harald Lauritz Lindberg
Objective: Patients with univentricular hearts (UVH) have high mortality despite modern treatment, and better methods to identify patients at highest risk are needed. We wanted to improve risk stratification in patients with UVH by focusing on the prognostic significance of single right versus single left ventricular morphology (SRV vs SLV). Methods: All 395 patients with UVH operated at our centre were prospectively included from 1972 to 2016 (195 SRV, 166 SLV, 34 mixed or indeterminate ventricular morphology)...
2018: Open Heart
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