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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
Chalak Berzingi, Vinay Badhwar, Fahad Alqahtani, Sami Aljohani, Zakeih Chaker, Mohamad Alkhouli
Background: Early experience with transcatheter mitral valve replacement (TMVR) highlighted several investigational challenges related to this novel therapy. Conclusive randomised clinical trials in the field may, therefore, be years ahead. In the interim, contemporary outcomes of isolated surgical bioprosthetic mitral valve replacement (MVR) can be used as a benchmark for the emerging TMVR therapies. Methods: We used the nationwide inpatient sample to examine recent trends and outcomes of surgical bioprosthetic MVR for mitral regurgitation (isolated and combined)...
2018: Open Heart
Robin Chung, Arjun Kumar Ghosh, Amitava Banerjee
No abstract text is available yet for this article.
2018: Open Heart
Takeshi Umazume, Takahiro Yamada, Satoshi Yamada, Satoshi Ishikawa, Itsuko Furuta, Hiroyuki Iwano, Daisuke Murai, Taichi Hayashi, Kazunori Okada, Mamoru Morikawa, Takashi Yamada, Kota Ono, Hiroyuki Tsutsui, Hisanori Minakami
Objective: This longitudinal study was performed to determine changes in echocardiography parameters in association with various biomarker levels in pregnancy/postpartum. Methods: Fifty-one healthy pregnant women underwent echocardiography with simultaneous determination of blood levels of five biomarkers at each of the first, second and third trimesters of pregnancy, immediately postpartum within 1 week after childbirth and approximately 1 month postpartum...
2018: Open Heart
Nashmil Hashemi, Jonas Johnson, Lars-Åke Brodin, Andreia Gomes-Bernardes, Ulrik Sartipy, Peter Svenarud, Magnus Dalén, Magnus Bäck, Mahbubul Alam, Reidar Winter
Objective: Minimally invasive aortic valve replacementsurgery (MIAVR) is an alternative surgical technique to conventional aortic valve replacement surgery (AVR) in selected patients. The randomised study Cardiac Function after Minimally Invasive Aortic Valve Implantation (CMILE) showed that right ventricular (RV) longitudinal function was reduced after both MIAVR and AVR, but the reduction was more pronounced following AVR. However, postoperative global RV function was equally impaired in both groups...
2018: Open Heart
Alexander S Harrison, Lars Tang, Patrick Doherty
Background: Cardiac rehabilitation (CR) is a well-evidenced and effective secondary intervention proven to reduce mortality and readmission in patients with cardiovascular disease. Improving physical fitness outcomes is a key target for CR programmes, with supervised group-based exercise dominating the mode of the delivery. However, the method of traditional supervised CR fails to attract many patients and may not be the only way of improving physical fitness. Methods: Using real-world routine clinical data from the National Audit of Cardiac Rehabilitation across a 5-year period, this study evaluates the extent of association between physical fitness outcomes, incremental shuttle walk and 6 min walk test, and mode of delivery, delivered as traditional supervised versus facilitated self-delivered...
2018: Open Heart
Ivo M van Dongen, Joëlle Elias, K Gert van Houwelingen, Pierfrancesco Agostoni, Bimmer E P M Claessen, Loes P Hoebers, Dagmar M Ouweneel, Esther M Scheunhage, Ronak Delewi, Jan J Piek, Truls Råmunddal, Peep Laanmets, Erlend Eriksen, Matthijs Bax, Maarten J Suttorp, René J van der Schaaf, Jan G P Tijssen, José P S Henriques
Objective: The impact on cardiac function of collaterals towards a concomitant chronic total coronary occlusion (CTO) in patients with ST-elevation myocardial infarction (STEMI) has not been investigated yet. Therefore, we have evaluated the impact of well-developed collaterals compared with poorly developed collaterals to a concomitant CTO in STEMI. Methods and results: In the EXPLORE trial, patients with STEMI and a concomitant CTO were randomised to either CTO percutaneous coronary intervention (PCI) or no-CTO PCI...
2018: Open Heart
Andriany Qanitha, Cuno S P M Uiterwaal, Jose P S Henriques, Idar Mappangara, Irfan Idris, Muzakkir Amir, Bastianus A J M de Mol
Objective: To measure medium-term outcomes and determine the predictors of mortality in patients with coronary artery disease (CAD) both during and after hospitalisation in a resource-limited South-East Asian setting. Methods: From February 2013 to December 2014, we conducted a prospective observational cohort study of 477 patients admitted to Makassar Cardiac Center, Indonesia, with acute coronary syndrome and stable CAD. We actively obtained data on clinical outcomes and after-discharge management until April 2017...
2018: Open Heart
Fei Fei Gong, Michael V Jelinek, Julian M Castro, Jennifer M Coller, Michele McGrady, Umberto Boffa, Louise Shiel, Danny Liew, Rory Wolfe, Simon Stewart, Alice J Owen, Henry Krum, Christopher M Reid, David L Prior, Duncan J Campbell
Background: The lack of effective therapies for heart failure with preserved ejection fraction (HFpEF) reflects an incomplete understanding of its pathogenesis. Design: We analysed baseline risk factors for incident HFpEF, heart failure with reduced ejection fraction (HFrEF) and valvular heart failure (VHF) in a community-based cohort. Methods: We recruited 2101 men and 1746 women ≥60 years of age with hypertension, diabetes, ischaemic heart disease (IHD), abnormal heart rhythm, cerebrovascular disease or renal impairment...
2018: Open Heart
Sebastian Udholm, Nael Aldweib, Vibeke Elisabeth Hjortdal, Gruschen R Veldtman
Objective: Exercise impairment is common in Fontan patients. Our aim is to systematically review previous literature to determine the prognostic value of exercise capacity in older adolescent and adult Fontan patients with respect to late outcome. Additionally, we reviewed the determinants of exercise capacity in Fontan patients and changes in exercise capacity over time. Methods: PubMed, CINAHL, Embase, The Cochrane Library and Scopus were searched systematically for studies reporting exercise capacity and late outcome such as mortality, cardiac transplantation and hospitalisation...
2018: Open Heart
Anne-Sophie Zenses, Abdellaziz Dahou, Erwan Salaun, Marie-Annick Clavel, Josep Rodés-Cabau, Géraldine Ong, Ezéquiel Guzzetti, Mélanie Côté, Robert De Larochellière, Jean-Michel Paradis, Daniel Doyle, Siamak Mohammadi, Éric Dumont, Chekrallah Chamandi, Tania Rodriguez-Gabella, Régis Rieu, Philippe Pibarot
Background and objectives: Transcatheter aortic valve-in-valve implantation (ViV) has emerged as a valuable technique to treat failed surgical bioprostheses (BPs) in patients with high risk for redo surgical aortic valve replacement (SAVR). Small BP size (≤21 mm), stenotic pattern of degeneration and pre-existing prosthesis-patient mismatch (PPM) have been associated with worse clinical outcomes after ViV. However, no study has evaluated the actual haemodynamic benefit associated with ViV...
2018: Open Heart
Takeshi Kitai, W H Wilson Tang, Andrew Xanthopoulos, Ryosuke Murai, Takafumi Yamane, Kitae Kim, Shogo Oishi, Eiichi Akiyama, Satoshi Suzuki, Masayoshi Yamamoto, Keisuke Kida, Takahiro Okumura, Shuichiro Kaji, Yutaka Furukawa, Yuya Matsue
Objective: Although vasodilators are used in acute heart failure (AHF) management, there have been no clear supportive evidence regarding their routine use. Recent European guidelines recommend systolic blood pressure (SBP) reduction in the range of 25% during the first few hours after diagnosis. This study aimed to examine clinical and prognostic significance of early treatment with intravenous vasodilators in relation to their subsequent SBP reduction in hospitalised AHF. Methods: We performed post hoc analysis of 1670 consecutive patients enrolled in the Registry Focused on Very Early Presentation and Treatment in Emergency Department of Acute Heart Failure...
2018: Open Heart
Jeffrey Laurence, Sonia Elhadad, Jasimuddin Ahamed
HIV infection is a risk factor for cardiovascular disease (CVD). This risk is accentuated by certain combination antiretroviral therapies (cARTs), independent of their effects on lipid metabolism and insulin sensitivity. We sought to define potential mechanisms for this association through systematic review of clinical and preclinical studies of CVD in the setting of HIV/cART from the English language literature from 1989 to March 2018. We used PubMed, Web of Knowledge and Google Scholar, and conference abstracts for the years 2015-March 2018...
2018: Open Heart
Kjersti Stormark Rabanal, Haakon Eduard Meyer, Romana Pylypchuk, Suneela Mehta, Randi Marie Selmer, Rodney T Jackson
Objectives: To evaluate a Framingham 5-year cardiovascular disease (CVD) risk score in Indians and Europeans in New Zealand, and determine whether body mass index (BMI) and socioeconomic deprivation were independent predictors of CVD risk. Methods: We included Indians and Europeans, aged 30-74 years without prior CVD undergoing risk assessment in New Zealand primary care during 2002-2015 (n=256 446). Risk profiles included standard Framingham predictors (age, sex, systolic blood pressure, total cholesterol/high-density lipoprotein ratio, smoking and diabetes) and were linked with national CVD hospitalisations and mortality datasets...
2018: Open Heart
Melissa J Pearson, Nicola King, Neil A Smart
Background: Biomarkers are important in the diagnosis, risk stratification and management of patients with heart failure (HF). The established biomarkers of myocardial stretch, brain natriuretic peptide (BNP) and amino (N) portion of BNP (NT-proBNP) have been extensively studied, and early analyses have demonstrated response to exercise training. Several other biomarkers have been identified over the last decade and may provide valuable and complementary information which may guide treatment strategies, including exercise therapy...
2018: Open Heart
Iain Thomas Parsons, Clare Bannister, John Badelek, Mark Ingram, Emma Wood, Alex Horton, Michael Hickman, Edward Leatham
Introduction: CT coronary angiography (CTCA) has excellent sensitivity but lacks specificity when compared with invasive coronary angiography (ICA) particularly in patients with a high coronary calcium burden. CTCA has been shown in large trials to decrease the requirement for diagnostic ICA and provide diagnostic clarity. We describe the methodology used to provide a standardised CTCA service established in a District General Hospital, which may assist other hospitals aiming to develop a cardiac CT service...
2018: Open Heart
J J Coughlan, Nial Blake, Napohn Chongprasertpon, Munir Ibrahim, Samer Arnous, Thomas John Kiernan
Purpose: In this study, we sought to prospectively analyse the management and long term outcomes associated with revascularisation of left main stem disease via percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) in our centre. Methods: This prospective study enrolled all patients with unprotected left main stem disease undergoing revascularisation from January 2013 to June 2014. Baseline characteristics, hospital presentation and hospital stay length were collected...
2018: Open Heart
Dan Liu, Daniel Oder, Tim Salinger, Kai Hu, Jonas Müntze, Frank Weidemann, Sebastian Herrmann, Georg Ertl, Christoph Wanner, Stefan Frantz, Stefan Störk, Peter Nordbeck
Objectives: Current guidelines highlight important therapy implications of cardiac fibrosis in patients with Fabry disease (FD). However, association between morphological and functional impairments with cardiac fibrosis in hereditary cardiomyopathies remains elusive. We investigated the association between echocardiography-determined cardiac dysfunction and cardiac MRI (cMRI)-detected myocardial fibrosis (late gadolinium enhancement, LE) in patients with FD with preserved left ventricular ejection fraction (≥50%)...
2018: Open Heart
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