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https://www.readbyqxmd.com/read/29161389/innovations-in-management-of-cardiac-disease-drugs-treatment-strategies-and-technology
#1
P Foëx
Within the last generation, the management of patients with heart disease has been transformed by advances in drug treatments, interventions and diagnostic technologies. The management of arterial hypertension saw beta-blockers demoted from first- to third-line treatment. Recent studies suggest that the goal of treatment may have to change to lower systolic blood pressures to prevent long-term organ damage. Today less than 15% of coronary revascularizations are surgical and more than 85% are done by interventional cardiologists inserting coronary stents...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29154427/design-of-a-multicentre-randomized-controlled-trial-to-assess-the-safety-and-efficacy-of-dose-titration-by-specialized-nurses-in-patients-with-heart-failure-etific-study-protocol
#2
Juana Oyanguren, LLuisa García-Garrido, Magdalena Nebot Margalef, Iñaki Lekuona, Josep Comin-Colet, Nicolás Manito, Julia Roure, Pilar Ruiz Rodriguez, Cristina Enjuanes, Pedro Latorre, Jesús Torcal Laguna, Susana García-Gutiérrez
AIMS: Heart failure (HF) is associated with many hospital admissions and relatively high mortality, rates decreasing with administration of beta-blockers (BBs), angiotensin-converting-enzyme inhibitors, angiotensin II receptor blockers, and mineralocorticoid receptor antagonists. The effect is dose dependent, suboptimal doses being common in clinical practice. The 2012 European guidelines recommend close monitoring and dose titration by HF nurses. Our main aim is to compare BB doses achieved by patients after 4 months in intervention (HF nurse-managed) and control (cardiologist-managed) groups...
November 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/29146551/dual-lumen-microcatheters-for-complex-percutaneous-coronary-interventions
#3
REVIEW
Jacopo A Oreglia, Roberto Garbo, Andrea Gagnor, Gabriele L Gasparini
In some bifurcation anatomies side branch wiring can be difficult particularly when side branch is highly angulated. Furthermore a combination of bifurcations and chronic total occlusion can be a real challenge for interventional cardiologists. New devices have been produced to facilitate complex PCI and recently introduced dual lumen microcatheters can be really helpful in these scenarios. All these devices have both a rapid-exchange and an over-the-wire lumen. The rationale for dual lumen microcatheters is to preserve the highest number of side-branches...
October 4, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29145782/comprehensive-preclinical-postmortem-evaluation-of-valvular-prosthesis
#4
Armando Tellez, Krista N Dillon, Serge D Rousselle
Transcatheter prosthetic valves are heralding a new era in interventional cardiology and affording real therapeutic options to categories of patients currently medically disqualified, namely the elderly and higher risk individuals. An increasing variety of novel artificial valve designs and delivery systems are being tested preclinically. Cardiologists and surgeons are generally well-equipped to assess deliverability and function; however, methods for pathological evaluation of animals enrolled in transcatheter valve implant testing are scant, often vague, and far from consensual...
January 1, 2017: Toxicologic Pathology
https://www.readbyqxmd.com/read/29135621/efficacy-of-implementation-of-a-chest-pain-center-at-a-community-hospital
#5
Alexandra Davis, Jason Chiu, Stanley K Lau, Yih Jen Kok, Jonathan Y H Wu
INTRODUCTION: Chest pain is the second leading cause for emergency department (ED) visits in the United States; however, <20% of the patients have acute coronary syndrome that require immediate attention. The HEART score is designed for rapid risk stratification of ED chest pain patients using the following criteria: history, electrocardiogram, age, risk factors, and troponin. It has been shown to be superior in identifying patients with low (HEART score 0-3) and high (7-10) risk of major adverse cardiac events, who can then be rapidly discharged or admitted for intervention...
December 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29131836/opportunistic-screening-for-atrial-fibrillation-in-a-real-life-setting-in-general-practice-in-denmark-the-atrial-fibrillation-found-on-routine-detection-afford-non-interventional-study
#6
Jonas Hald, Peter Bo Poulsen, Ina Qvist, Lisbeth Holm, Dorte Wedell-Wedellsborg, Lars Dybro, Lars Frost
Atrial fibrillation (AF) is a chronic disease with an incidence increasing steeply by age and affecting more than 11 million patients in Europe and the United States. Diagnosing AF is essential for the prevention of stroke by oral anticoagulation. Opportunistic screening for AF in patients ≥65 years of age is recommended by the European and Danish Societies of Cardiology. The study aim was to examine the detection rate of AF in consecutively screened patients in the primary care setting in Denmark. In an open, non-interventional, cluster, multicenter, cross-sectional, observational study patients ≥65 years of age entering consecutively into general practice clinics were invited to nurse-assisted opportunistic screening for AF...
2017: PloS One
https://www.readbyqxmd.com/read/29122104/the-diagnosis-of-chronic-coronary-heart-disease
#7
Christian Albus, Jörg Barkhausen, Eckart Fleck, Jörg Haasenritter, Oliver Lindner, Sigmund Silber
BACKGROUND: Chronic coronary heart disease (CHD) and acute myocardial infarction are endemic conditions. In Germany, an estimated 900 000 cardiac catheterizations were performed in the year 2014, and a percutaneous intervention was carried out in 40% of these procedures. It would be desirable to lessen the number of invasive diagnostic procedures while preserving the reliability of diagnosis. In this article, we present the updated recommendations of the German National Care Guideline for Chronic CHD with regard to diagnostic evaluation...
October 20, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29106837/evaluation-of-industrial-compensation-to-cardiologists-in-2015
#8
Muhammad Shahzeb Khan, Tariq Jamal Siddiqi, Kaneez Fatima, Haris Riaz, Faisal Khosa, Warren J Manning, Richard Krasuski
The categorization and characterization of pharmaceutical and device manufacturers or group purchasing organization payments to clinicians is an important step toward assessing conflicts of interest and the potential impact of these payments on practice patterns. Payments have not previously been compared among the subspecialties of cardiology. This is a retrospective analysis of the Open Payments database, including all installments and payments made to doctors in the calendar year 2015 by pharmaceutical and device manufacturers or group purchasing organization...
September 19, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29101664/high-risk-percutaneous-coronary-intervention-in-public-reporting-states-the-evidence-exclusion-of-critically-ill-patients-and-implications
#9
REVIEW
Rishi K Wadhera, Jordan D Anderson, Robert W Yeh
PURPOSE OF REVIEW: Public reporting of outcomes for percutaneous coronary intervention (PCI) is used in some states to drive improvements in care delivery and performance. However, a growing body of evidence suggests unintended consequences, particularly provider aversion to performing PCI in high-risk patients. RECENT FINDINGS: There is mixed evidence regarding the impact of PCI public reporting on patient outcomes. In addition, providers in public reporting states likely have a higher threshold or potentially avoid performing PCI on high-risk patients, such as those with cardiogenic shock...
December 2017: Current Heart Failure Reports
https://www.readbyqxmd.com/read/29101625/radiation-exposure-levels-according-to-vascular-access-sites-during-pci-a%C3%A2-prospective-controlled-study
#10
A Tarighatnia, A R Farajollahi, A H Mohammadalian, M Ghojazadeh, M Azadeh, E Koleini, N D Nader
BACKGROUND: We previously showed that using the radial artery access site as opposed to the femoral artery site decreases the radiation exposure of patients during coronary artery interventions. The objective of this study was to compare radiation exposure levels of the operating physician during coronary interventions when incorporating both radial and femoral artery approaches. METHODS: The study assessed all coronary angioplasties performed in a major metropolitan general hospital...
November 3, 2017: Herz
https://www.readbyqxmd.com/read/29101108/transthoracic-echocardiography-is-adequate-for-intraprocedural-guidance-of-transcatheter-aortic-valve-implantation
#11
Renuka Jain, Daniel P O'Hair, Tanvir K Bajwa, Denise Ignatowski, Daniel Harland, Amanda M Kirby, Tracy Hammonds, Suhail Q Allaqaband, Jonathan Kay, Bijoy K Khandheria
BACKGROUND: While transcatheter aortic valve implantation (TAVI) has traditionally been supported intraprocedurally by transoesophageal echocardiography (TOE), transthoracic echocardiography (TTE) is increasingly being used. We evaluated echocardiographic imaging characteristics and clinical outcomes in patients who underwent TTE during TAVI (TTE-TAVI). METHODS AND RESULTS: A select team of dedicated sonographers and interventional echocardiographers performed TTE-TAVI in 278 patients, all of whom underwent TAVI through transfemoral access...
December 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/29100730/long-term-clinical-and-cost-outcomes-of-a-pharmacist-managed-risk-factor-management-clinic-in-singapore-an-observational-study
#12
She Hui Tan, Kwee Keng Kng, Sze Mian Lim, Alexandre Chan, Jason Kwok Kong Loh, Joyce Yu-Chia Lee
PURPOSE: Few studies have determined the benefits of pharmacist-run clinics within a tertiary institution, and specifically on their capability to improve clinical outcomes as well as reduce the cost of illness. This study was designed to investigate the effectiveness of a pharmacist-managed risk factor management clinic (RFMP) in an acute care setting through the comparison of clinical (improvement in glycosylated hemoglobin level) and cost outcomes with patients receiving usual care...
October 31, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/29089313/efficacy-of-the-radpad-protection-drape-in-reducing-operators-radiation-exposure-in-the-catheterization-laboratory-a-sham-controlled-randomized-trial
#13
Wieneke Vlastra, Ronak Delewi, Krischan D Sjauw, Marcel A Beijk, Bimmer E Claessen, Geert J Streekstra, Robbert J Bekker, Juliette C van Hattum, Joanna J Wykrzykowska, Marije M Vis, Karel T Koch, Robbert J de Winter, Jan J Piek, José P S Henriques
BACKGROUND: Interventional cardiologists are increasingly exposed to radiation-induced diseases like cataract and the stochastic risk of left-sided brain tumors. The RADPAD is a sterile, disposable, lead-free shield placed on the patient with the aim to minimize operator-received scatter radiation. The objective of the trial was to examine the RADPAD's efficacy in a real-world situation. METHODS AND RESULTS: In the current, double-blind, sham-controlled, all-comer trial, patients undergoing diagnostic catheterization or percutaneous coronary interventions were randomized in a 1:1:1 ratio to a radiation absorbing shield (RADPAD), standard treatment (NOPAD), or a sham shield (SHAMPAD)...
November 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29076956/long-qtc-during-methadone-maintenance-contributors-and-interventions-over-4-years
#14
Joseph Westermeyer, Paul Thuras, Gihyun Yoon, Tegan Batres-Y-Carr
Our goal consisted of describing the 4-year prevalence, contributors, and interventions for long QTc's in methadone maintenance treatment. Cardiologists' diagnosis of long QTc defined case-ness in 62 patients. Long QTc categories, drawn from epidemiological reports, encompassed 440 to 469 (borderline), 470 to 499 (moderate), and 500+ milliseconds (severe). Data collection included electrocardiograms, demographic characteristics, contributors to long QTc, and interventions-plus-outcomes (defined by resolution of long QTc)...
October 25, 2017: Journal of Nervous and Mental Disease
https://www.readbyqxmd.com/read/29076870/transcatheter-device-closure-of-atrial-septal-defects-more-to-think-about-than-just-closing-the-hole
#15
Michael L O'Byrne, Andrew C Glatz, Matthew J Gillespie
PURPOSE OF REVIEW: To review current controversies in the transcatheter device closure of ostium secundum atrial septal defects (ASD). RECENT FINDINGS: Transcatheter device closure of ASD (TC-ASD) has well established efficacy and safety. For most individual patients with suitable anatomy, TC-ASD is the preferred method for treating ASD. The availability of large multicenter data sets has made it possible to study practice patterns at a range of hospitals across the United States...
October 25, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29062749/transcatheter-aortic-valve-implantation-in-nonagenarians-selectively-feasible-or-extravagantly-futile
#16
Antonis S Manolis, Antonis A Manolis
A growing number of nonagenarians is recorded as life expectancy increases. Unfortunately, this extreme-aged group is plagued by increased prevalence of aortic stenosis amidst a higher occurrence of comorbidities that pose dilemmas to cardiologists and cardiac surgeons when having to choose a conservative or interventional treatment modality, and a surgical or transcatheter aortic valve implantation (TAVI) approach. TAVI is an expensive procedure, which also confers a higher mortality and morbidity risk in nonagenarians, compared to younger patients...
September 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29062376/reduction-of-radiation-risk-to-interventional-cardiologists-and-patients-during-angiography-and-coronary-angioplasty
#17
REVIEW
Mohsen Mohammadi, Leili Danaee, Effat Alizadeh
Radiation risk allied to invasive cardiology is relatively high, and protecting both patients and cardiologists is necessary. The aim of this review is to discuss how to better protect patients and cardiologists against radiation exposure. We performed a global search on PubMed, Science Direct, and Scopus databases via keywords of "interventional cardiologist", "patient", "radiation", and "exposure" and then performed an overview of the main strategies for risk reduction among interventional cardiologists and exposed patients...
July 2017: Journal of Tehran Heart Center
https://www.readbyqxmd.com/read/29061550/percutaneous-coronary-intervention-for-the-left-main-stem-and-other-bifurcation-lesions-the-12-th-consensus-document-from-the-european-bifurcation-club
#18
Jens Flensted Lassen, Francesco Burzotta, Adrian P Banning, Thierry Lefèvre, Olivier Darremont, David Hildick-Smith, Alaide Chieffo, Manuel Pan, Niels Ramsing Holm, Yves Louvard, Goran Stankovic
The European Bifurcation Club (EBC) was initiated in 2004, to support a continuously overview of the field of coronary artery bifurcation interventions and aims to facilitate a scientific discussion and an exchange of ideas on management of bifurcation disease. EBC hosts an annual, two days compact meeting, dedicated to bifurcations, which brings together physicians, pathologists, engineers, biologists, physicists, mathematicians, epidemiologists and statisticians for detailed discussions. Every meeting is finalized with a consensus statement that reflects the unique opportunity of combining the opinion of interventional cardiologists with the opinion of a large variety of other scientists on bifurcation management...
October 24, 2017: EuroIntervention
https://www.readbyqxmd.com/read/29060113/monte-carlo-method-applied-to-the-evaluation-of-the-relationship-between-ejection-fraction-and-its-constituent-components
#19
Peter L M Kerkhof, B W Yoo, Jean Paul Merillon, Richard A Peace, Neal Handly
Ventricular function is routinely assessed by applying the clinically accepted metric ejection fraction (EF). The numerical value of EF depends on the interplay between end-systolic volume (ESV) and end-diastolic volume (EDV). The relative impact of the two constitutive components has received little attention. Pediatric cardiologists are interested in EF vs ESV when evaluating various congenital abnormalities. Following successful surgical intervention of Fallot tetralogy, many of these patients receive follow-up, not only during childhood, but also when being adults...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29054516/eye-lens-dosimetry-and-the-study-on-radiation-cataract-in-interventional-cardiologists
#20
Kosuke Matsubara, Vorarit Lertsuwunseri, Suphot Srimahachota, Anchali Krisanachinda, Wasee Tulvatana, Bharkbhum Khambhiphant, Waraporn Sudchai, Madan Rehani
PURPOSE: To determine the eye lens dose of the Interventional Cardiology (IC) personnel using optically stimulated luminescent dosimeter (OSLD) and the prevalence and risk of radiation - associated lens opacities in Thailand. METHODS AND RESULTS: 48 IC staff, with age- and sex- matches 37 unexposed controls obtained eye examines. Posterior lens change was graded using a modified Merriam-Focht technique by two independent ophthalmologists. Occupational exposure (mSv) was measured in 42 IC staff, using 2 OSLD badges place at inside lead apron and at collar...
October 17, 2017: Physica Medica: PM
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