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https://www.readbyqxmd.com/read/27933569/decision-making-in-clinical-practice-oral-anticoagulant-therapy-in-patients-with-non-valvular-atrial-fibrillation-and-a-single-additional-stroke-risk-factor
#1
REVIEW
Tatjana S Potpara, Nikolaos Dagres, Nebojša Mujović, Dragan Vasić, Milika Ašanin, Milan Nedeljkovic, Francisco Marin, Laurent Fauchier, Carina Blomstrom-Lundqvist, Gregory Y H Lip
Approximately 1 in 3-4 patients presenting with an ischemic stroke will also have atrial fibrillation (AF), and AF-related strokes can be effectively prevented using oral anticoagulant therapy (OAC), either with well-controlled vitamin K antagonists (VKAs) or non-vitamin K antagonist oral anticoagulants (NOACs). In addition, OAC use (both VKAs and NOACs) is associated with a 26% reduction in all-cause mortality (VKAs) or an additional 10% mortality reduction with NOACs relative to VKAs. The decision to use OAC in individual AF patient is based on the estimated balance of the benefit from ischemic stroke reduction against the risk of major OAC-related bleeding [essentially intracranial hemorrhage (ICH)]...
December 8, 2016: Advances in Therapy
https://www.readbyqxmd.com/read/27932571/esmolol-before-cardioplegia-and-as-cardioplegia-adjuvant-reduces-cardiac-troponin-release-after-cardiac-surgery-a-randomized-trial
#2
Elena Bignami, Marcello Guarnieri, Annalisa Franco, Chiara Gerli, Monica De Luca, Fabrizio Monaco, Giovanni Landoni, Alberto Zangrillo
BACKGROUND: Cardioplegic solutions are the standard in myocardial protection during cardiac surgery, since they interrupt the electro-mechanical activity of the heart and protect it from ischemia during aortic cross-clamping. Nevertheless, myocardial damage has a strong clinical impact. We tested the hypothesis that the short-acting beta-blocker esmolol, given immediately before cardiopulmonary bypass and as a cardioplegia additive, would provide an extra protection to myocardial tissue during cardiopulmonary bypass by virtually reducing myocardial activity and, therefore, oxygen consumption to zero...
December 8, 2016: Perfusion
https://www.readbyqxmd.com/read/27928260/emergency-redo-mitral-valve-replacement-immediately-after-caesarean-section
#3
İbrahim Duvan, Ümit Pınar Sungur, Burak Emre Onuk, Mehmet Şanser Ateş, İbrahim Sami Karacan, Murat Kurtoğlu
Surgery for heart diseases during pregnancy, especially necessitating cardiopulmonary bypass, is believed to trigger maternal and fetal risks and should be performed only when medical therapy has been unsuccessful to alleviate the cardiac decompensation. A 33-year-old pregnant woman in her 33rd week of gestation was admitted to our hospital. She had rheumatic mitral valvular stenosis and had undergone mitral valve replacement (MVR) with a mechanical prosthesis 11 years earlier in another center. Echocardiography revealed a thrombotic mass obstructing the leaflets of the mechanical mitral valve...
April 13, 2016: Journal of Tehran Heart Center
https://www.readbyqxmd.com/read/27928033/mitral-valve-leaflet-remodelling-during-pregnancy-insights-into-cell-mediated-recovery-of-tissue-homeostasis
#4
Bruno V Rego, Sarah M Wells, Chung-Hao Lee, Michael S Sacks
Little is known about how valvular tissues grow and remodel in response to altered loading. In this work, we used the pregnancy state to represent a non-pathological cardiac volume overload that distends the mitral valve (MV), using both extant and new experimental data and a modified form of our MV structural constitutive model. We determined that there was an initial period of permanent set-like deformation where no remodelling occurs, followed by a remodelling phase that resulted in near-complete restoration of homeostatic tissue-level behaviour...
December 2016: Journal of the Royal Society, Interface
https://www.readbyqxmd.com/read/27926465/freestyle-stentless-bioprosthesis-for-aortic-valve-therapy-17-year-clinical-results
#5
Juergen Ennker, Markus Meilwes, Joern Pons-Kuehnemann, Bernd Niemann, Philippe Grieshaber, Ina C Ennker, Andreas Boening
BACKGROUND: Aortic valve replacement with stentless bioprostheses has been shown to produce lower aortic gradients than stented bioprostheses, thus facilitating left ventricular mass regression and preventing heart failure. We sought to determine the long-term results of stentless biological aortic valve replacement over a 17-year follow-up. METHODS: Between 1996 and 2012, 2551 patients underwent isolated aortic valve replacement with a stentless prosthesis (Medtronic Freestyle) at a single center...
November 2016: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/27924216/atrial-fibrillation-management-in-older-heart-failure-patients-a-complex-clinical-problem
#6
REVIEW
Giovanni Pulignano, Donatella Del Sindaco, Maria Denitza Tinti, Stefano Tolone, Giovanni Minardi, Antonio Lax, Massimo Uguccioni
BACKGROUND: Atrial fibrillation (AF) and heart failure (HF), two problems of growing prevalence as a consequence of the ageing population, are associated with high morbidity, mortality, and healthcare costs. AF and HF also share common risk factors and pathophysiologic processes such as hypertension, diabetes mellitus, ischemic heart disease, and valvular heart disease often occur together. Although elderly patients with both HF and AF are affected by worse symptoms and poorer prognosis, there is a paucity of data on appropriate management of these patients...
January 2016: Heart International
https://www.readbyqxmd.com/read/27920984/staphylococcus-lugdunensis-endocarditis-with-destruction-of-the-ventricular-septum-and-multiple-native-valves
#7
Celestine Ishiekwene, Monica Ghitan, Margaret Kuhn-Basti, Edward Chapnick, Yu Shia Lin
Staphylococcus lugdunensis (S. lugdunensis) is a coagulase negative staphylococcus (CoNS) that can cause destructive infective endocarditis. S. lugdunensis, unlike other CoNS, should be considered to be a pathogen. We report the first case of S. lugdunensis endocarditis causing ventricular septal defect and destruction of the aortic and mitral valves. A 53-year-old male with morbid obesity and COPD presented with intermittent fever and progressive shortness of breath for 2 weeks. Chest examination showed bilateral basal crepitations, and a grade 2 systolic murmur along the right sternal border...
2017: IDCases
https://www.readbyqxmd.com/read/27920399/anticoagulation-for-stroke-prevention-in-elderly-patients-with-non-valvular-atrial-fibrillation-what-are-the-obstacles
#8
C W Wong
The elderly with atrial fibrillation are more prone to stroke. Oral anticoagulants such as warfarin are effective in the prevention of atrial fibrillation-associated stroke and systemic embolism. The CHADS2 or CHA2D2-VASc score and HAS-BLED score were developed to stratify stroke risk associated with atrial fibrillation and bleeding risk in a patient with atrial fibrillation, respectively, to facilitate the decision for and safe use of oral anticoagulant. Nonetheless, the decision for anticoagulation is not straightforward and the elderly with non-valvular atrial fibrillation are often precluded from anticoagulant prescription...
December 2016: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/27919209/evaluation-of-echocardiographic-abnormalities-in-hiv-positive-patients-treated-with-antiretroviral-medications
#9
Sina Moradmand Badie, Mehrnaz Rasoulinejad, Mohammadreza Salehi, Hamid Emadi Kochak, SeyedAhmad SeyedAlinaghi, Seyed Ali Dehghan Manshadi, Fatemeh Jahanjo Amin Abad, Banafsheh Moradmand Badie
BACKGROUND: Echocardiography is a reliable means for the diagnosis of functional and valvular diseases of the heart in HIV positive and HIV negative patients. The current study was to evaluate echocardiographic abnormalities in HIV positive patients under an antiretroviral therapy (ART) program in Tehran, Imam Khomeini Hospital, Iran. METHODS: This is a descriptive cross-sectional study, conducted among 231 HIV positive patients under ART. All HIV positive patients including 150 men (65%) and 81 women (35%) (mean age of 41 years) were assessed by trans-thoracic echocardiography (TTE) in Imam Khomeini Hospital, over the period from 2013 to 2014...
December 5, 2016: Infectious Disorders Drug Targets
https://www.readbyqxmd.com/read/27918213/percutaneous-therapies-for-tricuspid-regurgitation
#10
Erin A Fender, Rick A Nishimura, David R Holmes
Chronic tricuspid valve regurgitation is usually associated with left-sided heart disease or pulmonary hypertension. Although severe tricuspid valve regurgitation carries a poor prognosis, isolated surgery is rarely performed due to high in-hospital mortality and an unclear impact on long term survival. The lack of adequate surgical treatment has resulted in a large population of patients with an unmet clinical need. Areas Covered: Transcatheter therapies have revolutionized the management of high risk patients with left-sided valvular disease, and have sparked interest in translating minimally invasive therapies to the tricuspid valve...
December 5, 2016: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/27915215/cha2ds2-vasc-hsf-score-new-predictor-of-severity-of-coronary-artery-disease-in-2976-patients
#11
Ranjan Modi, S V Patted, P C Halkati, Sanjay Porwal, Sameer Ambar, Prasad Mr, Vijay Metgudmath, Ameet Sattur
BACKGROUND: CHADS2 and CHA2DS2-VASc scores have been used for assessing prognostic risk of thromboembolism in non valvular atrial fibrillation patients. They include similar risk factors for the development of CAD To increase the likelihood of determining CAD severity, the CHA2DS2-VASc-HS and CHA2DS2-VASc-HSF score comprising of hyperlipidemia, smoking and family history respectively in addition to the components of the CHA2DS2-VASc score and male instead of female gender. The aim was to investigate whether these risk scores can be used to predict CAD severity...
October 29, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27914498/infective-endocarditis-in-patients-receiving-chronic-hemodialysis-a-21-year-observational-cohort-study-in-denmark
#12
Lene Ugilt Pagter Ludvigsen, Lars Skov Dalgaard, Henrik Wiggers, Søren Jensen-Fangel, Bente Jespersen, Svend Ellermann-Eriksen, Lars Østergaard, Ole Schmeltz Søgaard
BACKGROUND: Chronic hemodialysis is a risk factor for invasive bacterial infections. We conducted a nationwide study of risk and mortality of infective endocarditis (IE) among patients undergoing chronic hemodialysis. METHODS: In this observational cohort study, patients with end-stage renal disease who initiated hemodialysis in Denmark during 1990 to 2010 were matched on age, gender, and municipality with up to 19 population controls. We extracted information on first admissions with IE, comorbidity, and arteriovenous fistula surgery from medical administrative databases...
December 2016: American Heart Journal
https://www.readbyqxmd.com/read/27914161/streptococcus-agalactiae-native-valve-endocarditis-uncommon-presentation-of-multiple-myeloma
#13
Ana Pinho Oliveira, Anne Delgado, Cláudia Martins, Pedro Gama
Adults with chronic immunosuppressive conditions are at an increased risk for Streptococcus agalactiae endocarditis, which is typically characterized by acute onset, presence of large vegetations, rapid valvular destruction and frequent complications. We report a rare case of a 74 years old man presenting with fever, renal infarction, ischemic stroke and uveitis. Infective endocarditis was diagnosed and Streptococcus agalactiae was isolated in blood cultures. A multiple myeloma Ig G-K was also diagnosed. The infective endocarditis was successfully treated with a course of benzylpenicillin and gentamicin...
August 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/27913498/long-term-risk-of-second-malignancy-and-cardiovascular-disease-after-hodgkin-lymphoma-treatment
#14
Flora E van Leeuwen, Andrea K Ng
Long-term survivors of Hodgkin lymphoma (HL) experience several late adverse effects of treatment, with second malignant neoplasms (SMNs) and cardiovascular diseases (CVDs) being the leading causes of death in these patients. Other late effects have also been identified, such as pulmonary dysfunction, endocrinopathies (thyroid dysfunction, infertility), neck muscle atrophy, and persistent fatigue. HL survivors have two- to fourfold increased risks to develop SMNs and CVD compared with the general population...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27909542/which-factors-influence-resident-physicians-to-prescribe-noacs-to-patients-with-non-valvular-atrial-fibrillation
#15
Zardasht Oqab Md Frcpc, William F McIntyre Md Frcpc, Wilma M Hopman Ma, Adrian Baranchuk Md Facc Frcp
The Canadian Cardiovascular Society and the European Society of Cardiology recommend the use of non-vitamin K antagonists (NOAC) in preference to warfarin for stroke prevention in most patients with non-valvular atrial fibrillation (AF). The aim of this study was to identify factors that predict selection of a NOAC by resident physicians when faced with patients with non-valvular AF. A web-based survey was distributed to residents across Canada to learn the attitudes and behaviours regarding stroke, bleeding risk and choices of therapy in different clinical scenarios involving the same patient and one additional co-morbidity...
August 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27908608/a-hospital-based-survey-of-patients-with-severe-valvular-heart-disease-in-china
#16
Po Hu, Xian-Bao Liu, Jie Liang, Qi-Feng Zhu, Chao-Xia Pu, Meng-Yao Tang, Jian-An Wang
OBJECTIVES: Due to increasing aging, the epidemiology of VHD may have changed in China. This study aimed to provide contemporary information on the prevalence, distribution patterns, and etiology of severe VHD in China. METHODS: This was a retrospective survey at Second Affiliated Hospital of Zhejiang University, which included all consecutive patients between 2010 and 2015. RESULTS: In all, 139,496 patients were enrolled. Among severe valve diseases, MR was the most frequent (n=946, 0...
November 25, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27904843/cardiac-surgery-in-africa-a-thirty-five-year-experience-on-open-heart-surgery-in-cote-d-ivoire
#17
Koffi Herve Yangni-Angate, Christophe Meneas, Florent Diby, Manga Diomande, Anicet Adoubi, Yves Tanauh
BACKGROUND: Few centers for open heart surgery (OHS) are in Sub-Saharan Africa. Lack of OHS results is also noted. By reporting our African experience on OHS, the aim of this study was to fill the gap. METHODS: It is a retrospective study on 2,612 patients who were subject to an OHS between 1978 and 2013. Data were collected from demographical, clinical, investigative studies, surgical and outcomes parameters. RESULTS: There were 1,475 cases of rheumatic heart diseases (RHD), 126 endomyocardial fibrosis (EMF), 741 congenital heart diseases (CHDs) and 270 various affections...
October 2016: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/27904841/the-rebirth-of-cardiac-surgery-in-sudan
#18
Ahmed ElSayed, Elamin Elawad Elnur
BACKGROUND: Cardiac surgery is nowadays an integral part of a complete national health service. METHODS: In this paper the rebirth of cardiac surgery in Sudan from 1998 till 2007 is given by means of a literature search, personal interviews and searching hospital records. RESULTS: A summary of the initial birth of these services in 1959 till its demise in 1993 is first mentioned to set the stage for the subsequent period of sustainable growth...
October 2016: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/27904005/study-design-and-baseline-characteristics-of-the-expand-study-evaluation-of-effectiveness-and-safety-of-xa-inhibitor-rivaroxaban-for-the-prevention-of-stroke-and-systemic-embolism-in-a-nationwide-cohort-of-japanese-patients-diagnosed-as-non-valvular-atrial
#19
Takanori Ikeda, Hirotsugu Atarashi, Hiroshi Inoue, Shinichiro Uchiyama, Takanari Kitazono, Takeshi Yamashita, Wataru Shimizu, Masahiro Kamouchi, Koichi Kaikita, Koji Fukuda, Hideki Origasa, Ichiro Sakuma, Keijiro Saku, Yasuo Okumura, Yuichiro Nakamura, Hideo Morimoto, Naoki Matsumoto, Akihito Tsuchida, Junya Ako, Nobuyoshi Sugishita, Shogo Shimizu, Hiroaki Shimokawa
The use of rivaroxaban, a factor Xa inhibitor, has been increasing for prevention of ischemic stroke and systemic embolism in patients with non-valvular atrial fibrillation (AF) in Japan. We conducted the nationwide multicenter study, termed as the EXPAND Study, to address its effectiveness and safety in the real-world practice of patients with non-valvular AF in Japan. The EXPAND Study is a prospective, non-interventional, observational cohort study to evaluate the effectiveness and safety of rivaroxaban in non-valvular AF patients in a real-world clinical practice...
2016: Tohoku Journal of Experimental Medicine
https://www.readbyqxmd.com/read/27903032/-interventional-left-atrial-appendage-closure-in-a-patient-with-gave-syndrome
#20
Christian Fastner, Sebastian Belle, Ibrahim Akin
History and findings | A 56-year-old female with a gastric antral vascular ectasia (GAVE) suffered from recurrent episodes of upper gastrointestinal bleeding. Because of a history of a permanent atrial fibrillation (CHA2DS2-VASc score 3 points) an oral anticoagulation therapy with phenprocoumon was carried out which even worsened the bleeding frequency and intensity. A change of medication to low-molecular weight heparin did not lead to success. The frequent periods in hospital limited the patient's quality of life...
November 2016: Deutsche Medizinische Wochenschrift
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