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cardiology update

Kim P Wagenaar, Berna D L Broekhuizen, Tiny Jaarsma, Ilse Kok, Arend Mosterd, Frank F Willems, Gerard C M Linssen, Willem R P Agema, Sander Anneveldt, Carolien M H B Lucas, Herman F J Mannaerts, Elly M C J Wajon, Kenneth Dickstein, Maarten J Cramer, Marcel A J Landman, Arno W Hoes, Frans H Rutten
BACKGROUND: Efficient incorporation of e-health in patients with heart failure (HF) may enhance health care efficiency and patient empowerment. We aimed to assess the effect on self-care of (i) the European Society of Cardiology/Heart Failure Association website '' on top of usual care, and (ii) an e-health adjusted care pathway leaving out 'in person' routine HF nurse consultations in stable HF patients. METHODS AND RESULTS: In a three-group parallel-randomized trial in stable HF patients from nine Dutch outpatient clinics, we compared two interventions ( heartfailurematters...
November 28, 2018: European Journal of Heart Failure
Mengge Zhou, Jing Liu, Yongchen Hao, Jun Liu, Yong Huo, Sidney C Smith, Junbo Ge, Changsheng Ma, Yaling Han, Gregg C Fonarow, Kathryn A Taubert, Louise Morgan, Na Yang, Yueyan Xing, Dong Zhao
BACKGROUND: Guidelines have classified patients with acute coronary syndrome (ACS) and diabetes as a special population, with specific sections presented for the management of these patients considering their extremely high risk. However, in China up-to-date information is lacking regarding the burden of diabetes in patients with ACS and the potential impact of diabetes status on the in-hospital outcomes of these patients. This study aims to provide updated estimation for the burden of diabetes in patients with ACS in China and to evaluate whether diabetes is still associated with excess risks of early mortality and major adverse cardiovascular and cerebrovascular events (MACCE) for ACS patients...
November 27, 2018: Cardiovascular Diabetology
Antoni Bayes-Genis
The European Society of Cardiology guidelines for the diagnosis and treatment of heart failure (HF) was updated in 2016. In this article, highlights of the updates made based on new findings and practical recommendations are presented. The 2016 guidelines include definitions and criteria for diagnosing the different types of HF. In addition, a newly developed algorithm is proposed for treating particularly symptomatic HF with reduced ejection fraction, including the use of the angiotensin-converting enzyme inhibitors, beta-blockers, mineralocorticoid receptor antagonists and the angiotensin receptor neprilysin inhibitor sacubitril/valsartan...
December 2017: European Cardiology
Vahé S Tateosian, Deborah C Richman
Cardiac risk stratification before surgery informs consent, may advise optimization interventions, and guides intraoperative and postoperative management and monitoring. Published guidelines provide an outline for risk stratification but are only updated every 5 to 10 years; hence, cardiology expert opinion is often needed. Preoperative cardiovascular evaluation starts with an excellent history and physical examination. Accurate assessment of exercise tolerance is paramount in defining risk and determining the need for further testing...
December 2018: Anesthesiology Clinics
Robert M Carey, David A Calhoun, George L Bakris, Robert D Brook, Stacie L Daugherty, Cheryl R Dennison-Himmelfarb, Brent M Egan, John M Flack, Samuel S Gidding, Eric Judd, Daniel T Lackland, Cheryl L Laffer, Christopher Newton-Cheh, Steven M Smith, Sandra J Taler, Stephen C Textor, Tanya N Turan, William B White
Resistant hypertension (RH) is defined as above-goal elevated blood pressure (BP) in a patient despite the concurrent use of 3 antihypertensive drug classes, commonly including a long-acting calcium channel blocker, a blocker of the renin-angiotensin system (angiotensin-converting enzyme inhibitor or angiotensin receptor blocker), and a diuretic. The antihypertensive drugs should be administered at maximum or maximally tolerated daily doses. RH also includes patients whose BP achieves target values on ≥4 antihypertensive medications...
November 2018: Hypertension
Peter J Mason, Binita Shah, Jacqueline E Tamis-Holland, John A Bittl, Mauricio G Cohen, Jordan Safirstein, Douglas E Drachman, Javier A Valle, Denise Rhodes, Ian C Gilchrist
Transradial artery access for percutaneous coronary intervention is associated with lower bleeding and vascular complications than transfemoral artery access, especially in patients with acute coronary syndromes. A growing body of evidence supports adoption of transradial artery access to improve acute coronary syndrome-related outcomes, to improve healthcare quality, and to reduce cost. The purpose of this scientific statement is to propose and support a "radial-first" strategy in the United States for patients with acute coronary syndromes...
September 2018: Circulation. Cardiovascular Interventions
Maria Carmo Pereira Nunes, Andrea Beaton, Harry Acquatella, Caryn Bern, Ann F Bolger, Luis E Echeverría, Walderez O Dutra, Joaquim Gascon, Carlos A Morillo, Jamary Oliveira-Filho, Antonio Luiz Pinho Ribeiro, Jose Antonio Marin-Neto
BACKGROUND: Chagas disease, resulting from the protozoan Trypanosoma cruzi, is an important cause of heart failure, stroke, arrhythmia, and sudden death. Traditionally regarded as a tropical disease found only in Central America and South America, Chagas disease now affects at least 300 000 residents of the United States and is growing in prevalence in other traditionally nonendemic areas. Healthcare providers and health systems outside of Latin America need to be equipped to recognize, diagnose, and treat Chagas disease and to prevent further disease transmission...
September 18, 2018: Circulation
Geoffrey S Pitt
No abstract text is available yet for this article.
October 21, 2018: European Heart Journal
Pei-Jiang Wang, Farhad Rikhtegar Nezami, Maysam B Gorji, Francesca Berti, Lorenza Petrini, Tomasz Wierzbicki, Francesco Migliavacca, Elazer R Edelman
Polymeric bioresorbable scaffolds (BRS), at their early stages of invention, were considered as a promising revolution in interventional cardiology. However, they failed dramatically compared to metal stents showing substantially higher incidence of device failure and clinical events, especially thrombosis. One problem is that use of paradigms inherited from metal stents ignores dependency of polymer material properties on working environment and manufacturing/deployment steps. Unlike metals, polymeric material characterization experiments cannot be considered identical under dry and submerged conditions at varying rates of operation...
October 17, 2018: Acta Biomaterialia
Marco Zaffanello, Franco Antoniazzi, Laura Tenero, Luana Nosetti, Michele Piazza, Giorgio Piacentini
Childhood obstructive sleep apnea syndrome (OSAS) is characterized by anatomical and functional upper airway abnormalities as pathophysiological determinants, and clinical symptoms are frequently clear. OSAS is widely described in rare genetic disorders, such as achondroplasia, Down syndrome, Prader-Willi syndrome, Pierre Robin sequence, and mucopolysaccharidosis. Craniofacial and upper airway involvement is frequently morbid conditions. In children with genetic diseases, the clinical symptoms of OSAS are often slight or absent, and related morbidities are usually more severe and can be observed at any age...
September 2018: Annals of Translational Medicine
Francisco González-Vílchez, Luis Almenar-Bonet, María G Crespo-Leiro, Luis Alonso-Pulpón, José González-Costelo, José Manuel Sobrino-Márquez, José María Arizón Del Prado, Iago Sousa-Casasnovas, Juan Delgado-Jiménez, Félix Pérez-Villa
INTRODUCTION AND OBJECTIVES: The present report updates the characteristics and results of heart transplantation in Spain, mainly focused in the 2008-2017 period. METHODS: We describe the recipient and donor characteristics, surgical procedures, and outcomes of heart transplants performed in 2017. The 2017 data were compared with those obtained from 2008 to 2016. RESULTS: A total of 304 cardiac transplants were performed in 2017. Between 1984 and 2017, 8173 procedures were performed, 2689 of them after 2008...
November 2018: Revista Española de Cardiología
Roberto Sansone, Lucas Busch, Ralf Langhoff
The updated ESC guidelines on PAD were developed, for the first time, as a collaboration between cardiologists and vascular surgeons and unveiled at the European Society of Cardiology (ESC) 2017 congress. Although awareness has improved, PAD is still associated with significant morbidity, mortality, and quality of life impairment. Primarily, the guidelines emphasize the need for a multidisciplinary management of these patients and propose "a vascular team". A new chapter on antithrombotic therapies is provided...
October 2018: Deutsche Medizinische Wochenschrift
Josip A Borovac, Domenico D'Amario, Rocco Vergallo, Italo Porto, Antonio Bisignani, Mattia Galli, Gianmarco Annibali, Rocco A Montone, Antonio Maria Leone, Giampaolo Niccoli, Filippo Crea
The recognition that obstructive disease of the epicardial coronary arteries, causing ischemic heart disease, can be treated with a percutaneous coronary intervention (PCI) has been a major discovery in cardiology in the last 40 years contributing, in particular, to the reduction of mortality associated to acute myocardial infarction (AMI). However, even in the era of drug-eluting stent (DES) implantation, a sizable proportion of patients who undergo PCI may develop late or very late post-implantation complications, that occur in the form of restenosis, neoatherosclerosis and/or in-stent thrombosis...
October 4, 2018: European Heart Journal. Cardiovascular Pharmacotherapy
Mohammadreza Mohseni, Reza Faghihi, Mahdi Haghighatafshar, Seyed Mohammad Entezarmahdi
Nuclear cardiology has not witnessed development of new tracers or hardware for many years. Hence there is a need for the development of improvised techniques. Dynamic cardiac single photon emission computed tomography (SPECT) is one such technique that has a potential to overcome the limitations of conventional myocardial SPECT including the absolute quantification of blood flow. The main goal of this study is to evaluate the effect of attenuation correction (AC) on estimation of the washout parameters extracted from dynamic SPECT using a conventional protocol...
September 2018: Medicine (Baltimore)
Christopher Austin, Fred Kusumoto
Medical professional liability (MPL), traditionally known as medical malpractice, affects most electrophysiologists some point during their career, either directly through personal experience or indirectly by the experiences of colleagues. Despite this, most physicians struggle to accurately describe MPL in the context of clinical practice. Providers know little about the outcomes of malpractice claims as reporting of settled or litigated MPL cases is sparse in the medical literature. In the USA, individual patients can file a malpractice claim in a tort-based system, whereas in other parts of the world, no-fault malpractice systems are increasingly prevalent...
October 1, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Hanno H Leuchte, Henrik Ten Freyhaus, Henning Gall, Michael Halank, Marius M Hoeper, Harald Kaemmerer, Christian Kähler, Gabriela Riemekasten, Silvia Ulrich, Martin Schwaiblmair, Ralf Ewert
In the summer of 2016, delegates from the German Respiratory Society, the German Society of Cardiology and the German Society of Pediatric Cardiology met in Cologne, Germany, to define consensus-based practice recommendations for the management of patients with pulmonary arterial hypertension (PAH). These recommendations were built on the 2015 European Pulmonary Hypertension guidelines and included new evidence, where available, and were last updated in the spring of 2018. This article focusses on the proposed risk stratification and assessment of disease progression in patients with pulmonary arterial hypertension (PAH), covering 3 parts: In part 1, methods and markers that are recommended to assess severity and progression of PAH are discussed and commented...
September 13, 2018: International Journal of Cardiology
Katherine E Di Palo, Ileana L Piña, Hector O Ventura
PURPOSE OF REVIEW: Heart failure clinical practice guidelines are fundamental and serve as framework for providers to deliver evidence-based care that correlates with enhanced patient outcomes. However, adherence, particularly to guideline-directed medical therapy, remains suboptimal for a multitude of reasons. RECENT FINDINGS: Despite robust clinical trials, updated guidelines and an expert consensus statement from American Heart Association, American College of Cardiology, and Heart Failure Society of America registry data signal that heart failure patients do not receive appropriate pharmacotherapy and may receive an intracardiac device without prior initiation or optimization of medical therapy...
December 2018: Current Heart Failure Reports
Gabor Kovacs, Daniel Dumitrescu, Andreas Barner, Sebastian Greiner, Ekkehard Grünig, Alfred Hager, Thomas Köhler, Rainer Kozlik-Feldmann, Irmtraut Kruck, Astrid E Lammers, Derliz Mereles, Andreas Meyer, Joachim Meyer, Stefan Pabst, Hans-Jürgen Seyfarth, Christoph Sinning, Stephan Sorichter, Gerd Stähler, Heinrike Wilkens, Matthias Held
In the summer of 2016, delegates from the German Society of Cardiology (DGK), the German Respiratory Society (DGP), and the German Society of Pediatric Cardiology (DGPK) met in Cologne, Germany, to define consensus-based practice recommendations for the management of patients with pulmonary hypertension (PH). These recommendations were built on the 2015 European Pulmonary Hypertension guidelines, aiming at their practical implementation, considering country-specific issues, and including new evidence, where available...
August 27, 2018: International Journal of Cardiology
Harald Kaemmerer, Christian Apitz, Konrad Brockmeier, Andreas Eicken, Matthias Gorenflo, Alfred Hager, Fokko de Haan, Michael Huntgeburth, Rainer G Kozlik-Feldmann, Oliver Miera, Gerhard P Diller
In the summer of 2016, delegates from the German Respiratory Society (DGP), the German Society of Cardiology (DGK) and the German Society of Pediatric Cardiology (DGPK) met in Cologne, Germany, to define consensus-based practice recommendations for the management of patients with pulmonary hypertension (PH). These recommendations were built on the 2015 European Pulmonary Hypertension guidelines, aiming at their practical implementation, considering country-specific issues, and including new evidence, where available...
August 25, 2018: International Journal of Cardiology
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