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https://www.readbyqxmd.com/read/28441151/recent-clinical-trials-in-valvular-heart-disease
#1
Daniel Kiss, Saif Anwaruddin
PURPOSE OF REVIEW: With widespread adoption of transcatheter aortic valve replacement, there has been a change in the approach to management of valvular heart disease. New interest has taken hold in transcatheter therapies for valvular heart disease, as well as research into pathophysiology and progression of disease. Additionally, several key trials have further refined our understanding of surgical management of valvular heart disease. This review will elucidate recent clinical trial data leading to changes in practice...
April 24, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28440568/impact-of-t-wave-amplitude-in-lead-avr-on-predicting-cardiac-events-in-ischemic-and-nonischemic-cardiomyopathy-patients-with-an-implantable-cardioverter-defibrillator
#2
Yoshihiro Tanaka, Tetsuo Konno, Yudai Tamura, Toyonobu Tsuda, Hiroshi Furusho, Masayuki Takamura, Kenji Sakata, Masakazu Yamagishi, Kenshi Hayashi
BACKGROUND: T wave amplitudes during ventricular repolarization in the lead aVR (TAaVR) are shown to be associated with adverse cardiac events in patients with several cardiovascular diseases, such as postmyocardial infarction. However, the utility of TAaVR has not been previously evaluated in patients with cardiomyopathy who have received implantable cardioverter defibrillators (ICD). Patients with ischemic or nonischemic cardiomyopathy (ICM or NICM, respectively) and who received an ICD may experience worsening of their condition due to the introduction of electric shock during treatment...
April 25, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28429500/electrocardiographic-appearance-of-aortic-stenosis-before-and-after-aortic-valve-replacement
#3
Ivana I Vranic
BACKGROUND: So far, the specific appearance of QRS complex, ST-segment, and T wave was observed in aortic stenosis (AS). S-wave dynamic change in leads V1 -V3 was not reported in AS. METHODS: In a single-center, prospective study, we included a total number of 1.175 patients who underwent surgical aortic valve replacement (AVR). We conducted 3-year gathering of patients with symptomatic and asymptomatic severe AS, and separated them by hemodynamic stability into groups A and B, through EFLV (of more or less than 50%), AVA (of more or less than 0...
April 21, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28405096/cardiac-rehabilitation-for-a-skydiver-after-aortic-valve-replacement-for-pure-aortic-regurgitation-and-resection-of-the-ascending-aorta-complicated-by-active-infective-endocarditis-and-heart-block-requiring-a-pacemaker
#4
Tonja R Solomon, Sandra DeJong, Tim Bilbrey, Pasquale Carbone, Mark Campbell, Robert D Parker, Alessandra Lira, Diogo Amarante, Jeffrey M Schussler, Jenny Adams
A professional skydiver underwent aortic valve and ascending aorta replacement complicated by infective endocarditis with root abscess and pacemaker implantation. He then enrolled in the Baylor Heart and Vascular Hospital cardiac rehabilitation (CR) program as part of its specificity of testing and exercise training facility. He performed specific skydiving cardiovascular and muscular strength tests at the beginning and the end of the CR program. His pacemaker was interrogated to ascertain any arrhythmias or lead displacement over the course of the CR program...
April 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28360193/a-role-for-galectin-3-in-the-development-of-early-molecular-alterations-in-short-term-aortic-stenosis
#5
Vanessa Arrieta, Ernesto Martínez-Martínez, Jaime Ibarrola, Virginia Alvarez, Rafael Justo Sádaba, Amaia García-Peña, Amaya Fernández-Celis, Victoria Cachofeiro, Patrick Rossignol, Natalia Lopez-Andres
Aortic stenosis (AS) is characterized by pressure overload and causes left ventricular (LV) fibrosis and inflammation, two mechanisms which finally lead to cardiac dysfunction. Galectin-3 (Gal-3), a β-galactoside-binding lectin, promotes cardiac remodeling. We herein investigated the role of Gal-3 in LV remodeling in patients with AS and the effects of Gal-3 blockade in rats subjected to short-term (6-week) supravalvular aortic banding (AS group). Myocardial biopsies were obtained from 25 patients with severe AS referred for aortic valve replacement and from necropsies of 11 cardiovascular disease-free control subjects...
March 30, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/28316113/the-utility-of-exercise-testing-in-risk-stratification-of-asymptomatic-patients-with-type-1-brugada-pattern
#6
Muthiah Subramanian, Mukund A Prabhu, Madhavankutty Santhakumari Harikrishnan, Saritha S Shekhar, Praveen G Pai, Kumaraswamy Natarajan
INTRODUCTION: Risk stratification of asymptomatic patients with a Brugada type 1 ECG pattern remains an unresolved clinical conundrum. In contrast to provocative pharmacological testing in Brugada syndrome, there is limited data on the role of exercise stress testing as a risk stratification modality. The objective of this study was to evaluate the utility of exercise testing in asymptomatic patients with type 1 Brugada pattern to prognosticate major arrhythmic events (MAE) during follow-up...
March 18, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28304194/out-of-hospital-cardiac-arrest-survivors-sent-for-emergency-angiography-a-clinical-score-for-predicting-acute-myocardial-infarction
#7
Floriane Zeyons, Laurence Jesel, Olivier Morel, Hélène Kremer, Nathan Messas, Sebastien Hess, Ulun Crimizade, Philippe Reydel, Laurent Tritsch, Patrick Ohlmann
BACKGROUND: Out-of-hospital cardiac arrest (OHCA) remains a major public health issue. Emergency coronary angiography and percutaneous coronary intervention might improve survival, especially when cardiac arrest is caused by acute myocardial infarction (AMI). However, identifying patients with AMI after OHCA remains challenging. The aim of this study was to determine the clinical and ECG criteria in OHCA that may help to identify better the patients with AMI. METHODS: Consecutive OHCA patients who underwent emergency coronary angiography in our centre between 2009 and 2013 were included in this retrospective single-centre observational study...
March 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28302750/the-clinical-frailty-scale-upgrade-your-eyeball-test
#8
Jonathan Afilalo
With the emergence of transcatheter aortic valve replacement (TAVR) as a therapeutic option to treat high-risk older adults suffering from aortic stenosis, the geriatric concept of frailty has assumed mainstream relevance for cardiovascular practitioners. We have eagerly adopted tools to objectify the definition of frailty and accordingly discern good and bad candidates among a pool of complex octogenarians with multiple chronic conditions - a daunting yet mission-critical task. Initial studies published during the first half of this decade revealed that frailty status was one of the top predictors of mid-term mortality and incident disability after TAVR1, leading to its integration in clinical care pathways and predictive risk models...
March 16, 2017: Circulation
https://www.readbyqxmd.com/read/28296251/association-of-lead-avr-t-wave-amplitude-with-cardiovascular-events-or-mortality-among-prevalent-dialysis-patients
#9
Yuji Sato, Toshihide Hayashi, Nobuhiko Joki, Shouichi Fujimoto
In dialysis patients, electrocardiogram (ECG) abnormalities are common. However, the associations between the T-wave of the lead aVR (aVRT) amplitude and cardiovascular (CV) events or total mortality are unknown. We performed a prospective, observational cohort study of prevalent hemodialysis patients (N = 474), followed for 4 years. Outcomes were composite CV events and all-cause mortality. Predictors were baseline aVRT and other ECG findings. ECG parameters were analyzed in three models: model 1, univariate; model 2, basic adjustments; and model 3, model 2 plus serum albumin, C-reactive protein level, and NT-proBNP...
March 10, 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28277970/analyses-of-natural-variation-indicates-that-the-absence-of-rps4-rrs1-and-amino-acid-change-in-rps4-cause-loss-of-their-functions-and-resistance-to-pathogens
#10
Mari Narusaka, Satoshi Iuchi, Yoshihiro Narusaka
A pair of Arabidopsis thaliana resistance proteins, RPS4 and RRS1, recognizes the cognate Avr effector from the bacterial pathogens Pseudomonas syringae pv. tomato expressing avrRps4 (Pst-avrRps4), Ralstonia solanacearum, and the fungal pathogen Colletotrichum higginsianum and leads to defense signaling activation against the pathogens. In the present study, we analyzed 14 A. thaliana accessions for natural variation in Pst-avrRps4 and C. higginsianum susceptibility, and found new compatible and incompatible Arabidopsis-pathogen interactions...
March 4, 2017: Plant Signaling & Behavior
https://www.readbyqxmd.com/read/28270841/conditions-for-autonomous-choice-a-qualitative-study-of-older-adults-experience-of-decision-making-in-tavr
#11
Elisabeth Skaar, Anette Hylen Ranhoff, Jan Erik Nordrehaug, Daniel E Forman, Margrethe Aase Schaufel
BACKGROUND: Patient autonomy is a leading principle in bioethics and a basis for shared decision making. This study explores conditions for an autonomous choice experienced by older adults who recently underwent trans-catheter aortic valve replacement (TAVR). METHODS: Qualitative study entailing semi-structured interviews of a purposive sample of ten older (range 73-89, median 83.5 years) adults after TAVR (median 23 days). The study setting was a cardiac department at a university hospital performing TAVR since 2010...
January 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/28251807/early-readmissions-after-transcatheter-and-surgical-aortic-valve-replacement
#12
Pimprapa Vejpongsa, Viraj Bhise, Konstantinos Charitakis, H Vernon Anderson, Prakash Balan, Tom C Nguyen, Anthony L Estrera, Richard W Smalling, Abhijeet Dhoble
OBJECTIVES: We aimed to determine and compare the prevalence, and predictors of readmissions after the transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR). BACKGROUND: There are limited data on the readmission rates after TAVR in comparison with SAVR. METHODS: We analyzed the data from 2013 National Readmission Database. Propensity-matched pairs were used to analyze differences in readmission rates between TAVR and SAVR for patients aged ≥65...
March 2, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28250684/acute-st-segment-elevation-myocardial-infarction-the-prognostic-importance-of-lead-augmented-vector-right-and-leads-v7-v9
#13
Veeresh Patil Hebbal, Huliyurdurga Srinivasasetty Natraj Setty, Cholenahalli Manjunath Sathvik, Vikram Patil, Sarthak Sahoo, Cholenahalli Nanjappa Manjunath
BACKGROUND: Acute myocardial infarction (MI) is associated with high mortality and among survivors have high morbidity. Electrocardiogram (ECG), a cost-effective and easily available, has traditionally been used not only just for diagnosis of MI but also for culprit vessel recognition and for prognostication. However, the role of lead augmented vector right (aVR) and leads V7-V9 in acute MI are often neglected in clinical practice. We studied the role of lead aVR and leads V7-V9 in ST-elevation MI (STEMI) patients...
January 2017: Journal of Natural Science, Biology, and Medicine
https://www.readbyqxmd.com/read/28244598/exercise-test-predictors-of-severe-coronary-artery-disease-role-of-st-segment-elevation-in-lead-avr
#14
Giulio Russo, Salvatore Emanuele Ravenna, Antonio De Vita, Cristina Aurigemma, Priscilla Lamendola, Gaetano Antonio Lanza, Filippo Crea
BACKGROUND: The role of exercise stress test (EST)-induced ST-segment elevation (STE) in electrocardiographic lead aVR in predicting severe coronary artery disease (CAD) is controversial. HYPOTHESIS: Assessment of lead aVR during EST can be helpful to identify patients with severe CAD. METHODS: We performed maximal EST in 200 patients undergoing coronary angiography for suspect of CAD. Four angiographic findings of severe CAD were considered: (1) left main (LM) disease; (2) LM or equivalent LM (LM/EQLM) disease; (3) LM or proximal left anterior descending (LAD) artery (LM/proxLAD) disease; and (4) LM or 3-vessel (LM/3V) disease...
February 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28222749/the-impact-of-trans-catheter-aortic-valve-replacement-induced-left-bundle-branch-block-on-cardiac-reverse-remodeling
#15
Laura E Dobson, Tarique A Musa, Akhlaque Uddin, Timothy A Fairbairn, Owen J Bebb, Peter P Swoboda, Philip Haaf, James Foley, Pankaj Garg, Graham J Fent, Christopher J Malkin, Daniel J Blackman, Sven Plein, John P Greenwood
BACKGROUND: Left bundle branch block (LBBB) is common following trans-catheter aortic valve replacement (TAVR) and has been linked to increased mortality, although whether this is related to less favourable cardiac reverse remodeling is unclear. The aim of the study was to investigate the impact of TAVR induced LBBB on cardiac reverse remodeling. METHODS: 48 patients undergoing TAVR for severe aortic stenosis were evaluated. 24 patients with new LBBB (LBBB-T) following TAVR were matched with 24 patients with a narrow post-procedure QRS (nQRS)...
February 22, 2017: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/28215415/diagnostic-and-prognostic-value-of-lead-avr-during-exercise-testing-in-patients-suspected-of-having-myocardial-ischemia
#16
Max Wagener, Roger Abächerli, Ursina Honegger, Nicolas Schaerli, Gil Prêtre, Raphael Twerenbold, Christian Puelacher, Germaine Sunier, Philipp Reddiess, Maria Rubini Gimenez, Karin Wildi, Jasper Boeddinghaus, Thomas Nestelberger, Patrick Badertscher, Zaid Sabti, Ramun Schmid, Remo Leber, Dayana Flores Widmer, Samyut Shrestha, Ivo Strebel, Damian Wild, Stefan Osswald, Michael Zellweger, Christian Mueller, Tobias Reichlin
We aimed to assess the diagnostic and prognostic value of ST-segment deviation in aVR, a lead often ignored in clinical practice, during exercise testing and to compare it to the most widely used criterion of ST-segment depression in V5. We enrolled 1,596 patients with suspected myocardial ischemia referred for nuclear perfusion imaging undergoing bicycle stress testing. ST-segment amplitudes in leads aVR and V5 were automatically measured. The presence of inducible myocardial ischemia was the diagnostic end point and adjudicated based on nuclear perfusion imaging and coronary angiography...
April 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28213932/correlations-between-electrocardiogram-and-biomarkers-in-acute-pulmonary-embolism-analysis-of-zatpol-2-registry
#17
Piotr Kukla, Dariusz A Kosior, Andrzej Tomaszewski, Katarzyna Ptaszyńska-Kopczyńska, Katarzyna Widejko, Robert Długopolski, Andrzej Skrzyński, Piotr Błaszczak, Kamil Fijorek, Marcin Kurzyna
BACKGROUND: Electrocardiography (ECG) is still one of the first tests performed at admission, mostly in patients (pts) with chest pain or dyspnea. The aim of this study was to assess the correlation between electrocardiographic abnormalities and cardiac biomarkers as well as echocardiographic parameter in patients with acute pulmonary embolism. METHODS: We performed a retrospective analysis of 614 pts. (F/M 334/280; mean age of 67.9 ± 16.6 years) with confirmed acute pulmonary embolism (APE) who were enrolled to the ZATPOL-2 Registry between 2012 and 2014...
February 18, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28205276/positive-t-wave-in-lead-avr-as-an-independent-predictor-for-1-year-major-adverse-cardiac-events-in-patients-with-first-anterior-wall-st-segment-elevation-myocardial-infarction
#18
Akihiro Kobayashi, Naoki Misumida, Shunsuke Aoi, Yumiko Kanei
BACKGROUND: Positive T wave in lead aVR has been shown to predict an adverse in-hospital outcome in patients with anterior wall ST-segment elevation myocardial infarction (STEMI). However, the prognostic value of positive T wave in lead aVR on a long-term outcome has not been fully explored. METHODS: We performed a retrospective analysis of 190 consecutive patients with first anterior wall STEMI who underwent an emergent coronary angiogram. Patients were divided into those with positive T wave > 0 mV and those with negative T wave ≦ 0 mV in lead aVR...
February 16, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28159815/validation-of-the-prognostic-utility-of-the-electrocardiogram-for-acute-drug-overdose
#19
Alex F Manini, Ajith P Nair, Rajesh Vedanthan, David Vlahov, Robert S Hoffman
BACKGROUND: While it is certain that some emergency department patients with acute drug overdose suffer adverse cardiovascular events (ACVE), predicting ACVE is difficult. The prognostic utility of the ECG for heterogeneous drug overdose patients remains to be proven. This study was undertaken to validate previously derived features of the initial ECG associated with ACVE in this population. METHODS AND RESULTS: We performed a prospective validation cohort study to evaluate adult emergency department patients with acute drug overdose at 2 urban university hospitals over 5 years in whom an emergency department admission ECG was performed...
February 3, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28151798/modulating-portal-hemodynamics-with-vascular-ring-allows-efficient-regeneration-after-partial-hepatectomy-in-a-porcine-model
#20
Petru O Bucur, Mohamed Bekheit, Chloe Audebert, Amnah Othman, Seddik Hammad, Mylene Sebagh, Marc-Antoine Allard, Benoît Decante, Adrian Friebel, Elodie Miquelestorena-Standley, Dirk Drasdo, Jan G Hengstler, Irene E Vignon-Clementel, Eric Vibert
OBJECTIVE: To investigate safety and efficacy of temporary portal hemodynamics modulation with a novel percutaneously adjustable vascular ring (MID-AVR) onto a porcine model of 75% hepatectomy. BACKGROUND: Postoperative liver failure is a leading cause of mortality after major hepatectomy. Portal flow modulation is an increasingly accepted concept to prevent postoperative liver failure. Nonetheless, the current strategies have shortcomings. METHODS: Resection was performed under hemodynamic monitoring in 17 large, white pigs allocated into 2 groups...
February 1, 2017: Annals of Surgery
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