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Interventional cardiology

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https://www.readbyqxmd.com/read/29677464/improving-the-quality-of-preclinical-research-echocardiography-observations-training-and-guidelines-for-measurement
#1
Daniel G Donner, Helen Kiriazis, Xiao-Jun Du, Thomas H Marwick, Julie R McMullen
Informal training in preclinical research may be a contributor to the poor reproducibility of preclinical cardiology research and low rates of translation into clinical research and practice. Mouse echocardiography is a widely used technique to assess cardiac structure and function in drug intervention studies using disease models. The inter-observer variability (IOV) of clinical echocardiographic measurements has been shown to improve with formalized training, but preclinical echocardiography lacks similarly critical standardization of training...
April 20, 2018: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/29673467/transition-intervention-for-adolescents-with-congenital-heart-disease
#2
Andrew S Mackie, Gwen R Rempel, Adrienne H Kovacs, Miriam Kaufman, Kathryn N Rankin, Ahlexxi Jelen, Maryna Yaskina, Renee Sananes, Erwin Oechslin, Dimi Dragieva, Sonila Mustafa, Elina Williams, Michelle Schuh, Cedric Manlhiot, Samantha J Anthony, Joyce Magill-Evans, David Nicholas, Brian W McCrindle
BACKGROUND: There is little evidence regarding the efficacy of interventions to prepare adolescents with congenital heart disease (CHD) to enter adult care. OBJECTIVES: The goal of this study was to evaluate the impact of a nurse-led transition intervention on lapses between pediatric and adult care. METHODS: A cluster randomized clinical trial was conducted of a nurse-led transition intervention for 16- to 17-year-olds with moderate or complex CHD versus usual care...
April 24, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29671282/interventional-cardiology-for-congenital-heart-disease
#3
REVIEW
Damien Kenny
Congenital heart interventions are now replacing surgical palliation and correction in an evolving number of congenital heart defects. Right ventricular outflow tract and ductus arteriosus stenting have demonstrated favorable outcomes compared to surgical systemic to pulmonary artery shunting, and it is likely surgical pulmonary valve replacement will become an uncommon procedure within the next decade, mirroring current practices in the treatment of atrial septal defects. Challenges remain, including the lack of device design focused on smaller infants and the inevitable consequences of somatic growth...
March 29, 2018: Korean Circulation Journal
https://www.readbyqxmd.com/read/29670358/multidisciplinary-approach-to-the-management-of-pulmonary-embolism-patients-the-pulmonary-embolism-response-team-pert
#4
REVIEW
Christopher W Root, David M Dudzinski, Bishoy Zakhary, Oren A Friedman, Akhilesh K Sista, James M Horowitz
Pulmonary embolism (PE) is a potentially fatal disease with a broad range of treatment options that spans multiple specialties. The rapid evolution and expansion of novel therapies to treat PE make it a disease process that is well suited to a multidisciplinary approach. In order to facilitate a rapid, robust response to the diagnosis of PE, some hospitals have established multidisciplinary pulmonary embolism response teams (PERTs). The PERT model is based on existing multidisciplinary teams such as heart teams and rapid response teams...
2018: Journal of Multidisciplinary Healthcare
https://www.readbyqxmd.com/read/29667200/treatment-in-a-preventive-cardiology-clinic-utilizing-advanced-practice-providers-apps-effectively-closes-atherosclerotic-cardiovascular-disease-ascvd-risk-management-gaps-amongst-a-primary-prevention-population-compared-with-a-propensity-matched-primary-care
#5
Emilio Fentanes, Anthony G Vande Hei, R Scott Holuby, Norma Suarez, Yousif Slim, Jennifer N Slim, Ahmad M Slim, Dustin Thomas
BACKGROUND: Advanced Practice Providers (APPs) can fill access to care gaps created by physician shortages and improve adherence/compliance with preventive atherosclerotic cardiovascular disease (ASCVD) interventions. METHODS: We retrospectively reviewed data on 595 patients enrolled in a preventive cardiology clinic (PCC) utilizing APPs compared with a propensity-matched cohort (PMC) of 595 patients enrolled in primary care clinics alone. PCC patients were risk stratified using Framingham risk scoring (FRS) and coronary artery calcium scoring (CACS) and treated based on published guideline-based algorithms...
April 17, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29666706/impact-of-the-ceiling-mounted-radiation-shielding-position-on-the-physician-s-dose-from-scatter-radiation-during-interventional-procedures
#6
Lucie Sukupova, Ondrej Hlavacek, Daniel Vedlich
The effect of the ceiling-mounted radiation shielding on the amount of the scatter radiation was assessed under conditions simulating obese patients for clinically relevant exposure parameters. Measurements were performed in different projections and with different positions of the ceiling-mounted shielding: without shielding; shielding closest to the patient; and shielding closest to the physician performing the procedure. The protection provided by the shielding was assessed for cardiology when the femoral access is used and for radiology when the physician performs the procedure in the abdominal area...
2018: Radiology Research and Practice
https://www.readbyqxmd.com/read/29664530/-clinical-practice-guidelines-for-smoking-cessation
#7
María Paz Corvalán B, Leonardo Véjar M, Claudia Bambs S, Juana Pavié G, Mónica Zagolin B, Jaime Cerda L
Considering that a high proportion of the Chilean general population smokes, the Chilean Society of Respiratory Diseases in collaboration with the Chilean Societies of Cardiology and, Endocrinology and Diabetes, formed an interdisciplinary group, who issued a set of recommendations for the treatment of the smoker, methodologically advised by experts. These interventions should be prioritized in high-risk groups. Methods The panel elaborated and graded the recommendations following the GRADE methodology. To assess the effect of each intervention, systematic reviews and randomized clinical trials were identified...
November 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/29661196/the-women-s-heart-health-programme-a-pilot-trial-of-sex-specific-cardiovascular-management
#8
Ting Ting Low, Siew Pang Chan, Shin Hnin Wai, Zhou Ang, Kyu Kyu, Kim Yee Lee, Anne Ching, Sarah Comer, Naomi Qiu Pin Tan, Elizabeth Grace Hui En Thong, Tracy Nang, Mohan Dutta, Carolyn S P Lam
BACKGROUND: There is increasing knowledge of sex-specific differences in cardiovascular disease and recognition of sex disparities in management. In our study, we investigated whether a cardiovascular programme tailored to the specific needs of women could lead to improved outcomes. METHODS: We randomised 100 female patients to receive cardiology follow-up with the conventional sex-neutral cardiac programme (control), or the sex-tailored Women's Heart Health Programme (intervention)...
April 16, 2018: BMC Women's Health
https://www.readbyqxmd.com/read/29656120/systemic-inflammatory-response-syndromes-in-the-era-of-interventional-cardiology
#9
REVIEW
Riccardo Gorla, Raimund Erbel, Kim A Eagle, Eduardo Bossone
Systemic inflammatory response syndrome (SIRS), initially reported after cardiovascular surgery, has been described after various interventional cardiology procedures, including endovascular/thoracic aortic repair (EVAR/TEVAR), implantation of heart rhythm devices, percutaneous coronary intervention (PCI), electrophysiology procedures (EP), and transcatheter aortic valve implantation (TAVI). In these settings, a comprehensive understanding of the triggers, pathogenesis as well as a common diagnostic/therapeutic algorithm is lacking and will be discussed in this review...
April 12, 2018: Vascular Pharmacology
https://www.readbyqxmd.com/read/29651826/new-percutaneous-interventions-in-heart-failure
#10
Elisabetta Moscarella, Salvatore Brugaletta, Manel Sabaté
Chronic heart failure (HF) is one of the main causes of mortality and morbidity worldwide and represents a growing challenge in interventional cardiology. Its prevalence is recently increasing due to the improvements in cardiac care with subsequent significant reduction in the HF acute mortality. HF may occur with either a reduced left ventricular ejection fraction (LVEF) (LVEF<40%, HFrEF) or a preserved EF (typically LVEF≥50%, HFpEF) indicative of diastolic dysfunction. Despite recent advances in drug therapies as well as in nonpharmacological strategies, including defibrillators, cardiac resynchronization therapy, LV assist devices (LVAD), mortality in HF remains high...
April 12, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29650544/evaluation-and-management-of-right-sided-heart-failure-a-scientific-statement-from-the-american-heart-association
#11
REVIEW
Marvin A Konstam, Michael S Kiernan, Daniel Bernstein, Biykem Bozkurt, Miriam Jacob, Navin K Kapur, Robb D Kociol, Eldrin F Lewis, Mandeep R Mehra, Francis D Pagani, Amish N Raval, Carey Ward
BACKGROUND AND PURPOSE: The diverse causes of right-sided heart failure (RHF) include, among others, primary cardiomyopathies with right ventricular (RV) involvement, RV ischemia and infarction, volume loading caused by cardiac lesions associated with congenital heart disease and valvular pathologies, and pressure loading resulting from pulmonic stenosis or pulmonary hypertension from a variety of causes, including left-sided heart disease. Progressive RV dysfunction in these disease states is associated with increased morbidity and mortality...
April 12, 2018: Circulation
https://www.readbyqxmd.com/read/29650382/therapeutic-decisions-in-atrial-fibrillation-for-stroke-prevention-the-role-of-aversion-to-ambiguity-and-physicians-risk-preferences
#12
Luciano A Sposato, Devin Stirling, Gustavo Saposnik
BACKGROUND: Knowledge-to-action gaps influence therapeutic decisions in atrial fibrillation (AF). Physician-related factors are common, but the least studied. We evaluated the prevalence and determinants of physician-related factors and knowledge-to-action gaps among physicians involved in the management of AF patients. DESIGN: In this cross-sectional study, participants from 6 South American countries recruited during an educational program answered questions regarding 16 case scenarios of patients with AF and completed experiments assessing 3 outcome measures: therapeutic inertia, herding, and errors in risk stratification knowledge translated into action (ERSKTA) based on commonly used stratification tools (Congestive heart failure, Hypertension, Age ≥75 years (double), Diabetes mellitus, previous Stroke/transient ischemic attack/thromboembolism (double), Vascular disease, Age 65-74 years, and female gender (score of 0 for males and 1 for female) (CHA2 DS2 -VASc) and Congestive heart failure, Hypertension, Age ≥75 years, Diabetes mellitus, and previous Stroke/transient ischemic attack (double) (CHADS2 ))...
April 9, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29650125/restenosis-stent-thrombosis-and-bleeding-complications-navigating-between-scylla-and-charybdis
#13
REVIEW
Juan Torrado, Leo Buckley, Ariel Durán, Pedro Trujillo, Stefano Toldo, Juan Valle Raleigh, Antonio Abbate, Giuseppe Biondi-Zoccai, Luis A Guzmán
The field of interventional cardiology has significantly evolved over 40 years by overcoming several challenges. The introduction of first-generation drug-eluting stents significantly reduced the rates of restenosis, but at the expense of an increase of late stent thrombosis. Prolonged antithrombotic therapy reduced rates of stent thrombosis, but at the cost of increased bleeding. Although the advent of second-generation drug-eluting stents subsequently reduced the incidence of late stent thrombosis, its permanent nature prevents full recovery of vascular structure and function with accordant risk of very late stent failure...
April 17, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29644619/early-%C3%A2-30-days-late-31-360-days-and-very-late-360-days-stent-thrombosis-in-patients-with-insulin-treated-versus-non-insulin-treated-type-2-diabetes-mellitus-a-meta-analysis
#14
Wei Chen, Yubin Wu, Yubao Hu
INTRODUCTION: At this time in 2018, with type 2 diabetes mellitus (T2DM) and coronary artery disease (CAD) still on the rise, the post-percutaneous coronary interventional (PCI) outcomes observed in patients with diabetes mellitus who are on insulin therapy (ITDM) and those who do not require insulin (NITDM) are still controversial and require further investigation. Considering this idea to be of particular interest to the readers, as well as being an important issue in interventional cardiology, we aimed to systematically assess early (≤ 30 days), late (31-360 days) and very late (> 360 days) stent thrombosis in patients with ITDM and NITDM following drug-eluting stent (DES) implantation...
April 11, 2018: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/29623770/atypical-presentation-of-acute-coronary-syndrome-acs-a-case-report
#15
Axel Van Damme, Philippe Vanderheeren, Tine De Backer, Françine Desimpel
Case A 45-year-old man presented at the emergency department (ED) with stomach pain since eight days. The patient was not worried about his symptoms and requested only pain relief. The emergency physician requested a consult of the gastroenterologist. Clinical examination was unremarkable. However, 12-lead ECG and ischemic markers were suggestive of acute coronary syndrome (ACS) which led to admission at the cardiology department. Despite delayed presentation, the patient was still referred for urgent coronary angiogram after receiving heparin, ticagrelor and acetylsalicylic acid because of persistent pain...
April 6, 2018: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29623173/spontaneous-closure-of-a-secundum-atrial-septal-defect
#16
Stephen Y Wang, Terrence D Welch, Aryé Elfenbein, Aaron V Kaplan
Spontaneous closure of an atrial septal defect (ASD) is well described in pediatric cardiology but may be less familiar to adult internists and cardiologists. We report a moderately sized 6-mm ASD that closed spontaneously without intervention. A literature review found that a smaller defect size and an early age of diagnosis are the most important predictors of closure. Possible mechanisms of a spontaneous ASD closure include adaptive endothelial migration, limited myocardial proliferation, and fibroblast migration with extracellular matrix deposition...
January 2018: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/29622149/prevalence-and-outcomes-of-mitral-stenosis-in-patients-undergoing-transcatheter-aortic-valve-replacement-findings-from-the-society-of-thoracic-surgeons-american-college-of-cardiology-transcatheter-valve-therapies-registry
#17
Lee Joseph, Mohammad Bashir, Qun Xiang, Babatunde A Yerokun, Roland Albert Matsouaka, Sreekanth Vemulapalli, Samir Kapadia, Joaquin E Cigarroa, Firas Zahr
OBJECTIVES: This study sought to examine the prevalence of mitral stenosis (MS) and its impact on in-hospital and 1-year clinical outcomes among patients undergoing transcatheter aortic valve replacement (TAVR). BACKGROUND: Patients with coexisting severe aortic stenosis and MS are increasingly being considered for TAVR. METHODS: The study cohort included 44,755 patients (age ≥18 years) who underwent TAVR during November 1, 2011, to September 30, 2015, and were registered in Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapies (TVT) Registry...
April 9, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29618329/a-randomized-controlled-trial-to-evaluate-utilization-of-physical-activity-recommendations-among-patients-of-cardiovascular-healthcare-centres-in-eastern-slovakia-study-design-and-rationale-of-the-awatar-study
#18
Aurel Zelko, Alena Bukova, Peter Kolarcik, Peter Bakalar, Ivan Majercak, Jana Potocnikova, Sijmen A Reijneveld, Jitse P van Dijk
BACKGROUND: Guidelines on modifiable risk factors regarding cardiological patients are poorly implemented in clinical practice perhaps due to low health literacy. Several digital tools for improving lifestyle and behavioural intervention were developed. Our primary aim is to evaluate the effectiveness of a digital exercise prescription tool on the adherence to physical activity recommendations among patients with cardiovascular diseases. METHODS: A randomized controlled trial will be realized in cooperation with Cardiovascular Health Centres in Eastern Slovakia...
April 4, 2018: BMC Public Health
https://www.readbyqxmd.com/read/29614534/-current-concepts-of-cardiologic-therapies-in-the-elderly
#19
Ursula Müller-Werdan, Kristina Norman
MYOCARDIAL INFARCTION IN THE OLD PATIENT: Even old patients may crucially benefit from reopening the occluded coronary artery by percutaneous coronary intervention with stent implantation. Bleeding complications can be reduced by choosing the radial instead of the femoral vascular approach for cardiac catheterization. STATINS FOR THE ELDERLY: WHEN TO START UND WHEN TO STOP?: Elderly benefit no less than the younger from statins. "Goal-oriented statin therapy" is preferable to the "statin strategy of fixed dose"...
April 2018: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29610769/improving-driving-advice-provided-to-cardiology-patients-on-discharge
#20
Amoolya Vusirikala, Mark Backhouse, Sarah Schimansky
Certain cardiac conditions can limit patients' ability to drive. It remains the doctors' responsibility to advise patients of any driving restrictions and is particularly important after certain diagnoses or procedures. We identified that the quality of documented advice was variable and frequently no written driving advice was recorded on discharge. It was apparent that there was a lack of awareness and knowledge of the current Driving and Vehicle Licensing Agency (DVLA) guidance among junior doctors. We therefore designed a quality improvement project using Plan-Do-Study-Act (PDSA) methodology to improve the provision of driving advice on discharge from a cardiology ward by focusing on staff education...
2018: BMJ Open Quality
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