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cardiac risk stratification

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https://www.readbyqxmd.com/read/28528724/twelve-lead-ambulatory-electrocardiographic-monitoring-in-brugada-syndrome-potential-diagnostic-and-prognostic-implications
#1
Belinda Gray, Adrienne Kirby, Peter Kabunga, Saul B Freedman, Laura Yeates, Ajita Kanthan, Caroline Medi, Anthony Keech, Christopher Semsarian, Raymond W Sy
BACKGROUND: Patients with Brugada syndrome (BrS) are diagnosed and risk stratified on the basis of a spontaneous or drug-induced type 1 electrocardiographic (ECG) pattern, often at single time points not accounting for variation throughout the day. OBJECTIVES: The purpose of this study was to prospectively assess the overall burden of type 1 Brugada ECG changes using 12-lead 24-hour Holter monitoring and evaluate association with cardiac events. METHODS: From July 1, 2013 to December 31, 2015, patients with BrS were recruited from 3 Australian centers and the Australian Genetic Heart Disease Registry...
June 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28523594/the-relationship-between-coronary-artery-calcium-scores-and-left-atrium-size-in-hemodialysis-patients
#2
Ismail Baloglu, Kultigin Turkmen, H Zeki Tonbul, N Yılmaz Selcuk
PURPOSE: Hemodialysis patients have extremely increased cardiovascular mortality. The coronary artery calcification score (CACS) in uremic patients receiving hemodialysis reflects the severity of atherosclerotic vascular disease and predicts the cardiovascular events. In cardiac conditions, left atrial (LA) size has a prognostic importance. In this study, relationship between coronary artery calcification and left atrial size was investigated. METHODS: This was a cross-sectional study involving 32 hemodialysis patients (16 females, 16 males; mean age, 52...
May 18, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28523181/surgery-after-drug-eluting-stent-implantation-it-s-not-all-doom-and-gloom
#3
EDITORIAL
Francesco Saia
Up to 15-23% of the patients with percutaneous coronary intervention (PCI) and drug-eluting stent (DES) implantation need a surgical procedure <12 months from PCI. Perioperative risk stratification in these patients is challenging and should take into account many individual clinical and anatomic variables, along with the intrinsic surgical risk for ischemic and bleeding events. The presence of DES has always been considered as a harbinger of doom. In fact, DES are associated with delayed vascular healing and require longer dual antiplatelet treatment...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28521596/overcoming-the-current-issues-surrounding-device-leads-reducing-the-complications-during-extraction
#4
Maria Grazia Bongiorni, Luca Segreti, Andrea Di Cori, Giulio Zucchelli, Luca Paperini, Stefano Viani, Ezio Soldati
The implantation rate of of Cardiac implantable Elecrtonical Devices has consistently increased in the last 20 years, so as related complication rates. According, devices infections and malfunctions required the development of appropriate strategies. The most relevant issue is the removal of pacing and ICD leads, which, few months after implantation, tend to develop intravascular fibrosis, often making extraction a challenging and risky procedure. Areas Covered: TLE scenario is constantly evolving. Transvenous lead extraction (TLE) is a key procedure in lead management strategies...
May 18, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28511325/-feasibility-of-the-2014-european-guidelines-risk-prediction-model-for-sudden-cardiac-death-in-hypertrophic-cardiomyopathy-in-chinese-patients
#5
S H Zhu, Y Li, W Huang, H Jiang, S N Li, L Chen, S Huang, H S Yu, B Xu
Objective: Exploring the feasibility of the 2014 European Society of Cardiology(ESC)guideline's risk prediction model for sudden cardiac death in hypertrophic cardiomyopathy (HCM Risk-SCD) in Chinese patients. Methods: The study population consisted of a consecutive cohort of 172 Chinese patients with HCM without prior sudden cardiac death (SCD) event who were in patients in Nanjing Drum Tower Hospital from December 2010 to October 2015.The endpoint event was a composite of SCD and appropriate implantable cardioverter-defibrillator (ICD) therapy...
May 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/28511155/-the-role-of-inflammatory-biomarkers-in-cardiovascular-risk-stratification
#6
Світлана Г Пузік
INTRODUCTION: The increase in cardiovascular diseases requires the search for ways to predict complications based on research additional to traditional risk factors, conduct a study of the formation mechanisms of these complications and to design new treatment strategies. AIM: To get an idea about the relationship between inflammation in the blood vessels, atherosclerosis and cardiovascular consequences based on the study of the role of biomarkers of inflammation...
2017: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28507439/infrainguinal-open-reconstruction-a-review-of-surgical-considerations-and-expected-outcomes
#7
REVIEW
Sevan R Komshian, Kimberly Lu, Steven L Pike, Jeffrey J Siracuse
Infrainguinal arterial occlusive disease can lead to potentially disabling and limb-threatening conditions. Revascularization may be indicated for claudication, rest pain, or tissue loss. Although endovascular interventions are becoming more prevalent, open surgeries such as endarterectomy and bypass are still needed and performed regularly. Open reconstruction has been associated with postoperative morbidity, both at the local and at the systemic levels. Local complications include surgical site infections (SSIs 0-5...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/28500753/a-0h-1h-protocol-for-safe-early-discharge-of-chest-pain-patients
#8
Arash Mokhtari, Bertil Lindahl, Alexandru Schiopu, Troels Yndigegn, Ardavan Khoshnood, Patrik Gilje, Ulf Ekelund
OBJECTIVES: Guidelines recommend a 0h/1h high-sensitivity cardiac troponin T (hs-cTnT) diagnostic strategy in acute chest pain patients. There is however little data on the performance of this strategy when combined with clinical risk stratification. We aimed to evaluate the diagnostic accuracy of an accelerated diagnostic protocol (ADP) using the 0h/1h hs-cTnT strategy together with an adapted Thrombolysis In Myocardial Infarction (TIMI) score and ECG for ruling out major adverse cardiac events (MACE) within 30 days...
May 13, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28498904/the-acef-ii-risk-score-for-cardiac-surgery-updated-but-still-parsimonious
#9
Marco Ranucci, Valeria Pistuddi, Sabino Scolletta, Carlo de Vincentiis, Lorenzo Menicanti
Aims: The age, creatinine, and ejection fraction (ACEF) score was introduced in 2009 and is presently included in the guidelines for myocardial revascularization of the European Society of Cardiology and Association for Cardio-Thoracic Surgery as a risk stratification tool for surgical and percutaneous myocardial revascularization. The present study introduces an updated version of the ACEF (ACEF II) inclusive of emergency surgery and pre-operative anaemia. Methods and results: The development series includes 7011 consecutive cardiac surgery patients operated at a single institution...
May 12, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28496938/brugada-syndrome-risk-stratification-and-management
#10
REVIEW
Yoshifusa Aizawa
The Brugada syndrome (BrS) is an arrhythmogenic disease associated with an increased risk of ventricular fibrillation and sudden cardiac death. The risk stratification and management of BrS patients, particularly of asymptomatic ones, still remains challenging. A previous history of aborted sudden cardiac death or arrhythmic syncope in the presence of spontaneous type 1 ECG pattern of BrS phenotype appear to be the most reliable predictors of future arrhythmic events. Several other ECG parameters have been proposed for risk stratification...
October 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/28494887/preoperative-risk-stratification-of-critically-ill-patients
#11
Curtis C Copeland, Andrew Young, Tristan Grogan, Eilon Gabel, Anahat Dhillon, Vadim Gudzenko
STUDY OBJECTIVE: Risk assessment historically emphasized cardiac morbidity and mortality in elective, outpatient, non-cardiac surgery. However, critically ill patients increasingly present for therapeutic interventions. Our study investigated the relationship of American Society of Anesthesiologists (ASA) class, revised cardiac risk index (RCRI), and sequential organ failure assessment (SOFA) score with survival to discharge in critically ill patients with respiratory failure. DESIGN: Retrospective cohort analysis over a 21-month period...
June 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28494446/mutation-load-of-multiple-ion-channel-gene-mutations-in-brugada-syndrome
#12
Francesca Gualandi, Fatima Zaraket, Michele Malagù, Giulia Parmeggiani, Cecilia Trabanelli, Sergio Fini, Xiao Dang, Xiaoming Wei, Mingyan Fang, Matteo Bertini, Roberto Ferrari, Alessandra Ferlini
Brugada syndrome is a primary arrhythmic syndrome that accounts for 20% of all sudden cardiac death cases in individuals with a structurally normal heart. Pathogenic variants associated with Brugada syndrome have been identified in over 19 genes, with SCN5A as a pivotal gene accounting for nearly 30% of cases. In contrast to other arrhythmogenic channelopathies (such as long QT syndrome), digenic inheritance has never been reported in Brugada syndrome. Exploring 66 cardiac genes using a new custom next-generation sequencing panel, we identified a double heterozygosity for pathogenic mutations in SCN5A and TRPM4 in a Brugada syndrome patient...
May 12, 2017: Cardiology
https://www.readbyqxmd.com/read/28492563/-follow-up-strategies-after-percutaneous-coronary-intervention-prognostic-stratification-and-multidisciplinary-management-based-on-patient-risk-profile
#13
Giuseppe Musumeci, Pompilio Faggiano, Marco Ferlini, Corrado Lettieri, Battistina Castiglioni, Antonio Maggi, Fabrizio Negri, Paola Colombo, Fabrizio Oliva, Roberto F E Pedretti, Marco Centola, Roberta Rossini
The number of percutaneous coronary interventions (PCI) is increasing worldwide. Follow-up strategies after PCI are extremely heterogeneous and can greatly affect the cost of medical care. In the present paper, practical advises are provided with respect to a tailored follow-up strategy on the basis of patients' risk profile. Clinical and interventional cardiologists, cardiac rehabilitators, and general practitioners equally contributed to the creation of the present document and defined three follow-up strategies and types and timing of clinical and instrumental evaluations in post-PCI patients...
January 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28491088/novel-biomarkers-for-cardiovascular-risk-prediction
#14
REVIEW
Juan Wang, Guo-Juan Tan, Li-Na Han, Yong-Yi Bai, Miao He, Hong-Bin Liu
Cardiovascular disease (CVD) is the leading cause of death and disability worldwide. The primary prevention of CVD is dependent upon the ability to identify high-risk individuals long before the development of overt events. This highlights the need for accurate risk stratification. An increasing number of novel biomarkers have been identified to predict cardiovascular events. Biomarkers play a critical role in the definition, prognostication, and decision-making regarding the management of cardiovascular events...
February 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/28488096/improving-risk-assessment-for-post-surgical-low-cardiac-output-syndrome-in-patients-without-severely-reduced-ejection-fraction-undergoing-open-aortic-valve-replacement-the-role-of-global-longitudinal-strain-and-right-ventricular-free-wall-strain
#15
K Balderas-Muñoz, H Rodríguez-Zanella, J F Fritche-Salazar, N Ávila-Vanzzini, L E Juárez Orozco, J A Arias-Godínez, O Calvillo-Argüelles, S Rivera-Peralta, J C Sauza-Sosa, M E Ruiz-Esparza, E Bucio-Reta, A Rómero, N Espinola-Zavaleta, B Domínguez-Mendez, M Gaxiola-Macias, M A Martínez-Ríos
Low cardiac output syndrome (LCOS) after surgical aortic valve replacement (SAVR) is related to increased mortality and treatment related costs. We aimed to evaluate whether echocardiography-derived left ventricular global longitudinal strain (LV-GLS) relates to the occurrence of postoperative LCOS in patients undergoing SAVR. We prospectively enrolled 75 patients with symptomatic severe aortic stenosis, left ventricular ejection fraction (LVEF) >40%, NYHA Class <IV, without other significant valve disease...
May 9, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28485545/substrate-dependent-risk-stratification-for-implantable-cardioverter-defibrillator-therapies-using-cardiac-magnetic-resonance-imaging-the-importance-of-t1-mapping-in-non-ischemic-patients
#16
Simon Claridge, Silvia Mennuni, Thomas Jackson, Jonathan M Behar, Bradley Porter, Benjamin Sieniewicz, Julian Bostock, Mark O'Neill, Francis Murgatroyd, Jaswinder Gill, Gerald Carr-White, Amedeo Chiribiri, Reza Razavi, Zhong Chen, Christopher Aldo Rinaldi
INTRODUCTION: The role of implantable cardioverter defibrillators in non-ischemic cardiomyopathy is unclear and better risk-stratification is required. We sought to determine if T1 mapping predicts appropriate defibrillator therapy in patients with non-ischemic cardiomyopathy. We studied a mixed cohort of ischemic and non-ischemic patients to determine whether different CMR applications (T1 mapping, late gadolinium enhancement and Grayzone) were selectively predictive of therapies for the different arrhythmic substrates...
May 9, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28479268/progression-of-myocardial-sympathetic-denervation-assessed-by-123-i-mibg-imaging-in-familial-amyloid-polyneuropathy-and-the-effect-of-liver-transplantation
#17
Maria da Conceição Azevedo Coutinho, Nuno Cortez-Dias, Guilhermina Cantinho, Isabel Conceição, Tatiana Guimarães, Gustavo Lima da Silva, Miguel Nobre Menezes, Ana Rita Francisco, Rui Plácido, Fausto J Pinto
INTRODUCTION: Familial amyloid polyneuropathy (FAP) is a rare disease caused by systemic deposition of amyloidogenic variants of the transthyretin (TTR) protein. The TTR-V30M mutation is caused by the substitution of valine by methionine at position 30 and mainly affects the peripheral and autonomic nervous systems. Cardiovascular manifestations are common and are due to autonomic denervation and to amyloid deposition in the heart. Cardiac sympathetic denervation detected by iodine-123 labeled metaiodobenzylguanidine (MIBG) is an important prognostic marker in TTR-V30M FAP...
May 4, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28479166/usefulness-of-the-cha2ds2-vasc-score-to-predict-mortality-in-defibrillator-recipients
#18
Christopher Hong, Krishna Alluri, Nasir Shariff, Furqan Khattak, Evan Adelstein, Sandeep Jain, Samir Saba
The CHA2DS2-VASC score is a well-validated stratification tool that predicts the risk of thromboembolism and stroke in patients with nonvalvular atrial fibrillation. Several studies have examined its application as a predictor of mortality in clinical applications other than atrial fibrillation. However, there are current no studies examining its use as an outcome prediction tool in a population of patients with implantable cardiac defibrillators (ICDs). In this study, we examined data from 2,258 patients who underwent ICD device implantation at the hospitals of the University of Pittsburgh Medical Center from February 2002 to April 2014 (median follow-up 5...
April 12, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28474817/relationship-between-diabetes-and-ischemic-injury-among-patients-with-revascularized-st-elevation-myocardial-infarction-diabetes-and-myocardial-damage
#19
Sebastian J Reinstadler, Thomas Stiermaier, Charlotte Eitel, Bernhard Metzler, Suzanne de Waha, Georg Fuernau, Steffen Desch, Holger Thiele, Ingo Eitel
AIMS: Studies comparing reperfusion efficacy and myocardial damage between diabetic and non-diabetic patients with ST-elevation myocardial infarction (STEMI) are scarce and have reported conflicting results. Aim was to investigate the impact of preadmission diabetic status on myocardial salvage and damage as determined by cardiac magnetic resonance (CMR) and to evaluate its prognostic relevance. MATERIALS AND METHODS: We enrolled 792 patients with STEMI at eight sites...
May 5, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28470007/incidental-echocardiographic-finding-fractured-inferior-vena-cava-filter
#20
Bhradeev Sivasambu, Deepa Kabirdas, Assad Movahed
Inferior vena cava filters have gained increasing popularity in recent decades and knowledge on rare complications becomes vital to practicing physicians. A 30-year-old African American male with diabetes mellitus, hypertension, end-stage renal disease, history of deep venous thrombosis and placement of venacaval filter who was seen in the cardiology clinic for cardiac risks stratification prior to renal transplant. Patient denied any cardiac symptoms. A transthoracic echocardiogram was performed and showed two linear echoes bright densities in the right atrium and right ventricle embedded which was later found to be fractured filter struts by computed tomography...
April 16, 2017: World Journal of Clinical Cases
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