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cardiac risk stratification

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https://www.readbyqxmd.com/read/28633348/lifelong-arrhythmic-risk-stratification-in-arrhythmogenic-right-ventricular-cardiomyopathy-distribution-of-events-and-impact-of-periodical-reassessment
#1
Chiara Cappelletto, Davide Stolfo, Antonio De Luca, Bruno Pinamonti, Giulia Barbati, Alberto Pivetta, Marco Gobbo, Francesca Brun, Marco Merlo, Gianfranco Sinagra
Aims: The arrhythmic risk stratification of arrhythmogenic right ventricular cardiomyopathy (ARVC) remains controversial. We evaluated the long-term distribution of life-threatening arrhythmic events assessing the impact of periodical risk reassessment. Methods and results: Ninety-eight ARVC patients with no previous major ventricular arrhythmias were retrospectively analysed. Patients were assessed at baseline, at 22 [inter-quartile range (IQR) 16-26], 49 (IQR 41-55) and 97 months (IQR 90-108)...
June 13, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28625611/comparing-sf-36%C3%A2-scores-versus-biomarkers-to-predict-mortality-in-primary-cardiac-prevention-patients
#2
EDITORIAL
Rony Lahoud, Vasutakarn Chongthammakun, Yuping Wu, Nael Hawwa, Danielle M Brennan, Leslie Cho
BACKGROUND: Risk stratification plays an important role in evaluating patients with no known cardiovascular disease (CVD). Few studies have investigated health-related quality of life questionnaires such as the Medical Outcomes Study Short Form-36 (SF-36®) as predictive tools for mortality, particularly in direct comparison with biomarkers. Our objective is to measure the relative effectiveness of SF-36® scores in predicting mortality when compared to traditional and novel biomarkers in a primary prevention population...
June 15, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28624398/prognostic-significance-of-remote-myocardium-alterations-assessed-by-quantitative-noncontrast-t1-mapping-in-st-segment-elevation-myocardial-infarction
#3
Sebastian J Reinstadler, Thomas Stiermaier, Johanna Liebetrau, Georg Fuernau, Charlotte Eitel, Suzanne de Waha, Steffen Desch, Jan-Christian Reil, Janine Pöss, Bernhard Metzler, Christian Lücke, Matthias Gutberlet, Gerhard Schuler, Holger Thiele, Ingo Eitel
OBJECTIVES: This study assessed the prognostic significance of remote zone native T1 alterations for the prediction of clinical events in a population with ST-segment elevation myocardial infarction (STEMI) who were treated by primary percutaneous coronary intervention (PPCI) and compared it with conventional markers of infarct severity. BACKGROUND: The exact role and incremental prognostic relevance of remote myocardium native T1 mapping alterations assessed by cardiac magnetic resonance (CMR) after STEMI remains unclear...
June 9, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28614597/esc-sudden-death-risk-model-in-hypertrophic-cardiomyopathy-incremental-value-of-quantitative-contrast-enhanced-cmr-in-intermediate-risk-patients
#4
Rocio Hinojar, José Luis Zamorano, Ariana Gonzalez Gómez, Maria Plaza Martin, Amparo Esteban, Luis Miguel Rincón, Juan Carlos Portugal, José Julio Jimenez Nácher, Covadonga Fernández-Golfín
BACKGROUND: Hypertrophic cardiomyopathy (HCM) remains the most common cause of sudden cardiac death (SCD) in the young; however, current strategies do not identify all HCM patients at risk. A novel validated algorithm was proposed by the last European Society of Cardiology guidelines to guide implantable cardioverter-defibrillator (ICD) therapy. Recently, extensive myocardial fibrosis was independently associated with increased risk of SCD events. This study aimed to establish the relation between myocardial fibrosis (late gadolinium enhancement [LGE] extension) and the novel SCD risk-prediction model in a real population of HCM to evaluate its potential additional value in the different risk groups...
June 14, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28612915/how-to-predict-the-risk-of-postoperative-complications-after-coronary-artery-bypass-grafting-in-patients-under-50-and-over-80-years-old-a-retrospective-cross-sectional-study
#5
Jacek Piątek, Anna Kędziora, Grzegorz Kiełbasa, Marta Olszewska, Dorota Sobczyk, Bryan HyoChan Song, Janusz Konstanty-Kalandyk, Tomasz Darocha, Karol Wierzbicki, Irena Milaniak, Krzysztof Wróbel, Bogusław Kapelak
BACKGROUND: Coronary artery disease (CAD) remains the leading cause of death in developed countries and there is an increasing number of both young and elderly patients requiring surgical treatment. Despite improvement of conventional risk stratification scores (EuroSCORE II, STS risk score), all of the calculations are estimated based on the typical population and the studies emphasize that the scales may need further investigation and modernization, as demographic changes of the population suffering from CAD are unavoidable...
June 14, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28612913/the-usefulness-of-soluble-st2-and-galectin-3-as-novel-biomarkers-for-better-risk-stratification-in-hypertrophic-cardiomyopathy
#6
Monika Gawor, Mateusz Śpiewak, Jadwiga Janas, Katarzyna Kożuch, Aleksandra Wróbel, Łukasz Mazurkiewicz, Rafał Baranowski, Magdalena Marczak, Jacek Grzybowski
BACKGROUND: Estimation of sudden cardiac death (SCD) risk is an integral part of clinical management of patients with hypertrophic cardiomyopathy (HCM). Identification of novel biomarkers of this disease can provide additional criteria for SCD risk stratification. Soluble suppression of tumorigenicity (sST2) and galectin-3 (Gal-3) are useful biomarkers for prognosis of heart failure (HF). Both of them appear to mediate cardiac fibrosis - an important pathogenetic process in HCM. Data about sST2 and Gal-3 usefulness in patients with HCM are limited...
June 14, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28611229/variation-in-definition-of-prolonged-mechanical-ventilation
#7
Louise Rose, Michael McGinlay, Reshma Amin, Karen Ea Burns, Bronwen Connolly, Nicholas Hart, Philippe Jouvet, Sherri Katz, David Leasa, Cathy Mawdsley, Danny F McAuley, Marcus J Schultz, Bronagh Blackwood
Consistency of definitional criteria for terminology applied to describe subject cohorts receiving mechanical ventilation within ICU and post-acute care settings is important for understanding prevalence, risk stratification, effectiveness of interventions, and projections for resource allocation. Our objective was to quantify the application and definition of terms for prolonged mechanical ventilation. We conducted a scoping review of studies (all designs except single-case study) reporting a study population (adult and pediatric) using the term prolonged mechanical ventilation or a synonym...
June 13, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28602434/carotid-plaque-thickness-and-common-carotid-imt-show-additive-value-in-cardiovascular-risk-prediction-and-reclassification
#8
Mauro Amato, Fabrizio Veglia, Ulf de Faire, Philippe Giral, Rainer Rauramaa, Andries J Smit, Sudhir Kurl, Alessio Ravani, Beatrice Frigerio, Daniela Sansaro, Alice Bonomi, Calogero C Tedesco, Samuela Castelnuovo, Elmo Mannarino, Steve E Humphries, Anders Hamsten, Elena Tremoli, Damiano Baldassarre
BACKGROUND AND AIMS: Carotid plaque size and the mean common carotid intima-media thickness measured in plaque-free areas (PF CC-IMTmean) have been identified as predictors of vascular events (VEs), but their complementarity in risk prediction and stratification is still unresolved. The aim of this study was to evaluate the independence of carotid plaque thickness and PF CC-IMTmean in cardiovascular risk prediction and risk stratification. METHODS: The IMPROVE-study is a European cohort (n = 3703), where the thickness of the largest plaque detected in the whole carotid tree was indexed as cIMTmax...
May 19, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28600674/-value-of-cardiac-ct-in-the-diagnostic-work-up-of-coronary-artery-disease-update-2017
#9
M Meyer, T Henzler
The quantification of coronary calcifications using noncontrast-enhanced computed tomography (CT) as well as coronary CT angiography (cCTA) have rapidly evolved in the recent years. Nowadays, both techniques are increasingly clinically accepted regarding risk stratification and accurate exclusion of significant coronary artery disease (CAD). The higher acceptance of cCTA is mainly based on the higher robustness, lower radiation exposure through continuous technical innovations as well as by the growing scientific evidence...
June 9, 2017: Der Radiologe
https://www.readbyqxmd.com/read/28600367/development-and-validation-of-a-risk-stratification-model-for-prediction-of-disability-and-hospitalisation-in-patients-with-heart-failure-a-study-protocol
#10
Luis García-Olmos, Francisco Rodríguez-Salvanés, Maurice Batlle-Pérez, Río Aguilar-Torres, Carlos Porro-Fernández, Alfredo García-Cabello, Montserrat Carmona, Sergio Ruiz-Alonso, Sofía Garrido-Elustondo, Ángel Alberquilla, Luis María Sánchez-Gómez, Ricardo Sánchez de Madariaga, Elena Monge-Navarrete, Luis Benito-Ortiz, Nicolás Baños-Pérez, Amaya Simón-Puerta, Ana Belén López Rodríguez, Miguel Ángel Martínez-Álvarez, María Ángeles Velilla-Celma, María Isabel Bernal-Gómez
BACKGROUND: Chronic heart failure (CHF) reduces quality of life and causes hospitalisation and death. Identifying predictive factors of such events may help change the natural history of this condition. AIM: To develop and validate a stratification system for classifying patients with CHF, according to their degree of disability and need for hospitalisation due to any unscheduled cause, over a period of 1 year. METHODS AND ANALYSIS: Prospective, concurrent, cohort-type study in two towns in the Madrid autonomous region having a combined population of 1 32 851...
June 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/28600090/hemodynamics-of-cardiogenic-shock
#11
REVIEW
Ariel Furer, Jeffrey Wessler, Daniel Burkhoff
Cardiogenic shock (CS) represents an advanced state of morbidity along the pathophysiologic pathway of end-organ hypoperfusion caused by reduced cardiac output and blood pressure. Acute coronary syndromes remain the most common cause of CS. The spectrum of hypoperfusion states caused by low cardiac output ranges from pre-CS to refractory CS and can be characterized by an array of hemodynamic parameters. This review provides the foundation for a hemodynamic understanding of CS including the use of hemodynamic monitoring for diagnosis and treatment, the cardiac and vascular determinants of CS, and a hemodynamic approach to risk stratification and management of CS...
July 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28598033/decision-making-in-anomalous-aortic-origin-of-a-coronary-artery
#12
Carlos M Mery
Anomalous aortic origin of a coronary artery (AAOCA) is the second most common cause of sudden cardiac death (SCD) in young athletes in United States. The exact pathophysiological mechanisms of SCD are unknown. There is lack of long-term outcome data on repaired and unrepaired AAOCA and our current risk stratification scheme for these patients is suboptimal. These patients are evaluated in a nonuniform manner across institutions in United States, and even by different providers residing in the same institution...
June 9, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28597791/value-of-latent-outflow-obstruction-to-predict-clinical-course-of-patients-with-hypertrophic-cardiomyopathy
#13
Fatih Bayrak, Gokhan Kahveci, Ali Buturak, Tansu Karaahmet, Ulaankhuu Batgerel, Atilla Koyuncu, Bulent Mutlu
Objective The frequency, significance and prognostic value of left ventricle obstruction (LVO) induced with provocation (latent LVO) is controversial for hypertrophic cardiomyopathy (HC) patients. This study was designed to assess the value of latent LVO in predicting the clinical course in 101 patients with HC. Methods and results Patients were followed for a mean of 82 ± 48 months (range 2 to 148 months) for clinical end points defined as a composite of cardiovascular death resuscitated cardiac arrest, appropriate defibrillator shock or hospitalization due to worsening of heart failure symptoms...
April 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28597120/long-term-prognostic-implications-of-myocardial-perfusion-imaging-in-octogenarians-an-all-comer-cohort-study
#14
Athanasios Katsikis, Athanasios Theodorakos, Vassiliki Manira, Spyridon Papaioannou, Genovefa Kolovou, Vassilios Voudris, Maria Koutelou
PURPOSE: Evaluation of the long-term prognostic value of myocardial perfusion imaging (MPI) in octogenarians. METHODS: Six hundred and twenty-nine octogenarians [51% previous myocardial infarction (MI) or revascularization] who underwent single-isotope MPI (78% (201)Tl, 22% (99m)Tc-tetrofosmin) with exercise (38% Bruce, 2% leg ergometry) or pharmacologic (58% adenosine, 2% dobutamine) stress were studied. All patients had LVEF determined by echocardiography within 1 month from MPI...
June 8, 2017: European Journal of Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/28592591/identification-of-high-risk-patients-after-st-segment-elevation-myocardial-infarction-comparison-between-angiographic-and-magnetic-resonance-parameters
#15
COMPARATIVE STUDY
Alessandro Durante, Alessandra Laricchia, Giulia Benedetti, Antonio Esposito, Alberto Margonato, Ornella Rimoldi, Francesco De Cobelli, Antonio Colombo, Paolo G Camici
BACKGROUND: The incidence of angiographic no reflow (NR) and microvascular obstruction (MVO) at cardiac magnetic resonance is significantly different. The aim of this study was to investigate the occurrence of NR and MVO in a cohort of consecutive patients with ST-segment-elevation myocardial infarction treated with primary percutaneous coronary interventions. METHODS AND RESULTS: In this prospective study, 88 consecutive ST-segment-elevation myocardial infarction patients were enrolled within 12 hours from symptoms onset...
June 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28588093/implantable-cardioverter-defibrillator-therapy-in-arrhythmogenic-right-ventricular-dysplasia-cardiomyopathy-predictors-of-appropriate-therapy-outcomes-and-complications
#16
Gabriela M Orgeron, Cynthia A James, Anneline Te Riele, Crystal Tichnell, Brittney Murray, Aditya Bhonsale, Ihab R Kamel, Stephan L Zimmerman, Daniel P Judge, Jane Crosson, Harikrishna Tandri, Hugh Calkins
BACKGROUND: Arrhythmogenic right ventricular dysplasia/cardiomyopathy is characterized by ventricular arrhythmias and sudden cardiac death. Once the diagnosis is established, risk stratification to determine whether implantable cardioverter-defibrillator (ICD) placement is warranted is critical. METHODS AND RESULTS: The cohort included 312 patients (163 men, age at presentation 33.6±13.9 years) with definite arrhythmogenic right ventricular dysplasia/cardiomyopathy who received an ICD...
June 6, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28580611/isolated-pulmonary-regurgitation-causes-decreased-right-ventricular-longitudinal-function-and-compensatory-increased-septal%C3%A2-pumping-in-a-porcine-model
#17
Sascha Kopic, Sigurdur S Stephensen, Einar Heiberg, Håkan Arheden, Philipp Bonhoeffer, Mads Ersbøll, Niels Vejlstrup, Lars Søndergaard, Marcus Carlsson
AIM: Longitudinal ventricular contraction is a parameter of cardiac performance with predictive power. Right ventricular longitudinal function is impaired in patients with free pulmonary regurgitation (PR) following corrective surgery for Tetralogy of Fallot (TOF). It remains unclear whether this is a consequence of the surgical repair, or whether it is inherent to PR. The aim of this study was to assess the relationship between longitudinal, lateral and septal pumping in a porcine model of isolated PR...
June 5, 2017: Acta Physiologica
https://www.readbyqxmd.com/read/28577667/clinical-syntax-score-predicts-outcomes-of-patients-undergoing-coronary-artery-bypass-grafting
#18
Giovanni Melina, Emiliano Angeloni, Simone Refice, Francesco Monti, Roberto Serdoz, Stefano Rosato, Fulvia Seccareccia, Furio Colivicchi, Roberta Serdoz, Francesco Paneni, Riccardo Sinatra
BACKGROUND: The SYNTAX score (SS) is a determinant of outcome in patients undergoing percutaneous coronary intervention. In addition, it has been recently shown that the clinical SYNTAX score (cSS), obtained by adding clinical variables to the SS, improves the predictive power of the resulting risk model. We assessed the hypothesis that the use of the cSS may predict outcomes of patients undergoing coronary artery bypass grafting (CABG). METHODS: We measured the SYNTAX score in 874 patients undergoing isolated first time on-pump CABG...
June 2017: American Heart Journal
https://www.readbyqxmd.com/read/28573739/apical-hypertrophic-cardiomyopathy-with-left-ventricular-apical-aneurysm-importance-of-multi-modality-imaging
#19
Nisharahmed Kherada, Juan M Vinardell, Christos G Mihos, Orlando Santana
Apical hypertrophic cardiomyopathy (HCM) is an uncommon variant of HCM characterized by apical hypertrophy without the septal predominance seen in the majority of HCM cases. In 2% of patients, a concomitant left ventricular apical aneurysm is observed, which increases the risk of sudden death and adverse HCM-related events. Multimodality imaging is helpful for appropriate identification of this particular morphologic pattern. Herein, we present a case of apical HCM with a left ventricular apical aneurysm, exemplifying the utility of a multimodality approach from resting electrocardiogram, transthoracic echocardiogram, left ventriculography, and cardiac magnetic resonance imaging, for proper risk stratification and treatment planning...
June 1, 2017: Echocardiography
https://www.readbyqxmd.com/read/28566297/effect-of-coronary-revascularization-on-the-prognostic-value-of-stress-myocardial-contrast-wall-motion-and-perfusion-imaging
#20
Nicola Gaibazzi, Thomas Porter, Valentina Lorenzoni, Gianluca Pontone, Delia De Santis, Andrea De Rosa, Andrea Igoren Guaricci
BACKGROUND: The assessment of myocardial perfusion (MP) and wall motion (WM) using contrast dipyridamole echocardiography (cSE-WMP) improves the sensitivity to detect coronary artery disease and the stratification of cardiac events, but its long-term value for fatal and nonfatal ischemic cardiac events, also with respect to patients undergoing revascularization or not, remains to be determined. METHODS AND RESULTS: One-thousand three-hundred and twenty-nine patients with suspect or known CAD who underwent cSE-WMP were followed for a median 5...
May 31, 2017: Journal of the American Heart Association
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