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https://www.readbyqxmd.com/read/28925651/exercise-stress-testing-indications-and-common-questions
#1
Kathryn K Garner, William Pomeroy, James J Arnold
Exercise stress testing is a validated diagnostic test for coronary artery disease in symptomatic patients, and is used in the evaluation of patients with known cardiac disease. Testing of asymptomatic patients is generally not indicated. It may be performed in select deconditioned adults before starting a vigorous exercise program, but no studies have compared outcomes from preexercise testing vs. encouraging light exercise with gradual increases in exertion. Preoperative exercise stress testing is helpful for risk stratification in patients undergoing vascular surgery or who have active cardiac symptoms before undergoing nonemergent noncardiac surgery...
September 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28922191/acr-spr-str-practice-parameter-for-the-performance-of-cardiac-positron-emission-tomography-computed-tomography-pet-ct-imaging
#2
Rathan M Subramaniam, Warren R Janowitz, Geoffrey B Johnson, Martin A Lodge, Marguerite T Parisi, Mark R Ferguson, Jeffrey C Hellinger, Gregory W Gladish, Narainder K Gupta
This clinical practice parameter has been developed collaboratively by the American College of Radiology (ACR), the Society for Pediatric Radiology (SPR), and the Society of Thoracic Radiology (STR). This document is intended to act as a guide for physicians performing and interpreting positron emission tomography-computed tomography (PET/CT) of cardiac diseases in adults and children. The primary value of cardiac PET/CT imaging include evaluation of perfusion, function, viability, inflammation, anatomy, and risk stratification for cardiac-related events such as myocardial infarction and death...
September 15, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28921836/clinical-assessment-of-coronary-arteries-in-kawasaki-disease-focus-on-echocardiographic-assessment
#3
Carolyn A Altman
Echocardiography is an excellent noninvasive imaging modality for evaluation and follow-up of cardiac lesions, especially coronary artery changes occurring as a result of Kawasaki disease. The information obtained has prognostic implications and can be complemented with other modes of imaging for risk stratification and optimization of both medical and interventional therapy. The aim of this article is to describe the time line of echocardiographic follow-up of patients affected with Kawasaki disease. The classification of coronary artery changes and transthoracic echocardiographic views recommended for detailed evaluation of the coronary arteries are delineated in detail in this report...
September 18, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28917684/role-of-low-endothelial-shear-stress-and-plaque-characteristics-in-the-prediction-of-nonculprit-major-adverse-cardiac-events-the-prospect-study
#4
Peter H Stone, Akiko Maehara, Ahmet Umit Coskun, Charles C Maynard, Marina Zaromitydou, Gerasimos Siasos, Ioannis Andreou, Dimitris Fotiadis, Kostas Stefanou, Michail Papafaklis, Lampros Michalis, Alexandra J Lansky, Gary S Mintz, Patrick W Serruys, Charles L Feldman, Gregg W Stone
OBJECTIVES: This study sought to determine whether low endothelial shear stress (ESS) adds independent prognostication for future major adverse cardiac events (MACE) in coronary lesions in patients with high-risk acute coronary syndrome (ACS) from the United States and Europe. BACKGROUND: Low ESS is a proinflammatory, proatherogenic stimulus associated with coronary plaque development, progression, and destabilization in human-like animal models and in humans. Previous natural history studies including baseline ESS characterization investigated low-risk patients...
September 9, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28917674/prognostic-value-of-risk-factors-calcium%C3%A2-score-coronary-cta-myocardial%C3%A2-perfusion-imaging-and-invasive%C3%A2-coronary-angiography-in-kidney%C3%A2-transplantation-candidates
#5
Simon Winther, My Svensson, Hanne Skou Jørgensen, Laust Dupont Rasmussen, Niels Ramsing Holm, Lars Christian Gormsen, Kirsten Bouchelouche, Hans Erik Bøtker, Per Ivarsen, Morten Bøttcher
OBJECTIVES: This study sought to perform a prospective head-to-head comparison of the predictive value of clinical risk factors and a variety of cardiac imaging modalities including coronary artery calcium score (CACS), coronary computed tomography angiography (CTA), single-photon emission computed tomography (SPECT), and invasive coronary angiography (ICA) on major adverse cardiac events (MACE) and all-cause mortality in kidney transplantation candidates. BACKGROUND: Current guidelines recommend screening for coronary artery disease in kidney transplantation candidates...
September 9, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28917673/b-type-natriuretic-peptide-and-high-sensitivity-cardiac-troponin-for-risk-stratification-in-low-flow-low-gradient-aortic-stenosis-a-substudy-of-the-topas-study
#6
Abdellaziz Dahou, Marie-Annick Clavel, Romain Capoulade, Kim O'Connor, Henrique B Ribeiro, Nancy Côté, Florent Le Ven, Josep Rodés-Cabau, Jean G Dumesnil, Patrick Mathieu, Philippe Pibarot
OBJECTIVES: The objective of this study was to determine the prognostic value of combined measures of B-type natriuretic peptide (BNP) and high-sensitivity cardiac troponin T (hsTnT) in patients with low-flow, low-gradient aortic stenosis (LF-LG AS) who had either a preserved or reduced left ventricular ejection fraction (LVEF). BACKGROUND: An elevated BNP level is associated with increased risk of mortality in patients with LF-LG AS. The incremental prognostic value of hsTnT in these patients is unknown...
September 9, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28916176/risk-stratification-of-sudden-cardiac-death-in-hypertension
#7
Larisa G Tereshchenko, Elsayed Z Soliman, Barry R Davis, Suzanne Oparil
In the United States, up to 450,000 people per year die suddenly; an average of 1 sudden death every 70s. Strategies for preventing sudden cardiac death are urgently needed. Systemic arterial hypertension is a major risk factor for sudden cardiac death and the increasing burden of hypertension is a worldwide problem. The lifetime risk of sudden cardiac death at 30years of age is higher by 30% in individuals with hypertension. Each 20/10mmHg increase in systolic/diastolic blood pressure, is associated with a 20% additional increase in sudden cardiac death risk...
August 14, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28912212/risk-stratification-using-the-cha2ds2-vasc-score-in-takotsubo-syndrome-data-from-the-takotsubo-italian-network
#8
Guido Parodi, Fernando Scudiero, Rodolfo Citro, Angelo Silverio, Benedetta Bellandi, Concetta Zito, Francesco Antonini-Canterin, Fausto Rigo, Chiara Zocchi, Eduardo Bossone, Jorge Salerno-Uriarte, Federico Piscione, Carlo Di Mario
BACKGROUND: The CHA2DS2-VASc score predicts stroke in patients with atrial fibrillation and has been reported to have a prognostic role even in acute coronary syndrome patients. The Takotsubo syndrome is a condition that mimics acute coronary syndrome and may present several complications including stroke. We sought to assess the ability of CHA2DS2-VASc score to predict adverse events in Takotsubo syndrome patients. METHODS AND RESULTS: Overall, 371 Takotsubo syndrome patients were enrolled in a prospective registry...
September 14, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28903763/troponin-as-ischemic-biomarker-is-related-with-all-three-echocardiographic-risk-factors-for-sudden-death-in-hypertrophic-cardiomyopathy-esc-guidelines-2014
#9
Rafał Hładij, Renata Rajtar-Salwa, Paweł Petkow Dimitrow
BACKGROUND: Sudden cardiac death (SCD) risk stratification is the most important preventive action in patients with hypertrophic cardiomyopathy (HCM). The identification of the ischemia biomarker high sensitive troponin I (hs-TnI) role for this arrhythmic disease may provide additional information for SCD risk stratification. The aim of the study was to compare echocardiographic parameters (prognostic for risk stratification of SCD in HCM) among two subgroups of HCM patients: with elevated hs-TnI versus non-elevated hs-TnI level...
September 13, 2017: Cardiovascular Ultrasound
https://www.readbyqxmd.com/read/28901628/total-cosine-r-to-t-for-predicting-ventricular-arrhythmic-and-mortality-outcomes-a-systematic-review-and-meta-analysis
#10
Gary Tse, Mengqi Gong, Cheuk Wai Wong, Cynthia Chan, Stamatis Georgopoulos, Yat Sun Chan, Bryan P Yan, Guangping Li, Paula Whittaker, Ana Ciobanu, Sadeq Ali-Hasan-Al-Saegh, Sunny H Wong, William K K Wu, George Bazoukis, Konstantinos Lampropoulos, Wing Tak Wong, Lap Ah Tse, Adrian M Baranchuk, Konstantinos P Letsas, Tong Liu
BACKGROUND: The total cosine R-to-T (TCRT), a vectorcardiographic marker reflecting the spatial difference between the depolarization and repolarization wavefronts, has been used to predict ventricular tachycardia/fibrillation (VT/VF) and sudden cardiac death (SCD) in different clinical settings. However, its prognostic value has been controversial. OBJECTIVE: This systematic review and meta-analysis evaluated the significance of TRCT in predicting arrhythmic and/or mortality endpoints...
September 12, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28895038/a-retrospective-external-validation-study-of-the-heart-score-among-patients-presenting-to-the-emergency-department-with-chest-pain
#11
Matthew Jay Streitz, Joshua James Oliver, Jessica Marie Hyams, Richard Michael Wood, Yevgeniy Mikhaylovich Maksimenko, Brit Long, Robert Michael Barnwell, Michael David April
Emergency physicians must be able to effectively prognosticate outcomes for patients presenting to the Emergency Department (ED) with chest pain. The HEART score offers a prognostication tool, but external validation studies are limited. We conducted an external retrospective validation study of the HEART score among ED patients presenting to our ED with chest pain from 1 January 2014 to 9 June 2014. We utilized chart review methodology to abstract data from each patient's electronic medical record. We collected data relevant to each of the five elements of the HEART score: history, electrocardiogram (ECG) interpretation, patient age, patient risk factors, and troponin levels...
September 11, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28889326/myocardial-contractile-patterns-predict-future-cardiac-events-in-sarcoidosis
#12
Jian Chen, Juan Lei, Ernest Scalzetti, Mary McGrath, David Feiglin, Robert Voelker, Jingfeng Wang, Michael C Iannuzzi, Kan Liu
The poor prognosis of cardiac sarcoidosis (CS) underscores the need for risk stratification. We evaluated 84 consecutive sarcoidosis patients who were referred for echocardiographic studies for cardiac symptoms or abnormal electrocardiograms. In 54 patients without previous diagnosis of CS or other known structural heart disease, 13 reached endpoints during (median) 24 months follow up. Significantly impaired peak systolic longitudinal strain in their original echocardiograms were identified in 13 of 17 left ventricular segments, clustering in the free wall, interventricular septum and apex...
September 9, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28889147/acute-coronary-syndrome-risk-prediction-of-rapid-emergency-medicine-scoring-system-in-acute-chest-pain-an-observational-study-of-patients-presenting-with-chest-pain-in-the-emergency-department-in-central-saudi-arabia
#13
Tahir Mehmood, Mohammad S Al Shehrani, Muhammad Ahmad
To assess the diagnostic validity of the rapid emergency medical score (REMS) for the risk stratification of acute coronary syndrome (ACS) from non-cardiogenic chest pain. Methods: An observational cross-sectional study was carried out among patients presenting with chest pain to the Emergency Department of Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia, for 6 months from January to June 2016. All patients, included through non-probability convenience sampling, were assessed using standard protocols for the physiological parameters of the REMS, and ACS was confirmed through electrocardiography, cardiac enzyme testing, and angiography (if needed)...
September 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/28888266/new-york-heart-association-class-and-the-survival-benefit-from-primary-prevention-implantable-cardioverter-defibrillators-a-pooled-analysis-of-4-randomized-controlled-trials
#14
REVIEW
Daniel J Friedman, Sana M Al-Khatib, Emily P Zeitler, JooYoon Han, Gust H Bardy, Jeanne E Poole, J Thomas Bigger, Alfred E Buxton, Arthur J Moss, Kerry L Lee, Richard Steinman, Paul Dorian, Riccardo Cappato, Alan H Kadish, Peter J Kudenchuk, Daniel B Mark, Lurdes Y T Inoue, Gillian D Sanders
BACKGROUND: Primary prevention implantable cardioverter defibrillator (ICD) reduce all-cause mortality by reducing sudden cardiac death. There are conflicting data regarding whether patients with more advanced heart failure derive ICD benefit owing to the competing risk of nonsudden death. METHODS: We performed a patient-level meta-analysis of New York Heart Association (NYHA) class II/III heart failure patients (left ventricular ejection fraction ≤35%) from 4 primary prevention ICD trials (MADIT-I, MADIT-II, DEFINITE, SCD-HeFT)...
September 2017: American Heart Journal
https://www.readbyqxmd.com/read/28887316/prognostic-value-of-aortic-stiffness-in-patients-after-st-elevation-myocardial-infarction
#15
Hans-Josef Feistritzer, Gert Klug, Sebastian J Reinstadler, Martin Reindl, Lea Niess, Timo Nalbach, Christian Kremser, Agnes Mayr, Bernhard Metzler
BACKGROUND: High aortic stiffness has been shown to be a strong predictor of morbidity and mortality in the general population and several patient cohorts. However, in patients after ST-elevation myocardial infarction, the prognostic value of high aortic stiffness is unknown so far. METHODS AND RESULTS: This prospective observational study included 160 consecutive patients with first acute ST-elevation myocardial infarction. Aortic pulse wave velocity (PWV) was measured 2 (interquartile range 2-4 days) days after infarction using cardiac magnetic resonance imaging...
September 8, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28885393/the-association-between-red-cell-distribution-width-erythropoietin-levels-and-coronary-artery-disease
#16
Yuanmin Li, Min Li, Yufang Teng, Chen Zhang, Qinghua Liu, Haifeng Hou
BACKGROUND: Red cell distribution width (RDW) is a cardiac marker for risk stratification and prognostic evaluation of coronary artery disease (CAD); however, the underlying mechanism remains unclear. Erythropoietin (EPO), a crucial factor affecting erythropoiesis, has been reported to be a protective molecule regulating the process of myocardial ischemia and relevant damage. No study has as yet reported the relationship between RDW and endogenous EPO in CAD patients. This cross-sectional study aimed to establish the association between endogenous EPO levels and increases in RDW in CAD patients...
September 6, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28885062/out-of-hospital-cardiac-arrest-always-coronary-angiography
#17
Andrea Rognoni, Chiara Cavallino, Marco Giovanni Mennuni, Lucia Barbieri, Roberta Rosso, Francesco Rametta, Federico Nardi, Alessandro Lupi, Angelo Sante Bongo
Out-of-hospital cardiac arrest (OHCA) remains one of the principle challenges in the setting of critical care medicine and emergency cardiology. Areas covered: Long-term survival rates even after successful resuscitation are variable but increasing in the recent years; due to the improvement of base and advanced cardiac life support techniques an increasing number of resuscitated patients are admitted to the hospital. Some recent data have suggested that patients surviving to hospital discharge after OHCA presented long-term outcome similar to patients with ST-elevation myocardial infarction...
September 8, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28882227/left-atrial-fibrosis-and-risk-of-cerebrovascular-and-cardiovascular-events-in-patients-with%C3%A2-atrial-fibrillation
#18
MULTICENTER STUDY
Jordan B King, Peyman N Azadani, Promporn Suksaranjit, Adam P Bress, Daniel M Witt, Frederick T Han, Mihail G Chelu, Michelle A Silver, Joseph Biskupiak, Brent D Wilson, Alan K Morris, Eugene G Kholmovski, Nassir Marrouche
BACKGROUND: Severity of left atrial (LA) fibrosis is a strong predictor of atrial fibrillation (AF) ablation success and has been associated with a history of stroke, hypertension, and heart failure (HF). However, it is unclear whether more severe LA fibrosis independently increases the risk of major adverse cardiovascular and cerebrovascular events (MACCE) among those with AF. OBJECTIVES: The goal of this study was to evaluate the occurrence and frequency of MACCE by strata of LA fibrosis severity in patients with AF...
September 12, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28880921/urinary-proteomics-in-predicting-heart-transplantation-outcomes-uprophet-rationale-and-database-description
#19
Qi-Fang Huang, Sander Trenson, Zhen-Yu Zhang, Wen-Yi Yang, Lucas Van Aelst, Esther Nkuipou-Kenfack, Fang-Fei Wei, Blerim Mujaj, Lutgarde Thijs, Agnieszka Ciarka, Jerome Zoidakis, Walter Droogné, Antonia Vlahou, Stefan Janssens, Johan Vanhaecke, Johan Van Cleemput, Jan A Staessen
OBJECTIVES: Urinary Proteomics in Predicting Heart Transplantation Outcomes (uPROPHET; NCT03152422) aims: (i) to construct new multidimensional urinary proteomic (UP) classifiers that after heart transplantation (HTx) help in detecting graft vasculopathy, monitoring immune system activity and graft performance, and in adjusting immunosuppression; (ii) to sequence UP peptide fragments and to identify key proteins mediating HTx-related complications; (iii) to validate UP classifiers by demonstrating analogy between UP profiles and tissue proteomic signatures (TP) in diseased explanted hearts, to be compared with normal donor hearts; (iv) and to identify new drug targets...
2017: PloS One
https://www.readbyqxmd.com/read/28876374/do-we-need-to-personalize-renal-function-assessment-in-the-stratification-of-patients-undergoing-cardiac-surgery
#20
Camila P S Arthur, Omar A V Mejia, Diogo Osternack, Marcelo Arruda Nakazone, Maxim Goncharov, Luiz A F Lisboa, Luís A O Dallan, Pablo M A Pomerantzeff, Fabio B Jatene
BACKGROUND: Renal dysfunction is an independent predictor of morbidity and mortality in cardiac surgery. For a better assessment of renal function, calculation of creatinine clearance (CC) may be necessary. OBJECTIVE: To objectively evaluate whether CC is a better risk predictor than serum creatinine (SC) in patients undergoing cardiac surgery. METHODS: Analysis of 3,285 patients registered in a prospective, consecutive and mandatory manner in the Sao Paulo Registry of Cardiovascular Surgery (REPLICCAR) between November 2013 and January 2015...
September 4, 2017: Arquivos Brasileiros de Cardiologia
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