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cardiac risk stratification

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https://www.readbyqxmd.com/read/27932413/biomarkers-and-coronary-lesions-predict-outcomes-after-revascularization-in-non-st-elevation-acute-coronary-syndrome
#1
Daniel Lindholm, Stefan K James, Maria Bertilsson, Richard C Becker, Christopher P Cannon, Evangelos Giannitsis, Robert A Harrington, Anders Himmelmann, Frederic Kontny, Agneta Siegbahn, Philippe Gabriel Steg, Robert F Storey, Matthijs A Velders, W Douglas Weaver, Lars Wallentin
BACKGROUND: Risk stratification in non-ST-elevation acute coronary syndrome (NSTE-ACS) is currently mainly based on clinical characteristics. With routine invasive management, angiography findings and biomarkers are available and may improve prognostication. We aimed to assess if adding biomarkers [high-sensitivity cardiac troponin T (cTnT-hs), N-terminal probrain-type natriuretic peptide (NT-proBNP), growth differentiation factor 15 (GDF-15)] and extent of coronary artery disease (CAD) might improve prognostication in revascularized patients with NSTE-ACS...
December 8, 2016: Clinical Chemistry
https://www.readbyqxmd.com/read/27931611/arrhythmogenic-right-ventricular-cardiomyopathy-clinical-course-and-predictors-of-arrhythmic-risk
#2
Andrea Mazzanti, Kevin Ng, Alessandro Faragli, Riccardo Maragna, Elena Chiodaroli, Nicoletta Orphanou, Nicola Monteforte, Mirella Memmi, Patrick Gambelli, Valeria Novelli, Raffaella Bloise, Oronzo Catalano, Guido Moro, Valentina Tibollo, Massimo Morini, Riccardo Bellazzi, Carlo Napolitano, Vincenzo Bagnardi, Silvia G Priori
BACKGROUND: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a leading cause of sudden cardiac death, but its progression over time and predictors of arrhythmias are still being defined. OBJECTIVES: This study sought to describe the clinical course of ARVC and occurrence of life-threatening arrhythmic events (LAE) and cardiovascular mortality; identify risk factors associated with increased LAE risk; and define the response to therapy. METHODS: We determined the clinical course of 301 consecutive patients with ARVC using the Kaplan-Meier method adjusted to avoid the bias of delayed entry...
December 13, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27931009/successful-mace-risk-stratification-in-hypertrophic-cardiomyopathy-patients-using-different-2d-speckle-tracking-tte-approaches
#3
Koya Ozawa, Nobusada Funabashi, Hiroyuki Takaoka, Yoshio Kobayashi
PURPOSE: We performed 2D speckle tracking transthoracic-echocardiography (TTE) to compare the ability to predict occurrence of major adverse cardiac events (MACE) between global longitudinal strain (GLS) and circumferential strain (GCS) in left ventricular (LV) myocardium in hypertrophic cardiomyopathy (HCM) patients without obstructed coronary arteries. METHODS: We measured 2D LV GLS and GCS retrospectively by TTE within 13months of performance of cardiac CT in 41 consecutive symptomatic HCM patients (27 males; 60±13years) without obstructed coronary arteries on CT...
November 14, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27930686/comparison-of-ventricular-inducibility-with-late-gadolinium-enhancement-and-myocardial-inflammation-in-endomyocardial-biopsy-in-patients-with-dilated-cardiomyopathy
#4
Karin A L Mueller, Christian Heck, David Heinzmann, Johannes Schwille, Karin Klingel, Reinhard Kandolf, Ulrich Kramer, Michael Gramlich, Tobias Geisler, Meinrad P Gawaz, Juergen Schreieck, Peter Seizer
BACKGROUND: Risk stratification of patients with non-ischemic dilated cardiomyopathy remains a matter of debate in the era of device implantation. OBJECTIVE: We investigated associations between histopathological findings, contrast-enhanced cardiac MRI and the inducibility of ventricular tachycardia (VT) or fibrillation (VF) in programmed ventricular stimulation. METHODS: 56 patients with impaired left ventricular ejection fraction (LVEF≤50%, mean 36...
2016: PloS One
https://www.readbyqxmd.com/read/27930286/left-ventricular-geometry-and-risk-of-sudden-cardiac-arrest-in-patients-with-severely-reduced-ejection-fraction
#5
Derek Phan, Aapo L Aro, Kyndaron Reinier, Carmen Teodorescu, Audrey Uy-Evanado, Karen Gunson, Jonathan Jui, Sumeet S Chugh
BACKGROUND: Recent reports indicate that specific left ventricular (LV) geometric patterns predict recurrent ventricular arrhythmias in patients with implantable cardioverter-defibrillators and reduced left ventricular ejection fraction (LVEF). However, this relationship has not been evaluated among patients at risk of sudden cardiac arrest (SCA) in the general population. METHODS AND RESULTS: Adult SCA cases from the Oregon Sudden Unexpected Death Study were compared with geographic controls with no prior history of SCA...
August 18, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27923680/the-100-most-cited-manuscripts-in-emergency-abdominal-surgery-a-bibliometric-analysis
#6
Thomas Ellul, Nicholas Bullock, Tarig Abdelrahman, Arfon G M T Powell, Jolene Witherspoon, Wyn G Lewis
BACKGROUND: The number of citations a scientific article receives provides a good indication of its impact within any given field. This bibliometric analysis aimed to identify the 100 most cited articles in Emergency Abdominal Surgery (EAS), to highlight key areas of interest and identify those that have most significantly shaped contemporary clinical practice in this newly evolving surgical specialty. This is of increasing relevance as concerns grow regarding the variable and suboptimal outcomes in Emergency General Surgery...
December 3, 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27916321/exercise-induced-quantitative-microvolt-t-wave-alternans-in-hypertrophic-cardiomyopathy
#7
Murillo de Oliveira Antunes, Nelson Samesima, Horacio Gomes Pereira Filho, Afonso Yoshikiro Matsumoto, Richard L Verrier, Carlos Alberto Pastore, Edmundo Arteaga-Fernández, Charles Mady
BACKGROUND/PURPOSE: Patients with hypertrophic cardiomyopathy (HCM) have elevated risk for sudden cardiac death (SCD). Our study aimed to quantitatively characterize microvolt T-wave alternans (TWA), a potential arrhythmia risk stratification tool, in this HCM patient population. METHODS: TWA was analyzed with the quantitative modified moving average (MMA) in 132 HCM patients undergoing treadmill exercise testing, grouped according to Maron score risk factors as high-risk (H-Risk, n=67,), or low-risk (L-Risk, n=65, without these risk factors)...
October 28, 2016: Journal of Electrocardiology
https://www.readbyqxmd.com/read/27916210/heart-type-fatty-acid-binding-protein-in-the-assessment-of-acute-pulmonary-embolism
#8
Hai-Yan Qian, Ji Huang, Yue-Jin Yang, Yan-Min Yang, Zhi-Zhong Li, Jing-Mei Zhang
OBJECTIVE: To explore the predictive value of heart-type fatty acid binding protein (H-FABP) in the stratification and prognosis of patients with acute pulmonary embolism (APE). METHODS: According to risk stratification, 69 patients with APE admitted into the emergency department within 24 hours after onset were divided into the following 3 groups: high-risk group, moderate-risk group and low-risk group. H-FABP- and cardiac troponin I (cTNI)-positive rates of all groups were analyzed and compared, and the correlation between major adverse events (death, endotracheal intubation and cardiopulmonary resuscitation) and the cardiac markers (heart rate, arterial partial pressure of oxygen, right ventricular dimension, pulmonary arterial pressure, etc...
December 2016: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/27909531/brugada-syndrome-risk-stratification-and-management
#9
REVIEW
Konstantinos P Letsas Md Fesc, Stamatis Georgopoulos Md, Konstantinos Vlachos Md, Nikolaos Karamichalakis Md, Ioannis Liatakis Md, Panagiotis Korantzopoulos Md PhD, Tong Liu Md PhD, Michael Efremidis Md, Antonios Sideris Md
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...
August 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909495/the-wearable-cardioverter-defibrillator-toy-or-tool
#10
REVIEW
David Duncker Md, Christian Veltmann Md
After the success story of implantable cardioverter/defibrillator systems, prevention of sudden cardiac death (SCD) remains one of the main duties in cardiology. For patients with unkown or transient risk profile for SCD, a wearable cardioverter/defibrillator (WCD) has been established for temporary and effective prevention of sudden arrhythmic death. Several studies have shown safety and efficacy of the WCD, even though randomized studies proving a mortality benefit are still lacking. This review provides an overview of actual WCD data and usage, special indications and possible risks and complications...
April 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909290/highly-sensitive-detection-of-minimal-cardiac-ischemia-using-positron-emission-tomography-imaging-of-activated-platelets
#11
Melanie Ziegler, Karen Alt, Brett M Paterson, Peter Kanellakis, Alex Bobik, Paul S Donnelly, Christoph E Hagemeyer, Karlheinz Peter
A reliable method for the diagnosis of minimal cardiac ischemia would meet a strong demand for the sensitive diagnosis of coronary artery disease in cardiac stress testing and risk stratification in patients with chest pain but unremarkable ECGs and biomarkers. We hypothesized that platelets accumulate early on in ischemic myocardium and a newly developed technology of non-invasive molecular PET imaging of activated platelets can thus detect minimal degrees of myocardial ischemia. To induce different degrees of minimal cardiac ischemia, the left anterior descending artery (LAD) was ligated for 10, 20 or 60 min...
December 2, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27901331/clinical-indices-and-biomarkers-for-perioperative-cardiac-risk-stratification-an-update
#12
Radmilo J Janković, Danica Z Marković, Dušan T Sokolović, Ivana Zdravković, Massimiliano Sorbello
European Society of Cardiology (ESC)/ European Society of Anesthesiology (ESA) highlighted that anesthesiologist has a leading role in perioperative cardiovascular assessment and management in the year of 2014. During cardiovascular assessment one can rely on cooperation of multi-disciplinary specialists like: other anesthesiologists, cardiologists and surgeons. For the purpose of precise systematization and decision making the Lee score or NSQUIP database can be used besides the traditionally used ASA score...
November 30, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27900408/prevalence-and-risk-factors-for-pericardial-effusions-requiring-readmission-after-pediatric-cardiac-surgery
#13
Matthew D Elias, Andrew C Glatz, Matthew J O'Connor, Susan Schachtner, Chitra Ravishankar, Christoper E Mascio, Meryl S Cohen
Pericardial effusion (PE) may require readmission after cardiac surgery and has been associated with postoperative morbidity and mortality. We sought to identify the prevalence and risk factors for postoperative PE requiring readmission in children. A retrospective analysis of the Pediatric Health Information System database was performed between January 1, 2003, and September 30, 2014. All patients ≤18 years old who underwent cardiac surgery were identified by ICD-9 codes. Those readmitted within 1 year with an ICD-9 code for PE were identified...
November 30, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27898379/predicting-bradycardia-in-preterm-infants-using-point-process-analysis-of-heart-rate
#14
Alan H Gee, Riccardo Barbieri, David Paydarfar, Premananda Indic
OBJECTIVE: Episodes of bradycardia are common and recur sporadically in preterm infants, posing a threat to the developing brain and other vital organs. We hypothesize that bradycardias are a result of transient temporal destabilization of the cardiac autonomic control system and that fluctuations in the heart rate signal might contain information that precedes bradycardia. We investigate infant heart rate fluctuations with a novel application of point process theory. METHODS: In 10 preterm infants, we estimate instantaneous linear measures of the heart rate signal in neonates, use these measures to extract statistical features of bradycardia, and propose a simplistic framework for prediction of bradycardia...
November 24, 2016: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/27892886/safety-profile-and-utility-of-treadmill-exercise-in-patients-with-high-gradient-hypertrophic-cardiomyopathy
#15
Lars Lindholm Sorensen, Hsin-Yueh Liang, Aurelio Pinheiro, Alex Hilser, Veronica Dimaano, Niels Thue Olsen, Thomas Fritz Hansen, Peter Sogaard, Alexandra Nowbar, Chiara Pisanello, Iraklis Pozios, Susan Phillip, Xun Zhou, Roselle Abraham, Theodore P Abraham
: Exercise echocardiography in the evaluation of hypertrophic cardiomyopathy (HCM) provides valuable information for risk stratification, selection of optimal treatment, and prognostication. However, HCM patients with left ventricular outflow tract gradients ≥30mm Hg are often excluded from exercise testing because of safety considerations. We examined the safety and utility of exercise testing in patients with high-gradient HCM. METHODS: We evaluated clinical characteristics, hemodynamics, and imaging variables in 499 consecutive patients with HCM who performed 959 exercise tests...
October 20, 2016: American Heart Journal
https://www.readbyqxmd.com/read/27891375/flow-mediated-dilatation-carotid-intima-media-thickness-ankle-brachial-pressure-index-and-pulse-pressure-in-young-male-post-myocardial-infarction-patients-in-india
#16
Nikhil Gupta, Subhash Giri, Vinita Rathi, Gajender Singh Ranga
INTRODUCTION: Due to increase in Coronary Artery Disease (CAD) at a younger age, we should try to diagnose atherosclerotic process and population at risk, at the earliest. Flow Mediated Dilatation (FMD), Carotid Intima-Media Thickness (CIMT) and Ankle-Brachial Pressure Index (ABI) are probable markers for early atherosclerosis and may be useful in coronary risk stratification. AIM: To compare and correlate the FMD, CIMT, ABI and Pulse Pressure (PP) in young male patients of Myocardial Infarction (MI) with age and sex matched healthy controls...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27884085/the-roles-of-myeloperoxidase-in-coronary-artery-disease-and-its-potential-implication-in-plaque-rupture
#17
Nathaniel Teng, Ghassan J Maghzal, Jihan Talib, Imran Rashid, Antony K Lau, Roland Stocker
Atherosclerosis is the main pathophysiological process underlying coronary artery disease (CAD). Acute complications of atherosclerosis, such as myocardial infarction, are caused by the rupture of vulnerable atherosclerotic plaques, which are characterized by thin, highly inflamed, and collagen-poor fibrous caps. Several lines of evidence mechanistically link the heme peroxidase myeloperoxidase (MPO), inflammation as well as acute and chronic manifestations of atherosclerosis. MPO and MPO-derived oxidants have been shown to contribute to the formation of foam cells, endothelial dysfunction and apoptosis, the activation of latent matrix metalloproteinases, and the expression of tissue factor that can promote the development of vulnerable plaque...
November 25, 2016: Redox Report: Communications in Free Radical Research
https://www.readbyqxmd.com/read/27875062/role-of-risk-stratification-and-genetics-in-sudden-cardiac-death
#18
Vikrant Rai, Devendra K Agrawal
Sudden cardiac death (SCD) is a major public health issue due to its increasing incidence in the general population and the difficulty in identifying high-risk individuals. Nearly 300 000 - 350 000 patients in the United States and 4-5 million patients in the world die annually from SCD. Coronary artery disease and advanced heart failure are the main etiology for SCD. Ischemia of any cause precipitates lethal arrhythmias, and ventricular tachycardia and ventricular fibrillation are the most common lethal arrhythmias precipitating SCD...
October 16, 2016: Canadian Journal of Physiology and Pharmacology
https://www.readbyqxmd.com/read/27871578/children-with-heart-disease-risk-stratification-for-non-cardiac-surgery
#19
Angela K Saettele, Jacob L Christensen, Kelly L Chilson, David J Murray
STUDY OBJECTIVE: Children with congenital or acquired heart disease have an increased risk of anesthesia related morbidity and mortality. The child's anesthetic risk is related to the severity of their underlying cardiac disease, associated comorbidities, and surgical procedure. The goal of this project was to determine the ease of use of a preoperative risk stratification tool for assigning pediatric cardiac staff and to determine the relative frequency that children with low, moderate, and high risk cardiac disease present for non-cardiac surgery at a tertiary pediatric hospital...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27870734/incremental-value-of-preoperative-copeptin-for-predicting-myocardial-injury
#20
Eckhard Mauermann, Daniel Bolliger, Esther Seeberger, Christian Puelacher, Sydney Corbiere, Miodrag Filipovic, Manfred Seeberger, Christian Mueller, Giovanna Lurati Buse
BACKGROUND: Copeptin, a novel marker of endogenous stress, has shown diagnostic and prognostic value in nonsurgical patients with a suspected coronary event. We aimed to assess the incremental value of copeptin in addition to established preoperative risk indices to predict the occurrence of postoperative myocardial injury. METHODS: This secondary analysis of prospectively collected data included adults undergoing noncardiac surgery with risk factors for adverse perioperative cardiac events based on preoperative risk stratification...
December 2016: Anesthesia and Analgesia
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