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https://www.readbyqxmd.com/read/28549119/systematic-review-of-cost-effectiveness-of-myocardial-perfusion-scintigraphy-in-patients-with-ischaemic-heart-disease-a-report-from-the-cardiovascular-committee-of-the-european-association-of-nuclear-medicine-endorsed-by-the-european-association-of-cardiovascular
#1
Elin Trägårdh, Siok Swan Tan, Jan Bucerius, Alessia Gimelli, Oliver Gaemperli, Oliver Lindner, Denis Agostini, Christopher Übleis, Roberto Sciagrà, Riemer H Slart, S Richard Underwood, Fabien Hyafil, Marcus Hacker, Hein J Verberne
Coronary artery disease (CAD) is a major cause of death and disability. Several diagnostic tests, such as myocardial perfusion scintigraphy (MPS), are accurate for the detection of CAD, as well as having prognostic value for the prediction of cardiovascular events. Nevertheless, the diagnostic and prognostic value of these tests should be cost-effective and should lead to improved clinical outcome. We have reviewed the literature on the cost-effectiveness of MPS in different circumstances: (i) the diagnosis and management of CAD; (ii) comparison with exercise electrocardiography (ECG) and other imaging tests; (iii) as gatekeeper to invasive coronary angiography (ICA), (iv) the impact of appropriate use criteria; (v) acute chest pain, and (vi) screening of asymptomatic patients with type-2 diabetes...
May 26, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28549109/il-18-cleavage-triggers-cardiac-inflammation-and-fibrosis-upon-%C3%AE-adrenergic-insult
#2
Han Xiao, Hao Li, Jing-Jing Wang, Jian-Shu Zhang, Jing Shen, Xiang-Bo An, Cong-Cong Zhang, Ji-Min Wu, Yao Song, Xin-Yu Wang, Hai-Yi Yu, Xiang-Ning Deng, Zi-Jian Li, Ming Xu, Zhi-Zhen Lu, Jie Du, Wei Gao, Ai-Hua Zhang, Yue Feng, You-Yi Zhang
Aims: Rapid over-activation of β-adrenergic receptor (β-AR) upon stress leads to cardiac inflammation, a prevailing factor that underlies heart injury. However, mechanisms by which acute β-AR stimulation induce cardiac inflammation still remain unknown. Here, we set out to identify the crucial role of inflammasome/interleukin (IL)-18 in initiating and maintaining cardiac inflammatory cascades upon β-AR insult. Methods and results: Male C57BL/6 mice were injected with a single dose of β-AR agonist, isoproterenol (ISO, 5 mg/kg body weight) or saline subcutaneously...
May 26, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28545851/sex-specific-risk-of-emergency-department-revisits-and-early-readmission-following-myocardial-infarction
#3
Magnus Lundbäck, Danijela Gasevic, Eric Rullman, Toralph Ruge, Axel C Carlsson, Martin J Holzmann
BACKGROUND: Readmissions within 30days after hospitalization have been introduced as a measure of quality of care. There is a paucity of data regarding sex-specific risk of early readmissions after myocardial infarction (MI). OBJECTIVES: To investigate the association between sex and revisits to the emergency department (ED), and readmissions after MI. METHODS: All patients with chest pain, diagnosed with MI at the Karolinska University Hospital during 2011 and 2012 were included...
May 19, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28545690/adolescent-with-chest-pain
#4
Jeffrey T Neal, Rachel G Rempell
No abstract text is available yet for this article.
June 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28545635/outcomes-in-patients-with-chest-pain-discharged-after%C3%A2-evaluation-using-a-high-sensitivity-troponin-t-assay
#5
Atosa Nejatian, Åsa Omstedt, Jonas Höijer, L O Hansson, Therese Djärv, Kai M Eggers, Per Svensson
BACKGROUND: Most patients with chest pain are discharged from the emergency department (ED) with the diagnosis "unspecified chest pain." It is unknown if evaluation with a high-sensitivity troponin T (hsTnT) assay affects prognosis in this large population. OBJECTIVES: The aim was to investigate whether the introduction of an hsTnT assay is associated with reduced incidence of major adverse cardiac events (MACEs) and cardiovascular (CV) risk profile in patients with chest pain discharged from the ED...
May 30, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28544670/the-clinical-significance-of-esophagogastric-junction-outflow-obstruction-and-hypercontractile-esophagus-in-high-resolution-esophageal-manometry
#6
D Schupack, D A Katzka, D M Geno, K Ravi
BACKGROUND: Although major manometric abnormalities, the significance of esophagogastric junction outflow obstruction (EGJOO) and hypercontractile esophagus (HE) is poorly understood. We sought to determine long term outcomes for EGJOO and HE. METHODS: High-resolution impedance manometry (HRIM) studies conducted from 5/30/2012 to 8/1/2014 consistent with EGJOO and HE and normal studies from 5/30/12 to 11/1/12 were identified. Standardized follow up was conducted with a phone survey utilizing the impact dysphagia questionnaire (IDQ-10)...
May 23, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28544141/assessing-the-pre-and-postpeak-phases-in-a-swallow-using-esophageal-pressure-topography
#7
Y Xiao, D A Carlson, Z Lin, N Rinella, D Sifrim, J E Pandolfino
BACKGROUND: The current paradigm of measuring esophageal contractile vigor assesses the entirety of a pressure wave using a single measurement, the distal contractile integral (DCI). We hypothesize that an assessment identifying separate phases of the contractile pressure wave before and after the pressure peak may help distinguish abnormalities in patients presenting with chest pain and dysphagia. The aim of the present study was to develop a technique to assess the individual phases and report on the values in healthy controls...
May 22, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28544100/undetectable-concentrations-of-an-fda-approved-high-sensitivity-cardiac-troponin-t-assay-to-rule-out-acute-myocardial-infarction-at-emergency-department-arrival
#8
Andrew D McRae, Grant Innes, Michelle Graham, Eddy Lang, James E Andruchow, Yunqi Ji, Shabnam Vatanpour, Tasnima Abedin, Hong Yang, Danielle A Southern, Dongmei Wang, Isolde Seiden-Long, Lawrence DeKoning, Peter Kavsak
BACKGROUND: The objective of this study was to quantify the sensitivity of very low concentrations of high-sensitivity cardiac troponin T (hsTnT) at ED arrival for acute myocardial infarction (AMI) in a large cohort of chest pain patients evaluated in real-world clinical practice. METHODS: This retrospective study included consecutive ED patients with suspected cardiac chest pain evaluated in four urban EDs were, excluding those with ST-elevation AMI, cardiac arrest or abnormal kidney function...
May 19, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28541600/elevated-high-sensitivity-troponin-does-not-indicate-the-presence-of-coronary-artery-disease-in-patients-presenting-with-supraventricular-tachycardia
#9
Martin Murer, Florim Cuculi, Stefan Toggweiler, Vanessa Weberndoerfer, Mabelle Young, Richard Kobza
BACKGROUND: Patients with supraventricular tachycardia (SVT) and patients with coronary artery disease (CAD) often present with similar symptoms (chest pain, shortness of breath), similar electrocardiographic changes and elevated high-sensitivity troponin (cTn). It is not clear whether troponin reflects critical CAD or is elevated due to other causes in patients presenting with SVT. The aim of this study was to assess the role of elevated troponin in patients presenting with SVT. METHODS: Patients undergoing radiofrequency ablation (RFA) for SVT and simultaneous coronary angiography at the Heart Centre Lucerne, Switzerland between January 2010 and October 2014 were included in this analysis...
May 25, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28540208/myocardial-ct-perfusion-imaging-for-ischemia-detection
#10
REVIEW
Patricia Carrascosa, Carlos Capunay
Coronary computed tomography angiography (CCTA) plays an important role in many specific scenarios such as in symptomatic patients with intermediate pretest of coronary artery disease (CAD), as well as in the triage of patients with acute chest pain with TIMI risk ≤2. However, it cannot detect the presence of associated ischemia, which is critical for clinical decision making among patients with moderate to severe stenosis. Although functional information can be obtained with different non-invasive tools, cardiac CT is the unique modality that can perform a comprehensive evaluation of coronary anatomy plus the functional significance of lesions...
April 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28540180/hemoglobin-and-mean-platelet-volume-predicts-diffuse-t1-mri-white-matter-volume-decrease-in-sickle-cell-disease-patients
#11
Soyoung Choi, Adam M Bush, Matthew T Borzage, Anand A Joshi, William J Mack, Thomas D Coates, Richard M Leahy, John C Wood
Sickle cell disease (SCD) is a life-threatening genetic condition. Patients suffer from chronic systemic and cerebral vascular disease that leads to early and cumulative neurological damage. Few studies have quantified the effects of this disease on brain morphometry and even fewer efforts have been devoted to older patients despite the progressive nature of the disease. This study quantifies global and regional brain volumes in adolescent and young adult patients with SCD and racially matched controls with the aim of distinguishing between age related changes associated with normal brain maturation and damage from sickle cell disease...
2017: NeuroImage: Clinical
https://www.readbyqxmd.com/read/28539992/bi-directional-hepatic-hydrothorax
#12
Madhan Nellaiyappan, Anastasios Kapetanos
A 59-year-old male with alcoholic cirrhosis presented to our hospital with an acutely painful umbilical hernia, and 4 mo of exertional dyspnea. He was noted to be tachypneic and hypoxic. He had a massive right sided pleural effusion with leftward mediastinal shift and gross ascites, with a tense, fluid-filled, umbilical hernia. Emergent paracentesis with drain placement and a large volume thoracentesis were performed. Despite improvement in dyspnea and drainage of 15 L of ascitic fluid, the massive transudative pleural effusion remained largely unchanged...
May 8, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28539572/malondialdehyde-modified-low-density-lipoprotein-as-oxidative-stress-marker-in-vasospastic-angina-patients
#13
Tetsuo Oumi, Toshihiro Nozato, Atsushi Sakakibara, Hidetsugu Nomoto, Masakazu Ohno, Yoshihide Takahashi, Takashi Ashikaga, Yasuhiro Satoh, Mitsuaki Isobe
Vasospastic angina (VSA) is caused by endothelial dysfunction and hypercontraction of vascular smooth muscle cells. Although oxidative-stress can induce endothelial dysfunction, the relationship of VSA and the oxidative-stress marker malondialdehyde-modified low density lipoprotein (MDA-LDL) remains unclear. PURPOSE: Serum MDA-LDL was evaluated in candidate VSA patients.The subjects were 84 patients admitted to our hospital because of chest pain at rest. We stratified the patients into 3 groups; definite VSA, suspected VSA, and unlikely VSA according to a Japanese Circulation Society (JCS) guideline...
May 23, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28538776/spontaneous-pneumomediastinum-experience-in-18-patients-during-the-last-12-years
#14
Patrícia Dionísio, Luís Martins, Susana Moreira, Alda Manique, Rita Macedo, Fátima Caeiro, Luísa Boal, Cristina Bárbara
Objective: To characterize clinically all of the patients with spontaneous pneumomediastinum (SPM) admitted to an adult pulmonology ward in Lisbon, Portugal. Methods: This was a retrospective descriptive study of all adult patients (≥ 18 years of age) diagnosed with SPM between January of 2004 and September of 2015. Results: At least one predisposing factor was identified in most (88.9%) of the 18 patients who presented with SPM during the study period...
March 2017: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/28538760/a-multivariate-model-for-prediction-of-obstructive-coronary-disease-in-patients-with-acute-chest-pain-development-and-validation
#15
Luis Cláudio Lemos Correia, Maurício Cerqueira, Manuela Carvalhal, Felipe Ferreira, Guilherme Garcia, André Barcelos da Silva, Nicole de Sá, Fernanda Lopes, Ana Clara Barcelos, Márcia Noya-Rabelo
Background: Currently, there is no validated multivariate model to predict probability of obstructive coronary disease in patients with acute chest pain. Objective: To develop and validate a multivariate model to predict coronary artery disease (CAD) based on variables assessed at admission to the coronary care unit (CCU) due to acute chest pain. Methods: A total of 470 patients were studied, 370 utilized as the derivation sample and the subsequent 100 patients as the validation sample...
April 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28536223/cardiac-compression-due-to-gastric-volvulus-an-unusual-cause-of-chest-pain
#16
Alex Brown, David Austin, Venkatesh Kanakala
A 42-year-old man was admitted to coronary care for assessment with severe retrosternal chest pain. Echocardiography showed significant external compression of the left atrium. A subsequent CT scan revealed him to have a large hiatus hernia, with most of his stomach herniating into his thorax causing left atrial compression and gastric volvulus. He subsequently underwent successful emergency decompression of the gastric volvulus and repair of his hiatus hernia.
May 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28535660/-clinical-investigation-on-ct-guided-cryoablation-for-treating-invasive-chest-wall-or-pleural-tumors
#17
M Wang, Y W Pan, Z G Zhou, Y Cui, K P Du, S Li
Objective: To evaluate the feasibility and short-term effect of CT guided cryoablation for malignant chest wall or pleural involvement. Methods: To follow up 22 patients with chest wall or pleural involvement of various malignancies who underwent cryoablation from January 2012 to January 2015 by conducting postoperative 1-, 3- and 6-month enhanced CT, MRI or PET-CT examinations, respectively, evaluate local curative effect, and observe their progression-free survival (PFS), postoperative pain remission and complications after the cryoablation...
May 23, 2017: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
https://www.readbyqxmd.com/read/28534694/the-heart-score-for-early-rule-out-of-acute-coronary-syndromes-in-the-emergency-department-a-systematic-review-and-meta-analysis
#18
Patricia Van Den Berg, Richard Body
AIMS: The objective of this systematic review was to summarise the current evidence on the diagnostic accuracy of the HEART score for predicting major adverse cardiac events in patients presenting with undifferentiated chest pain to the emergency department. METHODS AND RESULTS: Two investigators independently searched Medline, Embase and Cochrane databases between 2008 and May 2016 identifying eligible studies providing diagnostic accuracy data on the HEART score for predicting major adverse cardiac events as the primary outcome...
May 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28533990/anomalous-origin-of-right-coronary-artery-originating-from-the-pulmonary-trunk-arcapa-an-incidental-finding-in-a-patient-presenting-with-chest-pain
#19
Pragathi Balakrishna, Michael Illovsky, Youssef M Al-Saghir, Abdul M Minhas
Anomalous origin of the right coronary artery originating from the pulmonary trunk (ARCAPA) is a rare congenital coronary anomaly with an estimated prevalence of 0.002%. Most patients are asymptomatic and the anomaly is detected incidentally during evaluation for other problems. Occasionally, ARCAPA may lead to myocardial ischemia and/or sudden cardiac arrest. We present a case of a 55-year-old female with a history of hypertension who presented to the emergency department with intermittent chest discomfort for three days...
April 17, 2017: Curēus
https://www.readbyqxmd.com/read/28533875/-management-of-spontaneous-pneumothorax-about-138-cases
#20
Bouchra Habibi, Leila Achachi, Sohaib Hayoun, Mohammed Raoufi, Laila Herrak, Mustapha El Ftouh
Pneumothorax is a collection of air in the pleural cavity. We conducted a retrospective study of patients with spontaneous pneumothorax in the Department of Pneumology at the Ibn Sina Hospital in Rabat (2009-2011) with the aim to determine the epidemiological, clinical, radiological, therapeutic and evolutionary manifestation of spontaneous pneumothorax. The study involved 138 patients: 128 men and 10 women (17-83 years), with an average age of 44.5 +/- 17.4 years and sex ratio of 12/8. 81.2% of patients were smokers...
2017: Pan African Medical Journal
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