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Cardiac Guidelines

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https://www.readbyqxmd.com/read/28214508/surgical-management-of-pericardial-diseases
#1
REVIEW
Douglas R Johnston
Disease of the pericardium represents a relatively rare indication for cardiac surgery, and there exist no widely accepted guidelines for surgical management. As such, the surgical approach to the pericardium has relied largely on institutional experience with a slow evolution based on published studies. In particular, management of pericardial constriction has varied widely from surgeon to surgeon and institution to institution, in large part due to a perception of inherent high risk to the procedure. This review covers the current practice of surgery for disease of the pericardium, with particular focus on the evolution of indications for pericardiectomy, new applications in inflammatory or relapsing pericarditis, and the progressive refinement in surgical technique and operative planning which have led to significantly improved outcomes in experienced centers...
January 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/28214152/clinical-and-genetic-diagnosis-of-familial-hypertrophic-cardiomyopathy-results-in-pediatric-cardiology
#2
Bárbara Cardoso, Inês Gomes, Petra Loureiro, Conceição Trigo, Fátima Ferreira Pinto
INTRODUCTION: Hypertrophic cardiomyopathy (HCM) is most often of autosomal dominant inheritance with incomplete penetrance and variable expression. The main purpose of family screening is to identify relatives with unrecognized HCM and to monitor those at risk for disease, in order to minimize complications and to assess risk of sudden cardiac death. The ESC and ACCF/AHA guidelines on the diagnosis and management of HCM recommend the screening of child relatives from the age of 10-12 years...
February 14, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28213888/transfusion-in-critical-care-a-uk-regional-audit-of-current-practice
#3
J O M Plumb, M G Taylor, E Clissold, M P W Grocott, R Gill
A consistent message within critical care publications has been that a restrictive transfusion strategy is non-inferior, and possibly superior, to a liberal strategy for stable, non-bleeding critically ill patients. Translation into clinical practice has, however, been slow. Here, we describe the degree of adherence to UK best practice guidelines in a regional network of nine intensive care units within Wessex. All transfusions given during a 2-month period were included (n = 444). Those given for active bleeding or within 24 h of major surgery, trauma or gastrointestinal bleeding were excluded (n = 148)...
February 18, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28213711/implantable-cardioverter-defibrillators-for-primary-prevention-in-dilated-cardiomyopathy-post-danish-an-updated-meta-analysis-and-systematic-review-of-randomized-controlled-trials
#4
Georg Wolff, Yingfeng Lin, Athanasios Karathanos, Maximilian Brockmeyer, Susanne Wolters, Bernd Nowak, Alexander Fürnkranz, Hisaki Makimoto, Malte Kelm, Volker Schulze
BACKGROUND: Sudden cardiac death (SCD) is frequent in patients with heart failure due to dilated cardiomyopathy (DCM). Implantable cardioverter/defibrillator (ICD) device therapy is currently used for primary prevention. However, publication of the DANISH trial has recently given reason for doubt, showing no significant improvement in all-cause mortality in comparison to contemporary medical therapy. METHODS: We performed a meta-analysis of all randomized controlled trials comparing ICD therapy to medical therapy (MT) for primary prevention in DCM...
February 17, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28212182/what-s-new-in-obstetric-anesthesia-the-2016-gerard-w-ostheimer-lecture
#5
Philip E Hess
This special article presents potentially important trends and issues affecting the field of obstetric anesthesia drawn from publications in 2015. Both maternal mortality and morbidity in the United States have increased in recent years because, in part, of the changing demographics of the childbearing population. Pregnant women are older and have more pre-existing conditions and complex medical histories. Cardiovascular and noncardiovascular medical diseases now account for half of maternal deaths in the United States...
March 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28212151/antibody-mediated-rejection-in-the-cardiac-allograft-diagnosis-treatment-and-future-considerations
#6
M Elizabeth H Hammond, Abdallah G Kfoury
PURPOSE OF REVIEW: This review summarizes the latest publications dealing with antibody-mediated rejection (AMR) and defines areas of controversy and future steps that may improve the outcome for patients with this virulent form of rejection. RECENT FINDINGS: Recent progress includes publication of standardized pathologic criteria for acute AMR by the International Society for Heart and Lung Transplantation (ISHLT) and guidelines for treatment of acute AMR by the American Heart Association, endorsed by ISHLT as well...
February 15, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28211604/delays-in-treatment-intensification-with-oral-antidiabetic-drugs-and-risk-of-microvascular-and-macrovascular-events-in-patients-with-poor-glycemic-control-an-individual-patient-simulation-study
#7
Henry J Folse, Jayanti Mukherjee, John J Sheehan, Alexandra J Ward, Ryan L Pelkey, Tuan A Dinh, Lei Qin, Jennifer Kim
AIMS: Despite guideline recommendations, many patients with type 2 diabetes on oral antidiabetic drugs (OADs) whose HbA1c results remain above target do not experience timely treatment intensification. This study uses the Archimedes Model® to estimate the consequences of delays in OAD treatment intensification on glycemic control and long-term outcomes at 5 and 20 years. MATERIALS AND METHODS: Using real world data, we modeled a cohort of hypothetical patients with HbA1c ≥8%, on metformin, with no history of insulin use...
February 17, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28208194/risk-stratification-for-proven-acute-pulmonary-embolism-what-information-is-needed
#8
Deisy Barrios, Roger D Yusen, David Jiménez
Classification of risk drives treatment decisions for patients with acute symptomatic pulmonary embolism (PE). High-risk patients with acute symptomatic PE have hemodynamic instability (i.e., shock or hypotension present), and treatment guidelines suggest systemically administered thrombolytic therapy in this setting. Normotensive PE patients at low risk for early complications (low-risk PE) might benefit from treatment at home or early discharge, while normotensive patients with preserved systemic arterial pressure deemed as having a high risk for PE-related adverse clinical events (intermediate-high-risk PE) might benefit from close observation and consideration of escalation of therapy...
February 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28203163/is-the-deep-inspiration-breath-hold-technique-superior-to-the-free-breathing-technique-in-cardiac-and-lung-sparing-while-treating-both-left-sided-post-mastectomy-chest-wall-and-supraclavicular-regions
#9
Anupama Darapu, Rajesh Balakrishnan, Patricia Sebastian, Mohamathu Rafic Kather Hussain, Paul Ravindran, Subhashini John
AIMS: To evaluate the efficacy of the deep inspirational breath-hold (DIBH) technique and its dosimetric advantages over the free breathing (FB) technique in cardiac (heart and left anterior descending artery [LAD]) and ipsilateral lung sparing in left-sided post-mastectomy field-in-field conformal radiotherapy. DIBH is highly reproducible, and this study aims to find out its dosimetric benefits over FB. MATERIALS AND METHODS: Nineteen left-sided mastectomy patients were immobilized using breast boards with both arms positioned above the head...
January 2017: Case Reports in Oncology
https://www.readbyqxmd.com/read/28193800/cardiovascular-and-ventilatory-consequences-of-laparoscopic-surgery
#10
Tamara M Atkinson, George D Giraud, Brandon M Togioka, Daniel B Jones, Joaquin E Cigarroa
Although laparoscopic surgery accounts for >2 million surgical procedures every year, the current preoperative risk scores and guidelines do not adequately assess the risks of laparoscopy. In general, laparoscopic procedures have a lower risk of morbidity and mortality compared with operations requiring a midline laparotomy. During laparoscopic surgery, carbon dioxide insufflation may produce significant hemodynamic and ventilatory consequences such as increased intraabdominal pressure and hypercarbia. Hemodynamic insults secondary to increased intraabdominal pressure include increased afterload and preload and decreased cardiac output, whereas ventilatory consequences include increased airway pressures, hypercarbia, and decreased pulmonary compliance...
February 14, 2017: Circulation
https://www.readbyqxmd.com/read/28193738/incidence-and-survival-after-in-hospital-cardiopulmonary-resuscitation-in-nonelderly-adults-us-experience-2007-to-2012
#11
Sagar Mallikethi-Reddy, Alexandros Briasoulis, Emmanuel Akintoye, Kavyashri Jagadeesh, Robert D Brook, Melvyn Rubenfire, Luis Afonso, Cindy L Grines
BACKGROUND: Survival trends after in-hospital cardiopulmonary resuscitation (ICPR) for cardiac arrest in nonelderly adults is not well known. Influence of cardiopulmonary resuscitation guidelines on nationwide survival after ICPR is yet to be well elucidated. METHODS AND RESULTS: We examined survival trends and factors associated with survival after ICPR in nonelderly adults aged 18 to 64 years, using Healthcare Utilization Project Nationwide Inpatient Sample Database from 2007 through 2012 in the United States...
February 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28188579/cardiac-biomarkers-of-acute-coronary-syndrome-from-history-to-high-sensitivity-cardiac-troponin
#12
REVIEW
Pankaj Garg, Paul Morris, Asma Lina Fazlanie, Sethumadhavan Vijayan, Balazs Dancso, Amardeep Ghosh Dastidar, Sven Plein, Christian Mueller, Philip Haaf
The role of cardiac troponins as diagnostic biomarkers of myocardial injury in the context of acute coronary syndrome (ACS) is well established. Since the initial 1st-generation assays, 5th-generation high-sensitivity cardiac troponin (hs-cTn) assays have been developed, and are now widely used. However, its clinical adoption preceded guidelines and even best practice evidence. This review summarizes the history of cardiac biomarkers with particular emphasis on hs-cTn. We aim to provide insights into using hs-cTn as a quantitative marker of cardiomyocyte injury to help in the differential diagnosis of coronary versus non-coronary cardiac diseases...
February 11, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28188473/outpatient-treatment-with-the-wearable-cardioverter-defibrillator-clinical-experience-in-two-dutch-centres
#13
A F B E Quast, V F van Dijk, A A M Wilde, R E Knops, L V A Boersma
INTRODUCTION: The latest European Society of Cardiology Guidelines recommend consideration of a wearable cardioverter-defibrillator (WCD) for patients with a poor left ventricular ejection fraction (LVEF) who are at risk of sudden arrhythmic death but are not eligible for an implantable defibrillator. For these patients a WCD can be an alternative to long-term hospitalisation. PURPOSE: To evaluate the use of WCD therapy in these patient groups in two Dutch centres...
February 10, 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/28187777/gmp-conformant-on-site-manufacturing-of-a-cd133-stem-cell-product-for-cardiovascular-regeneration
#14
Anna Skorska, Paula Müller, Ralf Gaebel, Jana Große, Heiko Lemcke, Cornelia A Lux, Manuela Bastian, Frauke Hausburg, Nicole Zarniko, Sandra Bubritzki, Ulrike Ruch, Gudrun Tiedemann, Robert David, Gustav Steinhoff
BACKGROUND: CD133(+) stem cells represent a promising subpopulation for innovative cell-based therapies in cardiovascular regeneration. Several clinical trials have shown remarkable beneficial effects following their intramyocardial transplantation. Yet, the purification of CD133(+) stem cells is typically performed in centralized clean room facilities using semi-automatic manufacturing processes based on magnetic cell sorting (MACS®). However, this requires time-consuming and cost-intensive logistics...
February 10, 2017: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28186444/the-diagnostic-accuracy-of-myocardial-perfusion-scintigraphy-in-athletes-with-abnormal-exercise-test-results
#15
Danny Ajp van de Sande, Ing Han Liem, Jan Hoogsteen, Hareld Mc Kemps
Background Previous studies revealed a relatively high prevalence of electrocardiographic findings indicative for myocardial ischemia in asymptomatic athletes undergoing pre-participation screening. Myocardial perfusion scintigraphy is generally considered a valuable diagnostic and prognostic modality and often used for further diagnostic evaluation in these subjects. However, data on the diagnostic accuracy of myocardial perfusion scintigraphy in athletes are scarce. Objectives The main purpose of this study was to investigate the positive predictive value of myocardial perfusion scintigraphy for detection of coronary artery disease in asymptomatic athletes with abnormal exercise testing results during pre-participation screening...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28185312/reproducibility-and-experience-dependence-of-echocardiographic-indices-of-left-ventricular-function-side-by-side-comparison-of-global-longitudinal-strain-and-ejection-fraction
#16
Diego Medvedofsky, Kalie Kebed, Luke Laffin, Jeremy Stone, Karima Addetia, Roberto M Lang, Victor Mor-Avi
BACKGROUND: Although left ventricular (LV) ejection fraction (EF) and global longitudinal strain (GLS) are recommended by the current echocardiographic chamber quantification guidelines, these measurements are not performed routinely. Because EF measurements rely on manual tracing of LV boundaries, and are subject to inter-reader variability and experience dependence, we hypothesized that semiautomated GLS measurements using speckle tracking would be more reproducible and less experience-dependent...
February 9, 2017: Echocardiography
https://www.readbyqxmd.com/read/28185214/prevention-of-cardiovascular-complications-in-patients-with-lp-a-hyperlipoproteinemia-and-progressive-cardiovascular-disease-by-long-term-lipoprotein-apheresis-according-to-german-national-guidelines
#17
Reinhard Klingel, Andreas Heibges, Cordula Fassbender
Lipoprotein(a) (Lp(a)) is an independent cardiovascular risk factor playing a causal role for atherosclerotic cardiovascular disease (CVD). Lipoprotein apheresis (LA) is a safe well-tolerated outpatient treatment to lower LDL-C and Lp(a) by 60-70%, and is the ultimate escalating therapeutic option in patients with hyperlipoproteinemias (HLP) involving LDL particles. Major therapeutic effect of LA is preventing cardiovascular events. Lp(a)-HLP associated with progressive CVD has been approved as indication for regular LA in Germany since 2008...
February 9, 2017: Clinical Research in Cardiology Supplements
https://www.readbyqxmd.com/read/28185172/-18-f-fdg-pet-ct-angiography-for-the-diagnosis-of-infective-endocarditis
#18
REVIEW
A Roque, M N Pizzi, H Cuéllar-Calàbria, S Aguadé-Bruix
PURPOSE OF REVIEW: This article reviews the current imaging role of (18)F-fluordeoxyglucose positron emission computed tomography ((18)F-FDG-PET/CT) combined with cardiac CT angiography (CTA) in infective endocarditis and discusses the strengths and limitations of this technique. RECENT FINDINGS: The diagnosis of infective endocarditis affecting prosthetic valves and intracardiac devices is challenging because echocardiography and, therefore, the modified Duke criteria have well-recognized limitations in this clinical scenario...
February 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28181585/single-or-dual-antiplatelet-therapy-after-pci
#19
REVIEW
Yosuke Miyazaki, Pannipa Suwannasom, Yohei Sotomi, Mohammad Abdelghani, Karthik Tummala, Yuki Katagiri, Taku Asano, Erhan Tenekecioglu, Yaping Zeng, Rafael Cavalcante, Carlos Collet, Yoshinobu Onuma, Patrick W Serruys
The optimal duration and type of antiplatelet therapy after implantation of a drug-eluting stent (DES) remains uncertain. At the time of the first-in-man implantation of the sirolimus DES in 1999, the protocol-defined dual antiplatelet therapy (DAPT) duration was only 2 months. Subsequently, DAPT duration was extended to 1 year on the basis of anecdotal historical data, and this practice was then incorporated into clinical guidelines. For >1 decade, trialists have sought to compare the safety and efficacy of abbreviated (<6 months) and prolonged (>12 months) DAPT regimens...
February 9, 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28178960/ultrasound-and-dynamic-functional-imaging-in-vascular-cognitive-impairment-and-alzheimer-s-disease
#20
REVIEW
Branko Malojcic, Panteleimon Giannakopoulos, Farzaneh A Sorond, Elsa Azevedo, Marina Diomedi, Janja Pretnar Oblak, Nicola Carraro, Marina Boban, Laszlo Olah, Stephan J Schreiber, Aleksandra Pavlovic, Zsolt Garami, Nantan M Bornstein, Bernhard Rosengarten
BACKGROUND: The vascular contributions to neurodegeneration and neuroinflammation may be assessed by magnetic resonance imaging (MRI) and ultrasonography (US). This review summarises the methodology for these widely available, safe and relatively low cost tools and analyses recent work highlighting their potential utility as biomarkers for differentiating subtypes of cognitive impairment and dementia, tracking disease progression and evaluating response to treatment in various neurocognitive disorders...
February 9, 2017: BMC Medicine
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