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https://www.readbyqxmd.com/read/29792299/a-simple-evidence-based-approach-to-help-guide-diagnosis-of-heart-failure-with-preserved-ejection-fraction
#1
Yogesh N V Reddy, Rickey E Carter, Masaru Obokata, Margaret M Redfield, Barry A Borlaug
Background -Diagnosis of heart failure with preserved ejection fraction (HFpEF) is challenging in euvolemic patients with dyspnea, and no evidence-based criteria are available. We sought to develop and then validate non-invasive diagnostic criteria that could be used to estimate the likelihood that HFpEF is present among patients with unexplained dyspnea in order to guide further testing. Methods -Consecutive patients with unexplained dyspnea referred for invasive hemodynamic exercise testing were retrospectively evaluated...
May 23, 2018: Circulation
https://www.readbyqxmd.com/read/29790252/should-we-still-be-utilizing-warfarin-in-the-type-2-diabetic-patient
#2
REVIEW
David S H Bell, Edison Goncalves
The frequency of non-valvular atrial fibrillation is increased by 40% in type 2 diabetic subjects and the thromboembolic risk associated with atrial fibrillation is increased by 79% compared with the non-diabetic individual with atrial fibrillation. Warfarin, the traditional anticoagulant used to prevent thromboembolism, is non-specific and affects several proteins outside the coagulation system. By decreasing the levels of matrix Gla protein there is an increase in coronary and renal artery calcification which has the potential to increase cardiovascular events and accelerate decline in renal function...
May 22, 2018: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29789335/prediction-of-thrombotic-and-bleeding-events-after-percutaneous-coronary-intervention-credo-kyoto-thrombotic-and-bleeding-risk-scores
#3
Masahiro Natsuaki, Takeshi Morimoto, Kyohei Yamaji, Hirotoshi Watanabe, Yusuke Yoshikawa, Hiroki Shiomi, Yoshihisa Nakagawa, Yutaka Furukawa, Kazushige Kadota, Kenji Ando, Takashi Akasaka, Keiichi Igarashi Hanaoka, Ken Kozuma, Kengo Tanabe, Yoshihiro Morino, Toshiya Muramatsu, Takeshi Kimura
BACKGROUND: Prediction of thrombotic and bleeding risk is important to optimize antithrombotic therapy after percutaneous coronary intervention. METHODS AND RESULTS: We developed the prediction rules for thrombotic and bleeding events separately in Japanese patients. Derivation and validation cohorts consisted of 4778 patients from CREDO-Kyoto (Coronary Revascularization Demonstrating Outcome Study in Kyoto) registry cohort 2 and 4669 patients from RESET (Randomized Evaluation of Sirolimus-Eluting Versus Everolimus-Eluting Stent Trial) and NEXT (Nobori Biolimus-Eluting Versus Xience/Promus Everolimus-Eluting Stent Trial)...
May 22, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29785271/right-ventricular-dysfunction-and-pulmonary-hypertension-a-neglected-presentation-of-thyrotoxicosis
#4
Carolina Shalini Singarayar, Foo Siew Hui, Nicholas Cheong, Goay Swee En
Thyrotoxicosis is associated with cardiac dysfunction; more commonly, left ventricular dysfunction. However, in recent years, there have been more cases reported on right ventricular dysfunction, often associated with pulmonary hypertension in patients with thyrotoxicosis. Three cases of thyrotoxicosis associated with right ventricular dysfunction were presented. A total of 25 other cases of thyrotoxicosis associated with right ventricular dysfunction published from 1994 to 2017 were reviewed along with the present 3 cases...
2018: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29782862/evaluation-of-cardiac-arrhythmic-risks-using-a-rabbit-model-of-left-ventricular-systolic-dysfunction
#5
Bianca Hemmeryckx, Yuanbo Feng, Liesbeth Frederix, Marleen Lox, Sander Trenson, Rob Vreeken, Hua Rong Lu, David Gallacher, Yicheng Ni, H Roger Lijnen
Patients with heart disease have a higher risk to develop cardiac arrhythmias, either spontaneously or drug-induced. In this study, we have used a rabbit model of myocardial infarction (MI) with severe left ventricular systolic dysfunction (LVSD) to study potential drug-induced cardiac risks with N-(piperidin-2-ylmethyl)-2,5-bis(2,2,2-trifluoroethoxy)benzamide (flecainide). Upon ligation of the left circumflex arteries, male New Zealand White rabbits developed a large MI and moderate or severe LVSD 7 weeks after surgery, in comparison to SHAM-operated animals...
May 18, 2018: European Journal of Pharmacology
https://www.readbyqxmd.com/read/29782283/-heart-failure-with-preserved-left-ventricular-ejection-fraction-epidemiology-patient-%C3%A2-portrait%C3%A2-clinic-and-diagnostics
#6
S V Gavryushina, F T Ageev
The article focuses on current aspects of epidemiology, clinical picture, and diagnostics of patients with chronic heart failure (CHF) associated with preserved left ventricular (LV) systolic function. Heart failure with preserved LV ejection fraction (HFpEF) is shown to be prevalent in a population that accounts for more than a half of all CHF cases. The group at risk for HFpEF consists primarily of older women with arterial hypertension, type 2 diabetes mellitus, obesity, and atrial fibrillation. The article presents algorithms for diagnosis of HFpEF based on classic and tissue Doppler echocardiography and measurement of natriuretic peptides...
2018: Kardiologiia
https://www.readbyqxmd.com/read/29782263/-nonvalvular-atrial-fibrillation-and-diabetic-nephropathy-epidemiology-prognosis-and-choice-of-anticoagulant-therapy
#7
N A Koziolova, E A Polyanskaya, M V Surovtseva, P G Karavaev
In this review we present data on prevalence of atrial fibrillation (AF) among patients with type 2 diabetes (T2D), diabetic nephropathy and chronic kidney disease (CKD). Patients with nonvalvular AF and T2D combined with CKD have elevated risk of both bleeding and thromboembolic complications, as well as of all cause death. Efficacy and safety of novel oral anticoagulants (NOAC) depend on comorbidities and can be determined by the presence of T2D and/or diabetic nephropathy. Use of warfarin in CKD in some cases provides no preventive effect relative to risk of stroke and is characterized by increased risk of bleeding because of poor INR control, and possibly development of calcification of arteries...
April 2018: Kardiologiia
https://www.readbyqxmd.com/read/29781321/metoprolol-in-the-treatment-of-cardiovascular-disease-a-critical-reappraisal
#8
Guido Grassi
Extensive clinical experience on metoprolol has been gained in different cardiovascular conditions. In this paper, we discuss the use of metoprolol, with a focus on the extended-release formulation, in clinical practice in the light of existing evidence and current recommendations. This is a narrative review based on existing evidence and clinical experience of the Author. Evidence on the use of metoprolol in heart failure, ischemic artery disease, arterial hypertension and atrial fibrillation is well-established...
May 21, 2018: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29780241/patient-and-physician-preferences-for-attributes-of-coronary-revascularization
#9
Carlos Alberto da Silva Magliano, Andrea Liborio Monteiro, Bernardo Rangel Tura, Claudia Silvia Rocha Oliveira, Amanda Rebeca de Oliveira Rebelo, Claudia Cristina de Aguiar Pereira
Background: Patients with a diagnosis of coronary artery disease (CAD) may face important decisions regarding treatment options, with the "right choice" depending on the relative weights of risks and benefits. Studies performed as discrete choice experiments are used to estimate these weights, and attribute selection is an essential step in the design of these studies. Attributes not included in the design cannot be analyzed. In this study, we aimed to elicit, rank, and rate attributes that may be considered important to patients and physicians who must choose between angioplasty and surgery for coronary revascularization...
2018: Patient Preference and Adherence
https://www.readbyqxmd.com/read/29780226/cerebral-border-zone-infarction-an-etiological-study
#10
Tarek Mohammed El-Gammal, Wafik Said Bahnasy, Osama Abd Allah Ragab, Ayman Mohammed Al-Malt
Background: Border zone infarcts (BZI) are ischemic lesions at the junction between two main arterial territories which may be either cortical or internal BZI. Methods: This study was conducted on 76 cerebral BZI patients and 20 healthy control subjects. Patients were divided to group I included 26 internal BZI, group II included 19 cortical BZI and group III included 21 mixed internal/cortical BZI patients. Included subjects were submitted to neurological examination, laboratory investigations, ECG, echocardiogram, brain CT and/or MRI and extra and intracranial blood vessels imaging by duplex and CT angiography...
2018: The Egyptian journal of neurology, psychiatry and neurosurgery
https://www.readbyqxmd.com/read/29780109/a-case-of-cardiogenic-shock-due-to-pulseless-electrical-activity-arrest-associated-with-severe-coronary-artery-spasm
#11
Shozo Sueda, Kaori Fujimoto, Yasuhiro Sasaki, Hirokazu Habara, Hiroaki Kohno
A 75-year-old man was admitted to our hospital for follow-up coronary angiography. Just after starting coronary angiography, his electrocardiogram showed ST-segment elevation in the V1-6, I, II, and aVF leads, and he fell into catastrophic cardiogenic shock. His left coronary arteriogram showed proximal total obstruction in the left anterior descending artery and proximal subtotal occlusion in the left circumflex artery. Because pulseless electrical activity arrest was recognized, cardiopulmonary support was started...
May 18, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29779883/gender-gap-and-risk-factors-for-poor-stroke-outcomes-a-single-hospital-based-prospective-cohort-study
#12
Kuo-Hua Hung, Jerry Cheng-Yen Lai, Kuang-Nan Hsu, Chihmin Hu, Hung-Chang Chang, Cheng-Neng Chen, He-Shu Ku, Ming-Shiang Yang, Pei-Hao Chen
BACKGROUND: This study intended to investigate whether etiological stroke subtypes and their corresponding major risk factors have differential effects on outcomes between genders. PATIENTS AND METHODS: We enrolled 403 consecutive patients with first-ever acute ischemic stroke (170 women, 233 men), from a referral hospital in Taiwan over a 2-year period. Gender differences in demographics, vascular risk factors, access to health care, etiological stroke subtypes, stroke severity, and outcomes were examined...
May 17, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29779528/analysis-of-variability-of-r-r-intervals-for-the-diagnosis-of-atrial-fibrillation-a-new-algorithm
#13
Taishi Matsui, Ryo Shinozaki, Eiichi Watanabe, Yoshifusa Aizawa
Differences in successive R-R intervals (RRIs) were normalized by RRIs before and after the indexing beats (normalized DRs) in individuals with normal sinus rhythm (NSR) and 98.89% of normalized DRs were found to distribute within mean±0.100 (≒mean±3SD), whereas 73.47% were out of this range in atrial fibrillation (AF). When 7 out 20 normalized DRs fell outside of 0.000±0.100, NSR (n=129) and AF (n=108) could be discriminated with high sensitivity, specificity, and predictive values (>99.0% for all)...
May 2018: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29778855/myocardial-strain-in-prediction-of-outcomes-after-surgery-for-severe-mitral-regurgitation
#14
Hyue Mee Kim, Goo-Yeong Cho, In-Chang Hwang, Hong-Mi Choi, Jun-Bean Park, Yeonyee E Yoon, Hyung-Kwan Kim
OBJECTIVES: We investigated whether global longitudinal strain (GLS) is a better predictor of clinical events after surgery for mitral regurgitation (MR) than conventional parameters. BACKGROUND: The optimal timing for surgery is guided by left ventricular (LV) dimension or left ventricular ejection fraction (LVEF), even though normal LVEF can mask depressed LV systolic function in severe mitral MR. METHODS: From 2006 to 2016, 506 patients (age 58...
May 11, 2018: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29776964/arrhythmias-in-adult-patients-with-congenital-heart-disease-and-pulmonary-arterial-hypertension
#15
Maria Drakopoulou, Heba Nashat, Aleksander Kempny, Rafael Alonso-Gonzalez, Lorna Swan, Stephen J Wort, Laura C Price, Colm McCabe, Tom Wong, Michael A Gatzoulis, Sabine Ernst, Konstantinos Dimopoulos
OBJECTIVES: Approximately 5%-10% of adults with congenital heart disease (CHD) develop pulmonary arterial hypertension (PAH), which affects life expectancy and quality of life. Arrhythmias are common among these patients, but their incidence and impact on outcome remains uncertain. METHODS: All adult patients with PAH associated with CHD (PAH-CHD) seen in a tertiary centre between 2007 and 2015 were followed for new-onset atrial or ventricular arrhythmia. Clinical variables associated with arrhythmia and their relation to mortality were assessed using Cox analysis...
May 18, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29776959/symptom-burden-of-atrial-fibrillation-and-its-relation-to-interventions-and-outcome-in-europe
#16
Renate B Schnabel, Ladislav Pecen, Nargiz Rzayeva, Markus Lucerna, Yanish Purmah, Francisco M Ojeda, Raffaele De Caterina, Paulus Kirchhof
BACKGROUND: Little is known about the association of atrial fibrillation symptom burden with quality of life and outcomes. METHODS AND RESULTS: In the Prevention of Thromboembolic Events-European Registry in Atrial Fibrillation (n=6196 patients with atrial fibrillation; mean±SD age, 71.8±10.4 years; 39.7% women), we assessed European Heart Rhythm Association score symptoms and calculated correlations with the standardized health status questionnaire (EQ-5D-5L)...
May 18, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29776578/oral-anticoagulation-alone-for-concomitant-stable-coronary-artery-disease-and-atrial-fibrillation-a-definitive-strategy
#17
EDITORIAL
Andrea Rubboli
No abstract text is available yet for this article.
August 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29776575/optimal-long-term-antithrombotic-treatment-of-patients-with-stable-coronary-artery-disease-and-atrial-fibrillation-oltat-registry
#18
Q Fischer, J L Georges, C Le Feuvre, A Sharma, N Hammoudi, E Berman, S Cohen, I Jolivet, J Silvain, G Helft
BACKGROUND: The optimal long-term antithrombotic treatment of patients with stable coronary artery disease (CAD) and atrial fibrillation (AF) is a challenge in daily practice. We sought to determine the prevalence of hemorrhagic complications and ischaemic events depending on antithrombotic strategy in patients with stable CAD and AF. METHODS: The primary outcome was major adverse cardiac and cerebrovascular events (MACCE) defined as a composite of cardiovascular mortality, myocardial infarction and ischaemic stroke...
August 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29768161/-practical-aspects-of-anticoagulant-therapy-in-patients-with-atrial-fibrillation-and-arterial-hypertension
#19
Z D Kobalava, A A Shavarov
Atrial fibrillation (AF) represents the most frequent sustained cardiac arrhythmia, the prevalence of AF is 1-2 % in the general population and up to 6 % for population over 80 years. Arterial hypertension (AH) is the commonest background comorbidity in patients with AF. Patients with AF have 3-6‑fold increased risk of ischemic stroke in comparison to that in general population, additionally the presence of AH leads an 2-3‑fold increase in risk of subsequent stroke. Current clinical guidelines recommend long-time anticoagulant treatment for prevention of stroke and thromboembolic complications in majority of patients with confirmed AF...
2018: Kardiologiia
https://www.readbyqxmd.com/read/29764706/atrial-fibrillation-and-ischemic-events-with-rivaroxaban-in-patients-with-stable-coronary-artery-disease-afire-protocol-for-a-multicenter-prospective-randomized-open-label-parallel-group-study
#20
Satoshi Yasuda, Koichi Kaikita, Hisao Ogawa, Masaharu Akao, Junya Ako, Tetsuya Matoba, Masato Nakamura, Katsumi Miyauchi, Nobuhisa Hagiwara, Kazuo Kimura, Atsushi Hirayama, Kunihiko Matsui
BACKGROUND: In atrial fibrillation (AF) patients with coronary artery disease (CAD), anticoagulants are commonly used in combination with antiplatelet drugs. However, dual therapy can increase the risk of bleeding, and the potential therapeutic benefits must be weighed against this. Therefore, it is recommended that dual therapy is only used for a limited time, and that monotherapy with anticoagulants should start from 1 year after percutaneous coronary intervention (PCI). However, there is a lack of evidence on the use of monotherapy, in particular with direct oral anticoagulants, in this group of patients...
May 2, 2018: International Journal of Cardiology
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