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Cardiac risk assessment

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https://www.readbyqxmd.com/read/29452351/impact-of-treatment-delay-on-mortality-in-st-segment-elevation-myocardial-infarction-stemi-patients-presenting-with-and-without-haemodynamic-instability-results-from-the-german-prospective-multicentre-fitt-stemi-trial
#1
Karl Heinrich Scholz, Sebastian K G Maier, Lars S Maier, Björn Lengenfelder, Claudius Jacobshagen, Jens Jung, Claus Fleischmann, Gerald S Werner, Hans G Olbrich, Rainer Ott, Harald Mudra, Karlheinz Seidl, P Christian Schulze, Christian Weiss, Josef Haimerl, Tim Friede, Thomas Meyer
Aims: The aim of this study was to investigate the effect of contact-to-balloon time on mortality in ST-segment elevation myocardial infarction (STEMI) patients with and without haemodynamic instability. Methods and results: Using data from the prospective, multicentre Feedback Intervention and Treatment Times in ST-Elevation Myocardial Infarction (FITT-STEMI) trial, we assessed the prognostic relevance of first medical contact-to-balloon time in n = 12 675 STEMI patients who used emergency medical service transportation and were treated with primary percutaneous coronary intervention (PCI)...
February 14, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29452348/non-invasive-screening-for-coronary-artery-disease-in-asymptomatic-diabetic-patients-a-systematic-review-and-meta-analysis-of-randomised-controlled-trials
#2
Olivier F Clerc, Tobias A Fuchs, Julia Stehli, Dominik C Benz, Christoph Gräni, Michael Messerli, Andreas A Giannopoulos, Ronny R Buechel, Thomas F Lüscher, Aju P Pazhenkottil, Philipp A Kaufmann, Oliver Gaemperli
It is unclear whether non-invasive screening of asymptomatic diabetic patients for coronary artery disease (CAD) may improve cardiac outcomes. Thus, we performed a systematic literature review and meta-analysis of randomised controlled trials (RCT's) on this topic. We searched appropriate RCT's in five online databases (PubMed/MEDLINE, Cochrane Library, Embase, Scopus, and Web of Science) from January 2000 to November 2017 and in 41 recent reviews. Two investigators independently extracted and assessed study data using standardised forms...
February 14, 2018: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/29450742/focused-cardiac-ultrasound-as-a-predictor-of-readmission-in-acute-decompensated-heart-failure
#3
Luke J Laffin, Amit V Patel, Narayan Saha, Julian Barbat, James K Hall, Matthew Cain, Kishan Parikh, Jay Shah, Kirk T Spencer
Acute decompensated heart failure (ADHF) is a common reason for admission to the hospital, and readmission is frequent. Multiple factors contribute to rehospitalizations, but inadequate assessment of volume status leading to persistent congestion is an important factor. We sought to determine if focused cardiac ultrasound (FCU) of the inferior vena cava (IVC), as a surrogate of volume status, would predict readmission of ADHF patients after index hospitalization. Patients admitted with a primary diagnosis of ADHF were prospectively enrolled...
February 15, 2018: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/29450394/update-on-retinal-vascular-caliber
#4
REVIEW
Alina Gabriela Dumitrescu, Liliana Voinea, Ioana Anca Badarau, Vanessa Andrada Paun, Marilena Schowe, Radu Ciuluvica
Retinal vessels are the only blood vessels that can be viewed directly, in vivo, repetitively and non-invasively. Retinal vessel caliber is influenced by physiological (age, sex, race, blood pressure, blood glucose, body mass index) and pathological (atherosclerosis, dyslipidemia, smoking) determinants. There are studies on large population groups that demonstrate the associations between retinal vasculature and subclinical or clinical changes in systemic diseases (hypertension, diabetes, stroke, renal or cardiac diseases)...
July 2017: Romanian Journal of Ophthalmology
https://www.readbyqxmd.com/read/29449274/clinical-relevance-of-functionally-insignificant-moderate-coronary-artery-stenosis-assessed-by-3-vessel-fractional-flow-reserve-measurement
#5
Jonghanne Park, Joo Myung Lee, Bon-Kwon Koo, Eun-Seok Shin, Chang-Wook Nam, Joon-Hyung Doh, Doyeon Hwang, Jinlong Zhang, Xinyang Hu, JianAn Wang, Fei Ye, Shaoliang Chen, Junqing Yang, Jiyan Chen, Nobuhiro Tanaka, Hiroyoshi Yokoi, Hitoshi Matsuo, Hiroaki Takashima, Yasutsugu Shiono, Takashi Akasaka
BACKGROUND: Understanding of the risk conferred by functionally insignificant lesions in multiple coronary vessels is limited. We investigated the prognostic implications of coronary artery disease (CAD) based on 3-vessel fractional flow reserve (FFR). METHODS AND RESULTS: A total of 1,136 patients underwent FFR measurement in the 3 major epicardial arteries. We defined vessels with "Moderate CAD" as vessels with FFR, 0.81 to 0.87. Patients were classified into Group 1: No apparent CAD (FFR>0...
February 15, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29449075/cardiac-transplantation-in-children-with-down-syndrome-turner-syndrome-and-other-chromosomal-anomalies-a-multi-institutional-outcomes-analysis
#6
Christopher R Broda, Antonio G Cabrera, Joseph W Rossano, John L Jefferies, Jeffrey A Towbin, Clifford Chin, Pirouz Shamszad
BACKGROUND: The purpose of this study was to describe the prevalence, characteristics, and outcomes in pediatric patients with chromosomal anomalies (CA) undergoing orthotopic heart transplantation (OHT). METHODS: A query of the database of the Pediatric Health Information System, a large administrative and billing database of 43 tertiary children's hospitals, was performed for the Years 2004 to 2016. Pediatric patients who received OHT were analyzed based on presence and type of CA...
January 31, 2018: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29447789/comprehensive-electrocardiogram-to-device-time-for-primary-percutaneous-coronary-intervention-in-st-segment-elevation-myocardial-infarction-a-report-from-the-american-heart-association-mission-lifeline-program
#7
Jay S Shavadia, William French, Anne S Hellkamp, Laine Thomas, Eric R Bates, Steven V Manoukian, Michael C Kontos, Robert Suter, Timothy D Henry, Harold L Dauerman, Matthew T Roe
BACKGROUND: Assessing hospital-related network-level primary percutaneous coronary intervention (PCI) performance for ST-segment elevation myocardial infarction (STEMI) is challenging due to differential time-to-treatment metrics based on location of diagnostic electrocardiogram (ECG) for STEMI. METHODS: STEMI patients undergoing primary PCI at 588 PCI-capable hospitals in AHA Mission: Lifeline (2008-2013) were categorized by initial STEMI identification location: PCI-capable hospitals (Group 1); pre-hospital setting (Group 2); and non-PCI-capable hospitals (Group 3)...
March 2018: American Heart Journal
https://www.readbyqxmd.com/read/29447739/native-t1-and-ecv-of-noninfarcted-myocardium-and-outcome-in-patients-with-coronary-artery-disease
#8
Valentina O Puntmann, Gerry Carr-White, Andrew Jabbour, Chung-Yao Yu, Rolf Gebker, Sebastian Kelle, Andreas Rolf, Sabine Zitzmann, Elif Peker, Tommaso D'Angelo, Faraz Pathan, Elen, Silvia Valbuena, Rocio Hinojar, Christophe Arendt, Jagat Narula, Eva Herrmann, Andreas M Zeiher, Eike Nagel
BACKGROUND: Coronary artery disease (CAD) remains the major cause of cardiac morbidity and mortality worldwide, despite the advances in treatment with coronary revascularization and modern antiremodeling therapy. Risk stratification in CAD patients is primarily based on left ventricular volumes, ejection fraction (LVEF), risk scores, and the presence and extent of late gadolinium enhancement (LGE). The prognostic role of T1 mapping in noninfarcted myocardium in CAD patients has not yet been determined...
February 20, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29447344/the-balance-between-short-term-and-long-term-outcomes-of-bilateral-internal-thoracic-artery-skeletonization-in-coronary-artery-bypass-surgery-a-propensity-matched-cohort-study
#9
Janet M C Ngu, Ming Hao Guo, David Glineur, Diem Tran, Fraser D Rubens
OBJECTIVES: There is growing interest in the use of bilateral internal thoracic arteries (BITAs) for myocardial revascularization. This study sought to compare the balance between early benefits and long-term outcomes of skeletonized or non-skeletonized conduits and to determine whether differences in outcomes are affected by other patient risk factors. METHODS: BITAs were used in 1504 cases with either SK or NSK conduits. Propensity matching was completed using 22 covariates identifying 441 pairs of patients...
February 13, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29447342/diagnosing-coronary-artery-disease-after-a-positive-coronary-computed-tomography-angiography-the-dan-nicad-open-label-parallel-head-to-head-randomized-controlled-diagnostic-accuracy-trial-of-cardiovascular-magnetic-resonance-and-myocardial-perfusion-scintigraphy
#10
L Nissen, S Winther, J Westra, J A Ejlersen, C Isaksen, A Rossi, N R Holm, G Urbonaviciene, L C Gormsen, L H Madsen, E H Christiansen, M Maeng, L L Knudsen, L Frost, L Brix, H E Bøtker, S E Petersen, M Bøttcher
Aims: Perfusion scans after coronary computed tomography angiography (CCTA) in patients with suspected coronary artery disease (CAD) may reduce unnecessary invasive coronary angiographies (ICAs). However, the diagnostic accuracy of perfusion scans after primary CCTA is unknown. The aim of this study was to determine the diagnostic accuracy of cardiac magnetic resonance (CMR) and myocardial perfusion scintigraphy (MPS) against ICA with fractional flow reserve (FFR) in patients suspected of CAD by CCTA...
February 13, 2018: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/29445096/chronic-intermittent-hypoxia-promotes-myocardial-ischemia-related-ventricular-arrhythmias-and-sudden-cardiac-death
#11
Jessica Morand, Claire Arnaud, Jean-Louis Pepin, Diane Godin-Ribuot
We investigated the effects of intermittent hypoxia (IH), such as that encountered in severe obstructive sleep apnea (OSA) patients, on the development and severity of myocardial ischemia-related ventricular arrhythmias. Rats were exposed to 14 days of IH (30 s at 5%O 2 and 30 s at 21%O 2 , 8 h·day -1 ) or normoxia (N, similar air-air cycles) and submitted to a 30-min coronary ligature. Arterial blood pressure (BP) and ECG were recorded for power spectral analysis, ECG interval measurement and arrhythmia quantification...
February 14, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29444274/shift-work-parental-cardiovascular-disease-and-myocardial-infarction-in-males
#12
J Hermansson, J Hallqvist, B Karlsson, A Knutsson, K Gillander Gådin
Background: Shift work has been associated with an increased risk of cardiovascular disease (CVD). However, there is a need for more studies to determine whether there is an interaction between shift work and other risk factors of CVD, thereby increasing the risk of CVD in shift workers. Aims: To discern whether shift work and parental mortality from myocardial infarction (MI) or sudden cardiac death (SCD) interact to increase the risk of MI in men. Methods: A case-control dataset was used to assess interaction between shift work and parental history of CVD, using death from MI or SCD, or death before age 65, on an additive scale...
February 10, 2018: Occupational Medicine
https://www.readbyqxmd.com/read/29443547/modeling-heart-failure-risk-in-diabetes-and-kidney-disease-limitations-and-potential-applications-of-transverse-aortic-constriction-in-high-fat-fed-mice
#13
Wei Sheng Tan, Thomas P Mullins, Melanie Flint, Sarah L Walton, Helle Bielefeldt-Ohmann, David A Carter, Meera R Gandhi, Hayley R McDonald, Joan Li, Karen M Moritz, Melissa E Reichelt, Linda A Gallo
There is an increased incidence of heart failure in individuals with diabetes mellitus (DM). The co-existence of kidney disease in DM exacerbates the cardiovascular prognosis. Researchers have attempted to combine the critical features of heart failure, using transverse aortic constriction, with DM in mice but variable findings have been reported. Furthermore, kidney outcomes have not been assessed in this setting thus its utility as a model of heart failure in DM and kidney disease is unknown. We generated a mouse model of obesity, hyperglycemia and mild kidney pathology by feeding male C57BL/6J mice a high fat diet (HFD)...
February 14, 2018: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/29443088/simultaneous-video-eeg-ecg-monitoring-to-identify-neurocardiac-dysfunction-in-mouse-models-of-epilepsy
#14
Vikas Mishra, Nicole M Gautier, Edward Glasscock
In epilepsy, seizures can evoke cardiac rhythm disturbances such as heart rate changes, conduction blocks, asystoles, and arrhythmias, which can potentially increase risk of sudden unexpected death in epilepsy (SUDEP). Electroencephalography (EEG) and electrocardiography (ECG) are widely used clinical diagnostic tools to monitor for abnormal brain and cardiac rhythms in patients. Here, a technique to simultaneously record video, EEG, and ECG in mice to measure behavior, brain, and cardiac activities, respectively, is described...
January 29, 2018: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29441818/comparative-effectiveness-and-harms-of-intraoperative-transesophageal-echocardiography-in-noncardiac-surgery-a-systematic-review
#15
Ashraf Fayad, Sasha Shillcutt, Massimiliano Meineri, Terrence D Ruddy, Mohammed Toseef Ansari
Intraoperative use of transesophageal echocardiography (TEE) has become commonplace in high-risk noncardiac surgeries but the balance of benefits and harms remains unclear. This systematic review investigated the comparative effectiveness and harms of intraoperative TEE in noncardiac surgery. We searched Ovid MEDLINE, PubMed, EMBASE, and the Cochrane Library from 1946 to March 2017. Two reviewers independently screened the literature for eligibility. Studies were assessed for the risk of selection bias, confounding, measurement bias, and reporting bias...
February 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29441350/perioperative-goal-directed-therapy-using-invasive-uncalibrated-pulse-contour-analysis
#16
Bernd Saugel, Daniel A Reuter
"Perioperative goal-directed therapy" (PGDT) aims at an optimization of basic and advanced global hemodynamic variables to maintain adequate oxygen delivery to the end-organs. PGDT protocols help to titrate fluids, vasopressors, or inotropes to hemodynamic target values. There is considerable evidence that PGDT can improve patient outcome in high-risk patients if both fluids and inotropes are administered to target hemodynamic variables reflecting blood flow. Despite this evidence, PGDT strategies aiming at an optimization of blood flow seem to be not well implemented in routine clinical care...
2018: Frontiers in Medicine
https://www.readbyqxmd.com/read/29440198/developing-a-clinical-approach-to-air-pollution-and-cardiovascular-health
#17
REVIEW
Michael B Hadley, Jill Baumgartner, Rajesh Vedanthan
Nearly 3 billion people are exposed to household air pollution emitted from inefficient cooking and heating stoves, and almost the entire global population is exposed to detectable levels of outdoor air pollution from traffic, industry, and other sources. Over 3 million people die annually of ischemic heart disease or stroke attributed to air pollution, more than from traditional cardiac risk factors such as obesity, diabetes mellitus, or smoking. Clinicians have a role to play in reducing the burden of pollution-attributable cardiovascular disease...
February 13, 2018: Circulation
https://www.readbyqxmd.com/read/29440187/repolarization-heterogeneity-measured-with-t-wave-area-dispersion-in-standard-12-lead-ecg-predicts-sudden-cardiac-death-in-general-population
#18
Tuomas V Kenttä, Moritz F Sinner, Bruce D Nearing, Rebecca Freudling, Kimmo Porthan, Jani T Tikkanen, Martina Müller-Nurasyid, Katharina Schramm, Matti Viitasalo, Antti Jula, Markku S Nieminen, Annette Peters, Veikko Salomaa, Lasse Oikarinen, Richard L Verrier, Stefan Kääb, M Juhani Junttila, Heikki V Huikuri
BACKGROUND: We developed a novel electrocardiographic marker, T-wave area dispersion (TW-Ad), which measures repolarization heterogeneity by assessing interlead T-wave areas during a single cardiac cycle and tested whether it can identify patients at risk for sudden cardiac death (SCD) in the general population. METHODS AND RESULTS: TW-Ad was measured from standard digital 12-lead ECG in 5618 adults (46% men; age, 50.9±12.5 years) participating in the Health 2000 Study-an epidemiological survey representative of the Finnish adult population...
February 2018: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29439517/hyperglycemia-alters-the-structure-and-hemodynamics-of-the-developing-embryonic-heart
#19
Taylor B Lawson, Devon E Scott-Drechsel, Venkat Keshav Chivukula, Sandra Rugonyi, Kent L Thornburg, Monica T Hinds
Congenital heart defects (CHDs) represent the most common form of human birth defects; approximately one-third of heart defects involve malformations of the outflow tract (OFT). Maternal diabetes increases the risk of CHD by 3-5 fold. During heart organogenesis, little is known about the effects of hyperglycemia on hemodynamics, which are critical to normal heart development. Heart development prior to septation in the chick embryo was studied under hyperglycemic conditions. Sustained hyperglycemic conditions were induced, raising the average plasma glucose concentration from 70 mg/dL to 180 mg/dL, akin to the fasting plasma glucose of a patient with diabetes...
February 12, 2018: Journal of Cardiovascular Development and Disease
https://www.readbyqxmd.com/read/29438436/assessment-of-coronary-vascular-function-with-cardiac-pet-in-relation-to-serum-uric-acid
#20
Seoyoung C Kim, Nishant R Shah, James R Rogers, Courtney F Bibbo, Marcelo F Di Carli, Daniel H Solomon
BACKGROUND: Elevated serum uric acid (SUA) levels have been independently associated with cardiovascular disease. Stress myocardial perfusion positron emission tomography (PET) allows for measurement of absolute myocardial blood flow (MBF) and quantification of global left ventricular coronary flow reserve (CFR). A CFR <2.0 is considered impaired coronary vascular function, and it is associated with increased cardiovascular risk. We evaluated the relationship between SUA and PET-measured markers of coronary vascular function...
2018: PloS One
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