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Cardiac risk assessment

Mohit Arora, Rekha S Patil
AIM AND OBJECTIVE: To study the cardiac manifestations of the dengue fever. METHODS: This one year descriptive study was undertaken at KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum under the Department of Medicine. A total of 120 patients with either dengue IgM or IgM and IgG were studied. The assessment of cardiac manifestations was done based on electrocardiogram, 2D echocardiography and cardiac enzymes. RESULTS: Of the 120 patients, 85 (70...
July 2016: Journal of the Association of Physicians of India
G Caleb Alexander, Geetha Iyer, Eleanor Lucas, Dora Lin, Sonal Singh
PURPOSE: We sought to evaluate whether exogenous testosterone therapy is associated with increased risk of serious cardiovascular events as compared to other treatments or placebo. METHODS: Study selection included randomized controlled trials (RCTs) and observational studies which enrolled men aged 18 years or older receiving exogenous testosterone for three or more days were included. The primary outcomes were death due to all causes, myocardial infarction and stroke...
October 14, 2016: American Journal of Medicine
Priccila Zuchinali, Gabriela C Souza, Maurício Pimentel, Diego Chemello, André Zimerman, Vanessa Giaretta, Joyce Salamoni, Bianca Fracasso, Leandro I Zimerman, Luis E Rohde
Importance: The presumed proarrhythmic action of caffeine is controversial. Few studies have assessed the effect of high doses of caffeine in patients with heart failure due to left ventricular systolic dysfunction at high risk for ventricular arrhythmias. Objective: To compare the effect of high-dose caffeine or placebo on the frequency of supraventricular and ventricular arrhythmias, both at rest and during a symptom-limited exercise test. Design, Setting, and Participants: Double-blinded randomized clinical trial with a crossover design conducted at the heart failure and cardiac transplant clinic of a tertiary-care university hospital...
October 17, 2016: JAMA Internal Medicine
Kate J Bowen, William S Harris, Penny M Kris-Etherton
Early secondary prevention trials of fish and omega-3 polyunsaturated fatty acid (PUFA) capsules reported beneficial effects on cardiovascular disease (CVD) outcomes, including all-cause mortality and sudden cardiac death. These clinical findings, as well as observational and experimental data, demonstrated that omega-3 PUFAs reduced the risk of coronary outcomes and overall mortality and were the basis for recommendations made in the early 2000s to increase omega-3 PUFA intake. In the last 6 years, however, results from both primary and secondary prevention trials have generally failed to show a beneficial effect of omega-3 PUFA supplementation, bringing current recommendations into question...
November 2016: Current Treatment Options in Cardiovascular Medicine
Sebastian Völz, Sara Svedlund, Bert Andersson, Gan Li-Ming, Bengt Rundqvist
Resistant hypertension is associated with increased risk for cardiovascular events. Coronary flow reserve (CFR) is impaired in patients with hypertension and an independent predictor of cardiac mortality. However, there are no published data on CFR in the subset of treatment-resistant hypertension. The aim of this study was to assess CFR in patients with resistant hypertension. Twenty-five consecutive patients with primary resistant hypertension, scheduled for renal denervation, 25 matched patients with controlled hypertension, and 25 healthy controls underwent transthoracic colour Doppler echocardiography at rest and during adenosine infusion...
October 17, 2016: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Yaw A Nyame, Helen Liang, Hans C Arora, Bradley C Gill, Peter Caputo, Daniel Ramirez, Matthew J Maurice, Khaled Fareed, Robert J Stein, Georges-Pascal Haber, Andrew J Stephenson, Amr Fergany, Jihad Kaouk
PURPOSE: Currently no data exists to guide renal surgeons on the perioperative use of renin-angiotensin (RAS) blockers despite their potential cardiorenal benefits. This study aims to assess the impact of resuming RAS blockers on postoperative renal function and adverse cardiac events following partial nephrectomy. PATIENTS AND METHODS: This is an observational analysis of patients undergoing robotic-assisted laparoscopic partial nephrectomy from 2006-2014 at a single institution...
October 13, 2016: Journal of Urology
Yibin Xie, Young-Jin Kim, Jianing Pang, Jung-Sun Kim, Qi Yang, Janet Wei, Christopher T Nguyen, Zixin Deng, Byoung Wook Choi, Zhaoyang Fan, C Noel Bairey Merz, Prediman K Shah, Daniel S Berman, Hyuk-Jae Chang, Debiao Li
OBJECTIVES: The aim of this work is the development of coronary atherosclerosis T1-weighted characterization with integrated anatomical reference (CATCH) technique and the validation by comparison with high-risk plaque features (HRPF) observed on intracoronary optical coherence tomography (OCT) and invasive coronary angiography. BACKGROUND: T1-weighted cardiac magnetic resonance with or without contrast media has been used for characterizing coronary atherosclerosis showing promising prognostic value...
October 6, 2016: JACC. Cardiovascular Imaging
Andreia Noites, Carla Patrícia Freitas, Joana Pinto, Cristina Melo, Ágata Vieira, Aníbal Albuquerque, Madalena Teixeira, Fernando Ribeiro, José Mesquita Bastos
BACKGROUND: Cardiovascular diseases are the leading cause of death globally and sedentary lifestyle is one of the main risk factors. Home-based cardiac rehabilitation (CR) programs appear to be effective to improve exercise tolerance. The aim of the study, therefore, was to evaluate the effects of a phase IV (maintenance) home-based CR program on cardiorespiratory fitness and daily physical activity of patients recovering from an acute myocardial infarction. METHODS: This pilot study, with a sub-group randomised controlled trial, included 32 individuals recovering from a myocardial infarction, randomly divided into the experimental group (EG, n=16) and the control group (CG, n=16)...
September 13, 2016: Heart, Lung & Circulation
Kyung Hye Lee, Sang Jin Ha, Jong-Shin Woo, Gi-Ja Lee, So-Ra Lee, Jung Wook Kim, Hun Kuk Park, Weon Kim
BACKGROUND: Exenatide exerts cardioprotective effects by attenuating ischaemic reperfusion injury, possibly through activating the opening of mitochondrial ATP-sensitive potassium channels. We used atomic force microscopy (AFM) to investigate changes in mitochondrial morphology and properties in order to assess exenatide-mediated cardioprotection in IR injury. METHODS: We used an in vivo Sprague-Dawley rat IR model and ex vivo Langendorff injury model. In the left anterior descending artery (LAD) occlusion model, animals were randomly divided into three groups: sham-operated rats (Sham, n=5), IR-injured rats treated with placebo (IR, n=6), and IR-injured treated with exenatide (IR + EXE, n=6)...
September 23, 2016: Heart, Lung & Circulation
Suvitesh Luthra, Miguel M Leiva Juárez, Eshan Senanayake, Heyman Luckraz, John S Billing, James Cotton, Michael S Norell
BACKGROUND: This retrospective propensity-matched study investigated the impact of prior percutaneous coronary intervention (PCI) on short-term and long-term survival after coronary artery bypass graft surgery (CABG). METHODS: A total of 4,634 patients underwent isolated first-time CABG between April 2004 and March 2014. Among these, 424 (9.2%) had PCI. Propensity score analysis yielded 1:1 risk-adjusted matched groups: PCI (330 patients) and non-PCI (330 patients)...
October 12, 2016: Annals of Thoracic Surgery
Adam Ali Ghotbi, Andreas Kjaer, Lars Nepper-Christensen, Kiril Aleksov Ahtarovski, Jacob Thomsen Lønborg, Niels Vejlstrup, Kasper Kyhl, Thomas Emil Christensen, Thomas Engstrøm, Henning Kelbæk, Lene Holmvang, Lia E Bang, Rasmus Sejersten Ripa, Philip Hasbak
BACKGROUND: Determining infarct size and myocardial salvage in patients with ST-segment elevation myocardial infarction (STEMI) is important when assessing the efficacy of new reperfusion strategies. We investigated whether rest (82)Rb-PET myocardial perfusion imaging can estimate area at risk, final infarct size, and myocardial salvage index when compared to cardiac SPECT and magnetic resonance (CMR). METHODS: Twelve STEMI patients were injected with (99m)Tc-Sestamibi intravenously immediate prior to reperfusion...
October 14, 2016: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
P Taura, G Martinez-Palli, A Blasi, E Rivas, J Beltran, J Balust
Liver transplantation (LT) offers patients with liver disease a real chance for long-term survival. In the past decade, successful survival after LT along with the Model for End-Stage Liver Disease-based allocation policy have increased willingness to accept patients with a higher risk profile and marginal organs and to prioritize the sickest patients on the waiting list. Therefore, the anesthesiologist now deals with very challenging patients. In the present review, we aimed to highlight key aspects of intraoperative LT management in high-risk patients and to place these aspects in the perspective of their impact on perioperative outcomes...
September 2016: Transplantation Proceedings
Briana Welsh, Michael Chao, Farshad Foroudi
INTRODUCTION: When irradiating the left breast, a small portion of the heart and left anterior descending coronary artery (LAD) are often included in the treatment field. Deep inspiration breath-hold (DIBH) techniques reduce dose to coronary structures, but are resource intensive and may not be tolerated by all patients. The aim of this study was to evaluate a simple multi-leaf collimator (MLC) modification technique with respect to target coverage and organ-at-risk sparing. METHODS: Forty nine patients with left-sided breast cancer, planned with a simultaneous integrated boost technique were retrospectively replanned with additional shielding of the LAD...
September 9, 2016: Journal of Medical Radiation Sciences
Yuko Y Inoue, Bharath Ambale-Venkatesh, Nathan Mewton, Gustavo J Volpe, Yoshiaki Ohyama, Ravi K Sharma, Colin O Wu, Chia-Ying Liu, David A Bluemke, Elsayed Z Soliman, João A C Lima, Hiroshi Ashikaga
Purpose To examine the associations of myocardial diffuse fibrosis and scar with surface electrocardiographic (ECG) parameters in individuals free of prior coronary heart disease in four different ethnicities. Materials and Methods This prospective cross-sectional study was approved by the institutional review boards, and all participants gave informed consent. A total of 1669 participants in the Multi-Ethnic Study of Atherosclerosis, or MESA, who were free of prior myocardial infarction underwent both ECG and cardiac magnetic resonance imaging...
October 13, 2016: Radiology
Dominik Buckert, Sebastian Kelle, Sebastian Buss, Grigorios Korosoglou, Rolf Gebker, Ralf Birkemeyer, Wolfgang Rottbauer, Hugo Katus, Burkert Pieske, Peter Bernhardt
BACKGROUND: Cardiac magnetic resonance imaging (CMR) has become a diagnostic modality that allows for prognostic risk stratification in various cardiac diseases. CMR derived detection of myocardial necrosis by late gadolinium enhancement (LGE) and assessment of left ventricular functional parameters such as left-ventricular ejection fraction (LVEF) have been proven to be significantly associated with outcome and prognosis. Our study focusses on the validation of specific thresholds for these parameters in a multi-center daily all-comers cohort of stable coronary artery disease (CAD) patients...
October 13, 2016: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Santosh Kumar Sinha, Shalini Garg, Ramesh Thakur, Vinay Krishna, Karandeep Singh, Mohit Sachan, Amit Goel, Mahamdula Razi, Umeshwar Pandey, Chandra Mohan Varma
BACKGROUND: The optimal timing of surgery in patients with chronic organic severe mitral regurgitation (MR) continues to be debated, especially for those who are asymptomatic. The aim of the study was to determine independent and additive prognostic value of exercise brain natriuretic peptide (eBNP) in patients with severe asymptomatic MR and normal left ventricular ejection fraction (LVEF). METHODS: Two hundred twenty-three consecutive patients with severe MR defined by effective regurgitant orifice (ERO) area ≥ 40 mm(2) and/or residual volume ≥ 60 mL, LVEF > 60%, and normal LV end-systolic diameter < 40 mm underwent symptom limited exercise treadmill test (TMT)...
November 2016: Journal of Clinical Medicine Research
A Ollila, L Vikatmaa, J Virolainen, P Vikatmaa, A Leppäniemi, A Albäck, M Salmenperä, V Pettilä
BACKGROUND AND AIMS: Perioperative myocardial infarction is an underdiagnosed complication causing morbidity, mortality, and considerable costs. However, evidence of preventive and therapeutic options is scarce. We investigated the incidence and outcome of perioperative myocardial infarction in non-cardiac surgery patients in order to define a target population for future interventional trials. MATERIAL AND METHODS: We conducted a prospective single-center study on non-cardiac surgery patients aged 50 years or older...
October 13, 2016: Scandinavian Journal of Surgery: SJS
Newton B Wiggins, Daniel T Chong, Penny L Houghtaling, Ayman A Hussein, Walid Saliba, Joseph F Sabik, Oussama Wazni, Bruce L Wilkoff, Khaldoun G Tarakji
AIMS: The incidence, indications, and risk factors for cardiac implantable electronic device (CIED) implantation after cardiac surgery in an era with an aging population are not well described. There are limited data about the survival of these patients compared with a non-device group. We aimed to evaluate the incidence, indications, and risk factors for postoperative CIED implantation. We also assessed survival of these patients compared with a non-device group. METHODS: We included all patients without prior CIED implantation who underwent cardiac surgery at our institution from 1996 to 2008...
October 12, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Antonio Berruezo, Juan Acosta, Juan Fernández-Armenta, Alonso Pedrote, Alberto Barrera, Eduardo Arana-Rueda, Andrés Ignacio Bodegas, Ignasi Anguera, Luis Tercedor, Diego Penela, David Andreu, Rosario Jesus Perea, Susana Prat-González, Lluis Mont
BACKGROUND: First-line endoepicardial ventricular tachycardia (VT) ablation has been proposed for patients with arrhythmogenic cardiomyopathy (AC). This study reports procedural safety, outcomes, and predictors of recurrence. METHODS AND RESULTS: Forty-one consecutive patients [12 with left ventricle (LV) involvement, 7 left-dominant] underwent first-line endoepicardial VT substrate ablation. Standard bipolar and unipolar thresholds were used to define low-voltage areas (LVA)...
October 12, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Maria Cecilia Gonzalez Corcia, Juan Sieira, Andrea Sarkozy, Carlo de Asmundis, Gian-Battista Chierchia, Jaime Hernandez Ojeda, Gudrun Pappaert, Pedro Brugada
AIMS: To investigate the clinical characteristics, prognoses, and presence of risk factors in young patients with Brugada syndrome (BS). METHODS AND RESULTS: A consecutive cohort of 128 young BS patients (≤25 years old at diagnosis) was analysed. Eighty-eight patients (69%) were asymptomatic, whereas 40 (31%) presented with clinical manifestations of BS. Markers of prognosis and risk were identified upon comparison of these two groups. A history of malignant syncope was strong predictors of ventricular arrhythmic events...
October 13, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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