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Cardiac risk assessment

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https://www.readbyqxmd.com/read/28214482/catheter-directed-ultrasound-assisted-thrombolysis-is-a-safe-and-effective-treatment-for-pulmonary-embolism-even-in-high-risk-patients
#1
Kristen A Lee, Andrew Cha, Mark H Kumar, Combiz Rezayat, Clifford M Sales
OBJECTIVE: We sought to assess the early success and safety of catheter-directed, ultrasound-assisted (CDUA) thrombolysis for acute pulmonary embolism (PE) in patients deemed to be "high risk" for thrombolytic therapy. METHODS: A retrospective evaluation of patients who underwent CDUA pulmonary thrombolysis in our practice during 39 months is reported. There were 91 patients considered, all of whom presented with acute PE as diagnosed by computed tomography angiography...
March 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28214153/arrhythmogenic-right-ventricular-dysplasia-atypical-clinical-presentation
#2
José Marçalo, Luiz Menezes Falcão
A 67-year-old man was admitted to our hospital after episodes of syncope preceded by malaise and diffuse neck and chest discomfort. No family history of cardiac disease was reported. Laboratory workup was within normal limits, including D-dimers, serum troponin I and arterial blood gases. The electrocardiogram showed sinus rhythm with T-wave inversion in leads V1 to V3. Computed tomography angiography to investigate pulmonary embolism showed no abnormal findings. Transthoracic echocardiography (TTE) displayed massive enlargement of the right ventricle with intact interatrial septum and no pulmonary hypertension...
February 14, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28214152/clinical-and-genetic-diagnosis-of-familial-hypertrophic-cardiomyopathy-results-in-pediatric-cardiology
#3
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/28214141/feasibility-and-safety-of-same-day-discharge-after-complex-percutaneous-coronary-intervention-using-forearm-approach
#4
Michael Koutouzis, Aris Karatasakis, Emmanouil S Brilakis, Maria Agelaki, Christos Maniotis, Panagiotis Dimitriou, Efstathios Lazaris
OBJECTIVES: We sought to assess the feasibility and safety of same-day discharge (SDD) after complex percutaneous coronary intervention (PCI) using a forearm approach. BACKGROUND: SDD has been shown to be safe after elective, low-risk PCI. However, the feasibility and safety of SDD in more complex patients and lesions has received limited study. METHODS: We retrospectively reviewed 1190 elective PCIs that were performed between January 2013 and December 2015 at the Red Cross General Hospital...
February 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28214080/clinical-outcome-and-correlates-of-coronary-microvascular-obstruction-in-latecomers-after-acute-myocardial-infarction
#5
Rocco A Montone, Giampaolo Niccoli, Silvia Minelli, Francesco Fracassi, Vincenzo Vetrugno, Cristina Aurigemma, Francesco Burzotta, Italo Porto, Carlo Trani, Filippo Crea
AIMS: Microvascular obstruction (MVO) is associated with a worse prognosis in patients with ST-elevation myocardial infarction (STEMI) treated by primary percutaneous coronary intervention (PCI). However, data about incidence, clinical outcome and correlates of MVO in latecomers after STEMI are still lacking. METHODS: We prospectively enrolled consecutive patients that were latecomers after STEMI (symptoms onset >12h) undergoing PCI. We performed an angiographic analysis to assess the occurrence of MVO [defined as TIMI flow grade ≤2 or 3 with a myocardial blush grade <2]...
February 12, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28213932/correlations-between-electrocardiogram-and-biomarkers-in-acute-pulmonary-embolism-analysis-of-zatpol-2-registry
#6
Piotr Kukla, Dariusz A Kosior, Andrzej Tomaszewski, Katarzyna Ptaszyńska-Kopczyńska, Katarzyna Widejko, Robert Długopolski, Andrzej Skrzyński, Piotr Błaszczak, Kamil Fijorek, Marcin Kurzyna
BACKGROUND: Electrocardiography (ECG) is still one of the first tests performed at admission, mostly in patients (pts) with chest pain or dyspnea. The aim of this study was to assess the correlation between electrocardiographic abnormalities and cardiac biomarkers as well as echocardiographic parameter in patients with acute pulmonary embolism. METHODS: We performed a retrospective analysis of 614 pts. (F/M 334/280; mean age of 67.9 ± 16.6 years) with confirmed acute pulmonary embolism (APE) who were enrolled to the ZATPOL-2 Registry between 2012 and 2014...
February 18, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28213881/poor-adherence-to-p2y12-antagonists-increased-cardiovascular-risks-in-chinese-pci-treated-patients
#7
Yang Sun, Chenze Li, Lina Zhang, Dong Hu, Xudong Zhang, Ting Yu, Min Tao, Dao Wen Wang, Xiaoqing Shen
Low adherence to secondary prevention medications (ATM) of patients after acute coronary syndrome (ACS) is associated with poor clinical outcomes. However, literature provides limited data on assessment of ATM and risks associated with poor in Chinese patients with ACS. In the current work, ATM was assessed in consecutively recruited patients with ACS in Tongji Hospital from November 5, 2013 to December 31, 2014. A total of 2126 patients were classified under low adherence (proportion of days covered (PDC) C< 50%) and high adherence (PDC>50%) groups based on their performance after discharge...
February 17, 2017: Frontiers of Medicine
https://www.readbyqxmd.com/read/28213507/effect-of-sleep-disordered-breathing-on-appropriate-implantable-cardioverter-defibrillator-therapy-in-patients-with-heart-failure-a-systematic-review-and-meta-analysis
#8
Younghoon Kwon, Ryan J Koene, Osung Kwon, Jessica V Kealhofer, Selcuk Adabag, Sue Duval
BACKGROUND: Patients with heart failure and reduced ejection fraction are at increased risk of malignant ventricular arrhythmias. Implantable cardioverter-defibrillator (ICD) is recommended to prevent sudden cardiac death in some of these patients. Sleep-disordered breathing (SDB) is highly prevalent in this population and may impact arrhythmogenicity. We performed a systematic review and meta-analysis of prospective studies that assessed the impact of SDB on ICD therapy. METHODS AND RESULTS: Relevant prospective studies were identified in the Ovid MEDLINE, EMBASE, and Google Scholar databases...
February 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28212445/long-term-effects-of-fetal-undernutrition-on-rat-heart-role-of-hypertension-and-oxidative-stress
#9
Pilar Rodríguez-Rodríguez, Angel L López de Pablo, Concha F García-Prieto, Beatriz Somoza, Begoña Quintana-Villamandos, José J Gómez de Diego, Perla Y Gutierrez-Arzapalo, David Ramiro-Cortijo, M Carmen González, Silvia M Arribas
BACKGROUND AND AIMS: Fetal undernutrition is a risk factor for heart disease in both genders, despite the protection of women against hypertension development. Using a rat model of maternal undernutrition (MUN) we aimed to assess possible sex differences in the development of cardiac alterations and the implication of hypertension and cardiac oxidative stress. METHODS: Male and female offspring from rats fed ad libitum (control) or with 50% of the normal daily intake during the second half of gestation (MUN) were used...
2017: PloS One
https://www.readbyqxmd.com/read/28210769/preprocedural-risk-assessment-prior-to-ppvi-with-cmr-and-cardiac-ct
#10
Ladonna Malone, Brian Fonseca, Thomas Fagan, Jane Gralla, Neil Wilson, Micheal DiMaria, Uyen Truong, Lorna P Browne
Percutaneous pulmonary valve intervention (PPVI) is a less invasive and less costly approach to pulmonary valve replacement compared with the surgical alternative. Potential complications of PPVI include coronary compression and pulmonary arterial injury/rupture. The purpose of this study was to characterize the morphological risk factors for PPVI complication with cardiac MRI and cardiac CTA. A retrospective review of 88 PPVI procedures was performed. 44 patients had preprocedural cardiac MRIs or CTAs available for review...
February 16, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28210489/arterial-ventricular-coupling-and-parameters-of-vascular-stiffness-in-hypertensive-patients-role-of-gender
#11
Luca Faconti, Rosa Maria Bruno, Simona Buralli, Marta Barzacchi, Elisa Dal Canto, Lorenzo Ghiadoni, Stefano Taddei
OBJECTIVE: Non-invasive estimation of arterial-ventricular coupling has been extensively used for the evaluation of cardiovascular performance, however, a relative small amount of data is available regarding arterial-ventricular coupling and its components in hypertension. The present study was designed to investigate the relationship between left ventricular elastance, arterial elastance, parameters of vascular stiffness and the influence of gender in a population of hypertensive individuals...
January 2017: JRSM Cardiovascular Disease
https://www.readbyqxmd.com/read/28209402/chemokine-receptor-patterns-and-right-heart-failure-in-mechanical-circulatory-support
#12
Aditi Nayak, Colin Neill, Robert L Kormos, Luigi Lagazzi, Indrani Halder, Charles McTiernan, Jennifer Larsen, Ana Inashvili, Jeffrey Teuteberg, Timothy N Bachman, Karen Hanley-Yanez, Dennis M McNamara, Marc A Simon
BACKGROUND: Right ventricular failure (RVF) complicates 9% to 44% of left ventricular assist device (LVAD) implants post-operatively. Current prediction scores perform only modestly in validation studies, and do not include immune markers. Chemokines are inflammatory signaling molecules with a fundamental role in cardiac physiology and stress adaptation. In this study we investigated chemokine receptor regulation in LVAD recipients who develop RVF. METHODS: Expression of chemokine receptor (CCR) genes 3 to 8 were examined in the peripheral blood of 111 LVAD patients, collected 24 hours before implant...
December 23, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28209387/associations-of-cardiovascular-and-all-cause-mortality-events-with-oxygen-uptake-at-ventilatory-threshold
#13
Setor K Kunutsor, Sudhir Kurl, Hassan Khan, Francesco Zaccardi, Jari A Laukkanen
BACKGROUND: Oxygen uptake (VO2) at ventilatory threshold (VT), is a cardiopulmonary exercise testing parameter which may be a proxy for peak VO2. We aimed to assess the associations of VO2 at VT with sudden cardiac death (SCD), fatal coronary heart disease (CHD) and cardiovascular disease (CVD), and all-cause mortality. METHODS AND RESULTS: VO2 at VT was assessed during a submaximal exercise test using respiratory gas analyzers in the Kuopio Ischemic Heart Disease cohort of 1639 middle-aged men...
February 10, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28209220/very-low-density-lipoprotein-associated-apolipoproteins-predict-cardiovascular-events-and-are-lowered-by-inhibition%C3%A2-of%C3%A2-apoc-iii
#14
Raimund Pechlaner, Sotirios Tsimikas, Xiaoke Yin, Peter Willeit, Ferheen Baig, Peter Santer, Friedrich Oberhollenzer, Georg Egger, Joseph L Witztum, Veronica J Alexander, Johann Willeit, Stefan Kiechl, Manuel Mayr
BACKGROUND: Routine apolipoprotein (apo) measurements for cardiovascular disease (CVD) are restricted to apoA-I and apoB. Here, the authors measured an unprecedented range of apolipoproteins in a prospective, population-based study and relate their plasma levels to risk of CVD. OBJECTIVES: This study sought to measure apolipoproteins directly by mass spectrometry and compare their associations with incident CVD and to obtain a system-level understanding of the correlations of apolipoproteins with the plasma lipidome and proteome...
February 21, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28207997/chronically-elevated-bilirubin-protects-from-cardiac-reperfusion-injury-in-the-male-gunn-rat
#15
Bhavisha Bakrania, Eugene F Du Toit, Kevin J Ashton, Karl-Heinz Wagner, John P Headrick, Andrew C Bulmer
AIMS: Bilirubin is associated with reduced risk of cardiovascular disease, as evidenced in conditions of mild hyperbilirubinaemia (Gilbert's Syndrome). Little is known regarding myocardial stress-resistance in hyperbilirubinemic conditions or whether life-long exposure modifies cardiac function, which might contribute to protection from cardiovascular disease. METHODS: Hyperbilirubinemic rats and littermate controls underwent echocardiography at 3, 6 and 12 mo of age, with hearts subsequently assessed for resistance to 30 min of ischaemia...
February 16, 2017: Acta Physiologica
https://www.readbyqxmd.com/read/28207613/vagal-regulation-of-cardiac-function-in-early-childhood-and-cardiovascular-risk-in-adolescence
#16
Meghan J Gangel, Lilly Shanahan, Jacek Kolacz, James A Janssen, Ashley Brown, Susan D Calkins, Susan P Keane, Laurie Wideman
OBJECTIVE: Poor behavioral self-regulation in the first two decades of life has been identified as an important precursor of disease risk in adulthood. However, physiological regulation has not been well-studied as a disease risk factor before adulthood. We tested whether physiological regulation at age two, in the form of vagal regulation of cardiac function (indexed by RSA change), would predict three indicators of cardiovascular risk at age 16 (diastolic and systolic blood pressure and body mass index)...
February 15, 2017: Psychosomatic Medicine
https://www.readbyqxmd.com/read/28207554/isolated-cardiac-troponin-rise-does-not-modify-the-prognosis-in-elderly-patients-with-hip-fracture
#17
Hélène Vallet, Alice Breining, Yannick Le Manach, Judith Cohen-Bittan, Anthony Mézière, Mathieu Raux, Marc Verny, Bruno Riou, Frédéric Khiami, Jacques Boddaert
Perioperative myocardial infarction remains a life-threatening complication in noncardiac surgery and even an isolated troponin rise (ITR) is associated with significant mortality. Our aim was to assess the prognostic value of ITR in elderly patients with hip fracture.In this cohort study, all patients admitted between 2009 and 2013 in our dedicated geriatric postoperative unit after hip fracture surgery with a cardiac troponin I determination were included and divided into Control, ITR, and acute coronary syndrome (ACS) groups...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28207437/lack-of-association-between-preoperative-statin-use-and-respiratory-and-neurologic-complications-after-cardiac-surgery
#18
Ryu Komatsu, Huseyin Oguz Yilmaz, Jing You, C Allen Bashour, Shobana Rajan, Edward G Soltesz, Daniel I Sessler, Alparslan Turan
BACKGROUND: Statins may reduce the risk of pulmonary and neurologic complications after cardiac surgery. METHODS: The authors acquired data for adults who had coronary artery bypass graft, valve surgery, or combined procedures. The authors matched patients who took statins preoperatively to patients who did not. First, the authors assessed the association between preoperative statin use and the primary outcomes of prolonged ventilation (more than 24 h), pneumonia (positive cultures of sputum, transtracheal fluid, bronchial washings, and/or clinical findings consistent with the diagnosis of pneumonia), and in-hospital all-cause mortality, using logistic regressions...
February 16, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28205593/imaging-cardiac-scn5a-using-the-novel-f-18-radiotracer-radiocaine
#19
Jacob M Hooker, Martin G Strebl, Frederick A Schroeder, Hsiao-Ying Wey, Amrut V Ambardekar, Timothy A McKinsey, Matthias Schoenberger
The key function of the heart, a well-orchestrated series of contractions, is controlled by cardiac action potentials. These action potentials are initiated and propagated by a single isoform of voltage gated sodium channels - SCN5A. However, linking changes in SCN5A expression levels to human disease in vivo has not yet been possible. Radiocaine, an F-18 radiotracer for positron emission tomography (PET), is the first SCN5A imaging agent in the heart. Explants from healthy and failing human hearts were compared using radiocaine autoradiography to determine that the failing heart has ~30% lower SCN5A levels - the first evidence of changes in SCN5A expression in humans as a function of disease...
February 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28205339/doing-it-hard-in-the-bush-aligning-what-gets-measured-with-what-matters
#20
Malcolm I McDonald, Kenny D Lawson
What gets measured gets managed. Funding of health services is substantially determined by operational activity and specific outcome indicators. In day-to-day clinical decision-making, surrogate markers, such as glycosylated haemoglobin and blood pressure, are commonly used to modify risks of 'hard' outcomes that include kidney failure, ischaemic cardiac events, stroke and all-cause mortality. In many settings, surrogates are all we have to go on. As a consequence, current health funding models heavily rely on surrogate-based key performance indicators [KPIs]...
February 16, 2017: Australian Journal of Rural Health
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