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Cardiac risk assessment

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https://www.readbyqxmd.com/read/28535554/anesthetic-considerations-and-perioperative-management-of-spinal-cord-stimulators-literature-review-and-initial-recommendations
#1
Michael E Harned, Brandon Gish, Allison Zuelzer, Jay S Grider
BACKGROUND: Patients with implanted spinal cord stimulators (SCS) present to the anesthesia care team for management at many different points along the care continuum. Currently, the literature is sparse on the perioperative management. What is available is confusing; monopolar electrocautery is contraindicated but often used, full body magnetic resonance imaging (MRI) is safe with particular systems but with other manufactures only head and specific extremities exams are safe. Moreover, there are anesthetizing locations outside of the operating room where implanted SCS can interact with surrounding medical equipment and pose significant risk to patient and device...
May 2017: Pain Physician
https://www.readbyqxmd.com/read/28535172/invited-commentary-the-framingham-offspring-study-a-pioneering-investigation-into-familial-aggregation-of-cardiovascular-risk
#2
JoAnn E Manson, Shari S Bassuk
Launched in 1948, the Framingham Heart Study was a seminal prospective cohort study of 5,209 adult residents of Framingham, Massachusetts, that was designed to uncover the determinants and natural history of coronary heart disease. Data from this original cohort established the cardiac threat posed by high blood pressure, high cholesterol, smoking, obesity, physical inactivity, diabetes, and other factors. In the late 1960s, investigators conceived the innovative idea of assembling a second cohort that comprised the adult children of the original study population (and these children's spouses)...
May 23, 2017: American Journal of Epidemiology
https://www.readbyqxmd.com/read/28534694/the-heart-score-for-early-rule-out-of-acute-coronary-syndromes-in-the-emergency-department-a-systematic-review-and-meta-analysis
#3
Patricia Van Den Berg, Richard Body
AIMS: The objective of this systematic review was to summarise the current evidence on the diagnostic accuracy of the HEART score for predicting major adverse cardiac events in patients presenting with undifferentiated chest pain to the emergency department. METHODS AND RESULTS: Two investigators independently searched Medline, Embase and Cochrane databases between 2008 and May 2016 identifying eligible studies providing diagnostic accuracy data on the HEART score for predicting major adverse cardiac events as the primary outcome...
May 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28534102/circulating-microaggregates-during-cardiac-surgery-precedes-postoperative-stroke
#4
Zühre Uz, Dan M J Milstein, Can Ince, Bastian A J M de Mol
Postoperative stroke and encephalopathy are potentially serious complications associated with coronary artery bypass grafting. In this case report a 78-year-old male patient receiving routine elective cardiac surgery presented with microaggregations in the sublingual microcirculation while on cardiopulmonary bypass that was undetected by routine intraoperative anticoagulation assessment. Microaggregates identified using video microscopy on his sublingual microcirculation during the procedure preceded a stroke postoperatively...
May 22, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28533260/relationship-between-monocyte-platelet-aggregation-and-endothelial-function-in-middle-aged-and-elderly-adults
#5
Andrew Haynes, Matthew D Linden, Elisa Robey, Louise H Naylor, Kay L Cox, Nicola T Lautenschlager, Daniel J Green
Low-grade inflammation, endothelial dysfunction, and platelet hyper-reactivity to agonists are associated with an increased risk of cardiovascular events. In vitro and animal studies infer an inverse mechanistic relationship between platelet activation and the production of endothelium-derived nitric oxide and prostacyclin. This concept is supported by evidence of an inverse relationship between endothelial function and platelet activation in high-risk cardiac patients. The aim of this study was to investigate what relationship, if any, exists between platelet and endothelial function in healthy, middle-aged, and elderly adults...
May 2017: Physiological Reports
https://www.readbyqxmd.com/read/28533209/rationale-and-design-of-a-clinical-trial-to-evaluate-the-safety-and-efficacy-of-intracoronary-infusion-of-allogeneic-human-cardiac-stem-cells-in-patients-with-acute-myocardial-infarction-and-left-ventricular-dysfunction-the-randomized-multicenter-double-blind
#6
Ricardo Sanz-Ruiz, Ana Casado Plasencia, Luis R Borlado, María Eugenia Fernández-Santos, Reem Al-Daccak, Piet Claus, Itziar Palacios, Rafael Sádaba, Dominique Charron, Jan Bogaert, Miguel Mulet, Raquel Yotti, Inmaculada Gilaberte, Antonio Bernad, Javier Bermejo, Stefan Janssens, Francisco Fernández-Avilés
Rationale: Stem cell therapy has increased the therapeutic armamentarium in the fight against ischemic heart disease and heart failure (HF). The administration of exogenous stem cells has been investigated in patients suffering an acute myocardial infarction (AMI) with the final aim of salvaging jeopardized myocardium and preventing left ventricular adverse remodeling and functional deterioration. However, phase I and II clinical trials with autologous and "first-generation" stem cells have yielded inconsistent benefits and mixed results...
May 22, 2017: Circulation Research
https://www.readbyqxmd.com/read/28532771/benefits-of-statin-therapy-in-patients-with-acute-myocardial-infarction-with-serum-low-density-lipoprotein-cholesterol-%C3%A2-50%C3%A2-mg-dl
#7
Zhe Hao Piao, Li Jin, Ju Han Kim, Youngkeun Ahn, Young Jo Kim, Myeong Chan Cho, Chong Jin Kim, Hyo Soo Kim, Bin Liu, Myung Ho Jeong
Previous trials have found that statin therapy reduces low-density lipoprotein cholesterol (LDL-C) level and the risk of cardiovascular events. However, the benefit of statin therapy in patients with baseline LDL-C levels ≤ 50 mg/dl is less clear. Therefore, the aim of this study was to assess whether patients with acute myocardial infarction (AMI) who have baseline LDL-C levels ≤ 50 mg/dl would benefit from statin therapy in real-world clinical practice. We analyzed the clinical data of 1,048 patients (67...
April 27, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28532651/suboptimal-anticoagulant-management-in-japanese-patients-with-nonvalvular-atrial-fibrillation-receiving-warfarin-for-stroke-prevention
#8
Teruyuki Hirano, Hirokazu Kaneko, Sari Mishina, Feng Wang, Satoshi Morita
BACKGROUND: Atrial fibrillation (AF) is the most common cardiac arrhythmia, with increasing prevalence in Japan. Although prothrombin time-international normalized ratio (PT-INR) targets for monitoring warfarin therapy in patients with nonvalvular AF (NVAF) are well defined, real-world patient characteristics and PT-INR levels remain unknown among Japanese patients with NVAF who initiate and continue warfarin (warfarin maintainers) versus those who switch from warfarin to direct oral anticoagulants (DOACs; warfarin switchers)...
May 19, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28532587/sudden-cardiac-death-in-inherited-cardiomyopathy
#9
R Collis, P M Elliott
Cardiomyopathy is an important cause of sudden cardiac death particularly in adolescents and young adults. The risk of sudden cardiac death varies between individual cardiomyopathies and is dependent on the severity of disease, age and gender. Although rare in cardiomyopathies, a fundamental aspect of clinical management is a systematic and thorough clinical assessment to identify the small number of individuals who are at risk and who can be protected with prophylactic ICD therapy.
June 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28532575/readmission-rates-after-transcatheter-aortic-valve-replacement-in-high-and-extreme-risk-patients-with-severe-aortic-stenosis
#10
Jessica Forcillo, Jose F Condado, Jose N Binongo, Yi Lasanajak, Hope Caughron, Vasilis Babaliaros, Chandan Devireddy, Bradley Leshnower, Robert A Guyton, Peter C Block, Amy Simone, Patricia Keegan, Paul Khairy, Vinod H Thourani
OBJECTIVE: In high- or extreme-risk patients undergoing transcatheter aortic valve replacement, readmissions have not been adequately studied and are the subject of increased scrutiny by healthcare systems. The objectives of this study were to determine the incidence of 30-day and 1-year cardiac and noncardiac readmissions, identify predictors of readmission, and assess the association between readmission and 1-year mortality. METHODS: A retrospective review was performed on 714 patients who underwent transcatheter aortic valve replacement from September 2007 to January 2015 at Emory University...
April 18, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28531789/do-picu-patients-meet-technical-criteria-for-performing-indirect-calorimetry
#11
Megan R Beggs, Gonzalo Garcia Guerra, Bodil M K Larsen
BACKGROUND & AIMS: Indirect calorimetry (IC) is considered gold standard for assessing energy needs of critically ill children as predictive equations and clinical status indicators are often unreliable. Accurate assessment of energy requirements in this vulnerable population is essential given the high risk of over or underfeeding and the consequences thereof. The proportion of patients and patient days in pediatric intensive care (PICU) for which energy expenditure (EE) can be measured using IC is currently unknown...
October 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28528743/-18-f-sodium-fluoride-positron-emission-tomography-for-molecular-imaging-of-coronary-atherosclerosis-based-on-computed-tomography-analysis
#12
Toshiro Kitagawa, Hideya Yamamoto, Shinya Toshimitsu, Ko Sasaki, Atsuhiro Senoo, Yumiko Kubo, Fuminari Tatsugami, Kazuo Awai, Yutaka Hirokawa, Yasuki Kihara
BACKGROUND AND AIMS: We aimed at evaluating the relation of (18)F-sodium fluoride ((18)F-NaF) uptake on positron emission tomography (PET) to coronary atherosclerosis detected and assessed by computed tomography (CT). METHODS: Thirty-two patients with one or more coronary atherosclerotic lesions detected on cardiac CT underwent (18)F-NaF PET/CT. Each coronary atherosclerotic lesion was evaluated on CT angiography for plaque types (calcified plaque [CP], non-calcified plaque [NCP], partially calcified plaque [PCP]), and the presence of CT-based high-risk features (minimum CT density <30 Hounsfield units and vascular remodeling index >1...
April 29, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28528724/twelve-lead-ambulatory-electrocardiographic-monitoring-in-brugada-syndrome-potential-diagnostic-and-prognostic-implications
#13
Belinda Gray, Adrienne Kirby, Peter Kabunga, Saul B Freedman, Laura Yeates, Ajita Kanthan, Caroline Medi, Anthony Keech, Christopher Semsarian, Raymond W Sy
BACKGROUND: Patients with Brugada syndrome (BrS) are diagnosed and risk stratified on the basis of a spontaneous or drug-induced type 1 electrocardiographic (ECG) pattern, often at single time points not accounting for variation throughout the day. OBJECTIVES: The purpose of this study was to prospectively assess the overall burden of type 1 Brugada ECG changes using 12-lead 24-hour Holter monitoring and evaluate association with cardiac events. METHODS: From July 1, 2013 to December 31, 2015, patients with BrS were recruited from 3 Australian centers and the Australian Genetic Heart Disease Registry...
June 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28528579/phosphodiesterase-type-5-inhibition-may-reduce-diastolic-function-in-women-with-ischemia-but-no-obstructive-coronary-artery-disease
#14
Michael D Nelson, Puja K Mehta, Janet Wei, Behzad Sharif, Louise E J Thomson, Daniel Berman, Debiao Li, C Noel Bairey Merz
BACKGROUND: Ischemia, in the absence of obstructive coronary artery disease, is prevalent in women, and associated with increased risk for major cardiovascular events. Coronary microvascular dysfunction is prevalent in these patients, and associated with impaired diastolic function. Despite our general understanding, however, optimal treatment of this cohort remains elusive. METHODS: To address this knowledge gap, we performed an open-label treatment trial to assess whether phosphodiesterase type 5 inhibition improves coronary microvascular perfusion and diastolic function in women with signs and symptoms of ischemia but no evidence of obstructive coronary artery disease...
May 22, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28527814/desmoplakin-missense-and-non-missense-mutations-in-arrhythmogenic-right-ventricular-cardiomyopathy-genotype-phenotype-correlation
#15
Silvia Castelletti, Annina S Vischer, Petros Syrris, Lia Crotti, Carla Spazzolini, Alice Ghidoni, Gianfranco Parati, Sharon Jenkins, Maria-Christina Kotta, William J McKenna, Peter J Schwartz, Antonis Pantazis
BACKGROUND: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is traditionally considered as primarily affecting the right ventricle. Mutations in genes encoding desmosomal proteins account for 40-60% of cases. Genotype-phenotype correlations are scant and mostly non gene-specific. Accordingly, we assessed the genotype-phenotype correlation for desmoplakin (DSP) missense and non-missense mutations causing ARVC. METHODS AND RESULTS: We analyzed 27 ARVC patients carrying a missense or a non-missense DSP mutation, with complete clinical assessment...
May 10, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28526702/t-wave-morphology-restitution-predicts-sudden-cardiac-death-in-patients-with-chronic-heart-failure
#16
Julia Ramírez, Michele Orini, Ana Mincholé, Violeta Monasterio, Iwona Cygankiewicz, Antonio Bayés de Luna, Juan Pablo Martínez, Esther Pueyo, Pablo Laguna
BACKGROUND: Patients with chronic heart failure are at high risk of sudden cardiac death (SCD). Increased dispersion of repolarization restitution has been associated with SCD, and we hypothesize that this should be reflected in the morphology of the T-wave and its variations with heart rate. The aim of this study is to propose an electrocardiogram (ECG)-based index characterizing T-wave morphology restitution (TMR), and to assess its association with SCD risk in a population of chronic heart failure patients...
May 19, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28526264/celecoxib-aggravates-cardiac-apoptosis-in-l-name-induced-pressure-overload-model-in-rats-immunohistochemical-determination-of-cardiac-caspase-3-mcl-1-bax-and-bcl-2
#17
Sarah M Mosaad, Sawsan A Zaitone, Abdelazim Ibrahim, Amani A El-Baz, Dina M Abo-Elmatty, Yasser M Moustafa
The mechanism of celecoxib cardiovascular adverse events was earlier investigated; yet in-depth investigations are needed to assess the involvement of its pro-apoptotic effect throughout this process. An in-vivo chronic rat model of pressure overload employing Nʷ-nitro-l-arginine methyl ester (L-NAME) was tested at different time intervals to ensure the occurrence of persistent myocardial apoptosis along with pressure overload. Seven groups of male Wistar rats were assigned as (i) distilled water; (ii-iv) L-NAME (60 mg/kg) for 6, 12 or 16 weeks; (v-vii) L-NAME [16 weeks] + celecoxib (25, 50 or 100 mg/kg), from week 13 to week 16...
May 16, 2017: Chemico-biological Interactions
https://www.readbyqxmd.com/read/28525548/computational-fluid-dynamics-characterization-of-pulsatile-flow-in-central-and-sano-shunts-connected-to-the-pulmonary-arteries-importance-of-graft-angulation-on-shear-stress-induced-platelet-mediated-thrombosis
#18
Robert Ascuitto, Nancy Ross-Ascuitto, Martin Guillot, Carey Celestin
OBJECTIVES: Central (aorta) and Sano (right ventricle)-to-pulmonary artery (PA) shunts, palliative operations for infants with complex heart defects, can develop life-threatening thrombosis. We employed computational fluid dynamics (CFD) to study pulsatile flow in these shunts, with the goal to identify haemodynamic characteristics conducive to thrombus formation. METHODS: CFD, using the finite volume method with cardiac catheterization data, and computer simulations, based on angiography, were employed to determine flow-velocity field, wall shear stress (WSS) profile and oscillatory shear index (OSI)...
May 19, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28525506/haptoglobin-administration-in-cardiovascular-surgery-patients-its-association-with-the-risk-of-postoperative-acute-kidney-injury
#19
Kenta Kubota, Moritoki Egi, Satoshi Mizobuchi
BACKGROUND: Acute kidney injury (AKI) often occurs after cardiac surgery. During cardiac surgery, plasma free hemoglobin (fHb) would increase due to hemolysis. Since plasma fHb is thought to be nephrotoxic, haptoglobin, which is an fHb scavenger, may have the potential to prevent postoperative AKI (pAKI). However, there have been few studies in which the association of intraoperative administration of haptoglobin with the incidence of AKI after cardiac surgery was assessed. METHODS: This study was a retrospective observational study to assess the independent association of intraoperative administration of haptoglobin with the incidence pAKI in cardiac surgery patients...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28525464/the-cardiac-rehabilitation-model-improves-fitness-quality-of-life-and-depression-in-breast-cancer-survivors
#20
Lianne B Dolan, Danielle Barry, Teresa Petrella, Lindsay Davey, Ann Minnes, Allison Yantzi, Susan Marzolini, Paul Oh
PURPOSE: Exercise is a demonstrated, therapeutic strategy for cancer survivors to minimize many treatment-induced side effects and may decrease risk of recurrence. Nonetheless, structured programs that combine exercise and education are not yet standardized within cancer care. The Health, Exercise, Active Living, Therapeutic lifestyle (HEALTh) program is a clinical exercise program based on the established cardiac rehabilitation model, but customized for female breast cancer survivors...
May 18, 2017: Journal of Cardiopulmonary Rehabilitation and Prevention
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