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Cardiac risk assessment

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https://www.readbyqxmd.com/read/28092203/machine-learning-of-three-dimensional-right-ventricular-motion-enables-outcome-prediction-in-pulmonary-hypertension-a-cardiac-mr-imaging-study
#1
Timothy J W Dawes, Antonio de Marvao, Wenzhe Shi, Tristan Fletcher, Geoffrey M J Watson, John Wharton, Christopher J Rhodes, Luke S G E Howard, J Simon R Gibbs, Daniel Rueckert, Stuart A Cook, Martin R Wilkins, Declan P O'Regan
Purpose To determine if patient survival and mechanisms of right ventricular failure in pulmonary hypertension could be predicted by using supervised machine learning of three-dimensional patterns of systolic cardiac motion. Materials and Methods The study was approved by a research ethics committee, and participants gave written informed consent. Two hundred fifty-six patients (143 women; mean age ± standard deviation, 63 years ± 17) with newly diagnosed pulmonary hypertension underwent cardiac magnetic resonance (MR) imaging, right-sided heart catheterization, and 6-minute walk testing with a median follow-up of 4...
January 16, 2017: Radiology
https://www.readbyqxmd.com/read/28091969/quality-of-life-as-predictor-for-the-development-of-cardiac-ischemia-in-high-risk-asymptomatic-diabetic-patients
#2
Philip Haaf, Myriam Ritter, Leticia Grize, Matthias E Pfisterer, Michael J Zellweger
BACKGROUND: Ischemia induced by psychological stress and depression is a common phenomenon in stable coronary artery disease (CAD). We evaluated the quality of life (QoL) of diabetic patients screened for CAD and assessed the prognostic value of mental and physical QoL scores to predict the development of new cardiac ischemia. METHODS: Prospective multicentre outcome study. The study comprised 400 asymptomatic diabetic patients without history or symptoms of CAD...
January 13, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28090249/multimodality-imaging-for-left-ventricular-hypertrophy-severity-grading-a-methodological-review
#3
REVIEW
Maaike Alkema, Ernest Spitzer, Osama I I Soliman, Christian Loewe
Left ventricular hypertrophy (LVH), defined by an increase in left ventricular mass (LVM), is a common cardiac finding generally caused by an increase in pressure or volume load. Assessing severity of LVH is of great clinical value in terms of prognosis and treatment choices, as LVH severity grades correlate with the risk for presenting cardiovascular events. The three main cardiac parameters for the assessment of LVH are wall thickness, LVM, and LV geometry. Echocardiography, with large availability and low cost, is the technique of choice for their assessment...
December 2016: Journal of Cardiovascular Ultrasound
https://www.readbyqxmd.com/read/28089599/impact-of-oral-chlorhexidine-on-bloodstream-infection-in-critically-ill-patients-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#4
REVIEW
Luciano Silvestri, William I Weir, Dario Gregori, Nia Taylor, Durk F Zandstra, Joris J M van Saene, Hendrick K F van Saene
OBJECTIVES: Oropharyngeal overgrowth of microorganisms in the critically ill is a risk factor for lower respiratory tract infection and subsequent invasion of the bloodstream. Oral chlorhexidine has been used to prevent pneumonia, but its effect on bloodstream infection never has been assessed in meta-analyses. The authors explored the effect of oral chlorhexidine on the incidence of bloodstream infection, the causative microorganism, and on all-cause mortality in critically ill patients...
November 2, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28089252/practical-approaches-for-whole-genome-sequence-analysis-of-heart-and-blood-related-traits
#5
Alanna C Morrison, Zhuoyi Huang, Bing Yu, Ginger Metcalf, Xiaoming Liu, Christie Ballantyne, Josef Coresh, Fuli Yu, Donna Muzny, Elena Feofanova, Navin Rustagi, Richard Gibbs, Eric Boerwinkle
Whole-genome sequencing (WGS) allows for a comprehensive view of the sequence of the human genome. We present and apply integrated methodologic steps for interrogating WGS data to characterize the genetic architecture of 10 heart- and blood-related traits in a sample of 1,860 African Americans. In order to evaluate the contribution of regulatory and non-protein coding regions of the genome, we conducted aggregate tests of rare variation across the entire genomic landscape using a sliding window, complemented by an annotation-based assessment of the genome using predefined regulatory elements and within the first intron of all genes...
January 5, 2017: American Journal of Human Genetics
https://www.readbyqxmd.com/read/28089194/left-ventricular-global-longitudinal-strain-predicts-major-adverse-cardiac-events-and-all-cause-mortality-in-heart-transplant-patients
#6
Tor Skibsted Clemmensen, Hans Eiskjær, Brian Bridal Løgstrup, Lars Bo Ilkjær, Steen Hvitfeldt Poulsen
BACKGROUND: Left ventricular global longitudinal strain (LVGLS) is a robust longitudinal myocardial deformation marker that is strongly affected by cardiac allograft vasculopathy (CAV), microvascular dysfunction, and acute cellular rejection (ACR). We evaluated graft deformation for risk stratification in long-term heart transplant (HTx) patients. METHODS: The study included 196 patients who underwent HTx between 2011 and 2013. Patients underwent comprehensive echocardiography and coronary angiography...
December 15, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28089095/characteristics-of-anatomy-and-function-of-the-left-atrial-appendage-and-their-relationships-in-patients-with-cardioembolic-stroke-a-3-dimensional-transesophageal-echocardiography-study
#7
Yuki Matsumoto, Yoshihiro Morino, Akiko Kumagai, Maiko Hozawa, Motoyuki Nakamura, Yasuo Terayama, Atsushi Tashiro
BACKGROUND: Increasing attention is being paid to the left atrial appendage (LAA) in the context of risk stratification in cardioembolic stroke (CES) and the requirement for meticulous planning of percutaneous closure device implantation. However, detailed systematic assessment of the LAA remains limited. METHODS: This study evaluated the anatomy and function of LAA using 3-dimensional transesophageal echocardiography (3D-TEE) on 194 consecutive patients older than 50 years old hospitalized exclusively for CES...
January 6, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28088349/stroke-biomarkers-in-clinical-practice-a-critical-appraisal
#8
REVIEW
Geelyn J L Ng, Amy M L Quek, Christine Cheung, Thiruma V Arumugam, Raymond C S Seet
Biomarkers provide critical mechanistic insights to key biologic processes that occur during cerebral ischemia which, when carefully applied, can improve clinical decision-making in acute stroke management. The translation of a blood-based biomarker in ischemic stroke to clinical practice is challenging, in part, due to the complexity of ischemic stroke pathogenesis and the presence of a blood-brain barrier that restricts the release of brain-specific markers into the circulation. The pathologic and clinical aspects of ischemic stroke are described in this review, where a non-exhaustive list of biomarkers that interrogate different aspects of ischemic stroke such as oxidative damage, inflammation, thrombus formation, cardiac function and brain injury are described...
January 11, 2017: Neurochemistry International
https://www.readbyqxmd.com/read/28087362/clinical-phenotypes-and-outcomes-of-heritable-and-sporadic-pulmonary-veno-occlusive-disease-a-population-based-study
#9
David Montani, Barbara Girerd, Xavier Jaïs, Marilyne Levy, David Amar, Laurent Savale, Peter Dorfmüller, Andrei Seferian, Edmund M Lau, Mélanie Eyries, Jérôme Le Pavec, Florence Parent, Damien Bonnet, Florent Soubrier, Elie Fadel, Olivier Sitbon, Gérald Simonneau, Marc Humbert
BACKGROUND: Bi-allelic mutations of the EIF2AK4 gene cause heritable pulmonary veno-occlusive disease and/or pulmonary capillary haemangiomatosis (PVOD/PCH). We aimed to assess the effect of EIF2AK4 mutations on the clinical phenotypes and outcomes of PVOD/PCH. METHODS: We did a population-based study using clinical, functional, and haemodynamic data from the registry of the French Pulmonary Hypertension Network. We reviewed the clinical data and outcomes from all patients referred to the French Referral Centre (Pulmonary Department, Hospital Kremlin-Bicêtre, University Paris-Sud) with either confirmed or highly probable PVOD/PCH with DNA available for mutation screening (excluding patients with other risk factors of pulmonary hypertension, such as chronic respiratory diseases)...
January 10, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28087181/challenging-the-99th-percentile-a-lower-troponin-cutoff-leads-to-low-mortality-of-chest-pain-patients
#10
Nils Arne Sörensen, Johannes Tobias Neumann, Francisco Ojeda, Tjark Schwemer, Thomas Renné, Renate B Schnabel, Tanja Zeller, Mahir Karakas, Stefan Blankenberg, Dirk Westermann
BACKGROUND: Rule-out of non-ST-elevation myocardial infarction is based on consecutive measurements of cardiac troponins using the 99th percentile of the respective assay as cutoff. The new ESC guidelines alternatively offer rapid 1h algorithms with lower cutoffs than the 99th percentile for rule-out of non-ST-elevation myocardial infarction. We aimed to compare a recently introduced 1h algorithm based on a high-sensitivity cardiac troponin I (hs-TnI) cutoff of 6ng/L at 0h and 1h to the current standard of care using the 99th percentile (27ng/L) as cutoff with reference to follow-up events in a large chest pain cohort...
December 27, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28079927/developmental-programming-interaction-between-prenatal-bpa-and-postnatal-overfeeding-on-cardiac-tissue-gene-expression-in-female-sheep
#11
L A Koneva, A K Vyas, R C McEachin, M Puttabyatappa, H-S Wang, M A Sartor, V Padmanabhan
Epidemiologic studies and studies in rodents point to potential risks from developmental exposure to BPA on cardiometabolic diseases. Furthermore, it is becoming increasingly evident that the manifestation and severity of adverse outcomes is the result of interaction between developmental insults and the prevailing environment. Consistent with this premise, recent studies in sheep found prenatal BPA treatment prevented the adverse effects of postnatal obesity in inducing hypertension. The gene networks underlying these complex interactions are not known...
January 12, 2017: Environmental and Molecular Mutagenesis
https://www.readbyqxmd.com/read/28079394/the-positive-emotions-after-acute-coronary-events-behavioral-health-intervention-design-rationale-and-preliminary-feasibility-of-a-factorial-design-study
#12
Jeffery C Huffman, Ariana M Albanese, Kirsti A Campbell, Christopher M Celano, Rachel A Millstein, Carol A Mastromauro, Brian C Healy, Wei-Jean Chung, James L Januzzi, Linda M Collins, Elyse R Park
BACKGROUND: Positive psychological constructs, such as optimism, are associated with greater participation in cardiac health behaviors and improved cardiac outcomes. Positive psychology interventions, which target psychological well-being, may represent a promising approach to improving health behaviors in high-risk cardiac patients. However, no study has assessed whether a positive psychology intervention can promote physical activity following an acute coronary syndrome. OBJECTIVE: In this article we will describe the methods of a novel factorial design study to aid the development of a positive psychology-based intervention for acute coronary syndrome patients and aim to provide preliminary feasibility data on study implementation...
November 1, 2016: Clinical Trials: Journal of the Society for Clinical Trials
https://www.readbyqxmd.com/read/28078212/improvement-of-endothelial-function-following-initiation-of-testosterone-replacement-therapy
#13
Daniel A Shoskes, Barbara Tucky, Allan S Polackwich
BACKGROUND: Isolated recent studies have suggested an increased risk of heart attack as early as 3 months following testosterone replacement therapy (TRT). Such a rapid risk increase would likely require rapid deterioration of arterial endothelial function. Our goal was to assess arterial endothelial function in hypogonadal men prior to and at least 3 months after initiation of TRT. METHODS: Adult men were consented if they had symptoms of hypogonadism, a total testosterone <350 ng/dL, and planned to begin TRT...
December 2016: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28078076/sex-dependent-alteration-of-cardiac-cytochrome-p450-gene-expression-by-doxorubicin-in-c57bl-6-mice
#14
Marianne K O Grant, Davis M Seelig, Leslie C Sharkey, Beshay N Zordoky
BACKGROUND: There is inconclusive evidence about the role of sex as a risk factor for doxorubicin (DOX)-induced cardiotoxicity. Recent experimental studies have shown that adult female rats are protected against DOX-induced cardiotoxicity. However, the mechanisms of this sexual dimorphism are not fully elucidated. We have previously demonstrated that DOX alters the expression of several cytochrome P450 (CYP) enzymes in the hearts of male rats. Nevertheless, the sex-dependent effect of DOX on the expression of CYP enzymes is still not known...
2017: Biology of Sex Differences
https://www.readbyqxmd.com/read/28077467/gut-microbiota-dependent-trimethylamine-n-oxide-in-acute-coronary-syndromes-a-prognostic-marker-for-incident-cardiovascular-events-beyond-traditional-risk-factors
#15
Xinmin S Li, Slayman Obeid, Roland Klingenberg, Baris Gencer, François Mach, Lorenz Räber, Stephan Windecker, Nicolas Rodondi, David Nanchen, Olivier Muller, Melroy X Miranda, Christian M Matter, Yuping Wu, Lin Li, Zeneng Wang, Hassan S Alamri, Valentin Gogonea, Yoon-Mi Chung, W H Wilson Tang, Stanley L Hazen, Thomas F Lüscher
AIMS: Systemic levels of trimethylamine N-oxide (TMAO), a pro-atherogenic and pro-thrombotic metabolite produced from gut microbiota metabolism of dietary trimethylamine (TMA)-containing nutrients such as choline or carnitine, predict incident cardiovascular event risks in stable primary and secondary prevention subjects. However, the prognostic value of TMAO in the setting of acute coronary syndromes (ACS) remains unknown. METHODS AND RESULTS: We investigated the relationship of TMAO levels with incident cardiovascular risks among sequential patients presenting with ACS in two independent cohorts...
January 11, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28077227/impact-of-nutritional-assessment-and-body-mass-index-on-cardiovascular-outcomes-in-patients-with-stable-coronary-artery-disease
#16
Ayako Kunimura, Hideki Ishii, Tadayuki Uetani, Toshijirou Aoki, Kazuhiro Harada, Kenshi Hirayama, Yosuke Negishi, Yohei Shibata, Takuya Sumi, Kazuhiro Kawashima, Yosuke Tatami, Toshiki Kawamiya, Dai Yamamoto, Susumu Suzuki, Tetsuya Amano, Toyoaki Murohara
BACKGROUND: An inverse association between obesity, as defined by body mass index (BMI) and prognosis has been reported in patients with cardiovascular disease ("obesity paradox"). The aim of this study was to investigate whether adding nutritional information to BMI provides better risk assessment in patients undergoing elective percutaneous coronary intervention (PCI). METHOD: This study comprised 1004 patients undergoing elective PCI. We calculated each patient's controlling nutritional status (CONUT) score for nutritional screening at baseline...
January 4, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28076830/rosuvastatin-improves-myocardial-and-neurological-outcomes-after-asphyxial-cardiac-arrest-and-cardiopulmonary-resuscitation-in-rats
#17
Yun Qiu, Yichen Wu, Min Meng, Man Luo, Hongmei Zhao, Hong Sun, Sumin Gao
Rosuvastatin, a potent HMG-CoA reductase inhibitor, is cholesterol-lowering drugs and reduce the risk of myocardial infarction and stroke. This study is to explore whether rosuvastatin improves outcomes after cardiac arrest in rats. Male Sprague-Dawley rats were subjected to 8min of cardiac arrest (CA) by asphyxia and randomly assigned to three experimental groups immediately following successful resuscitation: Sham; Control; and Rosuvastatin. The survival, hemodynamics, myocardial function, neurological outcomes and apoptosis were assessed...
January 8, 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28076676/use-of-metformin-for-cardiometabolic-risks-in-psychiatric-practice-need-to-know-safety-issues
#18
Chittaranjan Andrade
Metformin, a biguanide drug, is emerging as an important treatment option for the prevention or treatment of weight gain, type 2 diabetes mellitus, and the metabolic syndrome in psychiatric patients, especially those who require or receive antipsychotic drugs. Metformin treatment is commonly associated with gastrointestinal adverse effects; the risk of these is reduced by gradual dose uptitration, administration of the drug with meals, and use of a time-release formulation. Lactic acidosis, a potentially fatal complication of biguanide therapy, is very rare with metformin; the risk can be reduced by avoidance of its prescription in patients with impaired renal function, impaired liver function, cardiac failure, and certain other conditions...
November 2016: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28075624/use-of-preprocedural-mdct-for-cardiac-implantable-electric-device-lead-extraction-frequency-of-findings-that-change-management
#19
Wendy L Ehieli, Daniel T Boll, Daniele Marin, Robert Lewis, Jonathan P Piccini, Lynne M Hurwitz
OBJECTIVE: Five percent of cardiac implantable electric devices (CIEDs) are removed each year. Percutaneous extraction is preferred but can be complicated if the leads adhere to the vasculature or perforate. The goal of this study is to assess the frequency of findings on dedicated MDCT that alter preprocedural planning for percutaneous CIED extraction. MATERIALS AND METHODS: One hundred patients with CIEDs who underwent MDCT before percutaneous lead extraction were analyzed...
January 11, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28075422/inflammation-cardiometabolic-markers-and-functional-changes-in-a-randomized-controlled-trial-of-a-12-month-exercise-program-for-prostate-cancer-men
#20
Katarzyna Hojan, Eliza Kwiatkowska-Borowczyk, Ewa Leporowska, Piotr Milecki
INTRODUCTION    Previous studies have shown that physical exercise in cancer patients during radiotherapy (RT) and androgen deprivation therapy (ADT) improves cardiac fitness and quality of life (QoL), and reduces fatigue but it is still not entirely known how it affects inflammation or metabolic factors and what its consequences are in prostate cancer (PCa) patients. OBJECTIVES    Effect of a 12-month physical exercise program on inflammatory and cardiometabolic factors, and on functional status in PCa patients undergoing RT and ADT...
January 10, 2017: Polskie Archiwum Medycyny Wewnętrznej
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