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https://www.readbyqxmd.com/read/29643926/the-evaluation-of-left-ventricular-diastolic-dysfunction-in-patients-with-non-hemorrhagic-stroke-and-atrial-fibrillation
#1
REVIEW
Mahdi Najafi-Dalui, Hasan Shemirani, Reyhaneh Zavar, Ali Eghbal
BACKGROUND: Atrial fibrillation (AF) is the most common tachyarrhythmia and an important risk factor for thromboembolic stroke. CHA2DS2-VASc score was introduced for assessment of embolic events and as criteria for starting anticoagulants. This study was performed to evaluate the left ventricular diastolic dysfunction (LVDD) in patients with non-hemorrhagic stroke and AF. METHODS: This cross-sectional study consisted of 76 consecutive patients with suspected non-hemorrhagic stroke referred to the Cardiology Department of Alzahra and Ayatollah Kashani hospitals in Isfahan, Iran, during 2015-2016...
November 2017: ARYA Atherosclerosis
https://www.readbyqxmd.com/read/29542828/rationale-design-and-preliminary-results-of-the-quebec-warfarin-cohort-study
#2
Sylvie Perreault, Payman Shahabi, Robert Côté, Stéphanie Dumas, Étienne Rouleau-Mailloux, Yassamin Feroz Zada, Sylvie Provost, Ian Mongrain, Marc Dorais, Thao Huynh, Simon Kouz, Ariel Diaz, Mark Blostein, Simon de Denus, Jacques Turgeon, Jeffrey Ginsberg, Jacques Lelorier, Lyne Lalonde, Lambert Busque, Jeannine Kassis, Mario Talajic, Jean-Claude Tardif, Marie-Pierre Dubé
BACKGROUND: Over- and under-coagulation with warfarin is associated with hemorrhagic and thromboembolic events, respectively. Genetic and clinical factors affect warfarin response, and the causes of this variability remain unclear. We present descriptive statistics and test for predictors of poor anticoagulation control. METHODS: The Quebec Warfarin Cohort (QWC) comprises 1,059 new warfarin users, with prospective follow up using telephone questionnaires every 3 months for one year, and using healthcare administrative databases (RAMQ and Med-Echo) for 5-year prior to cohort entry and up to 10-years following active patient participation...
March 15, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29535268/atrial-cardiopathy-and-the-risk-of-ischemic-stroke-in-the-chs-cardiovascular-health-study
#3
Hooman Kamel, Traci M Bartz, Mitchell S V Elkind, Peter M Okin, Evan L Thacker, Kristen K Patton, Phyllis K Stein, Christopher R deFilippi, Rebecca F Gottesman, Susan R Heckbert, Richard A Kronmal, Elsayed Z Soliman, W T Longstreth
BACKGROUND AND PURPOSE: Emerging evidence suggests that an underlying atrial cardiopathy may result in thromboembolism before atrial fibrillation (AF) develops. We examined the association between various markers of atrial cardiopathy and the risk of ischemic stroke. METHODS: The CHS (Cardiovascular Health Study) prospectively enrolled community-dwelling adults ≥65 years of age. For this study, we excluded participants diagnosed with stroke or AF before baseline...
March 13, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29467096/predictive-effect-of-hyperuricemia-on-left-atrial-stasis-in-non-valvular-atrial-fibrillation-patients
#4
Fang-Zhou Liu, Hong-Tao Liao, Wei-Dong Lin, Yu-Mei Xue, Xian-Zhang Zhan, Xian-Hong Fang, Fang Rao, Hai Deng, Jun Huang, Jo-Jo Hai, Hung-Fat Tse, Shu-Lin Wu
OBJECTIVES: To investigate the relationship between hyperuricemia and left atrial thrombus (LAT)/spontaneous echo contrast (SEC) and to determine the predictive value of hyperuricemia in non-valvular (NV) atrial fibrillation (AF) patients. METHODS: The study retrospectively reviewed 1198 consecutive patients (male 801, female 397, and mean age of 56.84 ± 12.22) who were diagnosed with AF and accepted transesophageal echocardiography (TEE) prior to catheter ablation, appendage occlusion and electrical cardioversion using a single-center database...
February 2, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29300883/left-atrial-function-to-identify-patients-with-atrial-fibrillation-at-high-risk-of-stroke-new-insights-from-a-large-registry
#5
Melissa Leung, Philippe J van Rosendael, Rachid Abou, Nina Ajmone Marsan, Dominic Y Leung, Victoria Delgado, Jeroen J Bax
Aims: Atrial fibrillation (AF) is an independent risk factor for ischaemic stroke. The CHA2DS2-VASc is the most widely used risk stratification model; however, echocardiographic refinement may be useful, particularly in low risk AF patients. The present study examined the association between advanced echocardiographic parameters and ischaemic stroke, independent of CHA2DS2-VASc score. Methods and results: One thousand, three hundred and sixty-one patients (mean age 65±12 years, 74% males) with first diagnosis of AF and baseline transthoracic echocardiogram were followed by chart review for the occurrence of stroke over a mean of 7...
December 28, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28980280/renin-angiotensin-system-inhibition-is-associated-with-reduced-risk-of-left-atrial-appendage-thrombosis-formation-in-patients-with-atrial-fibrillation
#6
Ya Suo, Yue Zhang, Yuanyuan Wang, Meng Yuan, Sayuri Kariyawasam, Gary Tse, Tong Liu, Huaying Fu, Guangping Li
BACKGROUND: Inhibition of the renin-angiotensin axis can reduce the likelihood of atrial fibrillation (AF). However, the effects of angiotensin-converting-enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) on thrombogenicity in AF remain incompletely elucidated. Thisretrospective case-control study was conducted to evaluate whether the use of ACEI or ARB could reduce the incidence of left atrial appendage thrombus (LAAT) and spontaneous echocardiographic contrast (SEC) in patients with AF...
October 5, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28972957/comparison-of-different-oral-anticoagulant-regimens-in-patients-with-atrial-fibrillation-undergoing-ablation-or-cardioversion
#7
Monika Gawałko, Agnieszka Kapłon-Cieślicka, Monika Budnik, Aldona Babiarz, Aleksandra Bodys, Robert Uliński, Maciej Żochowski, Michał Peller, Piotr Scisło, Janusz Kochanowski, Krzysztof J Filipiak, Grzegorz Opolski
INTRODUCTION    Non-vitamin K antagonist oral anticoagulants (NOACs) are an alternative to vitamin K antagonists (VKAs) for stroke prevention in atrial fibrillation (AF). OBJECTIVES    The aim of the study was to assess the incidence of left atrial appendage (LAA) thrombus and dense spontaneous echo contrast (SEC), as well as to compare the clinical characteristics of patients with AF treated with different anticoagulant regimens. PATIENTS AND METHODS    We studied 1033 consecutive patients with AF, who underwent transesophageal echocardiography (TEE) before AF ablation or cardioversion...
December 22, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28928995/acute-unilateral-renal-infarction-in-the-setting-of-an-inherited-thrombophilia-and-atrial-septal-defect
#8
Siavash Piran, Sam Schulman
We present a case of renal infarction in a 43-year-old female with history of stroke at age 14. She was found to be heterozygous for the prothrombin G20210A gene mutation. Loop monitoring revealed no atrial fibrillation. Transthoracic and transesophageal echocardiograms showed no thrombus. However, there was a small shunt due to an atrial septal defect (ASD). She was treated with warfarin and had device closure of her ASD. This was a suspected case of paradoxical embolism through an ASD leading to renal infarction...
2017: Case Reports in Hematology
https://www.readbyqxmd.com/read/28836342/single-trans-septal-access-technique-for-left-atrial-intracardiac-echocardiography-to-guide-left-atrial-appendage-closure
#9
Daniel Aguirre, Christian Pincetti, Luis Perez, Carlos Deck, Mario Alfaro, Maria Jesus Vergara, Gabriel Maluenda
OBJECTIVE: This registry aimed to describe the safety and feasibility of a single trans-septal (TS) access technique for left intracardiac echocardiography (ICE) guidance of left-atrial appendage (LAA) closure procedure. BACKGROUND: LAA closure is currently accepted as an alternative to oral anticoagulation (OAC) in patients with non-valvular atrial fibrillation (NVAF) who are at high-risk for bleeding. Currently, LAA closure procedure is typically performed under trans-esophageal echocardiogram (TEE) guidance...
August 24, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28664480/usefulness-of-left-ventricular-speckle-tracking-echocardiography-and-novel-measures-of-left-atrial-structure-and-function-in-diagnosing-paroxysmal-atrial-fibrillation-in-ischemic-stroke-and-transient-ischemic-attack-patients
#10
Kristoffer Grundtvig Skaarup, Hanne Christensen, Nis Høst, Masti Mahdy Mahmoud, Christian Ovesen, Flemming Javier Olsen, Jan Skov Jensen, Tor Biering-Sørensen
Asymptomatic paroxysmal atrial fibrillation (PAF) is often assumed to be the cause of cryptogenic ischemic strokes (IS) and transient ischemic attacks (TIA). We examined the usefulness of measures obtained by 2D speckle tracking echocardiography and novel left atrial measurements, in the diagnosis of PAF in patients with IS and TIA. We retrospectively included 205 patients who after acute IS or TIA underwent an echocardiogram in sinus rhythm. Patients were designated as PAF-patients if they had one or more reported incidents of AF before or after their echocardiographic examination...
December 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28129318/initial-experience-with-minimally-invasive-surgical-exclusion-of-the-left-atrial-appendage-with-an-epicardial-clip
#11
Nathan E Smith, Jeevan Joseph, John Morgan, Saqib Masroor
OBJECTIVE: Atrial fibrillation (AF) is the primary cardiac abnormality associated with ischemic stroke. Atrial fibrillation affects 2.7 million people with a stroke rate of 3.5% per year. Most of the emboli in patients with nonvalvular AF originate in the left atrial appendage (LAA). Surgical exclusion of the LAA decreases the yearly risk of stroke to 0.7% when combined with a Maze procedure. Traditional oversewing the LAA from inside the left atrium is associated with a significant number of recanalizations of LAA...
January 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28038818/clinical-characteristics-of-complex-aortic-plaque-in-patients-with-non-valvular-atrial-fibrillation
#12
Pil-Sung Yang, Tae-Hoon Kim, Jae-Sun Uhm, Jong-Youn Kim, Boyoung Joung, Moon-Hyoung Lee, Hui-Nam Pak
BACKGROUND: Although complex aortic plaque (CxAoP) is a component of the CHA2 DS2 -VASc score in patients with atrial fibrillation (AF), it is underestimated without detection by trans-esophageal echocardiogram (TEE). We have evaluated the incidence and significance of CxAoP among patients with non-valvular AF (NVAF). METHODS: We included 981 patients with NVAF who underwent catheter ablation (59.1±11.1years old, 73.7% male, 70.2% paroxysmal AF). All of the patients underwent pre-procedural TEE evaluation...
March 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27885496/descending-aortic-mechanics-and-atrial-fibrillation-a-two-dimensional-speckle-tracking-transesophageal-echocardiography-study
#13
Rogério Teixeira, Ricardo Monteiro, Paulo Dinis, Maria José Santos, Ana Botelho, Nuno Quintal, Nuno Cardim, Lino Gonçalves
Vascular mechanics assessed with two-dimensional speckle tracking echocardiography (2D-STE) could be used as a new imaging surrogate of vascular stiffening. The CHA2DS2-VASc score is considered accurate as an estimate of stroke risk in non-valvular AF, although many potential stroke risk factors have not been included in this scoring method. The purpose of this research is to study the feasibility of evaluating vascular mechanics at the descending aorta in non-valvular AF patients using transesophageal 2D-STE and to analyze the association between descending aortic mechanics and stroke...
April 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/27858918/global-longitudinal-strain-predicts-incident-atrial-fibrillation-and-stroke-occurrence-after-acute-myocardial-infarction
#14
Flemming Javier Olsen, Sune Pedersen, Jan Skov Jensen, Tor Biering-Sørensen
Patients with acute myocardial infarction are at increased risk of developing atrial fibrillation. We aimed to evaluate whether speckle tracking echocardiography improves risk stratification for atrial fibrillation in these patients.The study comprised of 373 patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention. Patients had an echocardiogram performed at a median of 2 days after their STEMI. The echocardiograms consisted of conventional measurements and myocardial strain analysis by speckle tracking from 3 apical projections...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27742243/cardiac-calcifications-on-echocardiography-are-associated-with-mortality-and-stroke
#15
Marvin Louis Roy Lu, Shuchita Gupta, Abel Romero-Corral, Magdaléna Matejková, Toni De Venecia, Edinrin Obasare, Vikas Bhalla, Gregg S Pressman
BACKGROUND: Calcium deposits in the aortic valve and mitral annulus have been associated with cardiovascular events and mortality. However, there is no accepted standard method for scoring such cardiac calcifications, and most existing methods are simplistic. The aim of this study was to test the hypothesis that a semiquantitative score, one that accounts for all visible calcium on echocardiography, could predict all-cause mortality and stroke in a graded fashion. METHODS: This was a retrospective study of 443 unselected subjects derived from a general echocardiography database...
December 2016: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/27437665/evaluation-of-flow-after-transcatheter-aortic-valve-replacement-in-patients-with-low-flow-aortic-stenosis-a-secondary-analysis-of-the-partner-randomized-clinical-trial
#16
Venkatesh Y Anjan, Howard C Herrmann, Philippe Pibarot, William J Stewart, Samir Kapadia, E Murat Tuzcu, Vasilis Babaliaros, Vinod H Thourani, Wilson Y Szeto, Joseph E Bavaria, Susheel Kodali, Rebecca T Hahn, Mathew Williams, D Craig Miller, Pamela S Douglas, Martin B Leon
IMPORTANCE: Low-flow (LF) severe aortic stenosis (AS) is an independent predictor of mortality in patients undergoing aortic valve replacement (AVR). Little is known about improvement in flow after AVR and its effects on survival. OBJECTIVE: To determine whether higher flow (left-ventricular stroke volume index [LVSVI]) after transcatheter AVR (TAVR) would indicate better clinical outcomes in this at-risk population. DESIGN, SETTING, AND PARTICIPANTS: A substudy analysis of data from the Placement of Aortic Transcatheter Valves (PARTNER) randomized clinical trial and continued-access registry was conducted...
August 1, 2016: JAMA Cardiology
https://www.readbyqxmd.com/read/27406344/dabigatran-exhibits-low-intensity-of-left-atrial-spontaneous-echo-contrast-in-patients-with-nonvalvular-atrial-fibrillation-as-compared-with-warfarin
#17
COMPARATIVE STUDY
Tetsuya Watanabe, Yukinori Shinoda, Kuniyasu Ikeoka, Hirooki Inui, Hidetada Fukuoka, Akihiro Sunaga, Takashi Kanda, Masaaki Uematsu, Shiro Hoshida
The presence of spontaneous echo contrast (SEC) in the left atrium has been reported to be an independent predictor of thromboembolic risk in patients with atrial fibrillation (AF). Dabigatran was associated with lower rates of stroke and systemic embolism as compared with warfarin when administered at a higher dose. Between July 2011 and October 2015, nonvalvular AF patients treated with warfarin or dabigatran who had transesophageal echocardiography prior to ablation therapy for AF were enrolled. The intensity of SEC was classified into four grades, from 0 to 3...
March 2017: Heart and Vessels
https://www.readbyqxmd.com/read/27406109/underutilization-of-ambulatory-ecg-monitoring-after-stroke-and-transient-ischemic-attack-missed-opportunities-for-atrial-fibrillation-detection
#18
Jodi D Edwards, Moira K Kapral, Jiming Fang, Gustavo Saposnik, David J Gladstone
BACKGROUND AND PURPOSE: Detection and treatment of atrial fibrillation is a major goal in secondary stroke prevention. Guidelines recommend at least 24 hours of ECG monitoring after stroke. However, it is unclear how often this is done in routine practice. METHODS: In this longitudinal cohort study using data from the Ontario Stroke Registry, we analyzed consecutive patients presenting to designated stroke centers in Ontario, Canada (2003-2013) with a first acute ischemic stroke or transient ischemic attack (TIA) in sinus rhythm and without known atrial fibrillation...
August 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27344417/prognostic-implications-of-lv-strain-risk%C3%A2-score%C3%A2-in%C3%A2-asymptomatic-patients-with%C3%A2-hypertensive-heart-disease
#19
Makoto Saito, Faisal Khan, Ted Stoklosa, Andrea Iannaccone, Kazuaki Negishi, Thomas H Marwick
OBJECTIVES: This study sought to investigate the associations of left ventricular (LV) strain and its serial change with major adverse cardiac events (MACE) in hypertensive heart disease, independent of and incremental to clinical and LV geometric parameters. BACKGROUND: In patients with hypertensive heart disease, MACE are associated with abnormal LV morphology, but their association with subclinical LV dysfunction is unclear. METHODS: We retrospectively studied 388 asymptomatic nonischemic patients with hypertension who had abnormal LV geometry at a baseline echocardiogram between 2005 and 2014...
August 2016: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/27147399/the-association-between-mean-platelet-volume-and-spontaneous-echocardiographic-contrast-or-left-atrial-thrombus-in-patients-with-mitral-stenosis
#20
Kevser Gülcihan Balcı, Orhan Maden, Mustafa Mücahit Balcı, Fatih Şen, Sefa Ünal, Serdar Kuyumcu, Meryem Kara, Hatice Selçuk, Mehmet Timur Selcuk, Ahmet Temizhan
OBJECTIVE: Although the role of platelet activation has been debated in patients with mitral stenosis (MS) and spontaneous echocardiographic contrast (SEC), data on differences in mean platelet volume (MPV) according to the presence of SEC/left atrial thrombus and the rhythm status are lacking. In this study, MPV was analyzed in patients with MS according to the presence of SEC/left atrial thrombus. METHODS: Between January 2005 and March 2014, 188 symptomatic patients having moderate or severe MS (mean age, 45...
November 2016: Anatolian Journal of Cardiology
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