keyword
https://read.qxmd.com/read/38476105/the-combination-of-high-frequency-qrs-and-st-segment-alterations-during-exercise-stress-tests-enhanced-the-diagnostic-efficacy-for-coronary-artery-disease
#1
JOURNAL ARTICLE
Long Liu, Xinyue Du, Xue Wei, Wei Dong, Hong Lu, Guishen Jiang, Guolan Deng
BACKGROUND: High-frequency QRS (HF-QRS) manifests as a novel adjunct electrocardiographic marker with potential utility in coronary artery disease (CAD) detection. HYPOTHESIS: We hypothesize that HF-QRS analysis may be superior to conventional ST-segment analysis in detecting CAD, and the combination of these two analyses in the exercise stress test may enhance the diagnostic efficacy for CAD. METHODS: The study incorporated a sample of 157 patients (mean age 62  <mml:math xmlns:mml="https://www...
March 2024: Clinical Cardiology
https://read.qxmd.com/read/38447749/the-differentiation-of-the-competitive-athlete-with-physiologic-cardiac-remodeling-from-the-athlete-with-cardiomyopathy
#2
REVIEW
Robert J Henning
There are currently 5 million active high school, collegiate, professional, and master athletes in the United States. Regular intense exercise by these athletes can promote structural, electrical and functional remodeling of the heart, which is termed the "athlete's heart." In addition, regular intense exercise can lead to pathological adaptions that promote or worsen cardiac disease. Many of the athletes in the United States seek medical care. Consequently, physicians must be aware of the normal cardiac anatomy and physiology of the athlete, the differentiation of the normal athlete heart from the athlete with cardiomyopathy, and the contemporary care of the athlete with a cardiomyopathy...
March 4, 2024: Current Problems in Cardiology
https://read.qxmd.com/read/38313326/a-case-report-of-complex-congenital-heart-disease-co-existing-with-hypertrophic-cardiomyopathy
#3
Kuldeepa Veeratterapillay, Caroline J Coats, Ruairidh Martin, Bill Chaudhry, Louise Coats
BACKGROUND: Myocardial abnormalities are sometimes overlooked in congenital heart disease (CHD). The co-existence of hypertrophic cardiomyopathy is so uncommon that it is assumed to be a coincidence rather than an association. CASE SUMMARY: A 24-year-old gentleman, who was previously clinically well following a staged Fontan palliation for single-ventricle CHD, was transferred to our centre following an out-of-hospital cardiac arrest. He had return of spontaneous circulation after a period of cardiopulmonary resuscitation...
February 2024: European Heart Journal. Case Reports
https://read.qxmd.com/read/38232023/men-with-nonobstructive-coronary-disease-have-higher-burden-of-ischemic-heart-disease-detected-by-cardiopulmonary-exercise-test
#4
JOURNAL ARTICLE
Siyuan Li, Yifang Yuan, Lanting Zhao, Tingting Lv, Fei She, Fang Liu, Yajun Xue, Boda Zhou, Ying Xie, Yu Geng, Ping Zhang
BACKGROUND: Nonobstructive coronary artery disease (NOCAD), characterized by the presence of myocardial ischemic symptoms and signs without obstructive coronaries, is a common clinical condition, but it is less well understood. Few studies have analyzed the gender differences in inducible myocardial ischemia assessed by cardiopulmonary exercise test (CPET) in NOCAD. METHODS: We conducted a study of 289 NOCAD patients (mean age 60, 56% women) with ischemic symptoms and confirmed ⫹50% coronaries stenoses by coronary angiography who underwent symptom-limited CPET...
February 2024: Microcirculation: the Official Journal of the Microcirculatory Society, Inc
https://read.qxmd.com/read/38218393/disparities-in-non-invasive-traditional-and-advanced-testing-for-coronary-artery-disease-findings-from-the-incaps-covid-2-study
#5
JOURNAL ARTICLE
Todd C Villines, Patricia Rodriguez-Lozano, Indika Mallawaarachchi, Michelle C Williams, Cole Hirschfeld, Nathan Better, Leslee J Shaw, Joao V Vitola, Rodrigo J Cerci, Sharmila Dorbala, Chiara Bucciarelli-Ducci, Ganesan Karthikeyan, Yosef A Cohen, Eli Malkovskiy, Michael J Randazzo, Andrew D Choi, Thomas N B Pascual, Yaroslav Pynda, Maurizio Dondi, Diana Paez, Andrew J Einstein
The COVID-19 pandemic disrupted delivery of cardiovascular care including non-invasive testing protocols and test selection for evaluation of coronary artery disease (CAD). Trends in test selection among traditional versus advanced noninvasive tests for CAD during the pandemic and among countries of varying income status have not been well studied. The International Atomic Energy Agency conducted a global survey to assess pandemic-related changes in the practice of cardiovascular diagnostic testing. Site procedural volumes for noninvasive tests to evaluate CAD from March 2019 (pre-pandemic), April 2020 (onset), and April 2021 (initial recovery) were collected...
January 11, 2024: American Journal of Cardiology
https://read.qxmd.com/read/38217283/atherosclerosis-vindicated-a-case-of-chest-pain-due-to-capecitabine-induced-coronary-artery-spasm
#6
JOURNAL ARTICLE
Kaitlyn Thomesen, Adam Kisling, Lisa Conte, Dean Park, Robert Gallagher
BACKGROUND Capecitabine and other 5-fluorouracil prodrugs are medications widely employed in treating solid tumors, including breast and colorectal cancer. However, they carry a notable risk for cardiotoxicity, including coronary vasospasm, possibly related to their impact on vascular endothelium and smooth muscle. CASE REPORT We present a case of a 45-year-old male with a pancreatic neuroendocrine tumor who developed exertional chest pain after starting capecitabine. Initial evaluations in the emergency department, including a 12-lead electrocardiogram and cardiac enzymes, were normal, but suspicion for coronary vasospasm persisted due to the temporal relationship with drug initiation and symptom characteristics...
January 13, 2024: American Journal of Case Reports
https://read.qxmd.com/read/38188194/exercise-induced-vasospastic-angina-diagnosed-with-a-hand-grip-test-in-the-catheterization-laboratory-a-case-report
#7
Yoshiaki Kawase, Takayuki Warisawa, Kento Kikuchi, Takuya Mizukami, Hitoshi Matsuo
BACKGROUND: Exercise-induced vasospastic angina (VSA) is a relatively uncommon clinical scenario and is difficult to diagnose in the catheterization laboratory. CASE SUMMARY: A 61-year-old Japanese man presented to our hospital with complaints of angina upon exertion in the morning. Neither a 12-lead electrocardiogram nor an echocardiogram showed any abnormal findings. Invasive coronary angiogram revealed moderate stenosis in the left anterior descending coronary artery...
January 2024: European Heart Journal. Case Reports
https://read.qxmd.com/read/38115312/refractory-hypotension-and-coronary-artery-spasm-induced-by-antipsychotic-drugs-a-challenging-case-and-treatment-consideration-a-case-report-and-literature-review
#8
REVIEW
Kang Song, Yang Ji, Kun Zhao, Xiaorong Han, Chuanmin Jian, Song Liu
RATIONALE: Coronary artery spasms may result from supply-demand mismatch due to hypotension. Norepinephrine is more effective in ameliorating antipsychotic-induced refractory hypotension. PATIENT CONCERNS: Postoperative difficult-to-correct hypoperfusion occurs in patients with comorbid depression and coronary spasm; the use of norepinephrine and epinephrine for rapidly raising blood pressure needs to be considered. DIAGNOSES: Electrocardiogram is an auxiliary tool and Digital Substraction Angiography is the gold standard for the diagnosis...
December 15, 2023: Medicine (Baltimore)
https://read.qxmd.com/read/37784153/highly-accelerated-free-breathing-real-time-myocardial-tagging-for-exercise-cardiovascular-magnetic-resonance
#9
JOURNAL ARTICLE
Manuel A Morales, Siyeop Yoon, Ahmed Fahmy, Fahime Ghanbari, Shiro Nakamori, Jennifer Rodriguez, Jennifer Yue, Jordan A Street, Daniel A Herzka, Warren J Manning, Reza Nezafat
BACKGROUND: Exercise cardiovascular magnetic resonance (Ex-CMR) myocardial tagging would enable quantification of myocardial deformation after exercise. However, current electrocardiogram (ECG)-segmented sequences are limited for Ex-CMR. METHODS: We developed a highly accelerated balanced steady-state free-precession real-time tagging technique for 3 T. A 12-fold acceleration was achieved using incoherent sixfold random Cartesian sampling, twofold truncated outer phase encoding, and a deep learning resolution enhancement model...
October 2, 2023: Journal of Cardiovascular Magnetic Resonance
https://read.qxmd.com/read/37691746/using-coronary-artery-calcium-score-as-diagnostic-tool-in-symptomatic-chronic-coronary-syndrome-patients-in-a-real-life-setting
#10
JOURNAL ARTICLE
M Patrick Witvliet, E Karin Arkenbout, Pieter W Kamphuisen
BACKGROUND: The coronary artery calcium (CAC) score can be used to increase (CAC score > 0) or decrease (CAC score = 0) the likelihood of coronary artery disease (CAD). We compared the CAC score with the pre-test probability (PTP) for CAD (low, intermediate, and high). Furthermore, we compared the CAC score with exercise electrocardiography (ECG) and compared both tests with coronary angiography. METHODS AND RESULTS: We retrospectively identified patients with angina and/or dyspnea for whom CAC score was used to increase or decrease the likelihood of CAD...
2023: Vascular Health and Risk Management
https://read.qxmd.com/read/37607813/exercise-electrocardiography-for-pre-test-assessment-of-the-likelihood-of-coronary-artery-disease
#11
JOURNAL ARTICLE
Laust Dupont Rasmussen, Samuel Emil Schmidt, Juhani Knuuti, David E Newby, Trisha Singh, Koen Nieman, Tjebbe W Galema, Christiaan Vrints, Morten Bøttcher, Simon Winther
OBJECTIVES: To develop a tool including exercise electrocardiography (ExECG) for patient-specific clinical likelihood estimation of patients with suspected obstructive coronary artery disease (CAD). METHODS: An ExECG-weighted clinical likelihood (ExECG-CL) model was developed in a training cohort of patients with suspected obstructive CAD undergoing ExECG. Next, the ExECG-CL model was applied in a CAD validation cohort undergoing ExECG and clinically driven invasive coronary angiography and a prognosis validation cohort and compared with the risk factor-weighted clinical likelihood (RF-CL) model for obstructive CAD discrimination and prognostication, respectively...
August 22, 2023: Heart
https://read.qxmd.com/read/37571836/the-diagnostic-utility-of-the-basal-and-post-exercise-qrs-t-angle-in-patients-with-stable-coronary-artery-disease
#12
JOURNAL ARTICLE
Tufan Günay, Alper Karakus
BACKGROUND: To evaluate the diagnostic utility of basal and post-exercise QRS-T angle in patients with stable coronary artery disease (CAD). METHODS: This cross-sectional and observational study analyzed 190 patients with stable angina. The QRS-T angle is measured on the 12-lead electrocardiograms at baseline and just after stopping the treadmill stress test in patients undergoing conventional coronary angiography (CAG). The pre- and post-exercise QRS-T angle and ΔQRS-T angle were analyzed...
August 11, 2023: Annals of Noninvasive Electrocardiology
https://read.qxmd.com/read/37546084/exercise-induced-intraventricular-gradients-as-a-potential-cause-of-sudden-cardiac-death
#13
Carlos A Cotrim, Nuno Cotrim, Jorge H Guardado, Luis Baquero
A 16-year-old boy reported an episode of dizziness related to intense training six months before an episode of aborted sudden death. The screening required for competitive sports practice was normal. There were no personal or familial antecedents of sudden death or heart disease. After winning a triathlon competition, he experienced a cardiac arrest episode. He received defibrillation with the return of spontaneous circulation. A medical evaluation that included electrocardiogram (ECG) and echocardiogram had normal results...
July 2023: Curēus
https://read.qxmd.com/read/37436520/clinical-analysis-of-sixty-nine-children-with-anomalous-aortic-origin-of-the-coronary-artery
#14
JOURNAL ARTICLE
Zhen Zhen, Ziyan Dong, Jia Na, Xi Chen, Qirui Li, Lu Gao, Yue Yuan
We aimed to analyse the clinical characteristics of children with different types of anomalous aortic origin of the coronary artery (AAOCA) at different ages, and to discuss the factors related to myocardial ischaemia. In this retrospective study, we included 69 children diagnosed with AAOCA using CT coronary angiography; we classified the participants based on the type of AAOCA, age, and high-risk anatomy. The clinical characteristics of the different AAOCA types and age groups were compared, and the correlation between manifestations and high-risk anatomy was analysed...
July 12, 2023: European Journal of Pediatrics
https://read.qxmd.com/read/37276592/diagnostic-strategies-for-the-assessment-of-suspected-stable-coronary-artery-disease-a-systematic-review-and-meta-analysis
#15
REVIEW
Andrea Zito, Mattia Galli, Giuseppe Biondi-Zoccai, Antonio Abbate, Pamela S Douglas, Giuseppe Princi, Domenico D'Amario, Cristina Aurigemma, Enrico Romagnoli, Carlo Trani, Francesco Burzotta
BACKGROUND: There is uncertainty about which diagnostic strategy for detecting coronary artery disease (CAD) provides better outcomes. PURPOSE: To compare the effect on clinical management and subsequent health effects of alternative diagnostic strategies for the initial assessment of suspected stable CAD. DATA SOURCES: PubMed, Embase, and Cochrane Central Register of Controlled Trials. STUDY SELECTION: Randomized clinical trials comparing diagnostic strategies for CAD detection among patients with symptoms suggestive of stable CAD...
June 2023: Annals of Internal Medicine
https://read.qxmd.com/read/37228970/bridge-of-the-left-anterior-descending-artery-revealed-by-syncope-a-case-report
#16
JOURNAL ARTICLE
Mohammed Boutaybi, Ikram Tahani, Mohammed El-Azrak, Nabila Ismaili, Noha El Ouafi
The myocardial bridge is a congenital coronary anomaly defined as the presence of a region of myocardium overlying an epicardial coronary artery. This is a 51-year-old patient, diabetic for 4 years on oral hypoglycemic, has had stress angina for 4 years, neglected by the patient. The current history goes back to 2 months by the installation of an episode of syncope occurring with the effort, then of a second episode the day of its admission. Electrocardiogram on admission showed complete atrioventricular block with an heart rate of 32 beats per minute, the patient spontaneously recovered sinus rhythm with a heart rate of 88 beats per minute and a PR interval of 200 ms, coronary angiography was performed showing coronary arteries without stenosis with an intramyocardial bridge of the left anterior descending artery...
May 2023: Annals of Medicine and Surgery
https://read.qxmd.com/read/36934479/-monocentric-retrospective-study-on-the-prevalence-and-significance-of-incomplete-right-bundle-branch-block-in-young-competitive-athletes-in-tunisia
#17
JOURNAL ARTICLE
Mohamed Aymen Ben Abdessalem, Anis Ghariani, Ahmed Fekih Romdhane, Zied Ben Ameur, Hatem Bouraoui, Mahdhaoui Abdelah, Samia Ernez-Hajri
AIMS: Few studies have assessed the prevalence and significance of right bundle branch block in athletes. Aims of this study were to evaluate the prevalence of incomplete right bundle branch block and its correlation with the nature of sports practice and to compare the athlete with right bundle branch block and the one with a normal electrocardiogram. METHODS: It was a retrospective study of the electrocardiogram and echocardiography of competitive athletes recruited in the medical-sports center of Sousse RESULTS: A total of 554 athletes were included...
March 17, 2023: Annales de Cardiologie et D'angéiologie
https://read.qxmd.com/read/36788916/a-case-of-multivessel-coronary-artery-disease-and-anomalous-origin-of-the-right-coronary-artery-with-a-malignant-course-presenting-with-non-exertional-chest-discomfort-and-brugada-phenocopy
#18
Maan Kathryn L Gozun, Isaac Mizrahi, Mohammed Ali, Dipanjan Banerjee, Peter Tsai
Coronary artery anomalies (CAAs) are an uncommon cause of chest pain in the younger population. Misdiagnosis can be detrimental and lead to sudden cardiac deaths. We present a 62-year-old male with a past medical history significant for chest pain history with a workup in 2001 presumed to be non-cardiac in origin from bronchial asthma. He presented from a Micronesian Island for the evaluation of non-exertional chest discomfort. Further workup showed a Brugada type I pattern on ECG and ST wave depressions on anterolateral and inferior leads with associated AVR elevation on exercise stress testing...
January 2023: Curēus
https://read.qxmd.com/read/36757305/-more-coronary-computed-tomography-angiographies-and-less-exercise-electrocardiograms-in-patients-under-investigation-for-coronary-artery-disease
#19
JOURNAL ARTICLE
Henrik Löfmark, Helge Brandberg, Ellen Ostenfeld, Giovanna Sarno, Rickard Linder
Chronic coronary syndrome is a clinical diagnosis based on medical history and risk factors. To confirm diagnosis, an anatomical or functional assessment is recommended. Selection of diagnostic test is guided by clinical likelihood, patient characteristics, local expertise and availability. If the likelihood is low to intermediate, coronary computed tomography angiography (CCTA) is recommended; if intermediate to high, a functional non-invasive test, such as stress echocardiography, is recommended. As compared with other non-invasive diagnostic tests, exercise electrocardiogram has the lowest sensitivity and is only recommended when other imaging diagnostic tests are unavailable...
February 9, 2023: Läkartidningen
https://read.qxmd.com/read/36452988/use-of-cardiac-imaging-in-chronic-coronary-syndromes-the-eureca-imaging-registry
#20
JOURNAL ARTICLE
Danilo Neglia, Riccardo Liga, Alessia Gimelli, Tomaž Podlesnikar, Marta Cvijić, Gianluca Pontone, Marcelo Haertel Miglioranza, Andrea Igoren Guaricci, Sara Seitun, Alberto Clemente, Alexey Sumin, João Vitola, Antti Saraste, Christian Paunonen, Ching-Hui Sia, Filipp Paleev, Leyla Elif Sade, Jose Luis Zamorano, Natallia Maroz-Vadalazhskaya, Constantinos Anagnostopoulos, Filipe Macedo, Juhani Knuuti, Thor Edvardsen, Bernard Cosyns, Steffen E Petersen, Julien Magne, Cecile Laroche, Clara Berlè, Bogdan A Popescu, Victoria Delgado
BACKGROUND: The prospective, multicentre EURECA registry assessed the use of imaging and adoption of the European Society of Cardiology (ESC) Guidelines (GL) in patients with chronic coronary syndromes (CCS). METHODS: Between May 2019 and March 2020, 5156 patients were recruited in 73 centres from 24 ESC member countries. The adoption of GL recommendations was evaluated according to clinical presentation and pre-test probability (PTP) of obstructive coronary artery disease (CAD)...
January 7, 2023: European Heart Journal
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