Subjects -> MEDICAL SCIENCES (Total: 8642 journals)
    - ALLERGOLOGY AND IMMUNOLOGY (218 journals)
    - ANAESTHESIOLOGY (120 journals)
    - CARDIOVASCULAR DISEASES (338 journals)
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    - UROLOGY, NEPHROLOGY AND ANDROLOGY (155 journals)

CARDIOVASCULAR DISEASES (338 journals)                  1 2 | Last

Showing 1 - 200 of 338 Journals sorted alphabetically
Acta Angiologica     Open Access   (Followers: 5)
Acta Cardiologica     Hybrid Journal   (Followers: 2)
Acute Cardiac Care     Hybrid Journal   (Followers: 8)
Adipositas - Ursachen, Folgeerkrankungen, Therapie     Hybrid Journal  
AJP Heart and Circulatory Physiology     Hybrid Journal   (Followers: 12)
Aktuelle Kardiologie     Hybrid Journal   (Followers: 1)
American Heart Journal     Hybrid Journal   (Followers: 60)
American Journal of Cardiology     Hybrid Journal   (Followers: 68)
American Journal of Cardiovascular Drugs     Hybrid Journal   (Followers: 17)
American Journal of Hypertension     Hybrid Journal   (Followers: 28)
Anales de Cirugia Vascular     Full-text available via subscription   (Followers: 1)
Anatolian Journal of Cardiology     Open Access   (Followers: 6)
Angiología     Full-text available via subscription  
Angiologia e Cirurgia Vascular     Open Access   (Followers: 1)
Angiology     Hybrid Journal   (Followers: 3)
Annales de Cardiologie et d'Angéiologie     Full-text available via subscription   (Followers: 1)
Annals of Circulation     Open Access   (Followers: 2)
Annals of Noninvasive Electrocardiology     Hybrid Journal   (Followers: 1)
Annals of Pediatric Cardiology     Open Access   (Followers: 12)
AORTA     Open Access  
Archives of Cardiovascular Diseases     Full-text available via subscription   (Followers: 5)
Archives of Cardiovascular Diseases Supplements     Full-text available via subscription   (Followers: 3)
Archives of Cardiovascular Imaging     Open Access   (Followers: 2)
Archivos de cardiología de México     Open Access   (Followers: 1)
Argentine Journal of Cardiology (English edition)     Open Access   (Followers: 2)
Arquivos Brasileiros de Cardiologia     Open Access   (Followers: 2)
Arrhythmia & Electrophysiology Review     Open Access   (Followers: 1)
Arteriosclerosis, Thrombosis and Vascular Biology     Full-text available via subscription   (Followers: 32)
Artery Research     Hybrid Journal   (Followers: 4)
ARYA Atherosclerosis     Open Access  
ASAIO Journal     Hybrid Journal   (Followers: 3)
ASEAN Heart Journal     Open Access   (Followers: 2)
Asian Cardiovascular and Thoracic Annals     Hybrid Journal   (Followers: 2)
Aswan Heart Centre Science & Practice Services     Open Access   (Followers: 1)
Atherosclerosis : X     Open Access  
Bangladesh Heart Journal     Open Access   (Followers: 3)
Basic Research in Cardiology     Hybrid Journal   (Followers: 10)
BMC Cardiovascular Disorders     Open Access   (Followers: 22)
Brain Circulation     Open Access   (Followers: 1)
British Journal of Cardiology     Full-text available via subscription   (Followers: 18)
Canadian Journal of Cardiology     Hybrid Journal   (Followers: 18)
Cardiac Cath Lab Director     Full-text available via subscription  
Cardiac Electrophysiology Review     Hybrid Journal   (Followers: 2)
Cardiac Failure Review     Open Access   (Followers: 1)
Cardiocore     Full-text available via subscription   (Followers: 1)
Cardiogenetics     Open Access   (Followers: 3)
Cardiology     Full-text available via subscription   (Followers: 20)
Cardiology and Angiology: An International Journal     Open Access   (Followers: 1)
Cardiology and Therapy     Open Access   (Followers: 12)
Cardiology Clinics     Full-text available via subscription   (Followers: 14)
Cardiology in Review     Hybrid Journal   (Followers: 8)
Cardiology in the Young     Hybrid Journal   (Followers: 34)
Cardiology Journal     Open Access   (Followers: 6)
Cardiology Plus     Open Access   (Followers: 1)
Cardiology Research     Open Access   (Followers: 15)
Cardiology Research and Practice     Open Access   (Followers: 10)
Cardiopulmonary Physical Therapy Journal     Hybrid Journal   (Followers: 8)
Cardiorenal Medicine     Full-text available via subscription   (Followers: 1)
Cardiothoracic Surgeon     Open Access   (Followers: 1)
CardioVasc     Full-text available via subscription   (Followers: 1)
Cardiovascular & Haematological Disorders - Drug Targets     Hybrid Journal   (Followers: 1)
Cardiovascular & Hematological Agents in Medicinal Chemistry     Hybrid Journal   (Followers: 2)
CardioVascular and Interventional Radiology     Hybrid Journal   (Followers: 15)
Cardiovascular and Thoracic Open     Open Access  
Cardiovascular Diabetology     Open Access   (Followers: 10)
Cardiovascular Drugs and Therapy     Hybrid Journal   (Followers: 14)
Cardiovascular Endocrinology & Metabolism     Hybrid Journal   (Followers: 1)
Cardiovascular Engineering     Hybrid Journal   (Followers: 1)
Cardiovascular Engineering and Technology     Hybrid Journal   (Followers: 1)
Cardiovascular Intervention and Therapeutics     Hybrid Journal   (Followers: 5)
Cardiovascular Journal     Open Access   (Followers: 6)
Cardiovascular Journal of Africa     Full-text available via subscription   (Followers: 5)
Cardiovascular Journal of South Africa     Full-text available via subscription   (Followers: 1)
Cardiovascular Medicine in General Practice     Full-text available via subscription   (Followers: 7)
Cardiovascular Pathology     Hybrid Journal   (Followers: 4)
Cardiovascular Regenerative Medicine     Open Access  
Cardiovascular Research     Hybrid Journal   (Followers: 15)
Cardiovascular Revascularization Medicine     Hybrid Journal   (Followers: 1)
Cardiovascular System     Open Access  
Cardiovascular Therapeutics     Open Access   (Followers: 1)
Cardiovascular Toxicology     Hybrid Journal   (Followers: 6)
Cardiovascular Ultrasound     Open Access   (Followers: 5)
Case Reports in Cardiology     Open Access   (Followers: 7)
Catheterization and Cardiovascular Interventions     Hybrid Journal   (Followers: 3)
Cerebrovascular Diseases     Full-text available via subscription   (Followers: 3)
Cerebrovascular Diseases Extra     Open Access  
Chest     Full-text available via subscription   (Followers: 103)
Choroby Serca i Naczyń     Open Access   (Followers: 1)
Circulation     Hybrid Journal   (Followers: 266)
Circulation : Cardiovascular Imaging     Hybrid Journal   (Followers: 15)
Circulation : Cardiovascular Interventions     Hybrid Journal   (Followers: 19)
Circulation : Cardiovascular Quality and Outcomes     Hybrid Journal   (Followers: 11)
Circulation : Genomic and Precision Medicine     Hybrid Journal   (Followers: 16)
Circulation : Heart Failure     Hybrid Journal   (Followers: 26)
Circulation Research     Hybrid Journal   (Followers: 36)
Cirugía Cardiovascular     Open Access  
Clínica e Investigación en Arteriosclerosis     Full-text available via subscription  
Clínica e Investigación en arteriosclerosis (English Edition)     Hybrid Journal  
Clinical and Experimental Hypertension     Hybrid Journal   (Followers: 3)
Clinical Cardiology     Hybrid Journal   (Followers: 11)
Clinical Hypertension     Open Access   (Followers: 5)
Clinical Medicine Insights : Cardiology     Open Access   (Followers: 6)
Clinical Research in Cardiology     Hybrid Journal   (Followers: 6)
Clinical Research in Cardiology Supplements     Hybrid Journal  
Clinical Trials and Regulatory Science in Cardiology     Open Access   (Followers: 4)
Congenital Heart Disease     Hybrid Journal   (Followers: 6)
Congestive Heart Failure     Hybrid Journal   (Followers: 4)
Cor et Vasa     Full-text available via subscription   (Followers: 1)
Coronary Artery Disease     Hybrid Journal   (Followers: 2)
CorSalud     Open Access  
Critical Pathways in Cardiology     Hybrid Journal   (Followers: 4)
Current Cardiology Reports     Hybrid Journal   (Followers: 7)
Current Cardiology Reviews     Hybrid Journal   (Followers: 4)
Current Cardiovascular Imaging Reports     Hybrid Journal   (Followers: 1)
Current Cardiovascular Risk Reports     Hybrid Journal  
Current Heart Failure Reports     Hybrid Journal   (Followers: 5)
Current Hypertension Reports     Hybrid Journal   (Followers: 6)
Current Hypertension Reviews     Hybrid Journal   (Followers: 6)
Current Opinion in Cardiology     Hybrid Journal   (Followers: 14)
Current Problems in Cardiology     Hybrid Journal   (Followers: 3)
Current Research : Cardiology     Full-text available via subscription   (Followers: 1)
Current Treatment Options in Cardiovascular Medicine     Hybrid Journal   (Followers: 1)
Current Vascular Pharmacology     Hybrid Journal   (Followers: 5)
CVIR Endovascular     Open Access   (Followers: 1)
Der Kardiologe     Hybrid Journal   (Followers: 2)
Echo Research and Practice     Open Access   (Followers: 2)
Echocardiography     Hybrid Journal   (Followers: 4)
Egyptian Heart Journal     Open Access   (Followers: 2)
Egyptian Journal of Cardiothoracic Anesthesia     Open Access  
ESC Heart Failure     Open Access   (Followers: 4)
European Cardiology Review     Open Access   (Followers: 1)
European Heart Journal     Hybrid Journal   (Followers: 68)
European Heart Journal - Cardiovascular Imaging     Hybrid Journal   (Followers: 10)
European Heart Journal - Cardiovascular Pharmacotherapy     Full-text available via subscription   (Followers: 2)
European Heart Journal - Quality of Care and Clinical Outcomes     Hybrid Journal  
European Heart Journal : Acute Cardiovascular Care     Hybrid Journal   (Followers: 1)
European Heart Journal : Case Reports     Open Access   (Followers: 1)
European Heart Journal Supplements     Hybrid Journal   (Followers: 8)
European Journal of Cardio-Thoracic Surgery     Hybrid Journal   (Followers: 9)
European Journal of Cardio-Thoracic Surgery Supplements     Full-text available via subscription   (Followers: 2)
European Journal of Cardiovascular Nursing     Hybrid Journal   (Followers: 5)
European Journal of Heart Failure     Hybrid Journal   (Followers: 14)
European Journal of Preventive Cardiology.     Hybrid Journal   (Followers: 6)
European Stroke Organisation     Hybrid Journal   (Followers: 3)
Experimental & Translational Stroke Medicine     Open Access   (Followers: 9)
Expert Review of Cardiovascular Therapy     Full-text available via subscription   (Followers: 3)
Folia Cardiologica     Open Access  
Forum Zaburzeń Metabolicznych     Hybrid Journal  
Frontiers in Cardiovascular Medicine     Open Access   (Followers: 1)
Future Cardiology     Hybrid Journal   (Followers: 6)
General Thoracic and Cardiovascular Surgery     Hybrid Journal   (Followers: 3)
Global Cardiology Science and Practice     Open Access   (Followers: 5)
Global Heart     Hybrid Journal   (Followers: 3)
Heart     Hybrid Journal   (Followers: 48)
Heart and Mind     Open Access  
Heart and Vessels     Hybrid Journal  
Heart Failure Clinics     Full-text available via subscription   (Followers: 2)
Heart Failure Reviews     Hybrid Journal   (Followers: 3)
Heart India     Open Access   (Followers: 2)
Heart International     Full-text available via subscription  
Heart Rhythm     Hybrid Journal   (Followers: 11)
Heart Views     Open Access   (Followers: 2)
HeartRhythm Case Reports     Open Access  
Hellenic Journal of Cardiology     Open Access   (Followers: 1)
Herz     Hybrid Journal   (Followers: 3)
High Blood Pressure & Cardiovascular Prevention     Full-text available via subscription   (Followers: 2)
Hypertension     Full-text available via subscription   (Followers: 23)
Hypertension     Open Access   (Followers: 2)
Hypertension in Pregnancy     Hybrid Journal   (Followers: 9)
Hypertension Research     Hybrid Journal   (Followers: 4)
Ibrahim Cardiac Medical Journal     Open Access  
IJC Heart & Vessels     Open Access   (Followers: 1)
IJC Heart & Vasculature     Open Access   (Followers: 1)
IJC Metabolic & Endocrine     Open Access   (Followers: 1)
Indian Heart Journal     Open Access   (Followers: 5)
Indian Journal of Cardiovascular Disease in Women WINCARS     Open Access  
Indian Journal of Thoracic and Cardiovascular Surgery     Hybrid Journal  
Indian Pacing and Electrophysiology Journal     Open Access   (Followers: 1)
Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery     Hybrid Journal   (Followers: 1)
Insuficiencia Cardíaca     Open Access  
Interactive CardioVascular and Thoracic Surgery     Hybrid Journal   (Followers: 7)
International Cardiovascular Forum Journal     Open Access  
International Journal of Angiology     Hybrid Journal   (Followers: 2)
International Journal of Cardiology     Hybrid Journal   (Followers: 18)
International Journal of Cardiology Hypertension     Open Access   (Followers: 1)
International Journal of Cardiovascular and Cerebrovascular Disease     Open Access   (Followers: 2)
International Journal of Cardiovascular Imaging     Hybrid Journal   (Followers: 2)
International Journal of Cardiovascular Research     Hybrid Journal   (Followers: 6)
International Journal of Heart Rhythm     Open Access  
International Journal of Hypertension     Open Access   (Followers: 8)
International Journal of Hyperthermia     Open Access  
International Journal of Stroke     Hybrid Journal   (Followers: 32)
International Journal of the Cardiovascular Academy     Open Access  
Interventional Cardiology Clinics     Full-text available via subscription   (Followers: 2)
Interventional Cardiology Review     Open Access  
JACC : Basic to Translational Science     Open Access   (Followers: 5)
JACC : Cardiovascular Imaging     Hybrid Journal   (Followers: 18)
JACC : Cardiovascular Interventions     Hybrid Journal   (Followers: 19)
JACC : Heart Failure     Full-text available via subscription   (Followers: 14)
JAMA Cardiology     Hybrid Journal   (Followers: 30)

        1 2 | Last

Similar Journals
Journal Cover
Herz
Journal Prestige (SJR): 0.322
Citation Impact (citeScore): 1
Number of Followers: 3  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1615-6692 - ISSN (Online) 0340-9937
Published by Springer-Verlag Homepage  [2626 journals]
  • Werden die Karten der CT-Koronarangiographie mit der FFR CT neu
           gemischt'
    • Abstract: Zusammenfassung Die koronare Computertomographie-Angiographie (CCTA) besitzt, insbesondere aufgrund ihres hohen negativen prädiktiven Werts und der hohen Sensitivität, bereits einen hohen Stellenwert in der Primärdiagnostik der koronaren Herzkrankheit (KHK) bei allerdings limitierter Spezifität. Invasiv lässt sich die Spezifität der Herzkatheteruntersuchung (HKU) mit der „fractional flow reserve“ (FFR) mittels Nachweises der hämodynamischen Relevanz einer morphologisch nachgewiesenen Koronarstenose gut erhöhen. Neue, entweder auf „computational fluid dynamics“ (CFD) oder „machine learning“ (ML) basierende, nicht-invasive Methoden der FFR-Bestimmung in der CT (FFRCT) zeigen vielversprechende Ergebnisse. Die Möglichkeit des Einsatzes der CCTA wird aber v. a. von der Bildqualität und der Möglichkeit einer guten Segmentierung der Koronararterien bestimmt, die in 7–12 % der CCTA für die Anwendung der FFRCT nicht ausreicht, obwohl eine rein morphologische Beurteilung meist möglich ist. Beim Verschluss eines Koronargefäßes, z. B. zur Beurteilung des Kollateralflusses, kann die FFRCT ebenfalls nicht angewendet werden. Die FFRCT ist somit allein kein „game changer“ bei der Diagnose der chronischen KHK („chronic conorary syndrome“, CCS), sondern vielmehr ist es der ergänzende Einsatz zur CCTA bei nicht eindeutigen Fällen. Außerdem gibt es bisher nur einen kommerziellen Anbieter der FFRCT, bei dem die Analyse zeitlich verzögert („off-site“) erfolgt, was den akuten Nutzen bisher noch einschränkt. Es gibt allerdings auch On-site-Lösungen, die jedoch bisher nur für wissenschaftliche Zwecke und nicht klinisch eingesetzt werden dürfen. Eine sinnvolle Ergänzung zur rein morphologischen Beurteilung stellt die FFRCT aber auf jeden Fall dar. Wenn On-site-FFRCT-Lösungen auch kommerziell verfügbar sind, werden sie die Wertigkeit der CCTA im klinischen Alltag zur Primärdiagnostik des CCS in jedem Fall noch weiter erhöhen helfen.
      PubDate: 2020-06-03
       
  • After ISCHEMIA: is invasive physiology the only remaining gatekeeper for
           myocardial revascularization in chronic coronary syndromes'
    • Abstract: Abstract The International Study of Comparative Health Effectiveness With Medical And Invasive Approaches (ISCHEMIA) has the potential to be a game changer in terms of the diagnostic and management approach to patients presenting with chronic coronary syndrome, suggesting that coronary revascularization may become almost like a “bail-out” strategy in the treatment of these patients. However, invasive perfusion assessment as a means of detecting the source of myocardial ischaemia at a lesion level, such as fractional flow reserve (FFR), has been validated in the past and established beyond doubt as a key diagnostic tool. The complementary role of the two approaches will be discussed here.
      PubDate: 2020-06-03
       
  • Transcatheter therapies for severe tricuspid regurgitation.
           Quo vadis'
    • Abstract: Abstract Moderate-to-severe tricuspid regurgitation (TR) is common and is associated with a poor prognosis. To date, most patients are undertreated; therefore, transcatheter options could be clinically impactful in those who are denied surgery. Several transcatheter solutions have been developed that address the problem via leaflet enhancement, annuloplasty, or heterotopic implantation of self-expandable or balloon-expandable valves in the caval veins. A comprehensive patient evaluation, based on multimodality imaging techniques for a better understanding of the valvular pathology and TR mechanism, remains paramount for an appropriate device selection. To date, several trials have shown the feasibility and safety of a multitude of devices in this setting, but data from randomized clinical trials regarding clinical benefit based on hard endpoints are still lacking. Although the optimal patient profile and timing of intervention remain under investigation, data from available studies indicate that an earlier treatment referral, before onset of irreversible right ventricular remodeling, could be beneficial. This review discusses the present landscape and future implications of transcatheter therapies for severe TR.
      PubDate: 2020-05-28
       
  • Drug-coated balloon versus drug-eluting stent for treating de novo
           coronary lesions in large vessels: a meta-analysis of clinical trials
    • Abstract: Background Studies examining the efficiency of drug-coated balloon (DCB) compared to drug-eluting stents (DES) for de novo lesions in large vessels have reported inconsistent results. Objective This comprehensive meta-analysis of clinical trials compared the efficacy and safety of DCB and DES for the treatment of de novo coronary lesions. Methods The authors formally searched electronic databases before October 2019 to identify randomized and non-randomized clinical trials (RCTs and non-RCTs, respectively). Clinical trials were eligible for inclusion if they compared DCB with DES in patients with coronary lumen diameters >2.5 mm. Results Three RCTs and one non-RCT with a total of 321 patients were included in our meta-analysis (DCB group = 152, DES group = 169). The primary endpoint was in-segment late lumen loss (LLL) with a standardized mean difference (SMD) of −0.07 (95% confidence interval [CI]: −0.31, 0.316; P = 0.548) and the secondary endpoint was target lesion revascularization (TLR) with a risk ratio (RR) of 1.17 (95% CI: 0.46, 2.95; P = 0.746). Conclusion This meta-analysis indicated that DCB might be non-inferior to DES as evidenced by quantitative coronary angiography (QCA) assessed at 6–9 months after percutaneous coronary intervention in patients presenting with coronary artery disease.
      PubDate: 2020-05-28
       
  • Biomarkers for infarct diagnosis and rapid rule-out/rule-in of acute
           myocardial infarction
    • Abstract: Abstract The 4th edition of the Universal Definition of Myocardial Infarction (MI) recommends measurement of cardiac troponin (cTn) T or I for the diagnosis of MI due to their absolute cardiac tissue specificity. In this MI definition, values exceeding the 99th percentile of a healthy reference population distinguish between detectable troponin due to physiological cell turnover as opposed to pathological myocardial injury. In clinical routine, high-sensitivity (hs) troponin assays that allow earlier diagnosis of MI and detection of myocardial injury that would have escaped detection due to the lower sensitivity of previous assay generations are increasingly used. While the 2015 European Society of Cardiology (ESC) guidelines already recommend a re-testing of cTn after 3 h, if an hs-cTn assay is available, faster protocols that reassess hs-cTn after 60–120 min are increasingly performed, since these protocols allow faster patient disposition, increase discharge rates from the emergency department (ED), and are at least as safe as the standard protocol for the guidance of discharge after rule-out. However, decision cut-offs are lower than the 99th percentile and concentration change criteria depend on the individual hs-cTn assay and protocol used. The following article provides an overview of the recommendations of the 4th universal MI definition as well as the current 2015 ESC guidelines on cTn and other potential biomarker candidates for patients presenting with suspected acute coronary syndromes. Limitations and areas of controversy are discussed.
      PubDate: 2020-05-28
       
  • Serum osteoprotegerin level is independently related to subclinical left
           atrial mechanical function in patients with hypertension and diabetes
    • Abstract: Objectives Previous studies showed that subclinical abnormal left atrial (LA) function could be diagnosed with LA speckle tracking evaluation long before chamber enlargement. Osteoprotegerin (OPG) is a member of the tumor necrosis factor (TNF) receptor superfamily and was recently found to be an indicator for adverse cardiovascular outcomes and a risk factor for new onset atrial fibrillation. The authors hypothesized that OPG values could predict LA mechanical dysfunction and LA remodeling assessed by two-dimensional speckle tracking echocardiography (2D-STE) in patients with hypertension (HT) and diabetes mellitus (DM). Methods A single center study was conducted including consecutive patients presenting to the authors’ outpatient clinic. Enrolled patients needed to have been treated for HT and DM for at least 1 year. Results The study included 80 patients (mean age, 57.5 ± 8.3 years). Patients in the impaired LA strain group were older (p = 0.035), had lower low density lipoprotein (LDL) cholesterol (mg/dl) (p = 0.021), and higher OPG (pmol/l) (p = 0.004) values than patients in the normal LA strain group. Univariate logistic regression analysis demonstrated that age (p = 0.039), LDL cholesterol (mg/dl) (p = 0.025), and OPG (pmol/l) (p = 0.008) values were associated with impaired LA strain. Backward multivariate logistic regression analysis showed that LDL cholesterol (mg/dl) (OR: 0.982, CI 95% 0.964–0.999, p = 0.049) and OPG (pmol/l) (OR: 1.438, CI 95% 1.043–1.983, p = 0.027) were independently associated with impaired LA strain. Conclusion In hypertensive and diabetic patients, higher OPG values were associated with impaired LA function assessed by 2D-STE. In this high-risk patient group, serum OPG can be used as a risk predictor for LA mechanical dysfunction.
      PubDate: 2020-05-27
       
  • Prognostic value of fragmented QRS complex in patients with acute
           myocardial infarction
    • Abstract: Background Several factors and risk stratification tools have been studied to determine the prognosis of acute coronary syndrome. Fragmented QRS (fQRS) is a marker of myocardial scar and its prognostic role has recently been demonstrated. The present study aimed to investigate the association between the presence of fQRS in electrocardiogram and the prognosis of ST-segment elevation and non-ST-segment elevation myocardial infarction (STEMI and NSTEMI). Methods A total of 661 patients with myocardial infarction (MI) were enrolled in a retrospective study. Based on the presence of fQRS in admission electrocardiogram, patients were divided into two groups. All patients were followed up for 6 months, and all major adverse cardiovascular events (MACE) were recorded. Results The mean age of patients was 61.3 ± 1.2 years, and 71.7% were male. In the acute phase, the detection rates of regional wall motion abnormality and aortic valve insufficiency were higher in positive fQRS compared to negative fQRS group (p = 0.003). The incidence of total MACE was significantly higher in the positive fQRS compared to the negative fQRS group among all patients and in both STEMI and NSTEMI subgroups (p < 0.001). Based on multivariate analysis, the presence of fQRS and hypertension were the strongest predictors of total MACE at 6‑month follow-up (odds ratio [OR] = 5.929; 95% confidence interval [CI] = 3.620–9.709; p < 0.001 and OR = 2.220; 95% CI = 1.390–3.547; p < 0.001, respectively). Conclusion Regardless of the type of MI, it was found that the presence of fQRS on admission electrocardiogram can be implemented in risk stratification tools in patients with acute MI.
      PubDate: 2020-05-26
       
  • After ISCHEMIA: Is cardiac MRI a reliable gatekeeper for invasive
           angiography and myocardial revascularization'
    • Abstract: Abstract This review surveys the findings of the International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) trial and puts them into a clinical perspective regarding its effect of the role of cardiac magnetic resonance imaging (CMR) as a well-validated gatekeeper for invasive angiography and myocardial revascularization. Noninvasive stress testing of patients with intermediate-to-high pretest likelihood for obstructive coronary artery disease (CAD) using perfusion CMR provides excellent diagnostic accuracy in detecting ischemic myocardium, and additional information from tissue characterization can guide the management of patients with stable angina toward a more individualized therapy as other non-coronary underlying causes of chest pain can be detected. Since ISCHEMIA failed to show that an invasive strategy using percutaneous coronary intervention or coronary artery bypass grafting was associated with an improved prognosis compared with initial conservative medical therapy among stable patients with moderate-to-severe ischemia, CMR as a multifaceted diagnostic imaging approach to explain patients’ symptoms should be preferred over anatomical and stress testing alone. Nevertheless, the exclusion of left main coronary artery stenosis either by coronary CT or MR angiography may be required. In conclusion, the results of the ISCHEMIA trial are in good accordance with those of the MR-INFORM trial recently published in the New England Journal of Medicine, as the noninvasive management of a large proportion of patients with CAD was shown to be noninferior to current invasive strategies. Recent outcome data from trials may therefore have an impact on future guidelines to further reduce the execution of unnecessary left heart catheterizations.
      PubDate: 2020-05-26
       
  • Left ventricular systolic dysfunction in patients with unprotected left
           main coronary artery disease
    • Abstract: Background The optimal coronary revascularization strategy for patients with unprotected left main coronary artery (ULMCA) disease and left ventricular systolic dysfunction (LVSD) remains uncertain. The purpose of this study was to evaluate the clinical outcomes after percutaneous coronary intervention (PCI) with a drug-eluting stent (DES) versus coronary artery bypass grafting (CABG) in patients with ULMCA disease with or without LVSD. Methods A total of 984 patients with ULMCA disease who received a DES (n = 511) or underwent CABG (n = 473) were included in this study. We retrospectively analyzed the clinical parameters and outcomes of ULMCA disease patients with different left ventricular ejection fraction levels. Results There were no significant differences in major adverse cardiac and cerebral events, all-cause death, cardiac death, myocardial infarction, or stroke between the CABG and DES groups with or without LVSD. The rate of target vessel revascularization was significantly higher with DES compared with CABG in patients without LVSD; however, the difference was not significant between the mild LVSD and severe LVSD groups. Conclusion For patients with ULMCA disease and LVSD, there was no significant difference between DES and CABG in terms of efficacy and safety. Treatment with DES was an acceptable alternative to CABG.
      PubDate: 2020-05-20
       
  • Effect of Ginkgo biloba extract on pacemaker channels encoded
           by  HCN gene
    • Abstract: Background In the present study, the electropharmacological activity of traditional Chinese medicine, Ginkgo biloba extract (GBE), on human hyperpolarization-activated nucleotide-gated (HCN) channels and the underlying “funny” currents was investigated. Methods Standard two-electrode voltage-clamp recordings were employed to examine the properties of cloned HCN subunit currents expressed in Xenopus oocytes under controlled conditions and GBE administration. Results We found that GBE irreversibly inhibited the HCN2 and HCN4 channel currents in a concentration-dependent fashion and that the HCN4 current was more sensitive to GBE compared with HCN2. In addition, GBE inhibition of the current amplitudes of HCN2 and HCN4 currents was accompanied by a decrease in the activation and deactivation kinetics. Conclusion The results of this study contribute toward illustrating the antiarrhythmic mechanism of GBE, which might be useful for the treatment of arrhythmia.
      PubDate: 2020-05-20
       
  • Multivessel vs. culprit-lesion only percutaneous coronary intervention in
           ST-elevation myocardial infarction
    • Abstract: Abstract The optimal treatment of non-infarct-related coronary arteries in patients presenting with ST-elevation myocardial infarction (STEMI) has been a subject of debate for many years. Earlier medium-sized randomized controlled trials reported a benefit of multivessel percutaneous coronary intervention (PCI) primarily due to a reduction of subsequent revascularizations. Recently, the well-powered COMPLETE trial showed a reduction in the composite endpoint of cardiovascular mortality and myocardial reinfarction through complete revascularization. The present review summarizes the current evidence regarding revascularization strategies in STEMI patients.
      PubDate: 2020-05-19
       
  • ESC 2019 guidelines for the diagnosis and management of chronic coronary
           syndromes
    • Abstract: Abstract The European Society of Cardiology (ESC) has recently published new guidelines on the diagnosis and management of chronic coronary syndromes (CCS). Due to variable symptoms, objective tests are often necessary to confirm the diagnosis, exclude alternative diagnoses, and assess the severity of underlying disease. This review provides a summary of the main diagnostic strategies listed in the guidelines for evaluation of patients suspected of having obstructive coronary artery disease (CAD). Based on data from contemporary cohorts of patients referred for diagnostic testing, the pre-test probabilities of obstructive CAD based on age, sex, and symptoms have been adjusted substantially downward compared with the previous guidelines. Further, a new concept of “clinical likelihood of CAD” was introduced accounting for the impact of various risk factors and modifiers on the pre-test probability. Noninvasive functional imaging for myocardial ischemia, coronary computed tomography angiography, or invasive coronary angiography combined with functional evaluation is recommended as the initial strategy to diagnose CAD in symptomatic patients, unless obstructive CAD can be excluded by clinical assessment alone. When available, imaging tests are recommended as noninvasive modalities instead of exercise electrocardiograms.
      PubDate: 2020-05-19
       
  • Vorhofohrverschluss zur Schlaganfallprävention bei Vorhofflimmern
    • Abstract: Zusammenfassung Ohne Therapie beträgt das jährliche ischämische Schlaganfallrisiko bei Patienten mit Vorhofflimmern (VHF) in Abhängigkeit vom kardiovaskulären Risikoprofil im Mittel 5–6 %. Daher wird bei VHF und erhöhtem Schlaganfallrisiko (CHA2DS2-VASc-Score ≥1) die Antikoagulation mit Nicht-Vitamin-K‑abhängigen oralen Antikoagulanzien (NOAK) oder Vitamin-K-Antagonisten (VKA) empfohlen. Schwere Blutungsereignisse sind mögliche Gründe für einen Abbruch dieser Medikation. Insgesamt verbleiben bis zu 30 % der Patienten mit VHF ohne effektive Thromboembolieprophylaxe. Der Verschluss des linken Vorhofohrs bietet eine Alternative zur medikamentösen Schlaganfallprävention. Zur Verfügung stehen katheterbasierte und chirurgische Techniken. Beim katheterbasierten Verfahren mittels Verschlusssystemen wurden hohe Implantationserfolgs- und relativ niedrige periprozedurale Ereignisraten in aktuellen Registerstudien beobachtet. Hintergrund für die zurückhaltende Empfehlung in den europäischen Leitlinien sind die bisher begrenzten Erfahrungen aus größeren randomisierten Studien.
      PubDate: 2020-05-15
       
  • Poor recovery of cardiac function in myocardial infarction patients with
           metabolic syndrome and microalbuminuria
    • Abstract: Background This study aimed to investigate the impact of metabolic syndrome (MetS) with microalbuminuria on the improvement of cardiac function after acute myocardial infarction (AMI). Methods Nondiabetic patients with acute ST segment elevation MI (STEMI) who underwent coronary revascularization from 2013 to 2017 were included. They were grouped according to history of MetS and microalbuminuria test results as follows: microalbuminuria/MetS group, normoalbuminuria/MetS group, microalbuminuria/no MetS group, and normoalbuminuria/no MetS group. Left ventricular ejection fraction (LVEF) and serum N-terminal pro-brain natriuretic peptide (NT-proBNP) levels at the 6‑month follow-up were measured and the predictive value of MetS with microalbuminuria on recovery of cardiac function was assessed by multivariable logistic regression modeling. Results A total of 530 STEMI patients were included (average age = 66.6 years). Analysis of covariance showed that LVEF recovery in the normoalbuminuria/no MetS group was better than that of the normoalbuminuria/MetS, microalbuminuria/no MetS, and microalbuminuria/MetS groups (49.22% vs. 48.92% vs. 47.48% vs. 46.99%, respectively, p < 0.001) when acute phase LVEF was the covariable. The NT-proBNP level of the normoalbuminuria/no MetS group at the 6‑month follow-up was lower than that of the microalbuminuria/MetS group (p < 0.001). Further regression analysis revealed that there was a lower probability of complete cardiac function recovery after 6 months in patients with microalbuminuria (odds ratio: 0.455) than in patients without microalbuminuria (95% CI: 0.316–0.655, p < 0.001). Conclusion Although post-AMI cardiac function in MetS patients with microalbuminuria can be improved after revascularization, the improvement is not as good as that of patients without microalbuminuria, suggesting that clinical attention should be paid to this subgroup.
      PubDate: 2020-05-11
       
  • Surgical vs. drug therapy in patients with patent foramen ovale and
           cryptogenic stroke
    • Abstract: Objective This study aimed to investigate the effectiveness of risk scoring for predicting stroke recurrence after percutaneous patent foramen ovale (PFO) closure or medication therapy in patients with PFO and a history of cryptogenic stroke. Methods This study included 559 patients with PFO and cryptogenic stroke who were treated in our hospital from January 2013 to January 2018 and were followed up for 15–72 months. After calculating the risk scores for stroke recurrence, we randomly divided the patients into two groups (ratio, 1:1): Patients in one group underwent PFO closure and those in the other received drug therapy. Results Patients in the PFO closure group had a lower risk of recurrent stroke than those in the drug therapy group (1.1% vs. 4.2%). Moreover, serious bleeding was less frequent in the PFO closure group than in the drug therapy group (0% vs. 3.2%), although the incidence of atrial fibrillation or flutter did not significantly differ between the groups (p = 0.67). Interestingly, a subgroup analysis revealed no inter-treatment group difference in the rate of cryptogenic stroke recurrence among patients with risk scores of 0–1. By contrast, PFO closure yielded superior outcomes among patients with risk scores of ≥2. Conclusion Compared with drug therapy, PFO closure reduced the risk of recurrent stroke among patients with a risk score of ≥2 and reduced the incidence of serious bleeding without increasing the risk of new-onset atrial fibrillation or atrial flutter.
      PubDate: 2020-05-11
       
  • Sex differences in cardiovascular risk factors for myocardial infarction
    • Abstract: Background Cardiovascular disease is a leading cause of mortality worldwide. This study investigated the effects of sex on traditional cardiovascular risk factors for remote myocardial infarction in a community. Methods A cross-sectional study was performed comprising 20,899 participants who underwent physical examination from 2013 to 2015, including systemic blood pressure and 12-lead electrocardiogram monitoring. Fasting blood samples were collected for blood cell counts and biochemistry tests. Remote myocardial infarction was diagnosed on the basis of electrocardiogram findings. Results A total of 71 male and 21 female patients aged over 50 years were identified with remote myocardial infarction. In the female cohort, low-density lipoprotein (LDL), total cholesterol (TC), as well as high-density lipoprotein (HDL) were negatively correlated with myocardial infarction after adjusting for age. In the male cohort, after adjusting for age, serum levels of glycated hemoglobin (HbA1c) and fasting glucose were positively correlated with myocardial infarction, but the lipid profile, including low-density lipoprotein (LDL), total cholesterol (TC), and high-density lipoprotein (HDL), was negatively correlated with remote myocardial infarction. Conclusion In the male population, dyslipidemia and abnormal glucose metabolism play a role in myocardial infarction. In the female population, dyslipidemia is independent of glucose metabolism. This study highlights sex differences in the regulation of lipids and glucose metabolism in patients with remote myocardial infarction.
      PubDate: 2020-05-06
       
  • Epicardial adipose tissue: good or bad for cardiac function'
    • PubDate: 2020-05-01
       
  • SARS-CoV-2: a potential novel etiology of fulminant myocarditis
    • PubDate: 2020-05-01
       
  • Cardiomyopathies—past, present, future
    • PubDate: 2020-05-01
       
  • Erratum zu: Sinnvolle Diagnostik: Bildgebung
    • Abstract: In der Legende der Abb. 1 „Sinnvolle Diagnostik: Bildgebung“ (https://doi.org/10.1007/s00059-019-04873-3) wurde der Endpunkt des 10-Jahres-Risikos des schematisch dargestellten ESC(European Society of Cardiology)-Heart-Scores nicht korrekt benannt. Anstatt nur auf den „fatalen Myokardinfarkt (MI)“
      PubDate: 2020-04-09
       
 
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