Subjects -> MEDICAL SCIENCES (Total: 8679 journals)
    - ANAESTHESIOLOGY (120 journals)
    - CARDIOVASCULAR DISEASES (338 journals)
    - DENTISTRY (294 journals)
    - ENDOCRINOLOGY (151 journals)
    - FORENSIC SCIENCES (42 journals)
    - HEMATOLOGY (157 journals)
    - HYPNOSIS (4 journals)
    - INTERNAL MEDICINE (177 journals)
    - MEDICAL GENETICS (58 journals)
    - MEDICAL SCIENCES (2410 journals)
    - NURSES AND NURSING (369 journals)
    - OBSTETRICS AND GYNECOLOGY (207 journals)
    - ONCOLOGY (386 journals)
    - OTORHINOLARYNGOLOGY (83 journals)
    - PATHOLOGY (100 journals)
    - PEDIATRICS (275 journals)
    - PSYCHIATRY AND NEUROLOGY (833 journals)
    - RESPIRATORY DISEASES (105 journals)
    - RHEUMATOLOGY (79 journals)
    - SPORTS MEDICINE (81 journals)
    - SURGERY (406 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: 18)
American Journal of Hypertension     Hybrid Journal   (Followers: 29)
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: 6)
Archives of Cardiovascular Diseases Supplements     Full-text available via subscription   (Followers: 4)
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: 33)
Artery Research     Hybrid Journal   (Followers: 5)
ARYA Atherosclerosis     Open Access  
ASAIO Journal     Hybrid Journal   (Followers: 4)
ASEAN Heart Journal     Open Access   (Followers: 3)
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: 9)
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: 2)
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: 11)
Cardiology Clinics     Full-text available via subscription   (Followers: 14)
Cardiology in Review     Hybrid Journal   (Followers: 9)
Cardiology in the Young     Hybrid Journal   (Followers: 35)
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: 11)
Cardiopulmonary Physical Therapy Journal     Hybrid Journal   (Followers: 9)
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: 2)
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: 16)
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: 104)
Choroby Serca i Naczyń     Open Access   (Followers: 1)
Circulation     Hybrid Journal   (Followers: 270)
Circulation : Cardiovascular Imaging     Hybrid Journal   (Followers: 15)
Circulation : Cardiovascular Interventions     Hybrid Journal   (Followers: 19)
Circulation : Cardiovascular Quality and Outcomes     Hybrid Journal   (Followers: 12)
Circulation : Genomic and Precision Medicine     Hybrid Journal   (Followers: 17)
Circulation : Heart Failure     Hybrid Journal   (Followers: 28)
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: 10)
Clinical Hypertension     Open Access   (Followers: 5)
Clinical Medicine Insights : Cardiology     Open Access   (Followers: 6)
Clinical Research in Cardiology     Hybrid Journal   (Followers: 5)
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: 3)
CorSalud     Open Access  
Critical Pathways in Cardiology     Hybrid Journal   (Followers: 5)
Current Cardiology Reports     Hybrid Journal   (Followers: 6)
Current Cardiology Reviews     Hybrid Journal   (Followers: 3)
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: 13)
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: 1)
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: 7)
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: 13)
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: 5)
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: 49)
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: 2)
High Blood Pressure & Cardiovascular Prevention     Full-text available via subscription   (Followers: 2)
Hypertension     Full-text available via subscription   (Followers: 24)
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: 6)
International Cardiovascular Forum Journal     Open Access  
International Journal of Angiology     Hybrid Journal   (Followers: 2)
International Journal of Cardiology     Hybrid Journal   (Followers: 17)
International Journal of Cardiology Hypertension     Open Access   (Followers: 1)
International Journal of Cardiovascular and Cerebrovascular Disease     Open Access   (Followers: 3)
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: 33)
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: 6)
JACC : Cardiovascular Imaging     Hybrid Journal   (Followers: 19)
JACC : Cardiovascular Interventions     Hybrid Journal   (Followers: 21)
JACC : Heart Failure     Full-text available via subscription   (Followers: 16)
JAMA Cardiology     Hybrid Journal   (Followers: 32)

        1 2 | Last

Similar Journals
Journal Cover
IJC Heart & Vessels
Number of Followers: 1  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2214-7632
Published by Elsevier Homepage  [3200 journals]
  • Study of vitamin D deficiency prevalence in acute myocardial infarction

    • Authors: Satish Karur; Virupakshappa Veerappa; Manjunath C. Nanjappa
      Pages: 57 - 59
      Abstract: Publication date: June 2014
      Source:IJC Heart & Vessels, Volume 3
      Author(s): Satish Karur, Virupakshappa Veerappa, Manjunath C. Nanjappa
      Background Deficiency of 25-hydroxy vitamin D [25(OH)D] is a treatable condition that has been associated with coronary artery disease and many of its risk factors. A practical time to assess for 25(OH)D deficiency, and to initiate treatment, is at the time of an acute myocardial infarction(AMI). The prevalence of 25(OH)D deficiency and the characteristics associated with it in patients with acute myocardial infarction are unknown. Methods In this study 25(OH)D was assessed in 314 subjects enrolled in a Sri Jayadeva Institute of Cardiovascular Science and Research(SJICS&R). Patients enrolled from December 1, 2011 to February 28, 2012 had serum samples sent to a centralized laboratory for analysis using the ELECYS assay. Normal 25(OH)D levels are ≥30ng/ml, and patients with levels <30 and >20ng/ml were classified as insufficient and those with levels ≤20ng/ml as deficient. Vitamin D and other baseline characteristics were analyzed with T-test and chi-squared test. Results Of the 314 enrolled patents, 212 (67.5%) were 25(OH)D deficient and 50(16%) were insufficient, for a total of 83.5% of patients with abnormally low 25(OH)D levels. No significant heterogeneity was observed among age or gender sub groups but 25(OH)D deficiency was more commonly seen in those with lower socioeconomic status, lower activity levels, diabetes, hypercholesterolemia(LDL), hypertriglyceridemia and in smokers. Conclusion Vitamin D deficiency is present in most of the patients with acute myocardial infarction and it is associated with many of its risk factors in our study.

      PubDate: 2015-12-03T10:18:35Z
      DOI: 10.1016/j.ijchv.2014.03.004
      Issue No: Vol. 3 (2015)
  • Sonothrombolysis in acute stroke and myocardial infarction: A systematic

    • Authors: Sebastiaan T. Roos; Lynda J.M. Juffermans; Jeroen Slikkerveer; Evan C. Unger; Thomas R. Porter; Otto Kamp
      Pages: 1 - 6
      Abstract: Publication date: Available online 19 August 2014
      Source:IJC Heart & Vessels
      Author(s): Sebastiaan T. Roos , Lynda J.M. Juffermans , Jeroen Slikkerveer , Evan C. Unger , Thomas R. Porter , Otto Kamp
      Introduction Current treatment of patients with an acute occlusion of a cranial or a coronary artery, in for example ST segment elevation myocardial infarction (STEMI), consists of either thrombolysis or percutaneous intervention. Various thrombolytic agents (tissue plasminogen activators) are used for reperfusion therapy in patients with STEMI. However, their use may be associated with an increased risk of bleeding which is inherent to their action mechanism. Therefore, new methods of coronary clot resolution are being studied in an attempt to potentiate the efficacy and reduce the side effects of thrombolytics. A new method is ultrasound mediated thrombus dissolution, or sonothrombolysis. The current literature exploring sonothrombolysis is diverse in size and quality. In this systematic review of the current literature, we describe cardiovascular applications of sonothrombolysis in patients. A comparison to the neurovascular application in ischemic stroke is made, as more research has been performed on patients suffering from stroke. Methods A systematic search was performed following the PRISMA guidelines using EMBASE and MEDLINE databases regarding sonothrombolysis in human ischemic stroke and acute myocardial infarction patients. Results 12 original case–control or randomized controlled trials using a combination of ultrasound and microbubbles were found. 6 trials studied ischemic stroke, and 6 trials studied acute myocardial infarction. Conclusion This systematic review provides up to date information on the subject of sonothrombolysis.
      Graphical abstract image

      PubDate: 2014-09-01T05:14:35Z
      DOI: 10.1016/j.ijchv.2014.08.003
      Issue No: Vol. 4 (2014)
  • Surgical Ablation of Atrial Fibrillation

    • Authors: Yufeng Zhang; Li Zhu
      Pages: 7 - 11
      Abstract: Publication date: Available online 5 July 2014
      Source:IJC Heart & Vessels
      Author(s): Yufeng Zhang , Li Zhu
      Surgical ablation of atrial fibrillation (AF) is currently performed in many major hospitals throughout the world. This paper reviews the development of surgical procedures for AF ablation. It is hoped that the paper can provide a foundation for those involved with ablation of AF to improve patient care. AF was triggered by a rapidly firing focus and could be treated with a localized ablation procedure. A large body of literature has confirmed the safety and efficacy of surgical ablation of AF. New ablation technologies have simplified the surgical treatment of AF and expanded the indications. Generally, more extensive lesion sets have had better long-term outcomes. Despite the tremendous progress that has been made in the development of surgical ablation of AF, many questions remain unanswered. It is anticipated that well designed clinical trials will continue to provide solid evidence to help formulate practice guidelines in the future.

      PubDate: 2014-07-26T17:41:49Z
      DOI: 10.1016/j.ijchv.2014.06.005
      Issue No: Vol. 4 (2014)
  • Review of biomechanical studies of arteries and their effect on stent

    • Authors: Aleksandra Fortier; Vikranth Gullapalli; Reza A. Mirshams
      Pages: 12 - 18
      Abstract: Publication date: September 2014
      Source:IJC Heart & Vessels, Volume 4
      Author(s): Aleksandra Fortier , Vikranth Gullapalli , Reza A. Mirshams
      Factors such as aging, atherosclerosis, hypertension, genetic defects and diabetes mellitus have been known to cause arteries to develop various shapes and characteristics in patients such as tortuosity, kinking, twisting, elongation, contraction, and curving. The change in artery mechanics can cause a variety of cardiovascular diseases among men and women. The improvement in technology and techniques has allowed access to different therapies such as balloon angioplasty or stenting. Stents are permanent implants that undergo repetitive deformations as a result of patient daily activities such as walking, flexing, sitting, climbing stairs, and getting into a car. Often, these deformations imposed on the stents result in stent failures. It is imperative that the biomechanics environment of the arteries causing stent failure is well understood and the stents be evaluated under multiple loading modes for increased life-cycle. As a result, this paper aims to summarize part of the available literature that reports studies on biomechanical environment in healthy and diseased arteries using various analytical methods.

      PubDate: 2014-11-13T01:30:47Z
      DOI: 10.1016/j.ijchv.2014.04.007
      Issue No: Vol. 4 (2014)
  • The Impact of Moderate Intensity Physical Activity on Cardiac Structure
           and Performance in Older Sedentary Adults

    • Authors: Tisha B. Suboc; Scott J. Strath; Kodlipet Dharmashankar; Leanne Harmann; Allison Couillard; Mobin Malik; Kristoph Haak; Daniel Knabel; Michael E. Widlansky
      Pages: 19 - 24
      Abstract: Publication date: Available online 16 August 2014
      Source:IJC Heart & Vessels
      Author(s): Tisha B. Suboc , Scott J. Strath , Kodlipet Dharmashankar , Leanne Harmann , Allison Couillard , Mobin Malik , Kristoph Haak , Daniel Knabel , Michael E. Widlansky
      Background Sedentary aging leads to adverse changes in vascular function and cardiac performance. We published improvements in vascular function with moderate intensity physical activity (PA) in continuous bouts. Whether moderate intensity PA also impacts cardiac structure and cardiovascular performance of the aging left ventricle (LV) is unknown. Methods We recruited and analyzed results from 102 sedentary older adults ages≥50 from a randomized controlled trial with 3 study groups: control (group 1), a pedometer-only intervention (group 2), or a pedometer with an interactive website employing strategies to increase habitual physical activity (PA, group 3) for 12weeks. Transthoracic echocardiograms were performed prior to and following the 12week intervention period to assess cardiac morphology, left ventricular (LV) systolic performance, LV diastolic function, arterial and LV ventricular elastance. Step count and PA intensity/distribution were measured by pedometer and accelerometer. Results We found no significant changes in cardiac morphology. Further, we found no improvement in the aforementioned cardiac functional parameters. Comparing those who achieved the following benchmarks to those who did not showed no significant changes in cardiac structure or performance: 1)10,000 steps/day, 2)≥30minutes/day of moderate intensity physical activity, or 3) moderate intensity PA in bouts≥10minutes for≥20minutes/day Conclusions In sedentary older adults, increasing moderate intensity PA to currently recommend levels does not result in favorable changes in LV morphology or performance over 12weeks. More prolonged exposure, higher PA intensity, or earlier initiation of PA may be necessary to see benefits.

      PubDate: 2014-09-01T05:14:35Z
      DOI: 10.1016/j.ijchv.2014.08.007
      Issue No: Vol. 4 (2014)
  • Automated Template Matching Correlates with Earliest Activation During
           Mapping of Idiopathic Premature Ventricular Contractions

    • Authors: Jakob Lüker; Arian Sultan; Helge Servatius; Imke Berner; Boris Alexander Hoffmann; Stephan Willems; Daniel Steven
      Pages: 25 - 29
      Abstract: Publication date: Available online 16 August 2014
      Source:IJC Heart & Vessels
      Author(s): Jakob Lüker , Arian Sultan , Helge Servatius , Imke Berner , Boris Alexander Hoffmann , Stephan Willems , Daniel Steven
      Background Ablation of premature ventricular contractions (PVC) can be challenging due to infrequent spontaneous ectopy and the limitations subjective pacemapping (PM). Activation mapping (AM) provides an objective parameter, but relies on spontaneous ectopic activity. Objectives The objective of the study was to evaluate the correlation of automated template matching (TM) with activation timing and to investigate potential implications towards ablation success. Methods Forty Patients undergoing catheter ablation of idiopathic outflow tract VT or PVC in 47 procedures were included. PVC/VT origin was determined by PM and AM. A percentage value for PM was calculated using TM software and correlated with corresponding activation timing. Overall, 126 TM and corresponding AM values were analysed. All patients were followed (313±158days after ablation) including a 24-hour Holter ECG. Results A correlation between TM and activation timing (r=0.66, p<0.0001) could be shown. Success rate at follow up was 77%. No statistically significant coherence of TM percentage and relapse was observed. Conclusions Template matching correlates with activation timing in the process of mapping idiopathic focal PVC/VT. TM helps to objectify the process of PM and may therefore be helpful to guide successful ablation in the absence of spontaneous ectopy.

      PubDate: 2014-09-01T05:14:35Z
      DOI: 10.1016/j.ijchv.2014.08.006
      Issue No: Vol. 4 (2014)
  • Predictive value of neutrophil to lymphocyte ratio for presence of
           coronary artery ectasia in patients with aortic aneurysms

    • Authors: Hiroki Ikenaga; Satoshi Kurisu; Noriaki Watanabe; Takashi Shimonaga; Tadanao Higaki; Toshitaka Iwasaki; Hiroto Utsunomiya; Naoya Mitsuba; Ken Ishibashi; Yoshihiro Dohi; Yukihiro Fukuda; Katsuhiko Imai; Taijiro Sueda; Yasuki Kihara
      Pages: 30 - 34
      Abstract: Publication date: Available online 15 August 2014
      Source:IJC Heart & Vessels
      Author(s): Hiroki Ikenaga , Satoshi Kurisu , Noriaki Watanabe , Takashi Shimonaga , Tadanao Higaki , Toshitaka Iwasaki , Hiroto Utsunomiya , Naoya Mitsuba , Ken Ishibashi , Yoshihiro Dohi , Yukihiro Fukuda , Katsuhiko Imai , Taijiro Sueda , Yasuki Kihara
      Background : Both aortic aneurysms and coronary artery ectasia (CAE) frequently coexist and are associated with more pronounced inflammation. Neutrophil to lymphocyte ratio (NL ratio) is widely used as a marker of inflammation. However, relation between CAE and NL ratio in patients with aortic aneurysms is not fully understood. This study was undertaken to assess relation between CAE and NL ratio in patients with aortic aneurysms. Methods : This study consisted of 93 consecutive patients with aortic aneurysms (AA group) and 79 patients without aortic aneurysms who had angiographically normal coronary arteries as the control group. Moreover, patients with aortic aneurysms were classified into two groups based on presence of CAE; CAE (+) group (n=44) and CAE (−) group (n=49). We compared blood chemical parameters in the both groups. Results : In the AA group, 44 patients (47.3%) had CAE. The AA group had a significantly higher NL ratio than the control group (2.93±1.43 vs. 2.45±1.05, p=0.027). Furthermore, the CAE (+) group had a significantly higher NL ratio than the CAE (−) group (3.39±1.67 vs. 2.52±1.04, p<0.01). Multivariate logistic regression analysis revealed that high NL ratio was an independent predictor for CAE in patients with aortic aneurysms (odds ratio 1.76, 95% confidence interval 1.24–2.69, p=0.001). Conclusions : Patients with aortic aneurysms had significantly higher NL ratio than those without aortic aneurysms. Furthermore, NL ratio might predict presence of CAE in patients with aortic aneurysms.

      PubDate: 2014-09-01T05:14:35Z
      DOI: 10.1016/j.ijchv.2014.08.002
      Issue No: Vol. 4 (2014)
  • Trends in percutaneous coronary intervention and angiography in Ireland,
           2004–2011: Implications for Ireland and Europe

    • Authors: S. Jennings; K. Bennett; E. Shelley; P. Kearney; K. Daly; W. Fennell
      Pages: 35 - 39
      Abstract: Publication date: Available online 12 August 2014
      Source:IJC Heart & Vessels
      Author(s): S. Jennings , K. Bennett , E. Shelley , P. Kearney , K. Daly , W. Fennell
      Background/Objectives To study temporal trends in crude and age standardised rates of cardiac catheterisation and percutaneous coronary intervention (PCI) in Ireland, 2004 – 2011. Methods Two data sources were used: a) a survey of publicly and privately funded hospitals with cardiac catheter laboratories to obtain the annual number of procedures performed, b) anonymised data from the Hospital In-Patient Enquiry (HIPE) for angiography and PCI in acute publicly funded hospitals; age standardised rates were calculated to study trends over time. Results From 2004 to 2011 the crude rate of angiography and PCI increased by 47.8% and 35.9% respectively, with rates of 6,689 and 1,825 per million population in 2011. Following age standardisation, however, PCI activity showed a non-significant decrease over time. The PCI to angiography ratio decreased from 30% to 27% and PCI was performed predominantly for stable coronary heart disease (54%) in 2011. Conclusion Angiography and PCI rates have increased in Ireland but PCI crude and age adjusted rates show divergent trends. While Ireland differs from USA and UK, with a higher proportion of PCI being performed for stable CHD in recent years, little systematic surveillance of cardiological interventions within Europe is available to benchmark improvements in Ireland.

      PubDate: 2014-08-15T04:35:16Z
      DOI: 10.1016/j.ijchv.2014.08.001
      Issue No: Vol. 4 (2014)
  • Systemic perfusion at peak incremental exercise in left ventricular assist
           device recipients: Partitioning pump and native left ventricle relative

    • Authors: Alessandro Mezzani; Massimo Pistono; Ugo Corrà; Andrea Giordano; Marco Gnemmi; Alessandro Imparato; Paolo Centofanti; Mauro Rinaldi; Silvia Colombo; Elena Canal; Pantaleo Giannuzzi
      Pages: 40 - 45
      Abstract: Publication date: Available online 8 August 2014
      Source:IJC Heart & Vessels
      Author(s): Alessandro Mezzani , Massimo Pistono , Ugo Corrà , Andrea Giordano , Marco Gnemmi , Alessandro Imparato , Paolo Centofanti , Mauro Rinaldi , Silvia Colombo , Elena Canal , Pantaleo Giannuzzi
      Background In continuous-flow left ventricular assist device (LVAD) recipients, little is known about the relative pump- and left ventricle-generated blood flow (PBF and LVBF, respectively) contribution to peak systemic perfusion during incremental exercise and about how PBF/LVBF interplay and exercise capacity may be affected by pump speed increase. Methods Twenty-two LVAD recipients underwent ramp cardiopulmonary exercise tests at fixed and increasing pump speed (+1.5% of baseline speed/10W workload increase), echocardiography and NT-proBNP dosage. Peak systemic perfusion was peak VO2/estimated peak arterio-venous O2 difference, and LVBF was systemic perfusion minus PBF provided by LVAD controller. A change of peak percentage of predicted VO2max (Δpeak%VO2) ≥3 in increasing- vs. fixed-speed test was considered significant. Results Tricuspid annular plane systolic excursion (TAPSE) and NT-proBNP were significantly lower and higher, respectively, in Δpeak%VO2 <3 than ≥3. A LVBF contribution to systemic perfusion significantly larger than that of PBF was observed in Δpeak%VO2 ≥3 vs. <3 in fixed-speed test, which was further amplified in increasing-speed test (2.4±1.7l/min vs. 2.0±1.5l/min and 0.8±2.2l/min vs. 1.3±2.3l/min, respectively, p for trend <0.0005). Among several clinical-instrumental parameters, logistic regression selected only TAPSE >13mm as a predictor of Δpeak%VO2 ≥3. Conclusions A significant LVBF contribution to peak systemic perfusion and pump speed increase-induced peak VO2 improvement was detectable only in patients with a more preserved right ventricular systolic function and stable hemodynamic picture. These findings should be taken into consideration when designing LVADs controllers aiming to increase pump speed according to increasing exercise demands.

      PubDate: 2014-08-10T19:32:00Z
      DOI: 10.1016/j.ijchv.2014.07.004
      Issue No: Vol. 4 (2014)
  • Extreme interatrial conduction delay and regularization of atrial
           arrhythmias in a subgroup of patients with hypertrophic cardiomyopathy

    • Authors: Tamas Szili-Torok; Ferdi Akca; Kadir Caliskan; Folkert Ten Cate; Dominic Theuns; Michelle Michels
      Pages: 46 - 52
      Abstract: Publication date: Available online 8 August 2014
      Source:IJC Heart & Vessels
      Author(s): Tamas Szili-Torok , Ferdi Akca , Kadir Caliskan , Folkert Ten Cate , Dominic Theuns , Michelle Michels
      Background Hypertrophic cardiomyopathy (HCM) patients may develop interatrial activation delay, indicated by complete separation of right and left atrial activation on the ECG. This study aimed to determine the prevalence of interatrial activation delay and the relation to atrial tachycardia (AT) cycle length (CL) in HCM patients. Methods 159 HCM patients were included (mean age 52±14yrs). In group I (n=15,9%) patients had atrial arrhythmias and progressive ATCL. In group II (n=22, 14%) patients had a stable ATCL. In group III (n=122, 77%) HCM patients without AT were included. P wave morphology and change in P wave duration (ΔP and Pmax) and changes in ATCL (ΔATCL) were analysed. Mean follow up was 8.7±4.7years. Results In group I 33% (n=5) had separated P waves. In group II no P wave separation was identified (OR 1.50 [1.05-2.15], p=0.007). In group I patients were older compared to group III (62.6±15.1vs. 50.2±14.0 y, p=0.002) and had longer follow up (13.4±2.2 vs. 7.8±4.6 y, p<0.001). In group III Pmax and ΔP was significantly lower (105.1±22.0ms and 8.9±13.2ms, both p<0.0001). Group I patients had an increased LA size compared to group II (61.1±11.6 vs. 53.7±7.5mm, p=0.028) and higher E/A and E/E prime ratios (p=0.007; p=0.037, respectively). In group I 93.3% of the identified mutations were typical Dutch founder mutations of the MYBPC3 gene. Conclusion In HCM patients a unique combination of separated P waves and regularization of ATs is associated with larger atria, higher LA pressures and myosin binding protein mutations.

      PubDate: 2014-08-10T19:32:00Z
      DOI: 10.1016/j.ijchv.2014.07.003
      Issue No: Vol. 4 (2014)
  • Health-Related Quality of Life is poor but does not vary with
           cardiovascular disease burden among patients operated for severe
           atherosclerotic disease

    • Authors: Saskia Haitjema; Gert-Jan de Borst; Jean-Paul de Vries; Frans Moll; Gerard Pasterkamp; Hester den Ruijter
      Pages: 53 - 58
      Abstract: Publication date: Available online 8 August 2014
      Source:IJC Heart & Vessels
      Author(s): Saskia Haitjema , Gert-Jan de Borst , Jean-Paul de Vries , Frans Moll , Gerard Pasterkamp , Hester den Ruijter
      Background Patients with cardiovascular disease (CVD) are reported to have a poorer Health-Related Quality of Life (HRQoL) compared to healthy age- and gender-matched individuals. Moreover, HRQoL seems to predict survival in CVD populations. We studied HRQoL and the association with outcome during follow-up in a population undergoing surgery for peripheral artery disease or cerebrovascular large artery disease. Methods In the Athero-Express biobank cohort study patients filled in a questionnaire containing RAND-36. We stratified the cohort to compare HRQoL scores (range 0–100, higher scores representing better HRQoL) and assessed three-year event-free survival for composite cardiovascular endpoints of patients with good (above median) versus poor (equal to and below median) HRQoL at baseline. Additionally we compared the cohort to a healthy age-matched population. Results 2,012 and 865 patients undergoing carotid endarterectomy (CEA) or endarterectomy of femoral/iliac arteries (FEA) were included respectively. The median HRQoL was 75 (IQR 0–100 (both patient groups)) for physical role limitations versus 0 (IQR 0–100 (CEA) and 0–66.7 (FEA)) for emotional role limitations. No differences in HRQoL subscores were found, CVD burden did not associate with HRQoL and three-year composite event rates did not associate with the reported HRQoL in both CEA and FEA. Both groups had poor HRQoL scores compared to an age-matched general population, especially regarding emotional role limitations and social functioning. Conclusions HRQoL is poor and does not associate with CVD burden within patients suffering from severe atherosclerotic disease. Reported HRQoL was not associated with incident cardiovascular events during follow-up.

      PubDate: 2014-08-10T19:32:00Z
      DOI: 10.1016/j.ijchv.2014.07.001
      Issue No: Vol. 4 (2014)
  • Absence of Significant Aortic Regurgitation Seven Years after Closure of
           Patent Foramen Ovale

    • Authors: Naqibullah Mirzada; Per Ladenvall; Magnus C. Johansson
      Pages: 59 - 62
      Abstract: Publication date: Available online 27 July 2014
      Source:IJC Heart & Vessels
      Author(s): Naqibullah Mirzada , Per Ladenvall , Magnus C. Johansson
      Background It has been suggested that there is an increase in aortic regurgitation (AR) in the short and medium term after percutaneous closure of patent foramen ovale (PFO). The aim of this study is to determine the long-term effect of percutaneous closure of PFO on the prevalence of AR. Methods Patients with cryptogenic stroke or transient ischemic attack who had undergone percutaneous closure of PFO more than five years before the study were invited to an echocardiography examination. Results Out of 83 invited patients, 64 accepted the invitation and were examined with echocardiography. Mild AR was found in one patient (2%), but this was already evident in the patient’s echocardiography result before PFO closure. Trace AR was detected in 11 patients (17%). No case of moderate or severe AR was detected. Patients with AR were more often hypertensive (six out of 12 patients with AR, compared to nine of the 52 without AR, p=0.025), and the indexed sinus of Valsalva was larger in patients with AR (18.6mm/m2, SD 1.6, as compared to 17.3mm/m2, SD 1.6, p=0.02). Conclusion In this long-term study with a minimum follow-up of 5.6years and a mean of 7.1years, we found negligible levels of AR. Where present, AR was associated with hypertension and mild dilatation of the aortic root, but there was no indication that device closure per se increased the risk of developing AR.

      PubDate: 2014-08-01T00:23:32Z
      DOI: 10.1016/j.ijchv.2014.06.014
      Issue No: Vol. 4 (2014)
  • A decade of complex fractionated electrograms catheter-based ablation for
           atrial fibrillation: literature analysis, meta-analysis and systematic

    • Authors: Jia Chen; Yubi Lin; Lifang Chen; Jian Yu; Zuoyi Du; Shushu Li; Zhenzhen Yang; Chuqian Zeng; Xiaoshu Lai; Qiji Lu; Bixia Tian; Jingwen Zhou; Jing Xu; Aidong Zhang; Zicheng Li
      Pages: 63 - 72
      Abstract: Publication date: Available online 8 July 2014
      Source:IJC Heart & Vessels
      Author(s): Jia Chen , Yubi Lin , Lifang Chen , Jian Yu , Zuoyi Du , Shushu Li , Zhenzhen Yang , Chuqian Zeng , Xiaoshu Lai , Qiji Lu , Bixia Tian , Jingwen Zhou , Jing Xu , Aidong Zhang , Zicheng Li
      Background It is a decade since the complex fractionated atrial electrograms (CFAEs) was first established following the publication of Nademanee’s standards. However, the status and focus of CFAEs research is unclear, as is the efficacy of additional CFAEs ablation in atrial fibrillation (AF). This literature review and meta-analysis was designed to determine the status of CFAEs research and the efficacy and complications of CFAEs ablation alone, pulmonary vein isolation (PVI) alone and PVI plus CFAEs ablation in AF. Methods With assistance from reference librarians and investigators trained in systematic review, we conducted a literature search of MEDLINE (via PubMed), Embase, the Cochrane Library, ScienceDirect, Wiley Blackwell and Web of Knowledge, using “complex fractionated atrial electrograms” for MeSH and keyword search. Results The literature on CFAEs increased from 2007, mainly focusing on mapping studies, with mechanism studies increasing significantly from 2012. Fifteen trials with 1525 patients were qualified for our meta-analysis. Success rates were as follows. Overall (P <0.001): CFAEs ablation alone, 23.5–26.2%; PVI, 64.7%; PVI plus CFAEs ablation, 67.0%. Single ablation: PVI, 60.4%; PVI plus CFAEs, 68.8% (OR 1.53, 95%CI 1.07–2.20, P =0.02). Re-ablation: PVI, 69.0%; PVI plus CFAEs, 77.2% (OR 1.54, 95%CI 1.06–2.24, P =0.02). Paroxysmal AF: PVI, 76.7%; PVI plus CFAEs, 79.1% (OR 1.20, 95%CI 0.79–1.81, P =0.39). Persistent or permanent AF: PVI, 47.9%; PVI plus CFAEs, 58.7% (OR=1.59, 95%CI 1.13–2.24, P =0.008). Complication rates: PVI, 2.6%; PVI plus CFAEs, 3.4% (OR 1.22, 95%CI 0.58–2.57, P =0.61). Conclusions In the literature, CFAEs mapping studies preceded mechanism studies. CFAEs ablation alone is insufficient for treatment of AF. Additional CFAEs ablation after adequate PVI or PVI plus linear ablation improves the outcome of single ablation and re-ablation without increasing complications, especially in persistent or permanent AF. There are insufficient data to support a similar improvement in paroxysmal AF or inducible AF after PVI for paroxysmal AF.

      PubDate: 2014-07-26T17:41:49Z
      DOI: 10.1016/j.ijchv.2014.06.013
      Issue No: Vol. 4 (2014)
  • In-hospital and 3-year clinical outcomes following ad hoc versus staged
           percutaneous coronary interventions in chronic total occlusion — A real
           world practice

    • Authors: Hsiu-Yu Fang; Wei-Chieh Lee; Hesham Hussein; Chih-Yuan Fang; Cheng-I Cheng; Cheng-Hsu Yang; Chien-Jen Chen; Chi-Ling Hang; Hon-Kan Yip; Yu-Sheng Lin; Chiung-Jen Wu
      Pages: 73 - 80
      Abstract: Publication date: Available online 6 July 2014
      Source:IJC Heart & Vessels
      Author(s): Hsiu-Yu Fang , Wei-Chieh Lee , Hesham Hussein , Chih-Yuan Fang , Cheng-I Cheng , Cheng-Hsu Yang , Chien-Jen Chen , Chi-Ling Hang , Hon-Kan Yip , Yu-Sheng Lin , Chiung-Jen Wu
      Background Ad hoc percutaneous coronary intervention (PCI) which was performed immediately after diagnostic catheterization has become the most common way of coronary intervention. However, limited data is available on in-hospital and long-term outcome comparing ad hoc and staged chronic total occlusion (CTO) PCI. The aim of our study was to figure the short-term and long-term outcomes after ad hoc or staged CTO PCI. Methods This retrospective analysis included 512 consecutive patients that underwent 561 CTO PCI procedures between January 2002 and December 2009. Patient basic demographics, lesion characteristics, interventional procedure, devices used and in-hospital outcomes were compared between ad hoc and staged CTO PCI groups. 3-Year clinical outcomes that included all-cause mortality, cardiac mortality, myocardial infarction (MI), the need for coronary artery bypass graft surgery (CABG), major adverse cardiac events (MACE) and target vessel revascularization (TVR) were compared. Time-to-event analyses were performed using Kaplan–Meier statistics. Results Four hundred fifty-one patients (80.4%) were enrolled in ad hoc CTO PCI group. Final successful revascularization was higher in ad hoc CTO PCI group compared with staged CTO PCI group (82.9 vs. 77.3%, p =0.17) without statistical significance. There was no significant difference between ad hoc CTO PCI and staged CTO PCI groups in in-hospital outcomes such as all-cause mortality, cardiac death, myocardial infarction, urgent bypass surgery, urgent PCI or complications. Patients with ad hoc CTO PCI had lower rate of all-cause mortality (6.2% vs. 6.5%, p =0.89), the need for CABG (1.9% vs. 2.1%, p =0.89) but higher rate of cardiac mortality (1.7% vs. 0.0%, p =0.21), MI (1.0% vs. 0.0%, p =0.34), MACE (24.1% vs. 17.5%, p =0.19) and TVR (17.8% vs. 10.0%, p =0.069) without statistical significance in 3-year clinical outcomes. Conclusion 3-Year clinical outcomes compared with ad hoc CTO PCI and staged CTO PCI had insignificant differences between: all-cause mortality, cardiac mortality, MI, the need for CABG, MACE and TVR.

      PubDate: 2014-07-26T17:41:49Z
      DOI: 10.1016/j.ijchv.2014.06.012
      Issue No: Vol. 4 (2014)
  • The predictive role of electrocardiographic abnormalities in ischemic
           stroke patients with intravenous thrombolysis

    • Authors: Fei Wu; Wenjie Cao; Yifeng Ling; Lumeng Yang; Xin Cheng; Qiang Dong
      Pages: 81 - 83
      Abstract: Publication date: Available online 9 July 2014
      Source:IJC Heart & Vessels
      Author(s): Fei Wu , Wenjie Cao , Yifeng Ling , Lumeng Yang , Xin Cheng , Qiang Dong
      Background/Objectives The association between electrocardiographic abnormalities and the outcomes in acute ischemic stroke patients after intravenous thrombolysis remains unclear. We sought to assess the predictive value of electrocardiographic abnormalities in stroke patients after thrombolysis. Methods Consecutive acute stroke patients with thrombolysis from Feb 2008 to Jun 2013 were included. Electrocardiographic abnormalities during hospitalization were retrospectively reviewed. Outcomes were 90-day modified Rankin's Score. Multivariate logistic regression was used to analyze the association of electrocardiographic abnormalities with 90-day outcome. Results From Feb 2008 to Jun 2013, 95 acute stroke patients (median age of 67 and 64.2% male) with electrocardiographic before/after thrombolysis and 90day modified Rankin's Score were recruited in our study. Increased age (p=0.027), higher baseline National Institutes of Health Stroke Scale (p<0.001) and T-wave changes (p=0.030) were significantly associated with worse functional outcome. T-wave changes (odds ratio 5.54, 95% confidence interval 1.37–22.37, p=0.016) were independently associated with unfavorable outcome. Conclusions T-wave changes can be useful markers to predict the outcome in stroke patients after thrombolysis.

      PubDate: 2014-07-26T17:41:49Z
      DOI: 10.1016/j.ijchv.2014.06.010
      Issue No: Vol. 4 (2014)
  • Coronary artery disease in adults with schizophrenia: Anatomy, treatment
           and outcomes

    • Authors: Ryan A. Todd; Adriane M. Lewin; Lauren C. Bresee; Danielle Southern; Doreen M. Rabi
      Pages: 84 - 89
      Abstract: Publication date: Available online 8 July 2014
      Source:IJC Heart & Vessels
      Author(s): Ryan A. Todd , Adriane M. Lewin , Lauren C. Bresee , Danielle Southern , Doreen M. Rabi
      Background People with schizophrenia are at significantly greater risk of cardiovascular disease-related mortality. We set out to determine if people with and without schizophrenia who undergo coronary artery catheterization differ with respect to coronary anatomy, coronary artery disease management, or outcome. Methods and results This study used provincial administrative data and a clinical registry that included all individuals who undergo coronary catheterization in Alberta, Canada. Individuals with schizophrenia were identified in hospital discharge data using ICD-9 codes. We identified 271 Albertans with a hospital discharge diagnosis of schizophrenia and a subsequent coronary catheterization and were matched with 1083 controls without schizophrenia that had undergone a coronary catheterization. Extent of coronary disease was assessed using 1) left ventricular ejection fraction; 2) the Duke Jeopardy Score (a valid measure of myocardium at risk for ischemic injury); and 3) a categorical assessment of coronary anatomy risk. People with schizophrenia were less likely to be categorized as high risk on the Duke coronary index (p<.005) and more likely to be categorized as having a normal coronary anatomy (p<.05). Significant differences in mortality were found among those with and without schizophrenia both before and after adjustment for clinical differences. Conclusions Our results suggest that people with schizophrenia have less severe coronary atherosclerosis, and are less likely to receive revascularization. Despite less severe coronary atherosclerosis, individuals with schizophrenia had a significantly higher mortality following catheterization. Interventions to increase therapeutic adherence and clinical follow up of patients with mental illness may improve health outcomes.

      PubDate: 2014-07-26T17:41:49Z
      DOI: 10.1016/j.ijchv.2014.06.009
      Issue No: Vol. 4 (2014)
  • Regional variations in baseline characteristics of cardiac rhythm device
           recipients: The PANORAMA observational cohort study

    • Authors: Fawziah Al Kandari; Andrejs Erglis; Raed Sweidan; Ingrid Dannheimer; Milan Sepsi; Juan Bénézet; Michal Padour; Ajay Naik; Jaime Escudero; Teena West; Reece Holbrook; Faizel Lorgat
      Pages: 90 - 96
      Abstract: Publication date: Available online 6 July 2014
      Source:IJC Heart & Vessels
      Author(s): Fawziah Al Kandari , Andrejs Erglis , Raed Sweidan , Ingrid Dannheimer , Milan Sepsi , Juan Bénézet , Michal Padour , Ajay Naik , Jaime Escudero , Teena West , Reece Holbrook , Faizel Lorgat
      Background The PANORAMA study was designed to collect concurrent data on subjects from different worldwide regions implanted with CRM devices. Methods In this prospective, multi-center study, we analyzed baseline data on 8586 subjects implanted with CRM devices with no additional selection criteria (66% pacemaker (IPG), 16% implantable cardiac defibrillators (ICD), 17% cardiac resynchronization therapy (CRT) and <1% Internal Loop Recorder) from 156 hospitals across 6 geographical regions between 2005 and 2011. Results Regardless of the device implanted, subjects from the Middle East and India often had more diabetes than other regions. Eastern and Western Europe had higher rates of atrial fibrillation reported, and men were more likely to smoke than women (46% vs 11%, p<0.001). Within the CRT cohort there was significant variation in the proportion of males receiving a device, ranging from 55% in India to 83% in Eastern Europe. Conclusions We provide comprehensive descriptive data on patients receiving CRM devices from a range of geographies that are not typically reported in literature. We found significant variations in clinical characteristics and implant practices. Long term follow-up data will help evaluate if these variations require adjustments to outcome expectations.

      PubDate: 2014-07-26T17:41:49Z
      DOI: 10.1016/j.ijchv.2014.06.008
      Issue No: Vol. 4 (2014)
  • Factors associated with longer delays in reperfusion in ST-Segment
           Elevation Myocardial Infarction

    • Authors: Daisy Abreu; M. Salomé Cabral; Fernando Ribeiro
      Pages: 97 - 101
      Abstract: Publication date: Available online 10 July 2014
      Source:IJC Heart & Vessels
      Author(s): Daisy Abreu , M. Salomé Cabral , Fernando Ribeiro
      Background/Objectives The goal of this paper is to identify the predictors of delay in total ischemia time that would be the focus of improvement efforts in patients with ST-Segment Elevation Myocardial Infarction. Methods data was collected retrospectively through the patient´s clinical records and by direct telephone interview. Total ischemic time was categorized in two classes according to the elapsed time since symptom presentation until restored flow, less than 6hours and 6hours or less. Logistic regression analysis was applied to evaluate the relationship between total ischemic time and a set of variables. Discrimination ability of the model was also assessed, as well as sensitivity and specificity, through ROC curves. Results Data from 128 patients, 74.22% males and 25.78% females, were analyzed. The average age was approximately 62years (±13.6). Six variables associated with total ischemia were selected in the final model: the patient age, the level of pain intensity, the region of origin, the socioeconomic status, the activity that the patient was performing at the time of symptoms onset, and the fact that the patient has been transferred from another hospital. Conclusion The identification of variables associated with the total ischemia time allows the recognition of patients with possibility of worse prognosis, for which should be directed educational efforts and also the identification of variables that can be modified to optimize the therapy.

      PubDate: 2014-07-26T17:41:49Z
      DOI: 10.1016/j.ijchv.2014.06.007
      Issue No: Vol. 4 (2014)
  • Atrial fibrillation in severe aortic valve stenosis — Association with
           left ventricular left atrial remodeling

    • Authors: Jordi S. Dahl; Axel Brandes; Lars Videbæk; Mikael K. Poulsen; Rasmus Carter-Storch; Nicolaj Lyhne Christensen; Ann B. Banke; Patricia A. Pellikka; Jacob E. Møller
      Pages: 102 - 107
      Abstract: Publication date: Available online 6 July 2014
      Source:IJC Heart & Vessels
      Author(s): Jordi S. Dahl , Axel Brandes , Lars Videbæk , Mikael K. Poulsen , Rasmus Carter-Storch , Nicolaj Lyhne Christensen , Ann B. Banke , Patricia A. Pellikka , Jacob E. Møller
      Background Atrial fibrillation (AF) is common in patients with aortic stenosis (AS) although the exact mechanism is unclear. The purpose of this study was to investigate echocardiographic characteristics among patients with severe AS and AF and to identify factors associated with the development of new-onset AF after aortic valve replacement (AVR). Methods 125 patients with severe AS and ejection fraction >40% scheduled for AVR were evaluated preoperatively and 3, 6, 9 and 12months postoperatively with electrocardiography (ECG) and echocardiography, and Holter-ECG analysis was performed after 3 and 12months. The primary endpoint was new-onset AF defined as an episode of AF exceeding 30s, on the ECG or Holter-ECG and/or patients hospitalized due to AF. Results AF was present in 19 patients prior to AVR, compared to patients in sinus rhythm AF patients had increased NT-proBNP, increased left atrial (LA) volume (61±21 vs. 47±17ml/m2, p=0.002), reduced global longitudinal left ventricular strain (−13.1±3.7 vs. −16.0±3.5, p=0.002) and presented more often with a restrictive filling pattern (37% vs. 10%, p=0.002). During follow-up 23 patients developed new-onset AF; predictors were LA volume, restrictive filling pattern, NT-proBNP, E/e′ and systolic blood pressure. After correcting for age and LA volume index, a restrictive filling pattern and systolic blood pressure remained associated with new-onset AF. Conclusions The presence of preoperative AF and development of new-onset AF after AVR is associated with restrictive filling pattern and LA dilatation in patients with severe AS.

      PubDate: 2014-07-26T17:41:49Z
      DOI: 10.1016/j.ijchv.2014.06.006
      Issue No: Vol. 4 (2014)
  • Clinical Outcomes and Risk Factors of Coronary Artery Aneurysms after
           Successful Percutaneous Coronary Intervention and Drug-eluting Stent
           Implantation for Chronic Total Occlusions

    • Authors: Xin Zhong; Hua Li; Chenguang Li; Nobel Zong; David Liem; X'avia Chan; Shuning Zhang; Youen Zhang; Xinggang Wang; Xing Wu; Wenbin Zhang; Kang Yao; Xuebo Liu; Lei Ge; Kai Hu; Juying Qian; Mario Deng; Junbo Ge
      Pages: 108 - 115
      Abstract: Publication date: Available online 6 July 2014
      Source:IJC Heart & Vessels
      Author(s): Xin Zhong , Hua Li , Chenguang Li , Nobel Zong , David Liem , X’avia Chan , Shuning Zhang , Youen Zhang , Xinggang Wang , Xing Wu , Wenbin Zhang , Kang Yao , Xuebo Liu , Lei Ge , Kai Hu , Juying Qian , Mario Deng , Peiei Ping , Junbo Ge
      Objective : The study aimed to analyze the risk factors and long-term outcomes associated with coronary artery aneurysms (CAAs) after successful percutaneous coronary intervention (PCI) and drug-eluting stent (DES) implantation in patients with CTOs. Background :There are sporadic data available on post-procedure CAAs after transcatheter revascularization for CTOs. Methods and Results: A total of 141 patients with 149 CTOs who underwent successful CTO-PCI and DES implantation with angiographic follow-up from 2004 to 2010 were included. Patients were divided into CAA group and non-CAA group according to the presence of CAAs in the follow-up angiography. The independent predictors and major adverse cardiac events (MACEs) including cardiac death, myocardial infarction (MI) and target-vessel revascularization (TVR) were compared between two groups. The incidence of CAAs was 11.4% (17/149) after index procedure. Multivariate analysis showed that age (OR: 0.925, CI 0.873-0.980, P=0.008), ostial occlusion (OR: 6.715, CI 1.473-30.610, P=0.014), the parallel wire technique (OR: 6.167, CI 1.709-22.259, P=0.005) and DES length (OR: 1.030, CI 1.002-1.058, P=0.036) were the independent predictors of CAAs after successful CTO-PCI and DES implantation. MACEs was similar between two groups (adjusted hazard ratio 0.670; 95% CI 0.160-2.808; p=0.584) during the 5-year follow-up. Conclusions : The independent predictors of CAAs after successful CTO-PCI and DES implantation are age, ostial occlusion, the parallel wire technique and DES length. CAAs after index procedure are not frequently associated with adverse clinical events under dual antiplatelet therapy. Further large clinical studies are warranted to explore the clinical implications of patients with this distinct new entity.

      PubDate: 2014-07-26T17:41:49Z
      DOI: 10.1016/j.ijchv.2014.06.004
      Issue No: Vol. 4 (2014)
  • Impact of blood urea nitrogen for long-term risk stratification in
           patients with coronary artery disease undergoing percutaneous coronary

    • Authors: Masayuki Kawabe; Akira Sato; Tomoya Hoshi; Shunsuke Sakai; Daigo Hiraya; Hiroaki Watabe; Yuki Kakefuda; Mayu Ishibashi; Daisuke Abe; Noriyuki Takeyasu; Kazutaka Aonuma
      Pages: 116 - 121
      Abstract: Publication date: Available online 6 July 2014
      Source:IJC Heart & Vessels
      Author(s): Masayuki Kawabe , Akira Sato , Tomoya Hoshi , Shunsuke Sakai , Daigo Hiraya , Hiroaki Watabe , Yuki Kakefuda , Mayu Ishibashi , Daisuke Abe , Noriyuki Takeyasu , Kazutaka Aonuma
      Background Few studies have examined the association between blood urea nitrogen (BUN) and mortality in patients with coronary artery disease (CAD). We investigated the prognostic value of BUN concentration at hospital admission in patients with CAD. Methods A total of 3641 patients with CAD who underwent percutaneous coronary intervention (PCI) were included from April 2007 to June 2011. We measured BUN concentration at hospital admission and compared it with long-term clinical outcome. Patients were classified into three groups according to BUN concentration of <20mg/dl, 20 to 25mg/dl, or >25mg/dl. Primary endpoint was all-cause death. Results During the follow-up period (median 15months), 248 (6.8%) patients died. A higher BUN level was associated with multivessel disease, lower ejection fraction, lower systolic blood pressure, and higher prevalence of comorbidities. Cox regression analysis showed that patients with BUN of >25mg/dl had a hazard ratio (HR) for mortality of 2.73 (95% CI, 1.14 to 6.53; p=0.023) with an estimated glomerular filtration rate (eGFR) of ≥45ml/min/1.73m2 and a HR of 2.90 (95% CI, 1.75 to 4.82; p<0.001) with an eGFR of <45ml/min/1.73m2. Regardless of acute coronary syndrome or stable CAD, BUN of >25mg/dl was independently associated with higher mortality (HR, 2.58; 95% CI, 1.43 to 4.64; p=0.004 and HR, 2.16; 95% CI, 1.01 to 4.59; p=0.044, respectively). Conclusions A BUN of >25mg/dl was associated with long-term mortality in CAD patients who underwent PCI independent of traditional cardiovascular risk factors and eGFR.

      PubDate: 2014-07-26T17:41:49Z
      DOI: 10.1016/j.ijchv.2014.06.002
      Issue No: Vol. 4 (2014)
  • Long QT syndrome, cardiovascular anomaly and findings in ECG-guided
           genetic testing

    • Authors: Khalfan S. AlSenaidi; Guoliang Wang; Li Zhang; Dominik A. Beer; Abdullah M. AlFarqani; Salim N. AlMaskaryi; Daniel J. Penny; Peter R. Kowey; Yuxin Fan
      Pages: 122 - 128
      Abstract: Publication date: Available online 2 July 2014
      Source:IJC Heart & Vessels
      Author(s): Khalfan S. AlSenaidi , Guoliang Wang , Li Zhang , Dominik A. Beer , Abdullah M. AlFarqani , Salim N. AlMaskaryi , Daniel J. Penny , Peter R. Kowey , Yuxin Fan
      Objective Patients with inherited long QT syndrome (LQTS) are prone to torsade de pointes and sudden death (SD). Identifying affected individuals is important for SD prevention. This study aimed to determine the cause and genotype–phenotype characteristics of LQTS in a large Omani family. Methods Upon LQTS diagnosis of a 5-year-old girl (proband), targeted mutation screening was performed based on the gene-specific ECG pattern identified in her mother. ECG-guided family genotyping was conducted for identifying additional affected individuals. Results ECGs of the proband demonstrated 2:1 AV block, incomplete right bundle branch block (IRBBB) and markedly prolonged QTc (571–638ms) with bizarre T waves. Cardiac imaging revealed dilatation of the ascending aorta and pulmonary artery, and left ventricular non-compaction. Her parents were first cousins. Both showed mild QT prolongation, with the mother presenting a LQT2 T wave pattern and the father IRBBB. Targeted KCNH2 screening identified a novel homozygous frameshift mutation p.T1019Pfs×38 in the proband within 3 days. Family genotyping uncovered 3 concealed LQT2 and confirmed 11 members showing LQT2 ECG patterns as heterozygous mutation carriers. All heterozygous carriers were asymptomatic, with 71% showing normal to borderline prolonged QTc (458±33ms, range 409–522ms). Conclusion p.T1019Pfs×38, a novel KCNH2 mutation, has been identified in a large LQTS family in Oman. Consanguineous marriages resulted in a homozygous with severe LQTS. ECG-guided phenotyping and genotyping achieved a high efficiency. Genetic testing is essential in identifying concealed LQTS. Further investigation is warranted to determine if there is a causative relationship between homozygous p.T1019Pfs×38 and cardiovascular anomaly.

      PubDate: 2014-07-26T17:41:49Z
      DOI: 10.1016/j.ijchv.2014.06.001
      Issue No: Vol. 4 (2014)
  • High prevalence of pulmonary vein thrombi in elderly patients with chest
           pain, which has relationships with aging associated diseases

    • Authors: Hidekazu Takeuchi
      Pages: 129 - 134
      Abstract: Publication date: Available online 24 May 2014
      Source:IJC Heart & Vessels
      Author(s): Hidekazu Takeuchi
      Aim Pulmonary vein thrombi (PVT) are believed to be rare. Some cases of PVT were reported in patients with lung cancer, thoracic surgery or catheter ablation. PVT are possible cause of systemic embolism, but little is known about its complications. Since 2012, we have reported seven cases of PVT in patients without these predisposing factors. The aim of the present study was to clarify whether PVT were rare or not in patients without these predisposing factors and how can we treat patients with PVT. Methods We performed 64-slice multidetector CT (64-MDCT) scans on 57 consecutive Japanese patients (28 men and 29 women; age=73.8±8.6years old) with chest pain, but they didn’t have lung cancer, thoracic surgery or catheter ablation, from September 2012 to March 2013. Results Coronary artery plaque was detected in 32 patients (56%). PVT were clearly demonstrated in 35 patients (61%), which indicated that PVT are not rare. Furthermore, 32 patients (91%) among 35 patients with PVT had no cerebral infarctions. In older people, PVT are not uncommon and has many clinico-pathologic correlations. Small or fine thrombi in the pulmonary vein should occlude a small artery of every organ and make effects on many diseases, which are not recognized by almost all medical doctors. Conclusions PVT are common observation in patients with chest pain and no clear predisposing factor. Further studies are required to assess if PVT can be considered as an etiology of chest pain and to determine its optimal management.

      PubDate: 2014-05-28T06:23:03Z
      DOI: 10.1016/j.ijchv.2014.05.006
      Issue No: Vol. 4 (2014)
  • Improved Survival Rate after Myocardial Infarction using an Inducible
           Cholesterol Efflux (iCE) Peptide: FAMP

    • Authors: Eiji Yahiro; Yoshinari Uehara; Emi Kawachi; Setsuko Ando; Shin-ichiro Miura; Keijiro Saku
      Pages: 135 - 137
      Abstract: Publication date: Available online 25 May 2014
      Source:IJC Heart & Vessels
      Author(s): Eiji Yahiro , Yoshinari Uehara , Emi Kawachi , Setsuko Ando , Shin-ichiro Miura , Keijiro Saku
      Background There have been no previous reports that apolipoprotein (apo) A-I mimetic peptide improves survival rate after myocardial infarction (MI). Method and Results Male C57Bl/6J mice were subjected to left coronary artery permanent ligation as a model of MI. We synthesized a novel 24-amino acid apoA-I mimetic peptide-type5 (FAMP5), which potently removes cholesterol via specific ATP-binding cassette transporter A1 (ABCA1). FAMP5 was associated with a significantly improved survival rate by protecting against cardiac rupture compared to the control. mRNA for eNOS, Gata-4, CTGF and ANP were significantly increased in the hearts of the FAMP5-treated group, while that for MCP-1 decreased. Conclusion This is the first report that high-density lipoprotein (HDL) therapy with FAMP5 improved the survival rate after MI.

      PubDate: 2014-05-28T06:23:03Z
      DOI: 10.1016/j.ijchv.2014.05.005
      Issue No: Vol. 4 (2014)
  • Predictors of long-term outcome of percutaneous coronary intervention in
           octogenarians with acute coronary syndrome

    • Authors: Salim Bary Barywani; Maria Lindh; Josefin Ekelund; Max Petzold; Per Albertsson; Maria Schaufelberger; Lars Lund; Michael L.X. Fu
      Pages: 138 - 144
      Abstract: Publication date: Available online 23 May 2014
      Source:IJC Heart & Vessels
      Author(s): Salim Barywani , Maria Lindh , Josefin Ekelund , Max Petzold , Per Albertsson , Maria Schaufelberger , Lars Lund , Michael L.X. Fu
      Background The majority of patients with acute coronary syndrome (ACS) are elderly. Limited evidence makes decision-making on the use of percutaneous coronary intervention (PCI) mainly empirical. Old age is one risk factor, but other factors than age may have impact on mortality as well. Objective To study predictors of long-term all-cause mortality among octogenarians who have undergone PCI due to ACS. Methods and results A total of 182 patients≥80years who underwent PCI during 2006-2007 at Sahlgrenska University Hospital were studied consecutively from recorded clinical data. All-cause five-year mortality of follow-up was 46.2%. Mean age was 83.7±2.8, 62% were male, 76% were in sinus rhythm, and 42% had left ventricular ejection fraction<45%. Indications for PCI were STEMI (52%), NSTEMI (36%) and unstable angina (11%). Multivariate analysis in two steps identified atrial fibrillation, moderate tricuspid valve regurgitation, moderate mitral valve regurgitation, dependency in ADL and eGFR < 30ml/min at the first step and moderate mitral valve regurgitation, atrial fibrillation and eGFR < 30ml/min at the last step, as independent predictors of all-cause mortality. Kaplan Meier analysis of positive parameters from both steps of multivariate analysis showed high significant difference in survival between patients having these parameters and those who were free from these parameters, with worst prognosis in patients with accumulation of these parameters. Conclusions In an octogenarian patient cohort who suffered from ACS, undergone PCI in daily clinical practice, we were able to identify five prognostic predictors for all-cause death after five years’ follow-up.

      PubDate: 2014-05-28T06:23:03Z
      DOI: 10.1016/j.ijchv.2014.05.004
      Issue No: Vol. 4 (2014)
  • Distinct structural and molecular features of the myocardial extracellular
           matrix remodeling in compensated and decompensated cardiac hypertrophy due
           to aortic stenosis

    • Authors: Victoria Polyakova; Manfred Richter; Natalia Ganceva; Hans-Jürgen Lautze; Sokichi Kamata; Jochen Pöling; Andres Beiras-Fernandez; Stefan Hein; Zoltan Szalay; Thomas Braun; Thomas Walther; Sawa Kostin
      Pages: 145 - 160
      Abstract: Publication date: Available online 22 May 2014
      Source:IJC Heart & Vessels
      Author(s): Victoria Polyakova , Manfred Richter , Natalia Ganceva , Hans-Jürgen Lautze , Sokichi Kamata , Jochen Pöling , Andres Beiras-Fernandez , Stefan Hein , Zoltan Szalay , Thomas Braun , Thomas Walther , Sawa Kostin
      Objectives We used immuhistochemistry and Western blot to study fibrillar and non-fibrillar collagens, collagen metabolism, matricellular proteins and regulatory factors of the ECM remodeling in LV septum biopsies from 3 groups of patients with AS: (AS-1,n=9): ejection fraction (EF)>50%; AS-2,(n=12): EF 30-50%; AS-3,(n=9): EF<30%). Samples from 8 hearts with normal left ventricular function served as controls. Results In comparison with controls, fibrillar collagens I and III were progressively upregulated from compensated (AS-1) toward decompensated hypertrophy (AS-3). The collagenIII/collagen I ratio decreased 2-fold in the AS-2 and AS-3 groups as compared with AS-1 and controls. Non-fibrillar collagen IV was upregulated only in AS-3 patients, whereas collagen VI progressively increased from AS-1 to AS-3 group. Collagen synthesis in AS-3 was shifted to collagen I, while the maturation/degradation level was shifted to collagen III. RECK was downregulated only in AS-3 patients. Matricellular proteins tenascin and osteopontin were increased in all AS patients. However, thrombospondin 1, 4 and CTGF were increased only in AS-3. Only AS-3 patients were characterized by increased levels of TGFβ1 and downregulation of TGFβ3, TGFβ-activated kinase1 and Smad7. In contrast, phosphorylated Smad3 gradually increased from AS-1 toward AS-3. Similar trend of changes were observed for TNFα−R1 and TNFα−R2, whereas TNFα was diminished only in AS-2 and AS-3. Conclusions Distinct changes in fibrillar collagen turnover, non-fibrillar collagens, matricellular proteins and the key regulatory profibrotic and anti-fibrotic factors of the myocardial ECM remodeling might be involved in the transition from compensated to decompensated LV hypertrophy and HF in human patients with AS.

      PubDate: 2014-05-28T06:23:03Z
      DOI: 10.1016/j.ijchv.2014.05.001
      Issue No: Vol. 4 (2014)
  • Increase of pulmonary artery wedge pressure above 15mmHg in patients with
           pre-capillary pulmonary hypertension

    • Authors: Julien Wain-Hobson; Rémi Sabatier; Mamadou Koné; Damien Legallois; Thérèse Lognoné; Ziad Dahdouh; Farzin Beygui; Gilles Grollier; Paul Milliez; Emmanuel Bergot; Vincent Roule
      Pages: 161 - 169
      Abstract: Publication date: September 2014
      Source:IJC Heart & Vessels, Volume 4
      Author(s): Julien Wain-Hobson , Rémi Sabatier , Mamadou Koné , Damien Legallois , Thérèse Lognoné , Ziad Dahdouh , Farzin Beygui , Gilles Grollier , Paul Milliez , Emmanuel Bergot , Vincent Roule
      Aims Daily practice shows that patients with pre-capillary pulmonary hypertension (PH) may develop a secondary elevation of their pulmonary artery wedge pressure (PAWP) above the 15mmHg limit. This phenomenon has not been precisely described yet. We aimed at identifying factors present at initial diagnosis that could predict this secondary elevation of PAWP, its possible causes and impact on survival. Methods and results We included 90 patients followed between 2004 and 2011 in our center. At the end of follow-up (3.0±1.6years), patients were divided into two groups according to the successive PAWP measurements (always≤15mmHg or >15mmHg on at least one right heart catheterization (RHC)). Demographical, biological, echographic and hemodynamical data at first RHC were compared. Possible causes for PAWP >15mmHg were searched. A Kaplan–Meier method was used to assess differences in survival. One third of our cohort developed an elevation of PAWP above 15mmHg and patients with idiopathic pulmonary arterial hypertension were at smaller risk (OR 0.20 [0.05–0.82]; p=0.026). We did not identify any other baseline predictive factors. We highlighted several possible causes and factors that may unmask an underlying left ventricular diastolic dysfunction. Survival was not different between both groups (p=0.42). Conclusion Secondary elevation of PAWP in pre-capillary PH was frequent but less observed in idiopathic PH. We detailed many possible causes that can be sought, many of which may be related to an underlying left ventricular diastolic dysfunction.

      PubDate: 2014-11-13T01:30:47Z
      DOI: 10.1016/j.ijchv.2014.04.011
      Issue No: Vol. 4 (2014)
  • Prognostic Value of Tricuspid Annular Dilatation Assessed by
           Three-Dimensional Transesophageal Echocardiography

    • Authors: Hiroki Ikenaga; Takuji Kawagoe; Ichiro Inoue; Yuji Shimatani; Fumiharu Miura; Yasuharu Nakama; Kazuoki Dai; Osamu Oba; Hideo Yoshida; Masaharu Ishihara; Yasuki Kihara
      Pages: 170 - 176
      Abstract: Publication date: September 2014
      Source:IJC Heart & Vessels, Volume 4
      Author(s): Hiroki Ikenaga , Takuji Kawagoe , Ichiro Inoue , Yuji Shimatani , Fumiharu Miura , Yasuharu Nakama , Kazuoki Dai , Osamu Oba , Hideo Yoshida , Masaharu Ishihara , Yasuki Kihara
      Background This study aimed to evaluate the relationship between tricuspid annular dilatation (TAD) and tricuspid regurgitation (TR), and the prognostic value of TAD using three-dimensional transesophageal echocardiography (3D TEE). Methods Tricuspid annular area (TAA) was measured in 116 patients using 3D TEE. Patients were classified into three groups (mild TR: n=77, moderate TR: n=26, severe TR: n=13). Moreover, patients were classified into two groups based on rehospitalization for heart failure (HF); HF (+) group (n=18) and HF (−) group (n=98). Results TAA in the severe TR group was significantly larger than that in the mild and moderate TR groups (18.4±3.8cm2 vs. 11.7±3.2cm2, 12.3±3.4cm2, p<0.05). TAA in the HF (+) group was significantly larger than that in the HF (−) group (16.8±4.3cm2 vs. 11.8±3.3cm2, p<0.001). In receiver operating characteristics curve assessing the ability of TAA to predict hospitalization for HF, the area under the curve was 0.84. TAA≥15cm2 best predicted hospitalization for HF with 77.8% sensitivity and 84.6% specificity. The incidence of hospitalization for HF during 3years was significantly higher in the TAD (+) group (TAA≥15cm2) than the TAD (−) group (48.3% vs 4.6%, p<0.001). Conclusions The results of this study suggested a possible association between TAD and the TR severity. TAD estimated using 3D TEE may predict hospitalization for prospective HF.

      PubDate: 2014-11-13T01:30:47Z
      DOI: 10.1016/j.ijchv.2014.04.009
      Issue No: Vol. 4 (2014)
  • Time–frequency analysis of the QRS complex in patients with ischemic
           cardiomyopathy and myocardial infarction

    • Authors: Takeshi Tsutsumi; Yoshiwo Okamoto; Nami Kubota-Takano; Daisuke Wakatsuki; Hiroshi Suzuki; Kazunori Sezaki; Kuniaki Iwasawa; Toshiaki Nakajima
      Pages: 177 - 187
      Abstract: Publication date: September 2014
      Source:IJC Heart & Vessels, Volume 4
      Author(s): Takeshi Tsutsumi , Yoshiwo Okamoto , Nami Kubota-Takano , Daisuke Wakatsuki , Hiroshi Suzuki , Kazunori Sezaki , Kuniaki Iwasawa , Toshiaki Nakajima
      Background Time–frequency analysis of the electrocardiographic QRS complex (QRS) has not been uniformly accepted. We investigated this new method of analysis and evaluated its clinical significance in patients with ischemic cardiomyopathy (ICM) and with myocardial infarction (MI). Methods The study population included 71 consecutive patients with MI, 32 with ICM, and 40 healthy individuals. We recorded 12-lead electrocardiograms through a band pass filter (0.15–300Hz) and applied a continuous wavelet transform (CWT) to measure the time–frequency power within the QRS in leads V1 or II. Integrated time–frequency power (ITFP) between QRS complexes was measured to quantify the wavelet-transformed ECG signals (WT-ECG signal), which were classified into three frequency zones: low-frequency QRS (LF-QRS, 5–15Hz), mid-frequency QRS (MF-QRS, 15–80Hz) and high-frequency (HF-QRS, 150–250Hz). In addition, we explored the relationship between the frequency power within the QRS and the density of fibroblasts using a computer simulation. Results The ITFP values were lower in MF-QRS band in patients with anterior or inferior MI, but were significantly greater in LF-QRS and HF-QRS bands of ICM patients than in other groups. In the simulation study, the ITFP values from pseudo-QRS increased in the HF and LF zones if the fibroblast–myocyte ratio (r) was between 1.0 and 2.5. Conclusions The QRS frequency profile was characterized by an increase in HF-QRS in ICM, which might be due to the generation of micro-fibrous tissues in local areas of the cardiac ventricles.

      PubDate: 2014-11-13T01:30:47Z
      DOI: 10.1016/j.ijchv.2014.04.008
      Issue No: Vol. 4 (2014)
  • Impact of new P2Y12 blockers on platelet reactivity and clinical outcomes
           after acute coronary syndrome: Insight from a large single center registry

    • Authors: Pierre Deharo; Marie Loosveld; Guillaume Bonnet; Mathieu Pankert; Jacques Quilici; Marc Lambert; Valerie Verdier; Pierre Morange; Jean-Louis Bonnet; Marie-Christine Alessi; Thomas Cuisset
      Pages: 188 - 192
      Abstract: Publication date: September 2014
      Source:IJC Heart & Vessels, Volume 4
      Author(s): Pierre Deharo , Marie Loosveld , Guillaume Bonnet , Mathieu Pankert , Jacques Quilici , Marc Lambert , Valerie Verdier , Pierre Morange , Jean-Louis Bonnet , Marie-Christine Alessi , Thomas Cuisset
      Background We retrospectively studied the impact of the introduction of new P2Y12 inhibitors (prasugrel, ticagrelor) on platelet reactivity and clinical outcomes after Acute Coronary Syndrome (ACS) from a large single center registry. Methods Consecutive patients admitted for ACS since 2007 and discharged on dual antiplatelet therapy were enrolled. Biological response was assessed one month after discharge by PRI VASP and ADP-induced aggregation (%ADP). Patients were classified according to PRI VASP as very low on-treatment platelet reactivity (VLTPR) (PRI VASP≤10%), low on-treatment platelet reactivity (LTPR) (PRI VASP≤20%) and high on-treatment platelet reactivity HTPR (PRI VASP>50%). Ischemic and bleeding complications were reported. Results 1999 patients were analyzed, 605 before (July 2007–February 2010) and 1394 after introduction of new P2Y12 blockers (February 2010–August 2013). After introduction, we reported a significant lower PRI VASP values (38%±0.53 vs. 42%±0.81 p=0.001), %ADP aggregation (52%±0.4 vs. 54%±0.6 p=0.03) and HTPR incidence (22% versus 34% OR [95% CI]:0.65 [0.53–0.80]; p<0.001). Conversely, incidence of VLTPR and LTPR were significantly higher after the introduction of new P2Y12 inhibitors: 6% versus 3% (OR [95% CI]: 2.0 [1.2–3.3]; p<0.01) and 19% versus 8% (OR [95% CI]: 2.8 [2.0–3.9]; p<0.001) respectively. Clinical follow-up confirmed biological findings with higher incidence of bleeding 10% versus 5% (OR [95% CI]: 2.1 [1.4–3.2]; p<0.01) and lower incidence of stent thrombosis 1.3% versus 3.3% (OR [95% CI]: 0.39 [0.20–0.73]; p<0.01) with new P2Y12 blockers. Conclusion The introduction of new P2Y12 inhibitors modified both platelet reactivity and clinical outcome of ACS patients, with higher rate of hyper responders and bleedings, and lower rate of non responders and thrombotic events.

      PubDate: 2014-11-13T01:30:47Z
      DOI: 10.1016/j.ijchv.2014.04.005
      Issue No: Vol. 4 (2014)
  • Elevated urinary albumin excretion complements the Framingham Risk Score
           for the prediction of cardiovascular risk — response to treatment in the
           PREVEND IT trial

    • Authors: Frank P. Brouwers; Folkert W. Asselbergs; Hans L. Hillege; Ron T. Gansevoort; Rudolf A. de Boer; Wiek H. van Gilst
      Pages: 193 - 197
      Abstract: Publication date: September 2014
      Source:IJC Heart & Vessels, Volume 4
      Author(s): Frank P. Brouwers , Folkert W. Asselbergs , Hans L. Hillege , Ron T. Gansevoort , Rudolf A. de Boer , Wiek H. van Gilst
      Background The PREVEND IT trial reported on a high cardiovascular (CV) event rate in subjects with a baseline urinary albumin excretion (UAE) rate of ≥50mg/24h. Here, we report on the observed 10-year CV outcome of this population and compare this with the predicted Framingham Risk Score (FRS). In addition, we evaluated the effect of four years of fosinopril treatment on this relation. Methods and results From the PREVEND IT cohort, 833 subjects without history of CV disease, randomized to fosinopril (N=412) or placebo (N=421), were studied. The primary endpoint included CV mortality and adjudicated hospitalization for CV disease during a 10-year follow-up period. Mean age was 51±12years and 65% were males, while prevalence of diabetes (2.6%) and use of CV drugs (3.5%) was low. Subjects were categorized to high UAE (≥50mg/24h) or low UAE (<50mg/24h). After 10years of follow-up, the event rate in the high UAE group was almost twice as high as predicted by the FRS (29.5% vs. 17.2%). Treatment for four years with fosinopril reduced the event rate to comparable levels of that predicted by FRS. The addition of UAE ≥50mg/24h to the FRS improved the Integrated Discrimination Improvement (P=0.033) and increased the area under the curve by 0.54% (P=0.024). Conclusions The 10-year CV risk of subjects with an elevated UAE (≥50mg/24h) is substantially underestimated by the FRS. Treatment with fosinopril successfully reduced this increased event rate to FRS-predicted CV risk.

      PubDate: 2014-11-13T01:30:47Z
      DOI: 10.1016/j.ijchv.2014.04.004
      Issue No: Vol. 4 (2014)
  • Effects of transcatheter aortic valve implantation on ascending aorta wall
           elastic properties: Tissue Doppler imaging and strain Doppler
           echocardiography study

    • Authors: Enrico Vizzardi; Edoardo Sciatti; Ivano Bonadei; Antonio D'Aloia; Sandro Gelsomino; Roberto Lorusso; Federica Ettori; Marco Metra
      Pages: 198 - 202
      Abstract: Publication date: September 2014
      Source:IJC Heart & Vessels, Volume 4
      Author(s): Enrico Vizzardi , Edoardo Sciatti , Ivano Bonadei , Antonio D'Aloia , Sandro Gelsomino , Roberto Lorusso , Federica Ettori , Marco Metra
      Background Aortic elastic properties are determinants of left ventricular function by means of ventriculo-arterial coupling and indicators of cardiovascular risk. Aortic valve stenosis surgical replacement temporary reduces aortic function damaging vasa vasorum, while transcatheter aortic valve implantation (TAVI) does not influence it in the short term. We studied aortic distensibility, stiffness, M-mode strain and tissue strain after 6 and 12months from TAVI. Methods We enrolled 15 patients with symptomatic severe aortic stenosis who underwent CoreValve prosthesis (Medtronic, Minneapolis, MN) implantation. Everyone had blood pressure measurement and echocardiography registration before TAVI and after 6 and 12months. Results After TAVI NYHA class (p=0.016), peak and mean aortic valve gradients (p<0.001 for both) improved. Aortic distensibility increased (p=0.032 in the first 6months, p=0.005 in the second 6months, and p=0.003 from baseline to 12months), as well as stiffness decreased (p=0.034; 0.090; 0.001), M-mode strain and tissue strain ameliorated (p=0.041; 0.004; 0.004; and p=0.013; 0.002; 0.001, respectively), tissue Doppler imaging improved (S′ wave: p=0.289; 0.347; 0.018. E′ wave: p=0.018; 0.113; 0.007. A′ wave: p=0.002; 0.532; 0.001). Moreover, some left ventricular parameters improved at 6months, such as ejection fraction (from 49±16 to 57±11%; p=0.044) and diastolic interventricular septum thickness (from 14±2 to 12±2mm; p=0.010). Even systolic pulmonary artery pressure (p=0.019) and left diastolic dysfunction grade ameliorated (p=0.042). Conclusions For the first time we demonstrated that aortic elastic properties improve at 6 and 12months after TAVI, thus influencing ventriculo-arterial coupling and ameliorating left ventricular function.

      PubDate: 2014-11-13T01:30:47Z
      DOI: 10.1016/j.ijchv.2014.04.003
      Issue No: Vol. 4 (2014)
  • Left atrial emptying fraction predicts limited exercise performance in
           heart failure patients

    • Authors: Ibadete Bytyçi; Gani Bajraktari; Pranvera Ibrahimi; Gëzim Berisha; Nehat Rexhepaj; Michael Y. Henein
      Pages: 203 - 207
      Abstract: Publication date: September 2014
      Source:IJC Heart & Vessels, Volume 4
      Author(s): Ibadete Bytyçi , Gani Bajraktari , Pranvera Ibrahimi , Gëzim Berisha , Nehat Rexhepaj , Michael Y. Henein
      Aim We aimed in this study to assess the role of left atrial (LA), in addition to left ventricular (LV) indices, in predicting exercise capacity in patients with heart failure (HF). Methods This study included 88 consecutive patients (60±10years) with stable HF. LV end-diastolic and end-systolic dimensions, ejection fraction (EF), mitral and tricuspid annulus peak systolic excursion (MAPSE and TAPSE), myocardial velocities (s′, e′ and a′), LA dimensions, LA volume and LA emptying fraction were measured. A 6-min walking test (6-MWT) distance was performed on the same day of the echocardiographic examination. Results Patients with limited exercise performance (≤300m) were older (p =0.01), had higher NYHA functional class (p =0.004), higher LV mass index (p =0.003), larger LA (p =0.002), lower LV EF (p =0.009), larger LV end-systolic dimension (p =0.007), higher E/A ratio (p =0.03), reduced septal MAPSE (p <0.001), larger LA end-systolic volume (p =0.03), larger LA end-diastolic volume (p =0.005) and lower LA emptying fraction (p <0.001) compared with good performance patients. In multivariate analysis, only the LA emptying fraction [0.944 (0.898–0.993), p =0.025] independently predicted poor exercise performance. An LA emptying fraction <60% was 68% sensitive and 73% specific (AUC 0.73, p <0.001) in predicting poor exercise performance. Conclusion In heart failure patients, the impaired LA emptying function is the best predictor of poor exercise capacity. This finding highlights the need for routine LA size and function monitoring for better optimization of medical therapy in HF.

      PubDate: 2014-11-13T01:30:47Z
      DOI: 10.1016/j.ijchv.2014.04.002
      Issue No: Vol. 4 (2014)
  • Fractional flow reserve-guided endovascular therapy for common iliac
           artery stenosis; a comparison with the exercise ankle brachial index: A
           case report

    • Authors: Tsuyoshi Ito; Hiroshi Fujita; Tomomitsu Tani; Nobuyuki Ohte
      Pages: 208 - 210
      Abstract: Publication date: Available online 22 May 2014
      Source:IJC Heart & Vessels
      Author(s): Tsuyoshi Ito , Hiroshi Fujita , Tomomitsu Tani , Nobuyuki Ohte

      PubDate: 2014-05-28T06:23:03Z
      DOI: 10.1016/j.ijchv.2014.05.003
      Issue No: Vol. 4 (2014)
  • Three-dimensional optical coherence tomography: Precise diagnosis of stent

    • Authors: Yu Sugawara; Shiro Uemura; Takayuki Okamura; Tomoya Ueda; Makoto Watanabe; Satoshi Okayama; Yoshihiko Saito
      Pages: 211 - 212
      Abstract: Publication date: Available online 22 May 2014
      Source:IJC Heart & Vessels
      Author(s): Yu Sugawara , Shiro Uemura , Takayuki Okamura , Tomoya Ueda , Makoto Watanabe , Satoshi Okayama , Yoshihiko Saito

      PubDate: 2014-05-28T06:23:03Z
      DOI: 10.1016/j.ijchv.2014.05.002
      Issue No: Vol. 4 (2014)
  • Cardiac amyloidosis incidentally detected using technetium-99m
           hydroxymethylene diphosphonate bone scintigraphy in a patient with
           prostate cancer

    • Authors: Satoshi Okayama; Masashi Sugimoto; Tomoya Nakano; Kenji Onoue; Yasuhiro Sakaguchi; Shiro Uemura; Yoshihiko Saito
      Pages: 213 - 214
      Abstract: Publication date: September 2014
      Source:IJC Heart & Vessels, Volume 4
      Author(s): Satoshi Okayama , Masashi Sugimoto , Tomoya Nakano , Kenji Onoue , Yasuhiro Sakaguchi , Shiro Uemura , Yoshihiko Saito

      PubDate: 2014-11-13T01:30:47Z
      DOI: 10.1016/j.ijchv.2014.04.010
      Issue No: Vol. 4 (2014)
  • A Case of Left Ventricular Perforation due to Balloon Slip during
           Percutaneous Aortic Valvuloplasty

    • Authors: Yukiko Mizutani; Norio Tada; Kaname Takizawa; Tatsushi Ootomo; Naoto Inoue; Taiichiro Meguro
      Pages: 216 - 217
      Abstract: Publication date: Available online 16 August 2014
      Source:IJC Heart & Vessels
      Author(s): Yukiko Mizutani , Norio Tada , Kaname Takizawa , Tatsushi Ootomo , Naoto Inoue , Taiichiro Meguro

      PubDate: 2014-09-01T05:14:35Z
      DOI: 10.1016/j.ijchv.2014.08.005
      Issue No: Vol. 4 (2014)
  • Assessment of the circadian variation in the anticoagulant effect of
           rivaroxaban using a novel automated microchip flow-chamber system for the
           quantitative evaluation of thrombus formation

    • Authors: Kenji Norimatsu; Shin-ichiro Miura; Yasunori Suematsu; Yuhei Shiga; Masaya Yano; Yuka Hitaka; Takashi Kuwano; Joji Morii; Tomoo Yasuda; Masahiro Ogawa; Keijiro Saku
      Pages: 218 - 220
      Abstract: Publication date: Available online 17 August 2014
      Source:IJC Heart & Vessels
      Author(s): Kenji Norimatsu , Shin-ichiro Miura , Yasunori Suematsu , Yuhei Shiga , Masaya Yano , Yuka Hitaka , Takashi Kuwano , Joji Morii , Tomoo Yasuda , Masahiro Ogawa , Keijiro Saku

      PubDate: 2014-09-01T05:14:35Z
      DOI: 10.1016/j.ijchv.2014.08.004
      Issue No: Vol. 4 (2014)
  • Dobutamine Stress Testing Induced Transient Cardiomyopathy: A Systematic

    • Authors: Satish Chandraprakasam; Venkata M. Alla; Aryan N. Mooss; Claire B. Hunter
      Pages: 221 - 222
      Abstract: Publication date: Available online 8 August 2014
      Source:IJC Heart & Vessels
      Author(s): Satish Chandraprakasam , Venkata M. Alla , Aryan N. Mooss , Claire B. Hunter

      PubDate: 2014-08-10T19:32:00Z
      DOI: 10.1016/j.ijchv.2014.07.005
      Issue No: Vol. 4 (2014)
  • Detection of abdominal aortic aneurysm during transthoracic

    • Authors: Takao Kato; Seiko Ishida; Shoichi Miyamoto; Saori Kuruma; Akiko Itagaki; Tamae Iura; Yoko Ban; Hiromi Terawaki; Hiromichi Tabata; Jun Fujikawa; Eisaku Nakane; Toshiaki Izumi; Tetsuya Haruna; Moriaki Inoko
      Pages: 223 - 225
      Abstract: Publication date: Available online 6 July 2014
      Source:IJC Heart & Vessels
      Author(s): Takao Kato , Seiko Ishida , Shoichi Miyamoto , Saori Kuruma , Akiko Itagaki , Tamae Iura , Yoko Ban , Hiromi Terawaki , Hiromichi Tabata , Jun Fujikawa , Eisaku Nakane , Toshiaki Izumi , Tetsuya Haruna , Moriaki Inoko

      PubDate: 2014-07-26T17:41:49Z
      DOI: 10.1016/j.ijchv.2014.06.003
      Issue No: Vol. 4 (2014)
  • The predictive value of arterial and valvular calcification for mortality
           and cardiovascular events

    • Authors: Rachel Nicoll; Michael Y. Henein
      Pages: 1 - 5
      Abstract: Publication date: Available online 7 February 2014
      Source:IJC Heart & Vessels
      Author(s): Rachel Nicoll , Michael Y. Henein
      A review of the predictive ability of arterial and valvular calcification has shown an additive effect of calcification in more than 1 location in predicting mortality and coronary heart disease, with mitral annual calcification being a particularly strong predictor. In individual arteries and valves there is a clear association between calcification presence, extent and progression and future cardiovascular events and mortality in asymptomatic, symptomatic and high risk patients, although adjustment for calcification in other arterial beds generally renders associations non-significant. Furthermore, in acute coronary syndrome, culprit plaque normally not calcified. This would tend to reduce the validity of calcification as a predictor and suggests that the association with cardiovascular events and mortality may not be causal. The association with stroke is less clear; carotid and intracranial artery calcification show little predictive ability, with symptomatic plaques tending to be uncalcified.

      PubDate: 2014-02-08T17:20:15Z
      DOI: 10.1016/j.ijchv.2014.02.001
      Issue No: Vol. 3 (2014)
  • Mineralocorticoid Receptor Antagonist in Heart Failure: Past, Present and
           Future Perspectives

    • Authors: Enrico Vizzardi; Valentina Regazzoni; Giorgio Caretta; Mara Gavazzoni; Edoardo Sciatti; Ivano Bonadei; Eleftheria Trichaki; Riccardo Raddino; Marco Metra
      Pages: 6 - 14
      Abstract: Publication date: Available online 19 March 2014
      Source:IJC Heart & Vessels
      Author(s): Enrico Vizzardi , Valentina Regazzoni , Giorgio Caretta , Mara Gavazzoni , Edoardo Sciatti , Ivano Bonadei , Eleftheria Trichaki , Riccardo Raddino , Marco Metra
      Aldosterone is involved in various deleterious effects on the cardiovascular system, including sodium and fluid retention, myocardial fibrosis, vascular stiffening, endothelial dysfunction, catecholamine release and stimulation of cardiac arrhythmias. Therefore, aldosterone receptor blockade may have several potential benefits in patients with cardiovascular disease. Mineralocorticoid receptor antagonists (MRA) have been shown to prevent many of the maladaptive effects of aldosterone, in particular among patients with heart failure (HF). Randomized controlled trials have demonstrated efficacy of MRA in heart failure with reduced ejection fraction, both in patients with NYHA functional class III and IV and in asymptomatic and mildly symptomatic patients (NYHA classes I and II). Recent data in patients with heart failure with preserved ejection fraction are encouraging. MRA could also have anti-arrhythmic effects on atrial and ventricular arrhythmias and may be helpful in patient ischemic heart disease through prevention of myocardial fibrosis and vascular damage. This article aims to discuss the pathophysiological effects of aldosterone in patients with cardiovascular disease and to review the current data that support the use of MRA in heart failure.

      PubDate: 2014-03-20T17:24:51Z
      DOI: 10.1016/j.ijchv.2014.03.005
      Issue No: Vol. 3 (2014)
  • Late Gadolinium Enhancement (LGE) progresses with Right Ventricle Volume
           in Children after Repair of Tetralogy of Fallot

    • Authors: Pekka Ylitalo; Olli M. Pitkänen; Kirsi Lauerma; Miia Holmström; Otto Rahkonen; Markku Heikinheimo; Heikki Sairanen; Eero Jokinen
      Pages: 15 - 20
      Abstract: Publication date: Available online 12 February 2014
      Source:IJC Heart & Vessels
      Author(s): Pekka Ylitalo , Olli M. Pitkänen , Kirsi Lauerma , Miia Holmström , Otto Rahkonen , Markku Heikinheimo , Heikki Sairanen , Eero Jokinen
      Background Fibrosis after myocardial damage can be determined by cardiac magnetic resonance (CMR) with late gadolinium enhancement (LGE). We studied whether ventricular LGE is visible in the ventricles of paediatric and adolescent TOF (Tetralogy of Fallot) patients by measuring LGE and investigating whether fibrosis correlated with right ventricular volume, pulmonary regurgitation, N-terminal pro-brain natriuretic peptide (NT-proBNP) or the aminoterminal propeptide of type III procollagen (PIIINP). We also studied if the patient’s age, post-operative follow-up time or surgical history would affect LGE. Methods A total of 40 paediatric patients who had undergone TOF repair and 43 healthy age and gender matched controls underwent a CMR study, whereby LGE was scored in the right (RV) and left ventricle. To exclude the possible iatrogenic scarring we calculated the LGE score by excluding the right ventricular outflow tract and VSD patch region. Results All patients had RV LGE and in 39 of 40 it was seen also outside the surgically affected areas. The amount of LGE correlated positively with the RV end-diastolic volume (r=0.44, P=0.0045), pulmonary regurgitation (r=0.40, P=0.013), and with NT-proBNP. The presence of LGE also depended on post-operative follow-up time (r=0.53, P=0.006). PIIINP levels of TOF patients were significantly higher than in the control subjects but it did not correlate with LGE or with any of the studied clinical markers. Conclusions LGE is present globally in the right ventricular muscle in children and adolescents with TOF. The longer the follow-up time the more common was the LGE in the right ventricle.

      PubDate: 2014-02-13T22:17:11Z
      DOI: 10.1016/j.ijchv.2014.01.002
      Issue No: Vol. 3 (2014)
  • Difference of vascular response between everolimus- and paclitaxel-eluting
           stents for small coronary artery disease: Optical coherence tomography

    • Authors: Kenya Nasu; Yuji Oikawa; Tadanori Aizawa; Takahiko Suzuki
      Pages: 21 - 27
      Abstract: Publication date: Available online 8 February 2014
      Source:IJC Heart & Vessels
      Author(s): Kenya Nasu , Yuji Oikawa , Tadanori Aizawa , Takahiko Suzuki
      Background Previous clinical trials have demonstrated the clinical and angiographic superiority of everolimus-eluting stents (EES) compared with paclitaxel-eluting stents (PES) in the small coronary vessel. However, the differences of vascular response including assessment of morphological neointimal tissue (NIT) characteristics using optical coherence tomography (OCT) have not been fully evaluated. The aim of this study is to evaluate the differences of chronic vascular response following small coronary stenting between EES and PES using OCT. Methods and results A prospective OCT examination at 9 month follow-up was performed for 50 small coronary artery disease (50 patients) treated by a single 2.5mm stent for each stent group. Cross-sectional area within stent segments were analyzed at an interval of 1 mm. NIT structure (homogeneous or heterogeneous) was evaluated for qualitative assessment. Homogeneous NIT was observed significantly higher and heterogeneous NIT was lower in EES compared with PES (93% vs. 89%; p = 0.003, 6.5% vs. 10.3%; p = 0.002, respectively). The frequencies of exposed and malapposed struts were lower in EES compared with PES (0.2% vs. 1.7%; p = 0.0001, 0.1% vs. 0.3%; p = 0.001, respectively). NIT eccentricity index and NIT area were lower in EES compared with PES (0.69±0.08 vs. 0.76±0.10; p = 0.001, 0.97±0.42mm2 vs. 1.27±0.67mm2; p = 0.01, respectively). Conclusions A favorable vascular response was observed after EES implantation compared with PES for small coronary artery disease. In addition, the characteristics of NIT after EES implantation were more stable than PES at 9 month follow-up.

      PubDate: 2014-02-08T17:20:15Z
      DOI: 10.1016/j.ijchv.2014.01.001
      Issue No: Vol. 3 (2014)
  • Progress of right ventricular dilatation in adults with repaired tetralogy
           of Fallot and free pulmonary regurgitation

    • Authors: Shamus O’Meagher; Madhusudan Ganigara; David J. Tanous; David S. Celermajer; Rajesh Puranik
      Pages: 28 - 31
      Abstract: Publication date: Available online 2 March 2014
      Source:IJC Heart & Vessels
      Author(s): Shamus O’Meagher , Madhusudan Ganigara , David J. Tanous , David S. Celermajer , Rajesh Puranik
      Background The time course of progressive dilatation of the right ventricle (RV) in adults with pulmonary regurgitation (PR) late after repair of tetralogy of Fallot (TOF) is poorly characterized. Methods We analysed cardiac MRI data (1.5T) from 14 adult repaired TOF patients (26±11years of age) with dilated RVs and known significant PR, on 2 separate visits with a between MRI period of 2.1±1.0years. Results Indexed RV end diastolic volume (RVEDVi) increased over 2years (142±19 to 151±20mL/m2, p=0.005; change=8.4±9.3mL/m2, range=−6 to 26mL/m2; annual mL/m2 increase=4.3±4.6; annual percentage increase=3.1±3.3%), whilst RV ejection fraction decreased (53±8 to 49±7 %, p=0.039). RV muscular corpus (RVMC) EDVi significantly increased (130±19 to 138±20mL/m2, p=0.014), whereas RV outflow tract (RVOT) EDVi did not (12±7 vs 13±6mL/m2, p=0.390). No other RV or LV measures significantly changed during the inter-MRI period. The change in RVEDVi correlated significantly with LV end diastolic volume (r=−0.582, p=0.029), RVEDVi:LVEDVi (r=0.6, p=0.023) and RVMC EDVi (r=0.9, p<0.001) but not RVOT EDVi (r=0.225, p=0.459). Conclusions Adult repaired TOF patients with free PR experienced a mean 3.1%, or 4.3mL/m2, annual increase in RVEDVi, unrelated to the initial RVEDVi or PR fraction. The increase in RVEDVi was due to RVMC rather than RVOT dilatation. This provides a guide to the frequency of MR surveillance and insights into the natural history of progressive RV dilatation in this setting.

      PubDate: 2014-03-05T17:47:07Z
      DOI: 10.1016/j.ijchv.2014.02.003
      Issue No: Vol. 3 (2014)
  • Repair or prosthesis insertion in ischemic mitral regurgitation: two faces
           of the same medal

    • Authors: Antonio Maria Calafiore; Angela Lorena Iacò; Daniela Clemente; Reda Refaie; Silvio Romano; Mahmood Asif; Maria Penco; Michele Di Mauro
      Pages: 32 - 36
      Abstract: Publication date: Available online 3 March 2014
      Source:IJC Heart & Vessels
      Author(s): Antonio Maria Calafiore , Angela Lorena Iacò , Daniela Clemente , Reda Refaie , Silvio Romano , Mahmood Asif , Maria Penco , Michele Di Mauro
      Objective The proper treatment of chronic ischemic mitral regurgitation (CIMR) is still under evaluation. The different role of mitral valve repair (MVr) or mitral valve prosthesis insertion (MVPI) is still no defined. Methods From May 2009 to December 2011 167 patients with ejection fraction (EF) ≤40% had MV surgery for CIMR, MVr in 135 (80.8%) and MVPI in 32 (19.2%). Indication to MVPI was a MV coaptation depth >10mm. EF was lower (26±7 vs 32±6, p=0.0000) in MVPI, whereas MR grade (3.6±0.8 vs 2.7±0.9, p=0.0000), left ventricle dimensions (end diastolic, LVEDD, 62±7 vs 57±6mm, p=0.0001; end systolic, LVESD, 49±8 vs 44±8mm, p=0.0018), systolic pulmonary artery pressure (51±22 vs 41±16mmHg, p=0.0037) and NYHA Class (3.6±0.5 vs 2.8±0.6, p=0.0000) were higher. Results In-hospital mortality was similar (3.1 vs 3.7%) as well as 3-year survival (86±6 vs 88±4) and survival in NYHA Class I/II (80±5 vs 83±4). One hundred thirty nine patients had an echocardiographic evaluation after a minimum of 4months (13±8). EF rose significantly in both groups (from 26±7% to 30±4%, p=0.0122, and from 32±6% to 35±8%, p=0.0018). LVESD reduced significantly in both group (from 49±8 to 43±9mm, p=0.0109, and from 44±8 to 41±7mm, p=0.0033). MR grade was significantly lower in patients who had MVPI (0.1±0.2 vs 0.3±0.3, p=0.0011). Conclusions With appropriate indications, MVPI is a safe procedure which provides similar results to MVr with lower MR return, even if addressed to patients with worse preoperative parameters.

      PubDate: 2014-03-05T17:47:07Z
      DOI: 10.1016/j.ijchv.2014.02.002
      Issue No: Vol. 3 (2014)
  • Guideline-directed medical therapy for secondary prevention after coronary
           artery bypass grafting in patients with depression

    • Authors: Malin Stenman; Martin J. Holzmann; Ulrik Sartipy
      Pages: 37 - 42
      Abstract: Publication date: Available online 6 March 2014
      Source:IJC Heart & Vessels
      Author(s): Malin Stenman , Martin J. Holzmann , Ulrik Sartipy
      Background We hypothesized that depressed patients would have lower use of guideline-directed medical therapy for secondary prevention of cardiovascular events following coronary artery bypass grafting (CABG). Methods We included all patients who underwent primary isolated CABG in Sweden between 2006 and 2008. We cross-linked individual level data from national Swedish registers. Preoperative depression was defined as at least one antidepressant prescription dispensed before surgery. We defined medication use as at least two dispensed prescriptions in each medication class (antiplatelet agents, beta-blockers, angiotensin-converting enzyme inhibitors (ACEI)/angiotensin II receptor blocker (ARB), and statins) within a rolling 12months period. We calculated adjusted risk ratios (RR) for the use of each medication class, and for all four classes, after one and four years, respectively. Results During the first year after CABG, 93% of all patients (n=10586) had at least two dispensed prescriptions for an antiplatelet agent, 68% for an ACEI/ARB, 91% for a beta-blocker, and 92% for a statin. 57% had prescriptions for all four medication classes. After four years (n=4034), 44% had filled prescriptions for all four medication classes. Preoperative depression was not significantly associated with a lower use of all four medication classes after one year (RR 0.98, 95% confidence interval (CI) 0.93-1.03) or after four years (RR 0.97, 95% CI 0.86-1.09). Conclusions Preoperative depression was not associated with lower use of guideline-directed medical therapy for secondary prevention after CABG. These findings suggest that the observed higher mortality following CABG among depressed patients is not explained by inadequate secondary prevention medication.

      PubDate: 2014-03-10T17:29:21Z
      DOI: 10.1016/j.ijchv.2014.02.005
      Issue No: Vol. 3 (2014)
  • Efficacy of non-compliant balloon post-dilation in optimization of
           contemporary stents: A Digital Stent Enhancement study

    • Authors: Jaya Chandrasekhar; Christopher Allada; Simon O'Connor; Moyazur Rahman; Bruce Shadbolt; Ahmad Farshid
      Pages: 43 - 48
      Abstract: Publication date: Available online 19 March 2014
      Source:IJC Heart & Vessels
      Author(s): Jaya Chandrasekhar , Christopher Allada , Simon O’Connor , Moyazur Rahman , Bruce Shadbolt , Ahmad Farshid
      Background There is no evidence from randomized trials for benefit of routine non-compliant balloon(NCB) post-dilation after stent deployment. Despite being the gold standard, intravascular ultrasound is infrequently performed due to time and cost constraints and a suitable alternative technology is required for routine assessment of stent expansion. The purpose of this study was to assess the contribution of NCB post-dilation in optimizing contemporary stents by using digital stent enhancement (DSE). Methods We treated 120 patients with stent insertion and assessed the stents with DSE before and after NCB use. Optimal expansion was defined as minimum stent diameter (MSD) ≥90% of nominal stent diameter, an adaptation of the MUSIC and POSTIT trial criteria. Stent deployment was performed at 12atm pressure followed by routine NCB post-dilation at≥14atm. Results Mean reference diameter on QCA was 2.75mm (SD 0.63) and mean stent diameter was 3.15mm (SD 0.46). At a mean stent deployment pressure of 11.7atm (SD 2.4), only 21% of stents were optimally expanded. After NCB inflation at a mean of 16.9atm (SD 2.8), MSD increased by 0.26mm (SD 0.24), optimal stent expansion increased from 21% to 58% and mean stent symmetry ratio increased from 0.83 to 0.87 (p<0.0001). Conclusions Contemporary stents are sub-optimally expanded in the majority of cases after standard deployment compared with nominal sizes. Adjunctive NCB post-dilation optimized an additional 37% of stents. DSE analysis can assist in qualitative and quantitative stent assessment and can potentially facilitate a selective NCB post-dilation strategy to achieve optimal stent expansion.

      PubDate: 2014-03-20T17:24:51Z
      DOI: 10.1016/j.ijchv.2014.03.006
      Issue No: Vol. 3 (2014)
  • Corticosteroids increase intracellular free sodium ion concentration via
           glucocorticoid receptor pathway in cultured neonatal rat cardiomyocytes

    • Authors: Daisuke Katoh; Kenichi Hongo; Keiichi Ito; Takuya Yoshino; Yosuke Kayama; Makoto Kawai; Taro Date; Michihiro Yoshimura
      Pages: 49 - 56
      Abstract: Publication date: Available online 13 March 2014
      Source:IJC Heart & Vessels
      Author(s): Daisuke Katoh , Kenichi Hongo , Keiichi Ito , Takuya Yoshino , Yosuke Kayama , Makoto Kawai , Taro Date , Michihiro Yoshimura
      Background Glucocorticoids as well as mineralocorticoid have been shown to play essential roles in the regulation of electrical and mechanical activities in cardiomyocytes. Excess of these hormones are independent risk factors for cardiovascular disease. Intracellular sodium ([Na+]i) kinetics are involved in cardiac diseases, including ischemia, heart failure and hypertrophy. However, intrinsic mediators that regulate [Na+]i in cardiomyocytes have not been widely discussed. Moreover, the quantitative estimation of altered [Na+]i in cultured cardiomyocytes and the association between the level of [Na+]i and the severity of pathological conditions, such as hypertrophy, have not been precisely reported. Methods and results We herein demonstrate the quantitative estimation of [Na+]i in cultured neonatal rat cardiomyocytes following 24 hours of treatment with corticosterone, aldosterone and dexamethasone. The physiological concentration of glucocorticoids increased [Na+]i up to approximately 2.5 mM (an almost 1.5-fold increase compared to the control) in a dose-dependent manner; this effect was blocked by a glucocorticoid receptor (GR) antagonist but not a mineralocorticoid receptor antagonist. Furthermore, glucocorticoids induced cardiac hypertrophy, and the hypertrophic gene expression was positively and significantly correlated with the level of [Na+]i. Dexamethasone induced the upregulation of Na+/Ca2+ exchanger 1 at the mRNA and protein levels. Conclusions The physiological concentration of glucocorticoids increases [Na+]i via GR. The dexamethasone-induced upregulation of NCX1 is partly involved in the glucocorticoid-induced alteration of [Na+]i in cardiomyocytes. These results provide new insight into the mechanisms by which glucocorticoid excess within a physiological concentration contributes to the development of cardiac pathology.

      PubDate: 2014-03-15T17:32:19Z
      DOI: 10.1016/j.ijchv.2014.03.001
      Issue No: Vol. 3 (2014)
  • In memoriam

    • Authors: Manuela Aschauer; Matthias Fischer Friedrich
      Abstract: Publication date: September 2014
      Source:IJC Heart & Vessels, Volume 4
      Author(s): Manuela Aschauer , Matthias Fischer , Friedrich Köhler

      PubDate: 2014-11-13T01:30:47Z
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
Tel: +00 44 (0)131 4513762

Your IP address:
Home (Search)
About JournalTOCs
News (blog, publications)
JournalTOCs on Twitter   JournalTOCs on Facebook

JournalTOCs © 2009-