Subjects -> MEDICAL SCIENCES (Total: 8359 journals)
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CARDIOVASCULAR DISEASES (329 journals)                  1 2 | Last

Showing 1 - 200 of 329 Journals sorted alphabetically
Acta Angiologica     Open Access   (Followers: 5)
Acta Cardiologica     Hybrid Journal   (Followers: 2)
Acute Cardiac Care     Hybrid Journal   (Followers: 7)
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: 58)
American Journal of Cardiology     Hybrid Journal   (Followers: 67)
American Journal of Cardiovascular Drugs     Hybrid Journal   (Followers: 17)
American Journal of Hypertension     Hybrid Journal   (Followers: 28)
Anales de Cirugia Vascular     Full-text available via subscription   (Followers: 1)
Anatolian Journal of Cardiology     Open Access   (Followers: 6)
Angiología     Full-text available via subscription  
Angiologia e Cirurgia Vascular     Open Access   (Followers: 1)
Angiology     Hybrid Journal   (Followers: 3)
Annales de Cardiologie et d'Angéiologie     Full-text available via subscription   (Followers: 1)
Annals of Noninvasive Electrocardiology     Hybrid Journal   (Followers: 1)
Annals of Pediatric Cardiology     Open Access   (Followers: 12)
AORTA     Open Access  
Archives of Cardiovascular Diseases     Full-text available via subscription   (Followers: 5)
Archives of Cardiovascular Diseases Supplements     Full-text available via subscription   (Followers: 3)
Archives of Cardiovascular Imaging     Open Access   (Followers: 2)
Archivos de cardiología de México     Open Access   (Followers: 1)
Argentine Journal of Cardiology (English edition)     Open Access   (Followers: 2)
Arquivos Brasileiros de Cardiologia     Open Access   (Followers: 1)
Arteriosclerosis, Thrombosis and Vascular Biology     Full-text available via subscription   (Followers: 32)
Artery Research     Hybrid Journal   (Followers: 4)
ARYA Atherosclerosis     Open Access  
ASAIO Journal     Hybrid Journal   (Followers: 3)
ASEAN Heart Journal     Open Access   (Followers: 2)
Asian Cardiovascular and Thoracic Annals     Hybrid Journal   (Followers: 2)
Aswan Heart Centre Science & Practice Services     Open Access   (Followers: 1)
Atherosclerosis : X     Open Access  
Bangladesh Heart Journal     Open Access   (Followers: 3)
Basic Research in Cardiology     Hybrid Journal   (Followers: 10)
BMC Cardiovascular Disorders     Open Access   (Followers: 22)
Brain Circulation     Open Access   (Followers: 1)
British Journal of Cardiology     Full-text available via subscription   (Followers: 16)
Canadian Journal of Cardiology     Hybrid Journal   (Followers: 18)
Cardiac Cath Lab Director     Full-text available via subscription  
Cardiac Electrophysiology Review     Hybrid Journal   (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  
Cardiology and Therapy     Open Access   (Followers: 12)
Cardiology Clinics     Full-text available via subscription   (Followers: 14)
Cardiology in Review     Hybrid Journal   (Followers: 8)
Cardiology in the Young     Hybrid Journal   (Followers: 34)
Cardiology Journal     Open Access   (Followers: 6)
Cardiology Plus     Open Access   (Followers: 1)
Cardiology Research     Open Access   (Followers: 15)
Cardiology Research and Practice     Open Access   (Followers: 10)
Cardiopulmonary Physical Therapy Journal     Hybrid Journal   (Followers: 7)
Cardiorenal Medicine     Full-text available via subscription   (Followers: 1)
Cardiothoracic Surgeon     Open Access  
CardioVasc     Full-text available via subscription   (Followers: 1)
Cardiovascular & Haematological Disorders - Drug Targets     Hybrid Journal   (Followers: 1)
Cardiovascular & Hematological Agents in Medicinal Chemistry     Hybrid Journal   (Followers: 2)
CardioVascular and Interventional Radiology     Hybrid Journal   (Followers: 15)
Cardiovascular and Thoracic Open     Open Access  
Cardiovascular Diabetology     Open Access   (Followers: 10)
Cardiovascular Drugs and Therapy     Hybrid Journal   (Followers: 14)
Cardiovascular Endocrinology & Metabolism     Hybrid Journal   (Followers: 1)
Cardiovascular Engineering     Hybrid Journal   (Followers: 1)
Cardiovascular Engineering and Technology     Hybrid Journal   (Followers: 1)
Cardiovascular Intervention and Therapeutics     Hybrid Journal   (Followers: 5)
Cardiovascular Journal     Open Access   (Followers: 6)
Cardiovascular Journal of Africa     Full-text available via subscription   (Followers: 5)
Cardiovascular Journal of South Africa     Full-text available via subscription   (Followers: 1)
Cardiovascular Medicine in General Practice     Full-text available via subscription   (Followers: 7)
Cardiovascular Pathology     Hybrid Journal   (Followers: 4)
Cardiovascular Regenerative Medicine     Open Access  
Cardiovascular Research     Hybrid Journal   (Followers: 15)
Cardiovascular Revascularization Medicine     Hybrid Journal   (Followers: 1)
Cardiovascular System     Open Access  
Cardiovascular Therapeutics     Open Access   (Followers: 1)
Cardiovascular Toxicology     Hybrid Journal   (Followers: 6)
Cardiovascular Ultrasound     Open Access   (Followers: 5)
Case Reports in Cardiology     Open Access   (Followers: 7)
Catheterization and Cardiovascular Interventions     Hybrid Journal   (Followers: 3)
Cerebrovascular Diseases     Full-text available via subscription   (Followers: 3)
Cerebrovascular Diseases Extra     Open Access  
Chest     Full-text available via subscription   (Followers: 100)
Choroby Serca i Naczyń     Open Access   (Followers: 1)
Circulation     Hybrid Journal   (Followers: 246)
Circulation : Cardiovascular Imaging     Hybrid Journal   (Followers: 14)
Circulation : Cardiovascular Interventions     Hybrid Journal   (Followers: 17)
Circulation : Cardiovascular Quality and Outcomes     Hybrid Journal   (Followers: 11)
Circulation : Genomic and Precision Medicine     Hybrid Journal   (Followers: 15)
Circulation : Heart Failure     Hybrid Journal   (Followers: 26)
Circulation Research     Hybrid Journal   (Followers: 35)
Cirugía Cardiovascular     Open Access  
Clínica e Investigación en Arteriosclerosis     Full-text available via subscription  
Clínica e Investigación en arteriosclerosis (English Edition)     Hybrid Journal  
Clinical and Experimental Hypertension     Hybrid Journal   (Followers: 3)
Clinical Cardiology     Hybrid Journal   (Followers: 11)
Clinical Hypertension     Open Access   (Followers: 5)
Clinical Medicine Insights : Cardiology     Open Access   (Followers: 6)
Clinical Research in Cardiology     Hybrid Journal   (Followers: 6)
Clinical Research in Cardiology Supplements     Hybrid Journal  
Clinical Trials and Regulatory Science in Cardiology     Open Access   (Followers: 4)
Congenital Heart Disease     Hybrid Journal   (Followers: 6)
Congestive Heart Failure     Hybrid Journal   (Followers: 4)
Cor et Vasa     Full-text available via subscription   (Followers: 1)
Coronary Artery Disease     Hybrid Journal   (Followers: 2)
CorSalud     Open Access  
Critical Pathways in Cardiology     Hybrid Journal   (Followers: 4)
Current Cardiology Reports     Hybrid Journal   (Followers: 7)
Current Cardiology Reviews     Hybrid Journal   (Followers: 4)
Current Cardiovascular Imaging Reports     Hybrid Journal   (Followers: 1)
Current Cardiovascular Risk Reports     Hybrid Journal  
Current Heart Failure Reports     Hybrid Journal   (Followers: 5)
Current Hypertension Reports     Hybrid Journal   (Followers: 6)
Current Hypertension Reviews     Hybrid Journal   (Followers: 6)
Current Opinion in Cardiology     Hybrid Journal   (Followers: 14)
Current Problems in Cardiology     Hybrid Journal   (Followers: 3)
Current Research : Cardiology     Full-text available via subscription   (Followers: 1)
Current Treatment Options in Cardiovascular Medicine     Hybrid Journal   (Followers: 1)
Current Vascular Pharmacology     Hybrid Journal   (Followers: 5)
CVIR Endovascular     Open Access   (Followers: 1)
Der Kardiologe     Hybrid Journal   (Followers: 2)
Echo Research and Practice     Open Access   (Followers: 2)
Echocardiography     Hybrid Journal   (Followers: 4)
Egyptian Heart Journal     Open Access   (Followers: 2)
Egyptian Journal of Cardiothoracic Anesthesia     Open Access  
ESC Heart Failure     Open Access   (Followers: 4)
European Heart Journal     Hybrid Journal   (Followers: 67)
European Heart Journal - Cardiovascular Imaging     Hybrid Journal   (Followers: 10)
European Heart Journal - Cardiovascular Pharmacotherapy     Full-text available via subscription   (Followers: 3)
European Heart Journal - Quality of Care and Clinical Outcomes     Hybrid Journal  
European Heart Journal : Acute Cardiovascular Care     Hybrid Journal   (Followers: 1)
European Heart Journal : Case Reports     Open Access   (Followers: 1)
European Heart Journal Supplements     Hybrid Journal   (Followers: 8)
European Journal of Cardio-Thoracic Surgery     Hybrid Journal   (Followers: 9)
European Journal of Cardio-Thoracic Surgery Supplements     Full-text available via subscription   (Followers: 2)
European Journal of Cardiovascular Nursing     Hybrid Journal   (Followers: 5)
European Journal of Heart Failure     Hybrid Journal   (Followers: 14)
European Journal of Preventive Cardiology.     Hybrid Journal   (Followers: 6)
European Stroke Organisation     Hybrid Journal   (Followers: 3)
Experimental & Translational Stroke Medicine     Open Access   (Followers: 8)
Expert Review of Cardiovascular Therapy     Full-text available via subscription   (Followers: 3)
Folia Cardiologica     Open Access  
Forum Zaburzeń Metabolicznych     Hybrid Journal  
Frontiers in Cardiovascular Medicine     Open Access   (Followers: 1)
Future Cardiology     Hybrid Journal   (Followers: 6)
General Thoracic and Cardiovascular Surgery     Hybrid Journal   (Followers: 3)
Global Cardiology Science and Practice     Open Access   (Followers: 5)
Global Heart     Hybrid Journal   (Followers: 3)
Heart     Hybrid Journal   (Followers: 48)
Heart and Mind     Open Access  
Heart and Vessels     Hybrid Journal  
Heart Failure Clinics     Full-text available via subscription   (Followers: 2)
Heart Failure Reviews     Hybrid Journal   (Followers: 3)
Heart India     Open Access   (Followers: 2)
Heart International     Full-text available via subscription  
Heart Rhythm     Hybrid Journal   (Followers: 11)
Heart Views     Open Access   (Followers: 2)
HeartRhythm Case Reports     Open Access  
Hellenic Journal of Cardiology     Open Access   (Followers: 1)
Herz     Hybrid Journal   (Followers: 3)
High Blood Pressure & Cardiovascular Prevention     Full-text available via subscription   (Followers: 2)
Hypertension     Full-text available via subscription   (Followers: 23)
Hypertension in Pregnancy     Hybrid Journal   (Followers: 9)
Hypertension Research     Hybrid Journal   (Followers: 5)
Ibrahim Cardiac Medical Journal     Open Access  
IJC Heart & Vessels     Open Access   (Followers: 1)
IJC Heart & Vasculature     Open Access   (Followers: 1)
IJC Metabolic & Endocrine     Open Access   (Followers: 1)
Indian Heart Journal     Open Access   (Followers: 5)
Indian Journal of Cardiovascular Disease in Women WINCARS     Open Access  
Indian Journal of Thoracic and Cardiovascular Surgery     Hybrid Journal  
Indian Pacing and Electrophysiology Journal     Open Access   (Followers: 1)
Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery     Hybrid Journal   (Followers: 1)
Insuficiencia Cardíaca     Open Access  
Interactive CardioVascular and Thoracic Surgery     Hybrid Journal   (Followers: 7)
International Cardiovascular Forum Journal     Open Access  
International Journal of Angiology     Hybrid Journal   (Followers: 2)
International Journal of Cardiology     Hybrid Journal   (Followers: 18)
International Journal of Cardiovascular and Cerebrovascular Disease     Open Access   (Followers: 2)
International Journal of Cardiovascular Imaging     Hybrid Journal   (Followers: 2)
International Journal of Cardiovascular Research     Hybrid Journal   (Followers: 6)
International Journal of Heart Rhythm     Open Access  
International Journal of Hypertension     Open Access   (Followers: 8)
International Journal of Hyperthermia     Open Access  
International Journal of Stroke     Hybrid Journal   (Followers: 30)
International Journal of the Cardiovascular Academy     Open Access  
Interventional Cardiology Clinics     Full-text available via subscription   (Followers: 2)
Interventional Cardiology Review     Full-text available via subscription  
JACC : Basic to Translational Science     Open Access   (Followers: 5)
JACC : Cardiovascular Imaging     Hybrid Journal   (Followers: 18)
JACC : Cardiovascular Interventions     Hybrid Journal   (Followers: 17)
JACC : Heart Failure     Full-text available via subscription   (Followers: 14)
JAMA Cardiology     Hybrid Journal   (Followers: 28)
JMIR Cardio     Open Access  
Jornal Vascular Brasileiro     Open Access  
Journal of Clinical & Experimental Cardiology     Open Access   (Followers: 5)
Journal of Arrhythmia     Open Access  
Journal of Cardiac Critical Care TSS     Open Access   (Followers: 1)
Journal of Cardiac Failure     Hybrid Journal   (Followers: 1)

        1 2 | Last

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IJC Heart & Vasculature
Journal Prestige (SJR): 0.342
Citation Impact (citeScore): 1
Number of Followers: 1  

  This is an Open Access Journal Open Access journal
ISSN (Online) 2352-9067
Published by Elsevier Homepage  [3161 journals]
  • Feasibility, reproducibility and accuracy of electrical velocimetry for
           cardiac output assessment in congenital heart disease

    • Abstract: Publication date: February 2020Source: IJC Heart & Vasculature, Volume 26Author(s): Alexander C. Egbe, Muhammad Wajih Ullah, Arslan Afzal, Keerthana Banala, Rahul Vojjini, Maria Najam, Karim Osman, Sahith Thotamgari, Donald J. HaglerAbstractBackgroundNoninvasive cardiac output assessment is important for prognostication in patients with heart failure. Electrical velocimetry (EV), an impedance cardiography technique, can be used for noninvasive cardiac output assessment. The purpose of this study was to determine the feasibility, reproducibility and accuracy of cardiac output assessment by EV in adults with congenital heart disease (CHD).MethodsCross-sectional study of CHD patients that had simultaneous cardiac output assessment by Fick and EV (using Cardiotronic monitor, Osypka Medical). We divided the cohort into: Group 1 patients (n = 54) had hemodynamic assessment at rest only, while Group 2 patients (n = 7) had assessment both at rest and peak exercise.ResultsEV cardiac output assessment was feasible in 100% of the patients. There was good correlation between Fick-derived and EV-derived cardiac index (r = 0.89, p 
       
  • Successful thoracoscopic clipping of a thrombus-containing left atrial
           appendage

    • Abstract: Publication date: February 2020Source: IJC Heart & Vasculature, Volume 26Author(s): Mindy Vroomen, Justin G.L.M. Luermans, Mark La Meir, Bart Maesen
       
  • The progress and controversial of the use of beta blockers in patients
           with heart failure with a preserved ejection fraction

    • Abstract: Publication date: February 2020Source: IJC Heart & Vasculature, Volume 26Author(s): Xizhen Xu, Dao Wen WangAbstractBeta blockers are a recommended therapy in patients with heart failure with reduced ejection fraction(HFrEF). Beta blockers markedly and unequivocally reduce mortality in patients with heart failure with reduced ejection fraction. However, the beneficial effects of beta blockers in patients with heart failure with preserved ejection fraction(HFpEF) are not well established. In this review, we will assess the evidence basis of the recommendations for beta blockers and discuss emerging concerns about the use of beta blockers in patients with HFpEF. The available evidence for beta blockers is limited and it remains uncertain whether beta blockers have a beneficial role in the treatment of HFpEF in the absence of an alternative indication for their use.
       
  • The impact of tissue-tracking strain on the left atrial dysfunction in the
           patients with left ventricular dysfunction

    • Abstract: Publication date: February 2020Source: IJC Heart & Vasculature, Volume 26Author(s): Hideki Koike, Satoru Kishi, Naoki Hosoda, Shuhei Takemoto, Daijiro Tomii, Kai Ninomiya, Tetsu Tanaka, Masahiko Asami, Kazuyuki Yahagi, Kota Komiyama, Jun Tanaka, Hitomi Yuzawa, Rine Nakanishi, Tadashi Fujino, Jiro Aoki, Bharath A. Venkatesh, João A.C. Lima, Kengo Tanabe, Takanori IkedaAbstractBackgroundThe extracellular volume (ECV) calculated by T1 mapping, and tissue-tracking strain using cardiac magnetic resonance (CMR) are useful for assessing the left ventricular (LV) function. However, those parameters are controversial for assessing left atrial (LA) function. This study aimed to investigate the usefulness of CMR to evaluate the LA function using those parameters. Furthermore, those LA function parameters were compared in each LV function.MethodsA total of 65 consecutive patients who underwent contrast CMR were prospectively enrolled (age 55.7 ± 14. 6 years, males 67.7%). Among the 65 patients, there were 15 without hypertension, diabetes, or atrial fibrillation (Healthy group). The remaining 50 patients were divided into two groups according to a left ventricular ejection fraction (LVEF) of 50%. We assessed the correlations between the LV- and LA-CMR parameters among the three groups (LVEF 
       
  • Few with ST-segment elevation myocardial infarction are diagnosed within
           10 minutes from first medical contact, and women have longer delay times
           than men

    • Abstract: Publication date: February 2020Source: IJC Heart & Vasculature, Volume 26Author(s): Josephine Muhrbeck, Eli Maliniak, Lars Eurenius, Claes Hofman-Bang, Jonas PerssonAbstractBackgroundPrevious reports have questioned the feasibility and gender equality of obtaining a prehospital ECG within 10 minutes of ambulance arrival for patients with ST-segment elevation myocardial infarction (STEMI). The main objective of this study was to investigate the proportion of STEMI patients with a prehospital ECG within 10 minutes of ambulance arrival. The secondary objective was to study the gender differences in delay times in prehospital STEMI care.MethodsThis study was a retrospective study based on 539 patients with STEMI at the investigating hospital. Ambulance and medical charts, as well as the national quality registry “SWEDEHEART”, were reviewed for each patient for demographics and time information.ResultsA prehospital ECG was obtained within 10 minutes of ambulance arrival for 99 (29%) of the men and 19 (14%) of the women, p = 0.001. Women had a 2 minutes longer delay between ambulance arrival and prehospital ECG (95% CI 0–4 min, p = 0.018) than men. Women also had a significantly longer patient delay. None of the other time intervals differed among men and women.ConclusionsOnly for a minority of patients is a prehospital ECG taken within the recommended ten minutes from ambulance arrival. Women have longer patient delay times, as well as delay times to the acquisition of a prehospital ECG than men. Improvements of prehospital ECG acquisition and adjustments of the guidelines are warranted.
       
  • Resheathing of self-expanding bioprosthesis: Impact on procedural results,
           clinical outcome and prosthetic valve durability after transcatheter
           aortic valve implantation

    • Abstract: Publication date: February 2020Source: IJC Heart & Vasculature, Volume 26Author(s): Joelle Kefer, Frederic Maes, Jean Renkin, Shakeel Kautbally, Christophe De Meester, Marine Delacour, Anne-Catherine PouleurAbstractBackgroundNew transcatheter aortic valves were recently developed, enabling to resheath and reposition the prosthesis. The aim of the present study was to investigate whether the resheath manoeuvre did not impair the outcome of patients and the bioprosthesis durability after transcatheter aortic valve implantation (TAVI).Methods and resultsOn the 346 consecutive patients (84 ± 7 yrs-old, mean STS 6.7 ± 5%) undergoing a transfemoral TAVI in our institution since January 2008, 170 patients were implanted using a self-expanding valve (SEV). Among those, 39 (Group 1) required resheathing to achieve a successful implantation, while 131 did not require it (Group 2, N = 131). A balloon-expanding valve (BEV) was used in 176 patients (Group 3). Baseline characteristics were similar between groups. Device success was 98%, the rate of in-hospital death was 2%, and the number of procedural complications was similarly low, with no significant difference between groups. The follow-up was complete in 337 of 338 patients undergoing a successful TAVI (781 patients-year). Kaplan-Meier analysis showed that overall survival was 80 ± 2% and 42 ± 3% at 1 and 5 years respectively, with no difference between groups. On multivariate analysis, acute kidney injury, post-dilatation, pulmonary hypertension, porcelain aorta and STS score, but not resheath, were independant predictors of death after TAVI. The annual event rate of structural valve deterioration was 0.6% patients-year, and similar between groups.ConclusionsOur study shows that SEV resheath did not impair the procedural results, the outcome of patients nor the valve durability at short term after TAVI.
       
  • Impairment of left atrial function and cryptogenic stroke: Potential
           insights in the pathophysiology of stroke in the young

    • Abstract: Publication date: February 2020Source: IJC Heart & Vasculature, Volume 26Author(s): Aditya Bhat, Shaun Khanna, Henry H. Chen, Lina Lee, Gary C.H. Gan, Kazuaki Negishi, C. Raina MacIntyre, Maria Carmo P. Nunes, Timothy C. TanAbstractBackgroundStroke is one of the leading causes of morbidity and mortality with a significant percentage classified as cryptogenic. Left atrial (LA) remodelling, a substrate for atrial fibrillation (AF) and stroke development, may play a role in identification of the aetiology of cryptogenic stroke. We aimed to examine LA function to gain mechanistic insights into the pathophysiology of cryptogenic stroke in young patients otherwise at low risk for cardiovascular disease.MethodsPatients aged
       
  • Clinical usefulness of instantaneous wave-free ratio for the evaluation of
           coronary artery lesion with prior myocardial infarction: A multi-center
           study

    • Abstract: Publication date: February 2020Source: IJC Heart & Vasculature, Volume 26Author(s): Shusuke Fukuoka, Tairo Kurita, Akihiro Takasaki, Tomoyuki Nakata, Naoki Fujimoto, Jun Masuda, Kozo Hoshino, Takashi Tanigawa, Sukenari Koyabu, Masaaki Ito, Kaoru DohiAbstractBackgroundFractional flow reserve (FFR) is useful for assessing the functional significance of coronary artery stenosis, even in lesions with prior myocardial infarction (pMI). Instantaneous wave-free ratio (iFR) is a vasodilator-free alternative for the physiological assessment of coronary artery stenosis. In addition, iFR shows good diagnostic agreement with FFR and an iFR-guided revascularization strategy was non-inferior to an FFR-guided revascularization strategy. However, the clinical usefulness of iFR for the evaluation of a coronary artery lesions with pMI has not been evaluated.Methods and ResultsA total of 200 lesions from 200 patients (44 pMI territories lesions and 156 non-pMI coronary artery lesions) were analyzed retrospectively. Major adverse cardiac events (MACE) were defined as cardiovascular death, non-fatal MI, unstable angina pectoris, fatal arrhythmia and heart failure during 12 months follow-up after the physiological assessment of coronary artery stenosis. iFR was closely correlated with FFR in pMI and non-pMI lesions (r = 0.81 and 0.72; P 
       
  • Heart failure mortality prediction using PRISM score and development of a
           classification and regression tree model to refer patients for palliative
           care consultation

    • Abstract: Publication date: February 2020Source: IJC Heart & Vasculature, Volume 26Author(s): Sindhu Avula, Michael LaFata, Mohammed Nabhan, Ambreen Allana, Bhavana Toprani, Caleb Scheidel, Anupam SunejaAbstractIntroductionWe sought to assess one-year mortality in heart failure (HF) patients by using (Placement Resource Indicator for Systems Management) PRISM, a disease nonspecific risk stratification score, and use it along with modified Seattle Heart Failure Model (SHFM) to guide patient selection for palliative care consultation.MethodsA retrospective study design was used to examine 1-year mortality in 689 HF patients admitted from 2012 to 2014. One-year mortality was calculated using Pmort30/PRISM and modified SHFM scores, and the predicted scores were validated using the area under the ROC curve. CART was used to develop an algorithm to classify patients based on their mortality risk.ResultsThe discriminatory ability of PRISM categorical score (AUC = 0.701) was not significantly different than the discriminatory ability of modified SHFM (AUC = 0.686) (DeLong's test p = 0.56) but improved significantly with the combination of PRISM (categorical) score + modified SHFM (AUC = 0.740) (p = 0.002). The predictive capability of the CART tree model after cross-validation was 72.2% (AUC 0.631).ConclusionOur study suggests PRISM score performed as well as modified SHFM for one-year mortality prediction. Moreover, the addition of modified SHFM to PRISM score increases discriminatory ability in predicting 1-year mortality in heart failure patients compared to either of the two models alone. Together, when combined in a CART model, they can be used to identify the population subset with the highest mortality risk and hence guide goals of care discussion.
       
  • Is the sigma-1 receptor a potential pharmacological target for cardiac
           pathologies' A systematic review

    • Abstract: Publication date: February 2020Source: IJC Heart & Vasculature, Volume 26Author(s): Rebecca Lewis, Jiaqi Li, Peter J McCormick, Christopher L-H Huang, Kamalan JeevaratnamAbstractSigma-1 receptors are ligand-regulated chaperone proteins, involved in several cellular mechanisms. The aim of this systematic review was to examine the effects that the sigma-1 receptor has on the cardiovascular system. The interaction targets and proposed mechanisms of action of sigma-1 receptors were explored, with the aim of determining if the sigma-1 receptor is a potential pharmacological target for cardiac pathologies. This systematic review was conducted according to the PRISMA guidelines and these were used to critically appraise eligible studies. Pubmed and Scopus were systematically searched for articles investigating sigma-1 receptors in the cardiovascular system. Papers identified by the search terms were then subject to analysis against pre-determined inclusion criteria. 23 manuscripts met the inclusion criteria and were included in this review. The experimental platforms, experimental techniques utilised and the results of the studies were summarised. The sigma-1 receptor is found to be implicated in cardioprotection, via various mechanisms including stimulating the Akt-eNOS pathway, and reduction of Ca2 + leakage into the cytosol via modulating certain calcium channels. Sigma-1 receptors are also found to modulate other cardiac ion channels including different subtypes of potassium and sodium channels and have been shown to modulate intracardiac neuron excitability. The sigma-1 receptor is a potential therapeutic target for treatment of cardiac pathologies, particularly cardiac hypertrophy. We therefore suggest investigating the cardioprotective mechanisms of sigma-1 receptor function, alongside proposed potential ligands that can stimulate these functions.
       
  • European multicentre experience of staged hybrid atrial fibrillation
           ablation for the treatment of persistent and longstanding persistent
           atrial fibrillation

    • Abstract: Publication date: Available online 6 January 2020Source: IJC Heart & VasculatureAuthor(s): G.A. Haywood, R. Varini, P. Osmancik, M. Cireddu, J. Caldwell, M.A. Chaudhry, M. Loubani, P. Della Bella, E. Lapenna, P. Budera, M. Dalrymple-HayAbstractThe management of non-paroxysmal atrial fibrillation (AF) remains controversial. We examined the efficacy and safety of the 2 stage Hybrid AF ablation approach by analysing the largest series of this technique reported so far.MethodsThe approach aims to electrically isolate the left atrial posterior wall incorporating the pulmonary veins (‘box-set’pattern). An initial video-assisted thoracoscopic (VATS) epicardial ablation is followed after a minimum of 8 weeks by endocardial radiofrequency catheter ablation.ResultsOf 175 patients from 4 European cardiothoracic centers, who underwent the surgical (COBRA Fusion, AtriCure Inc) 1st stage ablation, 166 went on to complete 2nd stage catheter ablation. At median follow up of 18 months post 2nd stage procedure 93/166 (56%) had remained free of AF or atrial tachycardia (AT) recurrence off antiarrhythmic drugs. 110/175 62.9% were in sinus rhythm off all antiarrhythmic drugs at last clinic follow-up (132/175 75.4% including those on antiarrhythmic drugs). 18 patients (10.8%) underwent a further re-do ablation (mean of 1.1 ablations per patient) 105/166 (63%) remained free of AF/AT recurrence off antiarrhythmic drugs following last ablation procedure.Latterly, ILRs have been implanted in patients (n = 56); 60% have remained fully arrhythmia free and 80% have shown AF burden 
       
  • Emergence of endocardium/epicardium flow gradient as novel risk biomarker
           in patients with hypertrophic cardiomyopathy

    • Abstract: Publication date: Available online 6 January 2020Source: IJC Heart & VasculatureAuthor(s): Thomas H. Schindler, Ines Valenta, Sudhir Jain
       
  • Sleep apnea in atrial fibrillation – Highly prevalent, highly relevant,
           but most patients are not somnolent!

    • Abstract: Publication date: Available online 6 January 2020Source: IJC Heart & VasculatureAuthor(s): Kadhim Kadhim, Dennis H. Lau, Prashanthan Sanders, Dominik Linz
       
  • Effect of the antipsychotic drug haloperidol on arrhythmias during acute
           myocardial infarction in a porcine model

    • Abstract: Publication date: Available online 30 December 2019Source: IJC Heart & VasculatureAuthor(s): Stefan M. Sattler, Anniek F. Lubberding, Charlotte B. Kristensen, Rasmus Møgelvang, Paul Blanche, Anders Fink-Jensen, Thomas Engstrøm, Stefan Kääb, Thomas Jespersen, Jacob Tfelt-HansenAbstractPatients receiving psychiatric medication, like the antipsychotic drug haloperidol, are at an increased risk of sudden cardiac death (SCD). Haloperidol blocks the cardiac rapidly-activating delayed rectifier potassium current, thereby increasing electrical dispersion of repolarization which can potentially lead to arrhythmias. Whether these patients are also at a higher risk to develop SCD during an acute myocardial infarction (AMI) is unknown. AMI locally shortens action potential duration, which might further increase repolarization dispersion and increase the risk of arrhythmia in the presence of haloperidol compared to without. Our aim was to test whether treatment with haloperidol implies an increased risk of SCD when eventually experiencing AMI. Twenty-eight female Danish Landrace pigs were randomized into three groups: low dose haloperidol (0.1 mg/kg), high dose (1.0 mg/kg) or vehicle-control group. One hour after haloperidol/vehicle infusion, AMI was induced by balloon-occlusion of the mid-left anterior descending coronary artery and maintained for 120 min, followed by 60 min of reperfusion. VF occurred during occlusion in 7/11 pigs in the control group, 3/11 in the low dose (p = 0.198) and 2/6 in the high dose group (p = 0.335). High dose haloperidol significantly prolonged QT, and reduced heart rate, vascular resistance and blood pressure before and during AMI. Premature ventricular contractions in phase 1b during AMI were reduced with high dose haloperidol. AMI-induced arrhythmia was not aggravated in pigs with haloperidol treatment. Our results do not suggest that AMI is contributing to the excess mortality in patients treated with antipsychotic drugs seen in epidemiological studies.
       
  • Management of patients with newly-diagnosed atrial fibrillation: Insights
           from the BALKAN-AF survey

    • Abstract: Publication date: Available online 28 December 2019Source: IJC Heart & VasculatureAuthor(s): Monika Kozieł, Stefan Simovic, Nikola Pavlovic, Milan Nedeljkovic, Vilma Paparisto, Ljilja Music, Evgenii Goshev, Anca Rodica Dan, Sime Manola, Zumreta Kusljugic, Elina Trendafilova, Dobromir Dobrev, Gheorghe-Andrei Dan, Gregory Y.H. Lip, Tatjana S. Potpara, on behalf of the BALKAN-AF investigatorsAbstractBackgroundBALKAN-AF evaluated patterns of atrial fibrillation (AF) management in real-world clinical practice in the Balkans. The objectives were: to assess the proportion of patients with first-diagnosed AF in the BALKAN-AF cohort and to compare the management of patients with newly-diagnosed AF and those with previously known AF in clinical practice.MethodsConsecutive patients from 7 Balkan countries were enrolled prospectively to the snapshot BALKAN-AF survey.ResultsOf 2712 enrolled patients, 2677 (98.7%) with complete data were included. 631 (23.6%) patients had newly-diagnosed AF and 2046 (76.4%) patients had known AF. Patients with newly-diagnosed AF were more likely to be hospitalized for AF and to receive single antiplatelet therapy (SAPT) alone and less likely to receive OACs than those with known AF (all p 
       
  • Heart rate – A complex prognostic marker in acute heart failure

    • Abstract: Publication date: Available online 28 December 2019Source: IJC Heart & VasculatureAuthor(s): Jan Olligs, Dominik Linz, Dirk G. Dechering, Lars Eckardt, Patrick Müller
       
  • Positron emission tomography (15O-water, 11C-acetate, 11C-HED) risk
           markers and nonsustained ventricular tachycardia in hypertrophic
           cardiomyopathy

    • Abstract: Publication date: Available online 20 December 2019Source: IJC Heart & VasculatureAuthor(s): Peter Magnusson, Jonny Nordström, Hendrik J. Harms, Mark Lubberink, Fredrik Gadler, Jens Sörensen, Stellan MörnerAbstractBackgroundThe objectives of the study were to describe positron emission tomography (PET) parameters, using the tracers 15O-water at rest/stress, 11C-acetate, and 11C-HED, with regard to nonsustained ventricular tachycardia (NSVT) in hypertrophic cardiomyopathy (HCM). PET offers quantitative assessment of pathophysiology throughout the left ventricular segments, including the endocardium/epicardium. The potential use PET in risk stratification remains to be elucidated. NSVT provides a marker for sudden cardiac death.MethodsPatients with a validated diagnosis of HCM who had an implantable cardioverter-defibrillator were interrogated at 12 months and independently of PET-examinations.ResultsIn total, 25 patients (mean age 56.8 ± 12.9 years, 76% males) were included and 10 reported NSVT. Mean myocardial blood flow (MBF) at rest was 0.91 ml/g/min and decreased at stress, 1.59 ml/g/min. The mean gradient (endocardium/epicardium quotient) at rest was 1.14 ± 0.09, while inverse at stress (mean 0.92 ± 0.16). Notably, MBF gradient at stress was significantly lower in patients with NSVT (p = 0.022) and borderline at rest (p = 0.059) while global MBF at rest and stress were not. Mean myocardial oxygen consumption (MVO2) was 0.088 ml/g/min (higher in NSVT, p = 0.023) and myocardial external efficiency 18.5%. Using 11C-HED, the mean retention index was 0.11 min−1 and a higher volume of distribution (p = 0.089) or transmural gradient of clearance rate (p = 0.061) or lower clearance rate (p = 0.052) showed a tendency of association of NSVT.ConclusionsThe endocardium/epicardium MBF gradient at stress is significantly lower in HCM patients with NSVT. This provides a novel approach to further refine risk stratification of sudden cardiac death.
       
  • Prevalence, risk factors, and type of sleep apnea in patients with
           paroxysmal atrial fibrillation

    • Abstract: Publication date: Available online 19 December 2019Source: IJC Heart & VasculatureAuthor(s): G.M. Traaen, B. Øverland, L. Aakerøy, T.E. Hunt, C. Bendz, L. Sande, S. Aakhus, H. Zaré, S. Steinshamn, O.G. Anfinsen, J.P. Loennechen, L. Gullestad, H. AkreAbstractBackgroundRecent studies have suggested an association between sleep apnea (SA) and atrial fibrillation (AF). We aimed to study the prevalence, characteristics, risk factors and type of sleep apnea (SA) in ablation candidates with paroxysmal AF.Methods/ResultsWe prospectively studied 579 patients with paroxysmal AF, including 157 women (27.1%) and 422 men (72.9%). Mean age was 59.9 ± 9.6 years and mean body mass index (BMI) 28.5 ± 4.5 kg/m2. SA was diagnosed using polygraphy for two nights at home. The Epworth Sleepiness Scale (ESS), STOP-Bang Questionnaire, and Berlin Questionnaire (BQ) assessed the degree of SA symptoms. A total of 479 (82.7%) patients had an apnea-hypopnea index (AHI) ≥ 5, whereas moderate-severe SA (AHI ≥ 15) was diagnosed in 244 patients (42.1%). The type of SA was predominantly obstructive, with a median AHI of 12.1 (6.7–20.6) (range 0.4–85.8). The median central apnea index was 0.3 (0.1–0.7). AHI increased with age, BMI, waist and neck circumference, body and visceral fat. Using the Atrial Fibrillation Severity Scale and the SF-36, patients with more severe SA had a higher AF burden, severity and symptom score and a lower Physical-Component Summary score. Age, male gender, BMI, duration of AF, and habitual snoring were independent risk factors in multivariate analysis (AHI ≥ 15). We found no association between ESS and AHI (R2 = 0.003, p = 0.367).ConclusionsIn our AF population, SA was highly prevalent and predominantly obstructive. The high prevalence of SA detected in this study may indicate that SA is under-recognized in patients with AF. None of the screening questionnaires predicted SA reliably.
       
  • Coronary clot composition after myocardial infarction: Thrombus age
           matters

    • Abstract: Publication date: Available online 12 December 2019Source: IJC Heart & VasculatureAuthor(s): Anke C. Fender, Dobromir Dobrev
       
  • Prognostic value of discharge heart rate in acute heart failure patients:
           More relevant in atrial fibrillation'

    • Abstract: Publication date: Available online 4 December 2019Source: IJC Heart & VasculatureAuthor(s): Agra Bermejo Rosa, Pascual-Figal Domingo, Gude Sampedro Francisco, Delgado Jiménez Juan, Vidal Pérez Rafael, Gómez Otero Inés, Ferrero-Gregori Andreu, Álvarez-García Jesús, Worner Diz Fernando, Segovia Jesús, Crespo-Leiro María Generosa, Cinca Cuscullol Juan, Fernández Avilés Francisco, Gónzalez-Juanatey Jose Ramón, Red Española de Insuficiencia Cardiaca researchers (REDINSCOR II)AbstractAimsThe prognostic impact of heart rate (HR) in acute heart failure (AHF) patients is not well known especially in atrial fibrillation (AF) patients. The aim of the study was to evaluate the impact of admission HR, discharge HR, HR difference (admission-discharge) in AHF patients with sinus rhythm (SR) or AF on long- term outcomes.MethodsWe included 1398 patients consecutively admitted with AHF between October 2013 and December 2014 from a national multicentre, prospective registry. Logistic regression models were used to estimate the association between admission HR, discharge HR and HR difference and one- year all-cause mortality and HF readmission.ResultsThe mean age of the study population was 72 ± 12 years. Of these, 594 (42.4%) were female, 655 (77.8%) were hypertensive and 655 (46.8%) had diabetes. Among all included patients, 745 (53.2%) had sinus rhythm and 653 (46.7%) had atrial fibrillation. Only discharge HR was associated with one year all-cause mortality (Relative risk (RR) = 1.182, confidence interval (CI) 95% 1.024–1.366, p = 0.022) in SR. In AF patients discharge HR was associated with one year all cause mortality (RR = 1.276, CI 95% 1.115–1.459, p ≤ 0.001). We did not observe a prognostic effect of admission HR or HRD on long-term outcomes in both groups. This relationship is not dependent on left ventricular ejection fraction.ConclusionsIn AHF patients lower discharge HR, neither the admission nor the difference, is associated with better long-term outcomes especially in AF patients.
       
  • Association of the use of manual thrombus aspiration with intracoronary
           thrombotic burden in patients with ST segment elevation myocardial
           infarction in the real world

    • Abstract: Publication date: February 2020Source: IJC Heart & Vasculature, Volume 26Author(s): Juan Hernando del Portillo, Darío Echeverri, Jaime Cabrales
       
  • Etosis, rather than apoptosis or cell proliferation, typifies thrombus
           progression – An immunohistochemical study of coronary aspirates

    • Abstract: Publication date: Available online 25 November 2019Source: IJC Heart & VasculatureAuthor(s): Kartika R. Pertiwi, Onno J. de Boer, Pauline A.M. Gabriels, Allard C. van der WalAbstractBackgroundCoronary thrombosis is a process with unpredictable clinical outcome. Changes of thrombus composition overtime influence tissue repair and stabilization. We investigated rates of cell deaths and cell proliferation at different time points after initiation of thrombosis.MethodsThrombectomy aspirates of 55 myocardial infarction patients were selected and histomorphologically classified as fresh (25), lytic (25), partially fibrocellular (10), completely fibrocellular (10). Paraffin sections were immunostained with anti-(cleaved) caspase-3/Casp3 (apoptosis), Citrullinated histone/CitH 3 (etosis), C-reactive protein/CRP and Ki67 (proliferation) in combination with either Feulgen counterstaining (DNA) or cell markers for granulocytes, macrophages, SMCs, platelets and endothelium. Rates of apoptosis, etosis and proliferation were measured as a percentage of total number of immunopositive pixels versus total number of DNA positive pixels, while co-localization with cell markers was assessed by digital image analysis.ResultsPositive staining of CitH3 was observed more frequently (93%) than Casp3 (70%), Ki67 (79%) or CRP (59%) (p 
       
  • Sacubitril/valsartan in HFrEF – Should the aces up our sleeves be
           played earlier'

    • Abstract: Publication date: Available online 22 November 2019Source: IJC Heart & VasculatureAuthor(s): Andreas A. Boehmer, Joachim R. Ehrlich
       
  • Highlights from the II International Journal of Cardiology Heart &
           Vasculature: Heart failure, atrial fibrillation, coronary artery disease
           and myocardial infarction

    • Abstract: Publication date: Available online 20 November 2019Source: IJC Heart & VasculatureAuthor(s): Dominik Linz, Enrico Ammirati, Gheorghe-Andrei Dan, Jordi Heijman, Dobromir Dobrev
       
  • Early post-transplant elevated pulmonary artery pressure predicts adverse
           outcome in cardiac recipients

    • Abstract: Publication date: February 2020Source: IJC Heart & Vasculature, Volume 26Author(s): Entela Bollano, Bert Andersson, Clara Hjalmarsson, Göran Dellgren, Bledar Daka, Kristjan KarasonAbstractAimTo investigate the prognostic value of early post-transplant hemodynamic measurements on 5-year mortality in cardiac recipients (HTx).MethodsA right heart catheterization was performed in 290 heart transplantation (HTx) recipients at a one-year post-HTx evaluation. To study the effect of post-HTx hemodynamic variables on 5-year outcome, the cohort was stratified into several subgroups. For right atrial pressure (RAP), mean pulmonary artery pressure (MPAP), pulmonary artery wedge pressure (PAWP), and pulmonary vascular resistance (PVR), patients with values from the upper 10th percentile (high), were compared with those with values from the remaining lower 90th percentile (normal). For cardiac index (CI), patients with values from the lower 10th percentile (low) were compared with those with values from the remaining upper 90th percentile (normal).ResultsDeath or re-transplantation within 5 years after the one-year control occurred in 44 patients (13%). Of those, death or re-HTx was related to graft failure in 20 of cases (45%) and non-cardiac causes in 24 of cases (55%). The risk of death or re-HTx was higher in the subgroup with MPAP above 23 mmHg than those equal to or below this value [hazard ratio 3.22, 95% confidence interval (CI) 1.49–6.97; P = 0.003]. The association remained significant despite adjustment for several comorbidities. There were no differences in outcome between subgroups stratified with respect to high versus low RAP, PAWP, CI or PVR.ConclusionElevated pulmonary artery pressure at a first annual evaluation after HTx was the only hemodynamic variable that predicted impaired outcome in cardiac recipients.
       
  • Automated calcium scores collected during myocardial perfusion imaging
           improve identification of obstructive coronary artery disease

    • Abstract: Publication date: February 2020Source: IJC Heart & Vasculature, Volume 26Author(s): Mirthe Dekker, Farahnaz Waissi, Ingrid E.M. Bank, Nikolas Lessmann, Ivana Išgum, Birgitta K. Velthuis, Asbjørn M. Scholtens, Geert E. Leenders, Gerard Pasterkamp, Dominique P.V. de Kleijn, Leo Timmers, Arend MosterdAbstractBackgroundMyocardial perfusion imaging (MPI) is an accurate noninvasive test for patients with suspected obstructive coronary artery disease (CAD) and coronary artery calcium (CAC) score is known to be a powerful predictor of cardiovascular events. Collection of CAC scores simultaneously with MPI is unexplored.AimWe aimed to investigate whether automatically derived CAC scores during myocardial perfusion imaging would further improve the diagnostic accuracy of MPI to detect obstructive CAD.MethodsWe analyzed 150 consecutive patients without a history of coronary revascularization with suspected obstructive CAD who were referred for 82Rb PET/CT and available coronary angiographic data. Myocardial perfusion was evaluated both semi quantitatively as well as quantitatively according to the European guidelines. CAC scores were automatically derived from the low-dose attenuation correction CT scans using previously developed software based on deep learning. Obstructive CAD was defined as stenosis>70% (or>50% in the left main coronary artery) and/or fractional flow reserve (FFR) ≤0.80.ResultsIn total 58% of patients had obstructive CAD of which seventy-four percent were male. Addition of CAC scores to MPI and clinical predictors significantly improved the diagnostic accuracy of MPI to detect obstructive CAD. The area under the curve (AUC) increased from 0.87 to 0.91 (p: 0.025). Sensitivity and specificity analysis showed an incremental decrease in false negative tests with our MPI + CAC approach (n = 14 to n = 4), as a consequence an increase in false positive tests was seen (n = 11 to n = 28).ConclusionCAC scores collected simultaneously with MPI improve the detection of obstructive coronary artery disease in patients without a history of coronary revascularization.
       
  • Prognostic value of biomarkers of impaired metabolism in heart failure
           patients with reduced ejection fraction

    • Abstract: Publication date: Available online 19 November 2019Source: IJC Heart & VasculatureAuthor(s): Denisa Corina Ciuculete, Dobromir Dobrev, G.-Andrei Dan
       
  • Gender differences and daily variation in atrial fibrillation risk factor
           profiles: Considerations for risk factor management

    • Abstract: Publication date: Available online 19 November 2019Source: IJC Heart & VasculatureAuthor(s): Nikki A.H.A. Pluymaekers, Astrid N.L. Hermans, Melissa E. Middeldorp, Kadhim Kadhim, Harry J.G.M. Crijns, Prashanthan Sanders, Dominik Linz
       
  • Transcatheter aortic valve replacement: A potential option for aortic
           insufficiency management in patients with left ventricular assist device

    • Abstract: Publication date: February 2020Source: IJC Heart & Vasculature, Volume 26Author(s): Samhati Mondal, Murtaza Dawood, Dhrubajyoti Bandyopadhyay, Bradley S. Taylor, Kenechi Tanaka, Anuj Gupta
       
  • Effect of right ventricular pacing on left ventricular systolic function
           in patients with Tetralogy of Fallot

    • Abstract: Publication date: February 2020Source: IJC Heart & Vasculature, Volume 26Author(s): Alexander C. Egbe, Maria Najam, Keerthana Banala, Rahul Vojjini, Karim Osman, Deshmukh AbhishekAbstractBackgroundPrevalence of pacemaker-induced cardiomyopathy (PICM) in adults with congenital heart disease is unknown. Tetralogy of Fallot (TOF) is a common diagnosis in the adult congenital heart disease population, and the purpose of this study was to determine association between frequent right ventricular (RV) pacing and temporal decrease in left ventricular ejection fraction (LVEF) from pre-implantation to 2-years post-implantation (LVEFpost-pre) in TOF patients.MethodsWe studied TOF patients that received RV leads only (N = 51) and a reference group of 7 patients with atrial pacing or biventricular pacing. We defined PICM as a ≥10% decrease in LVEF resulting in LVEF 40%) and LVEFpost-pre.ResultsPICM occurred in 2 (4%) of 51 patients in RV pacing group. LVEFpost-pre was +3% (95% confidence interval [CI] 0% to +5%) in the reference group and −4% (95% CI −11% to +2%) in RV pacing group. No significant difference occured in LVEFpost-pre between the reference group (LVEFpost-pre +3%) vs RV pacing ≤20% (LVEFpost-pre +1%) vs RV pacing 21–40% (LVEFpost-pre −3%) vs RV pacing>40% (LVEFpost-pre −5%), p = 0.318. There was also no association between frequent RV pacing and LVEFpost-pre, R2 = 0.307, p = 0.10.ConclusionPICM occurred in 4% of TOF patients receiving RV pacing, and there was no association between frequent RV pacing and temporal decline in LVEF. Further studies are required to determine the long-term impact of RV pacing in the TOF population, and explore optimal treatment strategies.
       
  • The applications and potential limitations of right ventricular volumes as
           surrogate marker in tetralogy of fallot

    • Abstract: Publication date: February 2020Source: IJC Heart & Vasculature, Volume 26Author(s): Alexander C. Egbe, Keerthana Banala, Rahul Vojjini, Karim Osman, Arslan Afzal, Vaibhav Jain, Sahith Thotamgari, Naser M. AmmashAbstractCardiac magnetic resonance imaging derived right ventricular (RV) volumes are often necessary for optimal timing of pulmonary valve replacement in patients with tetralogy of Fallot (TOF). This practice is based on previous studies that reported preoperative RV volumetric thresholds that predicted postoperative RV remodeling. As a result, pulmonary valve replacements are being performed even in asymptomatic patients based on RV volumetric thresholds that predict complete postoperative RVOT remodeling. Hence, RV volumes are now being used as surrogate markers/endpoints for future cardiovascular outcomes. Unfortunately, there are no studies showing survival benefit for performing pulmonary valve replacement at smaller RV volumes. This review underscores some of the limitations of using RV volumes as surrogate markers for clinical outcomes, and also highlights knowledge gaps about the pathophysiologic mechanism of cardiovascular death in the TOF population.
       
  • Impact of oxidative posttranslational modifications of SERCA2 on heart
           failure exacerbation in young patients with non-ischemic cardiomyopathy: A
           pilot study

    • Abstract: Publication date: February 2020Source: IJC Heart & Vasculature, Volume 26Author(s): Takumi Toya, Kei Ito, Kazuki Kagami, Ayumu Osaki, Atsushi Sato, Toyokazu Kimura, Shunpei Horii, Risako Yasuda, Takayuki Namba, Yasuo Ido, Yuji Nagatomo, Katsumi Hayashi, Nobuyuki Masaki, Hirotaka Yada, Takeshi AdachiAbstractBackgroundOxidative posttranslational modifications (OPTM) impair the function of Sarcoplasmic/endoplasmic reticulum (SR) calcium (Ca2+) ATPase (SERCA) 2 and trigger cytosolic Ca2+ dysregulation. We investigated the extent of OPTM of SERCA2 in patients with non-ischemic cardiomyopathy (NICM).Methods and resultsEndomyocardial biopsy (EMB) was obtained in 40 consecutive patients with NICM. Total expression and OPTM of SERCA2, including sulfonylation at cysteine-674 (S-SERCA2) and nitration at tyrosine-294/295 (N-SERCA2), were examined by immunohistochemical analysis. S-SERCA2 increased in the presence of late gadolinium enhancement on cardiac magnetic resonance imaging. S-SERCA2/SERCA2 and N-SERCA2/SERCA2 correlated with cardiac fibrosis evaluated by Masson’s trichrome staining of EMB. SERCA2 expression modestly increased in parallel with an upward trend in OPTM of SERCA2 with aging. This tendency became prominent only in patients aged>65 years. OPTM of SERCA2 positively correlated with brain natriuretic peptide (BNP) values only in patients aged ≤65 years. Composite major adverse cardiac events (MACE) increased more in the high OPTM group of younger patients; however, MACE-free survival was similar irrespective of the extent of OPTM in older patients.ConclusionsOPTM of SERCA2 correlate with myocardial fibrosis in NICM. In younger patients, OPTM of SERCA2 correlate with elevated BNP and increased composite MACE.
       
  • Acute and sub-acute stent thrombosis: Frequency, predictors and features
           in patients undergoing primary percutaneous intervention at a tertiary
           care cardiac centre

    • Abstract: Publication date: February 2020Source: IJC Heart & Vasculature, Volume 26Author(s): Sahar Tariq, Rajesh Kumar, Madiha Fatima, Tahir Saghir, Sobia Masood, Musa KarimAbstractObjectivesTo assess the frequency of early (acute and sub-acute) stent thrombosis (ST) after primary percutaneous coronary intervention (pPCI) and to identify its potential predictors.BackgroundST is a serious clinical event associated with a high mortality rate. A very limited data are available regarding the incidence rate of early ST after pPCI and its predictors, especially for Pakistani population.MethodsStudy included consecutive patients who underwent primary PCI. Telephonic follow-ups were made to obtain 30-days outcomes including ST, mortality, and re-occurrence of symptoms. ST was defined as per the standardized definition proposed by the Academic Research Consortium and classified as acute (during the procedure) and sub-acute (within 30 days).ResultsA total of 569 patients were included with 80.5% (485) male patients. The stent thrombosis (acute or sub-acute) was observed in 33 (5.8%) patients out of which 3 (9.1%) were definite ST while remaining 30 (90.9%) were probable ST. Patients who develop ST were predominantly male, hypertensive, diabetic, with reduced pre PCI LVEF (%) and Killip Class. A significantly higher in-hospital mortality rate was observed in patients with ST as compared to without ST, 36.4% (12/33) vs. 0.2% (1/536); p-value 
       
  • Iranian Registry of Infective Endocarditis (IRIE): Time to relook at the
           guideline, regarding to regional differences

    • Abstract: Publication date: February 2020Source: IJC Heart & Vasculature, Volume 26Author(s): Anita Sadeghpour, Majid Maleki, Massoud Movassaghi, Leila Rezvani, Feridoun Noohi, Shabnam Boudagh, Behshid Ghadrdoost, Hooman Bakhshandeh, Azin Alizadehasl, Nasim Naderi, Monireh Kamali, Alireza A. Ghavidel, Mohammad Mahdi Peighambari, Majid Kyavar, Hamidreza Pasha
       
  • Circulating acetoacetate is associated with poor prognosis in heart
           failure patients

    • Abstract: Publication date: Available online 7 November 2019Source: IJC Heart & VasculatureAuthor(s): Tetsuro Yokokawa, Akiomi Yoshihisa, Yuki Kanno, Satoshi Abe, Tomofumi Misaka, Shinya Yamada, Takashi Kaneshiro, Takamasa Sato, Masayoshi Oikawa, Atsushi Kobayashi, Kazuhiko Nakazato, Takafumi Ishida, Yasuchika TakeishiAbstractBackgroundAcetoacetate is used as an alternative energy source in the heart, and has the potential to improve cardiac function. However, the prognostic impact of acetoacetate has not been investigated in heart failure.MethodsThis study enrolled consecutive 615 hospitalized patients with heart failure. We investigated the associations between circulating acetoacetate and clinical characteristics or prognosis in HF patients.ResultsWe divided the patients into two groups based on circulating acetoacetate levels (high group: acetoacetate ≥35 µmoL/L, n = 313; and low group: acetoacetate
       
  • Young-onset atrial fibrillation: Sex differences in clinical profile,
           progression rate and cardiovascular outcome

    • Abstract: Publication date: Available online 7 November 2019Source: IJC Heart & VasculatureAuthor(s): Ernaldo G. Marcos, Ruben R. De With, Bart A. Mulder, Isabelle C. Van Gelder, Michiel RienstraAbstractBackgroundWomen are underrepresented in major atrial fibrillation (AF) trials. In addition, data regarding clinical profile and outcome in young AF patients is limited. Therefore we aimed to investigate the clinical profile, AF progression rate and cardiovascular outcome between sexes in patients with young-onset AF.MethodsA total of 497 patients with AF-onset
       
  • Schistosomiasis-associated pulmonary arterial hypertension: survival in
           endemic area in Brazil

    • Abstract: Publication date: December 2019Source: IJC Heart & Vasculature, Volume 25Author(s): Carlos G. Piscoya Roncal, Adriano A. Mendes, Maria T.C. Muniz, Sheilla A. de Oliveira, Leonidas M. do Valle Neto, Nathália A. de Vasconcellos Piscoya, Gustavo H.B. Góes, Dario C. Sobral Filho, Mardi Gomberg-MaitlandAbstractBackgroundThe survival of schistosomiasis-associated pulmonary arterial hypertension (Sch-PAH) patients in endemic areas is unknown, but can be estimated using predictive equations.MethodsWe retrospectively analyzed all consecutive patients diagnosed with Sch-PAH referred to the Pronto SocorroCardiologico de Pernambuco between 2004 and 2010 using specific therapy and measured laboratory, diagnostic imaging, and baseline hemodynamic parameters. Observed and predicted survivals according to the National Institutes of Health (NIH) and Pulmonary Hypertension Connection (PHC) registry equations were compared by the Kaplan–Meier method, log-rank test and Cox proportional hazards model.ResultsSixty-eight patients (47 [69.1%] women) observed for a mean of 3.1 years (range, 7–72 months), median survival was 74 months, and 42 (61.7%) survived. The sex and age distributions were similar for functional class I/II and III/IV patients. Hemodynamic abnormalities were severe: mean right atrial pressure, 12.6 ± 6.2 mmHg; mean pulmonary artery pressure, 60.3 ± 13.69 mmHg; pulmonary vascular resistance, 14.62 ± 7.04 Wood units; and cardiac index, 2.3 ± 0.8 L/min/m2. The usual idiopathic PAH predictors were not prognostic in Sch-PAH patients. The 1-, 3- and 5-year survival rates were 92.1%, 75.2%, and 50.8%, respectively, and those estimatedby the NIH and PHC registry equations were 68%, 45% and 32% (p = 0.001), and 93%, 79% and 68% (p = 0.340), respectively.ConclusionsSch-PAH patients in endemic areas have severe hemodynamic profiles and reduced long-term survivaldespite treatment. The PHC registry equation may be a useful tool to estimate survival in Sch-PAH.
       
  • Ultra slow thrombolysis in dysfunctional prosthetic heart valves, a
           controversial technique in critically ill patients not candidates for
           surgery

    • Abstract: Publication date: December 2019Source: IJC Heart & Vasculature, Volume 25Author(s): Noel Alberto Flórez, German Camilo Giraldo, Julian David Yara, Stephania Galindo-Coral, Juan David López, Juan Esteban Gomez-Mesa
       
  • A deep neural network for 12-lead electrocardiogram interpretation
           outperforms a conventional algorithm, and its physician overread, in the
           diagnosis of atrial fibrillation

    • Abstract: Publication date: December 2019Source: IJC Heart & Vasculature, Volume 25Author(s): Stephen W. Smith, Jeremy Rapin, Jia Li, Yann Fleureau, William Fennell, Brooks M. Walsh, Arnaud Rosier, Laurent Fiorina, Christophe GardellaAbstractBackgroundAutomated electrocardiogram (ECG) interpretations may be erroneous, and lead to erroneous overreads, including for atrial fibrillation (AF). We compared the accuracy of the first version of a new deep neural network 12-Lead ECG algorithm (Cardiologs®) to the conventional Veritas algorithm in interpretation of AF.Methods24,123 consecutive 12-lead ECGs recorded over 6 months were interpreted by 1) the Veritas® algorithm, 2) physicians who overread Veritas® (Veritas® + physician), and 3) Cardiologs® algorithm. We randomly selected 500 out of 858 ECGs with a diagnosis of AF according to either algorithm, then compared the algorithms' interpretations, and Veritas® + physician, with expert interpretation. To assess sensitivity for AF, we analyzed a separate database of 1473 randomly selected ECGs interpreted by both algorithms and by blinded experts.ResultsAmong the 500 ECGs selected, 399 had a final classification of AF; 101 (20.2%) had ≥1 false positive automated interpretation. Accuracy of Cardiologs® (91.2%; CI: 82.4–94.4) was higher than Veritas® (80.2%; CI: 76.5–83.5) (p 
       
  • Native T1 time and extracellular volume fraction in differentiation of
           normal myocardium from non-ischemic dilated and hypertrophic
           cardiomyopathy myocardium: A systematic review and meta-analysis

    • Abstract: Publication date: December 2019Source: IJC Heart & Vasculature, Volume 25Author(s): Shintaro Minegishi, Shingo Kato, Kaoru Takase-Minegishi, Nobuyuki Horita, Kengo Azushima, Hiromichi Wakui, Tomoaki Ishigami, Masami Kosuge, Kazuo Kimura, Kouichi TamuraAbstractBackgroundBoth native T1 time and extracellular volume (ECV) fraction have been shown to be important measures for the detection of myocardial fibrosis. However, ECV determination requires the administration of an intravenous contrast agent, whereas native T1 mapping can be performed without a contrast agent.MethodsHere, we conducted a meta-analysis of myocardial native T1 data obtained for non-ischemic cardiomyopathy (NIC) patients and controls. A literature review included studies that applied T1 mapping using modified Look–Locker inversion recovery to measure myocardial fibrosis, and the results were validated by comparing datasets for dilated cardiomyopathy (DCM) or hypertrophic cardiomyopathy (HCM) patients and healthy controls (HCs).ResultsWe identified 16 eligible studies. Pooled mean differences (MDs) and 95% confidence intervals (CIs) were estimated as follows. Native T1 at 1.5-T, DCM vs. HC: MD = 45.26 (95% CI: 30.92–59.59); HCM vs. HC: MD = 47.09 (95% CI: 32.42–61.76). Native T1 at 3.0-T, DCM vs. HC: MD = 82.52 (95% CI: 47.60–117.44); HCM vs. HC: MD = 115.87 (95% CI: 50.71–181.04). ECV at 1.5-T, DCM vs. HC: MD = 4.26 (95% CI: 3.06–5.46); HCM vs. HC: MD = 1.49 (95% CI: −1.45–4.43). ECV at 3.0-T, DCM vs. HC: MD = 8.40 (95% CI: 2.94–13.86); HCM vs. HC: MD = 8.02 (95% CI: 5.45–1–0.59).ConclusionIn conclusion, native T1 values were significantly different between NIC patients and controls. Native T1 mapping may be a useful noninvasive method to detect diffuse myocardial fibrosis in NIC patients.
       
  • Intravascular ultrasound versus angiogram guided drug eluting stent
           implantation. A systematic review and updated meta-analysis with trial
           sequential analysis

    • Abstract: Publication date: December 2019Source: IJC Heart & Vasculature, Volume 25Author(s): Ashish Kumar, Mariam Shariff, Devina Adalja, Rajkumar DoshiAbstractBackgroundFurther advances have been achieved in the field of intravenous ultrasound (IVUS) guided drug eluting stent (DES) implantation and hence there was a need to rejuvenate the evidence. Hence, we performed a cumulative meta-analysis with trial sequential analysis (TSA) of randomized controlled trials (RCTs) comparing IVUS versus angiogram guided DES implantation.MethodologyWe searched PubMed/Medline and Cochrane database for relevant articles using predefined inclusion and exclusion criteria. Outcomes of interest were cardiovascular mortality, myocardial infarction (MI), target lesion revascularisation (TLR), stent thrombosis (ST). We used Mantel-Haenszel method with random error model to calculate odds ratio (OR) with 95% confidence interval (CI). We also performed TSA to accommodate for possible type I error.ResultsA total of 11 RCTs with 5352 patients were included in the final analysis. Follow up duration of included studies varied from 12 to 24 months. IVUS use was associated with significantly reduced incidence of cardiovascular mortality [OR: 0.45, CI: 0.25–0.80, p value = 0.007, I2 = 0%, χ2 p-value = 0.98], TLR [OR: 0.56, CI: 0.41–0.77, p value = 0.0004, I2 = 0%, χ2 p-value = 0.95] and ST [OR: 0.47, CI: 0.24–0.94, p value = 0.03, I2 = 0%, χ2 p-value = 0.75]. IVUS use had no effect on incidence of MI on follow up. The cumulative z curve crosses the TSA boundary indicating sufficient evidence without type I error for reduced incidence of cardiovascular mortality and TLR with the use IVUS.ConclusionIVUS-guided DES implantation should be the standard of care as it significantly reduced cardiovascular mortality and TLR.
       
  • Cardiotoxicity from immune checkpoint inhibitors

    • Abstract: Publication date: December 2019Source: IJC Heart & Vasculature, Volume 25Author(s): Lars Michel, Tienush Rassaf, Matthias TotzeckAbstractImmune checkpoint inhibitor (ICI) therapy has greatly improved treatment of various advanced cancers but increasing use of ICI therapy has exposed the risk of ICI-related cardiovascular side effects.Immune checkpoints are inhibitory regulators of T cell activation and mediate T cell effector functions during physiological responses to shield from autoimmune reactions. ICI therapy for advanced cancers promotes immune activity against tumors and is applied within a broad collective of cancer patients. Widespread use of ICI therapy has revealed the burden of immune related adverse events with various organ manifestations and characteristics. Since immune checkpoints are highly relevant for maintaining myocardial homeostasis as emerging evidence implicates, inhibition of immune checkpoint pathways has been associated with various forms of cardiotoxicity in preclinical models and patients. Although ICI-related cardiotoxicity is rare, it has significant relevance due to high mortality rates.This review focuses on current knowledge about cardiac ICI-related toxicity. We summarize the most common forms and delineate incidence, presentation, and treatment. Clinical characteristics are correlated to potential underlying pathomechanisms. We outline epidemiology, risk factors, and course of disease. Recommendations for monitoring and critical diagnostic measures are specified within the context of different forms of cardiac involvement. Different therapeutic implications for suspected ICI-related cardiotoxicity and their limitations are critically summarized.We highlight current gaps of knowledge concerning the underlying pathomechanisms and clinical characteristics of ICI-related cardiotoxicity. Future challenges are depicted for optimum cardio-oncology care of patients receiving ICI therapy.
       
  • Outcomes of patients with anemia and renal dysfunction in hospitalized
           heart failure with preserved ejection fraction (from the CN-HF registry)

    • Abstract: Publication date: December 2019Source: IJC Heart & Vasculature, Volume 25Author(s): Xuejuan Jin, Juan Cao, Jun Zhou, Yanyan Wang, Xueting Han, Yu Song, Yuyuan Fan, Zhenyue Chen, Dingli Xu, Xinchun Yang, Wei Dong, Liwen Li, Li Chen, Qiaoqing Zhong, Micheal Fu, Kai Hu, Jingmin Zhou, Junbo Ge, CN-HF investigatorsAbstractBackgroundAlthough a large number of studies on heart failure with reduced ejection fraction (HFrEF) have found that anemia and renal dysfunction (RD) independently predicted poor outcomes, there are still few reports on patients with heart failure with preserved ejection fraction (HFpEF).MethodsClinical data of HFpEF patients registered in the China National Heart Failure Registration Study (CN-HF) were evaluated and the clinical features of patients with or without anemia/RD were compared to explore the impact of anemia and RD on all-cause mortality and all-cause re-hospitalization.Results1604 patients with HFpEF were enrolled, the prevalence of anemia was 51.0%. Although anemia was associated with increased risk of all-cause mortality and all-cause re-hospitalization in univariate COX regression (p 
       
 
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