Subjects -> MEDICAL SCIENCES (Total: 8529 journals)
    - ANAESTHESIOLOGY (120 journals)
    - CARDIOVASCULAR DISEASES (332 journals)
    - DENTISTRY (292 journals)
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    - FORENSIC SCIENCES (41 journals)
    - HEMATOLOGY (155 journals)
    - HYPNOSIS (4 journals)
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    - PATHOLOGY (98 journals)
    - PEDIATRICS (273 journals)
    - PSYCHIATRY AND NEUROLOGY (822 journals)
    - RESPIRATORY DISEASES (103 journals)
    - RHEUMATOLOGY (78 journals)
    - SPORTS MEDICINE (81 journals)
    - SURGERY (401 journals)

CARDIOVASCULAR DISEASES (332 journals)                  1 2 | Last

Showing 1 - 200 of 333 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: 59)
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 Circulation     Open Access   (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: 2)
Arteriosclerosis, Thrombosis and Vascular Biology     Full-text available via subscription   (Followers: 32)
Artery Research     Hybrid Journal   (Followers: 4)
ARYA Atherosclerosis     Open Access  
ASAIO Journal     Hybrid Journal   (Followers: 3)
ASEAN Heart Journal     Open Access   (Followers: 2)
Asian Cardiovascular and Thoracic Annals     Hybrid Journal   (Followers: 2)
Aswan Heart Centre Science & Practice Services     Open Access   (Followers: 1)
Atherosclerosis : X     Open Access  
Bangladesh Heart Journal     Open Access   (Followers: 3)
Basic Research in Cardiology     Hybrid Journal   (Followers: 10)
BMC Cardiovascular Disorders     Open Access   (Followers: 22)
Brain Circulation     Open Access   (Followers: 1)
British Journal of Cardiology     Full-text available via subscription   (Followers: 18)
Canadian Journal of Cardiology     Hybrid Journal   (Followers: 18)
Cardiac Cath Lab Director     Full-text available via subscription  
Cardiac Electrophysiology Review     Hybrid Journal   (Followers: 2)
Cardiocore     Full-text available via subscription   (Followers: 1)
Cardiogenetics     Open Access   (Followers: 3)
Cardiology     Full-text available via subscription   (Followers: 20)
Cardiology and Angiology: An International Journal     Open Access   (Followers: 1)
Cardiology and Therapy     Open Access   (Followers: 12)
Cardiology Clinics     Full-text available via subscription   (Followers: 14)
Cardiology in Review     Hybrid Journal   (Followers: 8)
Cardiology in the Young     Hybrid Journal   (Followers: 34)
Cardiology Journal     Open Access   (Followers: 6)
Cardiology Plus     Open Access   (Followers: 1)
Cardiology Research     Open Access   (Followers: 15)
Cardiology Research and Practice     Open Access   (Followers: 10)
Cardiopulmonary Physical Therapy Journal     Hybrid Journal   (Followers: 8)
Cardiorenal Medicine     Full-text available via subscription   (Followers: 1)
Cardiothoracic Surgeon     Open Access   (Followers: 1)
CardioVasc     Full-text available via subscription   (Followers: 1)
Cardiovascular & Haematological Disorders - Drug Targets     Hybrid Journal   (Followers: 1)
Cardiovascular & Hematological Agents in Medicinal Chemistry     Hybrid Journal   (Followers: 2)
CardioVascular and Interventional Radiology     Hybrid Journal   (Followers: 15)
Cardiovascular and Thoracic Open     Open Access  
Cardiovascular Diabetology     Open Access   (Followers: 10)
Cardiovascular Drugs and Therapy     Hybrid Journal   (Followers: 14)
Cardiovascular Endocrinology & Metabolism     Hybrid Journal   (Followers: 1)
Cardiovascular Engineering     Hybrid Journal   (Followers: 1)
Cardiovascular Engineering and Technology     Hybrid Journal   (Followers: 1)
Cardiovascular Intervention and Therapeutics     Hybrid Journal   (Followers: 5)
Cardiovascular Journal     Open Access   (Followers: 6)
Cardiovascular Journal of Africa     Full-text available via subscription   (Followers: 5)
Cardiovascular Journal of South Africa     Full-text available via subscription   (Followers: 1)
Cardiovascular Medicine in General Practice     Full-text available via subscription   (Followers: 7)
Cardiovascular Pathology     Hybrid Journal   (Followers: 4)
Cardiovascular Regenerative Medicine     Open Access  
Cardiovascular Research     Hybrid Journal   (Followers: 15)
Cardiovascular Revascularization Medicine     Hybrid Journal   (Followers: 1)
Cardiovascular System     Open Access  
Cardiovascular Therapeutics     Open Access   (Followers: 1)
Cardiovascular Toxicology     Hybrid Journal   (Followers: 6)
Cardiovascular Ultrasound     Open Access   (Followers: 5)
Case Reports in Cardiology     Open Access   (Followers: 7)
Catheterization and Cardiovascular Interventions     Hybrid Journal   (Followers: 3)
Cerebrovascular Diseases     Full-text available via subscription   (Followers: 3)
Cerebrovascular Diseases Extra     Open Access  
Chest     Full-text available via subscription   (Followers: 102)
Choroby Serca i Naczyń     Open Access   (Followers: 1)
Circulation     Hybrid Journal   (Followers: 254)
Circulation : Cardiovascular Imaging     Hybrid Journal   (Followers: 15)
Circulation : Cardiovascular Interventions     Hybrid Journal   (Followers: 18)
Circulation : Cardiovascular Quality and Outcomes     Hybrid Journal   (Followers: 11)
Circulation : Genomic and Precision Medicine     Hybrid Journal   (Followers: 16)
Circulation : Heart Failure     Hybrid Journal   (Followers: 26)
Circulation Research     Hybrid Journal   (Followers: 36)
Cirugía Cardiovascular     Open Access  
Clínica e Investigación en Arteriosclerosis     Full-text available via subscription  
Clínica e Investigación en arteriosclerosis (English Edition)     Hybrid Journal  
Clinical and Experimental Hypertension     Hybrid Journal   (Followers: 3)
Clinical Cardiology     Hybrid Journal   (Followers: 11)
Clinical Hypertension     Open Access   (Followers: 5)
Clinical Medicine Insights : Cardiology     Open Access   (Followers: 6)
Clinical Research in Cardiology     Hybrid Journal   (Followers: 6)
Clinical Research in Cardiology Supplements     Hybrid Journal  
Clinical Trials and Regulatory Science in Cardiology     Open Access   (Followers: 4)
Congenital Heart Disease     Hybrid Journal   (Followers: 6)
Congestive Heart Failure     Hybrid Journal   (Followers: 4)
Cor et Vasa     Full-text available via subscription   (Followers: 1)
Coronary Artery Disease     Hybrid Journal   (Followers: 2)
CorSalud     Open Access  
Critical Pathways in Cardiology     Hybrid Journal   (Followers: 4)
Current Cardiology Reports     Hybrid Journal   (Followers: 7)
Current Cardiology Reviews     Hybrid Journal   (Followers: 4)
Current Cardiovascular Imaging Reports     Hybrid Journal   (Followers: 1)
Current Cardiovascular Risk Reports     Hybrid Journal  
Current Heart Failure Reports     Hybrid Journal   (Followers: 5)
Current Hypertension Reports     Hybrid Journal   (Followers: 6)
Current Hypertension Reviews     Hybrid Journal   (Followers: 6)
Current Opinion in Cardiology     Hybrid Journal   (Followers: 14)
Current Problems in Cardiology     Hybrid Journal   (Followers: 3)
Current Research : Cardiology     Full-text available via subscription   (Followers: 1)
Current Treatment Options in Cardiovascular Medicine     Hybrid Journal   (Followers: 1)
Current Vascular Pharmacology     Hybrid Journal   (Followers: 5)
CVIR Endovascular     Open Access   (Followers: 1)
Der Kardiologe     Hybrid Journal   (Followers: 2)
Echo Research and Practice     Open Access   (Followers: 2)
Echocardiography     Hybrid Journal   (Followers: 4)
Egyptian Heart Journal     Open Access   (Followers: 2)
Egyptian Journal of Cardiothoracic Anesthesia     Open Access  
ESC Heart Failure     Open Access   (Followers: 4)
European 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: 2)
European Heart Journal - Quality of Care and Clinical Outcomes     Hybrid Journal  
European Heart Journal : Acute Cardiovascular Care     Hybrid Journal   (Followers: 1)
European Heart Journal : Case Reports     Open Access   (Followers: 1)
European Heart Journal Supplements     Hybrid Journal   (Followers: 8)
European Journal of Cardio-Thoracic Surgery     Hybrid Journal   (Followers: 9)
European Journal of Cardio-Thoracic Surgery Supplements     Full-text available via subscription   (Followers: 2)
European Journal of Cardiovascular Nursing     Hybrid Journal   (Followers: 5)
European Journal of Heart Failure     Hybrid Journal   (Followers: 14)
European Journal of Preventive Cardiology.     Hybrid Journal   (Followers: 6)
European Stroke Organisation     Hybrid Journal   (Followers: 3)
Experimental & Translational Stroke Medicine     Open Access   (Followers: 9)
Expert Review of Cardiovascular Therapy     Full-text available via subscription   (Followers: 3)
Folia Cardiologica     Open Access  
Forum Zaburzeń Metabolicznych     Hybrid Journal  
Frontiers in Cardiovascular Medicine     Open Access   (Followers: 1)
Future Cardiology     Hybrid Journal   (Followers: 6)
General Thoracic and Cardiovascular Surgery     Hybrid Journal   (Followers: 3)
Global Cardiology Science and Practice     Open Access   (Followers: 5)
Global Heart     Hybrid Journal   (Followers: 3)
Heart     Hybrid Journal   (Followers: 48)
Heart and Mind     Open Access  
Heart and Vessels     Hybrid Journal  
Heart Failure Clinics     Full-text available via subscription   (Followers: 2)
Heart Failure Reviews     Hybrid Journal   (Followers: 3)
Heart India     Open Access   (Followers: 2)
Heart International     Full-text available via subscription  
Heart Rhythm     Hybrid Journal   (Followers: 11)
Heart Views     Open Access   (Followers: 2)
HeartRhythm Case Reports     Open Access  
Hellenic Journal of Cardiology     Open Access   (Followers: 1)
Herz     Hybrid Journal   (Followers: 3)
High Blood Pressure & Cardiovascular Prevention     Full-text available via subscription   (Followers: 2)
Hypertension     Full-text available via subscription   (Followers: 23)
Hypertension 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 Cardiology Hypertension     Open Access   (Followers: 1)
International Journal of Cardiovascular and Cerebrovascular Disease     Open Access   (Followers: 2)
International Journal of Cardiovascular Imaging     Hybrid Journal   (Followers: 2)
International Journal of Cardiovascular Research     Hybrid Journal   (Followers: 6)
International Journal of Heart Rhythm     Open Access  
International Journal of Hypertension     Open Access   (Followers: 8)
International Journal of Hyperthermia     Open Access  
International Journal of Stroke     Hybrid Journal   (Followers: 32)
International Journal of the Cardiovascular Academy     Open Access  
Interventional Cardiology Clinics     Full-text available via subscription   (Followers: 2)
Interventional Cardiology Review     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: 18)
JACC : Heart Failure     Full-text available via subscription   (Followers: 14)
JAMA Cardiology     Hybrid Journal   (Followers: 30)
JMIR Cardio     Open Access  
Jornal Vascular Brasileiro     Open Access  
Journal of Clinical & Experimental Cardiology     Open Access   (Followers: 5)
Journal of Arrhythmia     Open Access  

        1 2 | Last

Similar Journals
Journal Cover
Journal Prestige (SJR): 2.853
Citation Impact (citeScore): 3
Number of Followers: 48  
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1355-6037 - ISSN (Online) 1468-201X
Published by BMJ Publishing Group Homepage  [68 journals]
  • Heartbeat: cardiovascular disease risk and reproductive factors in women
    • Authors: Otto; C. M.
      Pages: 1045 - 1047
      Abstract: The likelihood of cardiovascular disease (CVD) in both women and men largely is explained by well-known lifestyle and clinical risk factors. Several studies have suggested that a woman’s reproductive history also might affect the risk of CVD, but results have been inconsistent and methodology suboptimal. In this issue of Heart, Peters and Woodward1 report the association between several reproductive factors and subsequent incident CVD over 7 years of follow-up in 482,000 participants in the UK Biobank study with CVD defined as incident myocardial infarction (fatal or non-fatal) or stroke.1 The risk of CVD was increased in women with early menarche (
      PubDate: 2018-06-12T01:05:14-07:00
      DOI: 10.1136/heartjnl-2018-313503
      Issue No: Vol. 104, No. 13 (2018)
  • Resting heart rate: what is normal'
    • Authors: Nanchen; D.
      Pages: 1048 - 1049
      Abstract: Resting heart rate (RHR) is a clinical parameter easily measurable with typical value between 50 and 90 beats per minute (bpm) that varies during the day with a night-time decrease.1 RHR can go down to 30 bpm in those with good physical condition, but RHR is also partly genetically determined, with slightly higher values in women than in men.2 The interpretation of RHR by clinicians is traditionally done in the acute setting, typically for evaluation of pulmonary embolism or acute infection. It is now possible to continuously and accurately self-measure RHR using a mobile phone or a watch bracelet, so that monitoring RHR has become very popular in the general population.3 Therefore, it is important for physicians to know the clinical significance of RHR and its usefulness for chronic disease prevention in healthy adults. Life expectancy of animal species is inversely correlated with their RHR.
      Keywords: Epidemiology
      PubDate: 2018-06-12T01:05:14-07:00
      DOI: 10.1136/heartjnl-2017-312731
      Issue No: Vol. 104, No. 13 (2018)
  • Preventing stroke in patients with heart failure: why are patients losing
    • Authors: Cowie, M. R; Zakeri, R.
      Pages: 1050 - 1052
      Abstract: According to international guidelines, including those from the European Society of Cardiology (ESC), patients with atrial fibrillation and an additional risk factor for thromboembolic events, such as heart failure, should be considered for long-term oral anticoagulation.1 Risk assessment should include the use of the CHA2DS2-VASc score, which among other things gives a point for the presence of the signs or symptoms of heart failure (or objective evidence of reduced left ventricular function), as well as for being female or older age (1 point for age 65–74 years, 2 points for age 75 years or older).2 Thus, for the vast majority of patients with heart failure and atrial fibrillation, oral anticoagulation should be the default position, the only exception being those who have excessively high bleeding risk and/or those who (after full discussion) do not wish to take an anticoagulant. In England, The National Institute for Health...
      PubDate: 2018-06-12T01:05:14-07:00
      DOI: 10.1136/heartjnl-2017-312862
      Issue No: Vol. 104, No. 13 (2018)
  • Cochrane corner: PCSK9 monoclonal antibodies for the primary and secondary
           prevention of cardiovascular disease
    • Authors: Schmidt, A. F; Pearce, L. S, Wilkins, J. T, Casas, J. P, Hingorani, A. D, Overington
      Pages: 1053 - 1055
      Abstract: Introduction Despite the availability of effective drug therapies reducing LDL-cholesterol (LDL-C), cardiovascular disease (CVD) remains a significant source of mortality and morbidity. Additional LDL-C reduction may be warranted, especially in patients that are unresponsive to or unable to take existing LDL-C reducing therapies.1 Monoclonal antibodies against PCSK9 (PCSK9 inhibitors) may provide such additional LDL-C reduction. In this synopsis, we summarise findings from a recent Cochrane systematic review2 on the safety and effectiveness of PCSK9 inhibitors. Here we particularly focus on the relative effectiveness of PCSK9 inhibitors compared to existing treatments such as statins and/or ezetimibe and report on the (perceived) quality of the evidence. Methods The following databases were systematically searched for eligible randomised controlled trials (RCTs): Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, Web of Science, and the International Clinical Trials Registry Platform. Parallel-group and factorial RCTs with at...
      PubDate: 2018-06-12T01:05:14-07:00
      DOI: 10.1136/heartjnl-2017-312858
      Issue No: Vol. 104, No. 13 (2018)
  • Cardiopulmonary resuscitation: the science behind the hands
    • Authors: Harris, A. W; Kudenchuk, P. J.
      Pages: 1056 - 1061
      Abstract: Sudden cardiac arrest is a leading cause of death worldwide. Despite significant advances in resuscitation science since the initial use of external chest compressions in humans nearly 60 years ago, there continues to be wide variability in rates of successful resuscitation across communities. The American Heart Association (AHA) and European Resuscitation Council emphasise the importance of high-quality chest compressions as the foundation of resuscitation care. We review the physiological basis for the association between chest compression quality and clinical outcomes and the scientific basis for the AHA’s key metrics for high-quality cardiopulmonary resuscitation. Finally, we highlight that implementation of strategies that promote effective chest compressions can improve outcomes in all patients with cardiac arrest.
      PubDate: 2018-06-12T01:05:14-07:00
      DOI: 10.1136/heartjnl-2017-312696
      Issue No: Vol. 104, No. 13 (2018)
  • Management of atrial fibrillation in patients with rheumatic mitral
    • Authors: Iung, B; Leenhardt, A, Extramiana, F.
      Pages: 1062 - 1068
      Abstract: Atrial fibrillation (AF) is frequent in patients with rheumatic mitral stenosis (MS). Pressure overload leads to marked structural and electrical remodelling of left atrium. The frequency of persistent AF increases with age and paroxysmal, asymptomatic, AF seems even more frequent. The occurrence of AF worsens the haemodynamic tolerance of MS and markedly increases the risk of thromboembolic events. AF has a negative impact on the natural history of MS and on its outcome after commissurotomy. The respective indications of rhythm and rate control should be adapted to patient characteristics, particularly the consequences of MS, and take into account the high risk of recurrence of AF. Oral anticoagulant therapy is mandatory when AF complicates MS, regardless of its severity and CHA2DS2-VASc score. Non-vitamin K antagonists oral anticoagulants are not recommended in moderate-to-severe MS due to the lack of data. Percutaneous mitral commissurotomy does not appear to prevent the occurrence of AF in MS but should be considered as the first-line therapy when AF is associated with severe symptomatic MS, followed by the discussion of cardioversion or ablation. AF ablation should be considered in patients with mitral disease requiring intervention, but the ideal timing and techniques are difficult to determine due to the lack of appropriate specific randomised trials in patients with MS.
      PubDate: 2018-06-12T01:05:14-07:00
      DOI: 10.1136/heartjnl-2017-311425
      Issue No: Vol. 104, No. 13 (2018)
  • Womens reproductive factors and incident cardiovascular disease in the UK
    • Authors: Peters, S. A; Woodward, M.
      Pages: 1069 - 1075
      Abstract: BackgroundStudies have suggested that women’s reproductive factors are associated with the risk of cardiovascular disease (CVD); however, findings are mixed. We assessed the relationship between reproductive factors and incident CVD in the UK Biobank.MethodsBetween 2006 and 2010, the UK Biobank recruited over 500 000 participants aged 40–69 years across the UK. During 7 years of follow-up, 9054 incident cases of CVD (34% women), 5782 cases of coronary heart disease (CHD) (28% women), and 3489 cases of stroke (43% women) were recorded among 267 440 women and 215 088 men without a history of CVD at baseline. Cox regression models yielded adjusted hazard ratios (HRs) for CVD, CHD and stroke associated with reproductive factors.ResultsAdjusted HRs (95% CI) for CVD were 1.10 (1.01 to 1.30) for early menarche (
      Keywords: Editor's choice
      PubDate: 2018-06-12T01:05:14-07:00
      DOI: 10.1136/heartjnl-2017-312289
      Issue No: Vol. 104, No. 13 (2018)
  • Resting heart rate, temporal changes in resting heart rate, and overall
           and cause-specific mortality
    • Authors: Seviiri, M; Lynch, B. M, Hodge, A. M, Yang, Y, Liew, D, English, D. R, Giles, G. G, Milne, R. L, Dugue, P.-A.
      Pages: 1076 - 1085
      Abstract: ObjectiveMost studies investigating the association between resting heart rate (RHR) and mortality have focused on cardiovascular disease (CVD) mortality, and measured RHR at only one time point. We aimed to assess associations of RHR and changes in RHR over approximately a decade with overall and cause-specific mortality.MethodsWe used data from participants in the Melbourne Collaborative Cohort Study with RHR measures at baseline (1990–1994; n=41 386; 9846 deaths) and at follow-up (2003–2007; n=21 692; 2818 deaths). RHR measures were taken by trained staff, using Dinamap monitors. Cox models were used to estimate HR and 95% CI for the associations between RHR and mortality. Vital status and cause of death were ascertained until August 2015 and December 2013, respectively.ResultsAfter adjustment for confounders, including blood pressure and known medical conditions but not arrhythmias or atrial fibrillation, RHR was associated with a higher risk of death of similar magnitude for CVD (HR per 10 beats per minute (bpm)=1.11, 95% CI 1.07 to 1.16), cancer (HR=1.10, 95% CI 1.06 to 1.13) and other causes (HR=1.20, 95% CI 1.16 to 1.25). Higher mortality was observed for most cancer sites, including breast (HR=1.16, 95% CI 1.03 to 1.31), colorectal (HR=1.18, 95% CI 1.08 to 1.29), kidney (HR=1.27, 95% CI 1.03 to 1.57) and lung cancer (HR=1.19, 95% CI 1.10 to 1.29). Temporal increases in RHR were associated with higher mortality, particularly for individuals whose RHR increased by more than 15 bpm.ConclusionsRHR and changes in RHR over a decade are associated with mortality risk, including from causes other than CVD such as breast, colorectal or lung cancer. Monitoring of RHR may have utility in identifying individuals at higher mortality risk.
      Keywords: Epidemiology
      PubDate: 2018-06-12T01:05:14-07:00
      DOI: 10.1136/heartjnl-2017-312251
      Issue No: Vol. 104, No. 13 (2018)
  • Heart rate at first postdischarge visit and outcomes in patients with
           heart failure
    • Authors: Kim, T.-H; Kim, H, Kim, I.-C, Yoon, H.-J, Park, H.-S, Cho, Y.-K, Nam, C.-W, Han, S, Hur, S.-H, Kim, Y.-N.
      Pages: 1086 - 1092
      Abstract: ObjectiveHeart rate control is important to prevent adverse outcomes in patients with heart failure (HF). However, postdischarge activity may worsen heart rate control, resulting in readmission. This study aimed to explore the implications of the heart rate differences between discharge and the first outpatient visit (D-O diff).MethodsWe retrospectively identified 458 patients (male: 46%; mean age: 72 years) discharged after HF. The heart rates at admission, discharge and first outpatient visit were analysed. The primary outcome was a composite of cardiovascular (CV) death and readmission of non-fatal myocardial infarction (MI), non-fatal stroke or non-fatal HF over a mean follow-up of 16 months.ResultsDuring follow-up, the clinical outcomes were noted in 223 patients (49%): HF, 199; stroke, 9; MI, 6; CV death, 9. The heart rate at the first outpatient visit (r=–0.311, P
      PubDate: 2018-06-12T01:05:14-07:00
      DOI: 10.1136/heartjnl-2017-312364
      Issue No: Vol. 104, No. 13 (2018)
  • Reasons for and consequences of oral anticoagulant underuse in atrial
           fibrillation with heart failure
    • Authors: Savarese, G; Sartipy, U, Friberg, L, Dahlström, U, Lund, L. H.
      Pages: 1093 - 1100
      Abstract: ObjectiveAtrial fibrillation (AF) is common in patients with heart failure (HF), and oral anticoagulants (OAC) are indicated. The aim was to assess prevalence of, predictors of and consequences of OAC non-use.MethodsWe included patients with AF, HF and no previous valve replacement from the Swedish Heart Failure Registry. High and low CHA2DS2-VASc and HAS-BLED scores were defined as above/below median. Multivariable logistic regressions were used to assess the associations between baseline characteristics and OAC use and between CHA2DS2-VASc and HAS-BLED scores and OAC use. Multivariable Cox regressions were used to assess associations between CHA2DS2-VASc and HAS-BLED scores, OAC use and two composite outcomes: all-cause death/stroke and all-cause death/major bleeding.ResultsOf 21 865 patients, only 12 659 (58%) received OAC. Selected predictors of OAC non-use were treatment with platelet inhibitors, less use of HF treatments, paroxysmal AF, history of bleeding, no previous stroke, planned follow-up in primary care, older age, living alone, lower income and variables associated with more severe HF. For each 1-unit increase in CHA2DS2-VASc and HAS-BLED, the ORs (95% CI) of OAC use were 1.24 (1.21–1.27) and 0.32 (0.30–0.33), and the HRs for death/stroke were 1.08 (1.06–1.10) and for death/major bleeding 1.18 (1.15–1.21), respectively. For high versus low CHA2DS2-VASc and HAS-BLED, the ORs of OAC use were 1.23 (1.15–1.32) and 0.20 (0.19–0.21), and the HRs for death/stroke were 1.25 (1.19–1.30) and for death/major bleeding 1.28 (1.21–1.34), respectively.ConclusionsPatients with AF and concomitant HF do not receive OAC on rational grounds. Bleeding risk inappropriately affects decision-making more than stroke risk.
      PubDate: 2018-06-12T01:05:14-07:00
      DOI: 10.1136/heartjnl-2017-312720
      Issue No: Vol. 104, No. 13 (2018)
  • Cardiac myosin-binding protein C is a novel marker of myocardial injury
           and fibrosis in aortic stenosis
    • Authors: Anand, A; Chin, C, Shah, A. S. V, Kwiecinski, J, Vesey, A, Cowell, J, Weber, E, Kaier, T, Newby, D. E, Dweck, M, Marber, M. S, Mills, N. L.
      Pages: 1101 - 1108
      Abstract: ObjectiveCardiac myosin-binding protein C (cMyC) is an abundant sarcomeric protein and novel highly specific marker of myocardial injury. Myocyte death characterises the transition from hypertrophy to replacement myocardial fibrosis in advanced aortic stenosis. We hypothesised that serum cMyC concentrations would be associated with cardiac structure and outcomes in patients with aortic stenosis.MethodscMyC was measured in two cohorts in which serum had previously been prospectively collected: a mechanism cohort of patients with aortic stenosis (n=161) and healthy controls (n=46) who underwent cardiac MRI, and an outcome cohort with aortic stenosis (n=104) followed for a median of 11.3 years.ResultsIn the mechanism cohort, cMyC concentration correlated with left ventricular mass (adjusted β=11.0 g/m2 per log unit increase in cMyC, P
      Keywords: Open access
      PubDate: 2018-06-12T01:05:14-07:00
      DOI: 10.1136/heartjnl-2017-312257
      Issue No: Vol. 104, No. 13 (2018)
  • Novel United Kingdom prognostic model for 30-day mortality following
           transcatheter aortic valve implantation
    • Authors: Martin, G. P; Sperrin, M, Ludman, P. F, de Belder, M. A, Redwood, S. R, Townend, J. N, Gunning, M, Moat, N. E, Banning, A. P, Buchan, I, Mamas, M. A.
      Pages: 1109 - 1116
      Abstract: ObjectiveExisting clinical prediction models (CPM) for short-term mortality after transcatheter aortic valve implantation (TAVI) have limited applicability in the UK due to moderate predictive performance and inconsistent recording practices across registries. The aim of this study was to derive a UK-TAVI CPM to predict 30-day mortality risk for benchmarking purposes.MethodsA two-step modelling strategy was undertaken: first, data from the UK-TAVI Registry between 2009 and 2014 were used to develop a multivariable logistic regression CPM using backwards stepwise regression. Second, model-updating techniques were applied using the 2013–2014 data, thereby leveraging new approaches to include frailty and to ensure the model was reflective of contemporary practice. Internal validation was performed by bootstrapping to estimate in-sample optimism-corrected performance.ResultsBetween 2009 and 2014, up to 6339 patients were included across 34 centres in the UK-TAVI Registry (mean age, 81.3; 2927 female (46.2%)). The observed 30-day mortality rate was 5.14%. The final UK-TAVI CPM included 15 risk factors, which included two variables associated with frailty. After correction for in-sample optimism, the model was well calibrated, with a calibration intercept of 0.02 (95% CI –0.17 to 0.20) and calibration slope of 0.79 (95% CI 0.55 to 1.03). The area under the receiver operating characteristic curve, after adjustment for in-sample optimism, was 0.66.ConclusionThe UK-TAVI CPM demonstrated strong calibration and moderate discrimination in UK-TAVI patients. This model shows potential for benchmarking, but even the inclusion of frailty did not overcome the need for more wide-ranging data and other outcomes might usefully be explored.
      Keywords: Open access
      PubDate: 2018-06-12T01:05:14-07:00
      DOI: 10.1136/heartjnl-2017-312489
      Issue No: Vol. 104, No. 13 (2018)
  • Sex differences in impact of coronary artery calcification to predict
           coronary artery disease
    • Authors: Nakao, Y. M; Miyamoto, Y, Higashi, M, Noguchi, T, Ohishi, M, Kubota, I, Tsutsui, H, Kawasaki, T, Furukawa, Y, Yoshimura, M, Morita, H, Nishimura, K, Kada, A, Goto, Y, Okamura, T, Tei, C, Tomoike, H, Naito, H, Yasuda, S.
      Pages: 1118 - 1124
      Abstract: ObjectiveTo assess sex-specific differences regarding use of conventional risks and coronary artery calcification (CAC) to detect coronary artery disease (CAD) using coronary CT angiography (CCTA).MethodsThe Nationwide Gender-specific Atherosclerosis Determinants Estimation and Ischemic Cardiovascular Disease Prospective Cohort study is a prospective, multicentre, nationwide cohort study. Candidates with suspected CAD aged 50–74 years enrolled from 2008 to 2012. The outcome was obstructive CAD defined as any stenosis ≥50% by CCTA. We constructed logistic regression models for obstructive CAD adjusted for conventional risks (clinical model) and CAC score. Improvement in discrimination beyond risks was assessed by C-statistic; net reclassification index (NRI) for CAD probability of low (
      Keywords: Open access
      PubDate: 2018-06-12T01:05:14-07:00
      DOI: 10.1136/heartjnl-2017-312151
      Issue No: Vol. 104, No. 13 (2018)
  • Management of mature athletes with cardiovascular conditions
    • Authors: DSilva, A; Sharma, S.
      Pages: 1125 - 1134
      Abstract: Learning objectives
      To appreciate the benefits of exercise training and safety issues in exercise and sport.
      To recognise the risk factors and mechanisms of sudden cardiac death during and after strenuous exercise with specific population challenges.
      To understand the contraindications to exercise/sporting competition and the recommendations for professional and recreational sport participation. Introduction Exercise is a potent therapy for the prevention1–4 and rehabilitation5 of cardiovascular disease, including the management of risk factors for atherosclerotic cardiovascular disease.6 It is important to recognise, however, that an ‘exercise paradox’ exists where vigorous physical activity transiently elevates the risk of sudden cardiac death (SCD) (figure 1). The risk is greatest in individuals who are not accustomed to regular exercise and undertake high intensity physical activity with little or no systematic training.
      Keywords: Education in Heart
      PubDate: 2018-06-12T01:05:14-07:00
      DOI: 10.1136/heartjnl-2016-310744
      Issue No: Vol. 104, No. 13 (2018)
  • Does the purported mortality benefit of beta-blocker therapy in heart
           failure with a preserved ejection fraction apply to patients without prior
           myocardial infarction'
    • Authors: Kumar; N.
      Pages: 1135 - 1135
      Abstract: To the Editor We read with interest the study by Zheng et al in which the authors conducted a meta-analysis of randomised controlled trials to evaluate the effect of different drug classes in heart failure with a preserved ejection fraction (HFpEF). Primary outcome was all-cause mortality and secondary outcome was cardiovascular mortality among other secondary outcomes. The authors found that beta-blocker therapy led to significant reductions in all-cause mortality (relative risk 0.78, 95% CI 0.65 to 0.94, P=0.008) and cardiovascular mortality (0.71, 95% CI 0.55 to 0.93).1 These pooled effect estimates were driven by one study by Aronow et al, which constitutes 63.7% of the weight for the pooled effect estimate for all-cause mortality and 72.8% of the weight for the pooled effect estimate for cardiovascular mortality. This trial conducted in the 1990s exclusively enrolled patients with HFpEF with prior myocardial infarction (MI).2 Other trials from the pre-reperfusion...
      PubDate: 2018-06-12T01:05:14-07:00
      DOI: 10.1136/heartjnl-2018-313079
      Issue No: Vol. 104, No. 13 (2018)
  • Non-vitamin K antagonist oral anticoagulants and infective endocarditis
    • Authors: Caldeira, D; Ferreira, J. J, Pinto, F. J, Costa, J.
      Pages: 1135 - 1136
      Abstract: To the Editor We read with great interest the Editorial by Erwin and Lung, which stated that in patients treated with oral anticoagulants and concomitant infective endocarditis, it is recommended to switch/bridge with heparin in the first 2 weeks to decrease the bleeding risk if cerebral embolism occurs, particularly in staphylococcal endocarditis.1 We recognise that the rate of embolic complications is critical in this timeframe.2 However, there are important clinical questions not covered by the recommendations, in particular for patients treated with NOACs (non-vitamin K antagonist oral anticoagulants, also termed as direct oral anticoagulants). First, the authors were not clear whether bridging should be done with unfractionated or low-molecular-weight heparin (the guidelines consider both options2). Second, in patients treated with NOACs the risk of intracranial haemorrhage is decreased compared with other anticoagulants, including the VKA-LMWH bridging in venous thromboembolism trials.3 Third, specific...
      PubDate: 2018-06-12T01:05:14-07:00
      DOI: 10.1136/heartjnl-2018-313168
      Issue No: Vol. 104, No. 13 (2018)
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
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