Subjects -> MEDICAL SCIENCES (Total: 8695 journals)
    - ANAESTHESIOLOGY (120 journals)
    - CARDIOVASCULAR DISEASES (339 journals)
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    - SPORTS MEDICINE (82 journals)
    - SURGERY (405 journals)

CARDIOVASCULAR DISEASES (339 journals)                  1 2 | Last

Showing 1 - 200 of 339 Journals sorted alphabetically
Acta Angiologica     Open Access   (Followers: 5)
Acta Cardiologica     Hybrid Journal   (Followers: 2)
Acute Cardiac Care     Hybrid Journal   (Followers: 9)
Adipositas - Ursachen, Folgeerkrankungen, Therapie     Hybrid Journal  
AJP Heart and Circulatory Physiology     Hybrid Journal   (Followers: 12)
Aktuelle Kardiologie     Hybrid Journal   (Followers: 2)
American Heart Journal     Hybrid Journal   (Followers: 64)
American Journal of Cardiology     Hybrid Journal   (Followers: 72)
American Journal of Cardiovascular Drugs     Hybrid Journal   (Followers: 21)
American Journal of Hypertension     Hybrid Journal   (Followers: 29)
Anales de Cirugia Vascular     Full-text available via subscription   (Followers: 1)
Anatolian Journal of Cardiology     Open Access   (Followers: 6)
Angiología     Full-text available via subscription  
Angiologia e Cirurgia Vascular     Open Access   (Followers: 1)
Angiology     Hybrid Journal   (Followers: 3)
Annales de Cardiologie et d'Angéiologie     Full-text available via subscription   (Followers: 1)
Annals of Circulation     Open Access   (Followers: 2)
Annals of Noninvasive Electrocardiology     Hybrid Journal   (Followers: 1)
Annals of Pediatric Cardiology     Open Access   (Followers: 12)
AORTA     Open Access  
Archives of Cardiovascular Diseases     Full-text available via subscription   (Followers: 6)
Archives of Cardiovascular Diseases Supplements     Full-text available via subscription   (Followers: 4)
Archives of Cardiovascular Imaging     Open Access   (Followers: 2)
Archivos de cardiología de México     Open Access   (Followers: 1)
Argentine Journal of Cardiology (English edition)     Open Access   (Followers: 3)
Arquivos Brasileiros de Cardiologia     Open Access   (Followers: 2)
Arrhythmia & Electrophysiology Review     Open Access   (Followers: 1)
Arteriosclerosis, Thrombosis and Vascular Biology     Full-text available via subscription   (Followers: 34)
Artery Research     Hybrid Journal   (Followers: 5)
ARYA Atherosclerosis     Open Access  
ASAIO Journal     Hybrid Journal   (Followers: 4)
ASEAN Heart Journal     Open Access   (Followers: 3)
Asian Cardiovascular and Thoracic Annals     Hybrid Journal   (Followers: 2)
Aswan Heart Centre Science & Practice Services     Open Access   (Followers: 1)
Atherosclerosis : X     Open Access  
Bangladesh Heart Journal     Open Access   (Followers: 3)
Basic Research in Cardiology     Hybrid Journal   (Followers: 10)
BMC Cardiovascular Disorders     Open Access   (Followers: 25)
Brain Circulation     Open Access   (Followers: 1)
British Journal of Cardiology     Full-text available via subscription   (Followers: 18)
Canadian Journal of Cardiology     Hybrid Journal   (Followers: 18)
Cardiac Cath Lab Director     Full-text available via subscription  
Cardiac Electrophysiology Review     Hybrid Journal   (Followers: 2)
Cardiac Failure Review     Open Access   (Followers: 2)
Cardiocore     Full-text available via subscription   (Followers: 1)
Cardiogenetics     Open Access   (Followers: 4)
Cardiology     Full-text available via subscription   (Followers: 20)
Cardiology and Angiology: An International Journal     Open Access   (Followers: 1)
Cardiology and Therapy     Open Access   (Followers: 11)
Cardiology Clinics     Full-text available via subscription   (Followers: 14)
Cardiology in Review     Hybrid Journal   (Followers: 9)
Cardiology in the Young     Hybrid Journal   (Followers: 35)
Cardiology Journal     Open Access   (Followers: 6)
Cardiology Plus     Open Access   (Followers: 1)
Cardiology Research     Open Access   (Followers: 15)
Cardiology Research and Practice     Open Access   (Followers: 11)
Cardiopulmonary Physical Therapy Journal     Hybrid Journal   (Followers: 9)
Cardiorenal Medicine     Full-text available via subscription   (Followers: 1)
Cardiothoracic Surgeon     Open Access   (Followers: 2)
CardioVasc     Full-text available via subscription   (Followers: 1)
Cardiovascular & Haematological Disorders - Drug Targets     Hybrid Journal   (Followers: 2)
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: 16)
Cardiovascular Endocrinology & Metabolism     Hybrid Journal   (Followers: 1)
Cardiovascular Engineering     Hybrid Journal   (Followers: 2)
Cardiovascular Engineering and Technology     Hybrid Journal   (Followers: 2)
Cardiovascular Intervention and Therapeutics     Hybrid Journal   (Followers: 6)
Cardiovascular Journal     Open Access   (Followers: 7)
Cardiovascular Journal of Africa     Full-text available via subscription   (Followers: 5)
Cardiovascular Journal of South Africa     Full-text available via subscription   (Followers: 2)
Cardiovascular Medicine in General Practice     Full-text available via subscription   (Followers: 7)
Cardiovascular Pathology     Hybrid Journal   (Followers: 4)
Cardiovascular Regenerative Medicine     Open Access  
Cardiovascular Research     Hybrid Journal   (Followers: 17)
Cardiovascular Revascularization Medicine     Hybrid Journal   (Followers: 1)
Cardiovascular System     Open Access  
Cardiovascular Therapeutics     Open Access   (Followers: 2)
Cardiovascular Toxicology     Hybrid Journal   (Followers: 8)
Cardiovascular Ultrasound     Open Access   (Followers: 5)
Case Reports in Cardiology     Open Access   (Followers: 8)
Catheterization and Cardiovascular Interventions     Hybrid Journal   (Followers: 4)
Cerebrovascular Diseases     Full-text available via subscription   (Followers: 3)
Cerebrovascular Diseases Extra     Open Access  
Chest     Full-text available via subscription   (Followers: 112)
Choroby Serca i Naczyń     Open Access   (Followers: 1)
Circulation     Hybrid Journal   (Followers: 285)
Circulation : Cardiovascular Imaging     Hybrid Journal   (Followers: 17)
Circulation : Cardiovascular Interventions     Hybrid Journal   (Followers: 20)
Circulation : Cardiovascular Quality and Outcomes     Hybrid Journal   (Followers: 13)
Circulation : Genomic and Precision Medicine     Hybrid Journal   (Followers: 17)
Circulation : Heart Failure     Hybrid Journal   (Followers: 32)
Circulation Research     Hybrid Journal   (Followers: 36)
Cirugía Cardiovascular     Open Access  
Clínica e Investigación en Arteriosclerosis     Full-text available via subscription  
Clínica e Investigación en arteriosclerosis (English Edition)     Hybrid Journal  
Clinical and Experimental Hypertension     Hybrid Journal   (Followers: 3)
Clinical Cardiology     Hybrid Journal   (Followers: 10)
Clinical Hypertension     Open Access   (Followers: 5)
Clinical Medicine Insights : Cardiology     Open Access   (Followers: 6)
Clinical Research in Cardiology     Hybrid Journal   (Followers: 5)
Clinical Research in Cardiology Supplements     Hybrid Journal  
Clinical Trials and Regulatory Science in Cardiology     Open Access   (Followers: 4)
Congenital Heart Disease     Hybrid Journal   (Followers: 7)
Congestive Heart Failure     Hybrid Journal   (Followers: 4)
Cor et Vasa     Full-text available via subscription   (Followers: 2)
Coronary Artery Disease     Hybrid Journal   (Followers: 3)
CorSalud     Open Access  
Critical Pathways in Cardiology     Hybrid Journal   (Followers: 5)
Current Cardiology Reports     Hybrid Journal   (Followers: 6)
Current Cardiology Reviews     Hybrid Journal   (Followers: 3)
Current Cardiovascular Imaging Reports     Hybrid Journal   (Followers: 1)
Current Cardiovascular Risk Reports     Hybrid Journal  
Current Heart Failure Reports     Hybrid Journal   (Followers: 5)
Current Hypertension Reports     Hybrid Journal   (Followers: 6)
Current Hypertension Reviews     Hybrid Journal   (Followers: 6)
Current Opinion in Cardiology     Hybrid Journal   (Followers: 13)
Current Problems in Cardiology     Hybrid Journal   (Followers: 3)
Current Research : Cardiology     Full-text available via subscription   (Followers: 1)
Current Treatment Options in Cardiovascular Medicine     Hybrid Journal   (Followers: 3)
Current Vascular Pharmacology     Hybrid Journal   (Followers: 5)
CVIR Endovascular     Open Access   (Followers: 1)
Der Kardiologe     Hybrid Journal   (Followers: 1)
Echo Research and Practice     Open Access   (Followers: 2)
Echocardiography     Hybrid Journal   (Followers: 4)
Egyptian Heart Journal     Open Access   (Followers: 2)
Egyptian Journal of Cardiothoracic Anesthesia     Open Access  
ESC Heart Failure     Open Access   (Followers: 4)
European Cardiology Review     Open Access   (Followers: 1)
European Heart Journal     Hybrid Journal   (Followers: 73)
European Heart Journal - Cardiovascular Imaging     Hybrid Journal   (Followers: 11)
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: 2)
European Heart Journal Supplements     Hybrid Journal   (Followers: 7)
European Journal of Cardio-Thoracic Surgery     Hybrid Journal   (Followers: 9)
European Journal of Cardio-Thoracic Surgery Supplements     Full-text available via subscription   (Followers: 2)
European Journal of Cardiovascular Nursing     Hybrid Journal   (Followers: 5)
European Journal of Heart Failure     Hybrid Journal   (Followers: 14)
European Journal of Preventive Cardiology.     Hybrid Journal   (Followers: 6)
European Stroke Organisation     Hybrid Journal   (Followers: 3)
Experimental & Translational Stroke Medicine     Open Access   (Followers: 10)
Expert Review of Cardiovascular Therapy     Full-text available via subscription   (Followers: 4)
Folia Cardiologica     Open Access  
Forum Zaburzeń Metabolicznych     Hybrid Journal  
Frontiers in Cardiovascular Medicine     Open Access   (Followers: 1)
Future Cardiology     Hybrid Journal   (Followers: 5)
General Thoracic and Cardiovascular Surgery     Hybrid Journal   (Followers: 4)
Global Cardiology Science and Practice     Open Access   (Followers: 5)
Global Heart     Hybrid Journal   (Followers: 3)
Heart     Hybrid Journal   (Followers: 52)
Heart and Mind     Open Access  
Heart and Vessels     Hybrid Journal  
Heart Failure Clinics     Full-text available via subscription   (Followers: 3)
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: 13)
Heart Views     Open Access   (Followers: 2)
HeartRhythm Case Reports     Open Access  
Hearts     Open Access   (Followers: 1)
Hellenic Journal of Cardiology     Open Access   (Followers: 1)
Herz     Hybrid Journal   (Followers: 2)
High Blood Pressure & Cardiovascular Prevention     Full-text available via subscription   (Followers: 3)
Hypertension     Full-text available via subscription   (Followers: 24)
Hypertension     Open Access   (Followers: 2)
Hypertension in Pregnancy     Hybrid Journal   (Followers: 9)
Hypertension Research     Hybrid Journal   (Followers: 4)
Ibrahim Cardiac Medical Journal     Open Access  
IJC Heart & Vessels     Open Access   (Followers: 1)
IJC Heart & Vasculature     Open Access   (Followers: 1)
IJC Metabolic & Endocrine     Open Access   (Followers: 1)
Indian Heart Journal     Open Access   (Followers: 5)
Indian Journal of Cardiovascular Disease in Women WINCARS     Open Access  
Indian Journal of Thoracic and Cardiovascular Surgery     Hybrid Journal  
Indian Pacing and Electrophysiology Journal     Open Access   (Followers: 1)
Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery     Hybrid Journal   (Followers: 2)
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  
International Journal of Cardiology     Hybrid Journal   (Followers: 17)
International Journal of Cardiology Hypertension     Open Access   (Followers: 1)
International Journal of Cardiovascular and Cerebrovascular Disease     Open Access   (Followers: 3)
International Journal of Cardiovascular Imaging     Hybrid Journal   (Followers: 2)
International Journal of Cardiovascular Research     Hybrid Journal   (Followers: 6)
International Journal of Heart Rhythm     Open Access  
International Journal of Hypertension     Open Access   (Followers: 8)
International Journal of Hyperthermia     Open Access  
International Journal of Stroke     Hybrid Journal   (Followers: 33)
International Journal of the Cardiovascular Academy     Open Access  
Interventional Cardiology Clinics     Full-text available via subscription   (Followers: 2)
Interventional Cardiology Review     Open Access  
JACC : Basic to Translational Science     Open Access   (Followers: 6)
JACC : Cardiovascular Imaging     Hybrid Journal   (Followers: 22)
JACC : Cardiovascular Interventions     Hybrid Journal   (Followers: 23)
JACC : Heart Failure     Full-text available via subscription   (Followers: 18)

        1 2 | Last

Similar Journals
Journal Cover
Journal Prestige (SJR): 2.853
Citation Impact (citeScore): 3
Number of Followers: 52  
  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: improving risk prediction and diagnosis of aortic dissection
    • Authors: Otto; C. M.
      Pages: 867 - 869
      Abstract: In patients at risk of ascending aortic dissection, timing of surgery typically is based on serial imaging measurements of aortic diameter. Clearly, the risk of dissection in an individual patient is higher at larger aortic diameters. Even so, from a population point-of-view, most acute dissections occur in patients with a diameter below the recommended threshold for prophylactic root replacement. In this issue of Heart, Heuts and colleagues1 evaluated the hypothesis that measures of aortic length and volume would be better predictors of the risk of dissection than diameter alone. (figure 1) In an observation cohort study of 477 consecutive patients with a Type A aortic dissection, 96% did not meet the surgical diameter threshold of 55 mm before dissection onset. Compared with a cohort 75 patients with an aortic aneurysm who did not suffer a dissection, the positive predictive values of aortic measurements for prediction of...
      PubDate: 2020-05-27T01:00:38-07:00
      DOI: 10.1136/heartjnl-2020-317283
      Issue No: Vol. 106, No. 12 (2020)
  • Prediction of aortic dissection
    • Authors: Akin, I; Nienaber, C. A.
      Pages: 870 - 871
      Abstract: Aortic dissection is a low-incidence, high-impact and potentially catastrophic condition if not treated adequately and in time. Acute aortic dissection is diagnosed within 2 weeks of onset of symptoms, which is the high-mortality period. Patients surviving 2 weeks are considered to have subacute disease, and chronic aortic dissection is diagnosed after 8 weeks. The anatomical classification is based on the involvement of ascending aorta (type A according to Stanford) or not (type B).1 Historical data for untreated type A aortic dissection show a mortality rate of 1%–2% per hour within the first 24 hours, resulting in a mortality rate of up to 50%–74% during the acute phase.2 Uncomplicated acute type B dissection is less frequently lethal, with survival rates for medically treated patients of 84% at 1 year. Within the risk factors, arterial hypertension is dominating. It affects arterial wall composition, causing intimal thickening, fibrosis,...
      PubDate: 2020-05-27T01:00:38-07:00
      DOI: 10.1136/heartjnl-2020-316617
      Issue No: Vol. 106, No. 12 (2020)
  • Severe mitral regurgitation: does one size fit all'
    • Authors: Minder, C. M; Whisenant, B. K.
      Pages: 872 - 873
      Abstract: For symptomatic patients presenting with chronic severe, primary mitral regurgitation, American College of Cardiology/American Heart Association guidelines recommend surgical mitral valve repair for those with ejection fraction ≥30% or consideration of transcatheter mitral valve repair (TMVR) for those with prohibitive surgical risk.1 2 Contemporary clinical trial evidence also suggests benefit of TMVR for patients with heart failure and moderate-to-severe or severe secondary mitral regurgitation who remain symptomatic despite optimal medical therapy.3 As such, clinicians are often on the lookout for patients with mitral regurgitation and subjective complaints of dyspnoea, fatigue, palpitations as well as objective findings including decreased exercise capacity, elevated left atrial pressure (LAP), elevated pulmonary pressures, atrial fibrillation and/or the presence of abnormal biomarkers including brain natriuretic peptide to inform clinical decision-making.2 In a young, otherwise healthy patient without multisystem disease and multiple concordant clinical and imaging findings consistent with...
      PubDate: 2020-05-27T01:00:38-07:00
      DOI: 10.1136/heartjnl-2020-316523
      Issue No: Vol. 106, No. 12 (2020)
  • What is a better measure of regurgitant severity in secondary mitral
           regurgitation by echocardiography'
    • Authors: Kusunose; K.
      Pages: 874 - 875
      Abstract: Secondary mitral regurgitation (MR) is a hot topic of cardiovascular field after two randomised trials of transcatheter edge-to-edge repair in patients with secondary MR—Multicenter Study of Percutaneous Mitral Valve Repair MitraClip Device in Patients with Severe Secondary MR (MITRA-FR) and Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients with Functional MR (COAPT).1 2 The trials had similar aims, but in COAPT trial, MitraClip was associated with decreased risk of death and hospitalisation for heart failure, and in MITRA-FR, the intervention was not effectiveness for the prognosis. Many investigators try to clarify the difference between two trials.3 4 One possible explanation is the different cohort study between the two trials. From the standpoints of haemodynamic status, the effective regurgitant orifice area (EROA) can be estimated from left ventricular end-diastolic volume (LVEDV), left ventricular ejection fraction (LVEF) and regurgitant...
      PubDate: 2020-05-27T01:00:38-07:00
      DOI: 10.1136/heartjnl-2020-316846
      Issue No: Vol. 106, No. 12 (2020)
  • Is vWF really a very wonderful factor for risk stratification in adults
           with congenital heart disease'
    • Authors: Celermajer, D. S; Offen, S.
      Pages: 876 - 877
      Abstract: Adults with congenital heart disease (CHD) are indeed a 20th-century marvel. There were not too many adults with single ventricle hearts around, for example, before the 1980s. Extraordinary advances in paediatric cardiac care over the past decades have meant over 90% of babies born with cardiovascular anomalies are now expected to reach adulthood, a statistic that is likely to continue to improve. Despite this great success, many of the adults now living with CHD will experience significant complications. Those with complex pathology are unlikely to reach their 40s without one or more adverse events, even after ‘successful’ repair in childhood (the most common complications including need for further surgeries, heart failure, arrhythmias, endocarditis and thromboembolism). The risk of premature mortality remains substantial, across the spectrum of CHDs.1 One pivotal question that remains to be answered is how we can best predict such adverse outcomes, in this heterogenous...
      PubDate: 2020-05-27T01:00:38-07:00
      DOI: 10.1136/heartjnl-2020-316599
      Issue No: Vol. 106, No. 12 (2020)
  • Transcatheter treatment of postinfarct ventricular septal defects
    • Authors: Giblett, J. P; Jenkins, D. P, Calvert, P. A.
      Pages: 878 - 884
      Abstract: Postinfarct ventricular septal defects (VSDs) are a mechanical complication of acute myocardial infarction (AMI) with a very poor prognosis. They are estimated to occur in 0.2% of patients presenting with AMI, with 1-month survival of 6% without intervention. Guidelines recommend surgical repair, but recent advances in transcatheter technology, and bespoke device development, mean it is increasingly viable as a closure option. Surgical mortality is between 30% and 50% for all-comers, while in series of transcatheter closure, mortality was 32%. Transcatheter closure appears durable, with no evidence of late leaks and low long-term mortality in series with up to 5-year follow-up. Guidelines recommend early closure, which is likely to provide most benefit for patients regardless of the closure method. Multimodality cardiac imaging including echocardiography, CT and cardiac MRI can define size, shape, location of defects and their relationship to other cardiac structures, assisting with treatment decisions. Brief delay to allow stabilisation of the patient is appropriate, but untreated patients risk rapid deterioration. Mechanical circulatory support may be helpful, although the preferred modality is unclear. Transcatheter closure involves large bore venous access and the formation of an arteriovenous loop (under fluoroscopic and trans-oesophageal echocardiographic guidance) in order to facilitate deployment of the device in the defect and close the postinfarct VSD. Guidelines suggest transcatheter closure as an alternative to surgical repair in centres where appropriate expertise exists, but decisions for all patients with postinfarct VSD should be led by the multidisciplinary heart team.
      Keywords: Review articles
      PubDate: 2020-05-27T01:00:38-07:00
      DOI: 10.1136/heartjnl-2019-315751
      Issue No: Vol. 106, No. 12 (2020)
  • The risk of misdiagnosis in acute thoracic aortic dissection: a review of
           current guidelines
    • Authors: Salmasi, M. Y; Al-Saadi, N, Hartley, P, Jarral, O. A, Raja, S, Hussein, M, Redhead, J, Rosendahl, U, Nienaber, C. A, Pepper, J. R, Oo, A. Y, Athanasiou, T.
      Pages: 885 - 891
      Abstract: Acute aortic syndrome and in particular aortic dissection (AAD) persists as a cause of significant morbidity and mortality despite improvements in surgical management. This clinical review aims to explore the risks of misdiagnosis, outcomes associated with misdiagnosis and evaluate current diagnostic methods for reducing its incidence.Due to the nature of the pathology, misdiagnosing the condition and delaying management can dramatically worsen patient outcomes. Several diagnostic challenges exist, including low prevalence, rapidly propagating pathology, non-discrete symptomatology, non-specific signs, analogy with other acute conditions and lack of management infrastructure. A similarity to acute coronary syndromes is a specific concern and risks patient maltreatment. AAD with malperfusion syndromes are both a cause of misdiagnosis and marker of disease complication, requiring specifically tailored management plans from the emergency setting.Despite improvements in diagnostic measures, including imaging modalities and biomarkers, misdiagnosis of AAD remains commonplace and current guidelines are relatively limited in preventing its occurrence. This paper recommends the early use of AAD risk scoring, focused echocardiography and most importantly, fast-tracking patients to cross-sectional imaging where the suspicion of AAD is high. This has the potential to improve the diagnostic process for AAD and limit the risk of misdiagnosis. However, our understanding remains limited by the lack of large patient datasets and an adequately audited processes of emergency department practice.
      Keywords: Review articles
      PubDate: 2020-05-27T01:00:38-07:00
      DOI: 10.1136/heartjnl-2019-316322
      Issue No: Vol. 106, No. 12 (2020)
  • Imaging large arteries after arterial switch operation
    • Authors: van Broekhoven, I; Kroft, L. J. M, van der Palen, R. L. F.
      Pages: 891 - 950
      Abstract: Clinical introduction A girl born at a gestational age of 38 weeks was antenatally diagnosed with a transposition of the great arteries with intact ventricular septum. After a balloon atrioseptostomy in the first hour postbirth an arterial switch operation (ASO), including Lecompte manoeuvre, was successfully performed at day 8. Coronary arteries were implanted in the neoaortic root with the button technique. The proximal neoaorta was anastomosed to the distal ascending aorta by a running suture. Reconstruction of the neopulmonary artery after harvesting the coronary arteries was performed using a pantaloon shaped patch of fresh autologous pericardium. The proximal neopulmonary artery was anastomosed to the main pulmonary artery with a running suture. The girl recovered well. Echocardiographic examination during an outpatient visit 3 months post-ASO showed following images on a skewed parasternal long-axis view (figure 1A) and high parasternal short-axis view (figure 1B). Clinically the...
      Keywords: Image challenges
      PubDate: 2020-05-27T01:00:38-07:00
      DOI: 10.1136/heartjnl-2019-316504
      Issue No: Vol. 106, No. 12 (2020)
  • Evaluating the diagnostic accuracy of maximal aortic diameter, length and
           volume for prediction of aortic dissection
    • Authors: Heuts, S; Adriaans, B. P, Rylski, B, Mihl, C, Bekkers, S. C. A. M, Olsthoorn, J. R, Natour, E, Bouman, H, Berezowski, M, Kosiorowska, K, Crijns, H. J. G. M, Maessen, J. G, Wildberger, J, Schalla, S, Sardari Nia, P.
      Pages: 892 - 897
      Abstract: ObjectiveManagement of thoracic aortic aneurysms (TAAs) comprises regular diameter follow-up until the indication criterion for prophylactic surgery is reached. However, this approach is unable to predict the majority of acute type A aortic dissections (ATAADs). The current study aims to evaluate the diagnostic accuracy of ascending aortic diameter, length and volume for occurrence of ATAAD.MethodsThis two-centre observational cohort study retrospectively screened 477 consecutive patients who presented with ATAAD between 2009 and 2018. Of those, 25 (5.2%) underwent CT angiography (CTA) within 2 years before dissection onset. Aortic diameter, length and volume of these patients (‘pre-ATAAD’) were compared with those of TAA controls (n=75). Receiver operating curve analysis was performed to evaluate the predictive accuracy of the three different measurements.Results96% of patients with pre-ATAAD did not meet the surgical diameter threshold of 55 mm before dissection onset. Maximal aortic diameters (45 (40–49) mm vs 46 (44–49) mm, p=0.075) and volume (126 (95–157) cm3 vs 124 (102–136) cm3, p=0.909) were comparable between patients with pre-ATAAD and TAA controls. Conversely, ascending aortic length (84±9 mm vs 90±16 mm, p=0.031) was significantly larger in patients with pre-ATAAD. All three parameters had an area under the curve of>0.800. At the 55 mm cut-off point, the maximal diameter yielded a positive predictive value (PPV) of 20%. While maintaining same specificity levels, measurements of aortic volume and length showed superior diagnostic accuracy (PPV 55% and 70%, respectively).ConclusionMeasurements of aortic volume and length have superior diagnostic accuracy compared with the maximal diameter and could improve the timely identification of patients at risk for ATAAD.
      Keywords: Editor's choice
      PubDate: 2020-05-27T01:00:38-07:00
      DOI: 10.1136/heartjnl-2019-316251
      Issue No: Vol. 106, No. 12 (2020)
  • Characteristics and outcomes of patients with normal left atrial pressure
           undergoing transcatheter mitral valve repair
    • Authors: Sims, J. R; Reeder, G. S, Guerrero, M, Alkhouli, M, Nkomo, V. T, Nishimura, R. A, Rihal, C. S, Eleid, M. F.
      Pages: 898 - 903
      Abstract: ObjectiveA subset of patients at the time of transcatheter mitral valve repair (TMVR) will have normal left atrial pressure (LAP) (
      Keywords: Valvular heart disease
      PubDate: 2020-05-27T01:00:38-07:00
      DOI: 10.1136/heartjnl-2019-316133
      Issue No: Vol. 106, No. 12 (2020)
  • Average pixel intensity method for prediction of outcome in secondary
           mitral regurgitation
    • Authors: Kamoen, V; De Buyzere, M, El Haddad, M, de Backer, T. L. M, Timmermans, F.
      Pages: 904 - 909
      Abstract: BackgroundEchocardiographic grading of secondary mitral regurgitation (SMR) severity is challenging and involves multiple guideline-recommended parameters. We previously introduced the average pixel intensity (API) method for grading SMR. In this study, the clinical outcome in SMR based on the API method for grading MR was compared with conventional grading methods.Methods231 patients with systolic heart failure and reduced ejection fraction (ischaemic/non-ischaemic) and SMR were prospectively enrolled. MR was graded using all guideline-recommended parameters and the API method, which is based on the pixel intensity of the continuous wave Doppler signal. The primary outcome was MACE (major adverse cardiac event).ResultsThe API method was applicable in 98% of patients with SMR (n=227). During a median follow-up of 24 months, 98 patients (43%) had a MACE (cardiovascular mortality (n=50, 22%), heart failure hospitalisation (n=44, 19%), mitral valve surgery (n=11, 5%), percutaneous mitral intervention (n=12, 5%), heart transplantation (n=5, 2%)). On log-rank test, the API method was highly significant in predicting clinical outcome. On multivariable Cox proportional hazard analysis, SMR grading with the API method was an independent predictor of clinical outcome (along with NYHA class and right ventricular systolic pressure; p
      Keywords: Valvular heart disease
      PubDate: 2020-05-27T01:00:38-07:00
      DOI: 10.1136/heartjnl-2019-316157
      Issue No: Vol. 106, No. 12 (2020)
  • Prognostic value of von Willebrand factor in adult patients with
           congenital heart disease
    • Authors: Ohuchi, H; Hayama, Y, Miike, H, Suzuki, D, Nakajima, K, Iwasa, T, Konagai, N, Sakaguchi, H, Miyazaki, A, Shiraishi, I, Kurosaki, K.-i, Nakai, M.
      Pages: 910 - 915
      Abstract: Objectivesvon Willebrand factor (vWF) has prognostic value in patients with heart failure (HF) and in those with liver disease. Liver congestion, due to right-sided HF (RHF), is one of the major clinical pathophysiologic manifestations in adults with congenital heart disease (ACHD). The present study’s purpose was to clarify the prognostic value of plasma levels of vWF antigen (vWF:Ag) in ACHD.MethodsWe measured vWF:Ag (%) in 382 consecutive patients (20 unrepaired cyanotic ACHD, 172 Fontan patients and 190 ACHD after biventricular repair) and compared the results with the clinical profiles and prognosis.ResultsThe plasma vWF:Ag level was 130±53 (normal range: 55%–190%), and 48 patients (13%) showed high levels of vWF:Ag (≥190%). Older age, Fontan circulation, higher central venous pressure, lower arterial oxygen saturation and lower plasma levels of albumin were independently associated with high log (vWF:Ag) (p
      PubDate: 2020-05-27T01:00:38-07:00
      DOI: 10.1136/heartjnl-2019-316007
      Issue No: Vol. 106, No. 12 (2020)
  • Interstitial lung disease is a risk factor for ischaemic heart disease and
           myocardial infarction
    • Authors: Clarson, L. E; Bajpai, R, Whittle, R, Belcher, J, Abdul Sultan, A, Kwok, C. S, Welsh, V, Mamas, M, Mallen, C. D.
      Pages: 916 - 922
      Abstract: ObjectivesDespite many shared risk factors and pathophysiological pathways, the risk of ischaemic heart disease (IHD) and myocardial infarction (MI) in interstitial lung disease (ILD) remains poorly understood. This lack of data could be preventing patients who may benefit from screening for these cardiovascular diseases from receiving it.MethodsA population-based cohort study used electronic patient records from the Clinical Practice Research Datalink and linked Hospital Episode Statistics to identify 68 572 patients (11 688 ILD exposed (mean follow-up: 3.8 years); 56 884 unexposed controls (mean follow-up: 4.0 years), with 349 067 person-years of follow-up. ILD-exposed patients (pulmonary sarcoidosis (PS) or idiopathic pulmonary fibrosis (PF)) were matched (by age, sex, registered general practice and available follow-up time) to patients without ILD or IHD/MI. Rates of incident MI and IHD were estimated. HRs were modelled using multivariable Cox proportional hazards regression accounting for potential confounders.ResultsILD was independently associated with IHD (HR 1.85, 95% CI 1.56 to 2.18) and MI (HR 1.74, 95% CI 1.44 to 2.11). In all disease categories, risk of both IHD and MI peaked between ages 60 and 69 years, except for the risk of MI in PS which was greatest
      Keywords: Open access
      PubDate: 2020-05-27T01:00:38-07:00
      DOI: 10.1136/heartjnl-2019-315511
      Issue No: Vol. 106, No. 12 (2020)
  • Coronary slow flow is associated with a worse clinical outcome in patients
           with Takotsubo syndrome
    • Authors: Montone, R. A; Galiuto, L, Meucci, M. C, Del Buono, M. G, Vergni, F, Camilli, M, Sanna, T, Pedicino, D, Buffon, A, D'Amario, D, Giraldi, L, Trani, C, Liuzzo, G, Rebuzzi, A. G, Niccoli, G, Crea, F.
      Pages: 923 - 930
      Abstract: ObjectivePatients with Takotsubo syndrome (TTS) present an acute microvascular dysfunction that leads to an impaired myocardial perfusion and, in more severe forms, an impaired epicardial flow. However, clinical relevance of a delayed coronary flow, the coronary slow flow (CSF), has never been investigated. We studied the prognostic value of CSF occurring in the acute phase of TTS.MethodsThis cohort study prospectively evaluated patients with a diagnosis of TTS. CSF was defined as angiographically non-obstructive coronary arteries with thrombolysis in myocardial infarction-2 flow. The incidence of overall mortality and major adverse cardiovascular events (MACEs), defined as the composite of TTS recurrence, cardiac rehospitalisation, cerebrovascular events and mortality, was assessed at follow-up.ResultsWe enrolled 101 patients (mean age 71.0±11.1 years, 86 (85.1%) female); CSF occurred in 18 (17.8%) patients. At admission, patients with CSF presented more frequently with Killip class III/IV, moderate-to-severe left ventricle systolic dysfunction and right ventricle dysfunction. During the index admission, patients with CSF had a higher rate of intrahospital complications (12 (66.7%) vs 28 (33.7%), p=0.01). At long-term follow-up, patients with CSF had a significantly higher occurrence of overall mortality (9 (50%) vs 19 (22.9%), p=0.011), mainly due to non-cardiac causes (89.3%), and a higher rate of MACE (10 (55.5%) vs 27 (32.5%), p=0.06). At multivariable Cox regression, CSF was independently associated with death from any causes.ConclusionsPatients with TTS presenting with CSF have a worse clinical presentation with a higher rate of intrahospital complications and a poor long-term clinical outcome.
      PubDate: 2020-05-27T01:00:38-07:00
      DOI: 10.1136/heartjnl-2019-315909
      Issue No: Vol. 106, No. 12 (2020)
  • Financial and resource costs of transvenous lead extraction in a
           high-volume lead extraction centre
    • Authors: Gould, J; Sidhu, B. S, Porter, B, Sieniewicz, B. J, Freeman, S, de Wilt, E. C, Glover, J. C, Razavi, R, Rinaldi, C. A.
      Pages: 931 - 937
      Abstract: ObjectivesTransvenous lead extraction (TLE) poses a significant economic and resource burden on healthcare systems; however, limited data exist on its true cost. We therefore estimate real-world healthcare reimbursement costs of TLE to the UK healthcare system at a single extraction centre.MethodsConsecutive admissions entailing TLE at a high-volume UK centre between April 2013 and March 2018 were prospectively recorded in a computer registry. In the hospital’s National Health Service (NHS) clinical coding/reimbursement database, 447 cases were identified. Mean reimbursement cost (n=445) and length of stay (n=447) were calculated. Ordinary least squares regressions estimated the relationship between cost (bed days) and clinical factors.ResultsMean reimbursement cost per admission was £17 399.09±£13 966.49. Total reimbursement for all TLE admissions was £7 777 393.51. Mean length of stay was 16.3±15.16 days with a total of 7199 bed days. Implantable cardioverter-defibrillator and cardiac resynchronisation therapy defibrillator devices incurred higher reimbursement costs (70.5% and 68.7% higher, respectively, both p
      Keywords: Open access
      PubDate: 2020-05-27T01:00:38-07:00
      DOI: 10.1136/heartjnl-2019-315839
      Issue No: Vol. 106, No. 12 (2020)
  • Cardiogenetics: a primer for the clinical cardiologist
    • Authors: Otto, C. M; Savla, J. J, Hisama, F. M.
      Pages: 938 - 947
      Abstract: Learning objectives
      To integrate the family history and directed genetic testing into the diagnostic evaluation of patients with cardiovascular disease.
      To manage patients and families with inherited cardiovascular conditions.
      To manage the uncertainties associated with genetic testing.
      To integrate new information about genetic conditions into clinical care.
      To recognise phenotypes associated with inherited cardiovascular conditions. Genetic factors in cardiovascular disease Over the past decade, there has been increased recognition of genetic causes for many types of cardiovascular disease, with significant implications for patient management depending on the specific genetic condition. Although polygenetic associations with atherosclerotic cardiovascular disease have long been known, a number of inherited single-gene variants resulting in unique cardiovascular phenotypes has been recognised only more recently. Previously, it was difficult to make a genetic diagnosis because testing was expensive and rarely available. The current era of massively parallel...
      Keywords: Education in Heart
      PubDate: 2020-05-27T01:00:38-07:00
      DOI: 10.1136/heartjnl-2019-316241
      Issue No: Vol. 106, No. 12 (2020)
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
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