Heart International最新文献

{"title":"Management of Coronary Artery Disease in the Setting of Transcatheter Aortic Valve Replacement.","authors":"Natraj Katta,&nbsp;J Dawn Abbott,&nbsp;Ankur Kalra,&nbsp;Fawaz Alenezi,&nbsp;Andrew Goldsweig,&nbsp;Herbert Aronow,&nbsp;Poonam Velagapudi","doi":"10.17925/HI.2020.14.1.24","DOIUrl":"https://doi.org/10.17925/HI.2020.14.1.24","url":null,"abstract":"<p><p>Aortic stenosis and coronary artery disease (CAD) frequently co-exist, as they share a common pathophysiology and risk factors. Due to lack of randomised controlled trials (RCTs) and exclusion of significant CAD in transcatheter aortic valve replacement (TAVR) trials, the optimal method of revascularisation of CAD in patients undergoing TAVR remains unknown. Observational studies and meta-analyses have shown varied results in outcomes for patients with CAD undergoing TAVR, and no significant difference in post-TAVR outcomes in patients who underwent revascularisation either prior to or during TAVR versus those who did not. However, some observational studies have shown that patients with lower residual SYNTAX score (rSS) post-revascularisation have better outcomes post-TAVR compared to those with higher rSS. RCTs are needed to clearly understand whether revascularisation is beneficial in these patients. Until then, management of CAD in patients undergoing TAVR must be individualised based on discussion with the heart team.</p>","PeriodicalId":12836,"journal":{"name":"Heart International","volume":"14 1","pages":"24-28"},"PeriodicalIF":0.2,"publicationDate":"2020-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9524713/pdf/heart-int-14-24.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40583482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous Coronary Intervention Versus Coronary Artery Bypass Graft in Left Main Revascularisation.","authors":"Timir Kumar Paul","doi":"10.17925/HI.2020.14.1.11","DOIUrl":"10.17925/HI.2020.14.1.11","url":null,"abstract":"","PeriodicalId":12836,"journal":{"name":"Heart International","volume":"14 1","pages":"11-12"},"PeriodicalIF":1.9,"publicationDate":"2020-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9524751/pdf/heart-int-14-11.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40567776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New Consumer Guidance on Wearable Devices from the Consumer Electronics Show 2020.","authors":"Nassir F Marrouche","doi":"10.17925/HI.2020.14.1.9","DOIUrl":"https://doi.org/10.17925/HI.2020.14.1.9","url":null,"abstract":"","PeriodicalId":12836,"journal":{"name":"Heart International","volume":"14 1","pages":"9-10"},"PeriodicalIF":0.2,"publicationDate":"2020-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9524714/pdf/heart-int-14-09.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40568876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Summary of Practice Considerations for Percutaneous Coronary Intervention of Left Main Bifurcation Disease.","authors":"Tanveer Rab, J Dawn Abbott, Mir Babar Basir, Azeem Latib, Gautam Kumar, Perwaiz Meraj, Kevin Croce, Rajesh Davé","doi":"10.17925/HI.2020.14.2.69","DOIUrl":"10.17925/HI.2020.14.2.69","url":null,"abstract":"<p><p>Left main bifurcation percutaneous coronary intervention is a challenging subset that requires expertise in techniques that are in constant modification. Imaging is important in lesion preparation and optimising outcomes. The interventionalist needs to be highly skilled in the different techniques, as missteps may lead to stent thrombosis and critical in-stent restenosis. Lesion classification between simple and complex identifies those who would best benefit from a two-stent technique. Current technical approaches and practice considerations are summarised in this manuscript.</p>","PeriodicalId":12836,"journal":{"name":"Heart International","volume":"14 2","pages":"69-72"},"PeriodicalIF":1.9,"publicationDate":"2020-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9524749/pdf/heart-int-14-69.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40565403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter from the Editor-in-Chief.","authors":"Rajesh Davé","doi":"10.17925/HI.2019.13.2.9","DOIUrl":"https://doi.org/10.17925/HI.2019.13.2.9","url":null,"abstract":"","PeriodicalId":12836,"journal":{"name":"Heart International","volume":"13 2","pages":"9-10"},"PeriodicalIF":0.2,"publicationDate":"2019-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9562419/pdf/heart-int-13-10.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40663807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Review of the Ultrathin Orsiro Biodegradable Polymer Drug-eluting Stent in the Treatment of Coronary Artery Disease.","authors":"James J Wu, Joshua Ah Way, David Brieger","doi":"10.17925/HI.2019.13.2.17","DOIUrl":"10.17925/HI.2019.13.2.17","url":null,"abstract":"<p><p>Drug-eluting stents (DES) have revolutionised the treatment of coronary artery disease (CAD) in patients undergoing percutaneous coronary intervention. In recent years, there has been a focus on a new generation of DES, such as biodegradable polymer DES (BP-DES). This novel stent platform was developed with the hope of eliminating the risk of very late stent thrombosis associated with the current gold-standard durable polymer DES (DP-DES). Ultrathin Orsiro BP-DES (Biotronik, Bülach, Switzerland) are based on a cobalt-chromium stent platform that is coated with a bioresorbable polymer coating containing sirolimus. These devices have one of the thinnest struts available in the current market and have the theoretical benefit of reducing a chronic inflammatory response in the vessel wall. In 2019, the United States Food and Drug Administration (FDA) approved the use of Orsiro BP-DES in patients with CAD based on promising results in recent landmark trials, such as BIOFLOW V and BIOSTEMI. The aim of the present review article was to discuss the history of stent technology and the continued opportunities for improvements, focusing on the potential benefits of Orsiro BP-DES.</p>","PeriodicalId":12836,"journal":{"name":"Heart International","volume":"13 2","pages":"17-24"},"PeriodicalIF":1.9,"publicationDate":"2019-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9559229/pdf/heart-int-13-17.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40663809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterising the Clinical Spectrum, Diagnosis and Outcomes in Secondary Stress Cardiomyopathy.","authors":"Puneet Gupta,&nbsp;Anand Chockalingam","doi":"10.17925/HI.2019.13.2.26","DOIUrl":"https://doi.org/10.17925/HI.2019.13.2.26","url":null,"abstract":"<p><strong>Introduction: </strong>Available literature on takotsubo cardiomyopathy excludes critically ill patients due to challenges in angiographic confirmation. Secondary stress cardiomyopathy (sSC) occurs in patients already hospitalised for other critical illnesses. Diagnosis of sSC is challenging, while clinical presentation and outcomes are significantly different from primary stress cardiomyopathy. Our aim was to better characterise the clinical picture of sSC.</p><p><strong>Methods: </strong>The diagnosis of sSC was confirmed based on characteristic clinical and morphological features, applying our diagnostic algorithm suited for critically ill patients. We were able to characterise these sSC patients and differentiate their presentation from takotsubo registry population. Data on selected patients was extracted manually on Microsoft Excel worksheets with relevant patient demographics, presenting features and outcomes.</p><p><strong>Results: </strong>We developed a profile of sSC based on 18 consecutive confirmed cases diagnosed at our university hospital between April 2016 and September 2018. sSC differed from takotsubo cardiomyopathy in several key clinical aspects - younger people may develop sSC (range 21-86 years) and men were more frequently affected in comparison to takotsubo cardiomyopathy (29%). Dyspnoea was noted in 22% of our patients and angina was rare. Apical ballooning occurred in only 33% of the patients, while mid (39%) and basal left ventricular (11%) variants accounted for half of the patients. Mortality was much higher (28%) due to underlying medical comorbidities.</p><p><strong>Conclusions: </strong>Our series illustrates significant clinical and morphologic differences in the presentation of sSC. Shifting the emphasis to serial echocardiography would reduce the need for invasive catheterisation and downstream comorbidity in critical care settings.</p>","PeriodicalId":12836,"journal":{"name":"Heart International","volume":"13 2","pages":"26-30"},"PeriodicalIF":0.2,"publicationDate":"2019-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9559225/pdf/heart-int-13-26.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40651557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Equivocal Left Main Stenosis with Fractional Flow Reserve - Not all Daughter Vessels are Created Equally.","authors":"Ahmed Almomani,&nbsp;Abdul-Rahman Abdel-Karim,&nbsp;Barry F Uretsky","doi":"10.17925/HI.2019.13.2.38","DOIUrl":"https://doi.org/10.17925/HI.2019.13.2.38","url":null,"abstract":"<p><p>Fractional flow reserve (FFR) evaluation of intermediate left main coronary artery (LMCA) stenosis has been validated in clinical decision-making. However, the size of the daughter vessel, in which the FFR transducer is placed and the amount of myocardium it subtends, has received less attention. We present a case that demonstrates the importance of transducer location, size of the daughter vessel and the amount of subtended myocardium in evaluation of LMCA stenosis, pointing out potential pitfalls.</p>","PeriodicalId":12836,"journal":{"name":"Heart International","volume":"13 2","pages":"38-40"},"PeriodicalIF":0.2,"publicationDate":"2019-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9559224/pdf/heart-int-13-38.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40663808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantification of Seasonal Variation in Daily Physical Activity in Individuals with Heart Failure and Implantable Cardioverter Defibrillator/Cardiac Resynchronisation Therapy Devices.","authors":"Michael J Shoemaker,&nbsp;Amanda Ferrick,&nbsp;Cathryn Fischer,&nbsp;Colin Schuurman,&nbsp;Kelly Cartwright,&nbsp;Jessica McLeod,&nbsp;Emily Schuman,&nbsp;Ashley Van Dam,&nbsp;Michael G Dickinson","doi":"10.17925/HI.2019.13.2.31","DOIUrl":"https://doi.org/10.17925/HI.2019.13.2.31","url":null,"abstract":"<p><strong>Purpose: </strong>Understanding seasonal variation of daily physical activity (PA) in patients with heart failure (HF) has important implications for planning and interpretation of clinical trials, but the presence and magnitude of this seasonal variation in daily PA have yet to be established. The purpose of the present study was to determine the presence and magnitude of seasonal variation in daily PA in community-dwelling individuals with HF using several analytic approaches.</p><p><strong>Methods: </strong>Retrospective chart review of patients with HF and Medtronic implantable cardioverter defibrillator/cardiac resynchronisation therapy (ICD/CRT) devices. Data included in analyses (autocorrelation, analysis of covariance, one-way analysis of variance) were clinical characteristics, the patient activity measure of daily PA from the ICD/CRT devices, temperature and hours of daylight over the 1-year period of 1 November 2017-31 October 2018.</p><p><strong>Results: </strong>One hundred and sixty-eight patients were included. Visual analysis and autocorrelation demonstrated seasonal variation in daily PA. Daily PA seasonal difference between winter and summer months was 0.4 hours per day/24 minutes per day/2.8 hours per week/14.9%. This seasonal effect on daily PA is significantly greater in those with ≤8 comorbid conditions and an overall activity level of >2.2 hours per day compared to those with multiple comorbidities and low overall activity (0.7 versus 0.1 hours per day, respectively).</p><p><strong>Conclusions: </strong>The present study affirms the seasonality of daily PA in a cohort of patients with HF and ICD/CRT devices and reveals a disproportionate seasonal effect on those with fewer comorbidities and higher overall activity levels. Seasonal variation should be accounted for when interpreting change in daily PA in clinical practice and when designing and interpreting results of clinical trials investigating interventions to improve daily PA.</p>","PeriodicalId":12836,"journal":{"name":"Heart International","volume":"13 2","pages":"31-37"},"PeriodicalIF":0.2,"publicationDate":"2019-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9524607/pdf/heart-int-13-31.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40651559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal Denervation in High-risk Patients with Hypertension.","authors":"Marshall J Heradien,&nbsp;Pieter van der Bijl,&nbsp;Paul A Brink","doi":"10.17925/HI.2019.13.2.12","DOIUrl":"https://doi.org/10.17925/HI.2019.13.2.12","url":null,"abstract":"<p><p>Hypertension is a common health problem, which leads to a substantial mortality and morbidity burden, globally. The management of patients with high-risk and treatment-resistant hypertension remains a major clinical challenge to the treating physician. Renal denervation (RD) is an emerging technique, comprising modification of the renal sympathetic nerve supply which courses around the renal arteries. Endovascular access is obtained to the renal arteries, followed by delivery of heat energy to the peri-renal sympathetic nerves. This leads to the reduction of blood pressure with or without the addition of anti-hypertensive pharmacotherapy. Earlier trials led to clinical equipoise, but more recent trials (e.g. SPYRAL HTN-OFF MED, SPYRAL HTN-ON MED and RADIANCE-HTN SOLO), which were designed to overcome the limitations of the initial studies, have provided support for the efficacy of RD in hypertension management. Evidence (from randomised, non-randomised, sham-controlled and non-sham-controlled trials) for the use of RD in the treatment of hypertension is reviewed in this article. Finally, the current clinical role, gaps in evidence, and the expected future evolution of RD are discussed.</p>","PeriodicalId":12836,"journal":{"name":"Heart International","volume":"13 2","pages":"12-16"},"PeriodicalIF":0.2,"publicationDate":"2019-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9524839/pdf/heart-int-13-13.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40651558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}