British Heart Journal最新文献

{"title":"Joint British Societies’ guideline on management of cardiac arrest in the cardiac catheter laboratory","authors":"J. Dunning, A. Archbold, J. de Bono, Liz Butterfield, N. Curzen, C. Deakin, Ellie Gudde, Thomas R. Keeble, Alan Keys, Mike Lewis, N. O'Keeffe, J. Sarma, M. Stout, P. Swindell, S. Ray","doi":"10.1136/heartjnl-2021-320588","DOIUrl":"https://doi.org/10.1136/heartjnl-2021-320588","url":null,"abstract":"More than 300 000 procedures are performed in cardiac catheter laboratories in the UK each year. The variety and complexity of percutaneous cardiovascular procedures have both increased substantially since the early days of invasive cardiology, when it was largely focused on elective coronary angiography and single chamber (right ventricular) permanent pacemaker implantation. Modern-day invasive cardiology encompasses primary percutaneous coronary intervention, cardiac resynchronisation therapy, complex arrhythmia ablation and structural heart interventions. These procedures all carry the risk of cardiac arrest. We have developed evidence-based guidelines for the management of cardiac arrest in adult patients in the catheter laboratory. The guidelines include recommendations which were developed by collaboration between nine professional and patient societies that are involved in promoting high-quality care for patients with cardiovascular conditions. We present a set of protocols which use the skills of the whole catheter laboratory team and which are aimed at achieving the best possible outcomes for patients who suffer a cardiac arrest in this setting. We identified six roles and developed a treatment algorithm which should be adopted during cardiac arrest in the catheter laboratory. We recommend that all catheter laboratory staff undergo regular training for these emergency situations which they will inevitably face.","PeriodicalId":9311,"journal":{"name":"British Heart Journal","volume":"108 1","pages":"e3 - e3"},"PeriodicalIF":0.0,"publicationDate":"2022-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45424883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Calcium, vitamin D and aortic valve calcification: to the bone or to the heart?","authors":"J. Bergler-Klein","doi":"10.1136/heartjnl-2021-320672","DOIUrl":"https://doi.org/10.1136/heartjnl-2021-320672","url":null,"abstract":"CALCIUM AND VITAMIN D SUPPLEMENT: RIGHT OR WRONG? Intuitively, one might think that supplementing vitamins and minerals would be the right thing to do especially in older and comorbid people. Every year, billions of dollars are spent in this belief. However, we may all be wrong. A present study in this journal demonstrates a significantly increased cardiovascular (CV) mortality in elderly patients supplementing calcium, be it with or without vitamin D, who initially presented with mild to moderate aortic stenosis (AS) in a longitudinal analysis of a large contemporary echocardiography database cohort of 2657 patients. Patients were followed for aortic valve replacement (AVR) and/or death, as well as AS progression. About half of the study population was on supplementation, with about 40% taking calcium including vitamin D or not during more than 5.5 years. The absolute risk of CV mortality was strikingly higher with 13.7 for calcium±vitamin D supplementation and 9.6 for vitamin D only, compared with 5.8 per 1000 personyears in no supplementation. Surprisingly, also allcause mortality was significantly higher with calcium addition. In almost half of the patients with calcium administration, AVR was performed during the followup, whereas AVR was needed in only 11% of nonsupplementers. Interestingly, when stratifying by osteoporosis status, the differences in survival and AVR persisted unaltered between the groups.","PeriodicalId":9311,"journal":{"name":"British Heart Journal","volume":"108 1","pages":"905 - 906"},"PeriodicalIF":0.0,"publicationDate":"2022-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44600313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supplemental calcium and vitamin D and long-term mortality in aortic stenosis","authors":"Nicholas Kassis, E. Hariri, A. Karrthik, K. Ahuja, H. Layoun, Anas M. Saad, M. Gad, Manpreet Kaur, Najdat Bazarbashi, B. Griffin, Z. Popović, S. Harb, M. Desai, S. Kapadia","doi":"10.1136/heartjnl-2021-320215","DOIUrl":"https://doi.org/10.1136/heartjnl-2021-320215","url":null,"abstract":"Objective Calcium metabolism has long been implicated in aortic stenosis (AS). Studies assessing the long-term safety of oral calcium and/or vitamin D in AS are scarce yet imperative given the rising use among an elderly population prone to deficiency. We sought to identify the associations between supplemental calcium and vitamin D with mortality and progression of AS. Methods In this retrospective longitudinal study, patients aged ≥60 years with mild-moderate native AS were selected from the Cleveland Clinic Echocardiography Database from 2008 to 2016 and followed until 2018. Groups were stratified into no supplementation, supplementation with vitamin D alone and supplementation with calcium±vitamin D. The primary outcomes were mortality (all-cause, cardiovascular (CV) and non-CV) and aortic valve replacement (AVR), and the secondary outcome was AS progression by aortic valve area and peak/mean gradients. Results Of 2657 patients (mean age 74 years, 42% women) followed over a median duration of 69 months, 1292 (49%) did not supplement, 332 (12%) took vitamin D alone and 1033 (39%) supplemented with calcium±vitamin D. Calcium±vitamin D supplementation was associated with a significantly higher risk of all-cause mortality (absolute rate (AR)=43.0/1000 person-years; HR=1.31, 95% CI (1.07 to 1.62); p=0.009), CV mortality (AR=13.7/1000 person-years; HR=2.0, 95% CI (1.31 to 3.07); p=0.001) and AVR (AR=88.2/1000 person-years; HR=1.48, 95% CI (1.24 to 1.78); p<0.001). Any supplementation was not associated with longitudinal change in AS parameters in a linear mixed-effects model. Conclusions Supplemental calcium with or without vitamin D is associated with lower survival and greater AVR in elderly patients with mild-moderate AS.","PeriodicalId":9311,"journal":{"name":"British Heart Journal","volume":"108 1","pages":"964 - 972"},"PeriodicalIF":0.0,"publicationDate":"2022-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42318366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of cardiac arrest in the cardiac catheterisation laboratory: guidelines tailored to place and occasion","authors":"P. Kudenchuk","doi":"10.1136/heartjnl-2021-320756","DOIUrl":"https://doi.org/10.1136/heartjnl-2021-320756","url":null,"abstract":"Since first compiled in 45 BCE as the Hippocratic Corpus, medical practice guidelines have served to summarise scientific knowledge and inform clinical management. In 1992, the International Liaison Committee on Resuscitation (ILCOR—the acronym being a deliberate play on words by adding ‘ill’ to the Latin ‘cor’ for heart) was formed by the major world resuscitation councils to carry forward this challenge in emergency cardiovascular care. Comprised of recognised international experts in resuscitation, ILCOR has since been charged with conducting evidence reviews of resuscitation science. The quality of this evidence is rigorously evaluated in terms of its certainty, consistency, indirectness, risk of bias and confounding influences using Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology when formulating recommendations, and represents the current standard for timely and now continuously updated resuscitationrelated treatment guidance. The published guidance from ILCOR is then taken by the individual resuscitation councils (such as the American Heart Association, the European Resuscitation Council and others) and adapted to their localities, creating formal regional guidelines. ‘The Joint British Societies’ guideline on management of cardiac arrest in the cardiac catheter laboratory’ presents an additional adaptation of existing resuscitation guidelines. In this instance, the guidelines are applied to a specific place for such events—the cardiac catheterisation laboratory, and are tailored to a specific occasion—a witnessed cardiac arrest in a closely monitored patient. The need to adapt guidelines to this setting is understandable. Both the acuity of patients needing cardiac procedures and the complexity of the interventions themselves can provoke spontaneous or iatrogenic events resulting in haemodynamic destabilisation and cardiac arrest in the laboratory. The circumstances surrounding a cardiac arrest in a catheterisation laboratory also create a unique occasion for intervention. That is, unlike outofhospital cardiac arrest or arrest in other hospital locations, a patient in the laboratory is typically already being monitored and procedurally prepped. In addition, the event is usually witnessed by skilled providers from its outset; reasons for the arrest’s occurrence are likely already apparent or suspected, and invasive tools readily available for its management. Taken together, adapting resuscitation to this environment is sensible and the participating British Societies, which spanned a wide spectrum of specialties, are to be commended for this endeavour. In recognising this exemplary effort, it is also important to appreciate both the value and limitation of these guidelines. What the British Societies’ guidelines do well is provide a paradigm for resuscitation that takes advantage of the immediate","PeriodicalId":9311,"journal":{"name":"British Heart Journal","volume":"108 1","pages":"907 - 908"},"PeriodicalIF":0.0,"publicationDate":"2022-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42590452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac surgery and congenital heart disease: reflections on a modern revolution","authors":"J. Lim, Martin J. Elliott, J. Wallwork, B. Keogh","doi":"10.1136/heartjnl-2021-320148","DOIUrl":"https://doi.org/10.1136/heartjnl-2021-320148","url":null,"abstract":"The success of cardiac surgery has transformed the prospects of children with congenital heart disease with over 90% now surviving to adulthood. The early pioneering surgeons took on significant risk, whilst current surgical practice emphasises safety and consistency. In this article we review important British contributions to the field and consider challenges for the future, specifically how to better manage and reduce the adverse sequelae of congenital cardiac surgery by continuing to innovate safely.","PeriodicalId":9311,"journal":{"name":"British Heart Journal","volume":"108 1","pages":"787 - 793"},"PeriodicalIF":0.0,"publicationDate":"2022-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46606147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introduction to the British Cardiovascular Society centenary special issue","authors":"S. Ray, I. Simpson","doi":"10.1136/heartjnl-2021-320274","DOIUrl":"https://doi.org/10.1136/heartjnl-2021-320274","url":null,"abstract":"","PeriodicalId":9311,"journal":{"name":"British Heart Journal","volume":"108 1","pages":"748 - 748"},"PeriodicalIF":0.0,"publicationDate":"2022-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45195934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"American College of Cardiology and British Cardiovascular Society at 100—learning, sharing and growing together: a letter from America","authors":"D. Itchhaporia","doi":"10.1136/heartjnl-2021-320141","DOIUrl":"https://doi.org/10.1136/heartjnl-2021-320141","url":null,"abstract":"","PeriodicalId":9311,"journal":{"name":"British Heart Journal","volume":"108 1","pages":"751 - 752"},"PeriodicalIF":0.0,"publicationDate":"2022-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47957130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Let there be light! The meteoric rise of cardiac imaging","authors":"A. Reid, M. Dweck","doi":"10.1136/heartjnl-2021-320147","DOIUrl":"https://doi.org/10.1136/heartjnl-2021-320147","url":null,"abstract":"Imaging plays a central role in modern cardiovascular practice. It is a field characterised by exciting technological advances that have shaped our understanding of pathology and led to major improvements in patient diagnosis and care. The UK has played a key international role in the development of this subspecialty and is the current home to many of the leading global centres in multimodality cardiovascular imaging. In this short review, we will outline some of the key contributions of the British Cardiovascular Society and its members to this rapidly evolving field and look at how this relationship may continue to shape future cardiovascular practice.","PeriodicalId":9311,"journal":{"name":"British Heart Journal","volume":"108 1","pages":"780 - 786"},"PeriodicalIF":0.0,"publicationDate":"2022-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48958326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"History and evolution of pacing and devices","authors":"P. Haydock, A. Camm","doi":"10.1136/heartjnl-2021-320149","DOIUrl":"https://doi.org/10.1136/heartjnl-2021-320149","url":null,"abstract":"Cardiac implanted electronic devices are commonplace in the modern practice of cardiology. This article reviews the history of the development of these technologies, with particular reference to the role played by UK physicians and members of the British Cardiovascular Society. Key breakthroughs in the treatment of heart block, ventricular arrhythmia and heart failure are presented in their historical and contemporary context so that the reader might look back on the incredible progress and achievements of the last 100 years and also look forward to what may be achieved in the coming decades.","PeriodicalId":9311,"journal":{"name":"British Heart Journal","volume":"108 1","pages":"794 - 799"},"PeriodicalIF":0.0,"publicationDate":"2022-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45287789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"British Cardiovascular Society: from club to community","authors":"N. Boon","doi":"10.1136/heartjnl-2021-320140","DOIUrl":"https://doi.org/10.1136/heartjnl-2021-320140","url":null,"abstract":"","PeriodicalId":9311,"journal":{"name":"British Heart Journal","volume":"34 2","pages":"749 - 750"},"PeriodicalIF":0.0,"publicationDate":"2022-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41288567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}