European cardiologyPub Date : 2021-12-09eCollection Date: 2021-02-01DOI: 10.15420/ecr.2021.05
Moisés Rodríguez-Mañero, Jose Luis Martínez-Sande, Javier García-Seara, Teba González-Ferrero, José Ramón González-Juanatey, Paul Schurmann, Liliana Tavares, Miguel Valderrábano
{"title":"Neuromodulatory Approaches for Atrial Fibrillation Ablation.","authors":"Moisés Rodríguez-Mañero, Jose Luis Martínez-Sande, Javier García-Seara, Teba González-Ferrero, José Ramón González-Juanatey, Paul Schurmann, Liliana Tavares, Miguel Valderrábano","doi":"10.15420/ecr.2021.05","DOIUrl":"https://doi.org/10.15420/ecr.2021.05","url":null,"abstract":"<p><p>In this review, the authors describe evolving alternative strategies for the management of AF, focusing on non-invasive and percutaneous autonomic modulation. This modulation can be achieved - among other approaches - via tragus stimulation, renal denervation, cardiac afferent denervation, alcohol injection in the vein of Marshall, baroreceptor activation therapy and endocardial ganglionated plexi ablation. Although promising, these therapies are currently under investigation but could play a role in the treatment of AF in combination with conventional pulmonary vein isolation in the near future.</p>","PeriodicalId":93994,"journal":{"name":"European cardiology","volume":" ","pages":"e53"},"PeriodicalIF":3.0,"publicationDate":"2021-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e8/71/ecr-16-e53.PMC8728882.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39678466","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}
European cardiologyPub Date : 2021-12-09eCollection Date: 2021-02-01DOI: 10.15420/ecr.2021.36
Natalie Koh, Brian A Ference, Stephen J Nicholls, Ann Marie Navar, Derek P Chew, Karam Kostner, Ben He, Hung Fat Tse, Jamshed Dalal, Anwar Santoso, Junya Ako, Hayato Tada, Jin Joo Park, Mei Lin Ong, Eric Lim, Tavin Subramaniam, Yi-Heng Li, Arintaya Phrommintikul, S S Iyengar, Saumitra Ray, Kyung Woo Park, Hong Chang Tan, Narathip Chunhamaneewat, Khung Keong Yeo, Jack Wei Chieh Tan
{"title":"Asian Pacific Society of Cardiology Consensus Recommendations on Dyslipidaemia.","authors":"Natalie Koh, Brian A Ference, Stephen J Nicholls, Ann Marie Navar, Derek P Chew, Karam Kostner, Ben He, Hung Fat Tse, Jamshed Dalal, Anwar Santoso, Junya Ako, Hayato Tada, Jin Joo Park, Mei Lin Ong, Eric Lim, Tavin Subramaniam, Yi-Heng Li, Arintaya Phrommintikul, S S Iyengar, Saumitra Ray, Kyung Woo Park, Hong Chang Tan, Narathip Chunhamaneewat, Khung Keong Yeo, Jack Wei Chieh Tan","doi":"10.15420/ecr.2021.36","DOIUrl":"https://doi.org/10.15420/ecr.2021.36","url":null,"abstract":"<p><p>The prevalence of dyslipidaemia has been increasing in the Asia-Pacific region and this is attributed to dietary changes and decreasing physical activity. While there has been substantial progress in dyslipidaemia therapy, its management in the region is hindered by limitations in awareness, adherence and healthcare costs. The Asian Pacific Society of Cardiology (APSC) developed these consensus recommendations to address the need for a unified approach to managing dyslipidaemia. These recommendations are intended to guide general cardiologists and internists in the assessment and treatment of dyslipidaemia and are hoped to pave the way for improving screening, early diagnosis and treatment. The APSC expert panel reviewed and appraised the evidence using the Grading of Recommendations Assessment, Development, and Evaluation system. Consensus recommendations were developed, which were then put to an online vote. The resulting consensus recommendations tackle contemporary issues in the management of dyslipidaemia, familial hypercholesterolaemia and lipoprotein(a) in the Asia-Pacific region.</p>","PeriodicalId":93994,"journal":{"name":"European cardiology","volume":" ","pages":"e54"},"PeriodicalIF":3.0,"publicationDate":"2021-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3b/36/ecr-16-e54.PMC8728885.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39678467","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}
European cardiologyPub Date : 2021-12-09eCollection Date: 2021-02-01DOI: 10.15420/ecr.2021.49
Martha Gulati, Cara Hendry, Biljana Parapid, Sharon L Mulvagh
{"title":"Why We Need Specialised Centres for Women's Hearts: Changing the Face of Cardiovascular Care for Women.","authors":"Martha Gulati, Cara Hendry, Biljana Parapid, Sharon L Mulvagh","doi":"10.15420/ecr.2021.49","DOIUrl":"https://doi.org/10.15420/ecr.2021.49","url":null,"abstract":"<p><p>Although cardiovascular disease (CVD) is the leading cause of mortality in women globally, cardiovascular care for women remains suboptimal, with poorer outcomes than for men. During the past two decades, there has been an incremental increase in research and publications on CVD in women, addressing sex-specific risk factors, symptoms, pathophysiology, treatment, prevention and identification of inequities in care. Nonetheless, once women have manifested CVD, they continue to have increasingly worse outcomes than men. An approach to addressing these global disparities has been the worldwide establishment of specialised centres providing cardiovascular care for women. These women's heart centres (WHCs) allow a comprehensive approach to the cardiovascular care of women across the lifespan. The purpose of this article is to define the need for and role of these specialised centres by outlining sex-specific gaps in CVD care, and to provide guidance on components within WHCs that may be considered when establishing such programmes.</p>","PeriodicalId":93994,"journal":{"name":"European cardiology","volume":" ","pages":"e52"},"PeriodicalIF":3.0,"publicationDate":"2021-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4e/c4/ecr-16-e52.PMC8728884.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39818179","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}
European cardiologyPub Date : 2021-12-07eCollection Date: 2021-02-01DOI: 10.15420/ecr.2021.37
Laura Díaz-Chirón, Luis Negral, Laura Megido, Beatriz Suárez-Peña, Alberto Domínguez-Rodríguez, Sergio Rodríguez, Pedro Abreu-Gonzalez, Isaac Pascual, César Moris, Pablo Avanzas
{"title":"Relationship Between Exposure to Sulphur Dioxide Air Pollution, White Cell Inflammatory Biomarkers and Enzymatic Infarct Size in Patients With ST-segment Elevation Acute Coronary Syndromes.","authors":"Laura Díaz-Chirón, Luis Negral, Laura Megido, Beatriz Suárez-Peña, Alberto Domínguez-Rodríguez, Sergio Rodríguez, Pedro Abreu-Gonzalez, Isaac Pascual, César Moris, Pablo Avanzas","doi":"10.15420/ecr.2021.37","DOIUrl":"https://doi.org/10.15420/ecr.2021.37","url":null,"abstract":"<p><p><b>Aims:</b> To analyse the relationship among air pollutants, markers of inflammation and infarct size in patients with acute coronary syndrome (ACS). <b>Methods:</b> This was a prospective analysis of consecutive patients admitted to hospital because of ACS. Cardiac biomarkers were drawn. The daily mean values of the air pollutants from the day before until 7 days before admission were analysed. The study population was stratified according to infarct size, based on median peak troponin value. <b>Results:</b> Patients were divided into two groups of 108 subjects each, according to median peak troponin value. Patients with extensive MIs had a higher neutrophil:lymphocyte ratio and leukocyte and neutrophil counts than patients with smaller MIs. In addition, they were exposed to higher concentrations of sulphur dioxide (9.7 ± 4.1 versus 8.4 ± 3.1 μg/m<sup>3</sup>; p=0.009) and lower concentrations of ozone (33.8 ± 13.7 versus 38.6 ± 14.5 μg/m<sup>3</sup>; p=0.014). Multivariate analysis showed that sulphur dioxide levels (OR 1.12; 95% CI [1.031-1.21]; p=0.007) and neutrophil/lymphocyte ratio (OR 1.08; 95% CI [1.011-1.17]; p=0.024) were independent predictors of infarct size. <b>Conclusion:</b> Patients with extensive MIs had higher white cell inflammatory levels and had been exposed to higher sulphur dioxide concentrations in the ambient air.</p>","PeriodicalId":93994,"journal":{"name":"European cardiology","volume":" ","pages":"e50"},"PeriodicalIF":3.0,"publicationDate":"2021-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8a/11/ecr-16-e50.PMC8674636.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39847480","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}
European cardiologyPub Date : 2021-12-07eCollection Date: 2021-02-01DOI: 10.15420/ecr.2021.30
Gautam R Shroff, Michelle D Carlson, Roy O Mathew
{"title":"Coronary Artery Disease in Chronic Kidney Disease: Need for a Heart-Kidney Team-Based Approach.","authors":"Gautam R Shroff, Michelle D Carlson, Roy O Mathew","doi":"10.15420/ecr.2021.30","DOIUrl":"https://doi.org/10.15420/ecr.2021.30","url":null,"abstract":"<p><p>Chronic kidney disease and coronary artery disease are co-prevalent conditions with unique epidemiological and pathophysiological features, that culminate in high rates of major adverse cardiovascular outcomes, including all-cause mortality. This review outlines a summary of the literature, and nuances pertaining to non-invasive risk assessment of this population, medical management options for coronary heart disease and coronary revascularisation. A collaborative heart-kidney team-based approach is imperative for critical management decisions for this patient population, especially coronary revascularisation; this review outlines specific periprocedural considerations pertaining to coronary revascularisation, and provides a proposed algorithm for approaching revascularisation choices in patients with end-stage kidney disease based on available literature.</p>","PeriodicalId":93994,"journal":{"name":"European cardiology","volume":" ","pages":"e48"},"PeriodicalIF":3.0,"publicationDate":"2021-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0b/c1/ecr-16-e48.PMC8674634.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39847478","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}
European cardiologyPub Date : 2021-12-07eCollection Date: 2021-02-01DOI: 10.15420/ecr.2021.14
Andreas Seitz, Johanna McChord, Raffi Bekeredjian, Udo Sechtem, Peter Ong
{"title":"Definitions and Epidemiology of Coronary Functional Abnormalities.","authors":"Andreas Seitz, Johanna McChord, Raffi Bekeredjian, Udo Sechtem, Peter Ong","doi":"10.15420/ecr.2021.14","DOIUrl":"https://doi.org/10.15420/ecr.2021.14","url":null,"abstract":"<p><p>Coronary functional abnormalities are frequent causes of angina pectoris, particularly in patients with unobstructed coronary arteries. There is a spectrum of endotypes of functional coronary abnormalities with different mechanisms of pathology including enhanced vasoconstriction (i.e. coronary artery spasm) or impaired vasodilatation, such as impaired coronary flow reserve or increased microvascular resistance. These vasomotor abnormalities can affect various compartments of the coronary circulation such as the epicardial conduit arteries and/or the coronary microcirculation. Unequivocal categorisation and nomenclature of the broad spectrum of disease endotypes is crucial both in clinical practice as well as in clinical trials. This article describes the definitions of coronary functional abnormalities with currently accepted cut-off values, as well as diagnostic methods to identify and distinguish endotypes. The authors also provide a summary of contemporary data on the prevalence of the different endotypes of coronary functional abnormalities and their coexistence.</p>","PeriodicalId":93994,"journal":{"name":"European cardiology","volume":" ","pages":"e51"},"PeriodicalIF":3.0,"publicationDate":"2021-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/52/f0/ecr-16-e51.PMC8674628.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39847481","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}