Addressing the shortage of research capacity in cardiovascular disease in Africa via leadership training
Cardiovascular diseases (CVDs) have rapidly emerged as a major cause of disease and deaths in Africa. Contrasting with the global picture of disease, CVDs affect and kill the generation of breadwinners in Africa,1–3 this in a region suffering from the most severe health workforce shortage globally. This situation may hamper the achievement of the Sustainable Development Goals. In the global road map to achieve a 25% reduction in CVD morbidity and mortality by the year 2025 (‘25x25’ goal) as suggested by WHO, training champions who will lead the agenda in Africa is crucial. These champions would act as cat...
Source: Heart Asia - April 13, 2017 Category: Cardiology Authors: Dzudie, A., Sliwa, K. Tags: Viewpoint Source Type: research
High-sensitivity cardiac troponin I assays in the diagnosis of acute myocardial infarction
Chest pain is one of the most common presenting symptoms in patients attending the emergency department; yet, less than one in five patients receive a final diagnosis of acute myocardial infarction.1 In patients without ST segment elevation, early exclusion of acute coronary syndrome has the potential to reduce healthcare expenditure in a population with significant resource implications. Previous approaches were hindered by the performance of contemporary troponin assays, which used a decision threshold for the diagnosis of myocardial infarction based on assay imprecision rather than a defined upper reference limit from a...
Source: Heart Asia - April 7, 2017 Category: Cardiology Authors: Chapman, A. R., Newby, D. E., Mills, N. L. Tags: Open access Editorial Source Type: research
Asia-Pacific consensus statement on the optimal use of high-sensitivity troponin assays in acute coronary syndromes diagnosis: focus on hs-TnI
Conclusions
We propose an algorithm that will potentially reduce delays in discharge by the accurate ‘rule out’ of non-ACS patients within 3 hours. Appropriate research should be undertaken to ensure the efficacy and safety of the algorithm in clinical practice, with the long-term goal of improvement of care of patients with ACS in Asia Pacific. (Source: Heart Asia)
Source: Heart Asia - April 7, 2017 Category: Cardiology Authors: Tan, J. W. C., Lam, C. S. P., Kasim, S. S., Aw, T. C., Abanilla, J. M., Chang, W.-T., Dang, V. P., Iboleon-Dy, M., Mumpuni, S. S., Phommintikul, A., Ta, M. C., Topipat, P., Yiu, K. H., Cullen, L. Tags: Open access Clinical practice Source Type: research
Epidemiologic burden of hospitalisation for congestive heart failure among adults aged >=19 years in the Philippines
Conclusions
There were 16 cases of heart failure for every 1000 Filipino patients admitted due to a medical condition in 2014. Hypertension was possibly the most common aetiologic factor. Compared to western and Asia-Pacific countries, the local mortality rate was relatively higher. (Source: Heart Asia)
Source: Heart Asia - March 27, 2017 Category: Cardiology Authors: Tumanan-Mendoza, B. A., Mendoza, V. L., Bermudez-Delos Santos, A. A. A., Punzalan, F. E. R., Pestano, N. S., Natividad, R. B., Shiu, L. A., Macabeo, R. Tags: Original research Source Type: research
Normal echocardiographic mitral and aortic valve thickness in children
Conclusions
We have described a standardised method for mitral and aortic valve measurement in children which is objective and reproducible. Normal ranges of left heart valve thickness in a high prevalence RHD population are established. These results provide a reference range for school-age children in high prevalence RHD regions undergoing echocardiographic screening. (Source: Heart Asia)
Source: Heart Asia - March 20, 2017 Category: Cardiology Authors: Webb, R. H., Culliford-Semmens, N., Sidhu, K., Wilson, N. J. Tags: Original research Source Type: research
Caudal fluoroscopy to guide venous access for pacemaker device implantation: should this now be standard practice?
We describe a technique that uses both posterior-anterior and caudal fluoroscopy to achieve venous access for pacemaker device implantation. A significant advantage of this technique is the ability to clearly demarcate both the anatomy of venous drainage and the lung border. We would encourage all centres to adopt this technique as a safe approach to venous access. (Source: Heart Asia)
Source: Heart Asia - March 7, 2017 Category: Cardiology Authors: Patel, H. C., Hayward, C., Nanayakkara, S., Broughton, A., Mariani, J. A. Tags: Clinical practice Source Type: research
Reuse of pacemakers, defibrillators and cardiac resynchronisation devices
Conclusions
We found no difference in rate of infection or device malfunction among patients getting a reused device as compared with those with a new device. This study reinforces the safety of reusing devices for implant including CRT and ICDs. (Source: Heart Asia)
Source: Heart Asia - February 28, 2017 Category: Cardiology Authors: Selvaraj, R. J., Sakthivel, R., Satheesh, S., Ananthakrishna Pillai, A., Sagnol, P., Jouven, X., Dodinot, B., Balachander, J. Tags: Original research Source Type: research
Is endocarditis prophylaxis for dental procedures necessary?
Conclusion
A multi-national randomised controlled clinical trial that would include individuals from both developed and developing countries around the world is needed to ultimately define whether there is a role for antibiotic prophylaxis administered before certain dental procedures to prevent IE. (Source: Heart Asia)
Source: Heart Asia - February 22, 2017 Category: Cardiology Authors: Taubert, K. A., Wilson, W. Tags: Debates in cardiovascular medicine Source Type: research
Setting priorities to address cardiovascular diseases through universal health coverage in low- and middle-income countries
Over the past decade, universal health coverage (UHC) has emerged as a major policy goal for many low- and middle-income country governments. Yet, despite the high burden of cardiovascular diseases (CVD), relatively little is known about how to address CVD through UHC. This review covers three major topics. First, we define UHC and provide some context for its importance, and then we illustrate its relevance to CVD prevention and treatment. Second, we discuss how countries might select high-priority CVD interventions for a UHC health benefits package drawing on economic evaluation methods. Third, we explore some implementa...
Source: Heart Asia - February 21, 2017 Category: Cardiology Authors: Watkins, D. A., Nugent, R. A. Tags: Review Source Type: research
Acceleration of cardiovascular-biological age by amphetamine exposure is a power function of chronological age
Conclusions
These results show that subacute exposure to amphetamines is associated with an advancement of cardiovascular-organismal age both over age and over time, and is robust to adjustment. That this is associated with power functions of age implies a feed-forward positively reinforcing exacerbation of the underlying ageing process. (Source: Heart Asia)
Source: Heart Asia - February 8, 2017 Category: Cardiology Authors: Reece, A. S., Norman, A., Hulse, G. K. Tags: Press releases Original research Source Type: research
Electrocardiography in people living at high altitude of Nepal
Conclusions
Electrocardiographic evidence suggests that although high-altitude populations do not have a high prevalence of CHD, abnormal ECG findings increase by altitude and risk pattern varies by ethnicity. (Source: Heart Asia)
Source: Heart Asia - February 2, 2017 Category: Cardiology Authors: Aryal, N., Weatherall, M., Bhatta, Y. K. D., Mann, S. Tags: Original research Source Type: research
In defence of auscultation: a glorious future?
Auscultation of the heart using a simple stethoscope continues to be a central aspect of the cardiovascular examination despite declining proficiency and availability of competing technologies such as hand-held ultrasound. In the ears and mind of a trained cardiologist, heart sounds can provide important information to help screen for certain diseases such as valvar lesions and many congenital defects. Using emerging technology, auscultation is poised to undergo a transformation that will simultaneously improve the teaching and evaluation of this important clinical skill and create a new generation of smart stethoscopes, c...
Source: Heart Asia - January 31, 2017 Category: Cardiology Authors: Thompson, W. R. Tags: Viewpoint Source Type: research
Reuse of cardiac implantable electronic devices to improve and extend lives: a call to action
A dramatic increase in the heart disease burden has taken place in the last several decades. Cardiovascular disease is no longer the disease of the affluent world alone. According to WHO, at least three-quarters of the world’s deaths from cardiovascular disease occur in low/middle-income countries (LMICs).1 Patients in those countries, especially the poorest of the poor, experience enormous obstacles in access to essential medical care. Furthermore, disability from cardiovascular disease contributes to poverty through loss of income and high out-of-pocket expenditures. The World Bank views health as a developmental i...
Source: Heart Asia - January 22, 2017 Category: Cardiology Authors: Crawford, T. C., Eagle, K. A. Tags: Editorial Source Type: research
Reuse of pacemakers, defibrillators and cardiac resynchronisation devices
Conclusions
We found no difference in rate of infection or device malfunction among patients getting a reused device as compared with those with a new device. This study reinforces the safety of reusing devices for implant including CRT and ICDs. (Source: Heart Asia)
Source: Heart Asia - January 22, 2017 Category: Cardiology Authors: Selvaraj, R. J., Sakthivel, R., Satheesh, S., Ananthakrishna Pillai, A., Sagnol, P., Jouven, X., Dodinot, B., Balachander, J. Tags: Original research Source Type: research
Interactive clinical case: to give, or not to give, infective endocarditis prophylaxis
The practice of prophylactic use of antibiotics before certain procedures for preventing infective endocarditis (IE) is not based on rigorous scientific data. It seems reasonable, however, to offer prophylactic antibiotics before dental procedures to patients who would have the highest risk of adverse events if they were to develop IE. The current recommendations do not include patients with rheumatic heart disease (RHD) in such a category. In the real world, however, patients with underlying RHD suffer high morbidity and mortality with IE due to several reasons. Consequently, prophylactic antibiotics should be used judici...
Source: Heart Asia - January 5, 2017 Category: Cardiology Authors: Kothari, S. S. Tags: Debates in cardiovascular medicine Source Type: research
