Atrioventricular block after ASD closure
Conclusions
Late AV block in patients with repaired ASD is rare and most likely independent of the technique used. In the device subgroup, the only risk factor identified to be associated with late AV block was the presence of either preprocedural or postprocedural AV block, so long-term follow-up for these patients should be provided. (Source: Heart Asia)
Source: Heart Asia - July 31, 2016 Category: Cardiology Authors: Asakai, H., Weskamp, S., Eastaugh, L., d'Udekem, Y., Pflaumer, A. Tags: Original research Source Type: research
Correction
Shrestha A, Koju RP, Beresford SAA, et al. Food patterns measured by principal component analysis and obesity in the Nepalese adult. Heart Asia 2016;8:46–53. doi:10.1136/heartasia-2015-010666 The author list should read as follows: Archana Shrestha,1 Rajendra Prasad Koju,2,3 Shirley A A Beresford,1 Kwun Chuen Gary Chan,4 Frederick A. Connell, 5 Biraj Man Karmacharya,1,3,6,7 Annette L Fitzpatrick1,3,8 1Department of Epidemiology, University of Washington, Seattle, Washington, USA 2Department of Cardiology, Dhulikhel Hospital—Kathmandu University Hospital, Dhulikhel, Nepal 3Department of Global Health, University...
Source: Heart Asia - July 18, 2016 Category: Cardiology Tags: Correction Source Type: research
Coronary stent deformation by a catheter-induced intramural haematoma
A 71-year-old woman presented with chest pain on exertion. A coronary angiogram revealed a bifurcation lesion in the right coronary artery (figure 1A). A 2.75x20 mm drug-eluting stent was deployed (figure 1B), and intravascular ultrasound showed that the stent was fully dilated (figure 1C). However, a subsequent right coronary angiogram demonstrated severe coronary dissection from the ostium spreading to the stented segment (figure 1D), and a linear image of contrast can be seen outside the lumen underneath the proximal segment of the stent. Intravascular ultrasound demonstrated the presence of an intramural haematoma...
Source: Heart Asia - July 17, 2016 Category: Cardiology Authors: Sadamatsu, K., Antoku, Y., Ohe, K. Tags: Images in cardiovascular medicine Source Type: research
Predictors of warfarin non-adherence in younger adults after valve replacement surgery in the South Pacific
Conclusions
While medication adherence is complex and multifactorial, the consequences of warfarin non-adherence are potentially catastrophic. These results provide an important first step towards the development of country-specific and disease-specific strategies to improve warfarin adherence. (Source: Heart Asia)
Source: Heart Asia - June 13, 2016 Category: Cardiology Authors: Thomson Mangnall, L. J., Sibbritt, D. W., Al-Sheyab, N., Gallagher, R. D. Tags: Original research Source Type: research
Prognostic factors of in-hospital mortality in all comers with ST elevation myocardial infarction undergoing primary percutaneous coronary intervention
Conclusions
Age, left ventricular function and final TIMI flow are significant predictors of adverse outcomes in unselected patients with STEMI undergoing primary PCI. (Source: Heart Asia)
Source: Heart Asia - June 13, 2016 Category: Cardiology Authors: Kiatchoosakun, S., Wongwipaporn, C., Pussadhamma, B. Tags: Original research Source Type: research
Availability and characteristics of cardiac rehabilitation programmes in China
Conclusions
The availability of CR is low (24%) in the large medical centres in China we surveyed, highlighting the importance of efforts to raise awareness of the benefits of CR, to provide CR training to healthcare professionals and to improve CR availability throughout China. (Source: Heart Asia)
Source: Heart Asia - June 6, 2016 Category: Cardiology Authors: Zhang, Z., Pack, Q., Squires, R. W., Lopez-Jimenez, F., Yu, L., Thomas, R. J. Tags: Original research Source Type: research
Symmetric peripheral gangrene in antiphospholipid syndrome
A 75-year-old woman with a history of recurrent spontaneous abortions and smoking was referred to our hospital for the treatment of symmetric peripheral gangrene in all four extremities. Her painful digital and toe gangrene developed over 2 weeks (figure 1). Her peripheral pulses were absent, and angiography revealed total occlusion of the palmar and pedal arches (figure 1). Concomitant deep vein thrombosis in the soleus vein was revealed by duplex ultrasonography. Laboratory testing showed lupus anticoagulant (LA) positive with dilute Russell’s viper venom time (5.0, normal range <1.3), activated partial thr...
Source: Heart Asia - May 31, 2016 Category: Cardiology Authors: Shiba, M., Ieko, M., Kawarada, O. Tags: Images in cardiovascular medicine Source Type: research
Optimising diagnostic accuracy with the exercise ECG: opportunities for women and men with stable ischaemic heart disease
The exercise ECG is an integral part within the evaluation algorithm for diagnosis and risk stratification of patients with stable ischaemic heart disease (SIHD). There is evidence, both older and new, that the exercise ECG can be an effective and cost-efficient option for patients capable of performing at maximal levels of exercise with suitable resting ECG findings. In this review, we will highlight the major dilemmas in interpreting suspected coronary artery disease symptoms in women and identify optimal strategies for employing exercise ECG as a first-line diagnostic test in the SIHD evaluation algorithm. We will highl...
Source: Heart Asia - May 31, 2016 Category: Cardiology Authors: Shaw, L. J., Xie, J. X., Phillips, L. M., Goyal, A., Reynolds, H. R., Berman, D. S., Picard, M. H., Bhargava, B., Devlin, G., Chaitman, B. R. Tags: Review Source Type: research
Gender bias in cardiovascular healthcare of a tertiary care centre of North India
Conclusions
Significant gender discrepancies exist in healthcare-seeking behaviour of patients in North India despite the provision of free cardiac treatment. An equal prevalence of gender bias in urban and rural communities points towards deep-rooted social norms beyond just the economic constraints. Healthcare policies ensuring equal treatment of male and female children should be promulgated to ensure a complete eradication of this social evil. (Source: Heart Asia)
Source: Heart Asia - May 24, 2016 Category: Cardiology Authors: Chhabra, S. T., Masson, S., Kaur, T., Gupta, R., Sharma, S., Goyal, A., Singh, B., Tandon, R., Aslam, N., Mohan, B., Wander, G. S. Tags: Press releases Original research Source Type: research
Impact of interactions between risk alleles on clinical endpoints in hypertension
Conclusions
Interactions among the genetic loci of RAAS components may be used as a predictor for susceptibility to hypertension. (Source: Heart Asia)
Source: Heart Asia - May 18, 2016 Category: Cardiology Authors: Kohli, S., Kumar, R., Gupta, M., Tyagi, S., Pasha, M. A. Q. Tags: Original research Source Type: research
Riociguat for the treatment of pulmonary hypertension: Chinese subgroup analyses and comparison
Conclusions
Chinese patients displayed differences in baseline characteristics versus the overall populations in PATENT-1 and CHEST-1. Riociguat improved 6MWD, PVR, WHO FC, and other clinical outcomes in Chinese patients with PAH or CTEPH.
Trial registration number
PATENT-1: NCT00810693, Results; CHEST-1 NCT00855465, Results. (Source: Heart Asia)
Source: Heart Asia - May 16, 2016 Category: Cardiology Authors: Wang, C., Jing, Z.-C., Huang, Y.-G., Zhou, D.-X., Liu, Z.-H., Meier, C., Nikkho, S., Curram, J., Zhang, P., He, J.-G. Tags: Open access Original research Source Type: research
Rebuttal to: choice of prosthetic valve in a developing country
We read with interest the counterpoint suggesting that the best choice for the patient is a bioprosthetic valve. We acknowledge many of the points made by the authors,1 most importantly that the decision of valve prosthesis is a shared process between healthcare providers and patients. However, there several points that we feel need clarification. The authors highlight the need for anticoagulation in the context of atrial fibrillation (AF), but then suggest that the differences in the International Normalised Ratio (INR) targets for patients with a mechanical heart valve and those in AF are substantially different. Looking...
Source: Heart Asia - April 27, 2016 Category: Cardiology Authors: Jaffer, I. H., Whitlock, R. P. Tags: Debates in cardiovascular medicine Source Type: research
Choice of prosthetic heart valve in a developing country
Mechanical prostheses and stented xenografts (bioprosthesis) are most commonly used substitutes for aortic and mitral valve replacement. The mechanical valves have the advantage of durability but are accompanied with the risk of thromboembolism, problems of long-term anticoagulation, and associated risk of bleeding. In contrast, bioprosthetic valves do not require long-term anticoagulation, but carry the risk of structural valve degeneration and re-operation. A mechanical valve is favoured in young patients (<40 years) if reliable anticoagulation is ensured. In elderly patients (>60 years), a bioprosthesis is a suita...
Source: Heart Asia - April 27, 2016 Category: Cardiology Authors: Choudhary, S. K., Talwar, S., Airan, B. Tags: Debates in cardiovascular medicine Source Type: research
A mechanical heart valve is the best choice
The choice of prosthesis type in patients with valvular heart disease should always be individualised. The treating heart team must weigh the concerns surrounding durability of bioprosthetic valves compared with mechanical valves and the need for lifelong anticoagulation required with mechanical valves. In general, guidelines recommend that patients under the age of 60 would benefit from a mechanical valve, and those over 70 would benefit from a bioprosthetic valve. We would argue, in this context, that the most appropriate choice for this patient would be undertaking a mitral valve replacement with a mechanical prosthesis...
Source: Heart Asia - April 27, 2016 Category: Cardiology Authors: Jaffer, I. H., Whitlock, R. P. Tags: Debates in cardiovascular medicine Source Type: research
A case of recurrent palpitations with wide complex tachycardia
Clinical introduction A 50-year-old woman with recurrent episodic palpitations presented with hypotension to the emergency department. Her past medical history was inconsequential other than the use of β-blockers for occasional palpitations. A 12-lead surface ECG was taken (figure 1A) and the patient was subsequently cardioverted with 200 J to sinus rhythm (figure 1B). Her biochemical investigations and transthoracic echocardiogram were within normal limits. Figure 1Surface ECG during admission (A) and post-cardioversion (B). Question Identify the tachycardia and findings in post-cardioversion sinus rhyt...
Source: Heart Asia - April 17, 2016 Category: Cardiology Authors: Nair, A., Muneer, K., Sajeev, C. G. Tags: Image challenge Source Type: research
