5 Optimising heart failure care by multi-disciplinary heart failure clinic (MHFC)
In conclusion, the establishment of MHFC can improve HF-related hospitalisation and patients’ symptomatology. Our local study echoes the findings of a recent meta-analysis.5
References
Adib-Hajbaghery M, Maghaminejad F, Abbasi A. The role of continuous care in reducing readmission for patients with heart failure. J Caring Sci 2013;2:255–267.
Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JGF, Coats AJS, Falk V, González-Juanatey JR, Harjola VP, Jankowska EA, Jessup M, Linde C, Nihoyannopoulos P, Parissis JT, Pieske B, Riley JP, Rosano GMC, Ruilope LM, Ruschitzka F, Rutten FH, van der Meer P; ESC S...
Source: Heart Asia - April 24, 2019 Category: Cardiology Authors: Kam, K. K., Yu, A., Fung, E., Lee, A. P. Tags: Keynote Lecture Source Type: research
4 Updates on cardiac transplant and LVAD implants across the UK and europe
Whilst there has recently been unprecedented growth in heart transplants (HTx) in North America, the number has been static or falling in most European countries. These have resulted in significant increases in the waiting times.
In the UK, an Urgent Heart Allocation Scheme has been in existence since 2001. With a growing number of heart failure patients on temporary mechanical circulatory support (MCS) devices, a Super Urgent category was introduced in 2016. So far, ~15% of HTx in the UK are performed under this new category and the median waiting time has been 7 days. Post-transplant 30 day survival has been reassuring. ...
Source: Heart Asia - April 24, 2019 Category: Cardiology Authors: Tsui, S. S. Tags: Keynote Lecture Source Type: research
3 On setting up a heart transplant programme at ramathibodi hospital, bangkok, thailand
The first heart transplant (HTx) programmes in Asia began in Taiwan and Thailand in 1987.1 Since then, HTx has been accepted as a standard treatment for end-stage heart failure in Thailand. Currently, there are at least 10 Asian countries that have experience in HTx operation2 but few Asian countries (Taiwan, Korea and Japan) had more than 30 cases annually.3 The total number of HTx in Thailand during 2012–2017 ranged from 12–24 cases. There are five institutions in Bangkok that perform cardiac transplantation; namely, Chulalongkorn Hospital, Siriraj Hospital, Rajvithi Hospital, Bumrungrad Hospital and, in 2017...
Source: Heart Asia - April 24, 2019 Category: Cardiology Authors: Yingchoncharoen, T. Tags: Keynote Lecture Source Type: research
2 The heart transplant and VAD program at St Vincents hospital, sydney
2018 marks the 50th anniversary of heart transplantation at St Vincent’s Hospital in Sydney. The modern era of heart transplantation for our institution commenced in 1984 and since then the programme has performed >1000 heart transplants (HTx), >1000 lung transplants and almost 100 combined heart-lung transplants. Bridge-to-transplant ventricular assist device (VAD) support began in 1994 with the pulsatile Heartmate 1 device with a transition to continuous flow VADs in the mid 2000s. Current activity is 20–25 VADs, 40–50 HTx and 50–60 lung transplants per year.
Over the last 3 decades, there h...
Source: Heart Asia - April 24, 2019 Category: Cardiology Authors: Macdonald, P. S. Tags: Keynote Lecture Source Type: research
1 Ventricular assist devices: developments in asia and global outlook for the next 10 years
The advent of left ventricular assist systems to support patients with advanced-stage heart failure has been a 50 year odyssey, now available broadly to such patients.1 Engineering advances have ushered in an era of small, durable devices that can be fully implanted within the chest. Yet, haemocompatibility related adverse events, which emanate from the interaction between the device and the patient they support are manifest principally in increased stroke rates, de novo device thrombosis requiring replacement and in gastrointestinal bleeding (a peculiar adverse event resulting from the unnatural physiology of continuous f...
Source: Heart Asia - April 24, 2019 Category: Cardiology Authors: Mehra, M. R. Tags: Keynote Lecture Source Type: research
Impact of heart failure on stroke mortality and recurrence
Conclusions
HF increases the risk of mortality in both AIS and ICH. We are the first to report on high-risk periods of stroke recurrence in patients with HF with ICH. Specific targeted risk reduction strategies may have significant clinical impact for mortality and recurrence in stroke. (Source: Heart Asia)
Source: Heart Asia - April 20, 2019 Category: Cardiology Authors: Pana, T. A., Wood, A. D., Perdomo-Lampignano, J. A., Tiamkao, S., Clark, A. B., Kongbunkiat, K., Bettencourt-Silva, J. H., Sawanyawisuth, K., Kasemsap, N., Mamas, M. A., Myint, P. K. Tags: Original research Source Type: research
Antithrombotic therapy after femoropopliteal artery stenting: 12-month results from Japan Postmarketing Surveillance
Conclusions
Clinical benefits of DAPT or cilostazol might be small in terms of TLR and MACCE at 12 months. Anticoagulation with warfarin at discharge might increase TLR at 12 months. (Source: Heart Asia)
Source: Heart Asia - March 30, 2019 Category: Cardiology Authors: Kawarada, O., Nakai, M., Nishimura, K., Miwa, H., Iwasaki, Y., Kanno, D., Nakama, T., Yamamoto, Y., Ogata, N., Nakamura, M., Yasuda, S. Tags: Open access Original research Source Type: research
Prevalence of non-acute ischaemic cardiomyopathy in a Pakistani cohort
Conclusions
OCAD is detected in nearly half of the patients with reduced left ventricular systolic function undergoing CAG. Clinical judgement based on thorough history and use of NIV stress testing can help in appropriate patient selection for this test. (Source: Heart Asia)
Source: Heart Asia - March 25, 2019 Category: Cardiology Authors: Ghazni, M. S., Aijaz, S., Malik, R., Pathan, A. Z. Tags: Original research Source Type: research
The safety of morphine use in acute coronary syndrome: a meta-analysis
Conclusion
The use of morphine for pain control in ACS was associated with an increased risk of in-hospital recurrent MI. Randomised clinical trials are needed to further investigate the safety of morphine in ACS. (Source: Heart Asia)
Source: Heart Asia - March 19, 2019 Category: Cardiology Authors: Ghadban, R., Enezate, T., Payne, J., Allaham, H., Halawa, A., Fong, H. K., Abdullah, O., Aggarwal, K. Tags: Open access Original research Source Type: research
Influence of type and duration of training on the presence of an abnormal ECG in high-performance athletes
Conclusions
This study demonstrates that an increased length of time in a high performance programme was associated with an increased number of detectable Group 2 ECG changes. Overall, the further investigation rate was 6.2%. (Source: Heart Asia)
Source: Heart Asia - March 19, 2019 Category: Cardiology Authors: Verrall, G., Hains, A., Ayres, B., Hillock, R. Tags: Original research Source Type: research
Nine contemporary therapeutic directions in heart failure
The global burden of heart failure has continued to increase dramatically with 26 million people affected and an estimated health expenditure of $31 billion worldwide. Several practice-influencing studies were reported recently, bringing advances along many frontiers in heart failure, particularly heart failure with reduced ejection fraction. In this article, we discuss nine distinct therapeutic areas that were significantly influenced by this scientific progress. These distinct areas include the emergence of sodium-glucose cotransporter-2 inhibitors, broadening the application of angiotensin-neprilysin inhibition, clinica...
Source: Heart Asia - March 8, 2019 Category: Cardiology Authors: Almarzooq, Z., Pareek, M., Sinnenberg, L., Vaduganathan, M., Mehra, M. R. Tags: Review Source Type: research
Determinants of coronary artery disease risk factor management across three world regions
Conclusions
Overall, risk factor management was poorer in women, those younger than 55 years old, those with diabetes and those who did not participate in a cardiac rehabilitation. Determinants of cardiovascular risk factor management differed by region. (Source: Heart Asia)
Source: Heart Asia - March 8, 2019 Category: Cardiology Authors: Zhao, M., Graham, I., Cooney, M. T., Grobbee, D. E., Vaartjes, I., Klipstein-Grobusch, K. Tags: Open access Healthcare delivery, economics and global health Source Type: research
Primary prevention ICD generator at end of life: to replace or not to replace?
Implantable cardioverter-defibrillators (ICDs) are the cornerstone of therapy for primary prevention of sudden cardiac death in patients with severely depressed left ventricular ejection fraction (EF) ≤35%, irrespective of the aetiology.1–3 Current device guidelines and appropriate use criteria lay profound emphasis on the baseline left ventricular EF and New York Heart Association functional class in selecting appropriate candidates for primary prevention ICD implantation.4 5 However, these society guidelines do not provide guidance regarding a decision about replacing ICD generators, especially in patients who h...
Source: Heart Asia - February 28, 2019 Category: Cardiology Authors: Padala, S. K., Ellenbogen, K. A. Tags: Editorial Source Type: research
Outcomes of patients with heart failure after primary prevention ICD unit generator replacement
Conclusion
No predictive marker successfully stratified patients no longer needing ICD support prospectively. Finding such a marker is important in decision-making about device replacement particularly given the concerns about the complication rates. These factors should be considered at the time of ICD unit replacement. (Source: Heart Asia)
Source: Heart Asia - February 28, 2019 Category: Cardiology Authors: Looi, K.-L., Gavin, A., Cooper, L., Dawson, L., Slipper, D., Lever, N. Tags: Original research Source Type: research
Twenty-five-year-old woman with palpitations and hypertrophic cardiomyopathy
Clinical introduction
A 25-year-old woman with a diagnosis of hypertrophic cardiomyopathy (HCM) and pre-excitation on ECG presented with unexplained syncope and daily palpitation. Genetic testing was positive for lysosome-associated membrane protein 2 (LAMP2) mutation which confirmed the diagnosis of Danon disease. Her younger sister was diagnosed with a similar condition and received a defibrillator implantation. Her 12-lead ECG (figure 1) and a long strip tracing (figure 2) are shown below.
Figure 112-lead ECG.
Question
Where is the location of the accessory pathway and what is the next appropriate management?
Antero...
Source: Heart Asia - February 23, 2019 Category: Cardiology Authors: Akrawinthawong, K., Kumar, V. Tags: Open access Image challenge Source Type: research
