Impact of socioeconomic status on adverse cardiac events after coronary angioplasty: a cohort study
Conclusion
Low SES was associated with a higher incidence of major adverse cardiac events in patients undergoing PCI and was an independent predictor of MACE at 12 months. (Source: Heart Asia)
Source: Heart Asia - June 1, 2018 Category: Cardiology Authors: Kareem, H., Shetty, P. N., Devasia, T., Karkala, Y. R., Paramasivam, G., Guddattu, V., Singh, A., Chauhan, S. Tags: Original research Source Type: research
DKA-induced Brugada phenocopy mimicking STEMI
Case presentation
A 47-year-old Caucasian woman with type 1 diabetes presented with epigastric pain and vomiting. She had not been adherent with her diet and insulin therapy for the past 3 weeks. She never had a personal or family history of arrhythmia-related symptoms, ventricular tachycardia or fibrillation (VT/VF) or premature sudden cardiac death (SCD). Examination revealed dry mucosa, tachycardia and epigastric tenderness to palpation. Her ECG showed ST elevations (V1–V3) with associated T wave inversions (figure 1A). A baseline ECG 1 year ago had no abnormalities. Serial troponin I and T were negative, but ...
Source: Heart Asia - May 26, 2018 Category: Cardiology Authors: Abrahim, C., Maharaj, S. Tags: Image challenge Source Type: research
Validation of the American College of Surgeons Risk Calculator for preoperative risk stratification
Conclusion
The ACS NSQIP Surgical Risk Calculator is a valid tool for predicting MACE and other important perioperative outcomes among Filipinos. (Source: Heart Asia)
Source: Heart Asia - May 17, 2018 Category: Cardiology Authors: Yap, M. K. C., Ang, K. F., Gonzales-Porciuncula, L. A., Esposo, E. Tags: Original research Source Type: research
Cardiac events occurred commonly among apparently healthy Filipinos with the Brugada ECG pattern in the LIFECARE cohort
Conclusion
Cardiac events occurred commonly among initially asymptomatic Filipinos with the coved Brugada ECG pattern. Such patients need to be followed up closely. (Source: Heart Asia)
Source: Heart Asia - May 17, 2018 Category: Cardiology Authors: Gervacio, G. G., Aherrera, J. A. M., Sy, R. G., Abrahan IV, L. L., Agbayani, M. J., Punzalan, F. E., Llanes, E. J. B., Reganit, P. F. M., Sison, O. T., Tai, E. S., Velandria, F. V., Gumatay, A., Castillo-Carandang, N. T. Tags: Original research Source Type: research
Haemodynamic challenge in non-restrictive atrial septal defect
Clinical introduction A 55-year-old hypertensive man presented with history of New York Heart Association class II exertional dyspnoea for 3 years. The arterial pulse was normal. His blood pressure was 180/100 mm Hg. Jugular venous waveforms revealed prominent ‘a waves’ at the root of neck though the mean pressure appeared to be normal. A wide fixed split second heart sound and mid-systolic murmur at the pulmonary area were noted. A soft third heart sound and flow murmur at the left lower sternal border suggested significant pre-tricuspid left-to-right shunt. Echocardiography showed a 32 mm ostium secundum atri...
Source: Heart Asia - May 17, 2018 Category: Cardiology Authors: Gopalakrishnan, A., Mohanan Nair, K. K., Ganapathi, S. Tags: Image challenge Source Type: research
The development or worsening of hypertension after transcatheter aortic valve replacement (TAVR) improves short-term and long-term patient outcomes
Conclusions
The development or worsening of HTN after TAVR is associated with improved overall survival despite an increase in postprocedural HF exacerbations and antihypertensive medication utilisation. The outcomes of this study could be important in postoperative management of patients who underwent TAVR. (Source: Heart Asia)
Source: Heart Asia - May 7, 2018 Category: Cardiology Authors: Klinkhammer, B. J., Dyke, C. M., Haldis, T. A. Tags: Original research Source Type: research
Renin-angiotensin-aldosterone inhibition improves right ventricular function: a meta-analysis
The benefits of inhibiting the renin–angiotensin–aldosterone system (RAAS) are well established for left ventricular dysfunction, but remain unknown for right ventricular (RV) dysfunction. The aim of the current meta-analysis is to investigate the role of RAAS inhibition on RV function in those with or at risk of RV dysfunction. Medline, PubMed, EMBASE and Cochrane Libraries were systematically searched and 12 studies were included for statistical synthesis, comprising 265 RAAS inhibition treatment patients and 265 placebo control patients. The treatment arm showed a trend towards increased RV ejection fraction...
Source: Heart Asia - May 3, 2018 Category: Cardiology Authors: Cao, J. Y., Lee, S. Y., Phan, K., Celermajer, D. S., Lal, S. Tags: Review Source Type: research
Transcatheter tricuspid valve edge-to-edge repair for severe tricuspid regurgitation in a Chinese patient
An 80-year-old man with recurrent right heart failure despite optimal heart failure therapy, was referred to our institution. He had inferior myocardial infarction, had undergone a coronary artery bypass graft operation and had a permanent pacemaker. Echocardiography showed a dilated right ventricle with impaired systolic function (Tricuspid annular plane systolic excursion (TAPSE) 10 mm), a dilated tricuspid annulus (septal-lateral diameter 4 cm) and massive (4+) functional tricuspid regurgitation (TR) (figure 1A). The tricuspid valve (TV) was structurally intact without impingement or perforation by the pacemaker lead (f...
Source: Heart Asia - April 16, 2018 Category: Cardiology Authors: Cheung, G. S. H., Kam, K. K. H., Lam, Y.-y., Lee, A. P. W. Tags: Images in cardiovascular medicine Source Type: research
Introduction - Erik Fung - Chairman of the Organising Committee
On 15th of December 2017, speakers, delegates and attendees from over 10 countries in the Asia Pacific region and beyond congregated at the Postgraduate Education Centre of The Chinese University of Hong Kong (CUHK) at Prince of Wales Hospital, Hong Kong, for the first Asia Pacific Advanced Heart Failure Forum (APAHFF). APAHFF was organised by the Division of Cardiology, and co-organised with the Division of Cardiothoracic Surgery and the Nethersole School of Nursing, CUHK. Endorsed by the Asian Pacific Society of Cardiology and the Hong Kong College of Cardiology, APAHFF was a clinical educational event in academic and me...
Source: Heart Asia - April 13, 2018 Category: Cardiology Authors: Fung, E. Tags: Introduction - Erik Fung - Chairman of the Organising Committee Source Type: research
27 Palliative care in advanced heart failure
Heart failure (HF) is a chronic, progressive condition associated with high mortality, high symptom burden, and poor quality of life. Acute decompensated HF is one of the leading causes of hospitalisation and poses financial and resource burdens on patients, families, and health care systems. Guidelines from multiple cardiology societies recommend the integration of palliative care into HF management to improve the quality of life and provide support to HF patients and their families. However, the question of how best to deliver palliative care services remains an active area of research. Models of palliative care for HF p...
Source: Heart Asia - April 9, 2018 Category: Cardiology Authors: Yuen, J. K. Tags: APAHFF Abstracts 2017 Source Type: research
26 Managing drug-related problems in advanced heart failure patients
Heart failure (HF) is one of the most debilitating chronic illnesses. The prevalence is expected to increase due to ageing of populations. The literature indicate that implementation of a multidisciplinary HF management programme can improve outcomes, reduce hospitalisation and lower the cost in HF.1–3 The intervention generally focuses on optimising drug therapy, enhancing patients’ understanding of disease and drugs, and improving compliance with medications and lifestyle (e.g. salt restriction). Elderly patients with advanced HF patients face various drug-related problems including polypharmacy, drug non-adh...
Source: Heart Asia - April 9, 2018 Category: Cardiology Authors: Lee, V. W. Tags: APAHFF Abstracts 2017 Source Type: research
25 Weaning of VA ECMO: our experience
There is a lack of consensus on the timing of decannulation for venoarterial extracorporeal membrane oxygenation (VA-ECMO). Premature decannulation results in haemodynamic deterioration and urgent recannulation, while prolonging unneeded ECMO support leads to significant morbidity and mortality.
VA-ECMO weaning usually consists of serial decrements until an idling flow of 0.5–1.0 L/min is achieved, supported by echocardiographic and haemodynamic assessment. Even with this minimal idling flow, right ventricular (RV) preload is reduced and, hence, right heart function is not fully tested under adequate loading conditio...
Source: Heart Asia - April 9, 2018 Category: Cardiology Authors: Chan, K.-M. Tags: APAHFF Abstracts 2017 Source Type: research
24 Interventions for acute pulmonary embolism to prevent right heart failure and circulatory collapse
Pulmonary embolism (PE) is a common and life-threatening disease. Circulatory collapse is usually preceded by right heart dysfunction and dilatation due to acute increase in right ventricular afterload from pulmonary artery obstruction. The rationale for early intervention is to restore pulmonary perfusion and minimise the risk of right ventricular collapse. For patients with intermediate-high and high-risk PE, endovascular intervention has emerged as potential alternative to systemic thrombolysis or surgical embolectomy. Recent studies have shown that endovascular therapies, including catheter-directed thrombolysis and/or...
Source: Heart Asia - April 9, 2018 Category: Cardiology Authors: Yan, B. P. Tags: APAHFF Abstracts 2017 Source Type: research
23 Anticoagulation for mechanical circulatory support
The success of mechanical circulatory support (MCS) hinges on appropriate anticoagulation. The delicate balance between clotting and bleeding remains challenging to achieve consistently in the post-operative period and requires an individualised approach, especially in patients with acquired warfarin resistance including those with latent malignancies who have failed different anticoagulant regimens. Anecdotal studies and a recent randomised controlled trial have shown that dabigatran is not an alternative to warfarin in this setting.1 2
Predicting clotting or bleeding risk can be informative but published data remain sca...
Source: Heart Asia - April 9, 2018 Category: Cardiology Authors: Fung, E. Tags: APAHFF Abstracts 2017 Source Type: research
22 Supportive cardiology: an innovative practice model to integrate palliative care into the management of advanced heart failure
Despite advances in evidence-based treatment to improve survivorship of patients with heart failure, the progressive deteriorating disease trajectory results in an expanding cohort of patients with advanced disease stage. Patients with advanced heart failure experience persistent physical and psychosocial symptoms despite optimal medical therapy. Frequent disease exacerbations require repeated hospitalisations, which heavily reduce the quality of life of patients and their families, and burden the healthcare system. The World Health Organisation advocates palliative care to improve the quality of life of patients with life...
Source: Heart Asia - April 9, 2018 Category: Cardiology Authors: Yu, D., Li, P., Fung, E., Yuen, J., Woo, J., Chair, S., Lee, V., Choi, K., Lo, R. Tags: APAHFF Abstracts 2017 Source Type: research
