Canadian Journal of Cardiology

In 2021, the Canadian Journal of Cardiology published a "Practical Clinical Practice Update" to address emerging concerns about myocarditis and pericarditis following mRNA COVID-19 vaccines.1 Since publication, researchers have underscored the importance of standardizing diagnostic criteria and evaluation of incident cases. In this brief review, we summarize new evidence about the epidemiology and outcomes of patients with mRNA COVID-19 post-vaccine myocarditis and pericarditis. We also provide consensus guidance for evaluation, management, and follow-up...

Cancer and acute coronary syndrome (ACS) are the leading causes of morbidity and mortality globally, with many shared risk factors between both conditions. There are several challenges to the management of patients with cancer presenting with ACS due to their higher baseline risk profile, the complexities of their cancer-related therapies and prognosis, and their higher risk of adverse outcomes after ACS. Although previous studies have demonstrated disparities in the care of both cancer and ACS among patients from ethnic minorities and socioeconomic deprivation, there is limited evidence around the magnitude of such disparities specifically in cancer patients presenting with ACS...

The global population is ageing and with cardiovascular disease (CVD) prevalence also increasing, the face of the prototypical cardiology inpatient is changing, from a middle-aged man with cardiovascular risk factors, to an older adult with multimorbidity and frailty. Hospital care is inherently harmful, with immobilization and reliance on others causing functional decline to be the leading complication of hospitalization in older adults. It is imperative to reinvent hospital care, employing age-friendly health systems to maintain health and function in older adults, improving not only CVD outcomes, but patient-centered outcomes such as function and independence and preventing avoidable harms...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

The American approach to predicting sudden cardiac death (SCD) in patients with hypertrophic cardiomyopathy (HCM) diverges from the European method in that it relies on major risk factors independently justifying the implantation of an (implantable cardioverter-defibrillator) ICD for primary prevention, whereas the European approach utilizes a mathematical equation to estimate a 5-year risk percentage. The aim of this review is to outline the differences between the American and European guidelines and to demonstrate how they have arisen...

BACKGROUND: Angiotensin receptor blockers (ARBs) may slow down the progression of aortic stenosis (AS), through their antifibrotic effect. Females present more valvular fibrosis than males, thus ARBs may have more effect in females. Our aim was to assess the impact of ARBs on the remodeling of the aortic valve in males and females. METHODS: We included patients who had an aortic valve replacement± coronary bypass grafting between 2006-2013. Patients with missing echocardiographic or histologic data were excluded...

BACKGROUND: The cardiovascular literature is limited by the lack of consensus on what are the best metrics for reporting social determinants of health (SDH)/social deprivation and if they should be reported as a single metric or separately by their domains. METHODS: A systematic review of the literature on cardiovascular surgeries and procedures was conducted, identifying articles from January 1st 2010 to December 31st , 2023 that studied the relationship between health outcomes post cardiovascular procedures and/or surgeries and SDH/social deprivation...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

In patients with end-stage renal disease (ESRD), bloodstream infections and vascular access problems are frequently encountered, and patient management is critical if a cardiac implantable electronic device (CIED) infection develops in a pacing-dependent patient. Here, we describe a case of an ESRD patient with a device infection in whom a leadless pacemaker (LP) implantation from the jugular vein ipsilateral to the dialysis catheter (DC) was successful.

INTRODUCTION: In patients with atrial fibrillation (AF) on vitamin K antagonist (VKA) therapy and therapeutical INR range the incidence of cardiac thromboembolism is not negligible and the subgroup carrying a mechanical prosthetic mitral valve (PMV) has the highest risk. We aimed to assess the long-term effects of left atrial appendage closure (LAAC) in AF patients carriers of mechanical PMV who experienced a failure of VKA therapy. METHODS: In this retrospective, multicenter study, patients underwent LAAC because of thrombotic events including TIA/stroke, systemic embolism and evidence of left atrial appendage thrombosis/sludge despite VKA therapy were enrolled...

Hypertrophic cardiomyopathy (HCM) is a relatively common hereditable cardiomyopathy that affects between 1:200 to 1:500 of the general population. The role of cardiovascular magnetic resonance (CMR) imaging in the management of HCM has expanded over the past two decades to become a key informant of risk in this patient population, delivering unique insights into tissue health and its influence on future outcomes. Numerous mature CMR-based techniques are clinically available for the interrogation of tissue health in patients with HCM, inclusive of contrast and non-contrast methods...

Contemporary goals of cardiac pacing have expanded beyond the primary need for reliable myocardial capture. Advances in implantation techniques have permitted novel pacing systems that aim to improve electrocardiographic measures, ventricular synchrony, left ventricular function, and objective clinical outcomes across a broader population of patients. Physiologic pacing strategies, including left bundle branch area pacing (LBBAP), have emerged as potentially beneficial therapies compared to conventional non-physiological pacing modalities, such as right ventricular (RV) pacing...

This paper discusses some of the recent advances in the use of noninvasive imaging applied to patients with hypertrophic cardiomyopathy. Echocardiography and cardiac CT are briefly discussed with respect to their power to detect apical aneurysmal disease. Echo phenotype-genotype correlations and the ability of echo to characterize myocardial work are reviewed. Positron emission tomography (PET) is reviewed in the context of ischaemia imaging and also the use of a new tracer which may allow for recognition of early activation of the fibrosis pathway...

Simulation-based medical education (SBME) has been proposed as a method to expose cardiology residents to common and uncommon clinical scenarios. This approach aims to develop the core clinical competencies required for practice amidst many constraints, such as reduced training hours, limited patient encounters, and increased healthcare complexity. SBME fits particularly well in the Canadian Competency-by-Design framework, where the emphasis is on measurable competencies and achievement of milestones. This survey-based study aims to outline the current uses of SBME in Canadian cardiology residency programs, explore opportunities for SBME to enhance current approaches and identify barriers to its integration into the curriculum...

In Canada and worldwide, the elderly population (i.e., individuals >65 years of age) is increasing disproportionately relative to the total population. This is expected to have a substantial impact on the healthcare system, as increased aged is associated with a greater incidence of chronic non-communicable diseases. Within the elderly population cardiovascular disease is a leading cause of death, therefore developing therapies which can prevent or slow disease progression in this demography is highly desirable...

Age is a major risk factor for the development of cardiovascular diseases in men and in women. However, not all people age at the same rate and those who are aging rapidly are considered frail, when compared to their fit counterparts. Frailty is an important clinical challenge because those who are frail are more likely to develop and die from illnesses, including cardiovascular diseases, than fit people of the same age. This increase in susceptibility to cardiovascular diseases in older individuals may occur as the cellular and molecular mechanisms involved in the aging process facilitate structural and functional damage in the heart...

BACKGROUND: The cardiovascular and renal benefits of renin-angiotensin aldosterone system (RAAS) blockade are not well-established in patients with advanced CKD. We conducted a systematic review and meta-analysis to identify potential risks and benefits from RAAS blockade in patients with CKD stage 4-5. METHODS: A Medline search from inception to November 2022 was conducted to identify randomized controlled trials (RCTs) in patients with CKD stage 4-5 (estimated GFR ≤ 30 mL/min/1...

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