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Open Heart

John B Chambers, Ronak Rajani, Denise Parkin, Sahrai Saeed
Objective: To examine the clinical significance and prognostic value of an early rapid rise in heart rate (RR-HR) in asymptomatic patients with moderate or severe aortic stenosis (AS). Methods: We retrospectively assessed the prospectively collected data from 306 patients (age 65±12 years, 33% women) with moderate (n=204) or severe AS (n=102) with a median follow-up of 25 months (mean 34.9±34.6 months). All had echocardiography and modified Bruce exercise treadmill tests (ETT)...
2019: Open Heart
Martin Reriani, Andreas J Flammer, Jessica Duhé, Jing Li, Rajiv Gulati, Charanjit S Rihal, Ryan Lennon, Jonella M Tilford, Abhiram Prasad, Lilach O Lerman, Amir Lerman
Aim: Angina pectoris in the absence of obstructive coronary artery disease (CAD) is common and is associated with poor quality of life (QOL). Coronary microvascular endothelial dysfunction is associated with myocardial ischaemia and is a common cause of angina. We hypothesise that evaluation of coronary endothelial function, its diagnosis and treatment will favourably impact QOL in patients with angina symptoms and non-obstructive CAD. Methods and results: Follow-up was done on 457 patients with chest pain and non-obstructive coronary arteries who had undergone coronary vascular reactivity evaluation by administration of intracoronary acetylcholine at the time of diagnostic study...
2019: Open Heart
Kevin P Liou, Sze-Yuan M Ooi, Stephen P Hoole, Nick E J West
Background: The utility of fractional flow reserve (FFR) to guide revascularisation in the management of acute coronary syndrome (ACS) remains unclear. Objective: This study aims to compare the clinical outcomes of patients following FFR-guided revascularisation for either ACS or stable angina (SA) and in particular focuses on the outcome of those with deferred revascularisation after FFR. Methods: A meta-analysis of existing literature was performed...
2019: Open Heart
Alexander J Sharp, Nishith Patel, Barney C Reeves, Gianni D Angelini, Francesca Fiorentino
Objective: Quantify the efficacy of strategies to prevent contrast-induced acute kidney injury (CI-AKI) in high-risk patients undergoing coronary angiography (CAG) with or without percutaneous coronary intervention (PCI). Background: CI-AKI remains a common problem. The renoprotective efficacy of existing pharmacological agents remains uncertain in high-risk populations. Methods: Systematic review and meta-analysis of randomised controlled trials (RCTs) to compare different strategies versus hydration in patients with chronic kidney disease (CKD) undergoing CAG±PCI...
2019: Open Heart
Adam J Brownstein, Syed Usman Bin Mahmood, Ayman Saeyeldin, Camilo Velasquez Mejia, Mohammad A Zafar, Yupeng Li, John A Rizzo, Neera K Dahl, Young Erben, Bulat A Ziganshin, John A Elefteriades
Objective: This study aimed to assess the prevalence of thoracic aortic disease (TAD) and abdominal aortic aneurysms (AAA) among patients with simple renal cyst (SRC) and bovine aortic arch (BAA). Methods: Through a retrospective search for patients who underwent both chest and abdominal CT imaging at our institution from 2012 to 2016, we identified patients with SRC and BAA and propensity score matched them to those without these features by age, gender and presence of hypertension, hyperlipidaemia, diabetes and chronic kidney disease...
2019: Open Heart
Serge Cazeau, Matthieu Toulemont, Philippe Ritter, Julien Reygner
Objective: Mechanical evaluation of dyssynchrony by echocardiography has not replaced ECG in routine cardiac resynchronisation therapy (CRT) evaluation because of its complexity and lack of reproducibility. The objective of this study was to evaluate the potential correlations between electromechanical parameters (atrioventricular, interventricular and intraventricular from the dyssynchrony model presented in 2000), their ability to describe dyssynchrony and their potential use in resynchrony...
2019: Open Heart
David Corcoran, Thomas J Ford, Li-Yueh Hsu, Amedeo Chiribiri, Vanessa Orchard, Kenneth Mangion, Margaret McEntegart, Paul Rocchiccioli, Stuart Watkins, Richard Good, Katriona Brooksbank, Sandosh Padmanabhan, Naveed Sattar, Alex McConnachie, Keith G Oldroyd, Rhian M Touyz, Andrew Arai, Colin Berry
Introduction: Angina with no obstructive coronary artery disease (ANOCA) is a common syndrome with unmet clinical needs. Microvascular and vasospastic angina are relevant but may not be diagnosed without measuring coronary vascular function. The relationship between cardiovascular magnetic resonance (CMR)-derived myocardial blood flow (MBF) and reference invasive coronary function tests is uncertain. We hypothesise that multiparametric CMR assessment will be clinically useful in the ANOCA diagnostic pathway...
2018: Open Heart
Clara Gomes, Caíque Bueno Terhoch, Silvia Moreira Ayub-Ferreira, Germano Emilio Conceição-Souza, Vera Maria Cury Salemi, Paulo Roberto Chizzola, Mucio Tavares Oliveira, Silvia Helena Gelas Lage, Fernando Frioes, Edimar Alcides Bocchi, Victor Sarli Issa
Objectives: The prognostic significance of transient use of inotropes has been sufficiently studied in recent heart failure (HF) populations. We hypothesised that risk stratification in these patients could contribute to patient selection for advanced therapies. Methods: We analysed a prospective cohort of adult patients admitted with decompensated HF and ejection fraction (left ventricular ejection fraction (LVEF)) less than 50%. We explored the outcomes of patients requiring inotropic therapy during hospital admission and after discharge...
2018: Open Heart
Arnav Kumar, Kimi Sato, Beni Rai Verma, Chandra Kanth Ala, Jorge Betancor, Edlira Yzeiraj, Lin Lin, Divyanshu Mohananey, Salima Qamruddin, Apostolos Kontzias, Michael A Bolen, Massimo M Imazio, Deborah H Kwon, Rory Hachamovitch, Allan L Klein
Objectives: Recurrences of pericarditis (RP) are often difficult to diagnose due to lack of clinical signs and symptoms during subsequent episodes. We aimed to investigate the value of quantitative assessment of pericardial delayed hyperenhancement (DHE) in diagnosing ongoing recurrences of pericarditis. Methods: Quantitative DHE was measured in 200 patients with established diagnosis of RP using cardiac MRI. Conventional clinical criteria for diagnosis of pericarditis were ≥2 of the following: chest pain, pericardial rub, ECG changes and new or worsening pericardial effusion...
2018: Open Heart
Ole-Christian Walter Rutherford, Christian Jonasson, Waleed Ghanima, René Holst, Sigrun Halvorsen
Background: Information is needed on bleeding risk factors specific for patients with atrial fibrillation (AF) treated with non-vitamin K oral anticoagulants (NOACs). We aimed to identify risk factors in a large real-world cohort and to derive a bleeding risk score for patients with AF treated with NOACs. Methods: From nationwide registries (the Norwegian Patient Registry and the Norwegian Prescription Database), we identified patients with AF with a first prescription of a NOAC between January 2013 and June 2015...
2018: Open Heart
Rani Khatib, Nasrin Patel, Una Laverty, Gina Mcgawley, Jim McLenachan, Sarah Shield, Alistair S Hall
Background: Inadequate medicines optimisation and adherence are significant problems among patients taking secondary prevention medications following myocardial infarction (MI). A novel joint consultant cardiology pharmacist and cardiologist medicines optimisation clinic was initiated for patients recently discharged following MI. Methods: Patients completed a locally developed tool, the 'My Experience of Taking Medicines' questionnaire, designed to allow sharing of barriers to adherence with medications...
2018: Open Heart
Rine Bakkestrøm, Ann Banke, Redi Pecini, Akhmadjon Irmukhamedov, Søren Kristian Nielsen, Mads J Andersen, Barry A Borlaug, Jacob Eifer Moller
Objective: To assess the association between cardiac morphology and function assessed with cardiac MRI (CMRI) and haemodynamics at rest and during exercise in patients with primary mitral regurgitation (MR). Methods: In an observational study, subjects with significant primary MR (N = 46) with effective regurgitant orifice ≥ 0.30 cm2 and left ventricular (LV) ejection fraction > 60% were examined with right heart catheterisation during rest and exercise and CMRI at rest...
2018: Open Heart
Christelle Cantrelle, Richard Dorent, Camille Legeai, Thibaud Damy, Olivier Bastien, Philippe Tuppin
Objective: The objective of this study was to define the characteristics of hospital care use during the year prior to heart transplantation. Methods: A retrospective cohort of heart transplant recipients registered on the national hospital discharge database between 2010 and 2015 was analysed. Results: In this cohort of 2379 heart transplant recipients (mean age: 48 years, 74% men), 91% had been admitted at least once, for at least 1 day, to a short-stay hospital during the year before transplantation (mean: 4...
2018: Open Heart
Sebastian Berger, Pascal Meyre, Steffen Blum, Stefanie Aeschbacher, Marco Ruegg, Matthias Briel, David Conen
Background: Bariatric surgery reduces cardiovascular risk in obese patients. Heart failure (HF) is associated with an increased perioperative risk following bariatric surgery. This systematic review aimed to assemble the evidence on bariatric surgery in patients with known HF and the potential effect of bariatric surgery on incident HF in obese patients without prevalent HF. Methods: We performed a comprehensive literature search up to 30 September 2017 and included studies comparing bariatric surgery to non-surgical treatment in patients with known presurgical HF...
2018: Open Heart
Anette Borger Kvaslerud, Amjad Iqbal Hussain, Andreas Auensen, Thor Ueland, Annika E Michelsen, Kjell Ingar Pettersen, Pål Aukrust, Lars Mørkrid, Lars Gullestad, Kaspar Broch
Objective: The aim of this study was to evaluate the prevalence and prognostic implication of iron deficiency (ID) and anaemia in patients with severe aortic stenosis (AS). Methods: In an observational study of consecutive patients referred for aortic valve replacement (AVR), we assessed a wide range of biomarkers of iron status, including the definition of ID commonly applied in patients with chronic heart failure (ferritin <100 µg/L or ferritin 100-299 µg/L with a transferrin saturation <20%)...
2018: Open Heart
Masatoshi Minamisawa, Jun Koyama, Ayako Kozuka, Takashi Miura, Tatsuya Saigusa, Soichiro Ebisawa, Hirohiko Motoki, Ayako Okada, Uichi Ikeda, Koichiro Kuwahara
Objective: Myocardial early systolic lengthening (ESL) duration is prolonged in patients with coronary artery disease (CAD). However, the relationship between the fractional flow reserve (FFR), the current gold standard for evaluating physiological myocardial ischaemia, and ESL has not been studied. The aims of this study were to investigate whether left ventricular (LV) ESL duration could identify patients with CAD, and to examine the relationship between FFR and LV ESL duration. Methods: In this single-centre, cross-sectional, prospective study of 75 patients with suspected or known CAD, we performed two-dimensional speckle tracking echocardiography at rest on the day before coronary angiography or percutaneous coronary intervention...
2018: Open Heart
Nora Gatzke, Nadija Güc, Philipp Hillmeister, André Dülsner, Ferdinand Le Noble, Eva Elina Buschmann, Maja Ingwersen, Peter Bramlage, Ivo R Buschmann
Objective: We investigated the impact of cardioprotective drugs on ST-elevation, arrhythmias and infarct size in a rat model of repetitive coronary artery occlusion. Methods: Seventy Sprague-Dawley rats were randomised to two control and five treatment groups. Placebo was either implantation of a pneumatic occluder onto the left anterior descending coronary artery (LAD) without starting repetitive occlusion (SHAM) or subsequent RO of the LAD over 10 days without medication (ROP)...
2018: Open Heart
Neil A Smart, Nicola King, Jeffrey D Lambert, Melissa J Pearson, John L Campbell, Signe S Risom, Rod S Taylor
Objective: The aim of this study was to undertake a contemporary review of the impact of exercise-based cardiac rehabilitation (CR) targeted at patients with atrial fibrillation (AF). Methods: We conducted searches of PubMED, EMBASE and the Cochrane Library of Controlled Trials (up until 30 November 2017) using key terms related to exercise-based CR and AF. Randomised and non-randomised controlled trials were included if they compared the effects of an exercise-based CR intervention to a no exercise or usual care control group...
2018: Open Heart
Claire E O'Donovan, Kathryn E Waddell-Smith, Jonathan R Skinner, Elizabeth Broadbent
Objective: The cardiac inherited disease (CID) population has suboptimal adherence to long-term β-blocker therapy, which is known to be a risk for sudden cardiac death. This study aimed to identify the clinical and psychosocial variables associated with non-adherence in this population. Methods: 130 individuals (aged 16-81 years, median: 54) from the New Zealand Cardiac Inherited Disease Registry taking β-blockers participated: 65 (50%) long QT syndrome, 42 (32%) hypertrophic cardiomyopathy and 23 (18%) other...
2018: Open Heart
Stian Ross, Hans Henrik Odland, Trent Fischer, Thor Edvardsen, Lars Ove Gammelsrud, Trine Fink Haland, Richard Cornelussen, Einar Hopp, Erik Kongsgaard
Background: Patient-specific left ventricular (LV) lead optimisation strategies with immediate feedback on cardiac resynchronisation therapy (CRT) effectiveness are needed. The purpose of this study was to compare contractility surrogates derived from biventricular lead motion analysis to the peak positive time derivative of LV pressure (dP/dtmax) in patients undergoing CRT implantation. Methods: Twenty-seven patients underwent CRT implantation with continuous haemodynamic monitoring...
2018: Open Heart
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