Cardiology Topics
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Cardioprotective Therapy Initiation in Chemotherapy Patients
An international study of patients undergoing cancer chemotherapy or left chest radiation therapy showed that those who showed isolated reductions in echocardiography left ventricular global longitudinal strain but not ejection fraction during follow-up who were randomized to neurohormonal therapy vs. usual care showed better preservation of 12-month cardiac magnetic resonance-determined ejection fraction.
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Prognostic Value of Stress Echocardiography
A UK National Health Service database study of stress echocardiography has shown the degree of ischemia accurately predicts the risk of future cardiovascular events over five years. The same study also showed that a negative test in patients without a history of cardiac disease identifies patients with no more than the expected background risk of an event for patients in this demographic for five years.
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EARLY TAVR Study Reports a Win for TAVR in Asymptomatic Severe AS
In this multicenter, randomized trial comparing transcatheter aortic valve replacement (TAVR) with active surveillance in patients with asymptomatic severe aortic stenosis (AS), early TAVR showed an advantage regarding the composite endpoint of death, stroke, or unplanned hospitalization for cardiovascular causes. This result was driven primarily from the progression to severe symptomatic AS among the surveillance group, with no significant difference in mortality.
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Cardiac and Paracardiac Structure in the SUMMIT Trial
A cardiac magnetic resonance imaging study in a subgroup of the patients in the SUMMIT trial of tirzepatide in patients with heart failure with preserved ejection fraction has demonstrated that patients treated with tirzepatide had reduced left ventricular mass and paracardiac adipose tissue compared to placebo-treated patients, which may partially explain the reduction in heart failure events observed in the main SUMMIT trial.
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A New Treatment for Heart Failure with Preserved Ejection Fraction
A recent randomized, placebo-controlled trial of the long-acting glucagon-like peptide-1 receptor agonist tirzepatide in patients with heart failure with preserved left ventricular ejection fraction who have obesity, diabetes, and one other weight-related comorbidity has shown that tirzepatide not only reduces the symptoms of heart failure, but reduces the incidence of worsening heart failure events.
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Left Atrial vs. Left Ventricular Parameters for Intervention Decisions
A one-institution study of serial echocardiograms in patients with moderate to severe or severe aortic regurgitation demonstrated that changes in left atrial size and strain changed over time in a similar fashion regardless of sex and age, and were of incremental prognostic value compared to left ventricular size and function.
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Screening Relatives of Hypertrophic Cardiomyopathy Patients
A retrospective cohort study of the first-degree relatives of patients with hypertrophic cardiomyopathy (HCM) seen in screening clinics in Denmark has shown that the diagnostic yield of the first visit is 26% and subsequent visits add 4%. The best predictor of the development of HCM in relatives of families with negative genetic findings was maximal left ventricular wall thickness of ≥ 10 mm.
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Benefits of Early, Aggressive Cholesterol-Lowering After Myocardial Infarction
A large national registry study of myocardial infarction patients has shown that achieving target levels of non-high-density lipoprotein cholesterol by one month and maintaining them for at least one year reduces subsequent major adverse cardiac events and argues for aggressive early cholesterol management rather than the usual stepwise approach.
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Validation of the New American Heart Association’s PREVENT Equations
An analysis of the accuracy of the new American Heart Association PREVENT Equations for predicting 10-year cardiovascular disease mortality in the National Health and Nutrition Examination Survey population has shown excellent discrimination with only modest underprediction and supports its use vs. the pooled cohort equation, which is the current standard.
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Benefit of TAVR in Patients with Moderate Aortic Stenosis and Systolic Dysfunction
In this multicenter randomized trial of early transcatheter aortic valve replacement (TAVR) in patients with moderate aortic stenosis, TAVR was not superior to medical surveillance, with TAVR triggered by progression to severe aortic stenosis.