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Clinical Cardiology

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Articles

  • When Aortic Stenosis Is Almost Severe: What Happens Next?

    A study of patients with normal flow, low gradients, normal left ventricular systolic function but with calculated aortic valve areas <1.0 cm2 showed that about half of them progressed to severe aortic stenosis during the 25-month median follow-up period.

  • Perioperative Atrial Fibrillation: Is It Important?

    A large epidemiologic study with validated endpoints of patients with atrial fibrillation after non-cardiac surgery demonstrated such patients experience a higher incidence of subsequent atrial fibrillation, stroke, transient ischemic attacks, and all-cause mortality over five years of follow up.

  • Management of Cardiac Arrest Patients Without STEMI

    Since there were no significant differences in outcomes at 90 days or one year, coronary interventions in successfully resuscitated cardiac arrest patients without evidence of STEMI or cardiogenic shock can be delayed until neurologic recovery is evident.

  • Is Isolated Diastolic Hypertension a Disease?

    An analysis of three large prospective databases showed the 2017 American College of Cardiology/American Heart Association revised definition of isolated diastolic hypertension as > 80 mmHg rather than the previous definition of > 90 mmHg resulted in a 5% higher prevalence of diastolic hypertension. This was not significantly associated with cardiovascular disease outcomes.

  • What to Do with Large Pericardial Effusions

    An observational study of patients with chronic, large, hemodynamically insignificant, C-reactive protein-negative, idiopathic pericarditis in which the majority were treated by pericardiocentesis or surgical drainage showed most patients treated conservatively remained stable. The invasive approach did not reveal an etiology for the effusions.

  • Achieving AV Synchrony Without Wires

    In the MARVEL 2 prospective study of patients with atrioventricular block treated with a leadless ventricular pacemaker, atrial sensing via an accelerometer-based algorithm was largely successful in establishing atrioventricular synchronous pacing.

  • Who Benefits from Primary Prevention ICDs?

    Long-term follow-up of SCD-HeFT did not show any benefit in installing implantable cardioverter-defibrillator devices in patients with New York Heart Association class III symptoms or nonischemic cardiomyopathy.

  • Valve-in-Valve TAVR for Failed Surgical Prostheses: Short-Term Advantages, Long-Term Unknowns

    This large retrospective study of patients undergoing reintervention for failed bioprosthetic aortic valves showed better short-term outcomes with valve-in-valve transcatheter aortic valve replacement vs. redo surgical aortic valve replacement.

  • Sports Participation with Isolated Bicuspid Aortic Valve

    If they follow recommendations for restriction from competitive sports, more than one-third of children and young adults with isolated bicuspid aortic valves could be disqualified mainly for mild aortic dilatation.

  • Cheyne-Stokes Respiration in Heart Failure

    A comprehensive cardiorespiratory study of stable systolic heart failure patients showed Cheyne-Stokes breathing in the awake, upright position is related to hypercapnia and is independently associated with a higher risk of cardiac death.