Clinical Cardiology
RSSArticles
Can Echo/Doppler Accurately Estimate LVEDP in Pulmonary Hypertension Patients?
In patients with pulmonary hypertension evaluated in a specialty clinic, echo/Doppler estimation of left ventricular end-diastolic pressure is not reliable for the determination of pre- vs. post-capillary pulmonary hypertension.
Cardiac Resynchronization Therapy Reduces New Onset Ventricular Arrhythmias
In an analysis of the landmark Resynchronization in Ambulatory Heart Failure Trial, patients without prior ventricular arrhythmias randomized to cardiac resynchronization therapy experienced significantly less new onset ventricular arrhythmias than those randomized to implantable cardioverter defibrillator alone.
Predicting Electrical Cardioversion Failure
A study of the 30-day success rate of electrical cardioversion of acute atrial fibrillation revealed five clinical predictors of recurrence.
Complete vs. Infarct-related, Artery-only Revascularization in STEMI
Researchers randomized patients with ST elevation myocardial infarction and at least one noninfarct artery with angiographically significant stenosis to either fractional flow-reserve-guided complete revascularization by percutaneous coronary intervention or to no revascularization of noninfarct arteries.
Another Good Reason to Consider Early Ablation for Ventricular Tachycardia
In a retrospective cohort of patients with structural heart disease and ventricular tachycardia, amiodarone often could be safely reduced or discontinued after ablation.
Uncertainties in Assessing Stroke Risk in Atrial Fibrillation
An analysis of 34 randomized trials in atrial fibrillation patients not on anti-coagulation showed considerable variation in stroke rates corresponding to their predicted risk by the CHA2DS2-VASc scores. When these scores are 2 or less, stroke rates are low enough to question the benefit versus risk of anti-coagulation therapy.
Study Challenges Orthodoxy of IV Hydration for Prevention of Contrast Nephropathy
This trial randomized 660 patients with chronic kidney disease and a planned procedure requiring intravascular iodinated contrast to prophylactic hydration or to no hydration. No hydration was found to be non-inferior for prevention of contrast-induced nephropathy and saved significant costs.
Diastolic Stress Testing Improves Diagnostic Accuracy in Evaluation of Heart Failure With Preserved Ejection Fraction
Adding echocardiographic assessment of diastolic function during exercise improves the accuracy of current algorithms for evaluating suspected heart failure with preserved ejection fraction.
Left Ventricular Diastolic Function in the Elderly
Analysis of the ability of echo Doppler measures of diastolic function to predict heart failure and death in community subjects > 65 years of age was improved by applying age-adjusted normal values for e’, which are considerably lower than those recommended in the American Society of Echocardiography guidelines.
High-sensitivity Cardiac Troponin
In a recent trial, the use of high-sensitivity troponin T did not increase the use of coronary angiography or stress testing, but did reduce ED length of stay and costs.