Clinical Cardiology
RSSArticles
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Diastolic Blood Pressure Goals
An analysis of the community-based ARIC study showed that low diastolic blood pressures were associated with higher baseline and subsequent troponin T levels and adverse cardiac events, but not stroke.
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MitraClip Experience in Functional Mitral Regurgitation
A post-regulatory approval, observational study of patients with symptomatic functional mitral regurgitation stratified by baseline left ventricular ejection fraction (LVEF) showed that these patients received substantial benefit at low rates of hospital mortality and other adverse events, regardless of baseline LVEF.
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Left Main Confusion: Two Randomized Trials Reach Seemingly Opposite Conclusions
The NOBLE and EXCEL trials randomized patients presenting with left main disease to treatment with percutaneous coronary intervention or coronary artery bypass graft.
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Spironolactone Improves Exercise Capacity in Diastolic Heart Failure
In a small randomized, controlled trial of patients presenting with heart failure with preserved ejection fraction, treatment with spironolactone was associated with improved exercise capacity and less exercise-induced increase in left ventricular filling pressures.
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Right Ventricular Function Predicts Outcomes in Dilated Cardiomyopathy
Right ventricular dysfunction is common in dilated cardiomyopathy and frequently recovers with medical therapy for heart failure. Recovery of right ventricular function predicts subsequent improvement in left ventricular function and is associated with better outcomes.
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Is the Wearable Cardioverter-defibrillator Ready for Prime Time?
A large German experience with the wearable cardioverter-defibrillator confirms the finding of U.S. registry studies and suggests that the device is useful for patients with reduced left ventricular function at high risk of sudden cardiac death who are not currently good candidates for an implantable cardioverter-defibrillator.
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Coronary CT Angiography Prior to Heart Valve Surgery
A meta-analysis of available studies of coronary CT angiography compared to invasive angiography demonstrates that coronary CT angiography is a reasonable substitute for invasive angiography in patients with low- to intermediate-risk for coronary artery disease and without aortic stenosis undergoing valve surgery.
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Indications for Prophylactic Surgery in Dilated Ascending Aortas Revisited
An observational study of patients with dilated ascending aortas not due to inflammatory or syndromic conditions supports the current guideline recommending clinicians consider prophylactic surgery at ≥ 5.5 cm in diameter, and the risk of dissection or rupture is not greater in those with bicuspid aortic valves.
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Stent Complexity Matters When Choosing Dual Antiplatelet Therapy Duration
A new study shows that increased percutaneous coronary intervention procedural complexity helps risk stratify patients and correlates with the benefit of longer-term dual antiplatelet therapy.
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Heart Failure with Recovered Ejection Fraction: A Distinct Phenotype
Patients suffering from systolic heart failure who subsequently improve their ejection fraction experience a more favorable clinical course compared to those presenting with persistently reduced ejection fraction or heart failure with preserved ejection fraction.