Clinical Cardiology
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Predictors of Functional Status in Heart Failure with Preserved Ejection Fraction
In a retrospective cohort of patients presenting with heart failure with preserved ejection fraction, functional impairment was primarily driven by body mass index, diastolic dysfunction, and pulmonary vascular disease. New York Heart Association functional class, right ventricular dysfunction, and natriuretic peptide levels were the strongest predictors of death or heart failure hospitalization.
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Does Fludrocortisone Work in Vasovagal Syncope?
A multicenter, randomized, double-blind, controlled trial of fludrocortisone at a range of doses in patients with recurrent vasovagal syncope showed an overall trend toward reduced syncope, which was statistically significant in those who achieved the 0.2 mg daily dose.
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Management of Oral Anticoagulation in Atrial Fibrillation Patients with Worsening Renal Function
Approximately 25% of atrial fibrillation patients in a large trial comparing rivaroxaban to warfarin developed worsening renal failure during follow-up. Those treated with rivaroxaban had less embolic events, but equal bleeding events compared to those on warfarin.
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Take Two, and Call Me in the Morning?
In a real-world population of atrial fibrillation patients at moderate to high risk of stroke, more than one-third were treated with aspirin as opposed to an oral anticoagulant. Those with conditions related to coronary heart disease were more likely to be treated with aspirin.
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Searching for Heyde’s Syndrome in Prosthetic Valve Patients
In a recent analysis, abnormalities of von Willebrand factor were much more common in dysfunctional prostheses and were associated with gastrointestinal bleeding and angiodysplasia.
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TAVR Without On-site Cardiac Surgical Backup: Fringe Procedure, or Wave of the Future?
Data from transcatheter aortic valve replacement procedures performed at German hospitals without on-site cardiac surgery shows relatively low rates of major complications and mortality similar to hospitals with full surgical programs.
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Management of Mixed Aortic Valve Disease
Asymptomatic patients suffering from moderate aortic stenosis and regurgitation with preserved left ventricular function have the same prognosis as asymptomatic patients with severe aortic stenosis and normal left ventricular function and should be followed closely for the development of symptoms.
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Predictive Accuracy of the New Risk Equation
An evaluation of the predictive accuracy of the new pooled Cohort Risk Equation in > 300,000 subjects without heart disease or diabetes and a low-density lipoprotein cholesterol level between 70-189 mg/dL followed for five years showed that the new equation markedly overestimated the observed risk of cardiovascular events.
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Noninvasive Diagnosis of Transthyretin Amyloid Cardiomyopathy
A testing strategy combining bone scintigraphy and laboratory testing allows accurate diagnosis of transthyretin amyloid cardiomyopathy without the need for a biopsy.
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Can MRI Diagnose Myocarditis?
New quantitative MRI technique performs better than the older Lake Louise criteria for diagnosing myocarditis as compared to the standard of endomyocardial biopsy.