Ken Grauer, MD

DECEMBER 8, 2023

== CLICK HERE — for a V ideo presentation of this case! (22:3 0 min. ) Below are slides used in my video presentation. For full discussion of this case — See ECG Blog #292 — == The 2 ECGs shown in Figure-1 were obtained from a man in his 30s — who presented to the ED ( E mergency D epartment ) with chest pain that began several hours earlier. ECG #2 was recorded 1 hour after ECG #1.

Blog 165

Blog Chest Pain STEMI Ischemia 165

Dr. Malcolm Kendrick

DECEMBER 8, 2023

8th December 2023 Nothing can simply be ‘good enough’. Before beginning this blog, I thought I would introduce you to the first two laws of regulation ‘ regulation-omics’ : I know that many of the things that are obliterating productivity in the NHS are happening in all health care services, everywhere. A couple of blogs back I mentioned a US study which looked at all the guidelines primary care practitioners (PCPs) are now required to follow.

Blood Pressure 126

Blood Pressure Blog Document Hypertension 126

Med Page Today

DECEMBER 8, 2023

(MedPage Today) -- Consensus recommendations for spontaneous coronary artery dissection (SCAD) have been applied inconsistently despite increasing awareness of this condition, according to a meta-analysis. Observational studies showed significant.

SCAD 114

SCAD 114

DAIC

DECEMBER 8, 2023

The DRAIN-HF study will evaluate the Aortix percutaneous mechanical circulatory support (pMCS) technology in patients with acute decompensated heart failure (ADHF) who are unresponsive to standard medical therapy. milla1cf Fri, 12/08/2023 - 08:07 December 8, 2023 — Procyrion, Inc. , a medical device company dedicated to improving outcomes for patients with cardiac and renal impairment, announced the enrollment of the first patients in the company's IDE pivotal trial.

Technology 113

Technology Heart Failure Heart Transplant Transplant 113

Med Page Today

DECEMBER 8, 2023

(MedPage Today) -- Pharmacovigilance is needed to identify, monitor, and prevent cardiovascular adverse events (CV-AEs) associated with new agents for breast cancer and to reduce the risk of cardiotoxicity for the growing number of survivors, according.

Cancer 114

Cancer 114

Stroke Journal

DECEMBER 8, 2023

Stroke, Ahead of Print. BACKGROUND:Therapeutic-induced hypertension treatment (iHTN) is helpful for alleviating early neurological deterioration (END) in acute small vessel occlusive stroke. We examined the time parameters related to iHTN effectiveness in these patients.METHODS:We retrospectively reviewed patients with acute small vessel occlusive stroke who underwent iHTN for END, defined as an increase of ≥2 points in total National Institutes of Health Stroke Scale (NIHSS) score or ≥1 point i

Hypertension 75

Hypertension Stroke Strokes Risk Factors 75

Journal of Cardiothoracic Surgery

DECEMBER 8, 2023

Hemopericardium is a serious complication that can occur after cardiac surgery. While most post-operative causes are due to inflammation and bleeding, patients with broken sternal wires and an unstable sternum.

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52

DAIC

DECEMBER 8, 2023

Getty Images milla1cf Fri, 12/08/2023 - 08:17 December 8, 2023 — The American College of Cardiology (ACC) and the American Heart Association (AHA), along with several other leading medical associations, have issued a new guideline for preventing and optimally managing atrial fibrillation (AFib). The guideline was jointly published today in the Journal of the American College of Cardiology and Circulation.

Atrial Fibrillation 52

Atrial Fibrillation AFIB Stroke Strokes 52

CTVS

DECEMBER 8, 2023

At this time of year we reflect on all that we are grateful for as a practice, and among those are always the accolades we receive from our medical peers and the patients who we serve. To that end, once again, CTVS is proud to announce that several of our physicians have been named as 2023 Super Doctors and Super Doctors Rising Stars in Texas Monthly.

Cardiothoracic 52

Cardiothoracic 52

DAIC

DECEMBER 8, 2023

UC Gardner Neuroscience Institute. Image courtesy of UC Health / University of Cincinnati milla1cf Fri, 12/08/2023 - 08:35 December 8, 2023 — Ischemic stroke is the most common form of stroke in the U.S., affecting more than 690,000 people each year, according to the Centers for Disease Control & Prevention. And while endovascular therapy and clot-busting treatments such as tPA (tissue plasminogen activator) or TNK (Tenecteplase) have come a long way over the past 25 years, they are available t

Stroke 52

Stroke Strokes Blood Clot Research 52

Journal of the American Heart Association

DECEMBER 8, 2023

Journal of the American Heart Association, Ahead of Print. BackgroundData on the use of implanted hemodynamic monitoring (IHM) in patients with Fontan circulation are limited. This study reports our experience using the CardioMEMS HF system in adults with Fontan circulation.Methods and ResultsThis single‐center, retrospective study evaluated heart failure hospitalizations, procedural complications, and device‐related complications in patients with Fontan circulation referred for IHM placement (2

Circulation 49

Circulation Heart Failure Pulmonary Hospital 49

Becker's Hospital Review - Cardiology

DECEMBER 8, 2023

After bioprosthetic aortic valve replacement, patients who took the oral drug warfarin had better outcomes including lower mortality rates and fewer blood clots, according to new research from Rochester, Minn.-based Mayo Clinic.

Aortic valve 49

Aortic valve Aortic Blood Clot Research 49

Journal of the American Heart Association

DECEMBER 8, 2023

Journal of the American Heart Association, Ahead of Print. BackgroundChronic kidney disease (CKD) is closely associated with cardiovascular disease. We aimed to examine the association of Life's Essential 8 (LE8), the recently updated measurement of cardiovascular health, with the prevalence of CKD among US adults.Methods and ResultsThis population‐based cross‐sectional study used data from the National Health and Nutrition Examination Survey from 2007 to 2018 and included adults aged ≥20 years.

Kidney Disease 45

Kidney Disease Blood Pressure Cardiovascular Disease 45

Physiologically Speaking

DECEMBER 8, 2023

Greetings! Welcome to the Physiology Friday newsletter. This newsletter is brought to you by Examine.com — the best place on the internet for health and nutrition information — and my new eBook, “VO2 Max Essentials.” Details can be found at the end of the post! Physiologically Speaking is a reader-supported publication.

Physiology 40

Physiology Exercise 40

Journal of the American Heart Association

DECEMBER 8, 2023

Journal of the American Heart Association, Ahead of Print. BackgroundCatheter ablation of premature ventricular contractions (PVCs) that trigger polymorphic ventricular tachycardia (PVT) or ventricular fibrillation has been reported as a novel therapy to reduce the syncope events in patients with catecholaminergic PVT, whereas the long‐term ablation outcome and its value in improving exercise‐induced ventricular arrhythmias remain unclear.Methods and ResultsFourteen consecutive selected patients

Ablation 45

Ablation Tachycardia Electrophysiology Outcomes 45

Stroke: Vascular and Interventional Neurology

DECEMBER 8, 2023

Stroke: Vascular and Interventional Neurology, Ahead of Print. ABSTRACTThe infratentorial veins are densely packed in a smaller space compared to the supratentorial veins and have many variations, such as disconnections and anastomoses. Knowledge of the functional venous anatomy of the posterior fossa is becoming increasingly important in neurointerventional procedures.

Anatomy 40

Anatomy Stroke Strokes 40

Journal of the American Heart Association

DECEMBER 8, 2023

Journal of the American Heart Association, Ahead of Print. BackgroundA high fibrinogen‐to‐albumin ratio (FAR), a novel inflammatory marker, is considered to be a prognostic marker in vascular diseases. However, the association of FAR with large artery atherosclerosis (LAA) stroke is still unknown. This study was conducted to evaluate the association between FAR levels and clinical outcomes in patients with acute LAA stroke.Methods and ResultsA total of 809 patients within 72 hours of LAA stroke

Atherosclerosis 45

Atherosclerosis Stroke Strokes Outcomes 45

Stroke: Vascular and Interventional Neurology

DECEMBER 8, 2023

Stroke: Vascular and Interventional Neurology, Ahead of Print. ABSTRACTSupratentorial veins are divided into superficial and deep venous systems. Most superficial veins drain into the superior sagittal sinus, cavernous sinus, transverse sinus, and inferior sagittal sinuses. Most deep veins drain into the internal cerebral vein, and some drain into the basal vein of Rosenthal, which head toward the great cerebral vein of Galen.

Anatomy 40

Anatomy Stroke Strokes 40

Stroke Journal

DECEMBER 8, 2023

Stroke, Ahead of Print. BACKGROUND:Within hours after intracerebral hemorrhage (ICH) onset, masses of polymorphonuclear neutrophils (PMNs) infiltrate the ICH-affected brain. After degranulation involving controlled release of many toxic antimicrobial molecules, the PMNs undergo rapid apoptosis and then are removed by phagocytic microglia/macrophages (MΦ) through a process called efferocytosis.

Hemorrhage 40

Hemorrhage Stroke Strokes Outcomes 40

Stroke: Vascular and Interventional Neurology

DECEMBER 8, 2023

Stroke: Vascular and Interventional Neurology, Ahead of Print. BACKGROUNDDolichoectatic vertebrobasilar aneurysms (DVBAs) carry high morbidity, and treatment options are limited. The tumor necrosis factor α signaling cascade is implicated in DVBA growth and rupture, but the role of anti–tumor necrosis factor α therapy in DVBA has not been studied.METHODSA retrospective, case–control study of DVBA at a single institution was performed.

Aneurysm 40

Aneurysm Outcomes Stroke Strokes 40

Stroke Journal

DECEMBER 8, 2023

Stroke, Ahead of Print. BACKGROUND:Stroke is the fifth leading cause of death in the United States, one of the leading contributors to Medicare cost, including through Medicare hospice benefits, and the rate of stroke mortality has been increasing since 2013. We hypothesized that hospice utilization among Medicare beneficiaries with stroke has increased over time and that the increase is associated with trends in stroke death rate.METHODS:Using Medicare Part A claims data and Centers for Disease

Medicare 40

Medicare Stroke Strokes Dementia 40

Stroke: Vascular and Interventional Neurology

DECEMBER 8, 2023

Stroke: Vascular and Interventional Neurology, Ahead of Print. BACKGROUNDVascular tortuosity affects the outcomes of mechanical thrombectomy (MT). We classified vertebral artery (VA) tortuosity into 3 types and investigated the effect of VA tortuosity on the outcomes in patients with basilar artery occlusion.METHODSWe retrospectively included patients who underwent MT for basilar artery occlusion between January 2012 and May 2022.

Outcomes 40

Outcomes Hemorrhage Stroke Strokes 40

Stroke Journal

DECEMBER 8, 2023

Stroke, Ahead of Print. BACKGROUND:Aortic arch plaques are associated with an increased risk of ischemic stroke in patients with cryptogenic stroke or prior embolic events. However, this relationship is unclear in the community. We investigated (1) the long-term risk of stroke and cardiovascular events associated with arch plaques and (2) whether statin therapy prescribed for any indication modified the association.METHODS:A total of 934 stroke-free participants (72±9 years; 37% men) from the CA

Plaque 40

Plaque Aortic Stroke Strokes 40

Journal of the American Heart Association

DECEMBER 8, 2023

Journal of the American Heart Association, Ahead of Print. Thrombocytopenia is a rare but serious complication of the intravenous glycoprotein IIb/IIIa (GPIIb/IIIa; integrin αIIbβ3) receptor inhibitors (GPIs), abciximab, eptifibatide, and tirofiban. The thrombocytopenia ranges from mild (50 000–100 000 platelets/μL), to severe (20 000 to <50 000/μL), to profound (<20 000/μL).

Hemorrhage 40

Hemorrhage 40

Stroke Journal

DECEMBER 8, 2023

Stroke, Ahead of Print. BACKGROUND:Limited data exist on the temporal relationship between new-onset atrial fibrillation (AF) and ischemic stroke and its impact on patients’ clinical characteristics and mortality.METHODS:A population-based registry-linkage database includes all patients with new-onset AF in Finland from 2007 to 2018. Ischemic stroke temporally associated with AF (ISTAF) was defined as an ischemic stroke occurring within ±30 days from the first AF diagnosis.

Atrial Fibrillation 40

Atrial Fibrillation Stroke Strokes Kidney Disease 40

Journal of the American Heart Association

DECEMBER 8, 2023

Journal of the American Heart Association, Ahead of Print. BackgroundArterial/aortic tertiary lymphoid organs (ATLOs), characterized by germinal centers, control local arterial immune responses. T follicular helper cells (Tfh), resident in germinal centers, regulate immunoglobulin production and germinal center development. They consist of Tfh1, Tfh2, and Tfh17 subsets.

Aneurysm 40

Aneurysm Aortic 40

Journal of Cardiovascular Electrophysiology

DECEMBER 8, 2023

Abstract Background Incomplete atrial lesions resulting in pulmonary vein-left atrium reconnection after pulmonary vein antrum isolation (PVAI), are related to atrial fibrillation (AF) recurrence. Unfortunately, during the PVAI procedure, fluoroscopy and electroanatomic mapping cannot accurately determine the location and size of the ablation lesions in the atrial wall and this can result in incomplete PVAI lesions (PVAI-L) after radiofrequency catheter ablation (RFCA).

Atrial Fibrillation 40

Atrial Fibrillation Ablation Pulmonary Article 40

Journal of the American Heart Association

DECEMBER 8, 2023

Journal of the American Heart Association, Ahead of Print. BackgroundLiterature suggests a bidirectional association between advanced hepatic fibrosis (AHF) and coronary artery disease (CAD). We evaluated the association of AHF with immune activation, systemic inflammation, and adverse outcomes in patients with CAD.Methods and ResultsA fibrosis‐4 index cutoff value ≥2.67 was used to define AHF.

Coronary Artery Disease 40

Coronary Artery Disease Outcomes Heart Failure Circulation 40

Journal of Cardiovascular Electrophysiology

DECEMBER 8, 2023

Abstract Introduction Cardiac resynchronization therapy (CRT) is a standard treatment for patients with heart failure with reduced ejection fraction. However, there is still a gap of evidence in congenital heart disease (CHD) patients regarding resynchronization therapy. Methods We performed a meta-analysis and systematic review of CHD patients who received CRT implantation.

Congenital Heart Disease 40

Congenital Heart Disease Congenital Heart Disease Outcomes 40

Journal of the American Heart Association

DECEMBER 8, 2023

Journal of the American Heart Association, Ahead of Print. BackgroundThe relationship between depression and subclinical coronary atherosclerosis in asymptomatic individuals is not clear. We evaluated this relationship in a Korean population.Methods and ResultsWe analyzed 3920 individuals (mean age 54.7±7.9 years and 2603 men [66.4%]) with no history of coronary artery disease who voluntarily underwent coronary computed tomographic angiography and screening for depression using the Beck Depressi

Coronary Artery Disease 40

Coronary Artery Disease Atherosclerosis Plaque Stenosis 40

Physiologically Speaking

DECEMBER 8, 2023

Does being more active really reduce your risk of death?

Physiology 52

Physiology Exercise 52

Journal of the American Heart Association

DECEMBER 8, 2023

Journal of the American Heart Association, Ahead of Print.

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45

Physiologically Speaking

DECEMBER 8, 2023

Does being more active really reduce your risk of death?

Physiology 52

Physiology Exercise 52

Circulation: Cardiovascular Interventions

DECEMBER 8, 2023

Circulation: Cardiovascular Interventions, Ahead of Print.

Embolism 40

Embolism Pulmonary Cardiovascular Interventions Circulation 40

Stroke Journal

DECEMBER 8, 2023

Stroke, Ahead of Print.

Stroke 40

Stroke Strokes 40

Physiologically Speaking

DECEMBER 8, 2023

Greetings! Welcome to the Physiology Friday newsletter. This newsletter is brought to you by Examine.com — the best place on the internet for health and nutrition information — and my new eBook, “VO2 Max Essentials.” Details can be found at the end of the post! Physiologically Speaking is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.

Exercise 56

Exercise Physiology Research Biomarkers 56

Journal of the American Heart Association

DECEMBER 8, 2023

Journal of the American Heart Association, Ahead of Print. BackgroundTo examine the association of blood pressure (BP) levels with coronary artery calcium and carotid intima‐media thickness (CIMT) in people with maintained BP below the hypertension range based on current definitions.Methods and ResultsIn this post hoc analysis of the CARDIA (Coronary Artery Risk Development in Young Adults) prospective observational cohort study conducted in 4 US cities, we examined 1233 study participants (mean

Blood Pressure 45

Blood Pressure Cholesterol Education Hypertension 45