Sun.Jan 21, 2024

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Lipoprotein(a)’s Outsized Per-Particle Risks

CardiacWire

A pair of JACC studies laid what might be a new scientific foundation for all that research showing that people with high lipoprotein(a) have elevated cardiovascular risks. The first study analyzed 502k UK Biobank participants , identifying two clusters of genetic variants that either raise apoB by increasing Lp(a) or LDL, showing that the Lp(a) cluster faced far greater cardiovascular risks: Each 50 nmol/L higher Lp(a)-apoB brought a 28% greater risk for coronary heart disease, versus 4% with L

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“Did that go okay?” How to tell if your message is landing

Heart Sisters

"We all want the words we use publicly to be heard, understood and maybe even remembered."~ Carrie Fox :3 ways my public speaking skills evolved after my heart attack.

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Prognostic implications of systemic immune-inflammation index in myocardial infarction patients with and without diabetes: insights from the NOAFCAMI-SH registry

Cardiovascular Diabetology

It is well-known that systemic inflammation plays a crucial role in the pathogenesis and prognosis of acute myocardial infarction (AMI). The systemic immune-inflammation index (SII, platelet × neutrophil/lymph.

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Epidemiology, Pathophysiology, and Imaging of Atherosclerotic Intracranial Disease

Stroke Journal

Stroke, Volume 55, Issue 2 , Page 311-323, February 1, 2024. Intracranial atherosclerotic disease (ICAD) is one of the most common causes of stroke worldwide. Among people with stroke, those of East Asia descent and non-White populations in the United States have a higher burden of ICAD-related stroke compared with Whites of European descent. Disparities in the prevalence of asymptomatic ICAD are less marked than with symptomatic ICAD.

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Advancements in cardiac structures segmentation: a comprehensive systematic review of deep learning in CT imaging

Frontiers in Cardiovascular Medicine

Background Segmentation of cardiac structures is an important step in evaluation of the heart on imaging. There has been growing interest in how artificial intelligence (AI) methods—particularly deep learning (DL)—can be used to automate this process. Existing AI approaches to cardiac segmentation have mostly focused on cardiac MRI. This systematic review aimed to appraise the performance and quality of supervised DL tools for the segmentation of cardiac structures on CT.

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Emergent Large Vessel Occlusion due to Intracranial Stenosis: Identification, Management, Challenges, and Future Directions

Stroke Journal

Stroke, Volume 55, Issue 2 , Page 355-365, February 1, 2024. This comprehensive literature review focuses on acute stroke related to intracranial atherosclerotic stenosis (ICAS), with an emphasis on ICAS-large vessel occlusion. ICAS is the leading cause of stroke globally, with high recurrence risk, especially in Asian, Black, and Hispanic populations.

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A polyphenol-rich plant extract prevents hypercholesterolemia and modulates gut microbiota in western diet-fed mice

Frontiers in Cardiovascular Medicine

Introduction Totum-070 is a combination of five plant extracts enriched in polyphenols to target hypercholesterolemia, one of the main risk factors for cardiovascular diseases. The aim of this study was to investigate the effects of Totum-070 on cholesterol levels in an animal model of diet-induced hypercholesterolemia. Methods C57BL/6JOlaHsd male mice were fed a Western diet and received Totum-070, or not, by daily gavage (1g/kg and 3g/kg body weight) for 6 weeks.

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Strategy for acute DeBakey type I aortic dissection considering midterm results: a retrospective cohort study comparing ascending aortic replacement and total arch replacement with frozen elephant trunk technique

Journal of Cardiothoracic Surgery

Acute type A aortic dissection is treated with an emergency procedure that uses ascending aortic replacement (AAR). However, to avoid a residual dissected aorta with a false lumen, total arch replacement (TAR).

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HDL dysfunction & It’s clinical Implication

Dr. S. Venkatesan MD

High-density lipoproteins (HDLs) represent a class of lipids, very heterogeneous in structure, composition, and biological functions.The density is between 1.063 to 1.210. It has at least 5 sub-types. Normal HDL level in blood should be above 35mg (50-60mg Ideal). When it goes beyond 60 there is not much benefit to accrue and also some surprise findings are there.

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Risk factors for postoperative delirium in patients with Stanford type A aortic dissection: a systematic review and meta-analysis

Journal of Cardiothoracic Surgery

Delirium is a common postoperative complication among patients who undergo Stanford Type A aortic dissection (TAAD). It is associated with increased mortality, as well as other serious surgical outcomes. This.

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Peripheral venous pressure accurately reflects invasively measured resting and exercise Fontan pressures

The American Journal of Cardiology

Publication date: Available online 20 January 2024 Source: The American Journal of Cardiology Author(s): William R. Miranda, Alexander C. Egbe, Alexander Van De Bruaene, Heidi M. Connolly, Luke J. Burchill, C.

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Switch to Adalimumab Biosimilar Shows No Significant Differences for Uveitis

HCPLive

Patients with uveitis switched from adalimumab originator to SB5 did not experience clinically significant differences in treatment efficacy and safety.

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Danger of an Over-the-Counter Panacea

Circulation

Circulation, Volume 149, Issue 4 , Page 332-334, January 23, 2024.

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Low Dose, Controlled Release Morphine Alleviates Cough in Idiopathic Pulmonary Fibrosis

HCPLive

These data suggest the promise of morphine for cough among those with idiopathic pulmonary fibrosis, though longer term research may be necessary.

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Caudal-Tilt Ultrasound Guided Axillary Venous Access for Transvenous Pacing Lead Implant

HeartRhythm

The optimal technique for venous access (VA) in cardiac implantable electronic device (CIED) implant procedures is unclear1. Ultrasound guided (US) axillary VA has been established as a safe, effective, and efficient technique for CIED implantation2. Optimal technique for US guided axillary VA requires imaging and puncture of the “extrathoracic portion” of the axillary vein2.

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Roger A Levy, MD, PhD: KDIGO Guidelines Recommend Belimumab for Lupus Nephritis

HCPLive

Roger A Levy, MD, PhD, discusses the recent guideline updates regarding the treatment and management of lupus nephritis.

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Epidemiology of atherosclerotic cardiovascular disease in polygenic hypercholesterolemia with or without high lipoprotein(a) levels

Frontiers in Cardiovascular Medicine

Background and aims Epidemiology of atherosclerotic cardiovascular disease might be different in patients with polygenic hypercholesterolemia plus high levels (≥30 mg/dl) of Lp(a) (H-Lpa) than in those with polygenic hypercholesterolemia alone (H-LDL). We compared the incidence of peripheral artery disease (PAD), coronary artery disease (CAD), and cerebrovascular disease (CVD) in patients with H-Lpa and in those with H-LDL.

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Future of Endovascular and Surgical Treatments of Atherosclerotic Intracranial Stenosis

Stroke Journal

Stroke, Volume 55, Issue 2 , Page 344-354, February 1, 2024. Intracranial atherosclerotic disease and resultant intracranial stenosis is a global leading cause of stroke, and poses an ongoing treatment challenge. Among patients with intracranial stenosis, those with hemodynamic compromise are at high risk for recurrent stroke despite medical therapy and risk factor modification.

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Sodium loading in ambulatory patients with heart failure with reduced ejection fraction: Mechanistic insights into sodium handling

European Journal of Heart Failure

Summary of study findings. HFrEF, heart failure with reduced ejection fraction; NT-proBNP, N-terminal pro-brain natriuretic peptide. Aims Sodium restriction was not associated with improved outcomes in heart failure patients in recent trials. The skin might act as a sodium buffer, potentially explaining tolerance to fluctuations in sodium intake without volume overload, but this is insufficiently understood.

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Optimal Medical Management of Atherosclerotic Intracranial Stenosis

Stroke Journal

Stroke, Volume 55, Issue 2 , Page 335-343, February 1, 2024. Reducing the high risk of recurrent stroke in patients with symptomatic intracranial atherosclerotic stenosis (sICAS) has proven to be challenging, but aggressive medical management, with intensive risk factor control and antithrombotic therapy, has been shown to be beneficial. High-intensity statins are recommended for patients with atherosclerotic stroke, including sICAS.

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Early changes in estimated glomerular filtration rate post?initiation of empagliflozin in EMPEROR?Preserved

European Journal of Heart Failure

Early changes in estimated glomerular filtration rate (eGFR) post-initiation of empagliflozin in patients with heart failure with preserved ejection fraction (HFpEF). CI, confidence interval; CV, cardiovascular; HHF, hospitalization for heart failure; HR, hazard ratio; LVEF, left ventricular ejection fraction. Aims Renal function (estimated glomerular filtration rate [eGFR]) changes early after the introduction of empagliflozin have not been described in heart failure with preserved ejection fra

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Randomized Secondary Prevention Trials in Participants With Symptomatic Intracranial Atherosclerotic Stenosis

Stroke Journal

Stroke, Volume 55, Issue 2 , Page 324-334, February 1, 2024. Intracranial atherosclerotic stenosis is a prevalent cause of ischemic stroke worldwide. Its association with silent cerebral infarcts and its contribution to cognitive impairment and dementia emphasize the critical need for disease prevention and effective management strategies. Despite extensive research on secondary stroke prevention treatment over the past several decades, intracranial atherosclerotic stenosis continues to exhibit

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Myocardial perfusion in cardiac amyloidosis

European Journal of Heart Failure

Myocardial perfusion in cardiac amyloidosis. Images on the left panel show an example of coronary angiography, first-pass perfusion maps and stress and rest myocardial perfusion maps of a patient with cardiac amyloidosis. The coronary angiogram is unobstructed and visual analysis of first-pass perfusion shows a global reduction in myocardial blood flow.

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Net Clinical Benefit of Oral Anticoagulation Among Frail Patients With Atrial Fibrillation: Nationwide Cohort Study

Stroke Journal

Stroke, Volume 55, Issue 2 , Page 413-422, February 1, 2024. BACKGROUND:Frail people with atrial fibrillation are often undertreated with oral anticoagulants (OACs), and evidence for the net clinical benefit (NCB) of OAC is sparse. We, therefore, examined the risk of thromboembolic events, major bleeding, and NCB of anticoagulation treatment.METHODS:This was a nationwide cohort study including frail patients aged with incident atrial fibrillation between 2013 and 2018.

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Neuromodulation interventions in the management of heart failure

European Journal of Heart Failure

Abstract Despite remarkable improvements in the management of heart failure (HF), HF remains one of the most rapidly growing cardiovascular condition resulting in a substantial burden on healthcare systems worldwide. In clinical practice, however, a relevant proportion of patients are treated with suboptimal combinations and doses lower than those recommended in the current guidelines.

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Burden of Stroke in Europe: An Analysis of the Global Burden of Disease Study Findings From 2010 to 2019

Stroke Journal

Stroke, Volume 55, Issue 2 , Page 432-442, February 1, 2024. BACKGROUND:While most European Regions perform well in global comparisons, large discrepancies within stroke epidemiological parameters exist across Europe. The objective of this analysis was to evaluate the stroke burden across European regions and countries in 2019 and its difference to 2010.METHODS:The GBD 2019 analytical tools were used to evaluate regional and country-specific estimates of incidence, prevalence, deaths, and disabi

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Myocardial sodium–glucose cotransporter 2 expression and cardiac remodelling in patients with severe aortic stenosis: The BIO?AS study

European Journal of Heart Failure

Main findings of the study. Bar plots: in red, patients with low flow-low gradient (LF-LG) aortic stenosis; in blue, patients with normal flow-high gradient (HG) aortic stenosis; in black: controls. AS, aortic stenosis; AVR, aortic valve replacement; AU, arbitrary units; GDF-15, growth differentiation factor-15; GLUT, glucose transporter; IL, interleukin; MR-proADM, mid-regional pro-adrenomedullin; NF-κB, nuclear factor-κB; NHE, sodium–hydrogen exchanger, PICP, procollagen type I carboxy-termina

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Switching to Direct Anticoagulation or Continued Vitamin-K Antagonists in Frail Patients With Atrial Fibrillation in Whom Vitamin-K Antagonists Are Tolerated?

Circulation

Circulation, Volume 149, Issue 4 , Page 290-292, January 23, 2024.

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February 2024 Stroke Highlights

Stroke Journal

Stroke, Volume 55, Issue 2 , Page 259-259, February 1, 2024.

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A Hunter Who Hesitates to Strike May Just Get the Tail

Circulation

Circulation, Volume 149, Issue 4 , Page 277-278, January 23, 2024.

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Critical Look at the NIHSS Visual Stimuli

Stroke Journal

Stroke, Volume 55, Issue 2 , Page 452-453, February 1, 2024.

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From the Literature

Circulation

Circulation, Volume 149, Issue 4 , Page 330-331, January 23, 2024.

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Correction to: Code ICH: A Call to Action

Stroke Journal

Stroke, Volume 55, Issue 2 , Page e42-e42, February 1, 2024.

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Pulmonary Congestion and Left Ventricular Dysfunction After Myocardial Infarction: Insights From the PARADISE-MI Trial

Circulation

Circulation, Volume 149, Issue 4 , Page 335-338, January 23, 2024.

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Focused Update on Intracranial Atherosclerosis: Introduction, Highlights, and Knowledge Gaps

Stroke Journal

Stroke, Volume 55, Issue 2 , Page 305-310, February 1, 2024.

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Stroke Literature Synopses (Preclinical)

Stroke Journal

Stroke, Volume 55, Issue 2 , Page e33-e34, February 1, 2024.

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Immune-Neurovascular Interactions in Experimental Perinatal and Childhood Arterial Ischemic Stroke

Stroke Journal

Stroke, Volume 55, Issue 2 , Page 506-518, February 1, 2024. Emerging clinical and preclinical data have demonstrated that the pathophysiology of arterial ischemic stroke in the adult, neonates, and children share similar mechanisms that regulate brain damage but also have distinct molecular signatures and involved cellular pathways due to the maturational stage of the central nervous system and the immune system at the time of the insult.

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