Dr. Smith's ECG Blog

NOVEMBER 29, 2023

Written by Pendell Meyers Two adult patients in their 50s called EMS for acute chest pain that started within the last hour. Both were awake and alert with normal vital signs. Both cases had an EMS ECG that was transmitted to the ED physician asking "should we activate the cath lab?" What do you think? Here they are: Patient 1, ECG1: Zoll computer algorithm stated: " STEMI , Anterior Infarct" Patient 2, ECG1: Zoll computer algorithm stated: "ST elevation, probably benign early repolarization.

STEMI 116

STEMI Chest Pain Blog Pericarditis 116

American Heart News - Heart News

NOVEMBER 29, 2023

Research Highlights: People diagnosed with coronary heart disease had a significantly increased risk of developing dementia later in life, according to an analysis of data for more than 430,000 people from the UK Biobank. Participants who had.

Dementia 98

Dementia Heart Disease Research 98

Conquering CHD

NOVEMBER 29, 2023

We have some fantastic news to share with all of you! After a hiatus, we are thrilled to announce the triumphant return of Conquering CHDs National Committees. These dedicated committees are the heart and soul of our organization, and they play a vital role in our mission to support those affected by congenital heart defects (CHDs). If you’re interested in getting involved with any of these committees, want to learn more, or wish to apply, please see our National Committee page for details

Webinar 98

Webinar Pediatrics Congenital Research 98

Circulation

NOVEMBER 29, 2023

Circulation, Ahead of Print. AimThe “2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation” provides recommendations to guide clinicians in the treatment of patients with atrial fibrillation.MethodsA comprehensive literature search was conducted from May 12, 2022, to November 3, 2022, encompassing studies, reviews, and other evidence conducted on human subjects that were published in English from PubMed, EMBASE, the Cochrane Library, the Agency for Healthcare Re

Atrial Fibrillation 76

Atrial Fibrillation Risk Factors Ablation Arrhythmia 76

The New England Journal of Medicine

NOVEMBER 29, 2023

Wearable DHT has reached an inflection point between fanciful descriptions and practical applications. The editors announce a series of articles focusing on the clinical applications of wearable DHT.

Technology 75

Technology Article 75

Circulation

NOVEMBER 29, 2023

Circulation, Ahead of Print. BACKGROUND:Cholesterol efflux capacity (CEC) predicts cardiovascular disease independently of high-density lipoprotein (HDL) cholesterol levels. Isolated small HDL particles are potent promoters of macrophage CEC by the ABCA1 (ATP-binding cassette transporter A1) pathway, but the underlying mechanisms are unclear.METHODS:We used model system studies of reconstituted HDL and plasma from control and lecithin-cholesterol acyltransferase (LCAT)–deficient subjects to inve

Cholesterol 75

Cholesterol Cardiovascular Disease Physiology Circulation 75

Journal of Cardiovascular Electrophysiology

NOVEMBER 29, 2023

Abstract Left ventricular assist device (LVAD) implantation is an established treatment for patients with advanced heart failure refractory to medical therapy. However, the incidence of ventricular arrhythmias (VAs) is high in this population, both in the acute and delayed phases after implantation. About one-third of patients implanted with an LVAD will experience sustained VAs, predisposing these patients to worse outcomes and complicating patient management.

Arrhythmia 75

Arrhythmia Heart Failure Ablation Outcomes 75

Journal of the American Heart Association

NOVEMBER 29, 2023

Journal of the American Heart Association, Volume 12, Issue 23 , December 5, 2023. BackgroundThe association of age at coronary heart disease (CHD) onset with incident dementia remains unexplored. This study aimed to examine whether younger onset age of CHD is associated with a higher risk of incident dementia.Methods and ResultsData were obtained from the UK Biobank.

Dementia 75

Dementia Heart Disease 75

Science Daily - Heart Disease

NOVEMBER 29, 2023

Having coronary heart disease at a younger age was associated with an increased risk of dementia, Alzheimer's disease and vascular dementia, finds a new study.

Dementia 69

Dementia Heart Disease 69

The New England Journal of Medicine

NOVEMBER 29, 2023

In this randomized trial involving hemodynamically unstable brain-dead potential heart donors, intravenous levothyroxine infusion did not result in more hearts being transplanted than saline infusion.

Transplant 65

Transplant 65

Hypertension Journal

NOVEMBER 29, 2023

Hypertension, Ahead of Print. Hypertension-associated cerebral small vessel disease is a common finding in older people. Strongly associated with age and hypertension, small vessel disease is found at autopsy in over 50% of people aged ≥65 years, with a spectrum of clinical manifestations. It is the main cause of lacunar stroke and a major source of vascular contributions to cognitive impairment and dementia.

Dementia 64

Dementia Hypertension Pharmacology Biomarkers 64

The New England Journal of Medicine

NOVEMBER 29, 2023

A 69-year-old woman with a history of focal pleural plaques due to occupational asbestos exposure presented with chronic dyspnea on exertion. Chest imaging showed calcification of the pericardium.

Pericarditis 63

Pericarditis Plaque 63

Physiologically Speaking

NOVEMBER 29, 2023

Ketone esters have emerged as a novel addition to the realm of performance-enhancing supplements, yet the evidence for their efficacy has been less than compelling. Initial studies investigating ketone esters for endurance performance demonstrated a modest improvement of approximately 2% in physical endurance during a 30-minute cycling time trial following a 1-hour submaximal cycling bout.

Exercise 52

Exercise Diet Physiology Obesity 52

The British Journal of Cardiology

NOVEMBER 29, 2023

Primary percutaneous coronary intervention (PPCI) remains the gold-standard treatment for ST-elevation myocardial infarction (STEMI). Femoral arterial access for the procedure may be an ideal option in patients who are haemodynamically unwell. However, it is associated with rare, but life-threatening, complications such as perforation, leading to retroperitoneal haemorrhage.

STEMI 52

STEMI Cardiac Arrest Myocardial Infarction Ultrasound 52

CardiacWire

NOVEMBER 29, 2023

We’re dedicating today’s top story to the people and publications that we rely on to find the most interesting cardiology stories from across the web. Assuming that you already subscribe to Cardiac Wire , these are the 35 other newsletters, websites, and social media accounts to follow if you really want to know what’s happening in cardiology. I’ll always check the mainstream cardiology news websites ( TCTMD , Medscape , et al.) and the major cardiovascular journals ( JACC , AHA , JAMA Cardiolog

Education 52

Education Interventional Cardiology Cardiovascular Imaging Obesity 52

The British Journal of Cardiology

NOVEMBER 29, 2023

Despite widespread use of statins and other lipid-lowering therapies for hypercholesterolaemia, cardiovascular (CV) mortality and morbidity remains high. The proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, alirocumab and evolocumab, have been approved for use in patients with familial hypercholesterolaemia and high CV risk in the UK.

Cholesterol 52

Cholesterol Article 52

Physiologically Speaking

NOVEMBER 29, 2023

Ketone esters have emerged as a novel addition to the realm of performance-enhancing supplements, yet the evidence for their efficacy has been less than compelling. Initial studies investigating ketone esters for endurance performance demonstrated a modest improvement of approximately 2% in physical endurance during a 30-minute cycling time trial following a 1-hour submaximal cycling bout.

Exercise 52

Exercise Diet Physiology Obesity 52

The British Journal of Cardiology

NOVEMBER 29, 2023

In this study, we evaluated the change in left ventricular end-diastolic pressure (LVEDP) after primary percutaneous coronary intervention (PCI) and its impact on in-hospital outcomes and 30-day and three-month quality of life (SAQ-7), ejection fraction (EF), and major adverse cardiovascular events (MACE). LVEDP ≥19 mmHg was taken as elevated LVEDP.

Quality of Life 52

Quality of Life Hospital Outcomes Angina 52

Dr. S. Venkatesan MD

NOVEMBER 29, 2023

Many times , an Innocuous question poses a real challenge, to our life time understanding of circulatory physiology. This question is very important , if we want to understand the true mechanism of postural hypotension, a commonest autonomic disorder in elderly (& also the newly recognised entity orthostatic hypertension) Mechanism Orthostatic hypotension is defined as a sustained drop of at least 20 mm Hg in systolic blood pressure (SBP) or 10 mm Hg in diastolic blood pressure (DBP) within

Blood Pressure 52

Blood Pressure Hypertension POTS Physiology 52

The British Journal of Cardiology

NOVEMBER 29, 2023

Guidelines recommend decision-making using the heart team (HT) in complex patients considered for myocardial revascularisation, but there are little data on how this approach works in practice. We data-mined our electronic HT database and selected patients in whom the clinical question referred to revascularisation, and documented HT recommendations and their implementation.

Coronary Artery Bypass Graft 52

Coronary Artery Bypass Graft Electrophysiology Document Physiology 52

Science Daily - Heart Disease

NOVEMBER 29, 2023

The ARIES-HM3 Randomized Clinical Trial assessed the safety and efficacy of excluding aspirin from the antithrombotic regimen in patients with advanced heart failure who have undergone implantation of a fully magnetically levitated left ventricular assist device (LVAD). The clinical trial found that excluding aspirin from the antithrombotic regimen in patients with a levitated left ventricular assist device was safe.

Heart Failure 46

Heart Failure 46

The British Journal of Cardiology

NOVEMBER 29, 2023

To review the utility of cardiovascular magnetic resonance (CMR) in the management of hospital inpatients, we performed a retrospective review of all inpatient CMR scans performed over a six-month period at a tertiary referral cardiology centre. Patient demographics, indication for CMR imaging, results of the CMR scans and whether the results changed patient management were recorded.

Inpatient 52

Inpatient Coronary Artery Disease Cardiomyopathy Outpatient 52

The New England Journal of Medicine

NOVEMBER 29, 2023

The persistent scarcity of available donor hearts demands concerted efforts to expand the pool of donors and maximize their use for heart transplantation. Central to this goal is appropriate care for brain-dead donors as performed by organ-procurement organizations (OPOs) and guided by consensus protocols.1,2 Although decades old and.

Heart Transplant 40

Heart Transplant Transplant 40

The British Journal of Cardiology

NOVEMBER 29, 2023

Stroke is a major cause of mortality, morbidity and economic burden. Strokes can be thrombotic, embolic or haemorrhagic. The key risk factor for cardioembolic stroke is atrial fibrillation or flutter, and oral anticoagulation (OAC) is recommended in all but the lowest-risk patients with evidence of these arrhythmias. Risk factors for thrombotic stroke overlap strongly with those for other atherosclerotic cardiovascular diseases (ASCVDs).

Stroke 52

Stroke Strokes Risk Factors Blood Pressure 52

Journal of the American Heart Association

NOVEMBER 29, 2023

Journal of the American Heart Association, Volume 12, Issue 23 , December 5, 2023. BackgroundLittle is known about outcomes following heart failure (HF) hospitalization among adults with congenital heart disease (CHD) in the United States. We aim to compare the outcomes of HF versus non‐HF hospitalizations in adults with CHD.Methods and ResultsUsing a national deidentified administrative claims data set, patients with adult congenital heart disease (ACHD) hospitalized with and without HF (ACHDHF

Congenital Heart Disease 40

Congenital Heart Disease Congenital Heart Failure Heart Disease 40

Journal of Cardiovascular Electrophysiology

NOVEMBER 29, 2023

This study included 1188 patients who underwent initial ablation for atrial fibrillation (AF). Patients were divided into four groups by low-voltage area (LVA)-presence and left atrial volume index (LAVI). The distribution of LVA size and LAVI, and clinical characteristics of each group are shown. AF recurrence rates and clinical outcomes are compared between groups.

Atrial Fibrillation 40

Atrial Fibrillation Ablation Heart Failure Outcomes 40

Hypertension Journal

NOVEMBER 29, 2023

Hypertension, Ahead of Print. BACKGROUND:The chronic hypoxia of high-altitude residence poses challenges for tissue oxygen supply and metabolism. Exposure to high altitude during pregnancy increases the incidence of hypertensive disorders of pregnancy and fetal growth restriction and alters placental metabolism. High-altitude ancestry protects against altitude-associated fetal growth restriction, indicating hypoxia tolerance that is genetic in nature.

Hypertension 40

Hypertension 40

Journal of Cardiovascular Electrophysiology

NOVEMBER 29, 2023

Abstract Introduction Multiple analysis techniques evaluate electrograms during atrial fibrillation (AF), but none have been established to guide catheter ablation. This study compares electrogram properties recorded from multiple right (RA) and left atrial (LA) sites. Methods Multisite LA/RA mapping (281 ± 176/239 ± 166 sites/patient) was performed in 42 patients (30 males, age 63 ± 9 years) undergoing first ( n  = 32) or redo-AF ablation ( n  = 10).

Atrial Fibrillation 40

Atrial Fibrillation Ablation Outcomes Article 40

HeartRhythm

NOVEMBER 29, 2023

Our previous study showed that light-emitting diode (LED) modulation of hypothalamic paraventricular nucleus (PVN), which is the control center of the sympathetic nervous system, might attenuate neuroinflammation in PVN and prevent ventricular arrhythmias (VAs) after myocardial infarction (MI). Low-intensity focused ultrasound (LIFU) has deeper penetration than LED, while its effect on PVN has not been reported.

Myocardial Infarction 40

Myocardial Infarction Ultrasound Arrhythmia 40

European Journal of Heart Failure

NOVEMBER 29, 2023

Sacubitril/valsartan and a mineralocorticoid receptor anatogonist (MRA) can be initiated safely and used simultaneously in post-myocardial infarction complicated by left ventricular (LV) dysfunction, congestion or both – Insight from the PARADISE MI trial. Abstract Aim It is unknown whether safety and clinical endpoints by use of sacubitril/valsartan (an angiotensin receptor–neprilysin inhibitor [ARNI]) are affected by mineralocorticoid receptor antagonists (MRA) in high-risk myocardial infarcti

Myocardial Infarction 40

Myocardial Infarction ACE Inhibitor Heart Failure Pulmonary 40

HeartRhythm

NOVEMBER 29, 2023

Congenital complete atrioventricular block (CCAVB) is typically associated with structurally normal cardiac anatomy and coronary artery blood flow, yet patients remain at risk to develop myocardial dysfunction and heart failure. Reported risk factors have included adverse maternal-fetal autoantibody interactions as well as cardiac pacing, both of which are implicated in altering myocellular histology.

Anatomy 40

Anatomy Congenital Heart Failure Risk Factors 40

Circulation: Arrhythmia and Electrophysiology

NOVEMBER 29, 2023

Circulation: Arrhythmia and Electrophysiology, Ahead of Print. Atrial cardiomyopathy is a condition that causes electrical and contractile dysfunction of the atria, often along with structural and functional changes. Atrial cardiomyopathy most commonly occurs in conjunction with ventricular dysfunction, in which case it is difficult to discern the atrial features that are secondary to ventricular dysfunction from those that arise as a result of primary atrial abnormalities.

Cardiomyopathy 40

Cardiomyopathy Atrial Fibrillation Electrophysiology Arrhythmia 40

Circulation

NOVEMBER 29, 2023

Circulation, Ahead of Print. BACKGROUND:Abdominal aortic aneurysm (AAA) is a potentially life-threatening vascular condition, but approved medical therapies to prevent AAA progression and rupture are currently lacking. Sphingolipid metabolism disorders are associated with the occurrence and development of AAA. It has been discovered that ganglioside GM3, a sialic acid–containing type of glycosphingolipid, plays a protective role in atherosclerosis, which is an important risk factor for AAA; howe

Aneurysm 40

Aneurysm Aortic Atherosclerosis Risk Factors 40

Becker's Hospital Review - Cardiology

NOVEMBER 29, 2023

A recent study found noninvasive ultrasound therapy could be a treatment option for some patients who cannot undergo surgical or transcatheter valve replacement.

TAVR 40

TAVR Ultrasound 40

Circulation

NOVEMBER 29, 2023

Circulation, Ahead of Print. BACKGROUND:A better understanding of the molecular mechanism of aortic valve development and bicuspid aortic valve (BAV) formation would significantly improve and optimize the therapeutic strategy for BAV treatment. Over the past decade, the genes involved in aortic valve development and BAV formation have been increasingly recognized.

Aortic valve 40

Aortic valve Bicuspid/Mitral Aortic Circulation 40

Becker's Hospital Review - Cardiology

NOVEMBER 29, 2023

St. Louis-based Washington University School of Medicine researchers found radiation therapy can improve outcomes in patients with ventricular tachycardia.

Heart Failure 40

Heart Failure Outcomes Tachycardia Research 40

Physiologically Speaking

NOVEMBER 29, 2023

Could alertness and dopamine underlie the ergogenic benefits of ketone esters?

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