Fri.Dec 29, 2023

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ECG Blog #410 — How Tall are the T Waves?

Ken Grauer, MD

QUESTION: HOW would YOU interpret the ECG in Figure-1 — if no clinical information was provided? Figure-1: The initial ECG in today's case. ( To improve visualization — I've digitized the original ECG using PMcardio ). = The H ISTORY in T oday's C ASE: The patient in today's case is a teenager who presented to the ED ( E mergency D epartment ) in cardiac arrest after electrocution.

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Physiology Friday #198: The Anabolic Response to Postexercise Protein Intake Has "No Upper Limit"

Physiologically Speaking

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.

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Boston Scientific Initiates AVANT GUARD Clinical Trial to Evaluate FARAPULSE Pulsed Field Ablation System as First-Line Treatment for Persistent Atrial Fibrillation

DAIC

milla1cf Fri, 12/29/2023 - 09:39 December 29, 2023 — Boston Scientific Corporation has initiated the AVANT GUARD clinical trial to evaluate the safety and effectiveness of the FARAPULSE Pulsed Field Ablation (PFA) System* as a first-line treatment for persistent atrial fibrillation (AF), the only trial to study the use of PFA as frontline therapy in patients with this form of AF.

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Bernie Sanders Has COVID; Global Fake Ozempic Problem; Nitazenes, the New Fentanyl?

Med Page Today

(MedPage Today) -- Some links may require registration or subscription. Please note that in observance of the upcoming holiday, Morning Break will not publish on New Year's Day and will resume Tuesday, January 2. Sen. Bernie Sanders (I-Vt.), 82.

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Digoxin shows promise in enhancing post-surgery survival for infants with certain heart defects

Medical Xpress - Cardiology

A strong, rhythmic pulse is a lifelong companion for those with a healthy heart. But for about 1% of babies born in the U.S. every year, developmental heart problems compromise that steady beat.

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No Improved Outcomes for HF Patients With Sleep Apnea Using ASV Breathing Devices

Med Page Today

(MedPage Today) -- Breathing machines with adaptive servo-ventilation (ASV) did not improve survival or other clinical outcomes in patients with heart failure (HF) and reduced ejection fraction and sleep-disordered breathing, the phase III ADVENT.

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Diabetes Dialogue: Key Updates in ADA Standards of Care—2024

HCPLive

Hosts discuss what they consider the most significant or relevant updates in the ADA's Standards of Care—2024, with a focus on new recommendations for glycemic management, bone health, immunizations, and weight management.

More Trending

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50-year old with chest pain, “no ischemic changes”

Dr. Smith's ECG Blog

Written by Jesse McLaren A previously healthy 50 year-old presented with 24 hours of intermittent exertional chest pain, radiating to the arms and associated with shortness of breath. It was ongoing on arrival in the emergency department. Below is the old ECG (on top) and then new ECG (on bottom). What do you think? There is normal sinus rhythm, normal conduction, normal axis, and tall precordial voltages with J waves from early repolarization.

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Cardiovascular Risk Stratification of Patients Undergoing Hematopoietic Stem Cell Transplantation: The CARE?BMT Risk Score

Journal of the American Heart Association

Journal of the American Heart Association, Ahead of Print. BackgroundEvidence guiding the pre‐hematopoietic stem cell transplantation (HSCT) cardiovascular evaluation is limited. We sought to derive and validate a pre‐HSCT score for the cardiovascular risk stratification of HSCT candidates.Methods and ResultsWe leveraged the CARE‐BMT (Cardiovascular Registry in Bone Marrow Transplantation) study, a contemporary multicenter observational study of adult patients who underwent autologous or allogen

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Cerebral small vessel disease burden for bleeding risk during antithrombotic therapy

Medical Xpress - Cardiology

Antithrombotic agents (blood thinners), which prevent blood clots from forming, are widely used to prevent thromboembolic events such as ischemic stroke and myocardial infarction. This benefit of antithrombotic agents is not so rarely overshadowed by the drawback of an increased risk of bleeding complications, such as intracranial and gastrointestinal bleeding.

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Impact of Bariatric Surgery on Left Ventricular Structure and Function

Journal of the American Heart Association

Journal of the American Heart Association, Ahead of Print. BackgroundObesity leads to an increased risk of cardiovascular disease morbidity and death, including heart failure. Bariatric surgery has been proven to be the most effective long‐term weight management treatment. This study investigated the changes in cardiac structure and function after bariatric surgery, including left ventricular global longitudinal strain.Methods and ResultsThere were 398 consecutive patients who underwent bariatri

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2024 STS Mock Oral Exam Course

Society of Thoracic Surgeons - Early Career

Event 2024 STS Mock Oral Exam Course kchalko Fri, 12/29/2023 - 11:46 Event dates Apr 1 – May 31, 2024 Location Virtual Course Description The STS Mock Oral Exam Course helps decrease the stress of the Board exam by allowing trainees to prepare for and practice with the oral exam format. This course features two parts: A collection of online modules and resources that provide an overview of effective oral exam test-taking strategies, the anatomy of an oral exam, and mock oral exam dos and don’ts.

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2024 STS Workshop on Robotic Cardiac Surgery

Society of Thoracic Surgeons - Allied Health

Event 2024 STS Workshop on Robotic Cardiac Surgery kchalko Fri, 12/29/2023 - 11:25 Event dates May 9–10, 2024 Location Peachtree Corners, GA Save the date! The popular Workshop on Robotic Cardiac Surgery will return to the Atlanta area in spring 2024, with hands-on training sessions taking place at the headquarters of Intuitive Surgical. Details will be available soon!

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How cardiogenic shock in NSTEMI is different from STEMI?

Dr. S. Venkatesan MD

Cardiogenic shock (CS)is the most feared event following STEMI. The incidence is up to 5 to 10% with a mortality rate of around 50-60%. Still, we are finding it hard to bring this down below 50 %. There is one less addressed issue in ACS literature. We tend to perceive CS as an exclusive complication of STEMI. The fact is that NSTEMI can also result in CS is less recognized.

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Fecal Metabolite Profiling Predicts Infection in Liver Transplant Recipients

HCPLive

Reduced fecal concentrations of short- and branched-chain fatty acids, secondary bile acids, and tryptophan metabolites were associated with compositional microbiome dysbiosis and risk of postoperative infection.

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Exercise And Heart Health: Finding The Perfect Balance

MIBHS

Exercise and heart health— you’ve probably heard of the correlation before. Regular physical activity is a cornerstone of a healthy lifestyle, and its positive effects on heart health are widely recognized. Engaging in exercise can significantly contribute to maintaining a healthy heart and reducing the risk of cardiovascular diseases. However, like all good things, balance is key.

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Environmental Exposure to Toxic Metals May Increase Risk of MASLD, Study Finds

HCPLive

Greater selenium and lead exposure were associated with an increased risk of MASLD, with further analysis suggesting potential synergistic interactions between different metals and their joint effects on MASLD risk.

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New stroke risk down with clopidogrel-aspirin initiated within 72 hours

Medical Xpress - Cardiology

Combined clopidogrel-aspirin therapy initiated within 72 hours after stroke onset leads to lower risk for new stroke at 90 days among patients with mild ischemic stroke or high-risk transient ischemic attack (TIA) of presumed atherosclerotic cause, according to a study published in the Dec. 28 issue of the New England Journal of Medicine.

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Impact of Obesity on Atrial Fibrillation Pathogenesis and Treatment Options

Journal of the American Heart Association

Journal of the American Heart Association, Ahead of Print. ABSTRACTAtrial fibrillation (AF) is the most common cardiac arrhythmia. AF increases the risk of stroke, heart failure, dementia, and hospitalization. Obesity significantly increases AF risk, both directly and indirectly, through related conditions, like hypertension, diabetes, and heart failure.

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Potent and highly selective CDK9 inhibitor for treatment of hematologic malignancies

Medical Xpress - Cardiology

To evade cell cycle controls, malignant cells rely upon rapid expression of select proteins to mitigate pro-apoptotic signals resulting from damage caused by both cancer treatments and unchecked over-proliferation. Cyclin-dependent kinase 9 (CDK9)-dependent signaling induces transcription of downstream oncogenes promoting tumor growth, especially in hyperproliferative "oncogene-addicted" cancers, such as human hematological malignancies (HHMs).

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Causal Effects of Basal Metabolic Rate on Cardiovascular Disease: A Bidirectional Mendelian Randomization Study

Journal of the American Heart Association

Journal of the American Heart Association, Ahead of Print. BackgroundDespite the health effects of basal metabolic rate (BMR), the causal effect of BMR on cardiovascular diseases (CVDs) remains undetermined. To elucidate the causal nature, Mendelian randomization (MR) analyses were performed.Methods and ResultsSummary genome‐wide association statistics regarding BMR and 5 CVDs were obtained from European databases.

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Frequency of adding salt to foods linked to higher risk for CKD

Medical Xpress - Cardiology

A higher self-reported frequency of adding salt to foods is associated with a higher risk for chronic kidney disease (CKD) in the general population, according to a study published online Dec. 28 in JAMA Network Open.

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A Retrospective Cohort Study of the 2018 Angiotensin Receptor Blocker Recalls and Subsequent Drug Shortages in Patients With Hypertension

Journal of the American Heart Association

Journal of the American Heart Association, Ahead of Print. BackgroundValsartan was recalled by the US Food and Drug Administration in July 2018 for carcinogenic impurities, resulting in a drug shortage and management challenges for valsartan users. The influence of the valsartan recall on clinical outcomes is unknown. We compared the risk of adverse events between hypertensive patients using valsartan and a propensity score–matched group using nonrecalled angiotensin receptor blockers and angiot

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Cryoprotectants for red blood cells: Evaluating safety and effectiveness by in vitro measures

Medical Xpress - Cardiology

The cryopreservation of red blood cells (RBCs) holds great potential for ensuring timely blood transfusions and maintaining an adequate RBC inventory. Cryoprotectants (CPAs) are a series of biomaterials developed to reduce cryoinjuries. To achieve the high efficiency of RBC cryopreservation, suitable CPAs should be added before freezing.

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Development and Validation of a Bayesian Network?Based Model for Predicting Coronary Heart Disease Risk From Electronic Health Records

Journal of the American Heart Association

Journal of the American Heart Association, Ahead of Print. BackgroundTraditional risk evaluation models have been applied to guide public health and clinical practice in various studies. However, the application of existing methods to data sets with missing and censored data, as is often the case in electronic health records, requires additional considerations.

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Medicinal herb found to inhibit acetylation of eNOS in vascular dysfunction

Medical Xpress - Cardiology

Angelica gigas NAKAI (AG) is a popular traditional medicinal herb widely used to treat dyslipidemia due to its antioxidant activity. Vascular disease is intimately linked to obesity-induced metabolic syndrome, and AG extract (AGE) shows beneficial effects on obesity-associated vascular dysfunction. However, the effectiveness of AGE against obesity and its underlying mechanisms have not yet been extensively investigated.

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Association of Atrial Fibrillation Progression With Left Atrial Functional Reserve and Its Reversibility

Journal of the American Heart Association

Journal of the American Heart Association, Ahead of Print. BackgroundAtrial fibrillation (AF) progression is closely related to heart failure occurrence, and catheter ablation carries a beneficial effect for heart failure prevention. Recently, particular attention has been given to left atrial (LA) function and functional reserve in the pathogenesis linking AF and heart failure, although its significance and reversibility is not well studied.Methods and ResultsWe prospectively investigated 164 p

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Impact of Clinical Phenogroup Diversity and Multiplicity: Impact on Mechanisms of Exercise Intolerance in Heart Failure with Preserved Ejection Fraction

European Journal of Heart Failure

Abstract Aims We aim to clarify the extent to which cardiac and peripheral impairments to oxygen delivery and utilization contribute to exercise intolerance and risk for adverse events, and how this relates to diversity and multiplicity in pathophysiological traits. Methods Individuals with HFpEF and non-cardiac dyspnea (controls) underwent invasive cardiopulmonary exercise testing and clinical follow-up.

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Transcatheter Closure or Surgery for Symptomatic Paravalvular Leaks: The Multicenter KISS Registry

Journal of the American Heart Association

Journal of the American Heart Association, Ahead of Print. BackgroundThe optimal treatment of symptomatic paravalvular leak (PVL) remains controversial between transcatheter closure (TC) and surgery. This large‐scale study aimed to retrospectively evaluate the long‐term outcomes of the patients who underwent reoperation or TC of PVLs.Methods and ResultsA total of 335 (men, 209 [62.4%]; mean age, 58.15±12.77 years) patients who underwent treatment of PVL at 3 tertiary centers between January 2002

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Aging?Associated ALKBH5?m6A Modification Exacerbates Doxorubicin?Induced Cardiomyocyte Apoptosis Via AT?Rich Interaction Domain 2

Journal of the American Heart Association

Journal of the American Heart Association, Ahead of Print. BackgroundChemotherapy‐induced cardiovascular disease is a growing concern in the elderly population who have survived cancer, yet the underlying mechanism remains poorly understood. We investigated the role of ALKBH5 (AlkB homolog 5), a primary N6‐methyladenosine (m6A) demethylase, and its involvement in m6A methylation‐mediated regulation of targets in aging‐associated doxorubicin‐induced cardiotoxicity.Methods and ResultsTo validate t

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Hemodynamic Effect of Repeated Epinephrine Doses Decreases With Cardiopulmonary Resuscitation Cycle Progression

Journal of the American Heart Association

Journal of the American Heart Association, Ahead of Print. BackgroundEpinephrine is administered to increase coronary perfusion pressure during advanced life support and promote short‐term survival. Recent cardiopulmonary resuscitation (CPR) guidelines recommend an epinephrine dosing interval of 3 to 5 minutes during resuscitation; however, scientific evidence supporting this recommendation is lacking.

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Male–Female Differences in Acute Type B Aortic Dissection

Journal of the American Heart Association

Journal of the American Heart Association, Ahead of Print. BackgroundAcute type B aortic dissection is a cardiovascular emergency with considerable mortality and morbidity risk. Male–female differences have been observed in cardiovascular disease; however, literature on type B aortic dissection is scarce.Methods and ResultsA retrospective cohort study was conducted including all consecutive patients with acute type B aortic dissection between 2007 and 2017 in 4 tertiary hospitals using patient f

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Association of Abnormal Lung Function and Its Subtypes With Arterial Stiffness: A Longitudinal Cohort Study

Journal of the American Heart Association

Journal of the American Heart Association, Ahead of Print. BackgroundPrior studies have reported the cross‐sectional relationship between lung function and arterial stiffness, while the longitudinal association remains unclear to date. This study aimed to investigate whether abnormal lung function and its subtypes at baseline are associated with increased arterial stiffness using a cohort.Methods and ResultsThis was a secondary analysis extracting 2461 participants from Beijing Health Management

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Impact of Acute Kidney Injury After Transcatheter Aortic Valve Replacement: A Nationwide Study

Journal of the American Heart Association

Journal of the American Heart Association, Ahead of Print. BackgroundIn patients undergoing transcatheter aortic valve replacement (TAVR), the impact of acute kidney injury (AKI) on the prognosis and especially on future kidney function has been sparsely examined, and data from large cohorts are warranted.Methods and ResultsWith Danish nationwide registries, we identified all patients undergoing TAVR from 2014 to 2021 with no previous dialysis treatment.

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Suboptimal Sleep Duration Is Associated With Poorer Neuroimaging Brain Health Profiles in Middle?Aged Individuals Without Stroke or Dementia

Journal of the American Heart Association

Journal of the American Heart Association, Ahead of Print. BackgroundThe American Heart Association's Life's Simple 7, a public health construct capturing key determinants of cardiovascular health, became the Life's Essential 8 after the addition of sleep duration. The authors tested the hypothesis that suboptimal sleep duration is associated with poorer neuroimaging brain health profiles in asymptomatic middle‐aged adults.Methods and ResultsThe authors conducted a prospective magnetic resonance

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Quantitative Flow Ratio to Predict Non–Target?Vessel Events Before Planned Staged Percutaneous Coronary Intervention in Patients With Acute Coronary Syndrome

Journal of the American Heart Association

Journal of the American Heart Association, Ahead of Print. BackgroundThe optimal time point of staged percutaneous coronary intervention (PCI) among patients with acute coronary syndrome (ACS) remains a matter of debate. Quantitative flow ratio (QFR) is a novel noninvasive method to assess the hemodynamic significance of coronary stenoses. We aimed to investigate whether QFR could refine the timing of staged PCI of non‐target vessels (non‐TVs) on top of clinical judgment for patients with ACS.Me

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Prosthetic Valve Endocarditis After Aortic Valve Replacement With Bovine Versus Porcine Bioprostheses

Journal of the American Heart Association

Journal of the American Heart Association, Ahead of Print. BackgroundWhether a bovine or porcine aortic valve bioprosthesis carries a higher risk of endocarditis after aortic valve replacement is unknown. The aim of this study was to compare the risk of prosthetic endocarditis in patients undergoing aortic valve replacement with a bovine versus porcine bioprosthesis.Methods and ResultsThis nationwide, population‐based cohort study included all patients who underwent surgical aortic valve replace