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Mashup Score: 0
Background Elevated heart rate (HR) predicts cardiovascular disease and mortality, but there are no established normal limits for ambulatory HR. We used data from the Swedish CArdioPulmonary Imaging Study to determine reference ranges for ambulatory HR in a middle-aged population. We also studied clinical correlates of ambulatory HR. Methods A 24-hour ECG was registered in 5809 atrial fibrillation-free individuals, aged 50–65 years. A healthy subset (n=3942) was used to establish reference values (excluding persons with beta-blockers, cardiovascular disease, hypertension, heart failure, anaemia, diabetes, sleep apnoea or chronic obstructive pulmonary disease). Minimum HR was defined as the lowest 1-minute HR. Reference ranges are reported as means±SDs and 2.5th–97.5th percentiles. Clinical correlates of ambulatory HR were analysed with multivariable linear regression. Results The average mean and minimum HRs were 73±9 and 48±7 beats per minute (bpm) in men and 76±8 and 51±7 bpm in wome
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Mashup Score: 17Augmenting reality in echocardiography - 1 day(s) ago
Echocardiography is a vital first-line imaging tool for the diagnosis and management of many cardiovascular diseases. Its availability and low cost have encouraged widespread use by clinicians for the diagnosis and management of patients with heart failure.1 Visual estimation is widely used to assess ejection fraction (EF), the percentage of blood the left ventricle pumps out during a contraction. Accurately determining the EF in patients with heart failure is crucial for the implementation of timely guideline-directed medical treatment. There is a substantial need for high-fidelity determination of EF in emergency settings. However, there is high interobserver variability with visual estimation methods, which can be compounded by inadequate quality of capture and lack of specialised training in both obtaining and interpreting echocardiograms in these settings.2 The work presented by Choi et al 3 represents an important advance in reducing the burden of time and cost constraints in mea
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Mashup Score: 46Novel uses for implanted haemodynamic monitoring in adults with subaortic right ventricles - 2 day(s) ago
Background Pulmonary hypertension (PH) is a common complication in patients with complete dextro-transposition of the great arteries (TGA) after atrial switch (D-TGA/AS) and congenitally corrected TGA (ccTGA). In this population with subaortic right ventricles (sRVs), echocardiography is a poor screening tool for PH; implantable invasive haemodynamic monitoring (IHM) could be used for this purpose, but data are limited. The aim of this study is to report on novel uses of IHM in patients with sRV. Methods This retrospective study describes the uses of IHM, impact of IHM on heart failure hospitalisation (HFH) and device-related complications in adults with sRV from a single centre (2015–2022). Results IHM was placed in 18 patients with sRV (median age 43 (range 30–54) years, 8 female, 16 with D-TGA/AS, 2 with ccTGA); 16 had moderate or severe sRV systolic dysfunction, 13 had PH on catheterisation. IHM was used for (1) Medical therapy titration, (2) Medical management after ventricular as
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Mashup Score: 46Novel uses for implanted haemodynamic monitoring in adults with subaortic right ventricles - 2 day(s) ago
Background Pulmonary hypertension (PH) is a common complication in patients with complete dextro-transposition of the great arteries (TGA) after atrial switch (D-TGA/AS) and congenitally corrected TGA (ccTGA). In this population with subaortic right ventricles (sRVs), echocardiography is a poor screening tool for PH; implantable invasive haemodynamic monitoring (IHM) could be used for this purpose, but data are limited. The aim of this study is to report on novel uses of IHM in patients with sRV. Methods This retrospective study describes the uses of IHM, impact of IHM on heart failure hospitalisation (HFH) and device-related complications in adults with sRV from a single centre (2015–2022). Results IHM was placed in 18 patients with sRV (median age 43 (range 30–54) years, 8 female, 16 with D-TGA/AS, 2 with ccTGA); 16 had moderate or severe sRV systolic dysfunction, 13 had PH on catheterisation. IHM was used for (1) Medical therapy titration, (2) Medical management after ventricular as
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Mashup Score: 78Right atrial function, a mostly ignored but very valuable parameter in patients with secondary tricuspid regurgitation - 4 day(s) ago
Significant secondary tricuspid regurgitation (STR) has increasing prevalence with age, it is associated with impaired quality of life, and it is an independent predictor of patients’ morbidity and mortality. Although the association of right ventricular (RV) function with outcome has been reported in patients with STR,1 2 the role of the right atrial (RA) geometry and function remains to be elucidated. In the past, RA has been considered as an innocent bystander that passively dilates due to the chronic volume overload imposed by STR. Recently, the role of RA enlargement in determining the dilation of the tricuspid annulus, as the main mechanism in the pathophysiology of atrial-STR, has been postulated.3 4 However, the association of RA function with outcomes in patients with STR received less attention. , Galloo and co-authors5 reported that RA function (measured as RA longitudinal reservoir strain, RAsR) was independently associated with all-cause mortality at 10 years in a retrospe
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Mashup Score: 1Sarcopenia and aortic valve disease - 5 day(s) ago
Valvular heart disease, including calcific or degenerative aortic stenosis (AS), is increasingly prevalent among the older adult population. Over the last few decades, treatment of severe AS has been revolutionised following the development of transcatheter aortic valve replacement (TAVR). Despite improvements in outcomes, older adults with competing comorbidities and geriatric syndromes have suboptimal quality of life outcomes, highlighting the cumulative vulnerability that persists despite valve replacement. Sarcopenia, characterised by loss of muscle strength, mass and function, affects 21%–70% of older adults with AS. Sarcopenia is an independent predictor of short-term and long-term outcomes after TAVR and should be incorporated as a prognostic marker in preprocedural planning. Early diagnosis and treatment of sarcopenia may reduce morbidity and mortality and improve quality of life following TAVR. The adverse effects of sarcopenia can be mitigated through resistance training and
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Mashup Score: 38Long-term cardiac follow-up of athletes infected with SARS-CoV-2 after resumption of elite-level sports - 5 day(s) ago
Objective Longitudinal consequences and potential interactions of COVID-19 and elite-level sports and exercise are unclear. Therefore, we determined the long-term detrimental cardiac effects of the interaction between SARS-CoV-2 infection and the highest level of sports and exercise. Methods This prospective controlled study included elite athletes from the Evaluation of Lifetime participation in Intensive Top-level sports and Exercise cohort. Athletes infected with SARS-CoV-2were offered structured, additional cardiovascular screenings, including cardiovascular MRI (CMR). We compared ventricular volumes and function, late gadolinium enhancement (LGE) and T1 relaxation times, between infected and non-infected elite athletes, and collected follow-up data on cardiac adverse events, ventricular arrhythmia burden and the cessation of sports careers. Results We included 259 elite athletes (mean age 26±5 years; 40% women), of whom 123 were infected (9% cardiovascular symptoms) and 136 were c
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Mashup Score: 3Cardiovascular sequelae of trastuzumab and anthracycline in long-term survivors of breast cancer - 5 day(s) ago
Objectives Long-term follow-up of patients treated with trastuzumab largely focuses on those with reduced left ventricular ejection fraction (LVEF) on treatment completion. This study sought to evaluate the prevalence of cardiovascular risk factors, overt cardiovascular disease and cardiac imaging abnormalities using cardiac magnetic resonance (CMR), in participants with normal LVEF on completion of trastuzumab±anthracycline therapy at least 5 years previously. Methods Participants with human epidermal growth factor receptor 2-positive breast cancer treated with trastuzumab±anthracycline ≥5 years previously were identified from a clinical database. All participants had normal LVEF prior to, and on completion of, treatment. Participants underwent clinical cardiovascular evaluation, ECG, cardiac biomarker evaluation and CMR. Left ventricular systolic dysfunction (LVSD) was defined as LVEF <50%. Results Forty participants were recruited between 15 March 2021 and 19 July 2022. Median time
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Mashup Score: 21Shortness of breath as a diagnostic factor for acute coronary syndrome in male and female callers to out-of-hours primary care - 6 day(s) ago
Objective Chest discomfort and shortness of breath (SOB) are key symptoms in patients with acute coronary syndrome (ACS). It is, however, unknown whether SOB is valuable for recognising ACS during telephone triage in the out-of-hours primary care (OHS-PC) setting. Methods A cross-sectional study performed in the Netherlands. Telephone triage conversations were analysed of callers with chest discomfort who contacted the OHS-PC between 2014 and 2017, comparing patients with SOB with those who did not report SOB. We determine the relation between SOB and (1) High urgency allocation, (2) ACS and (3) ACS or other life-threatening diseases. Results Of the 2195 callers with chest discomfort, 1096 (49.9%) reported SOB (43.7% men, 56.3% women). In total, 15.3% men (13.2% in those with SOB) and 8.4% women (9.2% in those with SOB) appeared to have ACS. SOB compared with no SOB was associated with high urgency allocation (75.9% vs 60.8%, OR: 2.03; 95% CI 1.69 to 2.44, multivariable OR (mOR): 2.03;
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Mashup Score: 0Sarcopenia and aortic valve disease - 7 day(s) ago
Valvular heart disease, including calcific or degenerative aortic stenosis (AS), is increasingly prevalent among the older adult population. Over the last few decades, treatment of severe AS has been revolutionised following the development of transcatheter aortic valve replacement (TAVR). Despite improvements in outcomes, older adults with competing comorbidities and geriatric syndromes have suboptimal quality of life outcomes, highlighting the cumulative vulnerability that persists despite valve replacement. Sarcopenia, characterised by loss of muscle strength, mass and function, affects 21%–70% of older adults with AS. Sarcopenia is an independent predictor of short-term and long-term outcomes after TAVR and should be incorporated as a prognostic marker in preprocedural planning. Early diagnosis and treatment of sarcopenia may reduce morbidity and mortality and improve quality of life following TAVR. The adverse effects of sarcopenia can be mitigated through resistance training and
Source: heart.bmj.comCategories: General Medicine News, Cardiologists1Tweet
🤔. Yep, ambulatory heart rate varies widely, & is not really explained by clinical correlates. Reference ranges for ambulatory heart rate measurements in a middle-aged population @Heart_BMJ https://t.co/MDCLM3AW6Q