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EMBASE (updates since 2009-10-22)
<1>
Accession Number
2009545062
Authors
Moss A.J. Hall W.J. Cannom D.S. Klein H. Brown M.W. Daubert J.P. Estes III
N.A.M. Foster E. Greenberg H. Higgins S.L. Pfeffer M.A. Solomon S.D.
Wilber D. Zareba W.
Institution
(Moss, Klein, Brown, Zareba) Department of Medicine, University of
Rochester Medical Center, Rochester, NY, United States.
(Hall) Department of Biostatistics and Computational Biology, University
of Rochester Medical Center, Rochester, NY, United States.
(Cannom) Division of Cardiology, Hospital of the Good Samaritan, Los
Angeles, CA, United States.
(Daubert) Department of Medicine, Duke University Medical Center, Durham,
NC, United States.
(Estes III) New England Cardiac Arrhythmia Center, Tufts-New England
Medical Center, Boston, MA, United States.
(Foster) Cardiology Unit, University of California at San Francisco, San
Francisco, CA, United States.
(Greenberg) Cardiology Unit, St. Luke's-Roosevelt Hospital, New York, NY,
United States.
(Higgins) Department of Cardiology, Scripps Memorial Hospital, San Diego,
CA, United States.
(Pfeffer, Solomon) Cardiovascular Division, Brigham and Women's Hospital,
Harvard Medical School, Boston, MA, United States.
(Wilber) Cardiovascular Institute, Loyola University Medical Center,
Chicago, IL, United States.
(Moss) Heart Research Follow-up Program, University of Rochester Medical
Center, Box 653, Rochester, NY 14642, United States.
Title
Cardiac-resynchronization therapy for the prevention of heart-failure
events.
Source
New England Journal of Medicine. 361(14)(pp 1329-1338), 2009. Date of
Publication: 01 Oct 2009.
Publisher
Massachussetts Medical Society
Abstract
BACKGROUND: This trial was designed to determine whether
cardiac-resynchronization therapy (CRT) with biventricular pacing would
reduce the risk of death or heart-failure events in patients with mild
cardiac symptoms, a reduced ejection fraction, and a wide QRS complex.
METHODS: During a 4.5-year period, we enrolled and followed 1820 patients
with ischemic or nonischemic cardiomyopathy, an ejection fraction of 30%
or less, a QRS duration of 130 msec or more, and New York Heart
Association class I or II symptoms. Patients were randomly assigned in a
3:2 ratio to receive CRT plus an implantable cardioverter-defibrillator
(ICD) (1089 patients) or an ICD alone (731 patients). The primary end
point was death from any cause or a nonfatal heart-failure event
(whichever came first). Heart-failure events were diagnosed by physicians
who were aware of the treatment assignments, but they were adjudicated by
a committee that was unaware of assignments. RESULTS: During an average
follow-up of 2.4 years, the primary end point occurred in 187 of 1089
patients in the CRT-ICD group (17.2%) and 185 of 731 patients in the
ICD-only group (25.3%) (hazard ratio in the CRT-ICD group, 0.66; 95%
confidence interval [CI], 0.52 to 0.84; P = 0.001). The benefit did not
differ significantly between patients with ischemic cardiomyopathy and
those with nonischemic cardiomyopathy. The superiority of CRT was driven
by a 41% reduction in the risk of heart-failure events, a finding that was
evident primarily in a prespecified subgroup of patients with a QRS
duration of 150 msec or more. CRT was associated with a significant
reduction in left ventricular volumes and improvement in the ejection
fraction. There was no significant difference between the two groups in
the overall risk of death, with a 3% annual mortality rate in each
treatment group. Serious adverse events were infrequent in the two groups.
CONCLUSIONS: CRT combined with ICD decreased the risk of heart-failure
events in relatively asymptomatic patients with a low ejection fraction
and wide QRS complex. (ClinicalTrials.gov number, NCT00180271.) Copyright
copyright 2009 Massachusetts Medical Society. All rights reserved.
<2>
Accession Number
2009512394
Authors
Wijns W. Kolh P.
Institution
(Wijns) Cardiovascular Center Aalst, Moorselbaan 164, 9300 Aalst, Belgium.
(Kolh) Department of Cardiovascular Surgery, University Hospital Lige,
Liege, Belgium.
Title
Appropriate myocardial revascularization: A joint viewpoint from an
interventional cardiologist and a cardiac surgeon.
Source
European Heart Journal. 30(18)(pp 2182-2185), 2009. Date of Publication:
September 2009.
Publisher
Oxford University Press
<3>
[Use Link to view the full text]
Accession Number
2009501553
Authors
Cheng D. Pepper J. Martin J. Stanbridge R. Ferdinand F.D. Jamieson W.R.E.
Stelzer P. Berg G. Sani G.
Institution
(Cheng) Department of Anesthesia and Perioperative Medicine, London Health
Sciences Centre, The University of Western Ontario, London, ON, Canada.
(Pepper) Department of Cardiothoracic Surgery, Imperial College, Royal
Brompton Hospital, London, United Kingdom.
(Martin) High Impact Technology Evaluation Centre, London Health Sciences
Centre, London, ON, Canada.
(Stanbridge) Department of Cardiothoracic Surgery, St. Mary's Hospital,
London, United Kingdom.
(Ferdinand) Division of Thoracic and Cardiovascular Surgery, The Lankenau
Hospital, Wynnewood, PA, United States.
(Jamieson) Division of Cardiovascular Surgery, St. Paul's Hospital,
University of British Columbia, Vancouver, BC, Canada.
(Stelzer) Department of Cardiothoracic Surgery, Mount Sinai Medical
Center, Mount Sinai School of Medicine, NY, United States.
(Berg) Golden Jubilee National Hospital, Clydebank, United Kingdom.
(Sani) Department of Surgery, Siena University School of Medicine, Siena,
Italy.
Title
Stentless versus stented bioprosthetic aortic valves: A systematic review
and meta-analysis of controlled trials.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 4(2)(pp 61-73), 2009. Date of Publication: March-April 2009.
Publisher
Lippincott Williams and Wilkins
Abstract
Objective: This meta-analysis sought to determine whether stentless
bioprosthetic valves improve clinical and resource outcomes compared with
stented valves in patients undergoing aortic valve replacement. Methods: A
comprehensive search was undertaken to identify all randomized and
nonrandomized controlled trials comparing stent-less to stented
bioprosthetic valves in patients undergoing aortic valve replacement
available up to March 2008. The primary outcomes were clinical and
resource outcomes in randomized controlled trial (RCT). Secondary outcomes
clinical and resource outcomes in nonrandomized controlled trial
(non-RCT). Odds ratios (OR), weighted mean differences (WMD), or
standardized mean differences and their 95% confidence intervals (CI) were
analyzed as appropriate. Accepted for publication February 15, 2009.
Results: Seventeen RCTs published in 23 articles involving 1317 patients,
and 14 non-RCTs published in 18 articles involving 2485 patients were
included in the meta-analysis. For the primary analysis of randomized
trials, mortality for stentless versus stented valve groups did not differ
at 30 days (OR 1.36, 95% CI 0.68-2.72), 1 year (OR 1.01, 95% CI
0.55-1.85), or 2 to 10 years follow-up (OR 0.82, 95% CI 0.50-1.33).
Aggregate event rates for all-cause mortality at 30 days were 3.7% versus
2.9%, at 1 year were 5.5% versus 5.9% and at 2 to 10 years were 17% versus
19% for stentless versus stented valve groups, respectively. Stroke or
neurologic complications did not differ between stentless (3.6%) and
stented (4.0%) valve groups. Risk of prosthesis-patient mismatch was
numerically lower in the stentless group (11.0% vs. 31.3%, OR 0.30, 95% CI
0.05-1.66), but this parameter was reported in few trials and did not
reach statistical significance. Effective orifice area index was
significantly greater for stentless aortic valve compared with stented
valves at 30 days (WMD 0.12 cm2/m2), at 2 to 6 months (WMD 0.15 cm2/m2),
and at 1 year (WMD 0.26 cm2/m2). Mean gradient at 1 month was
significantly lower in the stentless valve group (WMD -6 mm Hg), at 2 to 6
month follow-up (WMD -4 mm Hg,), at 1 year follow-up (WMD -3 mm Hg) and up
to 3 year follow-up (WMD - 3 mm Hg) compared with the stented valve group.
Although the left ventricular mass index was generally lower in the
stentless group versus the stented valve group, the aggregate estimates of
mean difference did not reach significance during any time period of
follow-up (1 month, 2-6 months, 1 year, and 8 years). Conclusions:
Evidence from randomized trials shows that subcoro-nary stentless aortic
valves improve hemodynamic parameters of effective orifice area index,
mean gradient, and peak gradient over the short and long term. These
improvements have not led to proven impact on patient morbidity,
mortality, and resource-related outcomes; however, few trials reported on
clinical outcomes beyond 1 year and definitive conclusions are not
possible until sufficient evidence addresses longer-term effects.
Copyright copyright 2009 by the International Society for Minimally
Invasive Cardiothoracic Surgery.
<4>
[Use Link to view the full text]
Accession Number
2009498760
Authors
Joseph T. Dion Y.-M.
Institution
(Joseph) North Cumbria University Hospitals NHS Trust, Cumberland
Infirmary, Newtown Road, CA5 7HY, United Kingdom.
(Dion) Centre Hospitalier Universitaire de Quebec, Ho pital St-Francois
d'Assise, 10 Rue de l'Espinay, Quebec, QC, Canada.
Title
Minimally invasive interventions in aorto-iliac occlusive disease.
Source
Surgical Laparoscopy, Endoscopy and Percutaneous Techniques. 19(4)(pp
285-289), 2009. Date of Publication: August 2009.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Aorto-iliac occlusive disease can cause disabling symptoms
and Trans-Atlantic Inter-Society Consensus (TASC II) has recommended the
treatment options for varying severity of the disease. In the TASC II
article, an increasing interest for laparoscopic aorto-ilio-femoral
surgery was noted. Aim: To review the literature on the minimally invasive
interventions currently used in aorto-iliac occlusive disease with a focus
on laparoscopic aortic surgery. Methods: Medline search and hand search of
references from relevant articles to describe the current management
options for aorto-iliac occlusive disease. Conclusion: Laparoscopic
aorto-femoral surgery is a therapeuticoption for most TASC C and D
lesions. copyright 2009 by Lippincott Williams & Wilkins.
<5>
Accession Number
2009488998
Authors
Fahrleitner-Pammer A. Piswanger-Soelkner J.C. Pieber T.R.
Obermayer-Pietsch B.M. Pilz S. Dimai H.P. Prenner G. Tscheliessnigg K.-H.
Hauge E. Portugaller R.H. Dobnig H.
Institution
(Fahrleitner-Pammer, Piswanger-Soelkner, Pieber, Obermayer-Pietsch, Pilz,
Dimai, Dobnig) Division of Endocrinology and Nuclear Medicine, Department
of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15,
A-8036 Graz, Austria.
(Prenner, Tscheliessnigg) Department of Surgery, Division of
Transplantation Surgery, Medical University of Graz, Graz, Austria.
(Hauge) Department of Rheumatology, Aarhus University Hospital, Aarhus,
Denmark.
(Portugaller) Department of Radiology, Medical University of Graz, Graz,
Austria.
Title
Ibandronate prevents bone loss and reduces vertebral fracture risk in male
cardiac transplant patients: A randomized double-blind, placebo-controlled
trial.
Source
Journal of Bone and Mineral Research. 24(7)(pp 1335-1344), 2009. Date of
Publication: July 2009.
Publisher
American Society for Bone and Mineral Research
Abstract
Bone loss and fractures are common complications after cardiac
transplantation (CTP). The aim of this study was to investigate whether
intravenous ibandronate is an effective preventive option. Thirty-five
male cardiac transplant recipients received either ibandronate (IBN) 2 mg
intravenously every 3 mo or matching placebo (CTR) in addition to 500 mg
calcium carbonate and 400 IE vitamin D3. Sera were collected at CTP and
every 3 mo thereafter. At baseline and 6 and 12 mo, standardized spinal
X-rays and BMD measurements were taken. Bone biopsies were taken at CTP
and after 6 mo from six patients. In the IBN group, 13% of the patients
sustained a new morphometric vertebral fracture compared with 53% in the
CTR group (absolute risk reduction [ARR], 40%; relative risk reduction
[RRR], 75%; p = 0.04). BMD remained unchanged with IBN treatment but in
the CTR group decreased at the lumbar spine by 25% and at the femoral neck
by 23% (both p < 0.0001) over the 1-yr period. Serum bone resorption
markers carboxy-terminal telopeptide region of type I collagen (sCTX) and
TRACP 5b were significantly increased in the CTR group and decreased in
the IBN group at all time points compared with baseline. In contrast, both
osteocalcin and bone-specific alkaline phosphatase levels showed, after a
similar decrease over the first 3 mo in both groups, a marked rise in the
CTR subjects and steadily declining levels in the IBN patients throughout
the remainder of the study period. Three paired biopsies were available
from each group. Despite the small sample size, a difference in the
relative change of eroded surface (68% in the CTR versus -23% in the IBN
group, p < 0.05) could be shown. Intravenous IBN reduced fractures,
preserved bone mass, and prevented uncoupling of bone formation and
resorption after CTP. The favorable effects on bone turnover were also
supported by histomorphometric findings. copyright 2009 American Society
for Bone and Mineral Research.
<6>
Accession Number
2009481731
Authors
Moeinvaziri M.T. Jahanmirinejad F. Salari M. Janati M. Kojuri J. Alipoor
A.
Institution
(Moeinvaziri, Jahanmirinejad, Salari) Department of Anesthesiology, Shiraz
University of Medical Sciences, Shiraz, Iran, Islamic Republic of.
(Janati, Kojuri) Cardiovascular Research Center, Shiraz University of
Medical Sciences, Shiraz, Iran, Islamic Republic of.
(Alipoor) Department of Epidemiology, Shiraz University of Medical
Sciences, Shiraz, Iran, Islamic Republic of.
Title
Evaluation of hemodynamic changes due to protamine administration by
calcium gluconate after coronary artery bypass grafting surgery.
Source
Iranian Cardiovascular Research Journal. 3(2)(pp 102-108), 2009. Date of
Publication: 2009.
Publisher
Iranian Cardiovascular Research Journal
Abstract
Background: Administration of Protamine sulfate for heparin neutralization
after cardiopulmonary bypass may be associated with adverse reactions such
as transient hypotension to cardiovascular collapse. Although catastrophic
events are rare and occur only in 2.6% of cardiac surgeries, it is
associated with adverse postoperative outcome. The aim of this study is to
investigate whether bolus administration of calcium gluconate can minimize
the adverse hemodynamic effects of protamine. Patients and Methods: This
randomized clinical trial (RCT) prospective study was conducted between
Feb. 2006 to Dec. 2008. The patients were randomly allocated into three
groups including group A (42 patients) who received only protamine after
weaning from cardiopulmonary, group B (44 patients) concomitantly treated
with protamine sulfate and calcium gluconate, and group C (40 patients)
receiving calcium gluconate 5 minutes before administration of protamine.
Hemodynamic variables such as systolic and diastolic blood pressures, mean
of arterial pressure, central venous pressure and heart rate were obtained
0, 2, 4, 6, 8 and 10 minutes after protamine administration from each
group. Results: Systolic blood pressure in groups A (control) and C
(calcium administration before protamine) 0,2,4,6,8 and 10 minutes after
protamine administration initially decreased and increased subsequently
(P=0.228). Also no statistically significant difference was found in
diastolic blood pressure (DBP), mean arterial pressure (MAP), central
venous pressure (CVP), and heart rate (HR) in 0,2,4,6,8, and 10 minutes in
any of the three groups. Conclusion: In our study, hemodynamic changes in
10 minutes after protamine administration for heparin neutralization in
patients with good left ventricular systolic function after coronary
artery bypass grafting surgery were mild, and prophylactic calcium
gluconate administration concurrent with or before protamine injection was
not recommended.
<7>
Accession Number
2009472544
Authors
Sabatine M.S. Antman E.M. Widimsky P. Ebrahim I.O. Kiss R.G. Saaiman A.
Polasek R. Contant C.F. McCabe C.H. Braunwald E.
Institution
(Sabatine, Antman, Contant, McCabe, Braunwald) TIMI Study Group, Division
of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA,
United States.
(Widimsky) Cardiocentre, 3rd Faculty of Medicine, Charles University,
Prague, Czech Republic.
(Ebrahim) Unitas Hospital, Pretoria, South Africa.
(Kiss) Research Group for Inflammation Biology and Immunogenomics,
Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary.
(Saaiman) Kuils River Heart Unit, Cape Town, South Africa.
(Polasek) Department of Cardiology, District Hospital Liberec, Liberec,
Czech Republic.
Title
Otamixaban for the treatment of patients with non-ST-elevation acute
coronary syndromes (SEPIA-ACS1 TIMI 42): a randomised, double-blind,
active-controlled, phase 2 trial.
Source
The Lancet. 374(9692)(pp 787-795), 2009. Date of Publication:
20090905/11.
Publisher
Elsevier Limited
Abstract
Background: Otamixaban is an intravenous direct factor Xa inhibitor. We
aimed to assess its efficacy and safety in non-ST-elevation acute coronary
syndromes and to identify the optimum dose range for further assessment in
a phase 3 study. Methods: In this double-blind, phase 2 trial undertaken
in 196 sites in 36 countries, 3241 patients with non-ST-elevation acute
coronary syndromes were randomly assigned via a central, telephone-based
interactive voice response system to one of five doses of otamixaban (0.08
mg/kg bolus followed by infusions of 0.035 [n=125], 0.070 [676], 0.105
[662], 0.140 [658], or 0.175 [671] mg/kg/h) or to a control of
unfractionated heparin (60 IU/kg intravenous bolus followed by an infusion
of 12 IU/kg/h) plus eptifibatide (180 mug/kg intravenous bolus followed by
an infusion of 1.0-2.0 mug/kg/min [n=449]). Both investigators and
patients were unaware of treatment allocation. Enrolment into the lowest
dose group was stopped early at the recommendation of the Data Monitoring
Committee. The primary efficacy endpoint was a composite of death,
myocardial infarction, urgent revascularisation, or bailout glycoprotein
IIb/IIIa inhibitor use up to 7 days. The primary safety endpoint was TIMI
major or minor bleeding not related to coronary-artery bypass grafting.
Efficacy analyses were by intention to treat; safety analyses were in
treated patients. This study is registered with ClinicalTrials.gov, number
NCT00317395. Findings: Rates of the primary efficacy endpoint in the five
otamixaban doses were 7.2% (nine of 125) with 0.035 mg/kg/h, 4.6% (31/676)
with 0.070 mg/kg/h, 3.8% (25/662) with 0.105 mg/kg/h, 3.6% (24/658) with
0.140 mg/kg/h, and 4.3% (29/671) with 0.175 mg/kg/h (p=0.34 for trend). In
the control group, the rate was 6.2% (28/449), yielding relative risks for
the five otamixaban doses of 1.16 (95% CI 0.56-2.38), 0.74 (0.45-1.21),
0.61 (0.36-1.02), 0.58 (0.34-1.00), and 0.69 (0.42-1.15), respectively.
Rates of the primary safety endpoint in the five otamixaban doses were
1.6% (two of 122), 1.6% (11/669), 3.1% (20/651), 3.4% (22/651), and 5.4%
(36/664), respectively (p=0.0001 for trend); the rate in the control group
was 2.7% (12/448). Interpretation: In patients with non-ST-elevation acute
coronary syndromes, otamixaban infusions of 0.100-0.140 mg/kg/h might
reduce ischaemic events and have a safety profile similar to
unfractionated heparin plus eptifibatide. Further testing in a phase 3
trial is warranted. Funding: Sanofi-Aventis. copyright 2009 Elsevier Ltd.
All rights reserved.
<8>
Accession Number
2009489175
Authors
Roberts L. Ahmed I. Hall S. Davison A.
Institution
(Roberts) Hertford College, Catte Street, Oxford, OX1 3BW, United Kingdom.
(Ahmed) Psychiatry, Capital Region Mental Health Center, Hartford, CT,
United States.
(Hall) The Deanery, Southampton, United Kingdom.
(Davison) St. Stephen's House, Oxford, United Kingdom.
Title
Intercessory prayer for the alleviation of ill health.
Source
Cochrane Database of Systematic Reviews. (2), 2009. Article Number:
CD000368. Date of Publication: 2009.
Publisher
John Wiley and Sons Ltd
Abstract
Background: Prayer is amongst the oldest and most widespread interventions
used with the intention of alleviating illness and promoting good health.
Given the significance of this response to illness for a large proportion
of the world's population, there has been considerable interest in recent
years in measuring the efficacy of intercessory prayer for the alleviation
of ill health in a scientifically rigorous fashion. The question of
whether this may contribute towards proving or disproving the existence of
God is a philosophical question lying outside the scope of this review of
the effects of prayer. This revised version of the review has been
prepared in response to feedback and to reflect new methods in the conduct
and presentation of Cochrane reviews. Objectives: To review the effects of
intercessory prayer as an additional intervention for people with health
problems already receiving routine health care. Search strategy: We
systematically searched ten relevant databases including MEDLINE and
EMBASE (June 2007). Selection criteria: We included any randomised trial
comparing personal, focused, committed and organised intercessory prayer
with those interceding holding some belief that they are praying to God or
a god versus any other intervention. This prayer could be offered on
behalf of anyone with health problems. Data collection and analysis: We
extracted data independently and analysed it on an intention to treat
basis, where possible. We calculated, for binary data, the fixed-effect
relative risk (RR), their 95% confidence intervals (CI), and the number
needed to treat or harm (NNT or NNH). Main results: Ten studies are
included in this updated review (7646 patients). For the comparison of
intercessory prayer plus standard care versus standard care alone, overall
there was no clear effect of intercessory prayer on death, with the effect
not reaching statistical significance and data being heterogeneous (6
RCTs, n=6784, random-effects RR 0.77 CI 0.51 to 1.16, I2 83%). For general
clinical state there was also no significant difference between groups (5
RCTs, n=2705, RR intermediate or bad outcome 0.98 CI 0.86 to 1.11). Four
studies found no effect for re-admission to Coronary Care Unit (4 RCTs,
n=2644, RR 1.00 CI 0.77 to 1.30).Two other trials found intercessory
prayer had no effect on re-hospitalisation (2 RCTs, n=1155, RR 0.93 CI
0.71 to 1.22). Authors' conclusions: These findings are equivocal and,
although some of the results of individual studies suggest a positive
effect of intercessory prayer,the majority do not and the evidence does
not support a recommendation either in favour or against the use of
intercessory prayer. We are not convinced that further trials of this
intervention should be undertaken and would prefer to see any resources
available for such a trial used to investigate other questions in health
care. copyright 2009 The Cochrane Collaboration. Published by John Wiley &
Sons, Ltd.
<9>
Accession Number
2009489154
Authors
Madhava M.S.H. Settle P.
Institution
(Madhava) Department of Paediatrics, Leeds Teaching Hospitals NHS Trust,
45 Hastings way, Halifax, West Yorkshire, HX1 2QB, United Kingdom.
(Settle) Neonatal Unit, Hope Hospital, Salford, United Kingdom.
Title
Fluid restriction for symptomatic patent ductus arteriosus in preterm
infants.
Source
Cochrane Database of Systematic Reviews. (2), 2009. Article Number:
CD007800. Date of Publication: 2009.
Publisher
John Wiley and Sons Ltd
<10>
Accession Number
2009487375
Authors
Sheehy A.M. Coursin D.B. Keegan M.T.
Institution
(Sheehy) Department of Medicine, University of Wisconsin School of
Medicine and Public Health, 600 Highland Ave, H6/169, Madison, WI 53792,
United States.
(Coursin) Department of Medicine and Anesthesiology, University of
Wisconsin School of Medicine and Public Health, 600 Highland Ave, H6/169,
Madison, WI 53792, United States.
(Keegan) Department of Anesthesiology, Mayo Clinic, 200 First St SW,
Rochester, MN 55905, United States.
Title
Risks of Tight Glycemic Control During Adult Cardiac Surgery.
Source
Annals of Thoracic Surgery. 88(4)(pp 1384-1385), 2009. Date of
Publication: October 2009.
Publisher
Elsevier USA
<11>
Accession Number
2009487948
Authors
Dehdari T. Heidarnia A. Ramezankhani A. Sadeghian S. Ghofranipour F.
Institution
(Dehdari, Heidarnia, Ghofranipour) Department of Health Education, Faculty
of Medical Science, Tarbiat Modares University, Al-ahmad and Chamran Cross
Road, Tehran 14117-13116, Iran, Islamic Republic of.
(Ramezankhani) Department of Public Health, Shahid Beheshti University,
Tehran, Iran, Islamic Republic of.
(Sadeghian) Tehran Heart Center, Department of Medical Science, University
of Tehran, Tehran, Iran, Islamic Republic of.
Title
Effects of progressive muscular relaxation training on quality of life in
anxious patients after coronary artery bypass graft surgery.
Source
Indian Journal of Medical Research. 129(5)(pp 603-608), 2009. Date of
Publication: 2009.
Publisher
Indian Council of Medical Research
Abstract
Background & objectives: Evidences suggest that relaxation therapy may
improve psychological outcomes in heart patients. We evaluated the effect
of progressive muscular relaxation (PMR) training in decreasing anxiety
and improving quality of life among anxious patients after coronary artery
bypass graft surgery (CABG). Method: This study was an open uncontrolled
trial. The sample included 110 anxious patients referred to the cardiac
rehabilitation clinic of Tehran Heart Center, Tehran, Iran, during six
weeks after coronary artery bypass graft (CABG). Patients were allocated
to receive both exercise training and lifestyle education plus relaxation
therapy (relaxation group; n=55) or only exercise training beside
lifestyle education (control group or the recipient of usual care group;
n=55). Duration of the relaxation therapy was 6 wk and in the case of
usual care was 8 wk. Both the groups were followed up one month after
completion of intervention. Anxiety and quality of life in the two
treatment groups were compared. Results: There were no significant
differences in overall QOL, state anxiety and trait anxiety scores between
the two groups before intervention. Significant reductions in state
anxiety (P<0.01) and trait anxiety (P<0.01) levels were observed in
relaxation group after intervention compared to control group. Women had
high state anxiety and a low quality of life than men in the two groups
before intervention. After intervention, there was no difference between
men and women in the relaxation group. Interpretation & conclusions: Our
findings show that progressive muscular relaxation training may be an
effective therapy for improving psychological health and quality of life
in anxious heart patients.
<12>
Accession Number
2009476620
Authors
Barnason S. Zimmerman L. Nieveen J. Schulz P. Miller C. Hertzog M. Tu C.
Institution
(Barnason, Zimmerman, Nieveen, Schulz, Miller, Hertzog, Tu) University of
Nebraska Medical Center, College of Nursing-Lincoln Division, Lincoln, NE,
United States.
Title
Influence of a symptom management telehealth intervention on older adults'
early recovery outcomes after coronary artery bypass surgery.
Source
Heart and Lung: Journal of Acute and Critical Care. 38(5)(pp 364-376),
2009. Date of Publication: September/October 2009.
Publisher
Mosby Inc.
Abstract
Objective: The study objective was to examine the effect of a symptom
management (SM) telehealth intervention on physical activity and
functioning and to describe the health care use of older adult patients
(aged > 65 years) after coronary artery bypass surgery (CABS) by group (SM
intervention group and usual care group). Methods: A randomized clinical
trial design was used. The study was conducted in 4 Midwestern tertiary
hospitals. The 6-week SM telehealth intervention was delivered by the
Health Buddy (Health Hero Network, Palo Alto, CA). Measures included
Modified 7-Day Activity Interview, RT3 accelerometer (Stayhealthy, Inc,
Monrovia, CA), physical activity and exercise diary, Medical Outcomes
Study Short-Form 36, and subjects' self-report and provider records of
health care use. Follow-up times were 3 and 6 weeks and 3 and 6 months
after CABS. Results: Subjects (N = 232) had a mean age of 71.2 (+4.7)
years. There were no significant interactions using repeated-measures
analyses of covariance. There was a significant group effect for average
kilocalories/kilogram/day of estimated energy expenditure as measured by
the RT3 accelerometer, with the usual care group having a higher estimated
energy expenditure. Both groups had significant improvements over time for
role-physical, vitality, and mental functioning. Both groups had similar
health care use. Conclusion: Subjects were able to return to preoperative
levels of functioning between 3 and 6 months after CABS and to increase
their physical activity over reported preoperative levels of activity.
Further study of those patients undergoing CABS who could derive the most
benefit from the SM intervention is warranted. copyright 2009 Mosby, Inc.
All rights reserved.
<13>
Accession Number
2009471310
Authors
Adams J. Julian P. Hubbard M. Hartman J. Baugh S. Segrest W. Russell J.
McDonnell J. Wheelan K.
Institution
(Adams, Hubbard, Hartman, Wheelan) Baylor Hamilton Heart and Vascular
Hospital, 411 N. Washington, Dallas, TX 75246, United States.
(Julian, Baugh) Advanced Cardiologix, Estes Park, CO, United States.
(Segrest) American Heart Association, Dallas, TX, United States.
(Russell) Medical City Hospital, Dallas, TX, United States.
(McDonnell) Plano Independent School District, Plano, TX, United States.
Title
A randomized controlled trial of a controlled breathing protocol on heart
rate variability following myocardial infarction or coronary artery bypass
graft surgery.
Source
Clinical Rehabilitation. 23(9)(pp 782-789), 2009. Date of Publication:
2009.
Publisher
SAGE Publications Ltd
Abstract
Objectives: To determine whether a controlled breathing programme
increases heart rate variability following an acute myocardial infarction
and/or coronary artery bypass graft surgery. Rationale: Heart rate
variability is reduced following a myocardial infarction, and low heart
rate variability is associated with a high mortality risk. By changing
tidal volume and rate of breathing, individuals can alter beat-to-beat
heart rate variability. It is hypothesized that heart rate increases with
inspiration and decreases with exhalation, and that deep slow breathing
enhances respiratory sinus arrhythmia, increasing heart rate variability.
Design: Randomized controlled trial. Setting: Cardiac rehabilitation
programme at a large academic medical centre in North Texas. Subjects:
From 2001 to 2005, 44 patients, age 46-65 years, who had a myocardial
infarction and/or undergone coronary artery bypass graft surgery 1-8 weeks
previously and were referred to the Cardiac Rehabilitation Program.
Intervention: Patients were randomized to either usual cardiac
rehabilitation or cardiac rehabilitation with controlled breathing (6
breaths/min for 10 minutes twice daily during the eight-week treatment
period). Main measures: Weekly measurements of total power and
standarddeviation of the mean normal to normal RR interval (SDNN), and
fortnightly measurements of respiratory sinus arrhythmia were taken using
Biocom Technologies Heart Rhythm Scanner and Tracker software. Results: No
significant difference in change were seen between groups in SDNN (P =
0.3984), baseline respiratory sinus arrhythmia (P = 0.6556) or total power
(P = 0.6184). Conclusion: Results suggest participation in the controlled
breathing programme offered no additional benefit in increasing heart rate
variability following myocardial infarction or coronary artery bypass
graft surgery. However, 77% of study patients were on heart rate-lowering
medications, which may have masked changes in heart rate variability.
copyright SAGE Publications 2009.
<14>
Accession Number
2009482356
Authors
Hamilton-Craig I. Kostner K. Colquhoun D. Woodhouse S.
Institution
(Hamilton-Craig) Griffith University School of Medicine, Department of
Cardiology, Gold Coast Hospital, Southport, QLD 4215, Australia.
(Kostner, Woodhouse) University of Queensland, Mater Hospital, Brisbane,
QLD, Australia.
(Colquhoun) University of Queensland and Greenslopes and Wesley Hospitals,
Brisbane, QLD, Australia.
Title
At Sea with SEAS: The First Clinical Endpoint Trial for Ezetimibe,
Treatment of Patients with Mild to Moderate Aortic Stenosis, Ends with
Mixed Results and More Controversy.
Source
Heart Lung and Circulation. 18(5)(pp 343-346), 2009. Date of Publication:
October 2009.
Publisher
Elsevier Ltd
Abstract
SEAS (Simvastatin and Ezetimibe in Aortic Stenosis) hypothesised that
aggressive lipid lowering with simvastatin/ezetimibe reduced
cardiovascular disease (CVD) risk and the need for aortic valve
replacement (AVR) in patients with asymptomatic aortic stenosis (AS). The
study enrolled from 173 centres in seven European countries 1873 elderly
non-diabetics with mild to moderate AS (mean aortic-valve area 1.28 +/-
0.47 cm2), who had no indication for lipid-lowering therapy. Patients were
randomised to treatment with either simvastatin/ezetimibe 40/10 mg daily
or matching placebo after a four-week diet/placebo run-in period. Compared
with placebo, LDL cholesterol was reduced by 61% (2.0 mmol/l). There was
no difference in the primary endpoint (a combination of AVR, CV death,
non-fatal MI, congestive heart failure from AS progression, coronary
revascularisation, hospitalised unstable angina and non-haemorrhagic
stroke). Compared with placebo, CVD events were reduced by 4.4% from 20.1%
to 15.7% in the simvastatin/ezetimibe group (p = 0.02). Cancer incidence
and cancer deaths were more frequent in the simvastatin/ezetimibe group
(9.9% vs. 7.0%, p = 0.03 and 4.1% vs. 2.5%, p = 0.05, respectively). These
differences were not related to any form of cancer and did not increase
with increased duration of therapy. copyright 2009.
<15>
Accession Number
2009511920
Authors
Albus C. Theissen P. Hellmich M. Griebenow R. Wilhelm B. Aslim D. Schicha
H. Kohle K.
Institution
(Albus, Wilhelm, Kohle) Department of Psychosomatics and Psychotherapy,
University of Cologne, Cologne 50924, Germany.
(Theissen, Schicha) Department of Nuclear Medicine, University of Cologne,
Cologne 50924, Germany.
(Hellmich) Institute of Medical Statistics, Informatics and Epidemiology,
University of Cologne, Cologne 50924, Germany.
(Griebenow, Aslim) Department of Internal Medicine II, University of
Cologne, Cologne 50924, Germany.
Title
Long-term effects of a multimodal behavioral intervention on myocardial
perfusion-a randomized controlled trial.
Source
International Journal of Behavioral Medicine. 16(3)(pp 219-226), 2009.
Date of Publication: September 2009.
Publisher
Routledge
Abstract
Background: Recent advances in drug therapy question as to the additional
impact behavioral interventions may have on the prognosis of patients with
clinically stable coronary heart disease (CHD). Purpose: The aim of the
study was to evaluate the effects of a multimodal, behavioral intervention
on myocardial perfusion (MP) and cardiac events, compared to standardized
cardiologic care, in patients with stable CHD. Methods: Seventy-seven CHD
patients (age 54.2+/-6.9 years, male 87%) were randomly assigned to a
behavioral intervention plus standardized cardiologic care (INT, n=39) or
standardized cardiologic care alone (CO, n=38). MP was assessed by
201Thallium MP-scintigrams (SPECT) at baseline, after 2, 3, and 7 years,
respectively. Subsequent cardiac events (MI, PCI, CABG) were assessed
using the cardiologists' charts. Results: Sixty-five patients (84%)
completed the study. In all patients, the course of MP was significantly
better in INT analysis of variance (ANOVA groupxtime p=0.001); this was
also true for patients without subsequent PCI/CABG (ANOVA groupxtime
p=0.002). Incidence of cardiac events was significantly associated with
INT (6 vs. 14; log rank test p=.047). Conclusion: The study suggests
additional long-term benefits of a behavioral intervention on myocardial
perfusion and cardiac events in patients with stable CHD compared to
standardized cardiologic care only. copyright 2009 International Society
of Behavioral Medicine.
<16>
Accession Number
2009508439
Authors
Bignami E. Biondi-Zoccai G. Landoni G. Fochi O. Testa V. Sheiban I. Giunta
F. Zangrillo A.
Institution
(Bignami, Landoni, Testa, Zangrillo) Department of Anesthesia and
Intensive Care, Universita Vita-Salute San Raffaele, Milan, Italy.
(Biondi-Zoccai, Sheiban) Department of Interventional Cardiology, Division
of Cardiology, Universita di Torino, Turin, Italy.
(Fochi) Anesthesiology and Intensive Care Unit 1, Azienda Ospedaliera
Niguarda Ca' Granda, Milano, Italia e Universita degli Studi di Milano,
Milan, Italy.
(Giunta) Department of Anesthesiology and Intensive Care, Universita degli
Studi di Pisa, Italia e Ospedale Santa Chiara, Pisa, Italy.
Title
Volatile Anesthetics Reduce Mortality in Cardiac Surgery.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 23(5)(pp 594-599),
2009. Date of Publication: October 2009.
Publisher
W.B. Saunders
Abstract
Objectives: A recent meta-analysis suggested that volatile anesthetics
reduce postoperative mortality after cardiac surgery. Nonetheless, whether
volatile anesthetics improve the outcome of cardiac surgical patients is
still a matter of debate. The authors investigated whether the use of
volatile anesthetics reduces mortality in cardiac surgery. Design,
Setting, and Interventions: A longitudinal study of 34,310 coronary artery
bypass graft interventions performed in Italy estimated the risk-adjusted
mortality ratio for each center. A survey was conducted among these
centers to investigate whether the use of volatile anesthetics showed a
correlation with mortality. Measurements and Main Results: All 64 eligible
centers provided the required data. The median unadjusted 30-day mortality
among participating centers was 2.2% (0.3-8.8), whereas the median
risk-adjusted 30-day mortality was 1.8% (0.1-7.2). Risk-adjusted analysis
showed that the use of volatile anesthetics was associated with a
significantly lower rate of risk-adjusted 30-day mortality (beta = -1.172
[-2.259, -0.085], R2 = 0.070, p = 0.035). Dichotomization into centers
using volatile anesthetics in at least 25% of their cases or in less than
25% yielded even more statistically significant results (p = 0.003).
Furthermore, a longer use of volatile anesthetics was associated with a
significantly lower death rate (p = 0.022); and exploring the impact of
the specific volatile anesthetic agent, the use of isoflurane was
associated with significant reductions in risk-adjusted mortality rates (p
= 0.039). Conclusions: This survey among 64 Italian centers shows that
risk-adjusted mortality may be reduced by the use of volatile agents in
patients undergoing coronary artery bypass graft surgery. copyright 2009
Elsevier Inc. All rights reserved.
<17>
Accession Number
2009508437
Authors
Zangrillo A. Turi S. Crescenzi G. Oriani A. Distaso F. Monaco F. Bignami
E. Landoni G.
Institution
(Zangrillo, Turi, Crescenzi, Oriani, Distaso, Monaco, Bignami, Landoni)
Department of Anesthesia and Intensive Care, Universita Vita-Salute San
Raffaele, Milan, Italy.
Title
Esmolol Reduces Perioperative Ischemia in Cardiac Surgery: A Meta-analysis
of Randomized Controlled Studies.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 23(5)(pp 625-632),
2009. Date of Publication: October 2009.
Publisher
W.B. Saunders
Abstract
Objective: beta-Blockers were associated with a reduction of mortality and
morbidity in noncardiac surgery until recently when the POISE trial showed
that beta-blockers could be harmful in the perioperative period because of
hypotension and bradycardia. Esmolol is an ultra-short-acting beta-blocker
mostly used in emergency and high-risk patients. The authors performed a
meta-analysis to evaluate the clinical effects of esmolol in cardiac
surgery. Design: Meta-analysis. Setting: Hospitals. Participants: A total
of 778 patients from 20 randomized trials. Interventions: None.
Measurements and Main Result: Three investigators independently searched
BioMedCentral and PubMed. Inclusion criteria were random allocation to
treatment and comparison of esmolol versus other drugs, placebo, or
standard of care in cardiac surgery. Exclusion criteria were duplicate
publications, nonhuman experimental studies, and no data on clinical
outcomes. The use of esmolol was associated with a significant reduction
of myocardial ischemia episodes (15/122 [12.2%] in the esmolol group v
36/140 [25.7%] in the control arm, odds ratio [OR] =0.42 [0.23-0.79], p =
0.007) and development of arrhythmias after cardiopulmonary bypass (15/65
[23.07%] v 23/64 [35.9%], OR = 0.42 [0.18-1.01], p = 0.05). The authors
did not find a reduction in the use of inotropic drugs in esmolol-treated
patients (29/153 [18.9%] v 48/146 [32.8%], OR = 0.43 [0.16-1.10], p =
0.08). Esmolol-treated patients had more episodes of bradycardia (19/129
[14.72%] v 3/133 [2.25%], OR = 5.49 [2.21-13.62], p = 0.0002) and
hypotension (28/113 [24.77%] v 14/119 [11.76%], OR = 2.73 [0.83-9.04], p =
0.10). Conclusions: Esmolol reduces the incidence of myocardial ischemia
and arrhythmias in cardiac surgery. An increase in bradycardia was noted
as well. copyright 2009 Elsevier Inc. All rights reserved.
