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<1>
Accession Number
0019966363
Authors
Quek S.C. Wu W.X. Chan K.Y. Ang P. Ho T.F. Yip W.
Institution
(Quek, Wu, Chan, Ang, Ho, Yip) Department of Paediatrics, National
University of Singapore, Singapore and the Gleneagles Hospital, Singapore.
Title
A novel "in-situ tulip-bud deployment" method for transcatheter closure of
secundum atrial septal defect..
Source
The Journal of invasive cardiology. 21(12)(pp 623-626), 2009. Date of
Publication: Dec 2009.
Abstract
OBJECTIVE: We devised a new technique for interventional closure of atrial
septal defect (ASD) using the Amplatzer Septal Occluder (ASO), and
validated this by comparing it with a cohort using the conventional
method. BACKGROUND: Transcatheter closure of ASD is a widely accepted
modality of treatment. Although the outcome is good, there are occasional
technical difficulties encountered. METHOD: In this three-step technique,
the device is protruded to form a "tulip bud." This "tulip bud" is then
aligned adjacent to and along the plane of the ASD. The second step
involves withdrawing the sheath in quick succession to deploy atrial discs
over the septal defect. Finally, good placement of the occluder is checked
before release. RESULTS: Twenty-seven consecutive patients (1.4-77.2 years
of age, median = 15) underwent device closure by this method. Nineteen
(70.4%) had a deficient aortic rim (< 5 mm). Mean (+/- SD) ASD size by
transesophageal echocardiography (TEE) was 16.0 +/- 5.1 mm. The chosen ASO
size was 122 +/- 8% of the ASD size. The mean (+/- SD) duration of
deployment and of deployment to release was 1.27 +/- 1.91 minutes and 5.18
+/- 2.63 minutes, respectively. The total fluoroscopy and procedure time
was 9.93 +/- 5.61 minutes and 68.67 +/- 28.39 minutes, respectively.
Twenty-one out of 27 patients (77.8%) had closure in one attempt.
Comparing these 27 patients with the previous 48 consecutive patients with
a deficient aortic rim by the conventional method, there was no difference
in age, body weight, Qp/Qs, ASD size and ASO size or degree of oversizing
(p > 0.05). The percentage of patients with aortic root deficiency was
slightly higher in "tulip-bud" group compared to the conventional group
(63.2% vs. 58.4%; p = 0.039). No complications were observed in either
series. CONCLUSION: This is a promising new method to circumvent some of
the difficulties associated with closure of large ASDs and deficient
aortic rim.
<2>
Accession Number
2010134196
Authors
Cheng D. Martin J. Shennib H. Dunning J. Muneretto C. Schueler S. Von
Segesser L. Sergeant P. Turina M.
Institution
(Cheng, Martin) Department of Anesthesia and Perioperative Medicine,
Evidence-Based Perioperative Clinical Outcomes Research Group (EPiCOR),
London Health Sciences Centre, London, Ont., Canada.
(Shennib) Vascular, Heart and Lung Associates, Phoenix, AZ, United States.
(Dunning) Department Cardiothoracic Surgery, James Cook University
Hospital, Middlesbrough, United Kingdom.
(Muneretto) Department of Cardiac Surgery, University of Brescia Medical
School, Brescia, Italy.
(Schueler) Department for Cardiothoracic Surgery, Freeman Hospital,
Newcastle upon Tyne, United Kingdom.
(Von Segesser) Cardiovascular Surgery, University Hospital CHUV, Lausanne,
Switzerland.
(Sergeant) Cardiac Surgery Department, Gasthuisberg University Hospital,
Leuven, Belgium.
(Turina) Cardiac Surgery, University Hospital Zurich, Zurich, Switzerland.
Title
Endovascular Aortic Repair Versus Open Surgical Repair for Descending
Thoracic Aortic Disease. A Systematic Review and Meta-Analysis of
Comparative Studies.
Source
Journal of the American College of Cardiology. 55(10)(pp 986-1001), 2010.
Date of Publication: 09 Mar 2010.
Publisher
Elsevier USA
Abstract
Objectives: The purpose of this study was to determine whether thoracic
endovascular aortic repair (TEVAR) reduces death and morbidity compared
with open surgical repair for descending thoracic aortic disease.
Background: The role of TEVAR versus open surgery remains unclear.
Metaregression can be used to maximally inform adoption of new
technologies by utilizing evidence from existing trials. Methods: Data
from comparative studies of TEVAR versus open repair of the descending
aorta were combined through meta-analysis. Metaregression was performed to
account for baseline risk factor imbalances, study design, and thoracic
pathology. Due to significant heterogeneity, registry data were analyzed
separately from comparative studies. Results: Forty-two nonrandomized
studies involving 5,888 patients were included (38 comparative studies, 4
registries). Patient characteristics were balanced except for age, as
TEVAR patients were usually older than open surgery patients (p = 0.001).
Registry data suggested overall perioperative complications were reduced.
In comparative studies, all-cause mortality at 30 days (odds ratio [OR]:
0.44, 95% confidence interval [CI]: 0.33 to 0.59) and paraplegia (OR:
0.42, 95% CI: 0.28 to 0.63) were reduced for TEVAR versus open surgery. In
addition, cardiac complications, transfusions, reoperation for bleeding,
renal dysfunction, pneumonia, and length of stay were reduced. There was
no significant difference in stroke, myocardial infarction, aortic
reintervention, and mortality beyond 1 year. Metaregression to adjust for
age imbalance, study design, and pathology did not materially change the
results. Conclusions: Current data from nonrandomized studies suggest that
TEVAR may reduce early death, paraplegia, renal insufficiency,
transfusions, reoperation for bleeding, cardiac complications, pneumonia,
and length of stay compared with open surgery. Sustained benefits on
survival have not been proven. copyright 2010 American College of
Cardiology Foundation.
<3>
Accession Number
2010134187
Authors
Hirohata A. Yamamoto K. Miyoshi T. Hatanaka K. Hirohata S. Yamawaki H.
Komatsubara I. Murakami M. Hirose E. Sato S. Ohkawa K. Ishizawa M. Yamaji
H. Kawamura H. Kusachi S. Murakami T. Hina K. Ohe T.
Institution
(Hirohata, Yamamoto, Murakami, Hirose, Sato, Ohkawa, Ishizawa, Yamaji,
Kawamura, Murakami, Hina, Ohe) Sakakibara Heart Institute of Okayama,
Okayama, Japan.
(Miyoshi, Hatanaka, Hirohata) Okayama University Graduate School of
Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
(Yamawaki) Tottori City Hospital, Tottori, Japan.
(Komatsubara) Tsuyama Central Hospital, Tsuyama, Japan.
(Kusachi) Okayama University Graduate School of Health Sciences, Okayama,
Japan.
Title
Impact of Olmesartan on Progression of Coronary Atherosclerosis. A Serial
Volumetric Intravascular Ultrasound Analysis From the OLIVUS (Impact of
OLmesarten on progression of coronary atherosclerosis: evaluation by
IntraVascular UltraSound) Trial.
Source
Journal of the American College of Cardiology. 55(10)(pp 976-982), 2010.
Date of Publication: 09 Mar 2010.
Publisher
Elsevier USA
Abstract
Objectives: The aim of this study was to evaluate the impact of olmesartan
on progression of coronary atherosclerosis. Background: Prior
intravascular ultrasound (IVUS) trial results suggest slowing of coronary
atheroma progression with some medicines but have not shown convincing
evidence of regression with angiotension-II receptor blocking agents.
Methods: A prospective, randomized, multicenter trial-OLIVUS (Impact of
OLmesartan on progression of coronary atherosclerosis: evaluation by
IntraVascular UltraSound)-was performed in 247 stable angina pectoris
patients with native coronary artery disease. When these patients
underwent percutaneous coronary intervention for culprit lesions, IVUS was
performed in their nonculprit vessels (without angiographically documented
coronary stenosis [<50%]). Patients were randomly assigned to receive 10
to 40 mg of olmesartan or control and treated with a combination of
beta-blockers, calcium channel blockers, diuretics, nitrates, glycemic
control agents, and/or statins per physician's guidance. Serial IVUS
examinations (baseline and 14-month follow-up) were performed to assess
coronary atheroma volume. Volumetric IVUS analyses included lumen, plaque,
vessel volume, percent atheroma volume (PAV), percent change in total
atheroma volume (TAV) and PAV. Results: Patient characteristics and blood
pressure control were identical between the 2 groups. However, follow-up
IVUS showed significantly decreased TAV and percent change in PAV in the
olmesartan group (5.4% vs. 0.6 % for TAV and 3.1% vs. -0.7% for percent
change in PAV, control vs. olmesartan, p < 0.05 for all). Conclusions:
These observations suggest a positive role in a potentially lower rate of
coronary atheroma progression through the administration of olmesartan, an
angiotension-II receptor blocking agent, for patients with stable angina
pectoris. copyright 2010 American College of Cardiology Foundation.
<4>
Accession Number
2010132578
Authors
Allocco D.J. Cannon L.A. Britt A. Heil J.E. Nersesov A. Wehrenberg S.
Dawkins K.D. Kereiakes D.J.
Institution
(Allocco, Britt, Heil, Nersesov, Wehrenberg, Dawkins) Boston Scientific
Corporation, One Boston Scientific Place, Natick, MA 01760, United States.
(Cannon) Cardiac and Vascular Research Center of Northern Michigan,
Northern Michigan Regional Hospital, 560 W Mitchell St., Petoskey, Suite
#480, Petoskey, MI, United States.
(Kereiakes) The Christ Hospital Heart and Vascular Center, The Lindner
Center for Research and Education at The Christ Hospital, 2123 Auburn
Avenue, Suite 424, Cincinnati, OH, United States.
Title
A prospective evaluation of the safety and efficacy of the TAXUS Element
paclitaxel-eluting coronary stent system for the treatment of de novo
coronary artery lesions: Design and statistical methods of the PERSEUS
clinical program.
Source
Trials. 11, 2010. Article Number: 1. Date of Publication: 07 Jan 2010.
Publisher
BioMed Central Ltd.
Abstract
Background: Paclitaxel-eluting stents decrease angiographic and clinical
restenosis following percutaneous coronary intervention compared to bare
metal stents. TAXUS Element is a third-generation paclitaxel-eluting stent
which incorporates a novel, thinner-strut, platinum-enriched metal alloy
platform. The stent is intended to have enhanced radiopacity and improved
deliverability compared to other paclitaxel-eluting stents. The safety and
efficacy of the TAXUS Element stent are being evaluated in the pivotal
PERSEUS clinical trials.Methods/Design: The PERSEUS trials include two
parallel studies of the TAXUS Element stent in single, de novo coronary
atherosclerotic lesions. The PERSEUS Workhorse study is a prospective,
randomized (3:1), single-blind, non-inferiority trial in subjects with
lesion length [less-than or equal to]28 mm and vessel diameter
[greater-than or equal to]2.75 mm to [less-than or equal to]4.0 mm which
compares TAXUS Element to the TAXUS Express2 paclitaxel-eluting stent
system. The Workhorse study employs a novel Bayesian statistical approach
that uses prior information to limit the number of study subjects exposed
to the investigational device and thus provide a safer and more efficient
analysis of the TAXUS Element stent. PERSEUS Small Vessel is a
prospective, single-arm, superiority trial in subjects with lesion length
[less-than or equal to]20 mm and vessel diameter [greater-than or equal
to]2.25 mm to <2.75 mm that compares TAXUS Element with a matched
historical bare metal Express stent control.Discussion: The TAXUS PERSEUS
clinical trial program uses a novel statistical approach to evaluate
whether design and metal alloy iterations in the TAXUS Element stent
platform provide comparable safety and improved procedural performance
compared to the previous generation Express stent. PERSEUS trial
enrollment is complete and primary endpoint data are expected in 2010.
PERSEUS Workhorse and Small Vessel are registered at
http://www.clinicaltrials.gov, identification numbers NCT00484315 and
NCT00489541. copyright 2010 Allocco et al; licensee BioMed Central Ltd.
<5>
Accession Number
2010114375
Authors
Rathe M. Carlsen N.L.T. Oxhoj H. Nielsen G.
Institution
(Rathe, Carlsen) H.C. Andersen Children's Hospital, Odense University
Hospital, Sdr. Boulevard 29, 5000 Odense C, Denmark.
(Oxhoj, Nielsen) Paediatric Cardiology Unit, H.C. Andersen Children's
Hospital, Odense University Hospital, Odense, Denmark.
Title
Long-term cardiac follow-up of children treated with anthracycline doses
of 300 mg/m2 or less for acute lymphoblastic leukemia.
Source
Pediatric Blood and Cancer. 54(3)(pp 444-448), 2010. Date of Publication:
March 2010.
Publisher
Wiley-Liss Inc.
Abstract
Background. The cardiotoxic effect of anthracyclines has been well
described for moderate to high cumulative doses (>350 mg/m2). However, the
question of whether sub-clinical signs of cardiomyopathy may develop and
progress over time in children receiving doses of <350 mg/m 2 is
controversial. The aim of the present study was to examine cardiac
function with serial echocardiography from diagnosis to last follow-up,
relapse, or death, and to investigate whether suspected risk factors
(e.g., age at diagnosis, gender, cumulative dose, and length of follow-up)
had a significant influence on cardiac function. Procedure. An unselected
cohort of 80 patients treated with multi-drug chemotherapy including
anthracycline doses of 300 mg/m2 or less for childhood acute lymphoblastic
leukemia was followed with serial echocardiograms. The deviations of each
echocardiogram from normal values for the same age and body-surface areas
were calculated. The influences of risk factors were analyzed using
univariate and multivariate regression. Lowess curves of time dependence
were calculated. Results. All echocardiographic parameters including
ejection fraction (EF) deteriorated significantly over time. Male gender
was significantly associated with systolic dilatation of the left
ventricle and positively associated with left ventricular mass. Reduction
of EF was significantly associated with age at diagnosis and male gender.
Conclusions. Anthracycline doses of <300 mg/m2 may contribute to a decline
in cardiac function over time. Although the deterioration in cardiac
parameters was not associated with clinical symptoms, life-long cardiac
surveillance for these patients is important to establish the impact of
low-dose anthracycline therapy on long-term cardiac health. copyright 2009
Wiley-Liss, Inc.
<6>
Accession Number
2010109239
Authors
Narin B. Arman A. Arslan D. Simsek M. Narin A.
Institution
(Narin, Arslan, Simsek) Department of Radiology, Haydarpasa Numune
Education and Research Hospital, Istanbul, Turkey.
(Arman) Department of Radiology, Euromed Visualization Center, Istanbul,
Turkey.
(Narin) Department of Cardiology, Dr. Siyami Ersek Education and Research
Hospital, Istanbul, Turkey.
Title
Assessment of cardiac masses: Magnetic resonance imaging versus
transthoracic echocardiography.
Source
Anadolu Kardiyoloji Dergisi. 10(1)(pp 69-74), 2010. Date of Publication:
2010.
Publisher
Aves Yayincilik
Abstract
Objective: The purpose of this study is to compare the role of magnetic
resonance imaging (MRI) with transthoracic echocardiography (TTE) for
characterization of cardiac masses. Methods: Twenty-three patients were
examined with a 1.5T MRI Scanner and TTE for the evaluation of suspected
intracardiac masses. MRI examinations were performed with a protocol of
steady cine imaging, HASTE and 3D IR-FLASH sequence after administration
of gadolinium chelate. All patients were examined with MRI within a period
of 1-2 weeks after TTE. Results: According to the results of MRI, 15
patients underwent cardiac surgery. All of the operated patients were
proven to have cardiac tumors with no false positive diagnosis on MRI. In
3 of 8 unoperated patients who were diagnosed to have cardiac tumors on
TTE, cardiac thrombi were identified on MRI. Two patients with Eustachian
valve in the right atrium on MRI were misinterpreted as having cardiac
masses on TTE. In one patient with known renal cancer, metastases were
diagnosed within the myocardium on MRI. TTE demonstrated a mass in the
left atrium in one patient with a history of myxoma operation, whereas MRI
was able to show the paracardiac extension of the mass into pulmonary
veins and lung metastases, which are indicators of malignant
transformation. In one patient, a mediastinal mass compressing the left
atrium on MRI was misinterpreted as an intracavitary lesion with TTE.
Conclusion: Contrast enhanced MRI is a noninvasive method superior to TTE
in diagnosis, differentiation, and detection of extension of cardiac
masses. copyrightCopyright 2010 by AVES Yayincilik Ltd.
<7>
Accession Number
2010096174
Authors
Saso S. Vecht J.A. Rao C. Protopapas A. Ashrafian H. Leff D. Darzi A.
Athanasiou T.
Institution
(Saso, Vecht, Rao, Protopapas, Ashrafian, Leff, Darzi, Athanasiou)
Department of Biosurgery-Surgical Technology, Imperial College London, St.
Mary's Hospital, London W2 1NY, United Kingdom.
Title
Statin therapy may influence the incidence of postoperative atrial
fibrillation: What is the evidence?.
Source
Texas Heart Institute Journal. 36(6)(pp 521-529), 2009. Date of
Publication: 2009.
Publisher
Texas Heart Institute
Abstract
Atrial fibrillation is the most common postoperative arrhythmia in
patients who undergo cardiac surgery. We sought to determine whether the
administration of statins reduces the incidence of postoperative atrial
fibrillation in cardiac surgery patients. We performed a meta-analysis on
all studies published between 2004 and 2008 that reported comparisons
between statin treatment or nontreatment in these patients. Our primary
focus was the incidence of postoperative atrial fibrillation.
Random-effects modeling and sensitivity analysis were used to evaluate the
consistency of the calculated treatment effect. Ten qualifying studies
generated a total of 4,459 patients. The incidence of postoperative atrial
fibrillation was 22.6% (622/2,758) in the statin-treated group and 29.8%
(507/1,701) in the untreated group. Using the random-effects model, we
calculated an odds ratio (OR) of 0.60 (95% confidence interval [CI],
0.48-0.76). When we considered only the 4 randomized studies (919
patients) in order to reduce the effects of heterogeneity, this
significant reduction in the incidence of postoperative atrial
fibrillation in the statin group was maintained (OR, 0.55; 95% CI,
0.41-0.73) with no heterogeneity (chi2 of heterogeneity, 2.96; P=0.4). In
studies wherein only coronary artery bypass grafting was performed, statin
treatment decreased postoperative atrial fibrillation (OR, 0.64; 95% CI,
0.43-0.95). We conclude that statin administration results in a reduction
in the incidence of atrial fibrillation in patients who undergo cardiac
surgery. Further research into the underlying mechanism can elucidate
possible relationships between the dosage and type of statin used.
copyright 2009 by the Texas Heart Institute.
<8>
Accession Number
2010134120
Authors
Van Munster B.C. De Rooij S.E.J.A. Yazdanpanah M. Tienari P.J. Pitkala
K.H. Osse R.J. Adamis D. Smit O. Van Der Steen M.S. Van Houten M. Rahkonen
T. Sulkava R. Laurila J.V. Strandberg T.E. Tulen J.H.M. Zwang L. MacDonald
A.J.D. Treloar A. Sijbrands E.J.G. Zwinderman A.H. Korevaar J.C.
Institution
(Van Munster, Zwinderman, Korevaar) Department of Clinical Epidemiology
and Biostatistics, Academic Medical Center, University of Amsterdam,
Amsterdam, Netherlands.
(Van Munster, De Rooij) Department of Internal Medicine, Academic Medical
Centre, P.O. Box 22660, 1100 DD Amsterdam, Netherlands.
(Yazdanpanah, Sijbrands) Department of Internal Medicine, Erasmus MC,
Rotterdam, Netherlands.
(Tienari) Department of Neurology, Helsinki University Central Hospital,
Helsinki, Finland.
(Pitkala) Helsinki University Central Hospital, Unit of General Practice,
Helsinki, Finland.
(Osse, Tulen) Department of Psychiatry, Erasmus MC, Rotterdam,
Netherlands.
(Adamis) Psychiatry, Research and Academic Institute of Athens, Athens,
Greece.
(Smit) Department of Internal Medicine, VU Medical Center, Amsterdam,
Netherlands.
(Van Der Steen) Intensive Care, Gelderse Vallei Hospital, Ede,
Netherlands.
(Van Houten) Department of Geriatrics, Parnassia, Den Haag, Netherlands.
(Rahkonen, Sulkava) Department of Geriatrics, School of Public Health and
Clinical Nutrition, University of Kuopio, Kuopio, Finland.
(Laurila) Helsinki University Central Hospital, Clinics of General
Internal Medicine and Geriatrics, Helsinki, Finland.
(Strandberg) Oulu University Hospital, Unit of General Practice, Oulu,
Finland.
(Zwang) Department of Clinical Chemistry, Erasmus MC, Rotterdam,
Netherlands.
(MacDonald) Elderly Care Unit, St. Thomas' Hospital, Westminster, London,
United Kingdom.
(Treloar) Memorial Hospital, Shooters Hill, London, United Kingdom.
(Tienari) Molecular Neurology Programme, University of Helsinki, Helsinki,
Finland.
Title
The association of the dopamine transporter gene and the dopamine receptor
2 gene with delirium, a meta-analysis.
Source
American Journal of Medical Genetics, Part B: Neuropsychiatric Genetics.
153(2)(pp 648-655), 2010. Date of Publication: March 2010.
Publisher
Wiley-Liss Inc.
Abstract
Delirium is the most common neuropsychiatric syndrome in elderly ill
patients. Previously, associations between delirium and the dopamine
transporter gene (solute carrier family 6, member 3 (SLC6A3)) and dopamine
receptor 2 gene (DRD2) were found. The aim of this study was to validate
whether markers of the SLC6A3 and DRD2 genes are were associated with
delirium in independent populations. Six European populations collected
DNA of older delirious patients. Associations were determined per
population and results were combined in a meta-analysis. In total 820
medical inpatients, 185 cardiac surgery patients, 134 non-cardiac surgery
patients and 502 population-based elderly subjects were included. Mean age
was 82 years (SD 7.5 years), 598 (36%) were male, 665 (41%) had
pre-existing cognitive impairment, and 558 (34%) experienced delirium. The
SLC6A3 rs393795 homozygous AA genotype was more frequent in patients
without delirium in all populations. The meta-analysis showed an Odds
Ratio (OR) for delirium of 0.4 (95% confidence interval (C.I.) 0.2-0.6,
P=0.0003) for subjects with AA genotype compared to the AG and GG
genotypes. SLC6A3 marker rs1042098 showed no association with delirium. In
meta-analysis the DRD2 rs6276 homozygous GG genotype showed an OR of 0.8
for delirium (95% C.I. 0.6-1.1, P=0.24). When subjects were stratified for
cognitive status the rs6276 GG genotype showed ORs of 0.6 (95% C.I.
0.4-1.0, P=0.06) and 0.8 (95% C.I. 0.5-1.5, P=0.51) for delirium in
patients with and without cognitive impairment, respectively. In
independent cohorts, a variation in the SLC6A3 gene and possibly the DRD2
gene were found to protect for delirium. copyright 2009 Wiley-Liss, Inc.
<9>
Accession Number
2010112112
Authors
Zahn R. Hamm C.W. Schneider S. Richardt G. Kelm M. Levenson B. Bonzel T.
Tebbe U. Sabin G. Nienaber C.A.
Institution
(Zahn) Herzzentrum, Kardiologie, Ludwigshafen, Germany.
(Hamm) Kerckhoff Klinik, Kardiologie, Bad Nauheim, Germany.
(Schneider) Institut fur Herzinfarktforschung, Ludwigshafen, Germany.
(Richardt) Segeberger Kliniken, Kardiologie, Bad Segeberg,
(Kelm) Universitatsklinikum, Kardiologie, Aachen, Germany.
(Levenson) Kardiologische Praxis, Berlin, Germany.
(Bonzel) Klinikum Fulda, Kardiologie, Fulda, United States.
(Tebbe) Klinikum Lippe-Detmold, Kardiologie, Detmold,
(Sabin) Elisabeth Krankenhaus, Kardiologie, Essen, Germany.
(Nienaber) Universitatsklinikum, Kardiologie, Rostock, Germany.
Title
Coronary stenting with the sirolimus-eluting stent in clinical practice:
Final results from the prospective multicenter german cypher stent
registry.
Source
Journal of Interventional Cardiology. 23(1)(pp 18-25), 2010. Date of
Publication: February 2010.
Publisher
Blackwell Publishing Inc.
Abstract
Aims: Drug-eluting coronary stents (DES) have gained widespread use for
the treatment of coronary artery disease. However, because of safety
concerns and frequent "off-label" use data from "real life," registries
are necessary to monitor indications and outcome of DES in daily clinical
practice. Methods and Results: We evaluated data from the German Cypher
Stent Registry. A total of 10,894 patients treated with at least one
sirolimus-eluting stent (SES) at 152 hospitals were included. Follow-up at
a median of 6.4 months was available in 10,006 patients (92%). Median age
was 64.8 years and 75.5% were male. Per lesion a mean of 1.09 +/- 0.41 SES
were implanted with a mean length of 21.1 +/- 11.5mm. During follow-up,
death rate was 1.8% and the rates of myocardial infarction or stroke were
2.1% and 0.5%. Any target vessel revascularization (TVR) was performed in
8.0% of patients. Independent predictors for death, myocardial infarction,
or stroke were: cardiogenic shock, acute coronary syndromes, reduced left
ventricular function, renal insufficiency, diabetes mellitus, advanced
age, three-vessel disease, degree of stenosis, and prior myocardial
infarction. Predictors for a TVR were: two- or three-vessel disease,
target vessel = coronary bypass, advanced age, stent diameter, ostial
lesions, indication in-stent restenosis, renal failure, and target vessel
= left anterior descended artery. Conclusions: These results demonstrate
that SES use in clinical practice is safe and effective. The main
predictors of clinical events during follow-up are clinical parameters
whereas as predictors of TVR mainly are angiographic parameters. copyright
2009, Wiley Periodicals, Inc.
<10>
Accession Number
2010119647
Authors
Stassano P. Di Tommaso L. Monaco M. Mannacio V.A. Mottola M. La Marca A.
Pepino P. Vosa C.
Institution
(Stassano, Di Tommaso, Mannacio, Mottola, La Marca, Vosa) Cardiac Surgery
Unit, University Federico II, School of Medicine, Naples, Italy.
(Monaco, Pepino) Cardiac Surgery Unit, Istituto Clinico Pineta Grande,
Castelvolturno, Italy.
Title
Left ventricular-assisted myocardial revascularization favorably affects
levels of circulating adhesion molecules and lung function.
Source
Surgery. 147(3)(pp 434-440), 2010. Date of Publication: March 2010.
Publisher
Mosby Inc.
Abstract
Background: We investigated whether the use of left ventricular-assisted
(LVA) technique in beating heart myocardial revascularization would exert
less impact on patients adhesion molecules and oxygenation index as
compared with conventional cardiopulmonary bypass (CPB). Methods:
Sixty-six consecutive patients undergoing myocardial revascularization
were randomly assigned either to LVA (group A, 34 patients) or CPB (group
B, 32 patients). Adhesion molecules and oxygenation indexes were measured
at baseline and at various time points postoperatively. Results:
Pre-operative clinical and demographic data did not differ between the 2
groups. The 2 groups were also similar with respect to mortality, number
of grafts performed, duration of extracorporeal circulation, and need for
inotropes. However, postoperatively patients treated with LVA had a
reduced levels of adhesion molecules compared with patients treated with
CPB, as indicated by a significant difference in endothelial leukocyte
adhesion molecule-1 (P = .002), intercellullar adhesion molecule-1 (P =
.0001), and vascular cell adhesion molecule-1 (P = .004). The oxygenation
index at 1 (P = .04) and 3 hours (P = .03) postoperatively was better in
the LVA group than in the CPB group. Conclusion: Patients undergoing
beating heart myocardial revascularization with LVA show reduced levels of
adhesion molecules and better oxygenation index than patients treated with
CPB. copyright 2010 Mosby, Inc. All rights reserved.
<11>
Accession Number
2010088426
Authors
Inaba Y. Bergmann S.R.
Institution
(Inaba) Division of Cardiovascular Medicine, Oregon Health and Science
University, UHN62, 3181 SW Sam Jackson Park Road, Portland, OR 97239,
United States.
(Bergmann) Division of Cardiology, Beth Israel Medical Center, New York,
NY, United States.
Title
Prognostic value of myocardial metabolic imaging with BMIPP in the
spectrum of coronary artery disease: A systematic review.
Source
Journal of Nuclear Cardiology. 17(1)(pp 61-70), 2010. Date of
Publication: February 2010.
Publisher
Springer New York
Abstract
Background: We conducted a systematic review to summarize the current
literature on the prognostic value of BMIPP imaging, fatty-acid metabolic
imaging, for the prediction of cardiovascular events in coronary artery
disease. Methods and Results: Electronic databases (including Japanese
medical literature search engines) were searched by a Japanese
investigator using a predefined search strategy. Eleven studies, all
conducted in Japan, were included in the meta-analysis. In three studies
involving 541 patients with suspected acute coronary syndrome who were
excluded for acute myocardial infarction (AMI), an abnormal finding on
BMIPP imaging was significantly associated with future hard events
(cardiac death or non-fatal myocardial infarction). The negative
predictive value of BMIPP imaging for future hard events was 98.9%
(96.8-99.7%) over 3.5 years. In six studies involving 542 patients with
AMI, a larger defect on BMIPP imaging was significantly associated with
future hard events. The prognostic value of perfusion-metabolism mismatch
compared with myocardial perfusion imaging was dependent upon the relative
timing of BMIPP imaging, revascularization, and myocardial perfusion
damage. Conclusions: BMIPP imaging is useful for the risk stratification
of patients with coronary artery disease, particularly patients with acute
chest pain. copyright 2009 American Society of Nuclear Cardiology.
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Accession Number
0020042769
Authors
Saravanan P. Bridgewater B. West A.L. O'Neill S.C. Calder P.C. Davidson
N.C.
Institution
(Saravanan, Bridgewater, West, O'Neill, Calder, Davidson) University of
Manchester, Manchester, United Kingdom.
Title
Omega-3 fatty acid supplementation does not reduce risk of atrial
fibrillation after coronary artery bypass surgery: a randomized,
double-blind, placebo-controlled clinical trial..
Source
Circulation. Arrhythmia and electrophysiology. 3(1)(pp 46-53), 2010. Date
of Publication: 1 Feb 2010.
Abstract
BACKGROUND: Omega-3 polyunsaturated fatty acids (n-3 PUFA) have been
reported to reduce the risk of sudden cardiac death presumed to be due to
fatal ventricular arrhythmias, but their effect on atrial arrhythmias is
unclear. METHODS AND RESULTS: Patients (n=108) undergoing coronary artery
bypass graft surgery were randomly assigned to receive 2 g/d n-3 PUFA or
placebo (olive oil) for at least 5 days before surgery (median, 16 days;
range, 12 to 21 days). Phospholipid n-3 PUFA were measured in serum at
study entry and at surgery and in right atrial appendage tissue at
surgery. Echocardiography was used to assess left ventricular function and
left atrial dimensions. Postoperative continuous ECG monitoring (Lifecard
CF) for 5 days or until discharge, if earlier, was performed with a daily
12-lead ECG and clinical review if patients remained in the hospital
beyond 5 days. Lifecard recordings were analyzed for episodes of atrial
fibrillation (AF) > or =30 seconds (primary outcome). Clinical AF, AF
burden (% time in AF), hospital stay, and intensive care/high dependency
care stay were measured as secondary outcomes. One hundred three patients
completed the study (51 in the placebo group and 52 in the n-3 PUFA
group). There were no clinically relevant differences in baseline
characteristics between groups. n-3 PUFA levels were higher in serum and
right atrial tissue in the active treatment group. There was no
significant difference between groups in the primary outcome of AF (95%
confidence interval [CI], -6% to 30%, P=0.28) in any of the secondary
outcomes or in AF-free survival. CONCLUSIONS: Omega-3 PUFA do not reduce
the risk of AF after coronary artery bypass graft surgery. Clinical Trial
Registration- www.ukcrn.org.uk. Identifier: 4437.
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Accession Number
2010088996
Authors
Bloch M.J. Basile J.N.
Institution
(Bloch) Division of General Internal Medicine/Division of Cardiology,
University of Nevada School of Medicine, United States.
(Bloch) Risk Reduction Center, Saint Mary's Regional Medical Center, Reno,
NV, United States.
(Basile) Primary Care Service Line, Ralph H. Johnson VA Medical Center,
United States.
(Basile) Division of General Internal, Medicine/Geriatrics, Medical
University of South Carolina, Charleston, SC, United States.
Title
A lower blood pressure goal in patients without diabetes lessens the
occurrence of left ventricular hypertrophy.
Source
Journal of Clinical Hypertension. 12(2)(pp 109-111), 2010. Date of
Publication: February 2010.
Publisher
Blackwell Publishing Inc.
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Accession Number
2010103753
Authors
Carnlof C. Insulander P. Pettersson P.H. Jensen-Urstad M. Fossum B.
Institution
(Carnlof, Insulander, Jensen-Urstad) Department of Cardiology Karolinska
University Hospital, Stockholm, Sweden.
(Pettersson) Red Cross University College, Stockholm, Sweden and
Department of Molecular Medicine and Surgery, Karolinska Institute,
Stockholm, Sweden.
(Fossum) Sophiahemmet University College, Stockholm, Sweden and Department
of Public Health Sciences, Department of Clinical Sciences Danderyds
Hospital, Stockholm, Sweden.
(Insulander, Jensen-Urstad) Department of Medicine, Karolinska Institute,
Huddinge, Stockholm, Sweden.
Title
Health-related quality of life in patients with atrial fibrillation
undergoing pulmonary vein isolation, before and after treatment.
Source
European Journal of Cardiovascular Nursing. 9(1)(pp 45-49), 2010. Date of
Publication: March 2010.
Publisher
Elsevier
Abstract
Background: Atrial fibrillation (AF) is the most common arrhythmia and
many AF patients experience a significantly impaired health-related
quality of life (HRQOL). AF is also associated with a high risk of stroke
and death. Many pharmacologic treatments for AF are ineffective and may
have adverse effects. New methods, such as pulmonary vein isolation (PVI),
have been developed to treat AF. Aims: The aim of this study was to
investigate the HRQOL issues in severe symptomatic AF patients before and
after pulmonary vein isolation. Methods: Forty patients treated with PVI
were included of which 36 concluded the study with the self-reported HRQOL
questionnaires before and once after PVI. A standardized control group was
used. Results: Compared to the control group the HRQOL before PVI was
significantly lower in all domains except for bodily pain. The
preoperative scores were compared with the scores obtained at the
follow-up. All subscales of the SF-36 significantly improved after the PVI
except for bodily pain, which remained unaltered. Conclusion: HRQOL is
improved in AF patients with severe symptoms after PVI intervention.
copyright 2009 European Society of Cardiology.
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