Kirkegaarddamborg6067

A decreased hypercapnic ventilatory response of the overweight patients would lower the ventilation equivalent of carbon dioxide (VE/VCO

) slope but worsen prognosis. The aim of this study was to compare the prognostic ability of the VE/VCO

slope and peak oxygen consumption (pVO

) between normal and overweight heart failure (HF) patients.

Prospective evaluation of ambulatory patients with reduced left ventricular ejection fraction who underwent baseline assessment with a cardiopulmonary exercise test. check details The primary endpoint was cardiac death or urgent heart transplantation in the 5-year period of follow-up. The predictive power of VE/VCO

slope and pVO

were compared (area under the curve (AUC) analysis and Hanley & McNeil test), in the subgroups of patients with body mass index (BMI) of 18.5-24.9 kg/m

and ≥ 25 kg/m

. Statistical differences with a

value < 0.05 were considered significant.

There were 270 enrolled patients, with a mean BMI of 27 ± 4 kg/m

. No differences between normal and overweight patients (38.0% vs 29.8%, P=0.170) were found during the 5-year period for the primary endpoint. The VE/VCO

slope was non-inferior to pVO

in both groups at 1, 3 and 5 years of follow-up. The comparison of VE/VCO

slope between groups revealed a significant lower AUC at 3 (0.921 vs 0.787, P=0.022) and 5 years (0.898 vs 0.787, P=0.044) of follow-up for overweight patients.

Despite VE/VCO

slope provides a discriminative power at least as good as pVO

for predicting adverse events in both normal and overweight HF patients, a significant lower predictive power was found in overweight patients.

Despite VE/VCO2 slope provides a discriminative power at least as good as pVO2 for predicting adverse events in both normal and overweight HF patients, a significant lower predictive power was found in overweight patients.The Mediterranean diet, based on a rural life where people ate what they grew, has shown cardiovascular benefits. Cross-sectional study of congenital heart disease (CHD) patients recruited consecutively from a single hospital outpatient clinic with the aim of determining their adherence to the Mediterranean diet according to the PREDIMED questionnaire. CHD complexity was categorized as simple, moderate, or great and demographic, clinical and blood test data were recorded. link2 200 CHD patients, median age 28 (16-54) years old and 120 (60%) males were studied. 45 (22.5%), 122 (61%) and 33 (16.5%) CHD patients had simple, moderate, and great complexity defects respectively. PREDIMED score was classified as low (score 0-5), intermediate (6-9) or high (> 9). 146 (83%) CHD patients showed a suboptimal Mediterranean diet adherence (PREDIMED score less then 9) with less than half of patients eating enough vegetables, fruits, legumes, fish or nuts but with a high intake of butter/margarine, commercial sweets and carbonated beverages. No significant differences were seen between sex, body mass index, cardiovascular risk factors, CHD complexity or the educational level and the PREDIMED scores. Only being married was associated with a significant lower Mediterranean diet adherence (P=0.019). Meanwhile, no statistical significance was observed between serum glucose, creatinine, uric acid, albumin, LDL cholesterol, HDL cholesterol or triglycerides levels according to the PREDIMED classification (low, intermediate or high adherence). Conclusions CHD patients have a low adherence to the Mediterranean diet with a low intake of vegetables, fruits, legumes, and fish.

Overweight/obesity has predicted cardiovascular disease (CVD) risk for long with its standard measure of body mass index (BMI), which later was found to mis-classify risk oftentimes. This is because it does not differentiate between fat and whole body mass. The finding that fat especially visceral fat was more culpable shifted attention to ectopic fat as a more precise measure of CVD risk. link3 Peri-renal fat (PRF) is one such ectopic foci, which is hardly used despite the relative ease of assessment. We assessed PRF to correlate it with carotid intima media thickness (CIMT) to see if there was any significance in order to obviate need for heavy equipment in CVD risk assessment.

This is secondary analysis of data generated in the course of studying sub-clinical atherosclerosis in apparently normal individuals. Subjects underwent routine anthropometry to determine BMI. They then underwent abdominal ultrasound studies wherein PRF was measured as the size of the echogenic strip between the posterior part of the lcontrol CVD in the population.

PRF has shown to be correlated significantly with indices that predict atherosclerosis. Being an ectopic fat focus, its local and systemic effects on the kidney increase systemic vascular resistance and CVD. Since it can easily be measured on abdominal ultrasound, a test readily available and requiring lower level skills it should be used to advantage. Levels above 0.26 cm should prompt initiation of curative or preventive action to control CVD in the population.

Many patients with dilated cardiomyopathy (DCMP), presenting with only dyspnea, have hidden ischemic etiology. In low-income countries, logistic and financial restraints lead to reduced identification of this ischemic burden. We aimed to assess the role of coronary angiography in patients with cardiomyopathy presenting predominantly dyspnea.

This was a single-center, prospective, observational study conducted at a tertiary-care center in North India over the period of one year. The study population consisted of patients with dyspnea (NYHA II and III) and left ventricular dysfunction [i.e., left ventricular ejection fraction (< 40%)] without a prior documented coronary artery disease (CAD). All patients underwent invasive coronary angiography to detect underlying occult CAD.

A total of 209 patients with global left ventricular hypokinesia (LVEF) were enrolled. Almost half of the study population belonged to the 51-60-year-old group. Diabetes mellitus and smoking were most prevalent risk factors observed in 93 (44.5%) and 92 (44.1%) patients, respectively. Abnormal coronaries were detected in 75 (35.9%) patients; 44 (58.7%) and 29 (38.7%) patients had significant and insignificant CAD, respectively. Single-, double-, and triple-vessel disease was observed in 18 (40.9%), 14 (31.8%), and 12 (27.3%) patients, respectively. The mean age (54.08 ± 6.02 years), LVEF (39.83 ± 3.27%), SYNTAX score (17.14 ± 2.21), and left ventricular internal dimensions (4.93 ± 0.44 cm) were all statistically insignificant.

Patients with DCMP presenting predominantly with dyspnea and having silent underlying significant CAD may benefit from revascularization if CAD is detected by angiography on time.

Patients with DCMP presenting predominantly with dyspnea and having silent underlying significant CAD may benefit from revascularization if CAD is detected by angiography on time.

Recent studies have suggested that the routine use of aspiration thrombectomy catheters during primary percutaneous coronary intervention (PCI) do not result in improved mortality and may be associated with an increased stroke rate. This study sought to investigate this hypothesis.

This was an observational study analysing data from a prospective database of 6366 patients undergoing primary PCI between August 2003 and May 2015 at a UK cardiac centre. Patients' details were collected from the hospital electronic database. Primary outcome was thirty-day stroke rates.

3989 (62.7%) patients underwent PCI alone and 2,377 (37.3%) patients underwent PCI with adjuctive thrombus aspiration. PCI alone group had an older demographic (63 (± 14) years vs 60.7 (± 14)), a lower proportion of male participants 75% vs 79% (P=0.001) and cardiovascular risk factors such as hypertension 22.4% vs 25.3% (P=0.007), hypercholesterolemia 18.5% vs 22.6% (P<0.0001) and a history of smoking 33.5% vs 44.3% (P<0.0001). Thrombund the routine use of thrombus aspiration for primary PCI. A possible mortality reduction in patients with high thrombus grades was seen which may warrant further study.

Our data series of STEMI patients, suggest that routine thrombus aspiration during primary PCI is associated with a significantly higher stroke, rate however, thrombus aspiration reduced mortality rate. This is consistent with current guidelines which don't recommend the routine use of thrombus aspiration for primary PCI. A possible mortality reduction in patients with high thrombus grades was seen which may warrant further study.Intracardiac echocardiography (ICE) has emerged as an alternative to transesophageal echocardiography (TEE) to guide implantation of percutaneous left atrial appendage closure (LAAC) devices in patients with atrial fibrillation (AF) and a high bleeding risk. We reviewed the efficacy and safety of ICE compared to TEE in LAAC in this updated meta-analysis. Medline, CINAHL, EMBASE and Scopus were systematically searched for studies comparing ICE and TEE in percutaneous LAAC. Our primary outcomes of interest were procedural success and study reported periprocedural complications. Secondary outcomes included various procedural characteristics. Risk ratios (RR), standardized mean differences (SMD) and their corresponding 95% confidence intervals (CI) were calculated. The analysis was performed using a random-effect model. Nine observational studies met our inclusion criteria with a total of 2620 patients (ICE 679 and TEE 1941). Mean CHA2DS2-Vasc (4.4 ± 0.3 for ICE vs 4.5 ± 0.3 for TEE, P = 0.60) and HAS-BLED (3.2 ± 0.4 vs 3.1 ± 0.6, P = 0.78) scores were comparable between the two groups. There was no significant difference in procedure success rate (RR 1.01, 95% CI 0.99-1.02, P= 0.31) and periprocedural complications (RR 0.85, 95% CI 0.59-1.23, P = 0.39). No significant difference was observed in procedure duration, fluoroscopy time and contrast volume used while a trend towards decreased hospital length of stay was seen with the use of ICE. Thus, our updated meta-analysis shows ICE is as effective and safe as TEE for implantation of LAAC devices.

To evaluate safety and efficacy of endovascular stenting for aortic coarctation (AC) and to explore the effect of clinical parameters and stent characteristics on outcomes.

Clinical data of all patients with AC who had attempted transcatheter stenting between 2004 and 2019 were retrospectively reviewed. Eligible patients had native or recurrent AC with systemic arterial hypertension and resting arm-leg pressure gradient > 20 mmHg. Exclusions included distance between takeoff of cervical arteries and stenotic aortic lesion < 10 mm, contraindication to antithrombotic therapy, bodyweight < 25 kg, and secondary hypertension.

A total of 20 patients (75.0% with native lesions) were included with a mean age of 18.4 years and a mean bodyweight of 59.2 kg. Procedure was successful in 90.0% of cases with an immediate drop in the invasive pressure gradient across lesions. On a median follow-up of 12 months (range, 8 to 144.9 months), coarctation reoccurred in five patients, but four of them required intervention after a median of 104.4 months with successful outcomes. Cheatham Platinum stents were significantly associated with lower rates of recoarctations and reinterventions. At the latest follow-up, three out of six patients with persistent hypertension had no recoarctation. Analysis showed that the need for antihypertensive therapy was not influenced by clinical parameters, aortic arch geometry, or stent characteristics.

Treating AC with stent implantation is a safe and successful procedure. Using Cheatham Platinum stents appears to be associated with better outcomes. The persistence of arterial hypertension despite successful stenting remains a complex and challenging phenomenon.

Treating AC with stent implantation is a safe and successful procedure. Using Cheatham Platinum stents appears to be associated with better outcomes. The persistence of arterial hypertension despite successful stenting remains a complex and challenging phenomenon.