Article
Cardiac & Cardiovascular Systems
Yader Sandoval, Fred S. Apple, Simon A. Mahler, Richard Body, Paul O. Collinson, Allan S. Jaffe
Summary: The guidelines for the evaluation and diagnosis of acute chest pain released by multiple associations in 2021 provide important recommendations, including the use of high-sensitivity cardiac troponin (hs-cTn) as the preferred biomarker, defining myocardial injury with 99th percentile upper reference limits, and utilizing clinical decision pathways. However, the guidelines do not extensively address the details of integrating hs-cTn into clinical practice, and clinicians need to be aware of analytical aspects related to hs-cTn assays and how to best use it with clinical decision pathways.
Article
Medicine, General & Internal
Chunpeng Ma, Xiaoli Liu, Lixiang Ma
Summary: A new risk score has been developed for assessing the risk of acute chest pain patients without known coronary artery disease and ST-segment deviation, and with normal high-sensitivity troponin I levels, aiding in the assessment of major adverse cardiac events risk and patient triage in the emergency department.
FRONTIERS IN MEDICINE
(2022)
Article
Cardiac & Cardiovascular Systems
Cian McCarthy, Shuang Li, Tracy Y. Wang, Inbar Raber, Yader Sandoval, Nathaniel R. Smilowitz, Jason H. Wasfy, Ambarish Pandey, James A. de Lemos, Michael C. Kontos, Fred S. Apple, Lori B. Daniels, L. Kristin Newby, Allan S. Jaffe, James L. Januzzi
Summary: This study found that the implementation of high-sensitivity cardiac troponin assays in US hospitals is increasing, but the majority of hospitals still use less sensitive assays. The use of high-sensitivity cardiac troponin assays was associated with increased use of echocardiography for NSTE-ACS patients and reduced use of invasive coronary angiography for low-risk chest pain patients.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2023)
Review
Cardiac & Cardiovascular Systems
Stephen Boone, W. Frank Peacock
Summary: This review examines the strengths and limitations of conventional and high-sensitivity troponin in evaluating patients with suspected acute coronary syndromes. High-sensitivity troponin assays offer improved analytical precision, allowing for quicker diagnosis and exclusion of myocardial infarction. Furthermore, when implemented correctly, these assays can reduce the need for extended observation and testing.
REVIEWS IN CARDIOVASCULAR MEDICINE
(2022)
Review
Cardiac & Cardiovascular Systems
Connor M. O'Rielly, Tyrone G. Harrison, James E. Andruchow, Paul E. Ronksley, Tolu Sajobi, Helen Lee Robertson, Diane Lorenzetti, Andrew D. McRae
Summary: Chest pain is a common reason for emergency department visits, and clinical risk scores can help guide decisions on testing after ruling out myocardial infarction. This systematic review found that the HEART score with a cutoff value of 3 or less accurately identified the largest number of emergency department patients at low risk of major adverse cardiac events within 30 days, after ruling out myocardial infarction using high-sensitivity troponin testing.
CANADIAN JOURNAL OF CARDIOLOGY
(2023)
Article
Cardiac & Cardiovascular Systems
Laura De Michieli, Monica De Gaspari, Giulio Sinigiani, Alessandro Lupi, Luca Vedovelli, Alessandro Salvalaggio, Mila Della Barbera, Stefania Rizzo, Kalliopi Pilichou, Diego Cecchin, Chiara Briani, Dario Gregori, Giuseppe Tarantini, Tamara Berno, Livio Trentin, Cristina Basso, Domenico Corrado, Sabino Iliceto, Martina Perazzolo Marra, Alberto Cipriani
Summary: Chest pain is a common symptom in patients with cardiac amyloidosis, indicating advanced cardiac impairment and predicting future heart failure hospitalization. The etiology of chest pain differs between different types of cardiac amyloidosis, with obstructive coronary artery disease more common in transthyretin amyloidosis and amyloid vascular/perivascular involvement more common in light chain amyloidosis.
INTERNATIONAL JOURNAL OF CARDIOLOGY
(2023)
Article
Cardiac & Cardiovascular Systems
Na Yan, Ling Wei, Zhiwei Li, Yu Song
Summary: This study aimed to establish a clinical prediction model for risk stratification of acute chest pain patients based on rapid cardiac troponin testing and other clinical variables. The model, which included variables such as ECG results, troponin levels, hypotension, chest pain symptoms, Killip class, and gender, showed superior diagnostic accuracy compared to the GRACE score.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2023)
Article
Emergency Medicine
Jason P. Stopyra, Anna C. Snavely, Nicklaus P. Ashburn, R. Darrell. Nelson, Evan L. McMurray, Meagan R. Hunt, Chadwick D. Miller, Simon A. Mahler
Summary: Utilizing EMS blood collection for troponin measurement can significantly reduce Emergency Department (ED) length of stay (LOS) for patients with acute chest pain in the United States, while proving to be safe when integrated into the HEART Pathway.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2021)
Article
Medical Informatics
Pontus Olsson de Capretz, Anders Bjoerkelund, Jonas Bjoerk, Mattias Ohlsson, Arash Mokhtari, Axel Nystroem, Ulf Ekelund
Summary: The study aimed to evaluate machine learning models for identifying acute myocardial infarction (AMI) or death within 30 days among emergency department chest pain patients. Models based on logistic regression or artificial neural networks were created using data from 9519 patients. The best model, a convolutional neural network, achieved high sensitivity and specificity levels while ensuring safe rule-out or rule-in of patients without the need for serial blood tests. Comparison with the ESC 0 h algorithm showed superior performance.
BMC MEDICAL INFORMATICS AND DECISION MAKING
(2023)
Article
Medicine, General & Internal
Andreas Roos, Eva Sedin, Gustaf Edgren
Summary: This study in Sweden found that patients with psychiatric disorders who present with chest pain receive different management and have different outcomes compared to those without psychiatric disorders. Patients with affective or psychotic disorders had a reduced risk of myocardial infarction, but were less likely to receive cardiovascular medications or undergo percutaneous coronary intervention. On the other hand, patients with psychiatric disease had an increased risk of being diagnosed with a myocardial infarction within 30 days after the visit.
JOURNAL OF INTERNAL MEDICINE
(2023)
Article
Cardiac & Cardiovascular Systems
Maros Ferencik, Thomas Mayrhofer, Michael T. Lu, Daniel O. Bittner, Hamed Emami, Stefan B. Puchner, Nandini M. Meyersohn, Alexander V. Ivanov, Elizabeth C. Adami, Deepak Voora, Geoffrey S. Ginsburg, James L. Januzzi, Pamela S. Douglas, Udo Hoffmann
Summary: This study found that biomarkers of inflammation and myocardial injury were associated with characteristics of coronary artery disease (CAD) and major adverse cardiovascular events (MACEs), and the association was most pronounced in patients with nonobstructive CAD. These findings provide an opportunity for personalized treatment in high-risk populations.
JACC-CARDIOVASCULAR IMAGING
(2022)
Article
Medicine, Research & Experimental
Huiling Li, Yihan Chen, Qiaofeng Jin, Ya Wu, Cheng Deng, Yongkang Gai, Zhenxing Sun, Yuman Li, Jing Wang, Yali Yang, Qing Lv, Yongxue Zhang, Rui An, Xiaoli Lan, Li Zhang, Mingxing Xie
Summary: The study developed a radiolabeled probe Tc-99m-HYNIC-mAb(CD4) for visualization of CD4+ T lymphocyte infiltration and detection of acute rejection after heart transplantation, showing high affinity and specificity for binding to CD4+ T lymphocytes.
MOLECULAR PHARMACEUTICS
(2021)
Review
Radiology, Nuclear Medicine & Medical Imaging
Natalie Koh, Koen Nieman
Summary: Chest pain is a common complaint in the emergency department, and timely diagnosis and care are crucial. This article discusses the role of imaging in acute chest pain, including different imaging methods and relevant research advancements.
BRITISH JOURNAL OF RADIOLOGY
(2023)
Article
Cardiac & Cardiovascular Systems
Julia Karady, Thomas Mayrhofer, Maros Ferencik, John T. Nagurney, James E. Udelson, Andreas A. Kammerlander, Jerome L. Fleg, W. Frank Peacock, James L. Januzzi, Wolfgang Koenig, Udo Hoffmann
Summary: The study aimed to quantify differences between high-sensitivity cardiac troponin (hs-cTn) assays and determine whether these differences may result in different management recommendations for patients with suspected acute coronary syndrome (ACS).
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2021)
Article
Medicine, General & Internal
Peter A. Kavsak, Lorna Clark, Janet Martin, Ching-Tong Mark, Guillaume Pare, Shawn Mondoux, V. Tony Chetty, Craig Ainsworth, Andrew Worster
Summary: High-sensitivity cardiac troponin testing allows for earlier diagnostic and prognostic decisions in the hospital setting. However, caution is needed when interpreting results, as different assays may have varying accuracy, especially in patients with acute phase response.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Endocrinology & Metabolism
Sibel Altintas, Samanta van Workum, Madeleine Kok, Ivo A. P. G. Joosen, Mathijs O. Versteylen, Patricia J. Nelemans, Joachim E. Wildberger, Harry J. G. M. Crijns, Marco Das, Bas L. J. H. Kietselaer
Summary: This study investigated the association between body mass index (BMI) and coronary artery calcification (CAC), and found no significant association after adjusting for other risk factors.
OBESITY SCIENCE & PRACTICE
(2023)
Article
Radiology, Nuclear Medicine & Medical Imaging
Thomas Sartoretti, Michael Mcdermott, Victor Mergen, Andre Euler, Bernhard Schmidt, Gregor Jost, Joachim Wildberger, Hatem Alkadhi
Summary: This study assessed the impact of low kilo-electronvolt (keV) virtual monoenergetic image (VMI) energies and iterative reconstruction on image quality of coronary CT angiography (CCTA). The results showed that 40 keV VMI with QIR-4 significantly improved image quality of CCTA.
BRITISH JOURNAL OF RADIOLOGY
(2023)
Article
Cardiac & Cardiovascular Systems
Karolien Baldewijns, Josiane Boyne, Carla Rohde, Lieven de Maesschalck, Aleidis Deville, Vincent Brandenburg, Leentje De Bleser, Mieke Derickx, Sema Bektas, Hans-Peter Brunner-La Rocca
Summary: This study describes the perceptions and practices of different healthcare professionals regarding patient education and self-care support in the management of heart failure. HF nurses consider patient education and self-care support as one of their main tasks, while physicians pay limited attention to education. None of the regions covered all the recommended education and support topics.
Article
Endocrinology & Metabolism
Naomi L. P. Starmans, Frank J. Wolters, Annebet E. Leeuwis, Esther E. Bron, Hans-Peter Brunner La Rocca, Julie Staals, Geert Jan Biessels, L. Jaap Kappelle
Summary: Blood pressure variability is related to cerebral white matter hyperintensities, but long-term studies on WMH progression are rare. Absence of diastolic nocturnal dipping is associated with higher baseline WMH volume, while 24-hour diastolic ARV is significantly associated with WMH progression, particularly in participants with low cerebral perfusion at baseline.
JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM
(2023)
Article
Medicine, General & Internal
Arno Joachim Gingele, Hesam Amin, Aniek Vaassen, Ivana Schnur, Cathy Pearl, Hans-Peter Brunner-La Rocca, Josiane Boyne
Summary: By integrating a nurse avatar into a telemedicine application, the limitations of visual impairment and limited health-related literacy in heart failure patients can be overcome. The study found that heart failure patients had a positive assessment of this technology, with stable system usability and patient satisfaction over a 3-month period.
WIENER KLINISCHE WOCHENSCHRIFT
(2023)
Article
Public, Environmental & Occupational Health
Erik J. Timmermans, Anna E. Leeuwis, Michiel L. Bots, Juliette L. van Alphen, Geert Jan Biessels, Hans-Peter Brunner-La Rocca, L. Jaap Kappelle, Albert C. van Rossum, Matthias J. P. van Osch, Ilonca Vaartjes
Summary: This study examined the relationship between neighbourhood walkability and cognitive functioning in individuals without or with certain medical conditions. The findings showed that higher walkability levels were associated with better overall cognition and attention-psychomotor speed. These associations were stronger in patients with vascular cognitive impairment. Individuals living in areas with higher walkability levels were less likely to have impairments in language and executive functioning after two years.
Article
Geriatrics & Gerontology
Cas J. Fuchs, Remco Kuipers, Jan A. Rombouts, Kim Brouwers, Vera B. Schrauwen-Hinderling, Joachim E. Wildberger, Lex B. Verdijk, Luc J. C. van Loon
Summary: This study assessed the differences in muscle group volumes between young and older males and found that the most significant differences were observed in the thigh muscle group, with the quadriceps femoris showing the largest difference in muscle volume between young and older men. Overall, young men have larger muscle volumes compared to older men.
EXPERIMENTAL GERONTOLOGY
(2023)
Article
Radiology, Nuclear Medicine & Medical Imaging
Michael C. Mcdermott, Babs M. F. Hendriks, Joachim E. Wildberger, Sanne W. de Boer
Summary: Manual dilution of contrast media in endovascular procedures can result in inaccurate and uneven concentration, leading to incorrect reporting of administered doses to patients.
INVESTIGATIVE RADIOLOGY
(2023)
Article
Radiology, Nuclear Medicine & Medical Imaging
Mitch J. F. G. Ramaekers, Jos J. M. Westenberg, Max F. G. H. M. Venner, Joe F. Juffermans, Hans C. van Assen, Bastiaan J. C. te Kiefte, Bouke P. Adriaans, Hildo J. Lamb, Joachim E. Wildberger, Simon Schalla
Summary: This study compared the influence of static and multiphase segmentation methods on flow-related parameters in aortic 4D flow MRI and assessed the evolution of these parameters during systole. The results showed that static and multiphase segmentation yielded comparable results for flow-related parameters, eliminating the need for time-consuming multiple segmentations. However, multiphase quantification was necessary for assessing peak values of aortic flow-related parameters.
JOURNAL OF MAGNETIC RESONANCE IMAGING
(2023)
Article
Pharmacology & Pharmacy
Sumant P. P. Radhoe, Pascal R. D. Clephas, Gerard C. M. Linssen, Remko M. M. Oortman, Frank J. J. Smeele, Annemarie A. A. Van Drimmelen, Henk-Jan Schaafsma, Paul H. H. Westendorp, Hans-Peter Brunne-La r Rocca, Jasper J. J. Brugts
Summary: This study assessed the distribution of patient profiles and their treatment in a large real-world chronic heart failure cohort. The results showed that nearly 40% of the patients could be classified into one of the profiles suggested by the European Heart Failure Association (HFA). The study concluded that phenotype-specific treatment recommendations are crucial for improving guideline implementation.
FRONTIERS IN PHARMACOLOGY
(2023)
Article
Radiology, Nuclear Medicine & Medical Imaging
Marc B. I. Lobbes, Lidewij M. F. H. Neeter, Frank Raat, Kim Turk, Joachim E. Wildberger, Thiemo J. A. van Nijnatten, Patricia J. Nelemans
Summary: Breast MRI is considered the best modality for preoperative staging of invasive lobular carcinoma (ILC). However, evidence of the accuracy of contrast-enhanced mammography (CEM) in women diagnosed with ILC is limited. This study aimed to retrospectively evaluate the accuracy of CEM and MRI in preoperative staging of ILC.
EUROPEAN JOURNAL OF RADIOLOGY
(2023)
Article
Cardiac & Cardiovascular Systems
Jishnu Malgie, Pascal R. D. Clephas, Hans-Peter Brunner-La Rocca, Rudolf A. de Boer, Jasper J. Brugts
Summary: Multiple landmark trials in the past decade have significantly advanced the treatment of heart failure with reduced ejection fraction (HFrEF). The introduction of four main drug classes, including angiotensin-receptor neprilysin inhibitors/angiotensin-converting-enzyme inhibitors, beta-blockers, mineralocorticoid receptor antagonists, and sodium-glucose cotransporter-2 inhibitors, into the latest ESC guideline has proven their life-saving effect. Rapid drug implementation and up-titration have been shown to be superior to the traditional step-by-step approach, and various strategies have been proposed to reduce the time needed for the titration process.
HEART FAILURE REVIEWS
(2023)
Article
Cardiac & Cardiovascular Systems
Christian Knackstedt, Georg Schummers, Joerg Schroeder, Nikolaus Marx, Joost Lumens, Sandra Sanders-van Wijk, Bram Ramaekers, Michael Becker, Vanessa van Empel, Hans-Peter Brunner-La Rocca
Summary: The Simpson's method is widely used for determining left ventricular ejection fraction (EF) in echocardiography. However, there is significant variability among different observers in measuring LVEF, which can be attributed to various factors including experience, observer position, and timing.
INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING
(2023)
Review
Medicine, Research & Experimental
Martina Rohr, Vincent Brandenburg, Hans-Peter Brunner-La Rocca
Summary: Iron deficiency is a common nutritional disorder worldwide, often observed in patients with chronic diseases. It is associated with poor clinical outcomes and increased hospitalization and mortality. This review provides an overview of the role of iron deficiency in chronic diseases, its diagnostic accuracy in chronic inflammatory conditions, and its potential as a prognostic marker.
EUROPEAN JOURNAL OF MEDICAL RESEARCH
(2023)
Article
Cardiac & Cardiovascular Systems
Pascal R. D. Clephas, Jishnu Malgie, Jeroen Schaap, Stefan Koudstaal, Mireille Emans, Gerard C. M. Linssen, Grytsje A. de Boer, Loek van Heerebeek, C. Jan Willem Borleffs, Olivier C. Manintveld, Vanessa van Empel, Sandra van Wijk, Mieke van den Heuvel, Carlos da Fonseca, Kevin Damman, Jan van Ramshorst, Roland van Kimmenade, Arjen R. T. van de Ven, Rene A. Tio, Dennis van Veghel, Folkert W. Asselbergs, Rudolf A. de Boer, Peter van der Meer, Stephen J. Greene, Hans-Peter Brunner-La Rocca, Jasper J. Brugts
Summary: The TITRATE-HF study aims to assess the implementation of GDMT, sequencing strategies, and prognosis in patients with heart failure. It will provide valuable information for clinical practice.
Article
Cardiac & Cardiovascular Systems
Xiaoxi Yao, Zachi I. Attia, Emma M. Behnken, Melissa S. Hart, Shealeigh A. Inselman, Kayla C. Weber, Fan Li, Nikki H. Stricker, John L. Stricker, Paul A. Friedman, Peter A. Noseworthy
Summary: This study aims to explore whether Apple Watch, used as a long-term monitoring device, is effective in the early diagnosis of atrial fibrillation (AF) and the prevention of cognitive function decline in older adults. By using AI-ECG to screen high-risk patients and record electrocardiograms, the effectiveness of Apple Watch will be evaluated. If successful, this approach could have significant implications on how future clinical practice leverages consumer devices for early diagnosis and disease prevention.
AMERICAN HEART JOURNAL
(2024)