The American Heart Hospital Journal

Publisher: Blackwell Publishing

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ISSN 1751-7168
OCLC 209180235
Material type Series, Periodical
Document type Journal / Magazine / Newspaper

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Blackwell Publishing

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Publications in this journal

  • The American Heart Hospital Journal 01/2011; 9(2):125-127.
  • The American Heart Hospital Journal 01/2011; 9(1):E7.
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    ABSTRACT: Cardiologists may be the principal attending physician or the consultant to general internists or hospitalists in hospitalized patients with cardiovascular diseases. To find out which role may be best for quality and efficiency, a retrospective cohort study of 15, 113 patients in 11 cardiovascular diagnosis groups was carried out. Hospital cost, length of stay, mortality, and 30-day readmissions were compared among attending physicians who were hospitalists, general internists, or cardiologists. After adjustment for differences in demography and severity, cardiologists generally had substantially lower cost and length of stay compared with internists or hospitalists, especially when the diagnosis group included a cardiovascular procedure. Hospitalists and internists did not differ substantially in cost or length of stay. There were no statistically significant differences among the physician groups in mortality or 30-day readmissions. In conclusion, cardiologists may be the more efficient attending physician for selected cardiovascular diseases, especially when procedures are involved.
    The American Heart Hospital Journal 01/2011; 9(2):81-86.
  • The American Heart Hospital Journal 01/2011; 9(1):E24-7.
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    ABSTRACT: Cardiovascular imaging has advanced at breakneck speed over the past five years. With the steadily improving capability to image the cardiovascular system has come the appreciation that imaging is not an end in itself, but must lead to more effective and appropriate therapy in order to be clinically justified. Current economic challenges are particularly relevant to healthcare and will have major influence on further technical development and clinical application of advanced cardiovascular imaging modalities.
    The American Heart Hospital Journal 01/2011; 9(1):E8-10.
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    ABSTRACT: We report the case of a 78-year-old man who was incidentally found to have a large, ovoid mass on a chest X-ray. Nineteen years before, he had undergone a coronary artery bypass graft (CABG). A chest computed tomography (CT) scan revealed a 6.8 x 6.7 cm aneurysm of the saphenous vein bypass graft anastomosed to the distal right coronary artery with contrast filling only the proximal end of the graft. The inferior wall of the left ventricle was akinetic on echocardiography, suggesting prior myocardial infarction of this vascular bed. Because of the patient's comorbidities, occlusion of the graft, and prior inferior infarction, clinical observation was elected.
    The American Heart Hospital Journal 01/2011; 9(1):E52-4.
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    ABSTRACT: Objective: To report a case of seizure-induced takotsubo cardiomyopathy with rare etiology and rarer complications. Methods: A 50-year-old woman had multiple epileptic seizures and later developed acute heart failure complicated by ventricular fibrillation and shock. A two-dimensional echocardiogram revealed apical ballooning of the left ventricle resembling a takotsubo (a Japanese fisherman's pot used to trap octopi). The apex was also hypokinetic. Results: The hemodynamic abnormalities normalized with defibrillation, assisted ventilation, inotropic support, and pressor agents. More importantly, the apical ballooning deformity and systolic dysfunction reversed. The echocardiogram normalized three months later. A nuclear treadmill stress test was negative for ischemia. Conclusions: Apical ballooning of the left ventricle and hypokinesis are typical echocardiographic features in takotsubo cardiomyopathy, a stress-induced heart disease. It may follow severe emotional, physical, and neurologic stressors, in our rare case, grand mal seizures (0.2 % of all takotsubo disease patients). Also rare are life-threatening complications. Based on these observations, in a case with severe stress followed by acute heart failure, takotsubo cardiomyopathy should be a major diagnostic consideration. The dramatic initial triggering event, in our case an epileptic seizure, should not mask the possibility of coexisting takotsubo cardiomyopathy. Awareness of this disease, anticipation of complications, and two-dimensional echocardiography will help channel the management in the right direction.
    The American Heart Hospital Journal 01/2011; 9(2):119-121.
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    ABSTRACT: There is growing concern about increasing rates of obesity in young people, and increasing ST elevation myocardial infarction (STEMI) at a younger age. There are only a few studies performed to study the risk factors in STEMI among young populations. Retrospective chart reviews on all first event STEMI patients between December 2005 and July 2007 were performed. A young population was defined as: men <45 years of age and women <55 years of age. Among 206 patients with STEMI, 36 were young. In young patients with STEMI, 78 % were obese compared with 35 % obese, non-young (p<0.001). Also, among young patients with STEMI, family history of coronary heart disease (CHD) was positive in 39 %, compared with 19 % in non-young patients (p=0.009). This significance for obesity and family history persisted after adjusting for other risk factors using logistic regression (OR 2.96 to 17.75, 95 % CI, p<0.0001 and OR 1.36 to 7.47, 95 % CI, p=0.008, respectively). Obesity and family history of CHD were major risk factors with a higher prevalence in young patients with STEMI than non-young patients.
    The American Heart Hospital Journal 01/2011; 9(1):E37-40.
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    The American Heart Hospital Journal 01/2011; 9(1):E15-8.
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    ABSTRACT: This case report describes pathology-proven spontaneous coronary embolization from a calcific aortic valve resulting in an acute ST segment elevation myocardial infarction. It serves as an important reminder that, especially for elderly patients with coexisting aortic valvular disease, initial treatment for abrupt coronary artery occlusion with aspiration thrombectomy catheterization is standard of care.
    The American Heart Hospital Journal 01/2011; 9(1):E55-9.
  • The American Heart Hospital Journal 01/2011; 9(1):E6.
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    ABSTRACT: Background: Appearance of microalbuminuria, particularly in patients with hypertension, might be associated with a higher prevalence of left ventricular (LV) dysfunction and geometric abnormalities. This study was undertaken to determine whether high urine albumin to creatinine ratio (UACR) as a sensitive marker for microalbuminuria can be associated with LV hypertrophy (LVH) and systolic and diastolic LV dysfunction. Methods: The study population consisted of 125 consecutive patients with essential uncomplicated hypertension. Urine albumin and creatinine concentration was determined by standard methods. LVH was defined as a LV mass index >100 g/m2 of body surface area in women and >130 g/m2 in men. Echocardiographic LV systolic and diastolic parameters were measured. Results: The prevalence of microalbuminuria in patients with essential hypertension was 5.6 %. UACR was significantly no different in patients with LVH than in patients with normal LV geometry (21.26 ± 31.55 versus 17.80 ± 24.52 mg/mmol). No significant correlation was found between UACR measurement and systolic and diastolic function parameters, including early to late diastolic peak velocity (E/A) ratio (R=-0.192, p=0.038), early diastolic peak velocity to early mitral annulus velocity (E/E') ratio (R=-0.025, p=0.794), LV ejection fraction (R=0.008, p=0.929), and LV mass (R=-0.132, p=0.154). According to the receiver operator characteristic (ROC) curve analysis, UACR measurement was not an acceptable indicator of LVH with areas under the ROC curves 0.514 (95 % confidence interval 0.394-0.634). The optimal cut-off value for UACR for predicting LVH was identified at 9.4, yielding a sensitivity of 51.6 % and a specificity of 48.3 %. Conclusion: In patients with uncomplicated essential hypertension, abnormal systolic and diastolic LV function and geometry cannot be effectively predicted by the appearance of microalbuminuria.
    The American Heart Hospital Journal 01/2011; 9(2):90-94.
  • The American Heart Hospital Journal 01/2011; 9(2):71.
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    ABSTRACT: A coronary artery fistula is a rare congenital anomaly that creates a direct link between the coronary artery and the heart chambers or other vascular structures. It is often identified coincidentally during diagnostic coronary angiography and may cause coronary steal syndrome. We report on a 54-year-old man with myocardial ischemia who had coronary angiography and a recanalized fistula was detected during the procedure.
    The American Heart Hospital Journal 01/2011; 9(2):116-118.
  • The American Heart Hospital Journal 01/2011; 9(2):107-111.
  • The American Heart Hospital Journal 01/2011; 9(1):E33-6.
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    ABSTRACT: The US is facing an obesity epidemic. Recognizing the biomarkers associated with adipose tissue may impact physicians' management of cardiometabolic disease greatly. EVIDENCE OF ACQUISITION: We searched PubMed for keywords 'obesity', 'leptin', and 'adiponectin', reviewed national surveys, and searched reference articles used in review articles retrieved via the PubMed search. We included articles with multiple relevant citations. Observational data acquired from two sources, not previously published, were also used to support our conclusion. Literature review and analysis of observational data showed that the level of leptin increases with the increase in weight gain, while adiponectin decreases. The roles of these adipokines in the body have been defined. With the increase in leptin levels, the incidence and prevalence of the components of the metabolic syndrome were seen to be higher, resulting in higher cardiovascular disease, while adiponectin was seen to play a more protective role in the body against developing such disease. Measuring circulating levels of leptin and adiponectin as a screening tool may help recognize those individuals who do not only have obesity as a major risk factor toward developing cardiometabolic disease but also may have an unfavorable 'biomarker profile', putting them at highest risk. This may encourage the mobilization of resources to help these individuals lose weight rapidly with possibly aggressive measures such as bariatric surgery.
    The American Heart Hospital Journal 01/2011; 9(1):E28-32.
  • The American Heart Hospital Journal 01/2011; 9(1):E19-23.
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    ABSTRACT: Objective: Anthracyclines can damage the left ventricle, causing cardiomyopathy. This study evaluated the protective effect of carvedilol in cardiomyopathy caused by anthracyclines in patients suffering from breast cancer and lymphoma. Methods: In this clinical trial, patients undergoing chemotherapy were randomly divided into three groups. The first group received placebo and the second and third groups received, respectively, 12.5mg and 25mg of apo-carvedilol 24 hours before starting the study. The patients underwent echocardiography and tissue Doppler to look for cardiomyopathy. After four months the efficacy of carvedilol was evaluated. Results: Sixty-six patients were evaluated. No meaningful difference was observed among the groups in terms of mortality, age, gender, type of malignancy, chemotherapy regimen, and cumulative dose of doxorubicin and epirubicin. No statistically significant differences were observed between control and case groups considering the frequency of systolic cardiomyopathy (p=0.284) or the frequency of diastolic cardiomyopathy (p=0.284). Conclusion: Carvedilol at a daily dose of 12.5mg has a protective effect against diastolic disorder and at a daily dose of 25mg has a protective effect against both systolic and diastolic disorders.
    The American Heart Hospital Journal 01/2011; 9(2):95-98.