Multi-centered investigation of a point-of-care NT-proBNP ELISA assay to detect moderate to severe occult (pre-clinical) feline heart disease in cats referred for cardiac evaluation

The development of ultrasound technology to visualize cardiac structures, based on the pioneering work by Edler and Hertz at the University of Lund in Sweden, has literally created a revolution in the field of paediatric cardiology. Before the era of cardiac catheterization and echocardiography the diagnosis of congenital heart disease was mainly based on combining physical findings, cardiac auscultation, electrocardiogram (ECG), and chest X-ray. This was largely based on the work by Helen B. Taussig at John Hopkins in the 1930s who established the field of clinical paediatric cardiology by integrating pathology knowledge with clinical findings. Diagnosis at that time was based on clinical skills and was more an art than science. The introduction of paediatric cardiac surgery in the 1950s was made possible due to the simultaneous development of cardiac catheterization and angiography which allowed an accurate description of the different cardiac lesions and the associated haemodynamics prior to surgery. For a long period catheterization was the diagnostic gold standard and all surgical patients underwent an invasive cardiac evaluation. In the 1970s, echocardiography was developed as a clinical tool and due to its non-invasive nature, was introduced quickly in paediatric cardiology. As anatomical diagnosis is challenging by M-mode echocardiography, it was really the development of two-dimensional (2-D) echocardiography in the late 1970s and early 1980s that deeply influenced the field. For the first time the congenital defects could be imaged noninvasively and the 2-D images were extensively validated by comparing them with pathological and surgical findings. Adding pulsed, continuous, and colour Doppler data to the 2-D images resulted in a complete detailed description of congenital cardiac defects and their haemodynamic consequences. Further optimization of ultrasound technology specifically for paediatric imaging, such as the development of higher-frequency probes and increasing the standard grey-scale frame rates, further improved spatial and temporal resolution and overall image quality. Based on its excellent diagnostic accuracy and its non-invasive nature, echocardiography quickly became the primary non-invasive diagnostic technique for all children with heart disease. Currently every paediatric patient with suspected heart disease will undergo an echocardiographic examination as the first (and often only) diagnostic test.

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Echocardiographic wall motion abnormalities in patients with stroke may warrant cardiac evaluation

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2018-320219 ◽

2019 ◽

Vol 90 (7) ◽

pp. 792-795

Author(s):

Shadi Yaghi ◽

Andrew D Chang ◽

Brittany A Ricci ◽

Brian MacGrory ◽

Shawna Cutting ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Heart Disease ◽

Heart Disease ◽

Coronary Artery ◽

Ischaemic Stroke ◽

Wall Motion ◽

Cardiac Evaluation ◽

History Of ◽

Wall Motion Abnormalities ◽

Artery Disease

BackgroundThe aetiology of wall motion abnormalities (WMA) in patients with ischaemic stroke is unclear. We hypothesised that WMAs on transthoracic echocardiography (TTE) in the setting of ischaemic stroke mostly reflect pre-existing coronary heart disease rather than simply an isolated neurocardiogenic phenomenon.MethodsData were retrospectively abstracted from a prospective ischaemic stroke database over 18 months and included patients with ischaemic stroke who underwent a TTE. Coronary artery disease was defined as history of myocardial infarction (MI), coronary intervention or ECG evidence of prior MI. The presence (vs absence) of WMA was abstracted. Multivariable logistic regression was used to determine the association between coronary artery disease and WMA in models adjusting for potential confounders.ResultsWe identified 1044 patients who met inclusion criteria; 139 (13.3%, 95% CI 11.2% to 15.4%) had evidence of WMA of whom only 23 (16.6%, 95% CI 10.4% to 22.8%) had no history of heart disease or ECG evidence of prior MI. Among these 23 patients, 12 had a follow-up TTE after the stroke and WMA persisted in 92.7% (11/12) of patients. In fully adjusted models, factors associated with WMA were older age (OR per year increase 1.03, 95% 1.01 to 1.05, p=0.009), congestive heart failure (OR 4.44, 95% CI 2.39 to 8.33, p<0.001), history of coronary heart disease or ECG evidence prior MI (OR 27.03, 95% CI 14.93 to 50.0, p<0.001) and elevated serum troponin levels (OR 2.00, 95% CI 1.06 to 3.75, p=0.031).ConclusionIn patients with ischaemic stroke, WMA on TTE may reflect underlying cardiac disease and further cardiac evaluation may be considered.

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Point-of-care hemostasis in children with congenital heart disease, the POCHEMO study

Blood Coagulation & Fibrinolysis ◽

10.1097/mbc.0000000000000818 ◽

2019 ◽

Vol 30 (5) ◽

pp. 199-204

Author(s):

David Longchamp ◽

Marie-Hélène Perez ◽

Julia Natterer ◽

Vivianne Amiet ◽

Thomas Ferry ◽

...

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Congenital Heart ◽

Point Of Care

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Accurate Health Risk Classification for Heart Disease Using Point-of-Care Testing Lipid Quantitation in a Health Screening and Wellness Environment

Point of Care The Journal of Near-Patient Testing & Technology ◽

10.1097/poc.0b013e31821c69d7 ◽

2011 ◽

Vol 10 (2) ◽

pp. 79-84 ◽

Cited By ~ 2

Author(s):

Lee Springer ◽

Michelle Evans ◽

Gary Hughes ◽

Christina Williams ◽

Josh Brock ◽

...

Keyword(s):

Heart Disease ◽

Health Risk ◽

Point Of Care ◽

Health Screening ◽

Risk Classification ◽

Point Of Care Testing

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Expanding the impact of a longstanding Canadian cardiac registry through data linkage: challenges and opportunities

International Journal for Population Data Science ◽

10.23889/ijpds.v3i3.441 ◽

2018 ◽

Vol 3 (3) ◽

Cited By ~ 1

Author(s):

Danielle A Southern ◽

Matthew T James ◽

Stephen B Wilton ◽

Lawrence DeKoning ◽

Hude Quan ◽

...

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Data Linkage ◽

Point Of Care ◽

Clinical Information ◽

Inception Cohort ◽

Treatment Information ◽

Challenges And Opportunities ◽

The Impact ◽

Cardiovascular Care

The Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease (APPROACH) began as a province-wide inception cohort of all adult Alberta residents undergoing cardiac catheterization for ischemic heart disease. As of September 2017, clinical information has been collected by APPROACH on over 240,000 adult Alberta residents. Use of the APPROACH platform has also expanded across Canada and now facilitates the measurement and reporting of cardiovascular care across more than 18 major cardiovascular centres in 8 provinces. Strengths of the APPROACH initiative include the prospective collection of detailed clinical, procedural, and treatment information, measured at point-of-care. While this aspect of APPROACH provides data users with several advantages over of use of typical administrative data, the ability to link APPROACH with data from multiple other sources has provided several unique opportunities to measure cardiovascular care and outcomes. This paper describes applied examples of work that has leveraged the potential of linking several external datasets with the APPROACH registry.

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