Preoperative Dipyridamole Thallium Imaging and Ambulatory Electrocardiographic Monitoring as a Predictor of Perioperative Cardiac Events and Long-Term Outcome

1996 ◽  
Vol 40 (5) ◽  
pp. 324
Author(s):  
L. A. FLEISHER ◽  
S. H. ROSENBAUM ◽  
A. H. NELSON ◽  
D. JAIN ◽  
F. J. WACKERS ◽  
...  
Keyword(s):  
Cardiac Events ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Electrocardiographic Monitoring ◽  
Thallium Imaging ◽  
Dipyridamole Thallium

Preoperative Dipyridamole Thallium Imaging and Ambulatory Electrocardiographic Monitoring as a Predictor of Perioperative Cardiac Events and Long-term Outcome

1995 ◽  
Vol 83 (5) ◽  
pp. 906-917 ◽  
Author(s):  
Lee A. Fleisher ◽  
Stanley H. Rosenbaum ◽  
Ann H. Nelson ◽  
Diwaker Jain ◽  
Frans J. Th Wackers ◽  
...  
Keyword(s):  
Cardiac Events ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Cardiac Morbidity ◽  
Electrocardiographic Monitoring ◽  
Ambulatory Electrocardiography ◽  
Thallium Imaging ◽  
Dipyridamole Thallium ◽  
Long Term Mortality

Abstract Background Dipyridamole thallium imaging (DTI) and ambulatory electrocardiography (AEGC) have been advocated as means to stratify risk before vascular surgery. The purpose of this study was to compare the predictive value of both tests in noncardiac surgery patients for perioperative cardiac morbidity and long-term mortality.

scholarly journals Long-Term Follow-Up of Patients with Catecholaminergic Polymorphic Ventricular Arrhythmia

2020 ◽  
Vol 9 (4) ◽  
pp. 903
Author(s):  
Michael Veith ◽  
Ibrahim El-Battrawy ◽  
Gretje Roterberg ◽  
Laura Raschwitz ◽  
Siegfried Lang ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Beta Blockers ◽  
Polymorphic Ventricular Tachycardia ◽  
Cardiac Events ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Long Term Follow Up ◽  
Life Threatening

Background: Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare inherited disorder causing life-threatening arrhythmias. Long-term outcome studies of the channelopathy are limited. Objective: The aim of the present study was to summarize our knowledge on CPVT patients, including the clinical profile treatment approach and long-term outcome. Methods: In this single center study, we retrospectively and prospectively collected data from nine CPVT patients and analyzed them. Results: We reviewed nine patients with CPVT in seven families (22% male), with a median follow-up time of 8.6 years. Mean age at diagnosis was 26.4 ± 12 years. Symptoms at admission were syncope (four patients) and aborted cardiac arrest (four patients). Family history of sudden cardiac death was screened in five patients. In genetic analyses, we found five patients with ryanodine type 2 receptor (RYR2) mutations. Seven patients were treated with beta-blockers, and if symptoms persisted flecainide was added (four patients). Despite beta-blocker treatment, three patients suffered from seven adverse cardiac events. An implantable cardioverter defibrillator was implanted in seven patients (one primary, six secondary prevention). Over the follow-up period, three patients suffered from ventricular tachycardia (ten times) and five patients from ventricular fibrillation (nine times). No one died during follow-up. Conclusion: Our CPVT cohort showed a high risk of cardiac events. Family screening, optimal medical therapy and individualized treatment are necessary in affected patients in referral centers.

scholarly journals Uncomplicated moderate coronary artery dissections after balloon angioplasty: good outcome without stenting

Heart ◽  
2001 ◽  
Vol 86 (2) ◽  
pp. 193-198
Author(s):  
M Albertal ◽  
G Van Langenhove ◽  
E Regar ◽  
I P Kay ◽  
D Foley ◽  
...  
Keyword(s):  
Adverse Events ◽  
Balloon Angioplasty ◽  
Major Adverse Cardiac Events ◽  
Cardiac Events ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Adverse Cardiac Events ◽  
Group A ◽  
Group B

OBJECTIVETo study the relation between moderate coronary dissections, coronary flow velocity reserve (CFVR), and long term outcome.METHODS523 patients undergoing balloon angioplasty and sequential intracoronary Doppler measurements were examined as part of the DEBATE II trial (Doppler endpoints balloon angioplasty trial Europe). After successful balloon angioplasty, patients were randomised to stenting or no further treatment. Dissections were graded at the core laboratory by two observers and divided into four categories: none, mild (type A-B), moderate (type C), severe (types D to F). Patients with severe dissections (n = 128) or without available reference vessel CFVR (n = 139) were excluded. The remaining 256 patients were divided into two groups according to the presence (group A, n = 45) or absence (group B, n = 211) of moderate dissection.RESULTSFollowing balloon angioplasty, there was no difference in CFVR between the two groups. At 12 months follow up, a higher rate of major adverse cardiac events was observed overall in group A than in group B (10 (22%)v 23 (11%), p = 0.041). However, the risk of major adverse events was similar in the subgroups receiving balloon angioplasty (group A, 6 (19%) v group B, 16 (16%), NS). Among group A patients, the adverse events risk was greater in those randomised to stenting (odds ratios 6.603v 1.197, p = 0.046), whereas there was no difference in risk if the group was analysed according to whether the CFVR was < 2.5 or ⩾ 2.5 after balloon angioplasty.CONCLUSIONSModerate dissections left untreated result in no increased risk of major adverse cardiac events. Additional stenting does not improve the long term outcome.

scholarly journals Association Between Left Ventricular Global Function Index and Outcomes in Patients With Dilated Cardiomyopathy

2021 ◽  
Vol 8 ◽  
Author(s):  
Tong Liu ◽  
Zhen Zhou ◽  
Kairui Bo ◽  
Yifeng Gao ◽  
Hui Wang ◽  
...  
Keyword(s):  
Dilated Cardiomyopathy ◽  
Composite Endpoint ◽  
Left Ventricular ◽  
Cardiac Events ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Global Function ◽  
Cutoff Values ◽  
Function Index

Purpose: Left ventricular global function index (LVGFI) assessed using cardiac magnetic resonance (CMR) seems promising in the prediction of clinical outcomes. However, the role of the LVGFI is uncertain in patients with heart failure (HF) with dilated cardiomyopathy (DCM). To describe the association of LVGFI and outcomes in patients with DCM, it was hypothesized that LVGFI is associated with decreased major adverse cardiac events (MACEs) in patients with DCM.Materials and Methods: This prospective cohort study was conducted from January 2015 to April 2020 in consecutive patients with DCM who underwent CMR. The association between outcomes and LVGFI was assessed using a multivariable model adjusted with confounders. LVGFI was the primary exposure variable. The long-term outcome was a composite endpoint, including death or heart transplantation.Results: A total of 334 patients (mean age: 55 years) were included in this study. The average of CMR-LVGFI was 16.53%. Over a median follow-up of 565 days, 43 patients reached the composite endpoint. Kaplan–Meier analysis revealed that patients with LVGFI lower than the cutoff values (15.73%) had a higher estimated cumulative incidence of the endpoint compared to those with LVGFI higher than the cutoff values (P = 0.0021). The hazard of MACEs decreased by 38% for each 1 SD increase in LVGFI (hazard ratio 0.62[95%CI 0.43–0.91]) and after adjustment by 46% (HR 0.54 [95%CI 0.32–0.89]). The association was consistent across subgroup analyses.Conclusion: In this study, an increase in CMR-LVGFI was associated with decreasing the long-term risk of MACEs with DCM after adjustment for traditional confounders.

Abstract 2151: Long-Term Outcome in Patients Treated with Sirolimus Eluting Stents in Complex Coronary Artery Lesions. Analysis of 3-year Results of the Randomized SCANDSTENT Trial

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Henning Kelbćk ◽  
Leif Thuesen ◽  
Skejby Sygehus ◽  
Lene Kløvgaard ◽  
Steffen Helqvist ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Group Versus ◽  
Bare Metal Stents ◽  
Metal Stents ◽  
Coronary Artery Lesions ◽  
Cardiac Events ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Revised Definitions

Background - The long-term outcome of patients with complex coronary artery lesions treated with drug-eluting stents is unknown. This study evaluated the 3-year clinical outcome of patients randomized in the SCANDSTENT study to have sirolimus-eluting stents (SES) or bare metal stents (BMS) implanted in their complex lesions. Methods and Results - We randomly assigned 322 patients with symptomatic coronary artery disease and either a total coronary occlusion, a lesion located in a bifurcation, in an ostial or in an angulated segment of the coronary artery to have SES or BMS implanted. At 3 years, major adverse cardiac events had occurred in 24 patients (15%) in the SES group and in 59 patients (37%) in the BMS group ( P <0.001). Four versus 2 patients suffered a cardiac death (NS), and 5 versus 1 died of a non-cardiac disease (NS). Six patients in the SES group versus 15 patients in the BMS group suffered a myocardial infarction ( P <0.05), and target lesion revascularization was performed in 8 patients (4.9%) versus 53 patients (33.8%), respectively ( P <0.001); of these 4 in the SES versus 7 in the BMS group was performed between 1 and 3 years after the index treatment (NS). According to revised definitions, stent thrombosis occurred in 5 patients (3.1%) in the SES group and in 7 patients (4.4%) in the BMS group (NS); very late stent thromboses were observed in 4 versus 1 patient. Conclusions - A continued benefit was observed out to 3 years after implantation of SES in patients with complex coronary artery lesions. Late adverse events occurred less frequently in the SES group, and stent thromboses occurred rarely after 1 year.

scholarly journals Cardiac Arrhythmias and Impaired Heart Rate Variability in Older Patients With Ventricular Septal Defects

2021 ◽  
Author(s):  
Marie Maagaard ◽  
Filip Eckerström ◽  
Vibeke E. Hjortdal
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Ventricular Septal Defects ◽  
Cardiac Events ◽  
Term Outcome ◽  
Premature Ventricular Contractions ◽  
Long Term Outcome ◽  
Septal Defects ◽  
Normal Ranges

Background Congenital ventricular septal defects (VSDs) are considered to have benign long‐term outcome when treated correctly in childhood. However, abnormal parameters are described in younger adults, including impaired heart rate variability (HRV). It is not known whether such abnormalities will deteriorate with age. Therefore, HRV and cardiac events, such as premature ventricular contraction, were evaluated in patients aged >40 years with congenital VSDs and compared with healthy peers. Methods and Results A total of 30 surgically closed VSDs (51±8 years, repair at median age 6.3 years with total range 1.4–54 years) with 30 healthy controls (52±9 years) and 30 small, unrepaired VSDs (55±12 years) with 30 controls (55±10 years) were all equipped with a Holter monitor for 24 hours. Compared with healthy peers, surgically closed patients had lower SD of the normal‐to‐normal (NN) interbeat interval (129±37 versus 168±38 ms; P <0.01), SD of the average NN intervals for each 5‐minute segment of a 24‐hour HRV recording (116±35 versus 149±35 ms; P <0.01) and 24‐hour triangular index (31±9 versus 44±11; P <0.01). SD of the NN intervals, SD of the average NN intervals for each 5‐minute segment of a 24‐hour HRV recording, and triangular index were comparable between unrepaired VSDs and healthy peers. SD of the NN intervals was <100 ms in 22% of surgically closed and 10% of unrepaired VSDs, whereas controls were within normal ranges. A high number of premature ventricular contractions (>200 events) was registered in 57% of surgical patients compared with 3% of controls ( P <0.01), and 53% of unrepaired VSDs compared with 10% in controls ( P <0.01). Conclusions Adults aged >40 with congenital VSDs demonstrate impaired HRV, mainly among surgically closed VSDs. More than half demonstrated a high number of premature ventricular contractions. These novel findings could indicate long‐term cardiovascular disturbances. This necessitates continuous follow‐up of VSDs throughout adulthood.

Abstract 1516: Does A Normal Coronary Angiography Really Mean A Good Prognosis In Patients With Acute Coronary Syndromes?

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Dariusz Dudek ◽  
Rafal Depukat ◽  
Bernadeta Chyrchel ◽  
Zbigniew Siudak ◽  
Artur Dziewierz ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Coronary Angiography ◽  
Cardiac Events ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Adverse Cardiac Events ◽  
Normal Coronary Angiography ◽  
Coronary Lesions

Introduction: Coronary angiography remains gold standard for diagnosis of coronary artery disease (CAD) and acute coronary syndrome (ACS). Among patients (pts) referred to cath-lab with diagnosis of ACS exists a subgrup presenting symptoms of myocardial ischaemia and no criticial coronary lesions in angiography. The long-term outcome is not well established and managing treatment for such patients is still challenging. Aim: Evaluation of clinical outcome and received pharmacotherapy in pts with ACS and no significant coronary lesions. Methods: We collected data of consecutive pts admitted to cath-lab between July 2004 and June 2006 with diagnosis of ACS and coronary angiography considered as normal or near-normal (lesions under 50% of stenosis assessed visually). We analyzed demographic data, angiographic, electrocardiographic and laboratory tests results. During long-term follow-up received treatment, major adverse cardiac events were assessed. Results: One hundred eight pts (56 females; mean age 58.5 +/−13.5 years) admitted to cath-lab with diagnosis of acute myocardial infarction (38%) or unstable angina (62%) had normal or near normal coronary angiography. Mean LVEF was 52.6 +/− 12.9%, prevalence of CAD risk factors was: hypertension 72.2%, hypercholesterolemia 51.8%, diabetes mellitus 13.0%. The treatment administered during the hospitalization and follow-up is shown in table . During the mean follow-up of 16.5 months (range 6–30 months) all-cause mortality rate was 9.3%, cardiovascular mortality rate was 7.4%, repeat hospitalization for cardiovascular reasons 20.4%. Conclusions: Long-term outcome of patients with ACS and nonobstructive coronary angiography is not as benign as it is commonly thought. These patients have high rate of major adverse cardiac events and rehospitalization for cardiovascular reasons. They also are not receiving therapy directed at aggressive antiatherosclerotic therapy with statins, ACE-I and b-blockers. Treatment administered during the hospitalization, at discharge and during the follow-up

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