Future cardiology
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As a method to prevent recurrent paradoxical embolism and therefore cryptogenic stroke, catheter-based patent foramen ovale closure was first reported in 1992. Since then numerous different devices have been designed to prevent paradoxical embolism. The development of new devices has risen pretty rapidly. ⋯ The primary aim is to create a device which is easy to implant and able to prevent paradoxical embolism. Additional goals are to minimize early and late complications, such as thrombembolism, erosion of adjacent structures, thrombus formation or atrial arrhythmia. This review gives an overview of the data and the current literature regarding long-term complications (follow-up > or = 1 month) after patent foramen ovale closure with current devices and presents the initial, midterm and late results after patent foramen ovale closure with newer devices.
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Review
Pathological and physiological left ventricular hypertrophy: echocardiography for differentiation.
Distinguishing physiological left ventricular hypertrophy of an athlete's heart from that of pathological left ventricular (hypertrophic cardiomyopathy) can be difficult despite the advent of new imaging techniques. Nevertheless, the final diagnosis is of utmost importance as it will have a profound impact on an individual's life. A diagnosis of hypertrophic cardiomyopathy essentially excludes an individual from sport and strenuous exertion and necessitates the need for further tests and treatment, as well as the screening of family members. ⋯ Discussion will also focus on the newer and emerging echocardiographic techniques for this purpose. The term 'hypertrophic cardiomyopathy' is used to describe the nonobstuctive form of hypertrophic cardiomyopathy as this review article focuses on distinguishing the 'mild' form of hypertrophic cardiomyopathy from an athlete's heart. When the more severe obstructive form is being described, the term 'hypertrophic obstructive cardiomyopathy' is used.
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In patients with ST-segment elevation myocardial infarction (STEMI) the shorter the reperfusion time, the better the outcome is, regardless of the reperfusion method. Effective, early and rapid reperfusion is the most important goal in the treatment of patients with STEMI. ⋯ Reduced-dose prehospital fibrinolysis allows safe transport of STEMI patients to PCI centers for urgent culprit artery PCI, and may be a superior approach compared with transporting patients to the closest non-PCI hospital for fibrinolytic therapy. In this review we will discuss the evidence regarding reperfusion strategies in STEMI patients.
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The 13th Annual Meeting of the European Council for Cardiovascular Research (ECCR) gathered leading European groups in basic and clinical cardiovascular research in Nice, France, 10-12 October 2008. With 160 participants and approximately the same amount of oral and poster presentations, it was a small but very comprehensive meeting covering the most important and timely issues in research on cardiovascular diseases and their treatment. Highlights of this year's meeting were joint sessions with the European Society for Microcirculation about Vascular Disease and the European Society for Cardiology about the cardiorenal syndrome, along with the Danish Cardiovascular Research Academy (DACRA) about exercise hyperemia. The content of these sessions, as well as other important contributions to the conference, are summarized in this article.
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Evaluation of: Combination of isosorbide dinitrate and hydralazine in blacks with heart failure. Taylor AL, Zieche S, Yancy C et al.: N. Engl. ⋯ These data represent a significant advance in the medical management of African-American patients with advanced systolic heart failure. Additionally, the design of the AHeFT study represents a novel approach to the design of clinical trials in heart failure, based on an understanding of the mechanism of action of drugs and the underlying pathophysiology of the disease state in specific patients groups. Future research will be required to assess whether benefits of this drug combination seen in AHeFT can be extended to the wider population of patients with advanced heart failure.