International journal of cardiology
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Review Comparative Study
How accurate is pulse rate variability as an estimate of heart rate variability? A review on studies comparing photoplethysmographic technology with an electrocardiogram.
The usefulness of heart rate variability (HRV) as a clinical research and diagnostic tool has been verified in numerous studies. The gold standard technique comprises analyzing time series of RR intervals from an electrocardiographic signal. However, some authors have used pulse cycle intervals instead of RR intervals, as they can be determined from a pulse wave (e.g. a photoplethysmographic) signal. This option is often called pulse rate variability (PRV), and utilizing it could expand the serviceability of pulse oximeters or simplify ambulatory monitoring of HRV. ⋯ Results speak in favor of sufficient accuracy when subjects are at rest, although many studies suggest that short-term variability is somewhat overestimated by PRV, which reflects coupling effects between respiration and the cardiovascular system. Physical activity and some mental stressors seem to impair the agreement of PRV and HRV, often to an inacceptable extent. Findings regarding the position of the sensor or the detection algorithm are not conclusive. Generally, quantitative conclusions are impeded by the fact that results of different studies are mostly incommensurable due to diverse experimental settings and/or methods of analysis.
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CVD has the ability to interrupt an individual's ability to participate in the labour force, and this can have considerable follow-up on impacts to both the individual and the state. This study aimed to quantify the personal cost of lost income and the cost to the state from lost income taxation, increased benefit payments and lost GDP as a result of early retirement due to CVD in Australians aged 45-64 in 2009. ⋯ The costs of CVD to both individuals and the state are considerable. Whilst individuals bear the economic costs of lost income in addition to the burden of the condition itself, the state impacts are loss of productivity from reduced workforce participation, lost income taxation revenue, and increasing government support payments - in addition to direct health care costs.
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Editorial Comparative Study
Exploring the reduction in myocardial infarctions in the PLATO trial: which patients benefited on ticagrelor vs. clopidogrel?
Ticagrelor showed significant reductions in myocardial infarctions (MIs) compared to clopidogrel in the Platelet Inhibition and Patient Outcomes (PLATO) trial. However, there was no explanation as to whether there was an equal distribution of benefit throughout acute coronary syndrome (ACS) types. ⋯ Ticagrelor significantly reduced MIs compared to clopidogrel only in STEMI patients, with those receiving early PCI having worse outcomes with ticagrelor. Despite, NSTEMI patients showing no significant reduction in MI with ticagrelor vs. clopidogrel, CV mortality was significantly reduced. In summary, we cannot be sure what is driving the STEMI-MI benefit, the NSTEMI-CV mortality benefit, nor the overall mortality benefit for ticagrelor-treated patients compared to clopidogrel treated patients.
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In transposition of the great arteries (TGA), the right ventricle (RV) is subaortic and abnormal aortic structure or function could adversely affect the capacity of the RV to supply the systemic circulation. Our aim was to assess aortic dimensions and distensibility and RV function in patients with palliated TGA using cardiovascular magnetic resonance imaging (CMR). ⋯ The aortic root dilates and the ascending aorta stiffens in TGA, during young adult life. Although these proximal aortic changes did not show adverse effects on the RV in our young TGA sample, they might have important long-term physiopathological consequences in these patients.
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Today, more patients with congenital heart disease (CHD) reach adulthood. There are conflicting findings concerning the relationship between quality of life (QoL) or health state for adults with CHD and the complexity of their CHD. The aim of the study was, firstly, to compare the reported health status and health perception of adult patients with CHD and, secondly, to investigate what variables influenced the patients' health status and health perception. ⋯ The health status of adults with CHD is influenced by symptoms, NYHA-classification, age and gender. Adults with CHD report a lower occurrence of problems in comparison to previously published results from a general population, but the importance of actively asking about the patient's experience is demonstrated by the high degree of asymptomatic patients reporting problems on EQ-5D.