American heart journal
-
American heart journal · Dec 2015
Association of aortic stiffness and wave reflections with coronary flow reserve in women without obstructive coronary artery disease: An ancillary study from the National Heart, Lung, and Blood Institute-sponsored Women's Ischemia Syndrome Evaluation (WISE).
Increased aortic stiffness and reduced coronary flow reserve (CFR) independently predict adverse outcomes. But information about relationships between arterial properties and CFR in subjects without obstructive coronary artery disease (CAD) is limited. ⋯ Among symptomatic women without obstructive CAD, CFR was inversely related to aortic systolic pressure and indices of aortic stiffness. These changes in arterial properties increase left ventricular afterload requiring the ventricle to generate additional, but wasted, energy that increases indices of myocardial oxygen demand, reduces CFR and increases vulnerability to ischemia.
-
American heart journal · Nov 2015
Observational StudyIncidence and impact of delirium on clinical and functional outcomes in older patients hospitalized for acute cardiac diseases.
Delirium is one of the most frequent complications of hospitalization in elderly patients. Its influence on prognosis in patients admitted for acute cardiac diseases is not well known. The objective of this study is to assess the incidence of delirium and its impact on clinical and functional outcomes in older patients hospitalized for acute cardiac diseases. ⋯ Delirium is a common preventable complication in older patients with acute cardiac diseases. It is associated with poorer in-hospital functional and clinical outcomes, and increased postdischarge mortality.
-
American heart journal · Nov 2015
Randomized Controlled Trial Multicenter StudyRadial versus femoral access for elderly patients with acute coronary syndrome undergoing coronary angiography and intervention: insights from the RIVAL trial.
Radial access for percutaneous coronary intervention is associated with lower rates of access site complications and bleeding. However, elderly patients have more complex vascular anatomy and radial access may be more challenging in this population. There remains uncertainty regarding the role of radial access in elderly patients undergoing cardiac catheterization. ⋯ Consistent with the overall RIVAL trial population, elderly patients undergoing cardiac catheterization have lower rates of major bleeding or access site complications and higher rates of access site crossover with radial access compared to femoral access.
-
American heart journal · Nov 2015
Randomized Controlled TrialLifestyle modification for resistant hypertension: The TRIUMPH randomized clinical trial.
Resistant hypertension (RH) is a growing health burden in this country affecting as many as 1 in 5 adults being treated for hypertension. Resistant hypertension is associated with increased risk of adverse cardiovascular disease (CVD) events and all-cause mortality. Strategies to reduce blood pressure (BP) in this high-risk population are a national priority. ⋯ The TRIUMPH randomized clinical trial (ClinicalTrials.gov NCT02342808) is designed to test the efficacy of an intensive, center-based lifestyle intervention compared to a standardized education and physician advice counseling session on BP and CVD biomarkers in patients with RH after 4 months of treatment and will determine whether lifestyle changes can be maintained for a year.