Progress in cardiovascular diseases
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Prog Cardiovasc Dis · Mar 2018
Review Comparative StudyCombined Effect of Sauna Bathing and Cardiorespiratory Fitness on the Risk of Sudden Cardiac Deaths in Caucasian Men: A Long-term Prospective Cohort Study.
Both cardiorespiratory fitness (CRF) and frequency of sauna bathing (FSB) are each strongly and independently associated with sudden cardiac death (SCD) risk. However, the combined effect of CRF and FSB on SCD risk has not been previously investigated. We evaluated the joint impact of CRF and FSB on the risk of SCD in the Kuopio Ischemic Heart Disease prospective cohort study of 2291 men aged 42-61 years at recruitment. ⋯ Comparing high vs low FSB, the corresponding HR was 0.67 (0.46-0.98). Compared to men with low CRF & low FSB, the multivariate-adjusted HRs of SCD for the following groups: high CRF & high FSB; high CRF & low FSB; and low CRF & high FSB were 0.31 (0.16-0.63), 0.49 (0.34-0.70), and 0.71 (0.45-1.10) respectively. In a general male Caucasian population, the combined effect of high aerobic fitness (as measured by CRF) and frequent sauna baths is associated with a substantially lowered risk of future SCD compared with high CRF or frequent sauna bathing alone.
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Pulmonary embolism (PE) is a leading cause of cardiovascular mortality worldwide. Clinical presentation can be diverse, and clinicians should have a high index of suspicion regarding the diagnosis. Evaluation should include detailed history of possible risk factors, physical examination and laboratory tests that would support the diagnosis and help risk-stratify patients. ⋯ But treating moderate risk PE is challenging since aggressive treatment is not devoid of potential harm. This review focuses on the acute and chronic treatment of PE. We present risk stratification, guidance as to treatment choice and insights into chronic treatment with available anticoagulants.
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Prog Cardiovasc Dis · Jan 2018
ReviewSafety and Efficacy of Transcatheter Left Atrial Appendage Closure for Stroke Prevention in Patients with Atrial Fibrillation.
Atrial Fibrillation (AF) is associated with a substantial risk of thromboembolic stroke. Although long-term treatment with warfarin or the non-vitamin K oral anticoagulants can reduce this risk, such therapy is underutilized, and safe and consistent long-term treatment can be challenging. ⋯ Major bleeding is also reduced compared with continued warfarin therapy once the post-implant pharmacologic regimen is completed. This review summarizes the current dataset for the safety and efficacy of transcatheter LAA closure, and highlights the gaps in evidence and future directions for clinical research.
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Prog Cardiovasc Dis · Nov 2017
ReviewMitral Valve Repair in Degenerative Mitral Regurgitation: State of the Art.
In industrialized countries, the most common etiology of mitral regurgitation (MR) is degenerative mitral valve (MV) disease. The natural history of severe degenerative MR is poor. ⋯ Surgical MV repair is the gold standard treatment. This review will focus on the most recent evidence with a specific emphasis on surgical indications, timing of treatment, contemporary surgical techniques, Heart Teams and Centers of Excellence.
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Prog Cardiovasc Dis · Nov 2017
ReviewMitral Valve-in-Valve/Ring and Other Percutaneous Treatments of Surgical Failures.
Re-do mitral valve surgery is associated with high morbidity and mortality. In recent years a variety of percutaneous repair techniques of surgical failures have emerged as safe and effective treatment options for several post-surgical problems including bioprosthetic mitral valve failure, prosthetic regurgitation or stenosis following annuloplasty, and periprosthetic regurgitation. This review will cover the indications, techniques and outcomes of these novel percutaneous therapies.