2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC.

https://hull-repository.worktribe.com/preview/1797952/1-s2.0-S0140673618322797-main.pdf

Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

https://openresearch-repository.anu.edu.au/bitstream/1885/164632/2/01_Bin%2bSayeed_Global%252C_regional%252C_and_national_2018.pdf

Global, regional, and national incidence, prevalence, andyears lived with disability for 354 diseases and injuries for195 countries and territories, 1990–2017: a systematicanalysis for the Global Burden of Disease Study 2017

WRITING GROUP MEMBERS Emelia J. Benjamin, MD, SCM, FAHA Michael J. Blaha, MD, MPH Stephanie E. Chiuve, ScD Mary Cushman, MD, MSc, FAHA Sandeep R. Das, MD, MPH, FAHA Rajat Deo, MD, MTR Sarah D. de Ferranti, MD, MPH James Floyd, MD, MS Myriam Fornage, PhD, FAHA Cathleen Gillespie, MS Carmen R. Isasi, MD, PhD, FAHA Monik C. Jiménez, ScD, SM Lori Chaffin Jordan, MD, PhD Suzanne E. Judd, PhD Daniel Lackland, DrPH, FAHA Judith H. Lichtman, PhD, MPH, FAHA Lynda Lisabeth, PhD, MPH, FAHA Simin Liu, MD, ScD, FAHA Chris T. Longenecker, MD Rachel H. Mackey, PhD, MPH, FAHA Kunihiro Matsushita, MD, PhD, FAHA Dariush Mozaffarian, MD, DrPH, FAHA Michael E. Mussolino, PhD, FAHA Khurram Nasir, MD, MPH, FAHA Robert W. Neumar, MD, PhD, FAHA Latha Palaniappan, MD, MS, FAHA Dilip K. Pandey, MBBS, MS, PhD, FAHA Ravi R. Thiagarajan, MD, MPH Mathew J. Reeves, PhD Matthew Ritchey, PT, DPT, OCS, MPH Carlos J. Rodriguez, MD, MPH, FAHA Gregory A. Roth, MD, MPH Wayne D. Rosamond, PhD, FAHA Comilla Sasson, MD, PhD, FAHA Amytis Towfighi, MD Connie W. Tsao, MD, MPH Melanie B. Turner, MPH Salim S. Virani, MD, PhD, FAHA Jenifer H. Voeks, PhD Joshua Z. Willey, MD, MS John T. Wilkins, MD Jason HY. Wu, MSc, PhD, FAHA Heather M. Alger, PhD Sally S. Wong, PhD, RD, CDN, FAHA Paul Muntner, PhD, MHSc On behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee Heart Disease and Stroke Statistics—2017 Update

Heart Disease and Stroke Statistics—2017 Update: A Report From the American Heart Association

Author(s): Writing Group Members; Mozaffarian, Dariush; Benjamin, Emelia J; Go, Alan S; Arnett, Donna K; Blaha, Michael J; Cushman, Mary; Das, Sandeep R; de Ferranti, Sarah; Despres, Jean-Pierre; Fullerton, Heather J; Howard, Virginia J; Huffman, Mark D; Isasi, Carmen R; Jimenez, Monik C; Judd, Suzanne E; Kissela, Brett M; Lichtman, Judith H; Lisabeth, Lynda D; Liu, Simin; Mackey, Rachel H; Magid, David J; McGuire, Darren K; Mohler, Emile R; Moy, Claudia S; Muntner, Paul; Mussolino, Michael E; Nasir, Khurram; Neumar, Robert W; Nichol, Graham; Palaniappan, Latha; Pandey, Dilip K; Reeves, Mathew J; Rodriguez, Carlos J; Rosamond, Wayne; Sorlie, Paul D; Stein, Joel; Towfighi, Amytis; Turan, Tanya N; Virani, Salim S; Woo, Daniel; Yeh, Robert W; Turner, Melanie B; American Heart Association Statistics Committee; Stroke Statistics Subcommittee

Heart Disease and Stroke Statistics—2016 Update: A Report From the American Heart Association

https://www.ahajournals.org/doi/pdf/10.1161/STROKEAHA.121.034946

Relative Effect of Stroke Severity and Age on Outcomes of Mechanical Thrombectomy in Acute Ischemic Stroke.

Introduction The underlying pathophysiology of atrial fibrillation (AF) detected after stroke (AFDAS) is relatively unknown. Preliminary evidence suggests AFDAS has a lower prevalence of cardiovascular comorbidities and higher incidence of insular cortex involvement than AF known to exist before stroke occurrence (KAF). This favours a neurogenic AF substrate (autonomic dysregulation) in which the presence of underlying heart disease is not necessary for AF to occur. The main objective of this systematic review and meta-analysis is to compare the prevalence of cardiovascular comorbidities and echocardiographic abnormalities in patients with AFDAS, KAF and no AF (NAF). Secondary objectives are to compare the proportion with insular cortex involvement, stroke recurrence and death in the three rhythm groups. Methods and analysis We will perform a systematic review including cross-sectional, case–control, cohort studies and clinical trials involving ≥18 years patients, with ischaemic stroke or transient ischaemic attack published between inception and 31 December 2020 in any language, and reporting the proportion of patients with AFDAS, KAF and NAF. We will search PubMed, EMBASE and Scopus by applying predefined search terms. Two reviewers will independently screen titles and abstracts and retrieve full texts, extract data in a predesigned form, and assess the risk of bias. We will perform a meta-analysis of all included studies and we will report the results of the main outcome as proportions. We will report results of secondary outcomes as risk ORs. We will estimate heterogeneity across studies by using t2, Q and I2 measures. We will use funnel plots, Rosenthal’s Fail-Safe N and Egger’s regression intercept to assess publication bias. Ethics and dissemination This study will be based on published data and does therefore not require ethical clearance. The results will be published in peer-reviewed journals. PROSPERO registration number CRD42020202622.

https://bmjopen.bmj.com/content/bmjopen/11/7/e044288.full.pdf

Phenotypes of atrial fibrillation diagnosed before-versus-after ischaemic stroke and TIA: study protocol for a systematic review and meta-analysis.

We read with interest the study by Lubitz et al1 on stroke as the initial manifestation of atrial fibrillation (AF) in the Framingham Heart Study. Stroke occurred as the initial clinical expression of AF among 1.7% of patients on the same day, in 3.4% within 30 days before, in 3.7% within 90 days before, and among 4.8% within the first year before AF detection.

There are 2 possible ways of understanding these results. First, as acknowledged by the authors, stroke occurring at different time points within a year before AF detection could be regarded as the first clinically evident consequence of AF. In contrast, AF could be the consequence of the index stroke among some participants. The inflammatory response and impairment of the autonomic regulation of …

Letter by Sposato et al Regarding Article, “Stroke as the Initial Manifestation of Atrial Fibrillation: The Framingham Heart Study”

Abstract Cognitive-frailty has been proposed as a distinctive entity which preludes dementia. We examined the relationship between physical frailty, cognitive status, and gait performance as predictors of cognitive decline and incident dementia. Using a cohort study of 252 community older adults free of dementia at baseline, we found that participants with frailty had a higher prevalence of cognitive impairment (77%) compared to those without (54%, p=0.02) but the risk of progression to dementia was not significant. Adding cognitive impairment to the frailty phenotype (cognitive-frailty) predicted further cognitive impairment and progression to dementia. However, when the slow gait component of frailty was combined with baseline cognitive impairment, it showed the highest risk of progression to dementia (HR: 35.9; 95%CI: 4.0–319.2; p= 0.001). Frailty and Cognitive impairment are common and co-exist in the same individuals. However, slowing gait seems to be the frailty component driving the association with future dementia.

Physical Frailty, Cognitive Frailty, and the Risk of Dementia in the Gait & Brain Study

A 65-year-old woman presented with sudden-onset global aphasia and right-sided hemiplegia (NIH Stroke Scale score 22). She arrived to the hospital 1 hour and 55 minutes after symptoms onset. Her medical history was relevant for hypertension, idiopathic deep vein thrombosis (treated with apixaban for 3 months, 1 year earlier), smoking, and obesity. She was not on antiplatelet or anticoagulant therapy. Initial CT of the head showed early ischemic changes in the left insular ribbon and caudate head. A CT angiogram of the head showed an occluded left middle cerebral artery (MCA) with potentially reversible ischemia on CT perfusion imaging. A CT angiogram of the neck evidenced a 6.8 cm linear hypodensity extending distally from the proximal descending aorta, 39 mm away from the origin of the left common carotid artery (figure, A). On axial imaging, the appearance was that of the donut sign.

https://n.neurology.org/content/neurology/92/9/443.full.pdf

Luciano A. Sposato

Papers

Relative Effect of Stroke Severity and Age on Outcomes of Mechanical Thrombectomy in Acute Ischemic Stroke.

Phenotypes of atrial fibrillation diagnosed before-versus-after ischaemic stroke and TIA: study protocol for a systematic review and meta-analysis.

Letter by Sposato et al Regarding Article, “Stroke as the Initial Manifestation of Atrial Fibrillation: The Framingham Heart Study”

Physical Frailty, Cognitive Frailty, and the Risk of Dementia in the Gait & Brain Study

Pearls & Oy-sters: Giant descending aortic arch donut sign: Retrograde embolism as a cause of acute ischemic stroke.