Jeffrey L. Anderson, MD, FACC, FAHA, Chair 

Jonathan L. Halperin, MD, FACC, FAHA, Chair-Elect 

Nancy M. Albert, PhD, RN, FAHA

Biykem Bozkurt, MD, PhD, FACC, FAHA

Ralph G. Brindis, MD, MPH, MACC

Mark A. Creager, MD, FACC, FAHA[#][1]

Lesley H. Curtis, PhD, FAHA

David DeMets, PhD[#][1]

Robert A

/pdf/2014-aha-acc-hrs-guideline-for-the-management-of-patients-1v8ficsqox.pdf

2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society

ALAT
: alanine aminotransferase
ASAT
: aspartate aminotransferase
APAH
: associated pulmonary arterial hypertension
BAS
: balloon atrial septostomy
BMPR2
: bone morphogenetic protein receptor 2
BNP
: brain natriuretic peptide
BPA
: balloon pulmonary angioplasty
BREATHE
: Bosentan

/pdf/2015-esc-ers-guidelines-for-the-diagnosis-and-treatment-of-y26yabnnom.pdf

2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT).

Each chapter listed in the Table of Contents (see next page) is a hyperlink to that chapter. The reader clicks the chapter name to access that chapter.

Each chapter listed here is a hyperlink. Click on the chapter name to be taken to that chapter. 

Each year, the American Heart Association (AHA), in conjunction with the Centers for Disease Control and Prevention, the National Institutes of Health, and other government agencies, brings together in a single document the most up-to-date statistics related to heart disease, stroke, and the cardiovascular risk factors listed in the AHA’s My Life Check - Life’s Simple 7 (Figure1), which include core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure [BP], and glucose control) that contribute to cardiovascular health. The Statistical Update represents …

Heart Disease and Stroke Statistics-2018 Update: A Report From the American Heart Association.

Published on behalf of the European Society of Cardiology. All rights reserved. & 2015 European Society of Cardiology & European Respiratory Society. This article is being published concurrently in the European Heart Journal (10.1093/eurheartj/ehv317) and the European Respiratory Journal (10.1183/13993003.01032-2015). The articles are identical except for minor stylistic and spelling differences in keeping with each journal’s style. Either citation can be used when citing this article. * Corresponding authors: Nazzareno Galiè, Department of Experimental, Diagnostic and Specialty Medicine–DIMES, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy, Tel: +39 051 349 858, Fax: +39 051 344 859, Email: nazzareno.galie@unibo.it.

/pdf/special-article2015-esc-ers-guidelines-for-the-diagnosis-and-22zaj14m7s.pdf

Special article2015 ESC/ERS Guidelines for the Diagnosis and Treatment of Pulmonary Hypertension

Nazzareno Galiè (ESC Chairperson), Marc Humbert (ERS Chairperson), Jean-Luc Vachiery, Simon Gibbs, Irene Lang, Adam Torbicki, Gérald Simonneau, Andrew Peacock, Anton Vonk Noordegraaf, Maurice Beghetti, Ardeschir Ghofrani, Miguel Angel Gomez Sanchez, Georg Hansmann, Walter Klepetko, Patrizio Lancellotti, Marco Matucci, Theresa McDonagh, Luc A. Pierard, Pedro T. Trindade, Maurizio Zompatori and Marius Hoeper The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and of the European Respiratory Society (ERS)

https://journals.viamedica.pl/kardiologia_polska/article/download/KP.2015.0242/57586

[2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension].

TAVI-Implantationen in Deutschland: Was rechtfertigt die aktuelle Studienlage?

Transcatheter aortic valve implantation with different self-expanding devices - a propensity score matched multicenter comparison.


 
 
 Prosthetic valve endocarditis (PVE) is the most unfavourable complication after any aortic valve replacement.
 
 
 
 The aim of this study was to analyse the impact of antibiotic-only and additional surgical therapy in patients with TAVI-PVE and to compare it with the results of patients with PVE after surgical aortic valve replacement (SAVR) regarding survival.
 
 
 
 All patients who underwent primary isolated aortic valve replacement via SAVR (n=3.447) or TAVI (n=2.269) in our heart center between 01/2012–12/2018 were analysed. The diagnosis of PVE was made using the 2015 modified Duke criteria. Follow-up was performed until 06/2019 (max. 89, mean 34 months) with a follow-up rate of 98% regarding mortality.
 
 
 
 PVE incidence did not differ significantly between SAVR with 4.9 cases per 100 patient-years and TAVI with 2.4 cases per 100 patient-years (p=0.49), although TAVI patients were significantly older (mean 80 vs. 67 years) and had more multimorbidities (STS score mean 5.9 vs. 1.6) (p<0.001). TAVI prostheses with polymer showed a 4.3-fold higher risk to develop PVE than TAVI prostheses without polymer (p=0.004). Most common pathogens were staphylococci and enterococci in all PVEs. Antibiotic-only therapy in TAVI-PVE patients resulted in a significantly better 1-year survival compared with additional surgical therapy (90.9% vs. 33.3%; p=0.005) even in 4 patients with an indication for surgery according to ESC guidelines. In SAVR-PVE patients both therapies led to comparable survival (p=0.861). However, SAVR-PVE who were not operated although indication for surgery was given by the guidelines resulted in a significantly worse survival after 1 year (p=0.004).
 
 
 
 TAVI patients did not have a significantly higher risk to develop PVE than SAVR patients despite their older age and greater comorbidities. The 1-year survival of TAVI-PVE patients was significantly higher after antibiotic-only therapy than after additional surgery, even if surgery had been indicated according to guidelines. This new finding is presumably due to the fact that TAVI prostheses do not have a polymeric suture ring. Our results show for the first time that indication for surgery in TAVI-PVE patients should be made carefully. SAVR-PVE patients however benefit from guideline-compliant surgery as in this respect antibiotics-only led to a significantly worse prognosis. This is probably related to the ability of gram-positive cocci to migrate into the polymeric ring and to protect themselves from antibiotic therapy by forming a biofilm. Some of the newer TAVI prostheses contain plastic components which can also be cured often with antibiotic-only but are associated with an increased risk to develop PVE.
 
 
 
 Type of funding sources: None.


/pdf/tavi-prosthetic-valve-endocarditis-can-often-be-cured-2heodn9p.pdf

TAVI-prosthetic valve endocarditis can often be cured without surgery

Die kathetergestutzte Aortenklappenimplantation (TAVI) hat sich zur Therapie symptomatischer Aortenklappenstenosen bei inoperablen Patienten und solchen mit hohem Risiko etabliert. Das Verfahren hat inzwischen in Deutschland den chirurgischen Aortenklappenersatz als haufigstes Therapieverfahren uberholt und entwickelt sich in Richtung der Behandlung von Patienten mit intermediarem Risiko. Bevor die TAVI aber auch bei Patienten mit niedrigerem operativen Risiko eingesetzt wird, sind Studien zu fordern, die die Sicherheit und die Effektivitat dieser Methode fur dieses Patientenkollektiv demonstrieren.

TAVI-Implantationen in Deutschland


 
 
 Measurement of fractional flow reserve (FFR) is clinically indicated in order to assess the hemodynamic relevance of coronary artery lesions and determine the need for revascularization. Preliminary data sugest that there may be significant differences regarding use and outcome of FFR measurements in men versus women.
 
 
 
 We therefore analyzed the influence of sex on FFR values and treatment consequences in a large-scale, prospective multicenter registry of consecutive patients undergoing clinically indicated FFR measurements in the setting of chronic or acute coronary syndromes.
 
 
 
 In a large, multicenter prospective registry of patients undergoing FFR, the relationship of stenosis degree to FFR, the influence of FFR on revascularization decisions were compared between male and female patients. (clinicaltrials.gov NCT03055910)
 
 
 
 A cohort of 2000 patients from 8 centers was evaluated (73% male, 27% female, median age 69±10 years, 15% acute coronary syndromes). The median number of interrogated lesions was 2 in male and 2 in female patients. A total of 2958 lesions were interrogated by FFR (2156 male, 802 female; 67 LM, 1722 LAD, 646 LCX, 523 RCA). Median stenosis degree was 60% (IQR 50%-70%) in male and, identically, 60% (IQR 50%-70%) in female patients. All the same, median measured FFR values were 0.86 (IQR 0.81–0.92) in male and 0.89 (IQR 0.84–0.93) in female patients (p<0.001). Of all lesions interrrogated, 488/2156 (23%) in men and only 100/802 (12%) in women displayed an FFR value ≤0.80 (p<0.001). The median stenosis degree of lesions with an FFR value ≤0.80 was 70% (IQR 60–80%) in men and 70% (IQR 65–84%) in women (n.s.). In multivariable analysis, stenosis degree, lesion location in LAD, ACS culprit lesion, and male sex were independent predictors of an FFR value ≤0.80. The overall rate of revascularization was 24% in men and 14% in women (p<0.001), driven by lower FFR values in men. In lesions with FFR values ≤0.80, revascularization rate was 94% both in men and in women (n.s.).
 
 
 
 Female sex is independently associated with higher FFR values when used to determine the hemodynamic relevance of coronary lesions in the setting of chronic or acute coronary syndromes. Independent of stenosis degree, FFR measurements are significantly less frequently followed by revascularization in women.
 
 
 
 Type of funding sources: Private company. Main funding source(s): St. Jude Medical


/pdf/influence-of-sex-on-results-and-consequences-of-coronary-1k2rk18o.pdf

Influence of sex on results and consequences of coronary fractional flow reserve in clinical practice: results of a prospective large-scale multicenter registry

Tanja K. Rudolph

Papers

TAVI-Implantationen in Deutschland: Was rechtfertigt die aktuelle Studienlage?

Transcatheter aortic valve implantation with different self-expanding devices - a propensity score matched multicenter comparison.

TAVI-prosthetic valve endocarditis can often be cured without surgery

TAVI-Implantationen in Deutschland

Influence of sex on results and consequences of coronary fractional flow reserve in clinical practice: results of a prospective large-scale multicenter registry