Heart Podcast

Predictors for efficacy of percutaneous mitral valve repair using the MitraClip system: the results of the MitraSwiss registry http://goo.gl/DqHBAi

In this podcast, they discuss the expanding roles of electrophysiological specialists in managing arrhythmias, accessory pathways and the new upcoming NICE guidelines on atrial fibrillation.

Extensive research has established that physical activity is inversely associated with the risk of developing cardiovascular disease in healthy adults. In patients with manifest cardiovascular disease, current clinical practice guidelines recommend encouraging patients to undertake daily moderate intensity physical exercise for secondary prevention.

While such recommendations are based on numerous clinical trials clearly showing that exercise-based cardiac rehabilitation improves prognosis in heart disease patients, only a few prospective studies have examined the potential benefit of physical activity in clinical practice under real-life conditions.

A recent Heart paper investigates the association of leisure time physical activity level with prognosis in a cohort of patients with coronary heart disease. Lead author Ute Mons, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, discusses what they found.

Read the full paper:

http://goo.gl/gDHlH2

Experimental and epidemiological studies have provided evidence of associations between air pollution and cardiovascular health. More pollution-related deaths occur from heart disease than from any other cause.

A recent study in Heart aimed to further current understanding of pathophysiological mechanisms by examining the strength and specificity of acute relationships between ambient air pollution and a range of CVD events. The key mechanistic question addressed is whether events of clear thrombotic origin, namely, acute MI, stroke and related outcomes, have a stronger association with air pollution than non-thrombotic outcomes.

Lead author Ai Milojevic, Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, describes what they found.

In this podcast Heart editor in chief Catherine Otto, discusses patient prothesis mismatch with Professor Philippe Pibarot, Directeur, Chaire de Recherche du Canada sur les Maladies Valvulaires Cardiaques, after he presented a commentary on the issue at the Transcatheter Valve Therapies meeting in Vancouver, Canada on June 5, 2014.

Aortic valve stenosis is prevalent in the elderly and valve replacement for severe symptomatic obstruction improves symptoms and prolongs life. However, some patients have persistent symptoms after intervention because the functional valve area of the prosthetic valve is too small for the patient’s body size, a situation termed patient-prosthesis mismatch (PPM).

The hemodynamics of PPM have been well described but the actual clinical impact of PPM is controversial. In the June issue of Heart, Dr Price and colleagues (heartjnl-2013-305118) report that PPM was associated with decreased survival and persistent symptoms only in patients with a low left ventricular ejection fraction who were under age 70 years at the time of valve surgery. In older adults, although PPM was associated with impaired regression of LV hypertrophy, PPM was not associated with increased mortality or heart failure symptoms.

This data has important implications for clinical management suggesting that additional procedures to allow implantation of a larger prosthesis may not be necessary in older adults or in younger patients with normal left ventricular function.

See also:

The impact of prosthesis–patient mismatch after aortic valve replacement varies according to age at operation http://goo.gl/JNX42v

Determinants of effective heart failure self-care: a systematic review of patients’ and caregivers’ perceptions http://goo.gl/Lb3adm

This podcast discusses the 3rd Joint British Societies’ (JBS) consensus recommendations, released on 26th March 2014.

These eagerly anticipated guidelines incorporate much of the recent research in primary and secondary prevention of cardiovascular disease, and include a new risk calculator for physicians.

Heart’s social media editor, Dr Alistair Lindsay, discusses the most important points of the recommendations with Dr Iain Simpson, President of the British Cardiovascular Society and a member of the JBS 3 editorial group.

In this podcast, Philip Urban, Cardiovascular Department, Hôpital de La Tour, Geneva, discusses the Charlson Comorbidity Index (CCI).

Read the related paper:

Validity of Charlson Comorbidity Index in patients hospitalised with acute coronary syndrome. Insights from the nationwide AMIS Plus registry 2002–2012 http://goo.gl/Kjpj0l

Coronary heart disease (CHD) is a major public health problem not only in developed but also in developing countries.1 CHD rates in Japan are uniquely low compared to the USA and other developed countries.

In a paper in April's Heart, Akira Sekikawa and colleagues from the University of Pittsburgh looked at whether serum concentrations of long chain n-3 polyunsaturated fatty acids (LCn3PUFAs) contribute to the difference in the incidence rate of coronary artery calcification (CAC) between Japanese men in Japan and white men in the USA.

Alistair Lindsay asks him what they found.

Read the full paper:

Long chain n-3 polyunsaturated fatty acids and incidence rate of coronary artery calcification in Japanese men in Japan and white men in the USA: population based prospective cohort study http://goo.gl/rwKUCW

Catherine Otto, Heart editor, talks to Greg Roth from the Division of Cardiology at University of Washington about his editorial which appears on heart.bmj.com and discusses prescription of statins after an acute myocardial infarction.