This document is complementary to an Expert Review Document on Optical Coherence Tomography (OCT) for the study of coronary arteries and atherosclerosis.1 The goal of this companion manuscript is to provide a practical guide framework for the appropriate use and reporting of the novel frequency domain (FD) OCT imaging to guide interventional procedures, with a particular interest on the comparison with intravascular ultrasound (IVUS). Eur Heart J (2012) doi: 10.1093/eurheartj/ehs095 First published online: May 31, 2012. Published on behalf of the European Society of Cardiology. All rights reserved. Copyright © The Author 2012.
Myocardial infarction (MI) can be recognised by clinical features, including electrocardiographic (ECG) findings, elevated values of biochemical markers (biomarkers) of myocardial necrosis, and by imaging, or may be defined by pathology. It is a major cause of death and disability worldwide. MI may be the first manifestation of coronary artery disease (CAD) or it may occur, repeatedly, in patients with established disease. Information on MI rates can provide useful information regarding the burden of CAD within and across populations, especially if standardized data are collected in a manner that distinguishes between incident and recurrent events. From the epidemiological point of view, the incidence of MI in a population can be used as a proxy for the prevalence of CAD in that population. The term ‘myocardial infarction’ may have major psychological and legal implications for the individual and society. It is an indicator of one of the leading health problems in the world and it is an outcome measure in clinical trials, observational studies and quality assurance programmes. These studies and programmes require a precise and consistent definition of MI. Eur Heart J (2012) 33 (20): 2551-2567. doi: 10.1093/eurheartj/ehs184 First published online: August 24, 2012. Copyright © The European Society of Cardiology, American College of Cardiology Foundation, American Heart Association, Inc., and the World Heart Federation 2012.
Objectives The aim of the current Valve Academic Research Consortium (VARC)-2 initiative was to revisit the selection and definitions of transcatheter aortic valve implantation (TAVI)clinical endpoints to make them more suitable to the present and future needs of clinical trials. In addition, this document is intended to expand the understanding of patient risk stratification and case selection. Eur Heart J (2012) 33 (19): 2403-2418. doi: 10.1093/eurheartj/ehs255. Published on behalf of the European Society of Cardiology. The article has been co-published in EuroIntervention, Journal of the American College of Cardiology, European Journal of CardioThoracic Surgery, and Journal of Thoracic and Cardiovascular Surgery. All rights reserved. Copyright © The Author 2012.
The introduction of devices for transcatheter aortic valve implantation, mitral repair, and closure of prosthetic paravalvular leaks has led to a greatly expanded armamentarium of catheter-based approaches to patients with regurgitant as well as stenotic valvular disease. Echocardiography plays an essential role in identifying patients suitable for these interventions and in providing intra-procedural monitoring. Moreover, echocardiography is the primary modality for post-procedure follow-up. The echocardiographic assessment of patients undergoing transcatheter interventions places demands on echocardiographers that differ from those of the routine evaluation of patients with native or prosthetic valvular disease. Consequently, the European Association of Echocardiography in partnership with the American Society of Echocardiography has developed the recommendations for the use of echocardiography in new transcatheter interventions for valvular heart disease. It is intended that this document will serve as a reference for echocardiographers participating in any or all stages of new transcatheter treatments for patients with valvular heart disease. Eur Heart J (2011) 32 (17): 2189-2214. doi: 10.1093/eurheartj/ehr259. Published on behalf of the European Society of Cardiology. All rights reserved. Copyright © The Author 2011.
Bleeding has recently emerged as an important outcome in the management of acute coronary syndromes (ACS), which is relatively frequent compared with ischaemic outcomes and has important implications in terms of prognosis, outcomes, and costs. In particular, there is evidence that patients experiencing major bleeding in the acute phase are at higher risk for death in the following months, although the causal nature of this relation is still debated. This position paper aims to summarize current knowledge regarding the epidemiology of bleeding in ACS and percutaneous coronary intervention, including measurement and definitions of bleeding, with emphasis on the recent consensus Bleeding Academic Research Consortium (BARC) definitions. It also provides an European perspective on management strategies to minimize the rate, extent, and consequences of bleeding. Finally, the research implications of bleeding (measuring and reporting bleeding in trials, the importance of bleeding as an outcome measure, and bleeding as a subject for future research) are also discussed. Eur Heart J (2011) 32 (15): 1854-1864. doi: 10.1093/eurheartj/ehr204 First published online: June 29, 2011. Published on behalf of the European Society of Cardiology. All rights reserved. Copyright © The Author 2011.
High blood pressure (hypertension) is one of the most important preventable causes of premature morbidity and mortality in the UK. Hypertension is a major risk factor for ischaemic and haemorrhagic stroke, myocardial infarction, heart failure, chronic kidney disease, cognitive decline and premature death. Untreated hypertension is usually associated with a progressive rise in blood pressure. The vascular and renal damage that this may cause can culminate in a treatment-resistant state. Copyright © National Institute for Health and Clinical Excellence, 2011. All rights reserved. This material may be freely reproduced for educational and not-for-profit purposes. No reproduction by or for commercial organisations, or for commercial purposes, is allowed without the express written permission of NICE.
This document represents a review of the fundamental concepts and current clinical applications of intravascular optical coherence tomography (OCT). The goal is to provide a framework for standardization of terminology for the appropriate use and report of OCT imaging. While this is not a clinical guideline document, the expressed opinions represent a consensus among clinicians and investigators with a large experience in the utilization and evaluation of OCT technology. The document focuses on the physical principles, methodology of image acquisition, and clinical diagnostic applications. Eur Heart J (2010) 31 (4): 401-415. doi: 10.1093/eurheartj/ehp433 First published online: November 4, 2009. Published on behalf of the European Society of Cardiology. All rights reserved. Copyright © The Author 2009.
Many children born with complex childhood illnesses that historically caused early death are now surviving into adulthood with the expectation of leading meaningful and productive lives. They will ultimately need to transition their care from pediatric to adult-centered care. Unfortunately, in the absence of structured programs to guide this transition, there is often delayed or inappropriate care, improper timing of the transfer of care, and undue emotional and financial stress on the patients, their families, and the healthcare system. At its worst, and as frequently happens now, patients are lost to appropriate follow-up. In fact, the number of adults with congenital heart disease (CHD) in the United States is rising exponentially and now exceeds 1.000.000 Copyright © 2011 American Heart Association. All rights reserved. Print ISSN: 0009-7322. Online ISSN: 1524-4539.
A primary challenge in the development of clinical practice guidelines is keeping pace with the stream of new data on which recommendations are based. In an effort to respond promptly to new evidence, the American College of Cardiology Foundation/ American Heart Association (ACCF/AHA) Task Force on Practice Guidelines (Task Force) has created a “focused update” process to revise the existing guideline recommendations that are affected by the evolving data or opinion. Before the initiation of this focused approach, periodic updates and revisions of existing guidelines required up to 3 years to complete. Now, however, new evidence will be reviewed in an ongoing fashion to more efficiently respond to important science and treatment trends that could have a major impact on patient outcomes and quality of care. Evidence will be reviewed at least twice a year, and updates will be initiated on an as-needed basis and completed as quickly as possible while maintaining the rigorous methodology that the ACCF and AHA have developed during their partnership of more than 20 years. Copyright © 2011 American Heart Association. All rights reserved. Print ISSN: 0009-7322. Online ISSN: 1524-4539.
Since publication of the last American Heart Association (AHA) scientific statement on this topic in 1998, device technology, advances in interventional techniques, and an innovative spirit have opened the field of congenital heart therapeutic catheterization. Unfortunately, studies testing the safety and efficacy of catheterization and transcatheter therapy are rare in the field because of the difficulty in identifying a control population, the relatively small number of pediatric patients with congenital heart disease (CHD), and the broad spectrum of clinical expression. This has resulted in the almost exclusive “off-label” use of transcatheter devices, initially developed for management of adult diseases, for the treatment of CHD. Copyright © 2011 American Heart Association. All rights reserved. Print ISSN: 0009-7322. Online ISSN: 1524-4539.
It is important that the medical profession play a central role in critically evaluating the use of diagnostic procedures and therapies introduced and tested for detection, management, or prevention of disease. Rigorous, expert analysis of the available data documenting absolute and relative benefits and risks of these procedures and therapies can produce guidelines that improve the effectiveness of care, optimize patient outcomes,and favorably affect the cost of care by focusing resources on the most effective strategies. Copyright © 2008 American Heart Association. All rights reserved. Print ISSN: 0009-7322. Online ISSN: 1524-4539.
Journal of the American College of Cardiology Vol. 57, No. 11, 2011. Copyright © 2011 by the American College of Cardiology Foundation, the American Heart Association, Inc., and the European Society of Cardiology Published by Elsevier Inc. ISSN 0735-1097
The evidence on transcatheter aortic valve implantation for aortic stenosis is limited to small numbers of patients who were considered to be at high risk for conventional cardiac surgery. It shows good short-term efficacy but there is little evidence on long-term outcomes. There is a potential for serious complications; however, the patients on whom this procedure has been used have a poor prognosis without treatment and are at high risk if treated by open heart surgery. Clinicians wishing to use this procedure should do so only with special arrangements for clinical governance, consent and for audit or research. Copyright © National Institute for Health and Clinical Excellence, 2008. All rights reserved. This material may be freely reproduced for educational and not-for-profit purposes. No reproduction by or for commercial organisations, or for commercial purposes, is allowed without the express written permission of the Institute.
National Collaborating Centre for Chronic Conditions. Atrial fibrillation: national clinical guideline for management in primary and secondary care. London: Royal College of Physicians, 2006. All rights reserved. Copyright © 2006 Royal College of Physicians of London
In response to growing U.S. interest, the Society for Coronary Angiography and Interventions recently formed a Transradial Committee whose purpose is to examine the utility, utilization, and training considerations related to transradial access for percutaneous coronary and peripheral procedures. With international partnership, the committee has composed a comprehensive overview of this subject presented herewith. Published on behalf of The Society for Cardiovascular Angiography and Interventions (SCAI). Copyright 2011 Wiley Periodicals, Inc. Catheterization and Cardiovascular Interventions 78:823–839 (2011)
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