Use of TandemHeart as Bridge to Recovery for Antibody-Mediated Rejection in a Heart Transplant Patient.

Antibody-mediated rejection is a major cause of graft failure, mortality, and morbidity among cardiac transplant recipients. We present the first reported case of TandemHeart (LivaNova, Pittsburgh, Pennsylvania) used in the management of antibody-mediated rejection associated with cardiogenic shock. ().

A Staged Approach of Proximal Left Anterior Descending Coronary Artery Percutaneous Intervention Followed by Minimally Invasive Valve Surgery.

Background And Aim Of The Study: A subset of patients requiring coronary revascularization of the proximal left anterior descending coronary artery (LAD) and valve surgery may benefit from a staged approach, rather than combined median sternotomy coronary artery bypass graft (CABG) and valve surgery.

Methods: A retrospective evaluation was made of the outcomes of patients with significant proximal LAD and valvular heart disease undergoing a staged approach of percutaneous coronary intervention (PCI) followed by minimally invasive valve surgery (MIVS) at the authors' institution between February 2009 and April 2014. A Kaplan-Meier analysis was performed to estimate mid-term survival.

Acute Myocardial Infarction and Stress Cardiomyopathy Are Not Mutually Exclusive.

Background: Stress cardiomyopathy is a transient cardiac syndrome characterized by reversible left ventricular systolic dysfunction precipitated by emotional or physiologic stress. The presence of obstructive coronary artery disease has been noted in stress cardiomyopathy.

Methods: We describe 3 case reports of patients with acute coronary syndrome and transient wall motion abnormalities not usually seen in the distribution of coronary artery disease.

Bicuspid Aortic Valve and Aortic Root Morphology in Hispanic Patients.

Background: The study aim was to evaluate the aortic valve and aortic root morphology in Hispanic patients with a bicuspid aortic valve (BAV). BAV disease is one of the most common congenital anomaly of the heart, and is associated with abnormalities of the aorta. Interracial differences have been described between Caucasian and African-American patients with BAV, which may have clinical and therapeutic implications.

Normal-Weight Central Obesity: Implications for Total and Cardiovascular Mortality.

Background: The relationship between central obesity and survival in community-dwelling adults with normal body mass index (BMI) is not well-known.

Objective: To examine total and cardiovascular mortality risks associated with central obesity and normal BMI.

Design: Stratified multistage probability design.

Participation Rates, Process Monitoring, and Quality Improvement Among Cardiac Rehabilitation Programs in the United States: A NATIONAL SURVEY.

Purpose: Although strategies exist for improving cardiac rehabilitation (CR) participation rates, it is unclear how frequently these strategies are used and what efforts are being made by CR programs to improve participation rates.

Methods: We surveyed all CR program directors in the American Association of Cardiovascular and Pulmonary Rehabilitation's database. Data collection included program characteristics, the use of specific referral and recruitment strategies, and self-reported program participation rates.

Trends and predictors of smoking cessation after percutaneous coronary intervention (from Olmsted County, Minnesota, 1999 to 2010).

Smoke-free ordinance implementation and advances in smoking cessation (SC) treatment have occurred in the past decade; however, little is known about their impact on SC in patients with coronary artery disease. We conducted a retrospective cohort study of 2,306 consecutive patients from Olmsted County, Minnesota, who underwent their first percutaneous coronary intervention (PCI) from 1999 to 2009, and assessed the trends and predictors of SC after PCI. Smoking status was ascertained by structured telephone survey 6 and 12 months after PCI (ending in 2010).

The prognostic importance of weight loss in coronary artery disease: a systematic review and meta-analysis.

Objective: To assess the prognostic impact of weight loss on clinical outcomes in patients with coronary artery disease (CAD).

Methods: We performed a systematic review and meta-analysis of the prognostic effects of weight loss in patients with CAD on a composite outcome of all-cause mortality, cardiovascular mortality, and major adverse cardiac events considering studies published between January 1, 1964, and August 8, 2013. We considered weight loss "intentional" when it occurred in the presence of programmed therapeutic lifestyle changes and "observational" when no such intervention was specified.

The current and potential capacity for cardiac rehabilitation utilization in the United States.

Purpose: Prior studies suggest that program capacity restraints may be an important reason for outpatient cardiac rehabilitation (CR) underutilization. We sought to measure current CR capacity and growth potential.

Methods: We surveyed all CR program directors listed in the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) database in November 2012.

Normal weight obesity and functional outcomes in older adults.

Background: Obesity defined by body mass index (BMI) is associated with higher levels of functional impairment. However, BMI strata misrepresent true adiposity, particularly in those with a normal BMI but elevated body fat (BF%) (normal weight obesity [NWO]) whom are at higher metabolic and mortality risk. Whether this subset of patients is associated with worsening functional outcomes is unclear.

Diagnostic performance of skinfold method to identify obesity as measured by air displacement plethysmography in cardiac rehabilitation.

Purpose: To assess the diagnostic performance of the skinfold (SKF) method to detect obesity in patients enrolled in an outpatient cardiac rehabilitation (CR) program.

Methods: This study involves outpatients attending a phase II CR program who underwent air displacement plethysmography (ADP) to assess body composition. We measured body fat percentage (BF%), using a 3-site SKF method calculated through the Jackson-Pollock equation utilizing a Harpenden caliper.

Effect of a lifestyle therapy program using cardiac rehabilitation resources on metabolic syndrome components.

Purpose: To assess the effect of a lifestyle therapy program using cardiac rehabilitation (CR) resources for patients at risk for metabolic syndrome (MetS).

Methods: We designed a cardiometabolic program (CMP) using CR facilities and resources. We compared MetS components of 240 patients classified as either obese (body mass index, ≥30 kg/m) or hyperglycemic (fasting glucose, >100 mg/dL): 58 enrolled and completed the CMP, 59 signed up for the CMP but never attended or dropped out early (control 1) but had followup data, and 123 did not sign up for the CMP (control 2).

Mechanisms of adverse cardiometabolic consequences of obesity.

Obesity is an epidemic that threatens the health of millions of people worldwide and is a major risk factor for cardiovascular diseases, hypertension, diabetes, and dyslipidemia. There are multiple and complex mechanisms to explain how obesity can cause cardiovascular disease. In recent years, studies have shown some limitations in the way we currently define obesity and assess adiposity.

Normal weight obesity and mortality in United States subjects ≥60 years of age (from the Third National Health and Nutrition Examination Survey).

Current body mass index (BMI) strata likely misrepresent the accuracy of true adiposity in older adults. Subjects with normal BMI with elevated body fat may metabolically have higher cardiovascular and overall mortality than previously suspected. We identified 4,489 subjects aged ≥60 years (BMI = 18.

Diagnostic performance of weight loss to predict body fatness improvement in cardiac rehabilitation patients.

Purpose: To determine the diagnostic performance of weight loss to identify fat mass loss in cardiac rehabilitation (CR) patients.

Methods: We included consecutive patients enrolled in early outpatient CR who underwent air displacement plethysmography with measurements of height, weight, and waist circumference at initiation and completion of CR. We calculated the accuracy of >1 kg of weight loss to predict a >1 kg loss of fat mass.

Availability and characteristics of cardiovascular rehabilitation programs in South America.

Purpose: Cardiac rehabilitation (CR) programs decrease morbidity and mortality rates in patients with coronary artery disease, the leading cause of death in Latin America. This study was carried out to assess the characteristics and current level of CR program implementation in South America.

Methods: We carried out a survey of CR programs that were identified using the directory of the South American Society of Cardiology and through an exhaustive search by the investigators.

[Evidence-based cardiology: practical applications from epidemiology. IV Cardiovascular risk prediction].

Cardiovascular risk assessment in patients without established disease allows to match the intensity of risk factor modification to the underlying hazard for cardiovascular events. The cardiologist needs to know the characteristics of current risk prediction algorithms, their advantages and limitations.

[Evidence-based cardiology: practical applications from epidemiology. III. Diagnostic capacity of a clinical test].

This article reviews different characteristics of validity in a clinical diagnostic test. In particular, we emphasize the likelihood ratio as an instrument that facilitates the use of epidemiologic concepts in clinical diagnosis.