Point of Care Ultrasound (POCUS) in the Management of Heart Failure: A Narrative Review.

Assessing for volume overload is a key component of both short and long-term management of heart failure patients. Physical examination findings are neither sensitive nor specific for detecting congestion, and subclinical congestion may not be evident at the time of examination. Point of care ultrasound (POCUS) is an efficient and non-invasive way to assess heart failure patients for volume overload.

Utility of native T1 mapping and myocardial extracellular volume fraction in patients with nonischemic dilated cardiomyopathy: A systematic review and meta-analysis.

Background: Cardiac magnetic resonance imaging (CMR) based T1 mapping and extracellular volume fraction (ECV) are powerful tools for identifying myocardial fibrosis. This systematic review and -analysis aims to characterize the utility of native T1 mapping and ECV in patients with non-ischemic cardiomyopathy (NICM) and to clarify the prognostic significance of elevated values.

Methods: A literature search was conducted for studies reporting on use of CMR-based native T1 mapping and ECV measurement in NICM patients and their association with major adverse cardiac events (MACE), ventricular arrhythmias (VAs), and left ventricular reverse remodeling (LVRR).

Outcomes and Medical Therapy in Myocardial Infarction With Nonobstructive Coronary Arteries: A Systematic Review and Meta-Analysis.

Myocardial infarction with nonobstructive coronary arteries (MINOCAs) is a disease that has been poorly characterized with unclear clinical and therapeutic outcomes. The association of medical therapy with cardiovascular outcomes in patients with MINOCA has been inadequately assessed. The purpose of this meta-analysis is to evaluate the association of MINOCA at risk of adverse cardiovascular outcomes as compared with myocardial infarction with coronary artery disease (MICAD) and the efficacy of medical therapy in reducing the risk of adverse outcomes.

The Use of Quality Improvement Interventions in Reducing Rarely Appropriate Cardiac Imaging.

The use of cardiac imaging has become increasingly prevalent over the last decade. Approximately 10% to 15% of noninvasive cardiac imaging is ordered for rarely appropriate indications. The appropriate use criteria (AUC) for cardiac imaging were issued to decrease unnecessary testing and reduce health care costs.

The use of quality improvement interventions in reducing rarely appropriate echocardiograms: A systematic review and meta-analysis.

Background: The volume of cardiac imaging continues to increase, with many tests performed for rarely appropriate indications. Appropriate use criteria (AUC) documents were published by the American Society of Echocardiography and American College of Cardiology, with quality improvement (QI) interventions developed in various institutions. However, the effectiveness of these interventions has not been assessed in a systematic fashion.

Postpartum Cardiovascular Outcomes Among Women With Heart Disease from A Nationwide Study.

There is limited data on postpartum maternal postpartum major adverse cardiovascular and cerebrovascular events (MACCE) among women with heart disease (HD) in the US. Therefore, we aimed to determine the prevalence and predictors of MACCE in the US. The Nationwide Readmissions Databases (2010 to 2014) were screened for patients with and without HD undergoing delivery.

Management of Saphenous Vein Graft Disease in Patients with Prior Coronary Artery Bypass Surgery.

Purpose Of Review: In this review, we summarize the pathogenesis of saphenous venous graft (SVG) failure in patients following coronary artery bypass graft (CABG) surgery. We also provide an update on various aspects of prevention and management of SVG failure.

Recent Findings: Application of perioperative measures and medical therapies to promote SVG patency is crucial to optimize clinical outcomes in patients following CABG.

Effect of telemedicine on glycated hemoglobin in diabetes: a systematic review and meta-analysis of randomized trials.

Background: Telemedicine, the use of telecommunications to deliver health services, expertise and information, is a promising but unproven tool for improving the quality of diabetes care. We summarized the effectiveness of different methods of telemedicine for the management of diabetes compared with usual care.

Methods: We searched MEDLINE, Embase and the Cochrane Central Register of Controlled Trials databases (to November 2015) and reference lists of existing systematic reviews for randomized controlled trials (RCTs) comparing telemedicine with usual care for adults with diabetes.

Infarct Size, Shock, and Heart Failure: Does Reperfusion Strategy Matter in Early Presenting Patients With ST-Segment Elevation Myocardial Infarction?

Background: A pharmacoinvasive (PI) strategy for early presenting ST-segment elevation myocardial infarction nominally reduced 30-day cardiogenic shock and congestive heart failure compared with primary percutaneous coronary intervention (PPCI). We evaluated whether infarct size (IS) was related to this finding.

Methods And Results: Using the peak cardiac biomarker in patients randomized to PI versus PPCI within the Strategic Reperfusion Early After Myocardial Infarction (STREAM) trial, IS was divided into 3 groups: small (≤2 times the upper limit normal [ULN]), medium (>2 to ≤5 times the upper limit normal) and large (>5 times the upper limit normal).

Aborted myocardial infarction in ST-elevation myocardial infarction: insights from the STrategic Reperfusion Early After Myocardial infarction trial.

Background: We evaluated the prespecified endpoint, aborted myocardial infarction (AbMI), according to the use of a pharmacoinvasive (PI) strategy versus primary percutaneous coronary intervention (PCI) in 1754 patients randomised within 3 h of symptom onset in the STrategic Reperfusion Early After Myocardial infarction (STREAM) trial.

Methods: Based on sequential ECG's and biomarkers, AbMI was defined as ST-elevation resolution ≥50% (90 min posttenecteplase (TNK) in the PI arm or 30 min postprimary PCI) with minimal biomarker rise.

Results: In the PI arm 11.

Use of electrocardiogram indices of myocardial ischemia for risk stratification and decision making of reperfusion strategies.

After about a century since its clinical introduction, the 12-lead electrocardiogram (ECG) remains a cornerstone in diagnosis and management of acute ST-elevation myocardial infarction (STEMI). It provides clinicians and researchers with invaluable information regarding the presence, location, and extent of myocardial infarction. Moreover the ECG contains a wealth of prognostic information useful in risk stratification of STEMI patients and identification of particular subgroups that may benefit from more aggressive therapeutic interventions.

An assessment of ST-segment measurement variability between two core electrocardiogram laboratories.

Objectives: We evaluated inter-reader agreement of the ST-segment between two electrocardiogram (ECG) core laboratories.

Background: Accurate measurement of the ST-segment is key to diagnosis and management of acute coronary syndromes (ACS). Clinical trials also rely on adherence to the pre-specified ECG eligibility criteria.

Histopathologic and clinical findings of congenital nephrotic syndrome in Iranian children: a study of two centers.

Introduction: Congenital nephrotic syndrome (CNS), an uncommon form of kidney disease, presents during the first year of life and is a diagnostic and therapeutic challenge for the pediatricians as well as pediatric nephrologists. Our study is the first study of Iranian children with CNS in two pediatric nephrology centers in Tehran, Iran.

Materials And Methods: We reviewed medical charts of 30 infants diagnosed with CNS from 1990 to 2005.

The value of serum uric Acid as a mortality prediction in critically ill children.

Objective: The role of initial serum uric acid on admission in critically ill patients is controversial; we presumed that uric acid level can predict the mortality of the admitted patients to intensive care unit as a simple test.

Methods: Totally, 220 consecutively admitted children (96 girls, 124 boys) with mean age 3.5 years, who were at least 24 hours in pediatric intensive care unit (PICU), were enrolled in a prospective cohort study during January 2006 to December 2007.