Background The relationship between noninvasive cardiac diagnostic testing intensity and downstream clinical outcomes is unclear. Our objective was to examine the relationship between hospital network noninvasive cardiac diagnostic testing intensity and downstream clinical outcomes in patients who were discharged from the emergency department after assessment for chest pain. Methods and Results We employed a retrospective cohort study design of 387 809 patients evaluated for chest pain in the emergency department between April 1, 2010 and March 31, 2016. Hospital networks were divided into tertiles based on usage of noninvasive cardiac diagnostic testing. The primary outcome was a composite of acute myocardial infarction or all-cause mortality. Adjusted Cox proportional hazards models were used to compare the hazard of the composite outcome of myocardical infarction and/or all-cause mortality between the tertiles. After adjustment for clinically relevant covariates, patients evaluated for chest pain in intermediate noninvasive cardiac diagnostic testing usage tertile hospital networks did not have significantly different hazards of the composite outcome when compared with those evaluated in low usage tertile hospital networks >90 days (hazard ratio [HR], 1.00; 95% CI, 0.83-1.21), 6 months (HR, 1.07; 95% CI, 0.92-1.24), and 1 year (HR, 1.03; 95% CI, 0.94-1.14). Patients evaluated in the high usage tertile also did not have significantly different hazards of the composite outcome compared with those evaluated in the low usage tertile at 90 days (HR, 0.98; 95% CI, 0.80-1.19), 6 months (HR, 1.01; 95% CI, 0.87-1.17); and 1 year (HR, 0.95; 95% CI, 0.86-1.05). Conclusions Our population-based study demonstrated that high noninvasive cardiac diagnostic testing use intensity was not associated with reductions in downstream myocardial infarction or all-cause mortality.
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http://dx.doi.org/10.1161/JAHA.120.017330 | DOI Listing |
Front Med (Lausanne)
January 2025
Department of General Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research (DMIHER), Wardha, India.
Background: Cardiac autonomic neuropathy (CAN) is a significant complication in chronic kidney disease (CKD), leading to increased morbidity and mortality. Early detection is essential for managing CKD patients effectively, especially those on hemodialysis. This study evaluated the prevalence CAN in CKD and diagnostic accuracy of Bellavere's Score in predicting CAN in CKD patients, including those undergoing hemodialysis.
View Article and Find Full Text PDFClin Transl Radiat Oncol
March 2025
Smilow Center for Translational Research, Room 8-136, Univ of Pennsylvania, Perelman School of Medicine, 3400 Civic Center Blvd, Bldg 421, Philadelphia, PA 19104, USA.
Cardiac stereotactic body radiotherapy is a promising noninvasive treatment for patients with refractory ventricular tachycardia. With the aim to prove feasibility of a novel image guided radiotherapy and heart motion gating device, cardiac proton radiotherapy was performed using a porcine model. Using a novel adaptation of γ - H2AX tissue staining techniques, we have been able to localize a radiation beam in large animal tissue to assess targeting accuracy within a defined field.
View Article and Find Full Text PDFFront Neurosci
January 2025
Department of Evidence-Based Medicine and Social Medicine, School of Public Health, Chengdu Medical College, Chengdu, Sichuan, China.
Introduction: Sleep deprivation (SD) significantly disrupts the homeostasis of the cardiac-brain axis, yet the neuromodulation effects of deep magnetic stimulation (DMS), a non-invasive and safe method, remain poorly understood.
Methods: Sixty healthy adult males were recruited for a 36-h SD study, they were assigned to the DMS group or the control group according to their individual willing. All individuals underwent heart sound measurements and functional magnetic resonance imaging scans at the experiment's onset and terminal points.
Rev Cardiovasc Med
January 2025
Department of Cardiology, Renmin Hospital of Wuhan University, 430060 Wuhan, Hubei, China.
With a better understanding of the susceptibility to atrial fibrillation (AF) and the thrombogenicity of the left atrium, the concept of atrial cardiomyopathy (ACM) has emerged. The conventional viewpoint holds that AF-associated hemodynamic disturbances and thrombus formation in the left atrial appendage are the primary causes of cardiogenic embolism events. However, substantial evidence suggests that the relationship between cardiogenic embolism and AF is not so absolute, and that ACM may be an important, underestimated contributor to cardiogenic embolism events.
View Article and Find Full Text PDFNeurophotonics
January 2025
California Institute of Technology, Department of Electrical Engineering, Pasadena, California, United States.
Significance: Cerebral blood flow (CBF) and cerebral blood volume (CBV) are key metrics for regional cerebrovascular monitoring. Simultaneous, non-invasive measurement of CBF and CBV at different brain locations would advance cerebrovascular monitoring and pave the way for brain injury detection as current brain injury diagnostic methods are often constrained by high costs, limited sensitivity, and reliance on subjective symptom reporting.
Aim: We aim to develop a multi-channel non-invasive optical system for measuring CBF and CBV at different regions of the brain simultaneously with a cost-effective, reliable, and scalable system capable of detecting potential differences in CBF and CBV across different regions of the brain.
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