Clinical Cardiology Alert – August 1, 2024

The Role of Pulmonary Hypertension in the Decision to Intervene in Degenerative Mitral Regurgitation

A retrospective observational study of patients with degenerative mitral valve regurgitation has shown that Doppler echocardiographic-determined elevated pulmonary artery systolic pressure is related to mortality independent of the severity of mitral regurgitation, and that this excess mortality can be attenuated by mitral valve surgery.

Risk of Atherosclerotic Coronary Artery Disease in Autoimmune Disorders

A large Danish registry study of patients with autoimmune disease referred for coronary computed tomography angiography compared to those without autoimmune disease has shown that autoimmune disease increases the incidence of atherosclerotic events and that the event rate is influenced by traditional atherosclerotic disease risk factors. These results support aggressive risk factor management in patients with autoimmune disease.

CVD Risk from Ketogenic Diets

A recent analysis of the UK Biobank data found that subjects on a low-carbohydrate, high-fat diet had higher levels of low-density lipoprotein cholesterol and apolipoprotein B, and an increase in incident major adverse cardiovascular events over a 12-year follow-up than subjects on a standard diet.

Chlorthalidone vs. Hydrochlorothiazide for Hypertension

A subgroup analysis of those with prior myocardial infarction or ischemic stroke in the Diuretic Comparison Project for the treatment of hypertension has found that this higher-risk group experiences fewer major adverse cardiovascular events while taking chlorthalidone compared to hydrochlorothiazide, but at the expense of more hypokalemia.

Does Ascending Aorta Size Predict Dissection?

A large Australian database study has shown that, because of the much larger number of patients without severe aortic dilatation, almost all fatal dissections occur in individuals with non-severely dilated aortas — the so-called aortic paradox.