Clinical Cardiology Alert – April 1, 2017
April 1, 2017
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Left Ventricular Diastolic Function in the Elderly
Analysis of the ability of echo Doppler measures of diastolic function to predict heart failure and death in community subjects > 65 years of age was improved by applying age-adjusted normal values for e’, which are considerably lower than those recommended in the American Society of Echocardiography guidelines.
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Diastolic Stress Testing Improves Diagnostic Accuracy in Evaluation of Heart Failure With Preserved Ejection Fraction
Adding echocardiographic assessment of diastolic function during exercise improves the accuracy of current algorithms for evaluating suspected heart failure with preserved ejection fraction.
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Study Challenges Orthodoxy of IV Hydration for Prevention of Contrast Nephropathy
This trial randomized 660 patients with chronic kidney disease and a planned procedure requiring intravascular iodinated contrast to prophylactic hydration or to no hydration. No hydration was found to be non-inferior for prevention of contrast-induced nephropathy and saved significant costs.
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Uncertainties in Assessing Stroke Risk in Atrial Fibrillation
An analysis of 34 randomized trials in atrial fibrillation patients not on anti-coagulation showed considerable variation in stroke rates corresponding to their predicted risk by the CHA2DS2-VASc scores. When these scores are 2 or less, stroke rates are low enough to question the benefit versus risk of anti-coagulation therapy.
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Another Good Reason to Consider Early Ablation for Ventricular Tachycardia
In a retrospective cohort of patients with structural heart disease and ventricular tachycardia, amiodarone often could be safely reduced or discontinued after ablation.