Herz
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Review Practice Guideline
[Cardiovascular prevention and regular physical exercise : Activity and training as the true "polypill"].
Guidelines for cardiovascular prevention need to be regularly revised and updated. With respect to physical activity and exercise, many studies with practical relevance have been published in recent years. They are concerned with the evidence of physical activity for prevention of many diseases and the spectrum of indications for applying physical activity for prevention, therapy and rehabilitation. ⋯ The prescription of exercise is an important approach for improving the motivation for physical activity; however, prescribing exercise needs basic knowledge in sports physiology and proper training recommendations. Furthermore, population-based interventions for physical activity are urgently needed to implement more physical activity in the daily routine. The current ESC guidelines provide a great deal of new information to be implemented in the prevention in primary care; however, with regard to physical activity, more comprehensive biological data of physical activity should be presented in order to improve physician's knowledge, thus enhancing the fight against inactivity and sedentary lifestyles as one of the most significant risk factors.
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The treatment of mitral regurgitation has changed in recent years because of improvements in the surgical treatment, in particular valve repair, and the advent of interventional techniques, mainly percutaneous edge-to-edge repair. Regardless of the technique used, better results are obtained for interventions in primary mitral regurgitation than in secondary mitral regurgitation, which remains a challenge. Further developments are expected in the future thanks to a better understanding of the epidemiology and the mechanisms of secondary mitral regurgitation, the development of interventional techniques, and a careful evaluation.
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Review Meta Analysis
Effects of limiting fluid intake on clinical and laboratory outcomes in patients with heart failure : Results of a meta-analysis of randomized controlled trials.
The guidelines of the Scientific Societies of Cardiology recommend limiting fluid intake as a nonpharmacological measure for the management of chronic heart failure (HF). However, many patients with HF may suffer from severe thirst. A meta-analysis was performed to evaluate the effect of limiting fluid consumption based on various clinical and laboratory outcomes in patients with chronic HF. ⋯ In patients with HF, liberal fluid consumption does not seem to exert an unfavorable impact on HF rehospitalizations or all-cause mortality. Further randomized controlled trials are warranted to definitively confirm the present findings.
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The Osborn wave is a deflection with a dome-shaped configuration at the R-ST junction of the electrocardiogram. It is mainly encountered in hypothermic states but is also recognized in other nonhypothermic conditions. ⋯ Most important is its arrhythmogenic potential especially when observed in patients with myocardial ischemia where it was found to be a precursor of malignant ventricular arrhythmias. Herein, we provide a comprehensive review of the history, causes, electrocardiographic and electrophysiologic characteristics, as well as diagnostic and prognostic significance of the Osborn wave.
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Review Meta Analysis
Antithrombotic therapy after percutaneous coronary intervention in patients requiring oral anticoagulant treatment. A meta-analysis.
The aim of this meta-analysis was to evaluate the benefits and risks of triple therapy (TT) compared with dual therapy (DT) for patients with an indication for anticoagulation who had undergone percutaneous coronary intervention. ⋯ Our analysis found no statistically significant difference between TT and DT with regard to all-cause death and MACE/stroke risk. At the same time, the available data demonstrated that TT increased the risk of major bleeding. If the international normalized ratio is in the target range, the risk of bleeding may be lowered. The data from Asian countries were limited, and therefore we could not assess the difference between TT and DT in Asian populations. Finally,on the basis of our analysis, we do not recommend TT as conventional treatment for patients taking OACs and undergoing percutaneous coronary intervention.