Heart : official journal of the British Cardiac Society
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Multicenter Study
The NCDR ACTION Registry-GWTG: transforming contemporary acute myocardial infarction clinical care.
The NCDR ACTION Registry-GWTG collects detailed in-hospital clinical, process-of-care and outcomes data for patients admitted with acute myocardial infarction (AMI) in the USA. The registry is a national AMI surveillance system that contributes to the scientific enquiry process of AMI care through the facilitation of local and national quality improvement efforts. ⋯ Main outcome measures include American College of Cardiology/American Heart Association myocardial infarction performance indicators, as well as in-hospital patient outcomes. Data are available for research by application to: http://www.ncdr.com.
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Multicenter Study
Clinical characteristics and outcome of infective endocarditis in adults with bicuspid aortic valves: a multicentre observational study.
To analyse characteristics and outcomes of infective endocarditis (IE) on bicuspid aortic valves (BAV) and to compare the risk of death according to the presence or absence of BAV. ⋯ BAV is frequent in adults with native aortic valve IE. Patients with BAV IE incur high risk of abscess formation and require early surgery in almost three-quarters of cases. IE is a severe complication in the setting of BAV and warrants prompt diagnosis and treatment.
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Multicenter Study
Impact of prosthesis-patient mismatch on mitral regurgitation after aortic valve replacement.
Mitral regurgitation is frequently observed in patients undergoing aortic valve replacement (AVR) for aortic stenosis and often improves postoperatively, mainly due to left ventricular remodelling and changes in loading conditions. Aortic prosthesis-patient mismatch (PPM) is associated with poor outcome and lesser left ventricular remodelling. This study tested the hypothesis that aortic PPM affects mitral regurgitation. ⋯ The presence of PPM after AVR attenuates postoperative mitral regurgitation changes, mainly in patients with organic mitral regurgitation.
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To assess the long-term effect of spinal cord stimulation (SCS) on angina symptoms and quality of life in patients with refractory angina pectoris defined as severe angina due to coronary artery disease resistant to conventional pharmacological therapy and/or revascularisation. ⋯ SCS treatment is associated with symptom relief and improved quality of life in patients with refractory angina pectoris suffering from severe coronary artery disease.
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Multicenter Study Clinical Trial
Effects of cardiac resynchronisation therapy in patients with heart failure having a narrow QRS Complex enrolled in PROSPECT.
Current guidelines recommend cardiac resynchronisation therapy (CRT) in patients with severe symptomatic heart failure, depressed left ventricular (LV) systolic function and a wide QRS complex (>or=120 ms). However, patients with heart failure having a narrow QRS complex might also benefit from CRT. DESIGN SETTING PATIENTS INTERVENTIONS: During the Predictors of Response to Cardiac Resynchronisation Therapy (PROSPECT) trial, 41 patients were enrolled in a 'narrow' QRS sub-study. These patients had a QRS complex <130 ms, but documented evidence of mechanical dyssynchrony by any of seven pre-defined echocardiographic measures. ⋯ The results suggest that CRT may have a beneficial effect in heart failure patients with a narrow QRS complex and mechanical dyssynchrony as assessed by echocardiography. The majority of patients improved on clinical symptoms, and there was an evident reduction in LV diameters. Larger studies are needed to clearly define selection criteria for CRT in patients with a narrow QRS complex.