Cardiovascular Medicine

2 pages, 229 KB

Open AccessCommunication

Jahresbericht 2007 der Arbeitsgruppe «Herzinsuffizienz»

by Hans-Peter Brunner, Fritz Widmer, René Lerch, Thomas Suter, Charles Seydoux, Georg Noll, Giorgio Moschovitis, Karl Nüesch, Marcia Leventhal and Otto M. Hess

Cardiovasc. Med. 2009, 12(3), 98; https://doi.org/10.4414/cvm.2009.01402 - 20 Mar 2009

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Abstract

Die Arbeitsgruppe zählte am Ende des Berichtsjahres 138 Mitglieder, davon 84 ordentliche und 54 ausserordentliche Mitglieder [...] Full article

2 pages, 355 KB

Open AccessInteresting Images

Isolated Posterior Mitral Valve Cleft

by Stefan Toggweilera, David Hürlimanna, Jürg Grünenfelderb and Rolf Jenni

Cardiovasc. Med. 2009, 12(3), 96; https://doi.org/10.4414/cvm.2009.01408 (registering DOI) - 20 Mar 2009

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A 55-year-old man who presented with a history of atypical angina during the last five years [...] Full article

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2 pages, 533 KB

Open AccessInteresting Images

A Bad Memory

by Michael Kühne and Stefan Osswald

Cardiovasc. Med. 2009, 12(3), 94; https://doi.org/10.4414/cvm.2009.01399 - 20 Mar 2009

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Abstract

A 32-year-old male presented to the emergency department at midnight on a Sunday because of acute onset of chest pain [...] Full article

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9 pages, 1195 KB

Open AccessEditorial

The Implantable Loop Recorder: A Critical Review

by Juan F. Iglesias, Denis Graf, Patrizio Pascale and Etienne Pruvot

Cardiovasc. Med. 2009, 12(3), 85; https://doi.org/10.4414/cvm.2009.01406 - 20 Mar 2009

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Abstract

The investigation of recurrent unexplained syncope is a challenging clinical problem, as syncope remains unexplained in up to 60% of patients referred to an emergency department. In spite of the demonstrated benefit of a standardised stepwise non invasive work-up, syncope still remains undiagnosed [...] Read more.

The investigation of recurrent unexplained syncope is a challenging clinical problem, as syncope remains unexplained in up to 60% of patients referred to an emergency department. In spite of the demonstrated benefit of a standardised stepwise non invasive work-up, syncope still remains undiagnosed in up to 30% of patients. The “gold standard” for the diagnostic work-up of syncope is the correlation between clinical event and any alteration of physiological signals, but syncope rarely occurs during ECG monitoring. Recent advances in long-term cardiac monitoring techniques with implantable loop recorders (ILR) offer nowadays a powerful tool for the investigation of syncope as well as undiagnosed arrhythmias.
According to current indications, ILR is recommended in patients with recurrent unexplained syncope following a negative baseline work-up, who require further investigations because of syncope-related complications. ILR can also be implanted early in the work-up, before conventional investigations, in patients with clinical or ECG features suggesting an arrhythmic syncope or to assess the contribution of bradycardia in suspected cases of severe neurally mediated syncope before pacemaker implantation. Recently, ILR was proposed as a novel method for atrial fibrillation monitoring, particularly after catheter ablation, but it deserves additional clinical validation due to a high prevalence of inappropriate detection. Full article

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7 pages, 1057 KB

Open AccessEditorial

Prasugrel versus Clopidogrel beim akuten Koronarsyndrom Sicherheit und Wirksamkeit des neuen Thrombozytenhemmers

by Cathérine Gebhard and Jürg H. Beer

Cardiovasc. Med. 2009, 12(3), 78; https://doi.org/10.4414/cvm.2009.01398 - 20 Mar 2009

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Abstract

Prasugrel versus clopidogrel in the acute coronary syndrome: security and effectiveness of the new platelet inhibitor. The “Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition With Prasugrel Thrombolysis in Myocardial Infarction 38” (TRITON-TIMI-38) compared the clinical outcomes among subjects treated [...] Read more.

Prasugrel versus clopidogrel in the acute coronary syndrome: security and effectiveness of the new platelet inhibitor. The “Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition With Prasugrel Thrombolysis in Myocardial Infarction 38” (TRITON-TIMI-38) compared the clinical outcomes among subjects treated with prasugrel, a new thienopyridine, versus the standard approved clopidogrel regimen in patients with acute coronary syndromes (ACS) undergoing percutaneous coronary intervention (PCI). The analysis of the TRITON-TIMI study has been published recently and demonstrates a significant 19% reduction in ischaemic events in the prasugrel group as measured by the composite endpoint of cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke. Of concern, however, was the excess in major bleeding complications (0.4% vs 0.1%; p = 0.002), including life-threatening (1.4% vs 0.9%; p = 0.01) and fatal ones (0.4% vs 0.1%; p = 0.002), in the prasugrel group. Given the subgroup analysis of TRITON-TIMI, patients with previous stroke, transient ischaemic attack, low body weight, impaired renal function or advanced age seem to have a higher risk of bleeding and less or no overall benefit of prasugrel. In contrast, selected subgroups appear to derive particular benefit from prasugrel, such as diabetic patients, young patients, or patients with a high risk of developing stent thrombosis. Thus, antithrombotic therapy remains a balance of risk and benefit. Potentially, future research will support individualised antiplatelet therapy based on the risk and perhaps on the point of care testing of platelet function. For the time being, in vulnerable subgroups, moderate platelet inhibition, such as the standard dosage of clopidogrel, may still represent an advantage over more a Full article

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4 pages, 113 KB

Open AccessProceeding Paper

Role of the Renin-Angiotensin-Aldosterone System in Diastolic Dysfunction and Heart Failure

by Johann Bauersachs and Julian D. Widder

Cardiovasc. Med. 2009, 12(3), 74; https://doi.org/10.4414/cvm.2009.01403 - 20 Mar 2009

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Abstract

Heart failure with preserved left ventricular (LV) ejection fraction is commonly viewed as the consequence of diastolic dysfunction. Hypertension is the most common cause for the development of diastolic dysfunction and LV hypertrophy leading to symptomatic hypertensive heart disease. Strict blood pressure control [...] Read more.

Heart failure with preserved left ventricular (LV) ejection fraction is commonly viewed as the consequence of diastolic dysfunction. Hypertension is the most common cause for the development of diastolic dysfunction and LV hypertrophy leading to symptomatic hypertensive heart disease. Strict blood pressure control therefore is mandatory to prevent diastolic heart failure in patients with hypertension. Besides the mechanical pressure load activation of the renin-angiotensinaldosterone system (RAAS) essentially contributes to the progression of LV hypertrophy and diastolic heart failure in hypertensive heart disease. Inhibition of RAAS by angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor (AT1) blockers reduces LV mass, cardiovascular events and incidence of atrial fibrillation in patients with hypertension and LV hypertrophy. Thus, in patients with LV hypertrophy, diastolic dysfunction or heart failure blood pressure should be tightly controlled by medical treatment usually including an ACE inhibitor or AT1 receptor antagonist although to date prognosis was not shown to be improved by RAAS inhibition in randomised studies including patients with heart failure and preserved ejection fraction. Full article

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3 pages, 90 KB

Open AccessEditorial

Kann der Denkplatz Schweiz das Jahr 2024 Erleben? Zeitgemässe Betrachtungen zu Einer Unzeitgemässen Frage

by Thomas F. Lüscher

Cardiovasc. Med. 2009, 12(3), 71; https://doi.org/10.4414/cvm.2009.01407 - 20 Mar 2009

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Abstract

Als Andrej Amalrik 1969 seinen provokanten Aufsatz «Kann die Sowjetunion das Jahr 1984 überleben?» unter grossen Gefahren veröffentlichte [...] Full article

2 pages, 869 KB

Open AccessCommunication

HELP Zürich: Kampagne mit Tiefenwirkung

by Urs Niklaus Dürst, Walter Kaiser, Susan Kirmse, Reto Mettler, Peter Siegrist and Gabor Sütsch

Cardiovasc. Med. 2009, 12(3), 100; https://doi.org/10.4414/cvm.2009.01404 - 20 Mar 2009

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Abstract

Der Herz-Kreislauf-Stillstand ausserhalb des Spitals ist eine besondere Herausforderung an das Gesundheitssystem; weniger als 6% der Betroffenen überleben ihn [...] Full article

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Cardiovasc. Med., Volume 12, Issue 3 (03 2009) – 8 articles

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