Cardiovascular Medicine

6 pages, 648 KB

Open AccessArticle

Minimal Use of Contrast Media in Patients with Severe Chronic Kidney Disease Undergoing Transcatheter Aortic Valve Implantation

by Brinkert Miriam, de Boeck Bart, Petryka Joanna, Buhmann Ralf, Fornaro Jürgen, Weberndörfer Vanessa, Bossard Matthias, Roos Justus, Cuculi Florim, Kobza Richard and Toggweiler Stefan

Cardiovasc. Med. 2019, 22(1), w02021; https://doi.org/10.4414/cvm.2019.02021 - 26 Feb 2019

Cited by 1

Abstract

Background: Patients with severe kidney disease and severe aortic stenosis requiring transcatheter aortic valve implantation (TAVI) represent a growing cohort. In this context, we investigated the feasibility and safety of a novel integrated approach, including gadolinium-free magnetic resonance tomography (MR) in order to [...] Read more.

Background: Patients with severe kidney disease and severe aortic stenosis requiring transcatheter aortic valve implantation (TAVI) represent a growing cohort. In this context, we investigated the feasibility and safety of a novel integrated approach, including gadolinium-free magnetic resonance tomography (MR) in order to minimize use of any contrast media (CM) in those patients. Methods and results: Out of a cohort of 168 patients undergoing TAVI, 20 (12%) patients with severe chronic kidney disease (CKD) were managed by applying an integrated approach using minimal dosage of CM. Coronary angiographies were performed with 54±35ml and 85±44ml of CM in patients with severe CKD and patients without severe CKD, respectively (p <0.01). In patients with severe CKD, gadolinium-free magnetic resonance tomographies (MR) were performed for annular and iliofemoral assessment. All other patients were screened with ECGgated multislice computed tomography using 63±14ml of CM. In patients with severe versus without severe CKD, TAVIs were performed with 40± 32ml versus 112±50 ml of contrast media, respectively (p <0.01). During followup, stage 2 or 3 acute kidney injury (AKI) occurred in 1 (5%) versus 4 (2.8%, p = 0.05). At 30 days, there were no strokes, and survival was 100% and 98%, respectively. Conclusions: We were able to reduce the total amount of CM required for pre-procedural planning and TAVI by 64% from 260 ± 79 ml to 94 ± 54 ml. This study indicates that gadolinium-free MR can be used for pre-procedural annular and iliofemoral assessment, and thus selection of prosthesis size. Full article

1 pages, 225 KB

Open AccessEditorial

Swiss Amgen Cardiology Research Award 2019

by Karin Guldenfels

Cardiovasc. Med. 2019, 22(1), w02016; https://doi.org/10.4414/cvm.2019.02016 - 26 Feb 2019

Abstract

The Swiss Amgen Cardiology Research Award is awarded for original research work in cardiovascular disease[...] Full article

1 pages, 260 KB

Open AccessEditorial

Otto Hess Trainee Award 2019 of the Swiss Society of Cardiology

by Rickli Hans and Pedrazzini Giovanni

Cardiovasc. Med. 2019, 22(1), w02015; https://doi.org/10.4414/cvm.2019.02015 - 26 Feb 2019

Abstract

The Swiss Society of Cardiology (SSC) has created the Otto Hess Trainee Award to recognise and support trainees in cardiology who have made a significant contribution to research in the field of cardiology at an early stage of their career[...] Full article

1 pages, 256 KB

Open AccessEditorial

Moving Forward: Continuous Online Publishing

by Mach François, Flammer Andreas and Marty Natalie

Cardiovasc. Med. 2019, 22(1), w02014; https://doi.org/10.4414/cvm.2019.02014 - 26 Feb 2019

Abstract

Cardiovascular Medicine has established itself as the most important cardiology journal in Switzerland[...] Full article

8 pages, 1387 KB

Open AccessEditorial

From Past to Future in Cardiovascular Care and Research in Ticino

by Moccetti Tiziano

Cardiovasc. Med. 2019, 22(1), w02012; https://doi.org/10.4414/cvm.2019.02012 - 26 Feb 2019

Abstract

In this article based on the Grüntzig Lecture 2018 the author gives his personal memories and a review of the development of cardiology in the canton of Ticino. Full article

2 pages, 424 KB

Open AccessInteresting Images

Unusual Case of Large Vessel Vasculitis Limited to the Vertebral Arteries

by Campanale Daniela, Muoio Barbara, Raditchkova Mariana and Treglia Giorgio

Cardiovasc. Med. 2019, 22(1), w02011; https://doi.org/10.4414/cvm.2019.02011 - 26 Feb 2019

Abstract

A 80-year-old male patient was admitted to our hospital with fever and increased serum inflammatory markers (erythrocyte sedimentation rate, C-reactive protein and leucocyte count)[...] Full article

9 pages, 980 KB

Open AccessReview

Optimising the Early Rule-out and Rule-in of Myocardial Infarction Using Biomarkers

by Twerenbold Raphael, Gimenez Maria Rubini, Nestelberger Thomas, Boeddinghaus Jasper, Wildi Karin and Mueller Christian

Cardiovasc. Med. 2019, 22(1), w02010; https://doi.org/10.4414/cvm.2019.02010 - 26 Feb 2019

Cited by 4

Abstract

Detailed clinical assessment, the electrocardiogram and cardiac troponin form the three cornerstones of the early diagnosis of myocardial infarction (MI). After the clinical introduction of high-sensitivity cardiac troponin (hs-cTn) assays about 8 years ago, precise quantification of cardiomyocyte injury around the 99th percentile [...] Read more.

Detailed clinical assessment, the electrocardiogram and cardiac troponin form the three cornerstones of the early diagnosis of myocardial infarction (MI). After the clinical introduction of high-sensitivity cardiac troponin (hs-cTn) assays about 8 years ago, precise quantification of cardiomyocyte injury around the 99th percentile became possible and thereby substantially increased the accuracy of MI diagnosis from blood drawn at presentation to the emergency department. Higher diagnostic accuracy enabled the development and validation of multiple early hs-cTn-based diagnostic algorithms including the ESC 0/ 1-hour algorithm, which substantially reduced the time required for safe rule-out or rule-in of MI. This algorithm is widely applicable, including in patients with renal dysfunction and in the USA, where hs-cTn approval is slightly different from the rest of the world. Apart from hs-cTn, other emerging cardiac biomarkers might have the potential to further improve the early triage of patients with suspected MI. Full article

Open AccessLetter

Comment Regarding the Paper “40 Years of PTCA” by Bernhard Meier

by Ulrich Sigwart

Cardiovasc. Med. 2019, 22(1), w02009; https://doi.org/10.4414/cvm.2019.02009 - 26 Feb 2019

Abstract

I much enjoyed reading this fascinating account of the history of interventional cardiology - written by someone who has been actively involved from the first hour[...] Full article

8 pages, 515 KB

Open AccessReview

Soluble ST2—A New Biomarker in Heart Failure

by Biaggi Patric, Ammann Camille, Imperiali Mauro, Hammerer-Lercher Angelika, Breidthardt Tobias, Müller Christian, Maisel Alan and Ruschitzka Frank

Cardiovasc. Med. 2019, 22(1), w02008; https://doi.org/10.4414/cvm.2019.02008 - 26 Feb 2019

Cited by 17

Abstract

Cardiovascular biomarkers play an essential role in the diagnosis, risk stratification and treatment of patients with cardiac diseases and in particular heart failure patients. However, the accuracy of most biomarkers is limited by confounding comorbidities, rendering their interpretation difficult. The relatively new biomarker [...] Read more.

Cardiovascular biomarkers play an essential role in the diagnosis, risk stratification and treatment of patients with cardiac diseases and in particular heart failure patients. However, the accuracy of most biomarkers is limited by confounding comorbidities, rendering their interpretation difficult. The relatively new biomarker sST2 (soluble suppression of tumourigenicity 2) is said to reflect myocardial wall stress and activation of the fibrosis pathway and to be less dependent on common confounders. Elevated sST2 levels in acute heart failure patients predict both rehospitalisation and mortality. Chronic heart failure patients who have sST2 levels responsive to medical treatment have a better outcome. However, elevated sST2 levels in the absence of heart failure or heart disease are not uncommon and limit its use for diagnostic purposes in a general nonheart failure population. This review reflects the presentations and discussion by the participants at the first meeting of the Swiss working group on cardiovascular biomarkers held in September 2018 in Zurich, Switzerland. It also highlights current Swiss experience with sST2 and indicates areas of uncertainty, in particular the need to identify the exact pathway of sST2 in cardiac disease and specify its clinical implications for subgroups of heart failure and non-heart failure patients. Full article

3 pages, 1210 KB

Open AccessCase Report

Verschwinden Ischämie-verdächtiger EKG-Veränderungen nach Einlage eines biliären Stents

by Gozzoli Daniele and Balestra Brenno

Cardiovasc. Med. 2019, 22(1), w02007; https://doi.org/10.4414/cvm.2019.02007 - 26 Feb 2019

Abstract

Ischaemic type ECG-modifications are not always correlated to cardiac causes. We present a case of a 63-yearold man with metastatic kidney carcinoma who had ECGabnormalities suspicious for myocardial ischaemia due to a biliary problem, which were completely resolved after the treatment of obstructive [...] Read more.

Ischaemic type ECG-modifications are not always correlated to cardiac causes. We present a case of a 63-yearold man with metastatic kidney carcinoma who had ECGabnormalities suspicious for myocardial ischaemia due to a biliary problem, which were completely resolved after the treatment of obstructive jaundice. Full article

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Cardiovasc. Med., Volume 22, Issue 1 (02 2019) – 10 articles

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