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31.
The long‐term outcomes of transcoronary ablation of septal hypertrophy compared to surgical myectomy in patients with symptomatic hypertrophic obstructive cardiomyopathy 下载免费PDF全文
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Kevin C. Allman MBBS FRACP FACC FCSANZ FAANMS FASNC 《Journal of nuclear cardiology》2013,20(4):618-637
Observations of reversibility of cardiac contractile dysfunction in patients with coronary artery disease and ischemia were first made more than 40 years ago. Since that time a wealth of basic science and clinical data has been gathered exploring the mechanisms of this phenomenon of myocardial viability and relevance to clinical care of patients. Advances in cardiac imaging techniques have contributed greatly to knowledge in the area, first with thallium-201 imaging, then later with Tc-99m-based tracers for SPECT imaging and metabolic tracers used in conjunction with positron emission tomography (PET), most commonly F-18 FDG in conjunction with blood flow imaging with N-13 ammonia or Rb-82 Cl. In parallel, stress echocardiography has made great progress also. Over time observational studies in patients using these techniques accumulated and were later summarized in several meta-analyses. More recently, cardiac magnetic resonance imaging (CMR) has contributed further information in combination with either late gadolinium enhancement imaging or dobutamine stress. This review discusses the tracer and CMR imaging techniques, the pooled observational data, the results of clinical trials, and ongoing investigation in the field. It also examines some of the current challenges and issues for researchers and explores the emerging potential of combined PET/CMR imaging for myocardial viability. 相似文献
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Nicholas Collins BMed FRACP FCSANZ Lee N. Benson MD FRCPC FACC FSCAI Eric M. Horlick MD CM FRCPC 《Congenital heart disease》2012,7(1):80-83
Coronary artery fistulae are an uncommon anomaly and, while frequently asymptomatic, may require interventional therapy. Transcatheter approaches for closure of coronary artery fistulae are now commonly used, with various methods of fistula occlusion described, including detachable coils. During a percutaneous procedure to occlude a symptomatic left anterior descending coronary artery to pulmonary artery fistula, the patient experienced chest discomfort with anterior ST segment elevation. We demonstrate an unusual, unique and striking ECG abnormality complicating the delivery of coils designed to occlude the fistula in the absence of coronary artery injury. The mechanisms of the procedural ECG changes are discussed, as are potential alternate diagnoses and associated therapy. 相似文献
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William Thomas MBBS GradDipSurgAnat GradCertClinUS Jonathan Henry MBChB MClinUS CCPU AFRACMA FACEM Jay Ee Chew MD Manuja Premaratne MBBS FRACP FSCCT FCSANZ Gabriel Blecher MBBS PGradDipMan MSc CCPU FACEM Darsim L Haji MBChB PhD PGradDipCritCareEcho FACEM 《Emergency medicine Australasia : EMA》2023,35(5):720-730
Point-of-care ultrasound (POCUS) is becoming ubiquitous in emergency medicine. POCUS for abdominal aortic aneurysm is well established in practice. The thoracic aorta can also be assessed by POCUS for dissection and aneurysm and transthoracic echocardiography is endorsed by international guidelines as an initial test for thoracic aortic pathologies. A systematic search of Ovid Medline, PubMed, EMBASE, SCOPUS and Web of Science from January 2000 to August 2022 identified four studies evaluating diagnostic accuracy of emergency physician POCUS for thoracic aortic dissection (TAD) and five studies for thoracic aortic aneurysm (TAA). Study designs were heterogeneous including differing diagnostic criteria for aortic pathology. Convenience recruitment was frequent in prospective studies. Sensitivity and specificity ranges for studies of TAD were 41–91% and 94–100%, respectively when an intimal flap was seen. Sensitivity and specificity ranges for studies of thoracic aorta dilation >40 mm were 50–100% and 93–100%, respectively; for >45 mm ranges were 64–65% and 95–99%. Literature review identified that POCUS is specific for TAD and TAA. POCUS reduces the time to diagnosis of thoracic aortic pathology; however, it remains insensitive and cannot be recommended as a stand-alone rule-out test. We suggest that detection of thoracic aorta dilation >40 mm by POCUS at any site increases the suspicion of serious aortic pathology. Studies incorporating algorithmic use of POCUS, Aortic Dissection Detection Risk Score and D-dimer as decision tools are promising and may improve current ED practices. Further research is warranted in this rapidly evolving field. 相似文献
36.
Cardiovascular magnetic resonance‐GUIDEd management of mild to moderate left ventricular systolic dysfunction (CMR GUIDE): Study protocol for a randomized controlled trial 下载免费PDF全文
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Vasiliki Betihavas RN BN MN Phillip J. Newton RN BN PhD Hui Yun Du RN BN Peter S. Macdonald MBBS PhD MD FRACP Steven A. Frost RN BN MPH Simon Stewart PhD NFESC FAHA FCSANZ Patricia M. Davidson RN BA MEd PhD 《Australian critical care》2011,24(3):189-197
Introduction
The importance of the nursing role in chronic heart failure (CHF) management is increasingly recognised. With the recent release of the National Health and Hospitals Reform Commission (NHHRC) report in Australia, a review of nursing roles in CHF management is timely and appropriate.Aim
This paper aims to discuss the implications of the NHHRC report and nursing roles in the context of CHF management in Australia.Method
The electronic databases, Thomson Rheuters Web of Knowledge, Scopus and the Cumulative Index to Nursing and Allied Health Literature (CINAHL), were searched using keywords including; “heart failure”, “management”, “Australia” and “nursing”. In addition policy documents were reviewed including statements and reports from key professional organisations and Government Departments to identify issues impacting on nursing roles in CHF management.Results
There is a growing need for the prevention and control of chronic conditions, such as CHF. This involves an increasing emphasis on specialist cardiovascular nurses in community based settings, both in outreach and inreach health service models. This review has highlighted the need to base nursing roles on evidence based principles and identify the importance of the nursing role in coordinating and managing CHF care in both independent and collaborative practice settings.Conclusion
The importance of the nursing role in early chronic disease symptom recognition and implementing strategies to prevent further deterioration of individuals is crucial to improving health outcomes. Consideration should be given to ensure that evidence based principles are adopted in models of nursing care. 相似文献38.