Lifelong recurrent takotsubo cardiomyopathy : a case report

This patient’s clinical investigation course was supported by the British Heart Foundation Project [PG/15/108/31928].Peer reviewedPublisher PD

An Update on Cardiac Magnetic Resonance Imaging in Takotsubo Cardiomyopathy

Open Access via the Springer CompactPeer reviewedPublisher PD

Recurrent spontaneous coronary artery dissection in a middle-aged male athlete patient : A case report

This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model) Supplementary dataPeer reviewe

Effect of selective heart rate slowing in heart failure with preserved ejection fraction

Background Heart failure with preserved ejection fraction (HFpEF) is associated with significant morbidity and mortality but is currently refractory to therapy. Despite limited evidence, heart rate reduction has been advocated, on the basis of physiological considerations, as a therapeutic strategy in HFpEF. We tested the hypothesis that heart rate reduction improves exercise capacity in HFpEF. Methods and Results We conducted a randomized, crossover study comparing selective heart rate reduction with the If blocker ivabradine at 7.5 mg twice daily versus placebo for 2 weeks each in 22 symptomatic patients with HFpEF who had objective evidence of exercise limitation (peak oxygen consumption at maximal exercise [GraphicO2 peak] <80% predicted for age and sex). The result was compared with 22 similarly treated matched asymptomatic hypertensive volunteers. The primary end point was the change in GraphicO2 peak. Secondary outcomes included tissue Doppler–derived E/e′ at echocardiography, plasma brain natriuretic peptide, and quality-of-life scores. Ivabradine significantly reduced peak heart rate compared with placebo in the HFpEF (107 versus 129 bpm; P<0.0001) and hypertensive (127 versus 145 bpm; P=0.003) cohorts. Ivabradine compared with placebo significantly worsened the change in GraphicO2 peak in the HFpEF cohort (-2.1 versus 0.9 mL·kg−1·min−1; P=0.003) and significantly reduced submaximal exercise capacity, as determined by the oxygen uptake efficiency slope. No significant effects on the secondary end points were discernable. Conclusion Our observations bring into question the value of heart rate reduction with ivabradine for improving symptoms in a HFpEF population characterized by exercise limitation

Right Ventricular Involvement and Recovery after Acute Stress-Induced (Tako-tsubo) Cardiomyopathy

Acknowledgment: The authors would like to thank all National Health Service Consultant Colleagues at Aberdeen Royal Infirmary for help with prompt recruitment of these patients (Dr. M Metcalfe, MD, Dr. AD Stewart, MD, Dr. A Hannah, MD, Dr. A Noman, MD, Dr. P Broadhurst, MD, Dr. D Hogg, MD, and Dr. D Garg, MD) and to Dr. Gordon Prescott, PhD for help and advice with the statistical methods. This work was supported by a Tenovus Scotland, Nice, France award to Dr. Dawson and presented in part at the Society for Cardiovascular Magnetic Resonance Imaging/EuroCMR 2015 Joint Scientific Sessions from February 5 2015 to February 7, 2015Peer reviewedPostprin

Sex Differences in Ischemic Stroke Outcomes in Patients With Pulmonary Hypertension

Acknowledgments To the authors thank Dr Jesus A Perdomo‐Lampignano, MBChB for his assistance with the figures and also acknowledge the Healthcare Cost and Utilization Project Data Partners (https://www.hcup‐us.ahrq.gov/db/hcupdatapartners.jsp). Supplementary Material for this article is available at https://www.ahajournals.org/doi/suppl/10.1161/JAHA.120.019341 Open Access via the Jisc Wiley AgreementPeer reviewedPublisher PD

MOLLI T1 mapping versus T2 W-SPAIR at 3T : myocardial area at risk measurements and the influence of microvascular obstruction

Funding Information: This study was supported by a Medical Research Council (UK) grant, as a sub-study of Nitrites in Acute Myocardial Infarction, NCT01388504.Peer reviewe

Characterization of the Myocardial Inflammatory Response in Acute Stress-Induced (Takotsubo) Cardiomyopathy

This work was supported by grants from NHS Grampian Endowments and British Heart Foundation Project Grant no. PG/15/108/31928 The authors have reported that they have no relationships relevant to the contents of this paper to disclose.Peer reviewedPublisher PD

Inorganic nitrate in angina study:A randomized double-blind placebo-controlled trial

Background--In this double-blind randomized placebo-controlled crossover trial, we investigated whether oral sodium nitrate, when added to existing background medication, reduces exertional ischemia in patients with angina. Methods and Results--Seventy patients with stable angina, positive electrocardiogram treadmill test, and either angiographic or functional test evidence of significant ischemic heart disease were randomized to receive oral treatment with either placebo or sodium nitrate (600 mg; 7 mmol) for 7 to 10 days, followed by a 2-week washout period before crossing over to the other treatment (n=34 placebo-nitrate, n=36 nitrate-placebo). At baseline and at the end of each treatment, patients underwent modified Bruce electrocardiogram treadmill test, modified Seattle Questionnaire, and subgroups were investigated with dobutamine stress, echocardiogram, and blood tests. The primary outcome was time to 1 mm ST depression on electrocardiogram treadmill test. Compared with placebo, inorganic nitrate treatment tended to increase the primary outcome exercise time to 1 mm ST segment depression (645.6 [603.1, 688.0] seconds versus 661.2 [6183, 704.0] seconds, P=0.10) and significantly increased total exercise time (744.4 [702.4, 786.4] seconds versus 760.9 [719.5, 802.2] seconds, P=0.04; mean [95% confidence interval]). Nitrate treatment robustly increased plasma nitrate (18.3 [15.2, 21.5] versus 297.6 [218.4, 376.8] μmol/L, P < 0.0001) and almost doubled circulating nitrite concentrations (346 [285, 405] versus 552 [398, 706] nmol/L, P=0.003; placebo versus nitrate treatment). Other secondary outcomes were not significantly altered by the intervention. Patients on antacid medication appeared to benefit less from nitrate supplementation. Conclusions--Sodium nitrate treatment may confer a modest exercise capacity benefit in patients with chronic angina who are taking other background medication

Fast field-cycling magnetic resonance detection of intracellular ultra-small iron oxide particles in vitro : Proof-of-concept

DKD would like to declare funding from British Heart Foundation Project Grant PG/15/108/31928 with no financial conflict of interest. DJL would like to declare funding from the European Commission – ‘Improving Diagnosis by Fast Field-Cycling MRI’ grant number 668119 with no financial conflict of interest, and GE Healthcare in the form of funding for PhD studentship in radiofrequency coils for FFC-MRI, with potential financial conflict of interest. The authors have no additional financial interests.Peer reviewedPublisher PD