HEART INTERNATIONAL – VOLUME 14 ISSUE 1 – SUMMER 2020

Dear colleagues, welcome to the summer issue of Heart International. We hope this reaches you well and that your personal and professional lives have not been affected adversely by the coronavirus pandemic. As is fitting for the current circumstances, we include an editorial by Prof. Perera’s group on the effects of COVID-19 on cardiovascular health. The […]

The current landscape of wearable technology is one of the most exciting and rapidly changing fields in medicine, especially for the general consumer.1 The potential of capturing a wider and deeper range of personal health information is vast, allowing for changes in care to a more personalised approach across all therapy areas. Cardiology, in particular, […]

Left main (LM) coronary artery disease is the atherosclerotic narrowing of the LM segment, and is often associated with involvement of the ostial disease of the left anterior descending and left circumflex arteries, called distal LM disease. Significant LM disease is defined as ≥50% angiographically-detected stenosis of the LM or angiographically <50% stenosis with positive […]

Optimal medical therapy (OMT) is the cornerstone of management in patients with coronary atheroma, given the substantial evidence that it can delay disease progression and damp down both chronic and acute vascular inflammation, thereby leading to a reduction in cardiovascular events and mortality.1,2 In this context, revascularisation, with either percutaneous coronary intervention (PCI) or coronary […]

The current pandemic of coronavirus disease 2019 (COVID-19) is an unprecedented public health emergency, with worldwide health, social and economic implications. In contrast to other modern epidemics, little prior knowledge of the pathogen existed. Whilst this initially hampered both patient management and the public health response, we have observed a remarkable worldwide attempt to provide […]

The factor Xa (FXa) inhibitors apixaban, rivaroxaban and edoxaban, together with the thrombin inhibitor dabigatran, are collectively referred to as non-vitamin K antagonist (or direct) oral anticoagulants (NOACs). FXa inhibitors are widely used for stroke prevention in patients with nonvalvular atrial fibrillation,1 and for the treatment and prevention of deep vein thrombosis and pulmonary embolism.2,3 In patients […]

Individuals with aortic stenosis frequently have coronary artery disease (CAD).1 Both conditions share a common pathophysiology involving low‐density lipoprotein-mediated inflammatory response, resulting in an accelerated atherosclerotic process.2 They also share similar risk factors, such as age, smoking, hypertension, diabetes mellitus, hyperlipidaemia and chronic kidney disease.3,4 More than 50% of patients with severe aortic stenosis undergoing […]

Refractory angina pectoris is a chronic disabling condition affecting an increasing number of patients (10–15%) with severe ischaemic heart disease.1 It is generally defined as the presence of debilitating angina due to severe and/or diffuse coronary artery disease (CAD), despite optimal medical therapy and with no option for further percutaneous or surgical revascularisation procedures. As […]

Coronary artery disease (CAD), due to development of atherosclerotic plaques, remains a leading cause of morbidity and mortality. If unstable or clinically significant, these are frequently treated with percutaneous coronary intervention (PCI), typically involving balloon angioplasty and implantation of a metallic drug-eluting stent (DES).1 Coronary stents have substantially evolved since their first use in the 1980s […]

The exact aetiology of coronary artery ectasia (CAE) has yet to be fully elucidated; however, some underlying aetiologies such as atherosclerosis and microvascular abnormalities in coronary arteries have been proposed.1,2 Over the past few years, several inflammatory markers have been introduced as indicators of CAE and its severity. There is an association between the development of […]

Coeliac disease (CD) is a systemic disease of inappropriate immune response to gluten, which affects up to 1% of the population in the Western world.1 Gluten proteins are found in dietary products containing wheat, rye, barley and related grains. In patients who carry the human leukocyte antigen (HLA)-DQ2 and HLA-DQ8 alleles of the major histocompatibility […]

First described in 1868 by WS Church, cor triatriatum sinister (CTS) is one of the rarest congenital heart diseases in the world, with an estimated incidence of 0.1%.1,2 It is characterised by the presence of a fibrous membrane that divides the left atrium into two different regions: a proximal chamber with the pulmonary veins and […]

Antiplatelet agents are routinely given to prevent thrombosis of coronary stents.1 When antiplatelet drugs are not given before percutaneous coronary intervention (PCI), they may be given on the table during PCI.1 Ingestion of pills while supine on the catheterisation table often causes mild dysphagia and discomfort but, rarely, it can cause a more serious event. […]