theheart.org: Imaging news and education

heartbriefs

Serum phosphorous, kidney function predict CAC

Nov 5, 2009 17:00 EST

The Spokane Heart Study finds a connection between kidney function, serum phosphorus, and the risk of coronary artery calcification.

Imaging

CAC scoring plus SPECT provide long and short view of cardiac risk

6 COMMENTS - Nov 3, 2009 17:00 EST

UPDATED // An 1126-patient trial shows that SPECT and CAC scoring imaging tests are independent and complementary predictors of short- and long-term cardiac risk, respectively.

Imaging

CMS set to cut Medicare physician fees for cardiovascular imaging

5 COMMENTS - Nov 3, 2009 11:45 EST

The 2010 Medicare Physician Fee Schedule final rule released by the CMS makes major cuts to several cardiovascular imaging services.

Imaging

Imaging study shows plaque regression with niacin vs placebo

15 COMMENTS - Oct 30, 2009 16:00 EDT

Just weeks before ARBITER-HALTS 6 results come out at AHA 2009, an MRI study suggests that niacin is better than placebo in statin-treated patients with low HDL, at least for reducing carotid wall area. Experts say they'd also like to see insights into niacin effects on lipid-rich plaque volumes—the more commonly seen end point with MRI.

Heart failure

Benefits of targeted lead placement with CRT devices supported by long-term mortality data

Oct 29, 2009 15:00 EDT

An additional year of data from the INCREMENTAL study showed that echo-targeted LV lead positioning increased the likelihood of a response to device therapy by about 40% over standard lead placement. But does that difference translate into better long-term outcomes for the patient?

Lipid/Metabolic

New MESA data: Pericardial fat a better predictor of CHD than BMI

9 COMMENTS - Oct 23, 2009 17:00 EDT

Pericardial fat, which is found around the heart, predicts future CHD events and may even be a better predictor of these than conventional obesity measures, such as BMI and waist circumference, a new study of MESA participants shows.

heartbriefs

New model connects low-dose radiation to CVD risk

Oct 23, 2009 15:30 EDT

Data from Japanese atomic-bomb survivors and people exposed to radiation in their jobs show that even low doses of ionizing radiation may contribute to cardiovascular disease risk. British researchers have created a complex mathematical model to better understand the relationship between radiation exposure and heart disease.

Brain/Kidney/Peripheral

Iloprost prevents contrast-induced nephropathy in high-risk patients undergoing coronary intervention

Oct 21, 2009 13:00 EDT

Intravenously administered iloprost, a prostacyclin analog, may help prevent contrast-induced nephropathy in patients with renal dysfunction undergoing coronary procedures, a new pilot study suggests.

Imaging

Zero CAC score not 100% reassuring in those presenting to ER with chest pain

14 COMMENTS - Oct 16, 2009 12:45 EDT

In those presenting to the ER with chest pain, a prior zero calcium score cannot completely rule out a coronary obstruction, a new analysis of the MESA study has shown. This is likely due to the presence of soft plaques not detected by calcium screening, the researchers say.

Acute Coronary Syndromes

Racial background woefully underreported in CV trials

1 COMMENT - Oct 15, 2009 13:15 EDT

Two-thirds of the 156 trials considered by the AHA in preparing a recent guideline failed to even record the ethnic backgrounds of participants, a new study has found. The researchers call for the reporting of race/ethnicity to be mandatory in all clinical trials, and they suggest medical journals should enforce this policy.

Imaging

Incidental findings on cardiac CT costly and rarely clinically significant

Oct 6, 2009 15:15 EDT

Among nearly 1000 consecutive patients who underwent cardiac CT, 41% had noncardiac incidental findings, but just 1.2% of these were clinically significant. While another 7% were "indeterminate," none of these inconclusive findings became clinically significant during follow-up.

Clinical cardiology

New "principles" on authorship and COI from PhRMA get mixed response

3 COMMENTS - Oct 2, 2009 12:00 EDT

The "Principles on Conduct of Clinical Trials and Communication of Clinical Trial Results" echo recent standards set by medical journal editors, but some observers say the document, which has no penalty component, lacks real teeth.

Interventional/Surgery

FAUST: Ultrasound guidance improves femoral access in cases of high bifurcation, reduces risk of complication

3 COMMENTS - Sep 29, 2009 09:45 EDT

CORRECTED // A study has found that although ultrasound imaging doesn't seem to improve upon the overall success rate of fluoroscopy-assisted femoral-access PCI, it does seem to facilitate the procedure, reducing the risk of access complications by 59% and doubling the first-pass success rate.

Interventional/Surgery

PROSPECT: Vulnerable lesions lead to unstable angina rather than MI or death

4 COMMENTS - Sep 25, 2009 14:15 EDT

After successful PCI, 20% of patients go on to have a MACE at three years and 12% of patients develop events from nonculprit lesions. PROSPECT investigators say, however, that events from these nonculprit lesions are more likely to be unstable angina or progressive angina, rather than harder events such as MI or cardiac death.

Imaging

Further testing and increased costs only for those with high CAC scores: EISNER study

9 COMMENTS - Sep 21, 2009 17:00 EDT

Patients who undergo coronary artery calcium scans are unlikely to undergo further testing or invasive procedures if the CAC scores are low. The results suggest that CAC might play a role in more selective testing patterns in asymptomatic individuals at risk for cardiovascular disease, say researchers.

Clinical cardiology

Conflicts of interest affect best practices in both industry-funded and non-industry-funded trials

2 COMMENTS - Sep 15, 2009 12:00 EDT

Clinicians and researchers need to be more aware before signing on to studies about what potential conflicts might arise with the sponsor and set the ground rules for such areas as access to data, manuscript preparation, and right to publish.

Heart failure

Who should get CRT? Resynchronization benefits seen in heart failure with LVEF >35%

Sep 14, 2009 17:15 EDT

Heart-failure patients with ejection fractions >35% aren't necessarily excluded from the clinical and reverse-remodeling benefits of cardiac resynchronization therapy, suggests yet another study questioning the limits of CRT's current eligibility criteria.

Clinical cardiology

Sponsorship of med-school textbooks in Denmark exposes vulnerable minds to commercial bias

Sep 14, 2009 11:45 EDT

Results of a new survey showed that a surprising 15% of textbooks had one or more drug or device sponsors and, in two cases, those sponsors had tried to influence the content of the textbooks.

Clinical cardiology

Spin not uncommon in negative RCTs, study shows

4 COMMENTS - Sep 14, 2009 11:30 EDT

French researchers who systematically quantified the prevalence of spin across 72 negative randomized controlled trials say half of the studies put a positive spin on the negative findings in the conclusion sections of the papers.

Clinical cardiology

Ghost authorship on the wane, but guest authorship still common

Sep 11, 2009 11:00 EDT

UPDATED // Compared with a 1996 survey by JAMA editors, a 2008 survey indicates that the practice of having ghost writers pen papers, then not appear as authors, is down to 8%, from 12% in 1996. The practice of inviting a prominent name to appear in the list of authors, without requiring that person to contribute to the research, has held steady at roughly 20%.

Imaging

Cardiac CT protocol identifies perfusion defects, stenoses

1 COMMENT - Sep 10, 2009 15:30 EDT

The combined protocol is still considered investigational but suggests that cardiac CT has a potential role in myocardial perfusion imaging for the detection of myocardial ischemia as well as providing information on coronary stenoses.

Prevention

New ESC guidelines on infective endocarditis

7 COMMENTS - Sep 9, 2009 09:45 EDT

The ESC issues new recommendations on the prevention, diagnosis, and treatment of infective endocarditis—"an old but changing disease." The guidance with respect to antibiotic prophylaxis is similar to US advice, experts say.

Heart failure

European CRT Survey: Indications in real life often ahead of guidelines

Sep 4, 2009 17:30 EDT

In Europe, cardiac resynchronization therapy in clinical practice is applied to many patients for whom there is no supporting clinical-trial evidence, including those with atrial fib and patients older than 75.

Clinical cardiology

What if regular exercise were as good as a stent for stable angina?

Sep 4, 2009 10:30 EDT

That question may never be answered, after the multicenter PET study fizzled due to a lack of enthusiasm by enrolling centers, which may have been loathe to give up revenues that PCI brings in. Never mind that exercise seemed better at improving event-free survival.

Prevention

Interventional cardiologists at risk of developing cataracts

2 COMMENTS - Sep 3, 2009 14:15 EDT

More effort must be made to encourage interventional cardiologists to use protective eyewear, conclude the authors of the largest-ever study looking at radiation-induced eye damage among medical professionals.