Angiology Topic Homepage

Heart Failure

Heart Failure

Heart failure (HF) is a complex disorder whereby the heart becomes progressively unable to pump blood efficiently to the tissues of the body. The Heart Failure Knowledge Centre focuses on the pathophysiology, diagnosis and management of chronic and post myocardial infarction (post-MI) heart failure.

Risk factors for ACS, and subsequently post-MI heart failure, are usually the clinical consequence of the formation of an occlusive thrombus at the site of a ruptured or eroded atherosclerotic plaque in a coronary artery. These can be modifiable (smoking,1 obesity,1 lack of exercise,1 hypertension,1,2 hyperlipidaemia,2,3 diabetes mellitus3) and non-modifiable (increased age1, male gender1, family history1,2) risk-factors.

The Heart Failure Knowledge Centre aims to provides healthcare professionals with the tools to diagnose and manage patients with both chronic and post-MI heart failure in line with current ESC guidelines.


References

  1. Kumar P, Clark M. Clinical medicine. 7th ed. Edinburgh: Saunders Elsevier, 2009.
  2. Graham I, Atar D, Borch-Johnsen K, et al. European guidelines on cardiovascular disease prevention in clinical practice: executive summary. Eur J Cardiovasc Prevent Rehab 2007;14 Suppl. 2:E1-40.
  3. Zeljko Reiner, Alberico L. Catapano, Guy De Backer et al. ESC/EAS Guidelines for the management of dyslipidaemias: The Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). Eur Heart J first published online June 28, 2011 doi:10.1093/eurheartj/ehr158.

Type 2 Diabetes

,Type 2 Diabetes CME and Knowledge Centre

Based on current estimates, the global prevalence of Type 2 diabetes mellitus has increased almost 10 fold since 1985 and is expected to rise to 552 million by 2030,1 and when absolute numbers of people with diabetes are considered, it is South East Asia and the West Pacific that are expected to experience the highest increases in prevalence over the coming years.2

An EACCME accredited CME is available, awarded 1 European CME credits (ECMEC's). Consisting of 3 modules:

  • A Review of Newer Therapies for Type 2 Diabetes in Combination with Insulin, John Wilding (Chair)
  • Identifying and Managing the Psychosocial Aspects of Type 2 Diabetes Mellitus, Richard Holt (Faculty)
  • Potential Role of Newer Therapies for Type 2 Diabetes in Combination with Insulin: Interactive Case Discussion, Bernard Charbonnel (Faculty)

Take CME now

The Type 2 Diabetes Knowledge Centre aims to provide clear and concise information based on current accepted guidelines on the treatment and management of patients with this disease. In addition the Knowledge Centre also provides access to key guidelines and a review of treatment options available.

Visit Knowledge Centre 


References

  1. Murea M, Ma L, Freedman BI. Genetic and environmental factors associated with type 2 diabetes and diabetic vascular complications. Rev Diabetic Studies 2012;9:6-22.
  2. International Diabetes Federation. Diabetes atlas: second edition. 2002. Available at: www.idf.org/sites/default/files/IDF_Diabetes_Atlas_2ndEd.pdf (accessed 18 November 2013).

 

Clinical Case Studies

Pulmonary Hypertension

Respiratory Medicine & Allergy: Pulmonary Vascular Diseases

Bethia Bradley, Specialist Registrars in Respiratory Medicine, Guy's and St Thomas' NHS Foundation Trust, London, UK
Richard Leach, Consultant Respiratory Physicians, Guy's and St Thomas' NHS Foundation Trust, London, UK

Case History
A 26-year-old woman presented to the chest clinic with a two-year history of slowly progressive exertional dyspnoea. At presentation she was experiencing difficulty walking up inclines, keeping up with friends when walking on the flat, climbing two flights of stairs and cleaning the house.

Sickle Cell Lung Disease

Respiratory Medicine & Allergy: Pulmonary Vascular Diseases

Elizabeth Hadley, Consultant Respiratory and General Physician, Barking, Havering and Redbridge Hospitals University NHS Trust, London, UK
Boris Lams, Consultant Respiratory Physicians, Guy's and St Thomas' NHS Foundation Trust, London, UK
Christopher Kosky, Consultant Respiratory Physicians, Guy's and St Thomas' NHS Foundation Trust, London, UK

Case History
A 40-year-old man with known homozygous (HbSS) sickle cell disease (SCD) presented to the emergency department with a three-day history of cough, fever and sweats. He denied any chest pain.

Medical Videos

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Rivaroxaban vs enoxaparin for the Prevention of Venous Thromboembolism
Flash Lecture: Changes in Antithrombotic Use
Flash Lecture: Changes in Antithrombotic Use
Does chronic venous insufficiency play a role in MS pathogenesis? Commentary (CONy 2010)
Does chronic venous insufficiency play a role in MS pathogenesis? Commentary (CONy 2010)
A Guide to the Coronary Angioplasty Procedure
A Guide to the Coronary Angioplasty Procedure
Diabetic Peripheral Arterial Disease (P.A.D.)
Diabetic Peripheral Arterial Disease (P.A.D.)
Advances in Dual Antiplatelet Therapy for Acute Coronary Syndrome (ACS)
Advances in Dual Antiplatelet Therapy for Acute Coronary Syndrome (ACS)

Recent Drug Updates

Medical Journal Abstracts on Angiology

Causes and consequences of portal vein thrombosis in 1243 patients with cirrhosis: results of a longitudinal study

Mon 06 Oct 2014 -  Hepatology

Background & Aims: In cirrhosis, portal vein thrombosis (PVT) could be a cause or a consequence of the progression of liver disease. We analyzed data from a prospective trial of ultrasound ...

Small therapeutic window of warfarin in Japanese population

Fri 03 Oct 2014 -  Journal of Cardiology

Atrial fibrillation (AF) is an independent risk factor for ischemic strokes, making the prevention with an oral anticoagulant the mainstay of current clinical practice. An oral anticoagulant such as ...

Medical Images

Chest radiograph of sickle cell lung disease
Chest radiograph of sickle cell lung disease
Pulmonary angiogram
Pulmonary angiogram
Sickle cell lung disease
Sickle cell lung disease
Pulmonary arteriovenous malformation
 Pulmonary arteriovenous malformation

Clinical Guidelines

Lipid modification: Cardiovascular risk assessment and the modification of blood lipids for the primary and secondary prevention of cardiovascular disease

Jul 2014

This guideline offers best practice advice on the care of adults at high risk of developing CVD or..

... with established CVD.

Plant sterols and plant stanols in the management of dyslipidaemia and prevention of cardiovascular disease

Nov 2013

This EAS Consensus Panel critically appraised evidence relevant to the benefit to risk relationship..

... of functional foods with added plant sterols and/or plant stanols, as components of a healthy lifestyle, to reduce plasma low-density lipoprotein-cholesterol (LDL-C) levels, and thereby lower cardiovascular risk.

Clinical Trials

BIOFLOW-III UK Satellite Registry

02-10-2014

For the majority of Coronary Artery Disease (CAD) treatment with Percutaneous Transluminal Coronary Angioplasty (PTCA) provides high initial procedure success. However, the medium to long-term complications range from rather immediate elastic coil or..

... vessel contraction to longer processes like smooth muscle cell proliferation and excessive production of extra cellular matrix, thrombus formation and atherosclerotic changes like restenosis or angiographic re-narrowing. The reported incidence of restenosis after PTCA ranges from 30 to 50%. Such rates of recurrence have serious economic consequences. Bare Metal Stents (BMS), designed to address the limitations of PTCA, reduced the angiographic and clinical restenosis rates in De Novo lesions compared to PTCA alone and decreased the need for CABG. BMS substantially reduced the incidence of abrupt artery closure, but restenosis still occurred in about 20 to 40% of cases, necessitating repeat procedures.

The invention of Drug Eluting Stents (DES) significantly improved on the principle of BMS by adding an antiproliferative drug (directly immobilized on the stent surface or released from a polymer matrix), which inhibits neointimal hyperplasia. The introduction of DES greatly reduced the incidence of restenosis and resulted in better safety profile as compared to BMS with systemic drug administration. These advantages and a lower cost compared to surgical interventions has made DES an attractive option to treat coronary artery disease.

Therefore this observational registry has been designed for the clinical evaluation of the ORSIRO LESS requiring coronary revascularization with DES. It is designed to investigate and collect clinical evidence for the clinical performance and safety of the Orsiro Drug Eluting Stent System in an all-comers patient population in daily clinical practice.

Location of Lower Extremity Deep Vein Thrombosis by Emergency Physicians Using Portable Compression Ultrasonography (EchoComp TVP)

02-10-2014

The main objective of our study is to determine the diagnostic performance of an ultra-portable ultrasound (V-Scan®) device for emergency compression ultrasound when used by experienced ermergency doctors searching for proximal deep vein thrombosis..

... (DVT) in patients with no history of DVT. The gold standard is Doppler ultrasound of the lower limbs performed by a vascular exploration expert.

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