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 Knowledge Centre

Type 2 Diabetes Knowledge Centre

The leading cause of morbidity and mortality among patients with Type 2 diabetes mellitus is cardiovascular complications, with cardiovascular disease risk being 2- to 8-fold higher in the population than it is in non-diabetic individuals of a similar age, sex and ethnicity.1,2

Macrovascular complications (including coronary artery disease, peripheral arterial disease and stroke) and microvascular complications (including diabetic nephropathy, peripheral neuropathy and diabetic retinopathy), are collectively known as diabetic vascular complications that commonly develop in patients with Type 2 diabetes mellitus.3

The major predictive risk factor for both macrovascular and microvascular risk complications in Type 2 Diabetes is hyperglycaemia. This association is still present after adjustments are made for other known factors including age at diagnosis, sex, ethnic group, systolic blood pressure, lipid concentrations, smoking and albuminuria.4

The Type 2 Diabetes Knowledge Centre aims to provide clear and concise information based on current accepted guidelines on treatment and management. In addition the Knowledge Centre also provides access to key Type 2 diabetes guidelines and details the treatment options available.


References

  1. Haffner SM, Lehto S, Ronnemaa T et al. Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. N Engl J Med 1998;339:229-234.
  2. Brun E, Nelson NG, Bennett PH et al. Verona Diabetes Study. Diabetes duration and cause-specific mortality in the Verona Diabetes Study. Diabetes Care 2000;23:1119-1123.
  3. 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.
  4. Stratton IM, Adler AI, Neil HA et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ 2000;321:405-412.

Clinical Case Studies

MRSA Endocarditis

Infection: Cardiovascular Infections

Christopher D. Pfeiffer, Clinical Fellow, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA
Vance Fowler, Associate Professor and Infectious Diseases, Specialist, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA

Case History
A 64-year-old female presented with three weeks of progressive dyspnoea, nausea and vomiting.

Massive Pulmonary Embolism

Respiratory Medicine & Allergy: Pulmonary Vascular Diseases

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

Case History
A 46-year-old Afro-Caribbean man presented to hospital after he collapsed with brief loss of consciousness. He was short of breath at rest and felt as if he couldn't take a breath in.

Medical Videos

Advances in Dual Antiplatelet Therapy for Acute Coronary Syndrome (ACS)
Advances in Dual Antiplatelet Therapy for Acute Coronary Syndrome (ACS)
Rivaroxaban vs enoxaparin for the Prevention of Venous Thromboembolism
Rivaroxaban vs enoxaparin for the Prevention of Venous Thromboembolism
Diabetic Peripheral Arterial Disease (P.A.D.)
Diabetic Peripheral Arterial Disease (P.A.D.)
A Guide to the Coronary Angioplasty Procedure
A Guide to the Coronary Angioplasty Procedure
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)
Flash Lecture: Changes in Antithrombotic Use
Flash Lecture: Changes in Antithrombotic Use

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 cirrhosisportal vein thrombosis (PVTcould be a cause or a consequence of the progression of liver diseaseWe 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 (AFis an independent risk factor for ischemic strokesmaking the prevention with an oral anticoagulant the mainstay of current clinical practiceAn oral anticoagulant such as ...

Medical Images

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

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.

Back to top