Displaying publications 1 - 20 of 167 in total

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  1. Fulltext Promising Nutritional Fruits Against Cardiovascular Diseases: An Overview of Experimental Evidence and Understanding Their Mechanisms of Action
    Zuraini NZA, Sekar M, Wu YS, Gan SH, Bonam SR, Mat Rani NNI, et al.
    Vasc Health Risk Manag, 2021;17:739-769.
    PMID: 34858028 DOI: 10.2147/VHRM.S328096
    Cardiovascular diseases (CVDs) are one of the leading causes of morbidity and mortality in both developed and developing countries, affecting millions of individuals each year. Despite the fact that successful therapeutic drugs for the management and treatment of CVDs are available on the market, nutritional fruits appear to offer the greatest benefits to the heart and have been proved to alleviate CVDs. Experimental studies have also demonstrated that nutritional fruits have potential protective effects against CVDs. The aim of the review was to provide a comprehensive summary of scientific evidence on the effect of 10 of the most commonly available nutritional fruits reported against CVDs and describe the associated mechanisms of action. Relevant literatures were searched and collected from several scientific databases including PubMed, ScienceDirect, Google Scholar and Scopus. In the context of CVDs, 10 commonly consumed nutritious fruits including apple, avocado, grapes, mango, orange, kiwi, pomegranate, papaya, pineapple, and watermelon were analysed and addressed. The cardioprotective mechanisms of the 10 nutritional fruits were also compiled and highlighted. Overall, the present review found that the nutritious fruits and their constituents have significant benefits for the management and treatment of CVDs such as myocardial infarction, hypertension, peripheral artery disease, coronary artery disease, cardiomyopathies, dyslipidemias, ischemic stroke, aortic aneurysm, atherosclerosis, cardiac hypertrophy and heart failure, diabetic cardiovascular complications, drug-induced cardiotoxicity and cardiomyopathy. Among the 10 nutritional fruits, pomegranate and grapes have been well explored, and the mechanisms of action are well documented against CVDs. All of the nutritional fruits mentioned are edible and readily accessible on the market. Consuming these fruits, which may contain varying amounts of active constituents depending on the food source and season, the development of nutritious fruits-based health supplements would be more realistic for consistent CVD protection.
    Matched MeSH terms: Heart Failure/diet therapy*; Heart Failure/prevention & control
  2. Fulltext Trapped heart in heavily calcified pericardium
    Zaimi MA, Mamat AZ, Ghazali MZ, Zakaria AD, Sahid NA, Hayati F
    Oxf Med Case Reports, 2020 Oct;2020(10):omaa083.
    PMID: 33133617 DOI: 10.1093/omcr/omaa083
    Constrictive pericarditis is a disabling disease of the heart, which causes cardiac diastolic dysfunction. We present a case of a 44-year-old gentleman with a history of blunt chest trauma who presented with constrictive pericarditis with right-sided heart failure. Imaging studies revealed a calcified pericardium. He underwent an uneventful pericardiectomy. Calcification is common yet rare if it involves the pericardium. It normally occurs following fibrosis and adhesion which are associated with the chronicity of the disease, hence creating more challenge to the operating surgeon in the pericardiectomy procedure.
    Matched MeSH terms: Heart Failure
  3. Conduction abnormalities in thyrotoxicosis--a report of three cases
    Yusoff K, Khalid BA
    Ann Acad Med Singap, 1993 Jul;22(4):609-12.
    PMID: 8257070
    Cardiac arrhythmias are common in patients with thyrotoxicosis. Conduction abnormalities have been seen in a few thyrotoxic patients, but these, in particular high grade atrioventricular (AV) block, often occur in the presence of other conditions. Three thyrotoxic patients with conduction abnormalities are described: two were associated with severe hypokalaemia and the third had congestive cardiac failure. Conditions predisposing to conduction abnormality should be identified when this occurs in a thyrotoxic patient as their correction may help resolve or explain the conduction abnormality.
    Matched MeSH terms: Heart Failure/physiopathology
  4. The clinical benefit of cardiac resynchronization therapy for narrow QRS compared to broad QRS complex patients
    Yap LB, Qadir F, Nguyen ST, Ma SK, Koh KW, Muhammad Z, et al.
    Int J Cardiol, 2015 Mar 15;183:178-9.
    PMID: 25666128 DOI: 10.1016/j.ijcard.2015.01.042
    Matched MeSH terms: Heart Failure/physiopathology; Heart Failure/therapy*; Heart Failure/ultrasonography
  5. Large anomalous systemic arterial supply to the left lung without pulmonary sequestration: a rare cause of heart failure in a child
    Wong MN, Joshi P, Sim KH
    Pediatr Cardiol, 2009 Jan;30(1):85-6.
    PMID: 18663510 DOI: 10.1007/s00246-008-9287-z
    A 10-month-old boy was referred for tachypnea and heart murmur. An echocardiogram showed unexplained left heart dilation without evidence of an intracardiac shunt. A 64-slice computed tomographic contrast-enhanced angiography showed a large tortuous anomalous artery arising from the descending thoracic aorta and supplying the lower lobe of the left lung. The venous return into the left atrium was normal. The affected lobe had normal lung parenchyma, and its bronchial tree was connected normally with the left main bronchus. Hence, it was not a sequestrated lobe. The boy underwent surgical lobectomy of the left lower lobe and improved. Anomalous arterial supply of a lobe without sequestration of its bronchial tree is a rare pathologic entity. It also is a very rare cause of congestive heart failure in children. Computed tomographic angiography was a useful tool for evaluation of the intrathoracic anomalous vessel in this case.
    Matched MeSH terms: Heart Failure/etiology*; Heart Failure/physiopathology; Heart Failure/surgery
  6. Pulmonary hypertension and echocardiogram parameters in obstructive sleep apnea
    Wong HT, Chee KH, Chong AW
    Eur Arch Otorhinolaryngol, 2017 Jun;274(6):2601-2606.
    PMID: 28243782 DOI: 10.1007/s00405-017-4491-1
    Obstructive sleep apnea (OSA) is a growing health hazard in the United States and worldwide. OSA is now recognized as a disorder with systemic manifestations and its association with obesity and adverse cardiovascular consequences. There is increasing evidence that OSA may be associated with systemic hypertension and an increased incidence of stroke, heart failure, myocardial infarction, and arrhythmias. Less information is available about the association between OSA and pulmonary hypertension (PH). We therefore conduct this study to look at the prevalence of the pulmonary hypertension in obstructive sleep apnea patient and to identify risk factors leading to pulmonary hypertension among OSA patient. We studied and analyzed all OSA patient confirmed by polysomnograph in the year 2015. Twenty-five patients with OSA were included in this study with prevalence of pulmonary hypertension of 16%. Univariate analysis of various factors revealed a statistically significant association between having the lowest SpO2 of <70% and pulmonary hypertension (p = 0.016). There were no statistically significant associations between age, gender, smoking status, hypertension, body mass index (BMI), or apnea-hypopnea index (AHI) with occurrence of pulmonary hypertension. AHI is not a good predictor for pulmonary hypertension. The real value of using AHI to predict the health risk of OSA is doubtful. We recommend routine echocardiogram among OSA patient. The objective information in the echocardiogram provides evidence for counseling of patient with disease of OSA and hence hopefully can improve compliance of patient to treatment especially usage of CPAP.
    Matched MeSH terms: Heart Failure
  7. Galectin-3 is associated with severe heart failure and death: A hospital-based study in Chinese patients
    Wang N, Dang M, Zhang W, Lei Y, Liu Z
    Scand J Immunol, 2020 May;91(5):e12826.
    PMID: 31514240 DOI: 10.1111/sji.12826
    Heart failure (HF) is a serious disease syndrome characterized by elevated pro-inflammatory cytokines and inflammatory mediators presume to have significant contribution on disease progression. Galectins are carbohydrate-binding proteins responsible of various physiological functions. Role of galectins in heart failure has been ill-defined. In the present case-controls study, 136 patients clinically diagnosed with heart failure and 125 healthy Chinese controls were recruited. Levels of galectins (Gal-1, 3 and 9) and cytokines (IFN-γ, IL-17A, IL-4 and TGF-β) were quantified by ELISA. Increased levels of galectin-1 and 3 was observed in HF patients and associated with clinical severity. In addition, pro-inflammatory cytokines such as IFN-γ and IL-17A were increased in patients whereas, anti-inflammatory TGFβ was decreased. Galectin-3 was positively correlated with IFN-γ, IL-17A and inversely with TGF-β. Furthermore, ROC curve analysis suggested galectin-3 as a promising biomarker for diagnosis and HF and clinical severity. Interestingly, a two-year follow-up indicated significant association of elevated galectin-3 with mortality due to HF. In conclusion, galectin-3 associated with HF and clinical manifestations possibly by inducing pro-inflammatory cytokines and could be a possible biomarker of HF and severe clinical conditions.
    Matched MeSH terms: Heart Failure/blood*; Heart Failure/diagnosis; Heart Failure/mortality*; Heart Failure/epidemiology
  8. Fulltext A large left ventricular tumour presenting with arrhythmias in a 2-month-old infant
    Wan Adlina Wan Yusuf, Amelia Alias, Wan Hanifah Wan Hussin1, Mohd Nasir Abdul Kadir, Abdul Rahim Wong
    Malaysian Journal of Paediatrics and Child Health, 2018;24(2):1-5.
    MyJurnal
    Primary cardiac tumours (PCT) are rare in the paediatric population. They can present in a variety of ways – from being asymptomatic, obstructive with heart failure, strokes, arrhythmias or sudden death. We present a 2-month-old child who was admitted because of heart failure from varying types of arrhythmias and was found on echocardiography to have a large left ventricular tumour. A high clinical suspicion in any infant or child who presents with an unexplained heart murmur, arrhythmias or congestive heart failure should prompt relevant investigations ruling out this entity.
    Matched MeSH terms: Heart Failure
  9. The study of border zone formation in ischemic heart using electro-chemical coupled computational model
    Wan Ab Naim WN, Mokhtarudin MJM, Lim E, Chan BT, Ahmad Bakir A, Nik Mohamed NA
    Int J Numer Method Biomed Eng, 2020 11;36(11):e3398.
    PMID: 32857480 DOI: 10.1002/cnm.3398
    Myocardial infarction (MI) is the most common cause of a heart failure, which occurs due to myocardial ischemia leading to left ventricular (LV) remodeling. LV remodeling particularly occurs at the ischemic area and the region surrounds it, known as the border zone. The role of the border zone in initiating LV remodeling process urges the investigation on the correlation between early border zone changes and remodeling outcome. Thus, this study aims to simulate a preliminary conceptual work of the border zone formation and evolution during onset of MI and its effect towards early LV remodeling processes by incorporating the oxygen concentration effect on the electrophysiology of an idealized three-dimensional LV through electro-chemical coupled mathematical model. The simulation result shows that the region of border zone, represented by the distribution of electrical conductivities, keeps expanding over time. Based on this result, the border zone is also proposed to consist of three sub-regions, namely mildly, moderately, and seriously impaired conductivity regions, which each region categorized depending on its electrical conductivities. This division could be used as a biomarker for classification of reversible and irreversible myocardial injury and will help to identify the different risks for the survival of patient. Larger ischemic size and complete occlusion of the coronary artery can be associated with an increased risk of developing irreversible injury, in particular if the reperfusion treatment is delayed. Increased irreversible injury area can be related with cardiovascular events and will further deteriorate the LV function over time.
    Matched MeSH terms: Heart Failure
  10. Sequence Symmetry Analysis as a Signal Detection Tool for Potential Heart Failure Adverse Events in an Administrative Claims Database
    Wahab IA, Pratt NL, Ellett LK, Roughead EE
    Drug Saf, 2016 Apr;39(4):347-54.
    PMID: 26798053 DOI: 10.1007/s40264-015-0391-8
    The potential for routine sequence symmetry analysis (SSA) signal detection in health claims databases to detect new safety signals of medicines is unknown.
    Matched MeSH terms: Heart Failure/chemically induced*; Heart Failure/epidemiology
  11. Ablation of IL-33 gene exacerbate myocardial remodeling in mice with heart failure induced by mechanical stress
    Veeraveedu PT, Sanada S, Okuda K, Fu HY, Matsuzaki T, Araki R, et al.
    Biochem Pharmacol, 2017 Aug 15;138:73-80.
    PMID: 28450225 DOI: 10.1016/j.bcp.2017.04.022
    BACKGROUND AND PURPOSE: ST2 is one of the interleukin (IL)-1 receptor family members comprising of membrane-bound (ST2L) and soluble (sST2) isoforms. Clinical trials have revealed that serum sST2 levels predict outcome in patient with myocardial infarction or chronic heart failure (HF). Meanwhile, we and others have reported that ablation of ST2 caused exaggerated cardiac remodeling in both ischemic and non-ischemic HF. Here, we tested whether IL-33, the ligand for ST2, protects myocardium against HF induced by mechanical overload using ligand specific knockout (IL-33(-/-)) mice.

    METHODS AND RESULTS: Transverse aortic constriction (TAC)/sham surgery were carried out in both IL-33 and WT-littermates. Echocardiographic measurements were performed at frequent interval during the study period. Heart was harvested for RNA and histological measurements. Following mechanical overload by TAC, myocardial mRNA expressions of Th1 cytokines, such as TNF-α were enhanced in IL-33(-/-) mice than in WT mice. After 8-weeks, IL-33(-/-) mice exhibited exacerbated left ventricular hypertrophy, increased chamber dilation, reduced fractional shortening, aggravated fibrosis, inflammation, and impaired survival compared with WT littermates. Accordingly, myocardial mRNA expressions of hypertrophic (c-Myc/BNP) molecular markers were also significantly enhanced in IL-33(-/-) mice than those in WT mice.

    CONCLUSIONS: We report for the first time that ablation of IL-33 directly and significantly leads to exacerbate cardiac remodeling with impaired cardiac function and survival upon mechanical stress. These data highlight the cardioprotective role of IL-33/ST2 system in the stressed myocardium and reveal a potential therapeutic role for IL-33 in non-ischemic HF.

    Matched MeSH terms: Heart Failure/etiology; Heart Failure/metabolism*; Heart Failure/pathology; Heart Failure/physiopathology
  12. α-thalassemia-associated hydrops fetalis: A rare cause of thyrotoxic cardiomyopathy
    Tumian NR, Wong M, Wong CL
    J Obstet Gynaecol Res, 2015 Jun;41(6):967-70.
    PMID: 25510540 DOI: 10.1111/jog.12648
    α°-thalassemia is a well-known cause of hydrops fetalis in South-East Asia and can be detected in utero. We report a very rare case of thyrotoxic cardiomyopathy associated with hyperplacentosis secondary to α°-thalassemia-associated hydrops fetalis. A 22-year-old primigravida with microcytic anemia presented at 27 weeks' gestation with pre-eclampsia, hyperthyroidism and cardiac failure. Serum β-human chorionic gonadotrophin was markedly elevated and abdominal ultrasound revealed severe hydropic features and enlarged placenta. Serum β-human chorionic gonadotrophin, cardiac function and thyroid function tests normalized after she delivered a macerated stillbirth. Histopathology of the placenta showed hyperplacentosis. Blood DNA analysis revealed that both patient and husband have the α°-thalassemia trait. This case illustrates a very atypical presentation of α°-thalassemia-associated hydrops fetalis and the importance of early prenatal diagnosis of α-thalassemia in women of relevant ethnic origin with microcytic anemia so that appropriate genetic counseling can be provided to reduce maternal morbidity and the incidence of hydrops fetalis.
    Matched MeSH terms: Heart Failure
  13. Fulltext Multimorbidity in patients with heart failure from 11 Asian regions: A prospective cohort study using the ASIAN-HF registry
    Tromp J, Tay WT, Ouwerkerk W, Teng TK, Yap J, MacDonald MR, et al.
    PLoS Med, 2018 03;15(3):e1002541.
    PMID: 29584721 DOI: 10.1371/journal.pmed.1002541
    BACKGROUND: Comorbidities are common in patients with heart failure (HF) and complicate treatment and outcomes. We identified patterns of multimorbidity in Asian patients with HF and their association with patients' quality of life (QoL) and health outcomes.

    METHODS AND FINDINGS: We used data on 6,480 patients with chronic HF (1,204 with preserved ejection fraction) enrolled between 1 October 2012 and 6 October 2016 in the Asian Sudden Cardiac Death in Heart Failure (ASIAN-HF) registry. The ASIAN-HF registry is a prospective cohort study, with patients prospectively enrolled from in- and outpatient clinics from 11 Asian regions (Hong Kong, Taiwan, China, Japan, Korea, India, Malaysia, Thailand, Singapore, Indonesia, and Philippines). Latent class analysis was used to identify patterns of multimorbidity. The primary outcome was defined as a composite of all-cause mortality or HF hospitalization within 1 year. To assess differences in QoL, we used the Kansas City Cardiomyopathy Questionnaire. We identified 5 distinct multimorbidity groups: elderly/atrial fibrillation (AF) (N = 1,048; oldest, more AF), metabolic (N = 1,129; obesity, diabetes, hypertension), young (N = 1,759; youngest, low comorbidity rates, non-ischemic etiology), ischemic (N = 1,261; ischemic etiology), and lean diabetic (N = 1,283; diabetic, hypertensive, low prevalence of obesity, high prevalence of chronic kidney disease). Patients in the lean diabetic group had the worst QoL, more severe signs and symptoms of HF, and the highest rate of the primary combined outcome within 1 year (29% versus 11% in the young group) (p for all <0.001). Adjusting for confounders (demographics, New York Heart Association class, and medication) the lean diabetic (hazard ratio [HR] 1.79, 95% CI 1.46-2.22), elderly/AF (HR 1.57, 95% CI 1.26-1.96), ischemic (HR 1.51, 95% CI 1.22-1.88), and metabolic (HR 1.28, 95% CI 1.02-1.60) groups had higher rates of the primary combined outcome compared to the young group. Potential limitations include site selection and participation bias.

    CONCLUSIONS: Among Asian patients with HF, comorbidities naturally clustered in 5 distinct patterns, each differentially impacting patients' QoL and health outcomes. These data underscore the importance of studying multimorbidity in HF and the need for more comprehensive approaches in phenotyping patients with HF and multimorbidity.

    TRIAL REGISTRATION: ClinicalTrials.gov NCT01633398.
    Matched MeSH terms: Heart Failure/complications*; Heart Failure/epidemiology*
  14. Heart failure with preserved ejection fraction in Asia
    Tromp J, Teng TH, Tay WT, Hung CL, Narasimhan C, Shimizu W, et al.
    Eur J Heart Fail, 2019 01;21(1):23-36.
    PMID: 30113120 DOI: 10.1002/ejhf.1227
    BACKGROUND: Heart failure with preserved ejection fraction (HFpEF) is a global public health problem. Unfortunately, little is known about HFpEF across Asia.

    METHODS AND RESULTS: We prospectively studied clinical characteristics, echocardiographic parameters and outcomes in 1204 patients with HFpEF (left ventricular ejection fraction ≥50%) from 11 Asian regions, grouped as Northeast Asia (Hong Kong, Taiwan, China, Japan, Korea, n = 543), South Asia (India, n = 252), and Southeast Asia (Malaysia, Thailand, Singapore, Indonesia, Philippines, n = 409). Mean age was 68 ±12 years (37% were heart failure within 1 year. Southeast Asians were at higher risk for adverse outcomes, independent of co-morbidity burden and cardiac geometry.

    CONCLUSION: These first prospective multinational data from Asia show that HFpEF affects relatively young patients with a high burden of co-morbidities. Regional differences in types of co-morbidities, cardiac remodelling and outcomes of HFpEF across Asia have important implications for public health measures and global HFpEF trial design.
    Matched MeSH terms: Heart Failure/diagnosis; Heart Failure/epidemiology*; Heart Failure/physiopathology
  15. Fulltext Myxomatous mitral valve disease in a Shih Tzu dog
    Teoh, Y.B., Khor, K.H.
    Jurnal Veterinar Malaysia, 2017;29(1):18-22.
    MyJurnal
    An 11-year-old intact male Shih Tzu dog was referred to the University Veterinary Hospital (UVH) with history of coughing and laboured breathing. Auscultation revealed that the dog had a left systolic heart murmur grade V/VI at the base of the heart. Radiography showed findings of cardiomegaly and pulmonary oedema. Echocardiography findings revealed that dog has a myxomatous mitral valve disease. The mitral valve was severely thickened and prolapsed into the left atrium. Congestive heart failure (CHF) was treated with an angiotensin converting enzyme (ACE) inhibitor and diuretic. An anti-mucolytic agent was prescribed as a symptomatic treatmentfor the coughing that could be due to mild bronchitis. Dog did not response well with treatment as the frequency of cough was not reduced and the duration was longer each time. Pimobendan was then added on to the initial treatment and there was a tremendous improvement seen from the patient after that. Episodes of productive cough were noticed greatly reduced and dog was much more active at home post two weeks of ACE inhibitor, diuretic and dual-acting inodilator. We successfully maintained the dog with minimal coughing episodes. However, the prognosis is moderate to poor in this case due to possibilities of refraction towards medications.
    Matched MeSH terms: Heart Failure
  16. ß-blockers in congestive heart failure
    Teh BT, Wan Azman WA, Thuraisingham S, Choy AM, Tan KH, Jesudason P, et al.
    JUMMEC, 1999;4:26-33.
    Activation of the synlpathetic nervous system (SNS) and renin-angiotensin system (RAS) plays a pivotal role in the pathophysiology and progression of the disease in chronic heart failure (CHF). Blocking the activation of the RAS with angiotensin converting enzyme inhibitors not only improves sylnptonls but also prolongs life in symptomatic CHF. Does a similar analogy hold true for the use of ß-blockers in CHF? Evidence from a number of small trials and several recent large prospective trials show that b-blockers may improve ventricular function and symptoms in CHF. In a combination of trials investigating the use of carvedilol (an α, and ß-blocker) in congestive heart failure a mortality benefit appears to be evident. There are still a number of key questions that relnaill unanswered regarding the tolerability, patient type and stage of CHF in which ß-blockers should be advocated. Several large scale trials are in progress to answer some of these questions and also to add further information regarding its efficacy and impact on survival. KEYWORDS: Beta-adrenoreceptor antagonist, congestive heart failure.
    Matched MeSH terms: Heart Failure
  17. Quantifying health-related quality of life in Malaysian type 2 diabetes: focusing on complication types and severity
    Tan MHP, Ong SC, Vasan Thakumar A, Mustafa N
    Qual Life Res, 2023 Jul;32(7):1925-1941.
    PMID: 36781810 DOI: 10.1007/s11136-023-03360-x
    PURPOSE: There is a knowledge gap of health utility values for Type 2 Diabetes Mellitus (T2DM) complications in Malaysia. This study aimed to estimate EQ-5D-5L utility values and evaluate health-related quality of life (HRQoL) for Malaysian T2DM associated with complications and clinical characteristics.

    METHODS: A cross-sectional study was conducted on T2DM patients at a tertiary hospital outpatient using the Malay and English version of the EQ-5D-5L questionnaire. Health utility values were derived using the Malaysian EQ-5D-5L value set. Ordinary least squares (OLS) multivariable regression model was used to estimate the health utility decrements associated with T2DM-related complications and clinical characteristics.

    RESULTS: A total of 513 T2DM patients were recruited. Overall, pain was the most affected of all five EQ-5D-5L dimensions. Patients with foot ulcer, amputation, severe heart failure and frequent hypoglycemia reported more problems collectively in all EQ-5D-5L dimensions. Older age, lower education level, longer duration of T2DM, urine protein creatine index (UPCI) > 0.02 g/mmol, and injection therapy were significantly associated with lower EQ-5D-5L utility values (p heart failure 0.65 (interquartile range, IQR 0.50), frequent hypoglycemia 0.74 (0.22) and being amputated 0.78 (0.47). In the multivariable regression model after controlling for sociodemographic and clinical characteristics, the largest utility value decrement was observed for amputation (- 0.158, SE 0.087, p = 0.05), frequent hypoglycemia (- 0.101, SE 0.030, p = 0.001), myocardial infarction (-0.050, SE 0.022, p = 0.022) and obesity (-0.034, SE 0.016, p = 0.029).

    CONCLUSION: Larger utility value decrements were found for severe stages of complications. These findings suggest the value of defining severity of complications in utility elicitation studies. The utility decrement quantified for different T2DM complication severity will be useful for economic evaluations within diabetic-related fields.

    Matched MeSH terms: Heart Failure*
  18. Fulltext Consensus Recommendations by the Asian Pacific Society of Cardiology: Optimising Cardiovascular Outcomes in Patients with Type 2 Diabetes
    Tan JWC, Sim D, Ako J, Almahmeed W, Cooper ME, Dalal JJ, et al.
    Eur Cardiol, 2021 Feb;16:e14.
    PMID: 33976709 DOI: 10.15420/ecr.2020.52
    The Asian Pacific Society of Cardiology convened a consensus statement panel for optimising cardiovascular (CV) outcomes in type 2 diabetes, and reviewed the current literature. Relevant articles were appraised using the Grading of Recommendations, Assessment, Development and Evaluation system, and consensus statements were developed in two meetings and were confirmed through online voting. The consensus statements indicated that lifestyle interventions must be emphasised for patients with prediabetes, and optimal glucose control should be encouraged when possible. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are recommended for patients with chronic kidney disease with adequate renal function, and for patients with heart failure with reduced ejection fraction. In addition to SGLT2i, glucagon-like peptide-1 receptor agonists are recommended for patients at high risk of CV events. A blood pressure target below 140/90 mmHg is generally recommended for patients with type 2 diabetes. Antiplatelet therapy is recommended for secondary prevention in patients with atherosclerotic CV disease.
    Matched MeSH terms: Heart Failure
  19. Fulltext Spontaneous internal ilio-iliac fistula in an elderly woman presenting as heart failure
    Tan G, Abdullah B, Kunanayagam S
    Biomed Imaging Interv J, 2006 Apr;2(2):e13.
    PMID: 21614225 MyJurnal DOI: 10.2349/biij.2.2.e13
    Acquired intra-abdominal arteriovenous fistulas (AVFs) are a rare disorder where the communication most commonly occurs between abdominal aorta and inferior vena cava. Ilio-iliac AVF has been reported previously, but is exceedingly rare. We present a case of spontaneous ilio-iliac AVF in an elderly woman who presented with symptoms of right heart failure where the diagnosis was not considered. The computed tomographic (CT) and angiographic features are described. The current status of management as well as a review of the literature is also presented.
    Matched MeSH terms: Heart Failure
  20. Fulltext Multimodality imaging of left circumflex artery to coronary sinus fistula
    Sze TL, Abdul Aziz YF, Abu Bakar N, Mohd Sani F, Oemar H
    Iran J Radiol, 2015 Jan;12(1):e6878.
    PMID: 25793089 DOI: 10.5812/iranjradiol.6878
    Coronary artery fistula (CAF) is a rare anomaly of the coronary artery. Patients with this condition are usually asymptomatic. However, cardiac failure may occur later in life due to progressive enlargement of the fistula. Diagnosis is traditionally made by echocardiogram and conventional angiogram. However with the advantage of new technologies such as computed tomography (CT) coronary angiography, the course and communications of these fistulae can be delineated non-invasively and with greater accuracy. We report a case of a left circumflex artery fistula to the coronary sinus which was suspected on echocardiogram and the diagnosis was clinched on ECG-gated CT.
    Matched MeSH terms: Heart Failure
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