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Clinical Outcomes in Patients With Delayed Hospitalization for Non–ST-Segment Elevation Myocardial Infarction
Jung-JoonChaMDa∗SungABaeMDb∗Duk-WooParkMDcJae HyoungParkMDaSoon JunHongMDaSeong-MiParkMDaCheol WoongYuMDaSeung-WoonRhaMDdDo-SunLimMDaSoon YongSuhMDeSeung HwanHanMDeSeong-IllWooMDfNae-HeeLeeMDgDonghoonChoiMDbIn-HoChaeMDhHyo-SooKimMDiYoung JoonHongMDjYoungkeunAhnMDj…Tae HoonAhnMDa
doi : 10.1016/j.jacc.2021.11.019
Volume 79, Issue 4, 1 February 2022, Pages 311-323
Recently, the number of patients presenting with non–ST-segment elevation myocardial infarction (NSTEMI) has reduced, whereas increased mortality was reported. A plausible explanation for increased mortality was prehospital delay because of patients’ reticence of their symptoms.
When Time Is Not Muscle, Yet It Still May Be Important∗
José A.BarrabésMD, PhDabToniSoriano-ColoméMDabIgnacioFerreira-GonzálezMD, PhDac
doi : 10.1016/j.jacc.2021.11.037
Volume 79, Issue 4, 1 February 2022, Pages 324-326
Association of Longitudinal High-Sensitivity Troponin T With Mortality in Patients With Chronic Kidney Disease
Nicholas C.ChesnayePhDaEhabAl-SodanyMDbKarolinaSzummerMD, PhDcdPeterBaranyMD, PhDbOlofHeimbürgerMD, PhDbToraAlmquistMD, PhDeStefanMelanderMD, PhDfghFredrikUhlinMD, PhDfgFriedoDekkerMD, PhDiChristophWannerMD, PhDjKitty J.JagerMD, PhDaMarieEvansMD, PhDb
doi : 10.1016/j.jacc.2021.11.023
Volume 79, Issue 4, 1 February 2022, Pages 327-336
Cardiac troponin T (cTnT) is associated with mortality in chronic kidney disease (CKD). However, the association between longitudinal cTnT measurements and survival has not previously been assessed.
Advanced CKD, Delta Troponins, Mortality: A Step Toward a Customized Approach During a Perilous Transition?∗
Gautam R.ShroffMB, BSaRoy O.MathewMDbFred S.ApplePhDc
doi : 10.1016/j.jacc.2021.11.022
Volume 79, Issue 4, 1 February 2022, Pages 337-340
Criteria for Iron Deficiency in Patients With Heart Failure
GabrieleMasiniMDa∗Fraser J.GrahamMDb∗PierpaoloPellicoriMDbJohn G.F.ClelandMDbJoseph J.CuthbertMDcSyedKazmiMSccRiccardo M.InciardiMDaAndrew L.ClarkMA, MDc
doi : 10.1016/j.jacc.2021.11.039
Volume 79, Issue 4, 1 February 2022, Pages 341-351
Guidelines on heart failure (HF) define iron deficiency (ID) as a serum ferritin <100 ng/mL or, when 100-299 ng/mL, a transferrin saturation (TSAT) <20%. Inflammation (common in HF) may hinder interpretation of serum ferritin.
21st Century CE: The New Iron Age?∗
Maria RosaCostanzoMDaJames L.JanuzziJr.MDb
doi : 10.1016/j.jacc.2021.11.026
Volume 79, Issue 4, 1 February 2022, Pages 352-354
Race- and Gender-Based Differences in Cardiac Structure and Function and Risk of Heart Failure
AlvinChandraMDabHichamSkaliMDaBrianClaggettPhDaScott D.SolomonMDaJoseph S.RossiMDcStuart D.RussellMDdKunihiroMatsushitaMD, PhDeDalane W.KitzmanMDfSuma H.KonetyMBBSgThomas H.MosleyPhDhPatricia P.ChangMD, MHScAmil M.ShahMD, MPHa
doi : 10.1016/j.jacc.2021.11.024
Volume 79, Issue 4, 1 February 2022, Pages 355-368
Although heart failure (HF) risk and cardiac structure/function reportedly differ according to race and gender, limited data exist in late life when risk of HF is highest.
The Path to Better Understanding Heart Failure Epidemiology∗
João D.FontesMD, MPHaDanieleMasseraMD, MScb
doi : 10.1016/j.jacc.2021.11.025
Volume 79, Issue 4, 1 February 2022, Pages 369-371
Diagnosis and Evaluation of Hypertrophic Cardiomyopathy: JACC State-of-the-Art Review
Barry J.MaronMDaMilind Y.DesaiMDbRick A.NishimuraMDcPaoloSpiritoMDdHarryRakowskiMDeJeffrey A.TowbinMDfEthan J.RowinMDaMartin S.MaronMDaMark V.SherridMDg
doi : 10.1016/j.jacc.2021.12.002
Volume 79, Issue 4, 1 February 2022, Pages 372-389
Hypertrophic cardiomyopathy (HCM) is a relatively common often inherited global heart disease, with complex phenotypic and genetic expression and natural history, affecting both genders and many races and cultures. Prevalence is 1:200-1:500, largely based on the disease phenotype with imaging, inferring that 750,000 Americans may be affected by HCM. However, cross-sectional data show that only a fraction are clinically diagnosed, suggesting under-recognition, with most clinicians exposed to small segments of the broad disease spectrum. Highly effective HCM management strategies have emerged, altering clinical course and substantially lowering mortality and morbidity rates. These advances underscore the importance of reliable HCM diagnosis with echocardiography and cardiac magnetic resonance. Family screening with noninvasive imaging will identify relatives with the HCM phenotype, while genetic analysis recognizes preclinical sarcomere gene carriers without left ventricular hypertrophy, but with the potential to transmit disease. Comprehensive initial patient evaluations are important for reliable diagnosis, accurate portrayal of HCM and family history, risk stratification, and distinguishing obstructive versus nonobstructive forms.
Management of Hypertrophic Cardiomyopathy: JACC State-of-the-Art Review
Barry J.MaronMDaMilind Y.DesaiMDbRick A.NishimuraMDcPaoloSpiritoMDdHarryRakowskiMDeJeffrey A.TowbinMDfJoseph A.DearaniMDgEthan J.RowinMDaMartin S.MaronMDaMark V.SherridMDh
doi : 10.1016/j.jacc.2021.11.021
Volume 79, Issue 4, 1 February 2022, Pages 390-414
Hypertrophic cardiomyopathy (HCM), a relatively common, globally distributed, and often inherited primary cardiac disease, has now transformed into a contemporary highly treatable condition with effective options that alter natural history along specific personalized adverse pathways at all ages. HCM patients with disease-related complications benefit from: matured risk stratification in which major markers reliably select patients for prophylactic defibrillators and prevention of arrhythmic sudden death; low risk to high benefit surgical myectomy (with percutaneous alcohol ablation a selective alternative) that reverses progressive heart failure caused by outflow obstruction; anticoagulation prophylaxis that prevents atrial fibrillation-related embolic stroke and ablation techniques that decrease the frequency of paroxysmal episodes; and occasionally, heart transplant for end-stage nonobstructive patients. Those innovations have substantially improved outcomes by significantly reducing morbidity and HCM-related mortality to 0.5%/y. Palliative pharmacological strategies with currently available negative inotropic drugs can control symptoms over the short-term in some patients, but generally do not alter long-term clinical course. Notably, a substantial proportion of HCM patients (largely those identified without outflow obstruction) experience a stable/benign course without major interventions. The expert panel has critically appraised all available data and presented management insights and recommendations with concise principles for clinical decision-making.
Genetic IL-6 Signaling Modifies Incident Coronary Artery Disease Risk in Chronic Kidney Disease
ZhiYuMB, PhDSeyedeh M.ZekavatBSMichael C.HonigbergMD, MPPPradeepNatarajanMD, MMSc
doi : 10.1016/j.jacc.2021.11.020
Volume 79, Issue 4, 1 February 2022, Pages 415-416
Analyzing IMPROVE-IT Beyond LDL Cholesterol
UmidakhonMakhmudovaMDDieterLütjohannPhDP. ChristianSchulzeMDHarry R.DavisPhDOliverWeingärtnerMD
doi : 10.1016/j.jacc.2021.10.047
Volume 79, Issue 4, 1 February 2022, Pages e151-e152
Reply: Analyzing IMPROVE-IT Beyond LDL Cholesterol
KazumaOyamaMD, PhDRobert P.GiuglianoMD, SMMarc S.SabatineMD, MPHChristopher P.CannonMDEugeneBraunwaldMD
doi : 10.1016/j.jacc.2021.11.018
Volume 79, Issue 4, 1 February 2022, Page e153
