Ribbens McCarthy, Jane

Aliber, Robert Z

Cagle, Ronald B

Blumenthal, Noah, 1972-

Lakes, Richard D

Lahire, Nathalie

Filmer, Deon, author

International Labour Conference (93rd : 2005 : Geneva, Switzerland)

Payne, Pedro R., 1964-

Pauly, Thomas H

Mentinis, Mihalis

Scherer, Manual

Austin, James H., 1925-

Pickover, Clifford A

Ring, Laura A., 1968-

Sachikonye, L. M

Khan, Shahnaz

This cohort study compares the characteristics and management of acute heart failure in global regions comprising 44 countries.

Increased attention has focused on shared decision-making (SDM) and use of decision aids for treatment decisions in cardiology. In this issue of JAMA Cardiology, Coylewright et al report the results of a rigorously performed pilot study on the use of a decision aid to facilitate SDM for patients with symptomatic severe aortic stenosis (AS) at high or prohibitive risk for surgery considered for transcatheter aortic valve replacement vs medical therapy. Comparisons were made between encounters before clinicians were trained to use a decision aid and the first and fifth encounters after a decision aid was used. The patient-clinician interactions were audio recorded and later coded by independent reviewers using a validated measure to assess SDM. This mixed-methods study found that SDM significantly improved in a stepwise manner from the initial usual care encounter (before use of a decision aid) to the first and then fifth encounters after implementation of the decision aid. Along with this improvement in SDM, patients (n = 35) demonstrated increased knowledge about their treatment choices and reported increased satisfaction in their care with no increase in decisional conflict. In contrast, clinicians (n = 6) reported that they believed they already engaged in SDM prior to use of the decision aid and, after multiple uses of the decision aid, believed patients did not understand or benefit from this tool. The disconnect between clinician and patient perspectives was sobering and has implications for the adoption of decision aids or other tools to facilitate SDM in the clinical setting. Notable limitations of the study, which are acknowledged by the authors, include (1) small sample size (of clinicians and patients); (2) the decision aid is most useful for the relatively smaller number of patients at high or prohibitive risk for surgery for whom transcatheter aortic valve replacement and medical therapy may both be reasonable options; and (3) the lack of diversity in the clinicians (all male), which reflects the current demographics of interventional cardiology and cardiac surgery.

In this issue of JAMA Cardiology, Lim and colleagues report on cardiovascular functional reserve in people with end-stage renal disease before and after kidney transplant. They performed a 3-arm, prospective, concurrent cohort study to assess change in cardiovascular functional reserve after kidney transplant using state-of-the-art cardiopulmonary exercise testing (CPET). They also assessed left ventricular morphologic findings 1 year after transplant. They enrolled 81 participants with stage 5 chronic kidney disease (CKD) who underwent kidney transplant, 85 wait-listed participants with stage 5 CKD who had not undergone transplant, and 87 controls treated for hypertension only. The authors quantified cardiovascular functional reserve using CPET in parallel with transthoracic echocardiography. One year after transplant, a significant improvement in maximum oxygen consumption was found in the transplant group compared with the nontransplant group. Moreover, left ventricular function improved but not the body mass index.

This cross-sectional study investigates whether hospital inpatient percutaneous coronary intervention volume is associated with rates of 30-day risk-adjusted mortality and hospital readmission after transcatheter aortic valve replacement and transcatheter mitral valve repair.

This randomized clinical trial assesses the effectiveness of an implantable loop recorder plus 24-hour Holter electrocardiographic monitoring vs standard 24-hour Holter electrocardiographic monitoring alone for detecting arrhythmias in pregnant women with structural heart disease and/or symptoms suggestive of arrhythmias.

Hayden Library - PQ7123.W6 E88 2018

Stefanakis, Alexandros, 1982-

Berkes, Fikret

O'Toole, Peter Martin, author

Australia. Parliament. Senate. Environment and Communications References Committee, author

Hogarth, Peter J

Milroy, Scott P., author

Skillen, James R., author

Cornish, Vaughan, 1862-1948

Pickering, K. T. (Kevin T.), author