Cardiology News /Recent Literature Review / First Quarter 2013
Keywords:
cardiology, electrophysiology, cardiac pacing, newsAbstract
HRS Meeting will take place in Denver, 8-11/5/13
EuroPCR to be held in Paris, 21-24/5/13
EuroPace will be held in Athens, 23-26/6/13
ESC Congress will be held in Amsterdam, 31/8-4/9/13
TCT Meeting: San Francisco, 28/10-1/11/13
AHA 2013: Dallas, 16-20/11/13
Pre-RELAX-AHF and RELAX-AHF Trials: Relaxin Reduces 6-month Mortality in Acute Heart Failure Patients
In the Pre-RELAX-AHF (Relaxin in Acute Heart Failure) phase II study and RELAX-AHF phase III study patients hospitalized for acute heart failure were randomized within 16 h to IV placebo or serelaxin. Serelaxin reduced 6-month mortality in both studies (combined studies: N = 1,395; hazard ratio: 0.62; p = 0.0076). In RELAX-AHF, serelaxin improved the markers of cardiac (high-sensitivity cardiac troponin T), renal (creatinine/cystatin-C), and hepatic (AST/ALT) damage and of decongestion (N-T pro–BNP), while changes in these markers at day 2 and worsening heart failure during admission were associated with 6-month mortality. The authors concluded that early administration of serelaxin was associated with a reduction of 6-month mortality, while fewer signs of organ damage and more rapid relief of congestion were noted during the first days after admission (Metra et al, J Am Coll Cardiol 2013;61:196–206)
Favorable 5-Year Outcome after TAVI
The 5-year outcome was evaluated in 88 patients undergoing successful TAVI with a balloon-expandable valve. Mean aortic valve gradient decreased from 46 + 18 mm Hg to 10 + 4.5 mm Hg after TAVI and maintained at 11.8 + 5.7 mm Hg at 5 years (p for post-TAVI trend = 0.06). Mean aortic valve area increased from 0.62 + 0.17 cm2 to 1.67 + 0.41 cm2 after TAVI and 1.40 + 0.25 cm2 at 5 years (p for post-TAVI trend <0.01). At 5 years, 3 patients (3.4%) had moderate prosthetic valve dysfunction. Survival rates at 1 to 5 years were 83%, 74%, 53%, 42%, and 35%, respectively. Median survival time after TAVI was 3.4 years, and the risk of death was significantly increased in patients with chronic obstructive pulmonary disease (hazard ratio [HR]: 2.17) and at least moderate paravalvular regurgitation (adjusted HR: 2.98). Thus, a favorable long-term outcome after TAVI was demonstrated. Signs of moderate prosthetic valve failure were observed in 3.4% of patients. No patients developed severe prosthetic regurgitation or stenosis. Comorbidities, mainly chronic lung disease and at least moderate paravalvular regurgitation, were associated with reduced long-term survival (Toggweiler et al, J Am Coll Cardiol 2013;61:413–419)... (excerpt)
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